Science.gov

Sample records for shoulder joint forces

  1. Can shoulder joint reaction forces be estimated by neural networks?

    PubMed

    de Vries, W H K; Veeger, H E J; Baten, C T M; van der Helm, F C T

    2016-01-01

    To facilitate the development of future shoulder endoprostheses, a long term load profile of the shoulder joint is desired. A musculoskeletal model using 3D kinematics and external forces as input can estimate the mechanical load on the glenohumeral joint, in terms of joint reaction forces. For long term ambulatory measurements, these 3D kinematics can be measured by means of Inertial Magnetic Measurement Systems. Recording of external forces under daily conditions is not feasible; estimations of joint loading should preferably be independent of this input. EMG signals reflect the musculoskeletal response and can easily be measured under daily conditions. This study presents the use of a neural network for the prediction of glenohumeral joint reaction forces based upon arm kinematics and shoulder muscle EMG. Several setups were examined for NN training, with varying combinations of type of input, type of motion, and handled weights. When joint reaction forces are predicted by a trained NN, for motion data independent of the training data, results show a high intraclass correlation (ICC up to 0.98) and relative SEM as low as 3%, compared to similar output of a musculoskeletal model. A convenient setup in which kinematics and only one channel of EMG were used as input for the NN׳s showed comparable predictive power as more complex setups. These results are promising and enable long term estimation of shoulder joint reaction forces outside the motion lab, independent of external forces. PMID:26654109

  2. Glenohumeral joint reaction forces increase with critical shoulder angles representative of osteoarthritis-A biomechanical analysis.

    PubMed

    Viehöfer, Arnd F; Snedeker, Jess G; Baumgartner, Daniel; Gerber, Christian

    2016-06-01

    Osteoarthritis (OA) of the glenohumeral joint constitutes the most frequent indication for nontraumatic shoulder joint replacement. Recently, a small critical shoulder angle (CSA) was found to be associated with a high prevalence of OA. This study aims to verify the hypothesis that a small CSA leads to higher glenohumeral joint reaction forces during activities of daily living than a normal CSA. A shoulder simulator with simulated deltoid (DLT), supraspinatus (SSP), infraspinatus/teres minor (ISP/TM), and subscapularis (SSC) musculotendinous units was constructed. The DLT wrapping on the humerus was simulated using a pulley that could be horizontally adjusted to simulate the 28° CSA found in OA or the 33° CSA found in disease-free shoulders. Over a range of motion between 6° and 82° of thoracohumeral abduction joint forces were measured using a six-axis load cell. An OA-associated CSA yielded higher net joint reaction forces than a normal CSA over the entire range of motion. The maximum difference of 26.4 N (8.5%) was found at 55° of thoracohumeral abduction. Our model thus suggests that a CSA typical for OA predisposes the glenohumeral joint to higher joint reaction forces and could plausibly play a role in joint overloading and development of OA. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1047-1052, 2016. PMID:26638117

  3. Shoulder Joint For Protective Suit

    NASA Technical Reports Server (NTRS)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  4. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint glenoid (hemi-shoulder) metallic... Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis. (a) Identification. A shoulder joint... polyethylene and intended to be implanted to replace part of a shoulder joint. This generic type of device...

  5. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint glenoid (hemi-shoulder) metallic... Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis. (a) Identification. A shoulder joint... polyethylene and intended to be implanted to replace part of a shoulder joint. This generic type of device...

  6. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint glenoid (hemi-shoulder) metallic... Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis. (a) Identification. A shoulder joint... polyethylene and intended to be implanted to replace part of a shoulder joint. This generic type of device...

  7. Shoulder joint kinetics during the push phase of wheelchair propulsion.

    PubMed

    Kulig, K; Rao, S S; Mulroy, S J; Newsam, C J; Gronley, J K; Bontrager, E L; Perry, J

    1998-09-01

    The purpose of this investigation was to quantify the forces and moments at the shoulder joint during free, level wheelchair propulsion and to document changes imposed by increased speed, inclined terrain, and 15 minutes of continuous propulsion. Data were collected using a six-camera VICON motion analysis system, a strain gauge instrumented wheel, and a wheelchair ergometer. Seventeen men with low level paraplegia participated in this study. Shoulder joint forces and moments were calculated using a three-dimensional model applying the inverse dynamics approach. During free propulsion, peak shoulder joint forces were in the posterior (46 N) and superior directions (14 N), producing a peak resultant force of 51 N at an angle of 185 degrees (180 degrees = posterior). Peak shoulder joint moments were greatest in extension (14 Newton-meters [Nm]), followed by abduction (10 Nm), and internal rotation (6 Nm). With fast and inclined propulsion, peak vertical force increased by greater than 360%, and the increase in posterior force and shoulder moments ranged from 107% to 167%. At the end of 15 minutes of continuous free propulsion, there were no significant changes compared with short duration free propulsion. The increased joint loads documented during fast and inclined propulsion could lead to compression of subacromial structures against the overlying acromion.

  8. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint humeral (hemi-shoulder) metallic... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint... the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is...

  9. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint humeral (hemi-shoulder) metallic... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint... the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is...

  10. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint humeral (hemi-shoulder) metallic... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint... the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is...

  11. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint humeral (hemi-shoulder) metallic... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint... the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is...

  12. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint humeral (hemi-shoulder) metallic... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint... the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is...

  13. An investigation of shoulder forces in active shoulder tackles in rugby union football.

    PubMed

    Usman, Juliana; McIntosh, Andrew S; Fréchède, Bertrand

    2011-11-01

    In rugby union football the tackle is the most frequently executed skill and one most associated with injury, including shoulder injury to the tackler. Despite the importance of the tackle, little is known about the magnitude of shoulder forces in the tackle and influencing factors. The objectives of the study were to measure the shoulder force in the tackle, as well as the effects of shoulder padding, skill level, side of body, player size, and experimental setting on shoulder force. Experiments were conducted in laboratory and field settings using a repeated measures design. Thirty-five participants were recruited to the laboratory and 98 to the field setting. All were male aged over 18 years with rugby experience. The maximum force applied to the shoulder in an active shoulder tackle was measured with a custom built forceplate incorporated into a 45 kg tackle bag. The overall average maximum shoulder force was 1660 N in the laboratory and 1997 N in the field. This difference was significant. The shoulder force for tackling without shoulder pads was 1684 N compared to 1635 N with shoulder pads. There was no difference between the shoulder forces on the dominant and non-dominant sides. Shoulder force reduced with tackle repetition. No relationship was observed between player skill level and size. A substantial force can be applied to the shoulder and to an opponent in the tackle. This force is within the shoulder's injury tolerance range and is unaffected by shoulder pads.

  14. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... polyethylene and intended to be implanted to replace part of a shoulder joint. This generic type of device is limited to those prostheses intended for use with bone cement (§ 888.3027). (b) Classification. Class...

  15. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... polyethylene and intended to be implanted to replace part of a shoulder joint. This generic type of device is limited to those prostheses intended for use with bone cement (§ 888.3027). (b) Classification. Class...

  16. The shoulder distraction force in cricket fast bowling.

    PubMed

    Stuelcken, Max C; Ferdinands, René E D; Ginn, Karen A; Sinclair, Peter J

    2010-08-01

    This preliminary study aimed to quantify the magnitude of the peak shoulder distraction force during the bowling action of female cricket fast bowlers. An eight camera Vicon motion analysis system operating at 120 Hz recorded the fast bowling actions of 18 Australian female fast bowlers. A three segment inverse solution model of the bowling arm was used to calculate the shoulder distraction force. A large peak shoulder distraction force was recorded during the early stages of the follow-through of the bowling action. When normalized for body weight, the distraction force was within the range of values reported for baseball and softball pitchers, who are considered to be at high risk of shoulder injury. Therefore, the relative importance of the peak shoulder distraction force in the fast bowling action for the development of shoulder pain in female cricket fast bowlers warrants further investigation. PMID:20841630

  17. The shoulder distraction force in cricket fast bowling.

    PubMed

    Stuelcken, Max C; Ferdinands, René E D; Ginn, Karen A; Sinclair, Peter J

    2010-08-01

    This preliminary study aimed to quantify the magnitude of the peak shoulder distraction force during the bowling action of female cricket fast bowlers. An eight camera Vicon motion analysis system operating at 120 Hz recorded the fast bowling actions of 18 Australian female fast bowlers. A three segment inverse solution model of the bowling arm was used to calculate the shoulder distraction force. A large peak shoulder distraction force was recorded during the early stages of the follow-through of the bowling action. When normalized for body weight, the distraction force was within the range of values reported for baseball and softball pitchers, who are considered to be at high risk of shoulder injury. Therefore, the relative importance of the peak shoulder distraction force in the fast bowling action for the development of shoulder pain in female cricket fast bowlers warrants further investigation.

  18. Echographic and kinetic changes in the shoulder joint after manual wheelchair propulsion under two different workload settings.

    PubMed

    Gil-Agudo, Ángel; Solís-Mozos, Marta; Crespo-Ruiz, Beatriz; Del-Ama Eng, Antonio J; Pérez-Rizo, Enrique; Segura-Fragoso, Antonio; Jiménez-Díaz, Fernando

    2014-01-01

    Manual wheelchair users with spinal cord injury (SCI) have a high prevalence of shoulder pain due to the use of the upper extremity for independent mobility, transfers, and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with SCI while they performed high- and low-intensity wheelchair propulsion tests (constant and incremental). Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high-intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics. PMID:25566539

  19. Echographic and Kinetic Changes in the Shoulder Joint after Manual Wheelchair Propulsion Under Two Different Workload Settings

    PubMed Central

    Gil-Agudo, Ángel; Solís-Mozos, Marta; Crespo-Ruiz, Beatriz; del-Ama Eng, Antonio J.; Pérez-Rizo, Enrique; Segura-Fragoso, Antonio; Jiménez-Díaz, Fernando

    2014-01-01

    Manual wheelchair users with spinal cord injury (SCI) have a high prevalence of shoulder pain due to the use of the upper extremity for independent mobility, transfers, and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with SCI while they performed high- and low-intensity wheelchair propulsion tests (constant and incremental). Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high-intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics. PMID:25566539

  20. A larger critical shoulder angle requires more rotator cuff activity to preserve joint stability.

    PubMed

    Viehöfer, Arnd F; Gerber, Christian; Favre, Philippe; Bachmann, Elias; Snedeker, Jess G

    2016-06-01

    Shoulders with rotator cuff tears (RCT) tears are associated with significantly larger critical shoulder angles (CSA) (RCT CSA = 38.2°) than shoulders without RCT (CSA = 32.9°). We hypothesized that larger CSAs increase the ratio of glenohumeral joint shear to joint compression forces, requiring substantially increased compensatory supraspinatus loads to stabilize the arm in abduction. A previously established three dimensional (3D) finite element (FE) model was used. Two acromion shapes mimicked the mean CSA of 38.2° found in patients with RCT and that of a normal CSA (32.9°). In a first step, the moment arms for each muscle segment were obtained for 21 different thoracohumeral abduction angles to simulate a quasi-static abduction in the scapular plane. In a second step, the muscle forces were calculated by minimizing the range of muscle stresses able to compensate an external joint moment caused by the arm weight. If the joint became unstable, additional force was applied by the rotator cuff muscles to restore joint stability. The model showed a higher joint shear to joint compressive force for the RCT CSA (38.2°) for thoracohumeral abduction angles between 40° and 90° with a peak difference of 23% at 50° of abduction. To achieve stability in this case additional rotator cuff forces exceeding physiological values were required. Our results document that a higher CSA tends to destabilize the glenohumeral joint such that higher than normal supraspinatus forces are required to maintain modeled stability during active abduction. This lends strong support to the concept that a high CSA can induce supraspinatus (SSP) overload. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:961-968, 2016. PMID:26572231

  1. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  2. 21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace...

  3. 21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace...

  4. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  5. 21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace...

  6. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  7. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  8. 21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace...

  9. 21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace...

  10. 21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  11. Kinesio Tape and Shoulder-Joint Position Sense

    PubMed Central

    Aarseth, Lindsay M.; Suprak, David N.; Chalmers, Gordon R.; Lyon, Lonnie; Dahlquist, Dylan T.

    2015-01-01

    Context Joint position sense (JPS) is a key neuromuscular factor for developing and maintaining control of muscles around a joint. It is important when performing specialized tasks, especially at the shoulder. No researchers have studied how Kinesio Tape (KT) application affects JPS. Objective To investigate the effects of KT application and no tape on shoulder JPS at increasing shoulder elevations in athletes. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants A total of 27 healthy athletes who did not participate in overhead sports (age = 20.44 ± 1.05 years, height = 175.02 ± 11.67 cm, mass = 70.74 ± 9.65 kg) with no previous pathologic shoulder conditions volunteered for the study. All participants were from 1 university. Intervention(s) Shoulder JPS was assessed at increasing elevations with and without KT application. Participants attempted to actively replicate 3 target positions with and without the KT and without visual guidance. Main Outcome Measure(s) We examined absolute and variable repositioning errors at increasing shoulder-elevation levels with and without KT application. Results Data revealed an interaction between tape and position for absolute error (F2,52 = 4.07, P = .02); simple effects revealed an increase in error, with KT demonstrating a 2.65° increase in error at 90° of elevation compared with no tape (t26 = 2.65, P = .01). The effect size was medium (ω2 = .135). Variable error showed no interaction of tape and position (F2,52 = .709, P = .50). Further analysis of simple effects was not needed. However, we still calculated the effect size and observed small effect sizes for tape (ω2 = .002), position (ω2 = .072), and tape by position (ω2 = .027). Conclusions At 90° of elevation, shoulder JPS was impaired by the application of KT. PMID:26090707

  12. Shoulder limited joint mobility in people with diabetes mellitus

    PubMed Central

    Shah, Kshamata M.; Clark, B. Ruth; McGill, Janet B.; Lang, Catherine E.; Mueller, Michael J.

    2015-01-01

    Background Limited joint mobility at the shoulder is an understudied problem in people with diabetes mellitus. The purpose of this study was to determine the differences in shoulder kinematics between a group with diabetes and those without diabetes. Methods Fifty-two participants were recruited, 26 with diabetes and 26 non-diabetes controls (matched for age, BMI and sex). Three-dimensional position of the trunk, scapula and humerus were collected using electromagnetic tracking sensors during scapular plane elevation and rotation movements. Findings Glenohumeral external rotation was reduced by 11.1° – 16.3° (P<0.05) throughout the humerothoracic elevation range of motion, from neutral to peak elevation, in individuals with diabetes as compared to controls. Peak humerothoracic elevation was decreased by 10–14°, and peak external rotation with the arm abducted was decreased 22° in the diabetes group compared to controls (P<0.05). Scapulothoracic and glenohumeral internal rotation motions were not different between the two groups. Interpretation Shoulder limited joint mobility, in particular decreased external rotation, was seen in individuals with diabetes as compared to control participants. Future research should investigate causes of diabetic limited joint mobility and strategies to improve shoulder mobility and prevent additional detrimental changes in movement and function. PMID:25595462

  13. The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint

    PubMed Central

    Kim, Eun-Kyung; Kim, Seong-Gil

    2016-01-01

    [Purpose] The purpose of this study was to analyze the effect of an active vibration stimulus exercise according to shoulder joint angles on functional reach and stability of the shoulder joint. [Subjects and Methods] Thirty healthy male students participated in this study. Upper limb length of each subject was measured to obtain normalized measurement values. The exercise groups were as follows: group I (n=10, shoulder joint angle of 90°), group II (n=10, shoulder joint angle of 130°), and group III (n=10, shoulder joint angle of 180°). After warm-up, an active vibration stimulus was applied to the subjects with a Flexi-Bar. The Functional Reach Test and Y-balance test were conducted for measurement of shoulder stability. [Results] Analysis of covariance was conducted with values before the intervention as covariates to analyze the differences among the groups in the two tests. There were significant differences among the groups. According to Bonferroni post hoc comparison, group I showed greater improvement than group III in the Functional Reach Test, and group II showed greater improvement than group I and group III in the Y-balance test. [Conclusion] The effect of the exercise with different shoulder joint angles revealed that the shoulder joint has a certain effective joint angle for its functionality and stability. In addition, application of an active vibration stimulus with a Flexi-Bar can be a very effective tool for improvement of functionality and stability of the shoulder joint. PMID:27134352

  14. The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint.

    PubMed

    Kim, Eun-Kyung; Kim, Seong-Gil

    2016-03-01

    [Purpose] The purpose of this study was to analyze the effect of an active vibration stimulus exercise according to shoulder joint angles on functional reach and stability of the shoulder joint. [Subjects and Methods] Thirty healthy male students participated in this study. Upper limb length of each subject was measured to obtain normalized measurement values. The exercise groups were as follows: group I (n=10, shoulder joint angle of 90°), group II (n=10, shoulder joint angle of 130°), and group III (n=10, shoulder joint angle of 180°). After warm-up, an active vibration stimulus was applied to the subjects with a Flexi-Bar. The Functional Reach Test and Y-balance test were conducted for measurement of shoulder stability. [Results] Analysis of covariance was conducted with values before the intervention as covariates to analyze the differences among the groups in the two tests. There were significant differences among the groups. According to Bonferroni post hoc comparison, group I showed greater improvement than group III in the Functional Reach Test, and group II showed greater improvement than group I and group III in the Y-balance test. [Conclusion] The effect of the exercise with different shoulder joint angles revealed that the shoulder joint has a certain effective joint angle for its functionality and stability. In addition, application of an active vibration stimulus with a Flexi-Bar can be a very effective tool for improvement of functionality and stability of the shoulder joint. PMID:27134352

  15. The shoulder and elbow joints and right and left sides demonstrate similar joint position sense.

    PubMed

    King, Jacqlyn; Harding, Elizabeth; Karduna, Andrew

    2013-01-01

    Proper orientation of the shoulder and elbow is necessary for accurate and precise positioning of the hand. The authors' goal was to compare these joints with an active joint position sense task, while also taking into account the effects of joint flexion angle and arm dominance. Fifteen healthy subjects were asked to replicate presented joint angles with a single degree of freedom active positioning protocol. There were no significant differences in angular joint position sense errors with respect to joint (shoulder vs. elbow) and side (left vs. right). However, when considering linear positioning, errors were lower for the elbow, due to a shorter lever arm. Also, as flexion angles increased toward 90°, there was a consistent pattern of lower errors for both joints.

  16. Generalized joint laxity and multidirectional instability of the shoulder

    PubMed Central

    SACCOMANNO, MARISTELLA F.; FODALE, MARIO; CAPASSO, LUIGI; CAZZATO, GIAMPIERO; MILANO, GIUSEPPE

    2013-01-01

    Generalized joint laxity and shoulder instability are common conditions that exhibit a wide spectrum of different clinical forms and may coexist in the same patient. Generalized joint laxity can be congenital or acquired. It is fundamental to distinguish laxity from instability. Laxity is a physiological condition that may predispose to the development of shoulder instability. A high prevalence of generalized joint laxity has been identified in patients with multidirectional instability of the shoulder. Multidirectional instability is defined as symptomatic instability in two or more directions. The diagnosis and treatment of this condition are still challenging because of complexities in its classification and etiology. These complexities are compounded when multidirectional instability and laxity exist in the same patient. With an improved understanding of the clinical symptoms and physical examination findings, a successful strategy for conservative and/or surgical treatments can be developed. Conservative treatment is the first-line option. If it fails, different surgical options are available. Historically, open capsular shift has been considered the gold standard in the surgical management of these patients. Nowadays, advanced arthroscopic techniques offer several advantages over traditional open approaches and have shown similar outcomes. The correct approach to the management of failed stabilization procedures has not been yet defined. PMID:25606530

  17. A new shoulder model with a biologically inspired glenohumeral joint.

    PubMed

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

    2016-09-01

    Kinematically unconstrained biomechanical models of the glenohumeral (GH) joint are needed to study the GH joint function, especially the mechanisms of joint stability. The purpose of this study is to develop a large-scale multibody model of the upper limb that simulates the 6 degrees of freedom (DOF) of the GH joint and to propose a novel inverse dynamics procedure that allows the evaluation of not only the muscle and joint reaction forces of the upper limb but also the GH joint translations. The biomechanical model developed is composed of 7 rigid bodies, constrained by 6 anatomical joints, and acted upon by 21 muscles. The GH joint is described as a spherical joint with clearance. Assuming that the GH joint translates according to the muscle load distribution, the redundant muscle load sharing problem is formulated considering as design variables the 3 translational coordinates associated with the GH joint translations, the joint reaction forces associated with the remaining kinematic constraints, and the muscle activations. For the abduction motion in the frontal plane analysed, the muscle and joint reaction forces estimated by the new biomechanical model proposed are similar to those estimated by a model in which the GH joint is modeled as an ideal spherical joint. Even though this result supports the assumption of an ideal GH joint to study the muscle load sharing problem, only a 6 DOF model of the GH joint, as the one proposed here, provides information regarding the joint translations. In this study, the biomechanical model developed predicts an initial upward and posterior migration of the humeral head, followed by an inferior and anterior movement, which is in good agreement with the literature. PMID:27381499

  18. 3D visual presentation of shoulder joint motion.

    PubMed

    Totterman, S; Tamez-Pena, J; Kwok, E; Strang, J; Smith, J; Rubens, D; Parker, K

    1998-01-01

    The 3D visual presentation of biodynamic events of human joints is a challenging task. Although the 3D reconstruction of high contrast structures from CT data has been widely explored, then there is much less experience in reconstructing the small low contrast soft tissue structures from inhomogeneous and sometimes noisy MR data. Further, there are no algorithms for tracking the motion of moving anatomic structures through MR data. We represent a comprehensive approach to 3D musculoskeletal imagery that addresses these challenges. Specific imaging protocols, segmentation algorithms and rendering techniques are developed and applied to render complex 3D musculoskeletal systems for their 4D visual presentation. Applications of our approach include analysis of rotational motion of the shoulder, the knee flexion, and other complex musculoskeletal motions, and the development of interactive virtual human joints.

  19. The effect of simulated school load carriage configurations on shoulder strap tension forces and shoulder interface pressure.

    PubMed

    Mackie, Hamish W; Stevenson, Joan M; Reid, Susan A; Legg, Stephen J

    2005-03-01

    Recently, several studies have addressed the physical demands of school student's load carriage, in particular the load weight carried, using physical demands indicators such as oxygen consumption, gait, and posture. The objective of this study was to determine the effects of different load carriage configurations on shoulder strap tension forces and shoulder interface pressure during simulated school student's load carriage. A load carriage simulator was used to compare shoulder strap forces and shoulder pressure for 32 combinations of gait speed, backpack weight, load distribution, shoulder strap length and use of a hip-belt. The results showed that the manipulation of backpack weight, hip-belt use and shoulder strap length had a strong effect on shoulder strap tension and shoulder pressure. Backpack weight had the greatest influence on shoulder strap tension and shoulder pressure, whereas hip-belt use and then shoulder strap adjustment had the next greatest effects, respectively. While it is clear that researchers and practitioners are justified in focusing on load magnitude in backpack studies as it has the greatest effect on shoulder forces, hip-belt use and shoulder strap adjustment should also be examined further as they too may have significant effects on the demands placed on backpack users. Based on the present findings, school students should wear their backpacks with the least weight possible, use the hip-belt if present, allow a reasonable amount of looseness in the shoulder straps and should position the heaviest items closest to their back. However, more detailed work using human participants needs to be undertaken before these recommendations can be confirmed. PMID:15694074

  20. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 2: Glenohumeral Joint

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; STAKER, JUSTIN L.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare differences in glenohumeral joint angular motion and linear translations between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Numerous clinical theories have linked abnormal glenohumeral kinematics, including decreased glenohumeral external rotation and increased superior translation, to individuals with shoulder pain and impingement diagnoses. However, relatively few studies have investigated glenohumeral joint angular motion and linear translations in this population. METHODS Transcortical bone pins were inserted into the scapula and humerus of 12 a symptomatic and 10 symptomatic participants for direct bone-fixed tracking using electromagnetic sensors. Glenohumeral joint angular positions and linear translations were calculated during active shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups in angular positions were limited to glenohumeral elevation, coinciding with a reduction in scapulothoracic upward rotation. Symptomatic participants demonstrated 1.4 mm more anterior glenohumeral translation between 90° and 120° of shoulder flexion and an average of 1 mm more inferior glenohumeral translation throughout shoulder abduction. CONCLUSION Differences in glenohumeral kinematics exist between symptomatic and a symptomatic individuals. The clinical implications of these differences are not yet understood, and more research is needed to understand the relationship between abnormal kinematics, shoulder pain, and pathoanatomy. PMID:25103132

  1. Shoulder and hip joint for hard space suits

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    Shoulder and hip joints for hard space suits are disclosed which are comprised of three serially connected truncated spherical sections, the ends of which converge. Ball bearings between the sections permit relative rotation. The proximal end of the first section is connected to the torso covering by a ball bearing and the distal end of the outermost section is connected to the elbow or thigh covering by a ball bearing. The sections are equi-angular and this alleviates lockup, the condition where the distal end of the joint leaves the plane in which the user is attempting to flex. The axes of rotation of the bearings and the bearing mid planes are arranged to intersect in a particular manner that provides the joint with a minimum envelope. In one embodiment, the races of the bearing between the innermost section and the second section is partially within the inner race of the bearing between the torso and the innermost spherical section further to reduce bulk.

  2. Role of Subscapularis Repair on Muscle Force Requirements with Reverse Shoulder Arthroplasty.

    PubMed

    Hansen, Matthew L; Nayak, Aniruddh; Narayanan, Madusudanan Sathia; Worhacz, Kellen; Stowell, Richard; Jacofsky, Marc C; Roche, Christopher P

    2015-12-01

    Concomitant repair of the subscapularis with reverse shoulder arthroplasty (rTSA) is controversial. To evaluate the biomechanical impact of subscapularis repair with rTSA, a cadaveric shoulder controller quantified the muscle forces required to elevate the arm during scapular abduction with the elbow flexed at 90°. The results of this study demonstrate that concomitant subscapularis repair with rTSA creates a biomechanically unfavorable condition during arm elevation. Specifically, repair of the subscapularis significantly increased the force required by the deltoid and posterior rotator cuff and also significantly increased the joint reaction force relative to when the subscapularis was not repaired. These results also demonstrated that both the 42 mm Grammont and 42 mm Equinoxe® rTSA prostheses significantly decreased the mean force required by the posterior rotator cuff and also significantly decreased the mean joint reaction force over the range of motion relative to the native joint with a rotator cuff tear (supraspinatus). As the posterior rotator cuff is often compromised in patients undergoing rTSA, patients may not be able to sustain these elevated forces in the infraspinatus and teres minor required to counteract the adduction and internal rotation moments generated by the subscapularis during activities of daily living. Similarly, the elevated posterior deltoid force and joint reaction loads could be deleterious to the long-term life of the prosthesis and can also increase the risk of loosening and fractures. For all these reasons, rTSA functional outcomes may be compromised if the subscapularis is repaired. PMID:26631191

  3. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented prosthesis. (a) Identification. A shoulder joint...

  4. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  5. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  6. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  7. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  8. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented prosthesis. (a) Identification. A shoulder joint...

  9. 21 CFR 888.3640 - Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/metal or metal/polymer... § 888.3640 Shoulder joint metal/metal or metal/polymer constrained cemented prosthesis. (a) Identification. A shoulder joint metal/metal or metal/polymer constrained cemented prosthesis is a...

  10. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented prosthesis. (a) Identification. A shoulder joint...

  11. Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

    PubMed

    Gharbaoui, Idris S; Gogola, Gloria R; Aaron, Dorit H; Kozin, Scott H

    2015-01-01

    Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed. PMID:25835253

  12. ULTRASOUND MEASUREMENTS AND OBJECTIVE FORCES OF GLENOHUMERAL TRANSLATIONS DURING SHOULDER ACCESSORY PASSIVE MOTION TESTING IN HEALTHY INDIVIDUALS

    PubMed Central

    Worst, Haley; Decarreau, Ryan; Davies, George

    2016-01-01

    Background Clinical examination of caspuloligamentous structures of the glenohumeral joint has historically been subjective in nature, as demonstrated by limited intra-rater and inter-rater reproducibility. Musculoskeletal diagnostic ultrasound was utilized to develop a clinically objective measurement technique for glenohumeral inferior and posterolateral translation. Purpose The purpose of this study was to measure the accessory passive force required to achieve end range glenohumeral posterolateral and inferior accessory translation, as well as, to quantify the amount of translation of the glenohumeral joint caused by the applied force. Study Design Cross-sectional descriptive correlational study Methods Twenty-five asymptomatic subjects between the ages of 18 and 30 were recruited via convenience sampling. Posterolateral and inferior shoulder accessory passive translation was assessed and measured using a GE LOGIQe ultrasound, while concurrently using a hand held dynamometer to quantify the passive force applied during assessment. Normative values for force and translation were described as means and standard deviations. Results Mean values for posterolateral translation were 6.5 +/− 4.0 mm on the right shoulder and 6.3 +/− 3.5 mm on the left with an associated mean force of 127.1 +/− 55.6 N and 114.4 +/− 50.7 N, respectively. Mean values for inferior translation were 4.8 +/− 1.7 mm on the right shoulder and 5.4 +/− 1.8 mm on the left with an associated mean force of 84.5 +/− 30.5 N and 76.1 +/− 30.1 N, respectively. There was a significant association between inferior translation and inferior force (r = .51). No significant association was found between posterolateral translation and posterolateral force. Significant differences were found between dominant and non-dominant shoulders for posterolateral translation, posterolateral force to produce translation, and inferior translation values

  13. Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces.

    PubMed

    Engelhardt, Christoph; Malfroy Camine, Valérie; Ingram, David; Müllhaupt, Philippe; Farron, Alain; Pioletti, Dominique; Terrier, Alexandre

    2015-01-01

    The estimation of muscle forces in musculoskeletal shoulder models is still controversial. Two different methods are widely used to solve the indeterminacy of the system: electromyography (EMG)-based methods and stress-based methods. The goal of this work was to evaluate the influence of these two methods on the prediction of muscle forces, glenohumeral load and joint stability after total shoulder arthroplasty. An EMG-based and a stress-based method were implemented into the same musculoskeletal shoulder model. The model replicated the glenohumeral joint after total shoulder arthroplasty. It contained the scapula, the humerus, the joint prosthesis, the rotator cuff muscles supraspinatus, subscapularis and infraspinatus and the middle, anterior and posterior deltoid muscles. A movement of abduction was simulated in the plane of the scapula. The EMG-based method replicated muscular activity of experimentally measured EMG. The stress-based method minimised a cost function based on muscle stresses. We compared muscle forces, joint reaction force, articular contact pressure and translation of the humeral head. The stress-based method predicted a lower force of the rotator cuff muscles. This was partly counter-balanced by a higher force of the middle part of the deltoid muscle. As a consequence, the stress-based method predicted a lower joint load (16% reduced) and a higher superior-inferior translation of the humeral head (increased by 1.2 mm). The EMG-based method has the advantage of replicating the observed cocontraction of stabilising muscles of the rotator cuff. This method is, however, limited to available EMG measurements. The stress-based method has thus an advantage of flexibility, but may overestimate glenohumeral subluxation.

  14. Infected shoulder joint with loose Suture Anchor in the joint after Bankart’s Repair- A Case Report

    PubMed Central

    Kumar, Mukesh; Thilak, Jai

    2016-01-01

    Introduction: The glenoid labrum is frequently torn in traumatic glenohumeral dislocation; arthroscopic repair is the standard method of treatment. The complications associated with this repair are pulling out of metal suture anchors, chondrolysis and joint infection. The infection of joint after arthroscopy is less than 1%. Staphylococcus is most common organism and rarely followed by Pseudomonas aeruginosa. We report a case of infected shoulder with chondrolysis of the joint and pulled out metal suture anchor lying inside the joint after Bankart’s repair. Case Report: A 22-year-old gentleman came to us with complaints of shoulder joint pain & gross restriction of movements for one year, with history of intermittent fever and treatment in nearby hospital. He also gives past history of recurrent dislocation of shoulder with last episode 18 months back, which was diagnosed as Bankart’s lesion and arthroscopic Bankart’s repair was done 15 months back. He was evaluated at our institute and suspected to have infection of shoulder joint with pulled out metal suture anchor inside the joint. Arthroscopic removal of suture anchor and debridement of shoulder joint was done, Culture was obtained and culture specific antibiotics were given for six weeks, and significant improvement was observed with this line of treatment. At lyear follow up, the patient was able to perform his daily activities with terminal restriction of range of motion. Conclusions: Shoulder joint infection is rare after Bankart’s repair and required a high degree of suspicion. Any foreign materials inside the joint should be taken out & followed with aggressive treatment by debridement, irrigation and culture specific antibiotics. Suppression of joint infection with antibiotics should be avoided specially when there is foreign body inside the joint.

  15. Prevalence of shoulder pain in Swedish flatwater kayakers and its relation to range of motion and scapula stability of the shoulder joint.

    PubMed

    Johansson, Anette; Svantesson, Ulla; Tannerstedt, Jörgen; Alricsson, Marie

    2016-01-01

    Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n = 17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs. 60.0 (P = 0.017) and the left shoulder 51.9 vs. 66.0 (P = 0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n = 15 of 17 kayakers) to a significantly higher degree (P = 0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers.

  16. Patients' experiences of telerehabilitation at home after shoulder joint replacement.

    PubMed

    Eriksson, Lisbeth; Lindström, Britta; Ekenberg, Lilly

    2011-01-01

    We investigated the experience of ten patients who received video-based physiotherapy at home for two months after a shoulder joint replacement. Videoconferencing took place via the patient's home broadband connection at a bandwidth of 256-768 kbit/s. Qualitative interviews were carried out, transcribed and analysed. Through qualitative content analysis six categories were identified: (1) a different reinforced communication; (2) pain-free exercising as an effective routine; (3) from a dependent patient to a strengthened person at home; (4) closeness at a distance; (5) facilitated daily living; and (6) continuous physiotherapy chain. The access to bodily knowledge, continuity, collaboration and being at home were all aspects that contributed to the patients' recovery. The patients described experiences of safety, and strengthening during their daily exercise routine at home. The frequent interplay with the patient during telerehabilitation made it possible for the physiotherapist to make an individual judgement about each patient; this could be one reason for the positive findings. Home video-based physiotherapy may be useful in other kinds of physiotherapy. PMID:21075802

  17. Shoulder arthroscopy

    MedlinePlus

    SLAP repair; SLAP lesion; Acromioplasty; Bankart repair; Bankart lesion; Shoulder repair; Shoulder surgery; Rotator cuff repair ... the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on ...

  18. Epilepsia partialis continua present with shoulder joint-trunk-hip joint rhythmic clonic seizure: a case report

    PubMed Central

    Lv, Yudan; Wang, Zan; Chu, Fengna; Liu, Chang; Meng, Hongmei

    2016-01-01

    Epilepsia partialis continua (EPC) is a particular type of epilepsy which is distinguished from “common epilepsy” by its characteristic semiological features. However, unusual manifestations should be described in order to give awareness at clinical diagnosis. In this case report we describe a rare EPC case not previously reported, in which left shoulder joint-trunk-hip joint jerk was present for 1 week. Abnormal electroencephalogram and cerebrospinal fluid results supported a diagnosis of viral encephalitis. Antiepileptic treatment seemed effective. Our report emphasizes that a detailed functional anatomical analysis and synchronized electroencephalogram discharge should be done to avoid misdiagnosis in patients with synchronic shoulder-trunk-hip jerk symptoms.

  19. Epilepsia partialis continua present with shoulder joint-trunk-hip joint rhythmic clonic seizure: a case report

    PubMed Central

    Lv, Yudan; Wang, Zan; Chu, Fengna; Liu, Chang; Meng, Hongmei

    2016-01-01

    Epilepsia partialis continua (EPC) is a particular type of epilepsy which is distinguished from “common epilepsy” by its characteristic semiological features. However, unusual manifestations should be described in order to give awareness at clinical diagnosis. In this case report we describe a rare EPC case not previously reported, in which left shoulder joint-trunk-hip joint jerk was present for 1 week. Abnormal electroencephalogram and cerebrospinal fluid results supported a diagnosis of viral encephalitis. Antiepileptic treatment seemed effective. Our report emphasizes that a detailed functional anatomical analysis and synchronized electroencephalogram discharge should be done to avoid misdiagnosis in patients with synchronic shoulder-trunk-hip jerk symptoms. PMID:27698564

  20. Influence of Combinations of Shoulder, Elbow and Trunk Orientation on Elbow Joint Loads in Youth Baseball Pitchers

    PubMed Central

    Tanaka, Hiroshi; Hayashi, Toyohiko; Inui, Hiroaki; Ninomiya, Hiroki; Muto, Tomoyuki; Nobuhara, Katsuya

    2016-01-01

    Objectives: Shoulder and elbow pain in youth baseball pitchers is a well-recognized phenomenon. Common problems in pitching mechanics that can lead to injury begin with stride foot contact. The purpose of this study was to address the relationships between the combinations of shoulder, elbow and trunk orientation at the instant of stride foot contact and elbow joint loads in youth baseball pitchers. Methods: A total of 143 Japanese male youth baseball pitchers participated in this study after providing written informed consents approved by the hospital’s institutional review board. The procedures to be performed were also explained to their parent(s) or legal guardian(s). Each participant was not currently injured or recovering from an injury at time of testing. For data collection of baseball pitching, a set of 14-mm spherical reflective markers was placed on the skin overlying 34 anatomical landmarks determined. Subsequently, a motion capture three-dimensional automatic digitizing system was used to collect 500-Hz from 7 charge-coupled-device synchronized cameras was set up around the regulation pitching mound in an indoor laboratory. After performing a preparation routine of stretching and warm-up pitching, each player pitch to 5 fastball pitches off the pitching mound to a catcher at the regulation distance of 16 m for youth pitchers. The best pitch thrown for a strike was chosen for kinematic and kinetic analysis. The local coordinate systems were used to calculate 3-dimesional rotation at the trunk, shoulder and elbow using the typical Eulerian sequence. Afterward, the standard inverse dynamic equation was used to estimate resultant joint forces and torques at throwing shoulder and elbow. In order to normalize data between subjects, forces and torques were expressed as percent using body weight and height. A multiple regression analysis was carried out to assess the combined effects of shoulder (external rotation, abduction and horizontal adduction), elbow

  1. Joint Kinetics to Assess the Influence of the Racket on a Tennis Player’s Shoulder

    PubMed Central

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

    2013-01-01

    This study aimed at investigating the influence of three rackets on shoulder net joint moments, power and muscle activity during the flat tennis serve under field- conditions. A 6-camera Eagle® motion analysis system, operating at 256 Hz, captured racket and dominant upper limb kinematics of the serve in five tennis players under three racket conditions (A: low mass, high balance and polar moment, B: low three moments of inertia, and C: high mass, swingweight and twistweight). The electromyographic activity of six trunk and arm muscles was simultaneously recorded. Shoulder net joint moments and power were computed by 3D inverse dynamics. The results showed that greater shoulder joint power and internal/external rotation peak moments were found to accelerate and decelerate racket A in comparison with the racket C. Moreover, serving with the racket A resulted in less activity in latissimus dorsi muscle during the acceleration phase, and biceps brachii muscle during the follow-through phase when compared with racket C. These initial findings encourage studying the biomechanical measurements to quantify the loads on the body during play in order to reduce them, and then prevent shoulder injuries. Racket specifications may be a critical point for coaches who train players suffering from shoulder pain and chronic upper limb injuries should be considered in relation to the racket specifications of the players. Key Points Light racket required more joint power than heavy one to achieve similar post impact ball velocity. Serving with a light racket resulted in higher shoulder internal and external rotation moments than using a heavy one for similar performance. Chronic shoulder pain should encourage coaches to check for potentially inappropriate racket specifications of their players. PMID:24149804

  2. Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer.

    PubMed

    Kim, Sung Shin; Her, Jin Gan; Ko, Tae Sung

    2015-07-01

    [Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair. PMID:26310994

  3. Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer.

    PubMed

    Kim, Sung Shin; Her, Jin Gan; Ko, Tae Sung

    2015-07-01

    [Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair.

  4. Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer

    PubMed Central

    Kim, Sung Shin; Her, Jin Gan; Ko, Tae Sung

    2015-01-01

    [Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair. PMID:26310994

  5. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... articulating ultra-high molecular weight bearing surface fixed in a metal shell made of alloys such as Co-Cr-Mo... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or...

  6. 21 CFR 888.3670 - Shoulder joint metal/polymer/metal nonconstrained or semi-constrained porous-coated uncemented...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... articulating ultra-high molecular weight bearing surface fixed in a metal shell made of alloys such as Co-Cr-Mo... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shoulder joint metal/polymer/metal nonconstrained... ORTHOPEDIC DEVICES Prosthetic Devices § 888.3670 Shoulder joint metal/polymer/metal nonconstrained or...

  7. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap.

    PubMed

    Rout, Debesh Kumar; Nayak, Bibhuti Bhusan; Choudhury, Arun Kumar; Pati, Ajit Kumar

    2014-05-01

    We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique.

  8. Evaluation and management of adult shoulder pain: a focus on rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral arthritis.

    PubMed

    Armstrong, April

    2014-07-01

    Shoulder pain is a common reason for a patient to see their primary care physician. This article focuses on the evaluation and management of 3 common shoulder disorders; rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral joint arthritis. The typical history and physical examination findings for each of these entities are highlighted, in addition to treatment options.

  9. Processing of surface EMG through pattern recognition techniques aimed at classifying shoulder joint movements.

    PubMed

    Rivela, Diletta; Scannella, Alessia; Pavan, Esteban E; Frigo, Carlo A; Belluco, Paolo; Gini, Giuseppina

    2015-01-01

    Artificial arms for shoulder disarticulation need a high number of degrees of freedom to be controlled. In order to control a prosthetic shoulder joint, an intention detection system based on surface electromyography (sEMG) pattern recognition methods was proposed and experimentally investigated. Signals from eight trunk muscles that are generally preserved after shoulder disarticulation were recorded from a group of eight normal subjects in nine shoulder positions. After data segmentation, four different features were extracted (sample entropy, cepstral coefficients of the 4th order, root mean square and waveform length) and classified by means of linear discriminant analysis. The classification accuracy was 92.1% and this performance reached 97.9% after reducing the positions considered to five classes. To reduce the computational cost, the two channels with the least discriminating information were neglected yielding to a classification accuracy diminished by just 4.08%. PMID:26736704

  10. Assessment of Correlation Between MRI and Arthroscopic Pathologic Findings in the Shoulder Joint

    PubMed Central

    Momenzadeh, Omid R; Gerami, Mohamad H; Sefidbakht, Sepideh; Dehghani, Sakineh

    2015-01-01

    Background: The objective of this study was to determine the diagnostic value of magnetic resonance imaging for shoulder joint pathologies and then compare the results with arthroscopy, the standard for joint diagnosis. Methods: In this cross-sectional study, 80 patients with shoulder joint disorders, who underwent final arthroscopy, were studied. Based on patients’ medical history and physical examinations, shoulder MRI was requested if paraclinical investigations were. If non-surgical therapies failed, arthroscopy of the affected shoulder was done and the same structures were inspected. Subsequently, sensitivity, specificity, and positive and negative predictive values (PPV) and (NPV) of MRI were determined by arthroscopy comparisons. Results: The highest sensitivity, specificity, PPV and NPV were found in MRI pathology reports that included: Hill-Sach lesion (0.910), infraspinatus tendon (0.985), supraspinatus tendon (0.930), and biceps tendon (0.954), respectively. Rotator interval (0.250), biceps labrum complex (0.805), subscapularis tendon (0.538) and anterior labrum lesions (0.604) had the lowest sensitivity, specificity, PPV and NPV, respectively. Conclusion: The results showed that MRI can be a useful tool in ruling out possible abnormalities in the shoulder and to give clues to the most probable diagnosis. Although knowing some practical skills in order to successfully perform the procedure and experience of the radiologist with suitable feedback by surgeon is necessary. PMID:26550595

  11. New concepts in restoring shoulder elevation in a stiff and painful shoulder patient.

    PubMed

    Donatelli, Robert; Ruivo, R M; Thurner, Michael; Ibrahim, Mahmoud Ibrahim

    2014-02-01

    The treatment and evaluation of a stiff and painful shoulder, characteristic of adhesive capsulitis and "frozen" shoulders, is a dilemma for orthopedic rehabilitation specialists. A stiff and painful shoulder is all-inclusive of Adhesive capsulitis and Frozen Shoulder diagnoses. Adhesive capsulitis and frozen shoulder will be referred to as a stiff and painful shoulder, throughout this paper. Shoulder motion occurs in multiple planes of movement. Loss of shoulder mobility can result in significant functional impairment. The traditional treatment approach to restore shoulder mobility emphasizes mobilization of the shoulder overhead. Forced elevation in a stiff and painful shoulder can be painful and potentially destructive to the glenohumeral joint. This manuscript will introduce a new biomechanical approach to evaluate and treat patients with stiff and painful shoulders.

  12. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 1: Sternoclavicular, Acromioclavicular, and Scapulothoracic Joints

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. METHODS Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. CONCLUSION The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions. PMID:25103135

  13. Evaluation of Three Methods for Determining EMG-Muscle Force Parameter Estimates for the Shoulder Muscles

    PubMed Central

    Gatti, Christopher J.; Doro, Lisa Case; Langenderfer, Joseph E.; Mell, Amy G.; Maratt, Joseph D.; Carpenter, James E.; Hughes, Richard E.

    2008-01-01

    Background Accurate prediction of in vivo muscle forces is essential for relevant analyses of musculoskeletal biomechanics. The purpose of this study was to evaluate three methods for predicting muscle forces of the shoulder by comparing calculated muscle parameters, which relate electromyographic activity to muscle forces. Methods Thirteen subjects performed sub-maximal, isometric contractions consisting of six actions about the shoulder and two actions about the elbow. Electromyography from 12 shoulder muscles and internal shoulder moments were used to determine muscle parameters using traditional multiple linear regression, principal-components regression, and a sequential muscle parameter determination process using principal-components regression. Muscle parameters were evaluated based on their sign (positive or negative), standard deviations, and error between the measured and predicted internal shoulder moments. Findings It was found that no method was superior with respect to all evaluation criteria. The sequential principal-components regression method most frequently produced muscle parameters that could be used to estimate muscle forces, multiple regression best predicted the measured internal shoulder moments, and the results of principal-components regression fell between those of sequential principal-components regression and multiple regression. Interpretation The selection of a muscle parameter estimation method should be based on the importance of the evaluation criteria. Sequential principal-components regression should be used if a greater number of physiologically accurate muscle forces are desired, while multiple regression should be used for a more accurate prediction of measured internal shoulder moments. However, all methods produced muscle parameters which can be used to predict in vivo muscle forces of the shoulder. PMID:17945401

  14. Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects.

    PubMed

    Lin, Yin-Liang; Karduna, Andrew

    2016-10-01

    Proprioception is essential for shoulder neuromuscular control and shoulder stability. Exercise of the rotator cuff and scapulothoracic muscles is an important part of shoulder rehabilitation. The purpose of this study was to investigate the effect of rotator cuff and scapulothoracic muscle exercises on shoulder joint position sense. Thirty-six healthy subjects were recruited and randomly assigned into either a control or training group. The subjects in the training group received closed-chain and open-chain exercises focusing on rotator cuff and scapulothoracic muscles for four weeks. Shoulder joint position sense errors in elevation, including the humerothoracic, glenohumeral and scapulothoracic joints, was measured. After four weeks of exercise training, strength increased overall in the training group, which demonstrated the effect of exercise on the muscular system. However, the changes in shoulder joint position sense errors in any individual joint of the subjects in the training group were not different from those of the control subjects. Therefore, exercises specifically targeting individual muscles with low intensity may not be sufficient to improve shoulder joint position sense in healthy subjects. Future work is needed to further investigate which types of exercise are more effective in improving joint position sense, and the mechanisms associated with those changes. PMID:27475714

  15. Double Dislocation of Interphalangeal Joints Accompanied with Contralateral Shoulder Dislocation: A Case Report.

    PubMed

    Raval, Pradyumna Ramchandra; Jariwala, Arpit

    2016-02-01

    Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. In certain cases two joints may get dislocated simultaneously. Such dislocation is known as a double dislocation. Double dislocation of the proximal interphalangeal joint and the distal interphalangeal joint in the same finger is a rare injury. High impact loading at the fingertip is the primary cause in most cases and it is often associated with younger individuals playing contact sports. The right little finger is the digit commonly involved and this injury is evident in football players more often than not. Although closed reduction is a preferred treatment, it may not be always successful. Time of presentation, tendon interposition, associated swelling and co-existent phalangeal fractures are certain key impediments to a successful closed reduction manoeuvre. In patients with an open injury, a thorough wash out and appropriate antibiotic cover is mandatory. We report a rare case of double dislocation of the interphalangeal joints accompanied with contralateral shoulder dislocation in an elderly man sustained after a fall which was treated successfully with closed reduction and early mobilization. PMID:27028386

  16. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach.

    PubMed

    Ninković, Srdan; Stanković, Milan; Savić, Dragan; Matijević, Radmila; Milankov, Miroslav

    2008-01-01

    Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyse the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the the shoulder were operated on, 19 men and 2 women. The average age of those patients was 24.8 (15-40 year-olds). Ten patients had an injury of the left and 11 patients the injury of the right shoulder. There were eight handball players, four fighting skills players; two of them played volleyball and one was a basketball player. Six of them were not sportsmen. The preoperational and post operational mean value of the modified Rowe scale showed a statistically significant difference (P < 0.001). Observing the patients after the operation in the period of 2 years, according to Neer scale, 3 patients (14.28%) had great results (grade over 90), 16 patients (76.19%) had a good result, (75-89), and only two patients (9.52%) had results less than 75. The measuring of the volume of movements after physical treatment in 12 patients (57.14%) has shown the decrease of the outside rotation. Open surgery treatment of the front unstable shoulder joint is reliable and time tested and it gives good clinical results in young sportsmen with undirected unstable, bigger number of dislocations and associated osseous defects.

  17. Effects of upper trunk rotation on shoulder joint torque among baseball pitchers of various levels.

    PubMed

    Aguinaldo, Arnel L; Buttermore, Janet; Chambers, Henry

    2007-02-01

    High rotational torques during baseball pitching are believed to be linked to most overuse injuries at the shoulder. This study investigated the effects of trunk rotation on shoulder rotational torques during pitching. A total of 38 pitchers from the professional, college, high school, and youth ranks were recruited for motion analysis. Professional pitchers demonstrated the least amount of rotational torque (p = .001) among skeletally mature players, while exhibiting the ability to rotate their trunks significantly later in the pitching cycle, as compared to other groups (p = .01). It was concluded that the timing of their rotation was optimized as to allow the throwing shoulder to move with decreased joint loading by conserving the momentum generated by the trunk. These results suggest that a specific pattern in throwing can be utilized to increase the efficiency of the pitch, which would allow a player to improve performance with decreased risk of overuse injury.

  18. Shoulder Arthroscopy

    MedlinePlus

    ... synovial fluid that lubricates the shoulder joint. Rotator cuff. Four tendons surround the shoulder capsule and help ... This thick tendon material is called the rotator cuff. The cuff covers the head of the humerus ...

  19. Scapular dyskinesis is detrimental to shoulder tendon properties and joint mechanics in a rat model.

    PubMed

    Reuther, Katherine E; Thomas, Stephen J; Tucker, Jennica J; Yannascoli, Sarah M; Caro, Adam C; Vafa, Rameen P; Liu, Stephen S; Gordon, Joshua A; Bhatt, Pankti R; Kuntz, Andrew F; Soslowsky, Louis J

    2014-11-01

    Shoulder tendon injuries are frequently seen in the presence of abnormal scapular motion, termed scapular dyskinesis. The cause and effect relationship between scapular dyskinesis and shoulder injury has not been directly defined. We developed and used an animal model to examine the initiation and progression of pathological changes in the rotator cuff and biceps tendon. Sixty male Sprague-Dawley rats were randomized into two groups: nerve transection (to induce scapular dyskinesis, SD) or sham nerve transection (control). The animals were euthanized 4 and 8 weeks after surgery. Shoulder function and passive joint mechanics were evaluated over time. Tendon mechanical, histological, organizational, and compositional properties were evaluated at both time points. Gross observation demonstrated alterations in scapular motion, consistent with scapular "winging." Shoulder function, passive internal range of motion, and tendon mechanical properties were significantly altered. Histology results, consistent with tendon pathology (rounded cell shape and increased cell density), were observed, and protein expression of collagen III and decorin was altered. This study presents a new model of scapular dyskinesis that can rigorously evaluate cause and effect relationships in a controlled manner. Our results identify scapular dyskinesis as a causative mechanical mechanism for shoulder tendon pathology. PMID:25070580

  20. Scapular Dyskinesis is Detrimental to Shoulder Tendon Properties and Joint Mechanics in a Rat Model

    PubMed Central

    Reuther, Katherine E.; Thomas, Stephen J.; Tucker, Jennica J.; Yannascoli, Sarah M.; Caro, Adam C.; Vafa, Rameen P.; Liu, Stephen S.; Gordon, Joshua A.; Bhatt, Pankti R.; Kuntz, Andrew F.; Soslowsky, Louis J.

    2015-01-01

    Shoulder tendon injuries are frequently seen in the presence of abnormal scapular motion, termed scapular dyskinesis. The cause and effect relationship between scapular dyskinesis and shoulder injury has not been directly defined. The objective of this study was to develop and use an animal model to examine the initiation and progression of pathological changes in the rotator cuff and biceps tendon. 60 male Sprague-Dawley rats were randomized into two groups: nerve transection (to induce scapular dyskinesis, SD) or sham nerve transection (control). The animals were sacrificed 4 and 8 weeks after surgery. Shoulder function and passive joint mechanics were evaluated over time. Tendon mechanical, histological, organizational, and compositional properties were evaluated at 4 and 8 weeks. Gross observation demonstrated alterations in scapular motion, consistent with scapular “winging”. Shoulder function, passive internal range of motion, and tendon mechanical properties were significantly altered. Histology results, consistent with tendon pathology (rounded cell shape and increased cell density), were observed and protein expression of collagen III and decorin was altered. This study presents a new model of scapular dyskinesis that can rigorously evaluate cause and effect relationships in a controlled manner. These results identify scapular dyskinesis as a causative mechanical mechanism for shoulder tendon pathology. PMID:25070580

  1. [The Throwing Shoulder].

    PubMed

    Wieser, Karl; Gerber, Christian; Meyer, Dominik C

    2016-02-01

    Repetitive top-performance of overhead athletes induces a tremendous stress for the throwing shoulder. Throwers reach rotational speed of their arm of more than 7000°/s with joint compression and distraction forces of more than 1000 N. This performance is tributary to adaption of the shoulder muscles and the joint itself. These adaptions may, however lead to two specific problems of the throwing shoulder: 1. The posterosuperior internal impingement of the rotator cuff and labrum between glenoid and humeral head during late cooking phase; 2. A decreased internal rotation of the glenohumeral joint (GIRD) with compensatory problems of the scapula-stabilizing muscles. Precise analysis of kinematics and pathomechanics aims to improve understanding and treatment of those specific problems of the throwing shoulder. PMID:26837325

  2. A Biomechanical Model of the Scapulothoracic Joint to Accurately Capture Scapular Kinematics during Shoulder Movements

    PubMed Central

    Seth, Ajay; Matias, Ricardo; Veloso, António P.; Delp, Scott L.

    2016-01-01

    The complexity of shoulder mechanics combined with the movement of skin relative to the scapula makes it difficult to measure shoulder kinematics with sufficient accuracy to distinguish between symptomatic and asymptomatic individuals. Multibody skeletal models can improve motion capture accuracy by reducing the space of possible joint movements, and models are used widely to improve measurement of lower limb kinematics. In this study, we developed a rigid-body model of a scapulothoracic joint to describe the kinematics of the scapula relative to the thorax. This model describes scapular kinematics with four degrees of freedom: 1) elevation and 2) abduction of the scapula on an ellipsoidal thoracic surface, 3) upward rotation of the scapula normal to the thoracic surface, and 4) internal rotation of the scapula to lift the medial border of the scapula off the surface of the thorax. The surface dimensions and joint axes can be customized to match an individual’s anthropometry. We compared the model to “gold standard” bone-pin kinematics collected during three shoulder tasks and found modeled scapular kinematics to be accurate to within 2mm root-mean-squared error for individual bone-pin markers across all markers and movement tasks. As an additional test, we added random and systematic noise to the bone-pin marker data and found that the model reduced kinematic variability due to noise by 65% compared to Euler angles computed without the model. Our scapulothoracic joint model can be used for inverse and forward dynamics analyses and to compute joint reaction loads. The computational performance of the scapulothoracic joint model is well suited for real-time applications; it is freely available for use with OpenSim 3.2, and is customizable and usable with other OpenSim models. PMID:26734761

  3. Knee joint forces: prediction, measurement, and significance

    PubMed Central

    D’Lima, Darryl D.; Fregly, Benjamin J.; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W.

    2011-01-01

    Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

  4. Influence of anthropometry on meat-packing plant workers: an approach to the shoulder joint.

    PubMed

    Reis, Pedro Ferreira; Peres, Luis Sérgio; Tirloni, Adriana Seára; dos Reis, Diogo Cunha; Estrázulas, Jansen Atier; Rossato, Mateus; Moro, Antônio Renato Pereira

    2012-01-01

    This study was conducted with 90 poultry slaughterhouse workers, which perform the function of removing chicken parts from the conveyor belt, and sample was composed of 66 women (33.5 ± 6.5 years) and 24 men (35.7 ± 7.2 years), aiming to analyze the influence of anthropometry in the shoulder joint of these workers. Body discomfort was evaluated by a human body diagram, being applied at the end of the work shift. The anthropometric measurement of shoulder was performed by measuring the height of the acromion process, being compared with the height of the conveyor belt. Analysis of the results was performed by descriptive statistics, mean, standard deviation, percentage and percentiles 5%, 50% and 95%. It was found that the height of the conveyor belt was 1.74 meters, while the average shoulder height of workers was 1.38 meters for percentile 5%, 1.41 meters for percentile 50% and 1.65 meters for percentile 95%. The discomfort regions were shoulder 45%, neck 29%, column 26%, arms 23%, and wrists and hand 20%. The upper limb assessment was performed with percentile 5% through the Rapid Upper Limb Assessment method, resulting in a final score > 7, indicating the need for adjustments of the work organization. It was concluded that the workplace does not meet the workers' anthropometric characteristics, mainly affecting the shoulder joint, and correction ergonomics becomes necessary so that the workers involved in this study can perform their functions with health, comfort and safety. PMID:22317430

  5. A 200-m All-out Front-crawl Swim Modifies Competitive Swimmers' Shoulder Joint Position Sense.

    PubMed

    Uematsu, A; Kurita, Y; Inoue, K; Okuno, K; Hortobágyi, T; Suzuki, S

    2015-11-01

    We tested the hypothesis that an all-out-effort 200-m front-crawl swim trial affects competitive swimmers' shoulder joint position sense. On Day 1, we measured shoulder joint position sense before and after the swim trial, and on Day 2 before and after 2 min of seated rest. On both days, shoulder joint position sense was measured in the seated position using electromagnetic movement sensors in a position-matching paradigm. An investigator abducted participants' left (reference) shoulder joint in the frontal plane to test angles of 90°, 135°, and 180°. Participants then actively abducted the right (indicator) shoulder joint to match the position of the left, reference arm. After the 200-m all-out front-crawl swim trial, the indicator relative to the reference angle differed by 4.4° toward adduction at the 180° (vertical) testing position (P<0.05). Variation in absolute matching error was 3.2° or 2.2 times greater after swim compared with the no-swim control trial. An all-out 200-m front-crawl swim trial can selectively increase competitive swimmers' shoulder joint position sense error and increase variation in matching error in horizontal arm position.

  6. Shoulder joint movement of the non-throwing arm during baseball pitch--comparison between skilled and unskilled pitchers.

    PubMed

    Murata, A

    2001-12-01

    The shoulder of a non-throwing arm during a baseball pitch must be in a constant position while the shoulder of the throwing arm moves in a nearly circular path around it. However, it has not been investigated whether a skilled pitch requires less shoulder-joint movement. It was hypothesized that pitchers with less shoulder movement of the non-throwing arm can be considered to have higher skill and to attain higher initial ball velocity. Nine baseball pitchers were used as subjects. The coach classified them into a skilled and an unskilled group. The pitching motions were recorded using two high-speed cameras. The time series of three-dimensional landmark coordinates of the shoulder joint of the non-throwing arm during the baseball pitch were calculated using the direct linear transformation method. The shoulder-joint movement (SJM) index, which expresses the movement (displacement) of the shoulder joint of the non-throwing arm quantitatively, was proposed to compare the SJM at different skill levels and investigate the relationship between SJM and initial ball velocity. The SJM of the skilled pitchers was smaller than that of the unskilled pitchers, and the smaller value of the SJM led to faster initial ball velocity. The data suggest that the less SJM of the non-throwing arm is required to attain a skilled pitch and higher initial ball velocity.

  7. Computational reverse shoulder prosthesis model: Experimental data and verification.

    PubMed

    Martins, A; Quental, C; Folgado, J; Ambrósio, J; Monteiro, J; Sarmento, M

    2015-09-18

    The reverse shoulder prosthesis aims to restore the stability and function of pathological shoulders, but the biomechanical aspects of the geometrical changes induced by the implant are yet to be fully understood. Considering a large-scale musculoskeletal model of the upper limb, the aim of this study is to evaluate how the Delta reverse shoulder prosthesis influences the biomechanical behavior of the shoulder joint. In this study, the kinematic data of an unloaded abduction in the frontal plane and an unloaded forward flexion in the sagittal plane were experimentally acquired through video-imaging for a control group, composed of 10 healthy shoulders, and a reverse shoulder group, composed of 3 reverse shoulders. Synchronously, the EMG data of 7 superficial muscles were also collected. The muscle force sharing problem was solved through the minimization of the metabolic energy consumption. The evaluation of the shoulder kinematics shows an increase in the lateral rotation of the scapula in the reverse shoulder group, and an increase in the contribution of the scapulothoracic joint to the shoulder joint. Regarding the muscle force sharing problem, the musculoskeletal model estimates an increased activity of the deltoid, teres minor, clavicular fibers of the pectoralis major, and coracobrachialis muscles in the reverse shoulder group. The comparison between the muscle forces predicted and the EMG data acquired revealed a good correlation, which provides further confidence in the model. Overall, the shoulder joint reaction force was lower in the reverse shoulder group than in the control group. PMID:26206550

  8. Towards the development of a novel experimental shoulder simulator with rotating scapula and individually controlled muscle forces simulating the rotator cuff.

    PubMed

    Baumgartner, Daniel; Tomas, Daniel; Gossweiler, Lukas; Siegl, Walter; Osterhoff, Georg; Heinlein, Bernd

    2014-03-01

    A preclinical analysis of novel implants used in shoulder surgery requires biomechanical testing conditions close to physiology. Existing shoulder experiments may only partially apply multiple cycles to simulate postoperative, repetitive loading tasks. The aim of the present study was therefore the development of an experimental shoulder simulator with rotating scapula able to perform multiple humeral movement cycles by simulating individual muscles attached to the rotator cuff. A free-hanging, metallic humerus pivoted in a polyethylene glenoid is activated by tension forces of linear electroactuators to simulate muscles of the deltoideus (DELT), supraspinatus (SSP), infraspinatus/teres minor and subscapularis. The abductors DELT and SSP apply forces with a ratio of 3:1 up to an abduction angle of 85°. The rotating scapular part driven by a rotative electro actuator provides one-third to the overall arm abduction. Resulting joint forces and moments are measured by a 6-axis load cell. A linear increase in the DELT and SSP motors is shown up to a maximum of 150 and 50 N for the DELT and SSP, respectively. The force vector in the glenoid resulted in 253 N at the maximum abduction. The present investigation shows the contribution of individual muscle forces attached to the moving humerus to perform active abduction in order to reproducibly test shoulder implants.

  9. Evaluation of traction stirrup distraction technique to increase the joint space of the shoulder joint in the dog: A cadaveric study.

    PubMed

    Devesa, V; Rovesti, G L; Urrutia, P G; Sanroman, F; Rodriguez-Quiros, J

    2015-06-01

    The objective of this study was to evaluate technical feasibility and efficacy of a joint distraction technique by traction stirrup to facilitate shoulder arthroscopy and assess potential soft tissue damage. Twenty shoulders were evaluated radiographically before distraction. Distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and the joint space was recorded at each step by radiographic images. The effects of joint flexion and intra-articular air injection at maximum load were evaluated. Radiographic evaluation was performed after distraction to evaluate ensuing joint laxity. Joint distraction by traction stirrup technique produces a significant increase in the joint space; an increase in joint laxity could not be inferred by standard and stress radiographs. However, further clinical studies are required to evaluate potential neurovascular complications. A wider joint space may be useful to facilitate arthroscopy, reducing the likelihood for iatrogenic damage to intra-articular structures.

  10. Glenohumeral joint motion after subscapularis tendon repair: an analysis of cadaver shoulder models

    PubMed Central

    2014-01-01

    Background As for the surgical treatment of the rotator cuff tears, the subscapularis tendon tears have recently received much attention for the mini-open or arthroscopic repair. The results of surgical repair for the subscapularis tendon tear are satisfactory, but the range of external rotation is reported to be restricted after the repair. The purpose of this study was to evaluate the range of glenohumeral joint motion after repairs of various sizes of subscapularis tendon tears. Methods Using eight fresh frozen human cadaveric shoulders (mean age at death, 81.5 years), three sizes of subscapularis tendon tear (small, medium, and large) were made and then repaired. With the scapula fixed to the wooden jig, the end-range of glenohumeral motion was measured with passive movement applied through 1.0-Nm torque in the directions of scapular elevation, flexion, abduction, extension, horizontal abduction, and horizontal adduction. The passive end-ranges of external and internal rotation in various positions with rotational torque of 1.0 Nm were also measured. Differences in the ranges among the three type tears were analyzed. Results As tear size increased, range of glenohumeral motion in horizontal abduction after repair decreased gradually and was significantly decreased with the large size tear (P < 0.01). The end-range of external rotation decreased progressively with increasing tear size in every glenohumeral position. The prominent decrease in external rotation (around 40° reduction from intact shoulders) was observed in shoulders after repair of large size tear at 30° to 60° of scapular elevation and abduction. Conclusions As the size of the subscapularis tendon tear increased, the passive ranges of horizontal abduction and external rotation of the glenohumeral joint after repair decreased significantly. In shoulders with a subscapularis tendon tear, it is necessary to consider the reduction of external rotation depending on tear size. PMID:24885276

  11. Segmentation and measurement of collagen fibers for shoulder and joint therapy studies

    SciTech Connect

    Mascio, L.

    1994-11-15

    Various shoulder instabilities are debilitating, especially in individuals who perform overhead activities. Thermal modification of soft tissues in joints may allow precise alteration of these tissues` mechanical and/or structural properties to enhance joint function without inducing cell death or an inflammatory response. Several studies have evaluated laser energy for tissue welding. The collective findings are promising, and the next step is to identify the mechanisms responsible for laser-induced capsular tissue alternation, and the short- and long-term effects of non-ablative laser energy on joint capsular tissue. One step toward this goal is to compare the effect of three laser energy densities on the histologic properties of the tissue evaluating the architecture of the collagen (including density, fibril diameter distribution, and interfibrillar space) in sheep at various time intervals after surgery. The specific computer algorithms that are being used to make these measurements will be described.

  12. Joint Task Force on Undergraduate Physics Programs

    NASA Astrophysics Data System (ADS)

    This session will focus on the guidelines and recommendations being developed by the APS/AAPT Joint Task Force on Undergraduate Physics Programs. J-TUPP is studying how undergraduate physics programs might better prepare physics majors for diverse careers. The guidelines and recommendations will focus on curricular content, flexible tracks, pedagogical methods, research experiences and internships, the development of professional skills, and enhanced advising and mentoring for all physics majors.

  13. The effect of shoulder core exercises on isometric torque of glenohumeral joint movements in healthy young females

    PubMed Central

    Moghadam, Afsun Nodehi; Mohammadi, Roghayeh; Arab, Amir Massoud; Kazamnajad, Anoshirvan

    2011-01-01

    BACKGROUND: Strength improvement of the shoulder muscles is a major goal in rehabilitation or athletic conditioning programs. The purpose of this study was to determine the effect of shoulder core exercises on the isometric torque of glenohumeral joint movements. METHODS: A total of 36 healthy females with no history of shoulder injury enrolled in this study. Subjects were randomly assigned into the control group (n = 18, 22 ± 2.19 years of age) or experimental group (n = 18, 21 ± 2.05 years of age). Subjects in experimental group performed shoulder core exercises, using progressive resistance training, three times a week for six weeks. Subjects in control group performed no exercise. The isometric torque of shoulder movements were measured with Dynatorq device in isolated test positions of glenohumeral muscles at the beginning and after six weeks in both groups. RESULTS: shoulder core exercise training led to an increase in maximal isometric torques of shoulder scaption at 0° and 90° arm elevation, external and internal rotation, horizontal adduction and extension movements (p < 0.001 in all instances). No significant difference was found between initial scores and scores after six weeks in the control group (p > 0.05). CONCLUSIONS: These findings indicated that shoulder core exercise training leads to an increase in peak torque for all glenohumeral movements that can be considered in glenohumeral muscles strengthening programs. PMID:22973363

  14. 3 CFR - Disestablishment of United States Joint Forces Command

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Disestablishment of United States Joint Forces... of United States Joint Forces Command Memorandum for the Secretary of Defense Pursuant to my... States Joint Forces Command, effective on a date to be determined by the Secretary of Defense. I...

  15. Using your shoulder after replacement surgery

    MedlinePlus

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  16. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... slower if you have: Arthritis in your shoulder joint Damaged cartilage (cushioning tissue) between your collarbone and ...

  17. Shoulder and hip joints for hard space suits and the like

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.

    1986-01-01

    For use in hard space suits and the like, a joint between the torso covering and the upper arm covering (i.e., shoulder) or between the torso covering and upper leg covering (i.e., hip) is disclosed. Each joint has an outer covering and a inner covering. The outer covering has plural perferably truncated toroidal sections decreasing in size proceeding outwardly. In one embodiment at each joint there are two bearings, the first larger than the second. The outer race of the larger bearing is attached to the outer edge of the smaller end of each section and the inner race of the larger bearing is attached to the end wall. The inner race of the smaller bearing is attached to the end wall. The outer race of the smaller bearing is attached to the larger end of the next section. Each bearing hask appropriate seals. Between each section is a rubber ring for the comfort of the wearer. Such rubber rings have radial flanges attached to the inner races of two adjacent bearings. Matching semicircular grooves are formed in the abutting overlapping surfaces. Bellows-like inner walls are also provided for each section fixed at one end to an inner cylindrical flange and, at the opposite end, to an end wall. Each outer section may rotate 360 deg relative to the next outer section, whereas the bellows sections do not rotate, but rather expand or contract locally as the rigid sections rotate relative to each other.

  18. The friction coefficient of shoulder joints remains remarkably low over 24 h of loading.

    PubMed

    Jones, Brian K; Durney, Krista M; Hung, Clark T; Ateshian, Gerard A

    2015-11-01

    The frictional response of whole human joints over durations spanning activities of daily living has not been reported previously. This study measured the friction of human glenohumeral joints during 24 h of reciprocal loading in a pendulum testing device, at moderate (0.2 mm/s, 4320 cycles) and low (0.02 mm/s, 432 cycles) sliding speeds, under a 200 N load. The effect of joint congruence was also investigated by testing human humeral heads against significantly larger mature bovine glenoids. Eight human joints and six bovine joints were tested in four combinations: human joints tested at moderate (hHCMS, n=6) and low speed (hHCLS, n=3), human humeral heads tested against bovine glenoids at moderate speed (LCMS, n=3), and bovine joints tested at moderate speed (bHCMS, n=3). In the first half hour the mean±standard deviation of the friction coefficient was hHCMS: 0.0016±0.0011, hHCLS: 0.0012±0.0002, LCMS: 0.0008±0.0002 and bHCMS: 0.0024±0.0008; in the last four hours it was hHCMS: 0.0057±0.0025, hHCLS: 0.0047±0.0017, LCMS: 0.0012±0.0003 and bHCMS: 0.0056±0.0016. The initial value was lower than the final value (p<0.0001). The value in LCMS was significantly lower than in hHCMS and bHCMS (p<0.01). No visual damage was observed in any of the specimens. These are the first results to demonstrate that the friction coefficient of natural human shoulders remains remarkably low (averaging as little as 0.0015 and no greater than 0.006) for up to 24 h of continuous loading. The sustained low friction coefficients observed in incongruent joints (~0.001) likely represent rolling rather than sliding friction.

  19. Finger joint force minimization in pianists using optimization techniques.

    PubMed

    Harding, D C; Brandt, K D; Hillberry, B M

    1993-12-01

    A numerical optimization procedure was used to determine finger positions that minimize and maximize finger tendon and joint force objective functions during piano play. A biomechanical finger model for sagittal plane motion, based on finger anatomy, was used to investigate finger tendon tensions and joint reaction forces for finger positions used in playing the piano. For commonly used piano key strike positions, flexor and intrinsic muscle tendon tensions ranged from 0.7 to 3.2 times the fingertip key strike force, while resultant inter-joint compressive forces ranged from 2 to 7 times the magnitude of the fingertip force. In general, use of a curved finger position, with a large metacarpophalangeal joint flexion angle and a small proximal interphalangeal joint flexion angle, reduces flexor tendon tension and resultant finger joint force.

  20. Shoulder replacement

    MedlinePlus

    ... problem. Many people are able to return to sports such as golf, swimming, gardening, bowling, and others. Your new shoulder joint will last longer if less stress is placed on it. With normal use, a ...

  1. Effect of extracorporeal shock wave therapy on the shoulder joint functional status of patients with calcific tendinitis

    PubMed Central

    Kim, Eun-Kyung; Kwak, Kwang-Il

    2016-01-01

    [Purpose] This study aimed to analyze the effect of extracorporeal shock wave therapy on the shoulder function of patients with calcific tendinitis through a 12-week follow-up. [Subjects and Methods] A total of 34 patients with calcific tendinitis participated in this study. In the extracorporeal shock wave therapy group, 18 patients received 6-week extracorporeal shock wave therapy and 12-week follow-up. The Constant-Murley scale was used to evaluate shoulder joint function. [Results] Analysis of variance showed a significant difference between the measurement periods. The independent t-test showed significant differences between the groups at 2, 6, and 12 weeks. [Conclusion] Extracorporeal shock wave therapy can be an effective treatment method for calcific tendinitis that affects patients’ shoulder function. PMID:27799684

  2. [Biomechanics of the shoulder].

    PubMed

    Gohlke, F

    2000-10-01

    The shoulder joint takes a special position among all the other joints of the human body because of its special requirements of stability and mobility. Knowledge of the biomechanics of the shoulder joint forms the basis for the development of modern concepts of reconstructive surgery and arthroplasty. Most of the biomechanical findings are the result of research performed on cadaver shoulders using increasingly sophisticated methods of measurement. These studies elucidate the interaction of the static and dynamic factors which contribute to the delicate balance of the glenohumeral joint. Recently performed research is increasingly being focussed on more detailed analyses of muscle forces and stress distribution in the subchondral bone and periarticular soft tissues. The efficiency of the computer systems now available has enabled the development of complex, virtual shoulder models and three-dimensional finite element analyses. In the future a pure mechanical understanding has to be modified to extend to a concept which includes more data obtained from living subjects, especially with regard to muscle activity under varying loads and neuromuscular feedback systems which currently are difficult to assess.

  3. The validation of a human force model to predict dynamic forces resulting from multi-joint motions

    NASA Technical Reports Server (NTRS)

    Pandya, Abhilash K.; Maida, James C.; Aldridge, Ann M.; Hasson, Scott M.; Woolford, Barbara J.

    1992-01-01

    The development and validation is examined of a dynamic strength model for humans. This model is based on empirical data. The shoulder, elbow, and wrist joints were characterized in terms of maximum isolated torque, or position and velocity, in all rotational planes. This data was reduced by a least squares regression technique into a table of single variable second degree polynomial equations determining torque as a function of position and velocity. The isolated joint torque equations were then used to compute forces resulting from a composite motion, in this case, a ratchet wrench push and pull operation. A comparison of the predicted results of the model with the actual measured values for the composite motion indicates that forces derived from a composite motion of joints (ratcheting) can be predicted from isolated joint measures. Calculated T values comparing model versus measured values for 14 subjects were well within the statistically acceptable limits and regression analysis revealed coefficient of variation between actual and measured to be within 0.72 and 0.80.

  4. Changes of the mineralization pattern in the subchondral bone plate of the glenoid cavity in the shoulder joints of the throwing athletes.

    PubMed

    Mochizuki, Yu; Natsu, Koji; Kashiwagi, Kenji; Yasunaga, Yuji; Ochi, Mitsuo

    2005-01-01

    The distribution of mineralization in the subchondral bone plate (DMSB) is used as a parameter for individual stress distribution of shoulder joints. We have analyzed 28 shoulder joints of throwing athletes by DMSB of the glenoid with computed tomography osteoabsorptiometry and described their mineralization patterns. The throwing motion imposes a heavy rotational load on the shoulder joint, and this, in turn, may lead to excessive translation of the humeral head on the glenoid. This could explain why the two most frequent density maxima were localized to the anterior and posterior portions of the glenoid. Our finding of a frequent bicentric density distribution of the shoulder joints of throwing athletes should be useful in any future analysis of the relationship between the DMSB and the bone morphology of the glenoid.

  5. Absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer.

    PubMed

    Hirano, Masahiro; Katoh, Munenori

    2015-07-01

    [Purpose] The aim of this study was to verify the absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD). [Subjects and Methods] The subjects were 33 healthy college students. The measurements were made three times with the HHD fixed using a belt (BFHHD) or with the examiner's hand (conventional method; HFHHD). The absolute reliability of measurements was verified using Bland-Altman analysis, both in the all subjects group and a group of subjects showing measurements less than a fixed limit of 30 kgf. [Results] In the <30 kgf group, a systematic bias was not observed, and BFHHD values were greater than HFHHD values. BFHHD values in the all subjects group showed a systematic bias; the 3rd measurement value was less than the maximum value obtained during the 1st and 2nd measurements. [Conclusion] For obtaining an acceptable value during clinical measurements of horizontal adductor muscle strength, single measurements obtained using an HFHHD in the case of a <30 kgf group and the maximum value of two measurements obtained using a BFHHD are reliable. PMID:26311938

  6. The Treatment of Fibrosis of Joint Synovium and Frozen Shoulder by Smad4 Gene Silencing in Rats

    PubMed Central

    Xue, MingFeng; Gong, SuiLiang; Dai, JiaPing; Chen, Gang; Hu, JunYu

    2016-01-01

    Soft tissue fibrosis at the joint induced by inflammation is the pathological basis of frozen shoulder. In the present study, we utilized a lentiviral approach to silence the Smad4 gene in an in vitro fibrosis model of fibroblasts and an in vivo frozen shoulder model. We observed the change in the fibrosis process and the biological indicators of frozen shoulder. The in vitro fibrosis models (Rat myoblasts L6, Rat synovial cell RSC-364 and Rat chondrocytes RCs) were established using TGF-β1 induction, and the effect of Smad4 gene silencing on fibrosis was analyzed. The method of Kanno A was employed to establish a rat model of frozen shoulder, and Smad4 in the relevant part was knocked down with the lentiviral approach. We then examined the abduction and rotation angles and the length of synovial intima and measured the inflammatory factors in effusion and the fibrotic markers of tissues. We found that Smad4 knockdown suppressed the proliferation and expression of fibrotic markers in L6, RSC-364 and RCs cells induced by TGF-β1. MMP activity measurements showed that Smad4 knockdown significantly reversed the decrease in MMP activity in these three cell lines that were induced by TGF-β1. Furthermore, using lentivirus in the rat frozen shoulder model, we found that Smad4 silencing attenuated the inflammatory response and fibrosis. It significantly inhibited the increase of the Vimentin, α-SMA, collagen I and III, Lama1 and Timp1 proteins in synovial tissue as well as the inflammatory factors of TNF-a, IL-1α/β, IL-6 and IL-10 in effusion. MMP acidity assays revealed that Smad4 silencing inhibited MMP activity in the synovial, cartilage and ligament tissues in the model animals. The assessment of the phosphorylated Smad2/3 in the nuclei isolated from the synovial tissues showed that Smad4 silencing significantly inhibited the phosphorylation and subsequent nuclear translocation of Smad2/3 proteins. Moreover, Smad4-shRNA lentivirus inhibited the decrease in both

  7. Limits of the manipulative-fixed method for measurement of shoulder joint horizontal adduction muscle strength using a handheld dynamometer.

    PubMed

    Hirano, Masahiro; Katoh, Munenori

    2015-01-01

    [Purpose] The aim of this study was to verify the limit of isometric muscle strength of shoulder joint horizontal adduction using handheld dynamometer (HHD) manipulated by hand (referred to as the manipulative-fixed method). [Subjects and Methods] The subjects were 33 healthy college students. The examiner was a healthy college student. Shoulder joint horizontal adductor muscle strength was measured using HHD with the subject in the supine position. The belt-fixed and manipulative-fixed methods were used to secure the HHD sensor unit. The limitations of the manipulative-fixed method were assessed by simple regression analysis, in which the participants were divided into 2 groups according to a branch point. The slope of the straight line of the graph was visualized. [Results] Single regression analysis of the <30 kgf group revealed significant results. The results of single regression of the >30 kgf group were not significant. [Conclusion] The manipulative-fixed method is simple to perform. However, there exists the possibility that the actual muscle strength is not measurable by this method. The measurement limit of the shoulder horizontal adduction strength with the manipulative-fixed method was 30 kgf in the case of the examiner in the present study. The fixed limit was also found to influence in the muscle strength of the upper limbs. PMID:25642081

  8. Limits of the manipulative-fixed method for measurement of shoulder joint horizontal adduction muscle strength using a handheld dynamometer.

    PubMed

    Hirano, Masahiro; Katoh, Munenori

    2015-01-01

    [Purpose] The aim of this study was to verify the limit of isometric muscle strength of shoulder joint horizontal adduction using handheld dynamometer (HHD) manipulated by hand (referred to as the manipulative-fixed method). [Subjects and Methods] The subjects were 33 healthy college students. The examiner was a healthy college student. Shoulder joint horizontal adductor muscle strength was measured using HHD with the subject in the supine position. The belt-fixed and manipulative-fixed methods were used to secure the HHD sensor unit. The limitations of the manipulative-fixed method were assessed by simple regression analysis, in which the participants were divided into 2 groups according to a branch point. The slope of the straight line of the graph was visualized. [Results] Single regression analysis of the <30 kgf group revealed significant results. The results of single regression of the >30 kgf group were not significant. [Conclusion] The manipulative-fixed method is simple to perform. However, there exists the possibility that the actual muscle strength is not measurable by this method. The measurement limit of the shoulder horizontal adduction strength with the manipulative-fixed method was 30 kgf in the case of the examiner in the present study. The fixed limit was also found to influence in the muscle strength of the upper limbs.

  9. Increasing Running Step Rate Reduces Patellofemoral Joint Forces

    PubMed Central

    Lenhart, Rachel L.; Thelen, Darryl G.; Wille, Christa M.; Chumanov, Elizabeth S.; Heiderscheit, Bryan C.

    2013-01-01

    Purpose Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. Methods We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. Additionally, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. Results Increasing step rate to 110% of preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee and ankle extensor forces, and hip abductor forces all reduced in mid-stance. Compared to the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate, and was found to be the most important predictor of the reduction in patellofemoral joint loading. Conclusion Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain. PMID:23917470

  10. Arthroscopy of the shoulder joint--a cadaver and clinical study. Part 2: Clinical study.

    PubMed

    Rojvanit, V

    1984-10-01

    Shoulder arthroscopy was carried out 56 times on 50 patients. Different types of arthroscopes were employed. Anterior and posterior approaches were used. Diagnoses were 21 cases of glenohumeral instability including 17 of recurrent anterior dislocation and subluxation; 2 of voluntary anterior subluxation and 2 of habitual posterior dislocation, 13 of rotator cuff tear, 6 of chronic subacromial bursitis, 2 of fracture-dislocation, 2 of frozen shoulder, 2 of baseball shoulder, one of rheumatoid arthritis, and 3 miscellaneous. The arthroscopic findings in the instability group and rotator cuff tear group were verified. Bankart lesion and Hill-Sachs lesion were identified arthroscopically. The indications for shoulder arthroscopy are outlined. There was no significant morbidity with this procedure.

  11. Assessing Posterior Shoulder Contracture: The Reliability and Validity of Measuring Glenohumeral Joint Horizontal Adduction

    PubMed Central

    Laudner, Kevin G; Stanek, Justin M; Meister, Keith

    2006-01-01

    Context: Increased contracture of the dominant posterior shoulder in throwing athletes has been associated with the development of altered shoulder rotational motion as well as several shoulder conditions. Clinicians must be able to accurately and reliably measure posterior shoulder contractures during the evaluation of such athletes in order to provide appropriate treatment. Objective: To evaluate the reliability and validity of assessing posterior shoulder contracture by measuring supine glenohumeral (GH) horizontal adduction. Design: Descriptive with repeated measures. Setting: The biomechanics laboratory at Illinois State University (Normal, IL) and the athletic training room in Surprise, AZ. Patients or Other Participants: Twenty-four shoulders were tested in 12 subjects (age = 21.9 ± 4.3 years, height = 175.0 ± 10.0 cm, mass = 82.4 ± 19.1 kg) for determination of reliability, and 46 shoulders were tested in 23 professional baseball pitchers (age = 21.25 ± 1.66 years, height = 190.0 ± 5.0 cm, mass = 88.45 ± 6.99 kg) for determination of validity. Main Outcome Measure(s): We examined intratester and intertester reliability over 3 testing sessions by having 2 examiners measure GH horizontal adduction with the subject in a supine position with the scapula stabilized. To determine the validity and clinical usefulness of this measurement, we examined the relationship between GH horizontal adduction motion and internal shoulder rotational motion among a group of baseball pitchers. Results: Intraclass correlation coefficients were high for intratester (0.93, SEM = 1.64°) and intertester (0.91, SEM = 1.71°) measurements. This measurement was also shown to have a moderate to good relationship with lost internal shoulder rotational motion ( r = .72, P = .001) of the dominant arm among the baseball pitchers. Conclusions: Based on the results of this study, we found that measuring GH horizontal adduction with the subject supine and the scapula stabilized is a

  12. Automatic bone segmentation and bone-cartilage interface extraction for the shoulder joint from magnetic resonance images

    NASA Astrophysics Data System (ADS)

    Yang, Zhengyi; Fripp, Jurgen; Chandra, Shekhar S.; Neubert, Aleš; Xia, Ying; Strudwick, Mark; Paproki, Anthony; Engstrom, Craig; Crozier, Stuart

    2015-02-01

    We present a statistical shape model approach for automated segmentation of the proximal humerus and scapula with subsequent bone-cartilage interface (BCI) extraction from 3D magnetic resonance (MR) images of the shoulder region. Manual and automated bone segmentations from shoulder MR examinations from 25 healthy subjects acquired using steady-state free precession sequences were compared with the Dice similarity coefficient (DSC). The mean DSC scores between the manual and automated segmentations of the humerus and scapula bone volumes surrounding the BCI region were 0.926  ±  0.050 and 0.837  ±  0.059, respectively. The mean DSC values obtained for BCI extraction were 0.806  ±  0.133 for the humerus and 0.795  ±  0.117 for the scapula. The current model-based approach successfully provided automated bone segmentation and BCI extraction from MR images of the shoulder. In future work, this framework appears to provide a promising avenue for automated segmentation and quantitative analysis of cartilage in the glenohumeral joint.

  13. Effect of increased pushoff during gait on hip joint forces.

    PubMed

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to "push more with your foot when you walk". We collected motion data of markers placed on the subjects' trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to "push more with your foot when you walk" reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain.

  14. Biomechanics of the shoulder.

    PubMed

    Bechtol, C O

    1980-01-01

    Man's shoulder girdle is of the general pattern of his tree-swinging ancestors. With assumption of the upright posture, man's thorax has flattened from anterior-posterior. This results in a rotation of the scapula to a position of 45 degrees with the sagittal plane. In addition to this, man's forearm is habitually used in a position of approximately 45 degrees of internal rotation. This places the biceps tendon "off its trolley" and leads to biceps tinosynovitis. Motions of the glenohumeral joints result from the force couple of the deltoid muscle plus the rotator cuff muscles. The rotator cuff alone can abduct the arm with 50% force throughout the full range of its motion. In the absence of the supraspinatus muscle, however, the force couple is disrupted. Although initiation of abduction is with full force, the force rapidly falls off to 90 degrees. Above 90 degrees the arm can barely support its own weight. Although the shoulder undergoes progressive degenerative changes with age, the necessity for a joint implant, either partial or total--although successful--is rare.

  15. A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture.

    PubMed

    Madi, Sandesh; Pandey, Vivek; Khanna, Vikrant; Acharya, Kiran

    2015-11-23

    A direct blow to the shoulder, as may be sustained in a road traffic accident (RTA), can result in various combinations of fracture dislocations in the shoulder joint complex. Among these, a rare variety is an acromioclavicular joint (ACJ) dislocation coupled with ipsilateral mid-shaft clavicle fracture. Diverse treatment options have been described in the literature, ranging from non-operative and operative, to hybrid management. Treatment for this complex injury is predominantly dictated by the type of dislocation and displacement of the clavicle fracture, as well as age and demand of the patient. Acute high grades of ACJ dislocation require restoration of the coracoclavicular relationship (in place of torn coracoclavicular (CC) ligament) by some form of internal fixation, thereby maintaining the ACJ reduction. An arthroscopic reinstatement of the coracoclavicular relationship using a dog bone button and fibre tape implant for this composite injury pattern has not been previously described. Furthermore, a comprehensive review of the literature associated with this injury pattern is briefly described.

  16. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J.; Tirefort, Jérôme; Kolo, Frank C.; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-01-01

    Abstract Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation. Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography. Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values. While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  17. Muscular forces affect the glycosaminoglycan content of joint cartilage

    PubMed Central

    Ganse, Bergita; Zange, Jochen; Weber, Tobias; Pohle-Fröhlich, Regina; Johannes, Bernd W; Hackenbroch, Matthias; Rittweger, Jörn; Eysel, Peer; Koy, Timmo

    2015-01-01

    Background and purpose Unloading alters the thickness of joint cartilage. It is unknown, however, to what extent unloading leads to a loss of glycosaminoglycans (GAGs) in the cartilage tissue. We hypothesized that muscle forces, in addition to axial loading, are necessary to maintain the joint cartilage GAG content of the knee and the upper and lower ankle. Patients and methods The HEPHAISTOS orthosis was worn unilaterally by 11 men (mean age 31 (23–50) years old) for 56 days. The orthosis reduces activation and force production of the calf muscles while it permits full gravitational loading of the lower leg. MRI measurements of the knee and ankle were taken before the intervention, during the intervention (on day 49), and 14 days after the end of the intervention. Cartilage segmentation was conducted semiautomatically for the knee joint (4 segments) and for the upper (tibio-talar) and lower (subtalar) ankle joints (2 segments each). Linear mixed-effects (LME) models were used for statistical analysis. Results 8 volunteers completed the MRI experiment. In the lower ankle joint, differences in ΔT1 were found between the end of the intervention and 14 days after (p = 0.004), indicating a decrease in GAG content after reloading. There were no statistically significant differences in ΔT1 values in the knee and upper ankle joints. Interpretation Our findings suggest that in addition to gravitational load, muscular forces affect cartilage composition depending on the local distribution of forces in the joints affected by muscle contraction. PMID:25417835

  18. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    PubMed

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p < 0.001), lower HRQol on SF-36 Physical Component Scale (PCS: 28.1 versus 49.9; p < 0.001), and higher pain intensity (NRS: 6.4 versus 2.7; p < 0.001) than controls. Neck and shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain.

  19. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    PubMed

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p < 0.001), lower HRQol on SF-36 Physical Component Scale (PCS: 28.1 versus 49.9; p < 0.001), and higher pain intensity (NRS: 6.4 versus 2.7; p < 0.001) than controls. Neck and shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain. PMID:26824670

  20. The effects of shoulder joint abduction angles on the muscle activity of the serratus anterior muscle and the upper trapezius muscle while vibrations are applied

    PubMed Central

    Jung, Da-eun; Moon, Dong-chul

    2015-01-01

    [Purpose] The purpose of this study was to examine the ratio between the upper trapezius and the serratus anterior muscles during diverse shoulder abduction exercises applied with vibrations in order to determine the appropriate exercise methods for recovery of scapular muscle balance. [Subjects and Methods] Twenty-four subjects voluntarily participated in this study. The subjects performed shoulder abduction at various shoulder joint abduction angles (90°, 120°, 150°, 180°) with oscillation movements. [Results] At 120°, all the subjects showed significant increases in the muscle activity of the serratus anterior muscle in comparison with the upper trapezius muscle. However, no significant difference was found at angles other than 120°. [Conclusion] To selectively strengthen the serratus anterior, applying vibration stimuli at the 120° shoulder abduction position is considered to be appropriate. PMID:25642052

  1. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature.

    PubMed

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic bilateral acute anterior shoulder dislocations with associated Hill-Sachs lesions in a young, fit and well patient with no comorbidities. MRI illustrated the Hill-Sachs lesions with superior labral tear from anterior to posterior, and confirmed the acute nature of the injury by demonstrating the bone marrow oedema. The patient was treated surgically with arthroscopic anterior stabilisation. At 6 months following surgery, the patient has a pain free full range of movement of both shoulders with no further dislocations and has returned to work.

  2. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    PubMed Central

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic bilateral acute anterior shoulder dislocations with associated Hill-Sachs lesions in a young, fit and well patient with no comorbidities. MRI illustrated the Hill-Sachs lesions with superior labral tear from anterior to posterior, and confirmed the acute nature of the injury by demonstrating the bone marrow oedema. The patient was treated surgically with arthroscopic anterior stabilisation. At 6 months following surgery, the patient has a pain free full range of movement of both shoulders with no further dislocations and has returned to work. PMID:24895390

  3. 76 FR 1975 - Disestablishment of United States Joint Forces Command

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... From the Federal Register Online via the Government Publishing Office ] Part VII The President Memorandum of January 6, 2011--Disestablishment of United States Joint Forces Command #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 76, No. 7 / Tuesday, January 11, 2011 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President ] Memorandum...

  4. Using the American alligator and a repeated-measures design to place constraints on in vivo shoulder joint range of motion in dinosaurs and other fossil archosaurs.

    PubMed

    Hutson, Joel D; Hutson, Kelda N

    2013-01-15

    Using the extant phylogenetic bracket of dinosaurs (crocodylians and birds), recent work has reported that elbow joint range of motion (ROM) studies of fossil dinosaur forearms may be providing conservative underestimates of fully fleshed in vivo ROM. As humeral ROM occupies a more central role in forelimb movements, the placement of quantitative constraints on shoulder joint ROM could improve fossil reconstructions. Here, we investigated whether soft tissues affect the more mobile shoulder joint in the same manner in which they affect elbow joint ROM in an extant archosaur. This test involved separately and repeatedly measuring humeral ROM in Alligator mississippiensis as soft tissues were dissected away in stages to bare bone. Our data show that the ROMs of humeral flexion and extension, as well as abduction and adduction, both show a statistically significant increase as flesh is removed, but then decrease when the bones must be physically articulated and moved until they separate from one another and/or visible joint surfaces. A similar ROM pattern is inferred for humeral pronation and supination. All final skeletonized ROMs were less than initial fully fleshed ROMs. These results are consistent with previously reported elbow joint ROM patterns from the extant phylogenetic bracket of dinosaurs. Thus, studies that avoid separation of complementary articular surfaces may be providing fossil shoulder joint ROMs that underestimate in vivo ROM in dinosaurs, as well as other fossil archosaurs.

  5. Determination and optimization of joint torques and joint reaction forces in therapeutic exercises with elastic resistance.

    PubMed

    Biscarini, Andrea

    2012-01-01

    A model has been developed to definitively characterize the resistance properties and the joint loading (i.e., shear and compressive components of the joint reaction force) in single-joint exercises with ideal elastic bands. The model accounts for the relevant geometric and elastic properties of the band, the band pre-stretching, and the relative positioning among the joint center of rotation and the fixation points of the band. All the possible elastic torque profiles of ascending-descending, descending, or ascending type were disclosed in relation to the different ranges of joint angles. From these results the elastic resistance setting that best reproduces the average-user's knee extensor torque in maximal isometric/isokinetic efforts was determined. In this optimized setting, the shear tibiofemoral reaction force corresponding to an anterior (posterior) tibial displacement was 65% smaller than (nearly the same as) that obtained in a cam-equipped leg-extension equipment for equal values of resistance torque peak, whereas the compressive tibiofemoral reaction force was 22% higher. Compared to a weight-stack leg-extension equipment, an elastic resistance optimized setting has the potential to give a more effective quadriceps activation across the range of motion, and greatly reduces the anterior cruciate ligament strain force, which represents the main drawback of existing open kinetic-chain knee-extension exercises. PMID:21757393

  6. Determination and optimization of joint torques and joint reaction forces in therapeutic exercises with elastic resistance.

    PubMed

    Biscarini, Andrea

    2012-01-01

    A model has been developed to definitively characterize the resistance properties and the joint loading (i.e., shear and compressive components of the joint reaction force) in single-joint exercises with ideal elastic bands. The model accounts for the relevant geometric and elastic properties of the band, the band pre-stretching, and the relative positioning among the joint center of rotation and the fixation points of the band. All the possible elastic torque profiles of ascending-descending, descending, or ascending type were disclosed in relation to the different ranges of joint angles. From these results the elastic resistance setting that best reproduces the average-user's knee extensor torque in maximal isometric/isokinetic efforts was determined. In this optimized setting, the shear tibiofemoral reaction force corresponding to an anterior (posterior) tibial displacement was 65% smaller than (nearly the same as) that obtained in a cam-equipped leg-extension equipment for equal values of resistance torque peak, whereas the compressive tibiofemoral reaction force was 22% higher. Compared to a weight-stack leg-extension equipment, an elastic resistance optimized setting has the potential to give a more effective quadriceps activation across the range of motion, and greatly reduces the anterior cruciate ligament strain force, which represents the main drawback of existing open kinetic-chain knee-extension exercises.

  7. Putting the shoulder to the wheel: a new biomechanical model for the shoulder girdle.

    PubMed

    Levin, S M

    1997-01-01

    The least successfully modeled joint complex has been the shoulder. In multi-segmented mathematical shoulder models rigid beams (the bones) act as a series of columns or levers to transmit forces or loads to the axial skeleton. Forces passing through the almost frictionless joints must, somehow, always be directed perfectly perpendicular to the joints as only loads directed at right angles to the surfaces could transfer across frictionless joints. Loads transmitted to the axial skeleton would have to pass through the moving ribs or the weak jointed clavicle and then through the ribs. A new model of the shoulder girdle, based on the tension icosahedron described by Buckminster Fuller, is proposed that permits the compression loads passing through the arm and shoulder to be transferred to the axial skeleton through its soft tissues. In this model the scapula 'floats' in the tension network of shoulder girdle muscles just as the hub of the wire wheel is suspended in its tension network of spokes. With this construct inefficient beams and levers are eliminated. A more energy efficient, load distributing, integrated, hierarchical system is created.

  8. Static and dynamic mechanics of the temporomandibular joint: plowing forces, joint load and tissue stress.

    PubMed

    Nickel, J; Spilker, R; Iwasaki, L; Gonzalez, Y; McCall, W D; Ohrbach, R; Beatty, M W; Marx, D

    2009-08-01

    OBJECTIVES - To determine the combined effects 1) of stress-field aspect ratio and velocity and compressive strain and 2) joint load, on temporomandibular joint (TMJ) disc mechanics. SETTING AND SAMPLE POPULATION - Fifty-two subjects (30 female; 22 male) participated in the TMJ load experiments. MATERIAL AND METHODS - In the absence of human tissue, pig TMJ discs were used to determine the effects of variables 1) on surface plowing forces, and to build a biphasic finite element model (bFEM) to test the effect of human joint loads and 2) on tissue stresses. In the laboratory, discs received a 7.6 N static load via an acrylic indenter before cyclic movement. Data were recorded and analysed using anova. To determine human joint loads, Research Diagnostic Criteria calibrated investigators classified subjects based on signs of disc displacement (DD) and pain (+DD/+pain, n = 18; +DD/-pain, n = 17; -DD/-pain, n = 17). Three-dimensional geometries were produced for each subject and used in a computer model to calculate joint loads. RESULTS - The combined effects of compressive strain, and aspect ratio and velocity of stress-field translation correlated with plowing forces (R(2) = 0.85). +DD/-pain subjects produced 60% higher joint loads (ANOVA, p < 0.05), which increased bFEM-calculated compressive strain and peak total normal stress. CONCLUSIONS - Static and dynamic variables of the stress-field and subject-dependent joint load significantly affect disc mechanics.

  9. Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients.

    PubMed

    Hirano, Masahiro; Katoh, Munenori; Kawaguchi, Saori; Uemura, Tomomi

    2016-01-01

    [Purpose] This study aimed to verify the appropriate number of measurements and the intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD) for geriatric and stroke patients. [Subjects and Methods] The subjects were 40 inpatients, who were divided into two groups: 20 stroke patients in the stroke group (SG), and 20 geriatric patients in the no-stroke group (N-SG). Measurements were performed three times using an HHD with a belt. The reliability was verified using Bland-Altman analysis and the intraclass correlation coefficient (ICC). [Results] ICC (1, 1) was >0.9. A systematic bias was not observed between the first and second measurement values except for the right side in N-SG. A systematic bias between the maximum value obtained during the first and second measurements and third measurement value was observed on the left side in N-SG, and on the non-paralyzed side in SG: the third measurement values were small in both cases. [Conclusion] Intrarater reliabilities were high for shoulder horizontal adductor strength measurements using an HHD with a belt for geriatric and stroke patients. Taking the systematic bias into consideration, these findings suggest that the required number of measurements is two. PMID:26957727

  10. Distribution of beta-endorphin and substance P in the shoulder joint of the dog before and after a low impact exercise programme.

    PubMed

    Karahan, S; Kincaid, S A; Baird, A N; Kammermann, J R

    2002-04-01

    Beta-endorphin and substance P were immunolocalized in the articular cartilage, synovial membrane and fibrous joint capsule of dogs. Twelve adult greyhounds were randomly assigned to one of three groups: control, limited exercise, or regimented exercise. On day 0, biopsies of articular cartilage and joint capsule were obtained from the left shoulder joints of dogs receiving limited and regimented exercise. On day 72, biopsies of joint capsule from right and left shoulders and articular cartilage from the right shoulder joint were analysed for the presence of glycosaminoglycans (GAG) and for immunolocalization of substance P and beta-endorphin. Regimented exercise increased the presence of GAGs and immunolocalization of substance P and beta-endorphin in articular cartilage and synovial membrane compared to day 0 biopsies and untreated controls. Localization of beta-endorphin became prominent in and around the chondrocytes. Substance P was increased in chondrocytes and extracellular matrix. Concomitant changes in localization of beta-endorphin and substance P may have a role in the modulation of the microphysiological environment, metabolism, or function of joint tissues in response to low-impact exercise. PMID:12047242

  11. Shoulder pain

    PubMed Central

    2010-01-01

    Introduction Shoulder pain is a common problem with an estimated prevalence of 4% to 26%. About 1% of adults aged over 45 years consult their GP with a new presentation of shoulder pain every year in the UK. The aetiology of shoulder pain is diverse and includes pathology originating from the neck, glenohumeral joint, acromioclavicular joint, rotator cuff, and other soft tissues around the shoulder girdle. The most common source of shoulder pain is the rotator cuff, accounting for over two-thirds of cases. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatment, topical drug treatment, local injections, non-drug treatment, and surgical treatment? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 71 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, arthroscopic subacromial decompression, autologous whole blood injection, corticosteroids (oral, subacromial injection, or intra-articular injection), electrical stimulation, excision of distal clavicle, extracorporeal shock wave therapy, ice, laser treatment, manipulation under anaesthesia, suprascapular nerve block, non-steroidal anti-inflammatory drugs (oral, topical or intra-articular injection), opioid analgesics, paracetamol, physiotherapy (manual treatment, exercises), platelet-rich plasma injection

  12. Shoulder injuries from attacking motion

    NASA Astrophysics Data System (ADS)

    Yanagi, Shigeru; Nishimura, Tetsu; Itoh, Masaru; Wada, Yuhei; Watanabe, Naoki

    1997-03-01

    Sports injuries have bothered professional players. Although many medical doctors try to treat injured players, to prevent sports injuries is more important. Hence, it is required to clear a kinematic mechanism of the sport injuries. A shoulder of volleyball attacker or baseball pitcher is often inured by playing motion. The injuries are mainly caused at the end of long head tendon, which is located in the upper side of scapula. Generally, a muscle and tendon have enough strength against tensile force, however, it seems that they are sometimes defeated by the lateral force. It is imagined that the effect of the lateral force has a possibility of injuring the tendon. If we find the influence of the lateral force on the injured portion, the mechanism of injuries must be cleared. In our research, volleyball attacking motion is taken by high speed video cameras. We analyze the motion as links system and obtain an acceleration of an arm and a shoulder from video image data. The generated force at a shoulder joint is calculated and resolved into the lateral and longitudinal forces. Our final goal is to discuss a possibility that the lateral force causes the injuries.

  13. Restoration of Shoulder Function.

    PubMed

    Boe, Chelsea C; Elhassan, Bassem T

    2016-08-01

    Restoration of shoulder function in patients with brachial plexus injury can be challenging. Initial reported efforts were focused on stabilizing the shoulder, improving inferior subluxation and restoring abduction and flexion of the joint. Recent advancements and improved understanding of coordinated shoulder motion and the biomechanical properties of the muscles around the shoulder applicable to tendon transfer have expanded available surgical options to improve shoulder function, specifically external rotation. Despite the advances in reconstructive options, brachial plexus injury remains a serious problem that requires complex surgical solutions, prolonged recovery, and acceptance of functional loss. PMID:27387074

  14. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    PubMed Central

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  15. Influence of joint models on lower-limb musculo-tendon forces and three-dimensional joint reaction forces during gait.

    PubMed

    Dumas, Raphaël; Moissenet, Florent; Gasparutto, Xavier; Cheze, Laurence

    2012-02-01

    Several three-dimensional (3D) lower-limb musculo-skeletal models have been developed for gait analysis and different hip, knee and ankle joint models have been considered in the literature. Conversely to the influence of the musculo-tendon geometry, the influence of the joint models--i.e. number of degrees of freedom and passive joint moments--on the estimated musculo-tendon forces and 3D joint reaction forces has not been extensively examined. In this paper musculo-tendon forces and 3D joint reaction forces have been estimated for one subject and one gait cycle with nine variations of a musculoskeletal model and outputs have been compared to measured electromyographic signals and knee joint contact forces. The model outputs are generally in line with the measured signals. However, the 3D joint reaction forces were higher than published values and the contact forces measured for the subject. The results of this study show that, with more degrees of freedom in the model, the musculo-tendon forces and the 3D joint reaction forces tend to increase but with some redistribution between the muscles. In addition, when taking into account passive joint moments, the 3D joint reaction forces tend to decrease during the stance phase and increase during the swing phase. Although further investigations are needed, a five-degree-of-freedom lower-limb musculo-skeletal model with some angle-dependent joint coupling and stiffness seems to provide satisfactory musculo-tendon forces and 3D joint reaction forces.

  16. Effect of pain scrambler therapy on shoulder joint pain and range of motion in patients who had undergone arthroscopic rotator cuff repair for the first time

    PubMed Central

    Lee, Dong-Kyu; Kim, Eun-Kyung

    2016-01-01

    [Purpose] This study aimed to determine the effect of pain scrambler therapy on shoulder joint pain and range of motion in patients who had undergone arthroscopic rotator cuff repair for the first time. [Subjects and Methods] Pain scrambler therapy was administered once a day every 40 minutes for 10 days to patients that had undergone arthroscopic rotator cuff repair for the first time. The visual analog scale was used to measure pain, and a goniometer was used to measure shoulder range of motion. [Results] After 10 sessions of pain scrambler therapy, pain was significantly reduced from that before the treatment. In addition, shoulder range of motion was increased after 10 treatment sessions. [Conclusion] Thus, pain scrambler therapy greatly reduced pain and increased should range of motion in the patients who had undergone arthroscopic rotator cuff repair for the first time. PMID:27512291

  17. [Orthopedic treatment of the shoulder joint impairment in patients with rheumatoid arthritis].

    PubMed

    Herasymenko, S I; Babko, A M; Poluliakh, M V; Huzhevs'kyĭ, I V; Herasymenko, A S

    2014-12-01

    Brachial joint affection in patients, suffering rheumatoid arthritis, occupies a third place after such of the elbow and the hand. Due to significant reduction of a freedom degree, caused by inflammation, the upper extremity looses function of active instrument for the items transposition. Volume of surgical treatment of such patients depends on stage of the process. On early stages arthroscopic synovectomy of brachial joint is performed and on the late--endoprosthesis. Late results of the treatment are mainly positive. Satisfactory results are based, predominantly, on raising of activity of general rheumatoid inflammation.

  18. Investigating shoulder muscle loading and exerted forces during wall painting tasks: influence of gender, work height and paint tool design.

    PubMed

    Rosati, Patricia M; Chopp, Jaclyn N; Dickerson, Clark R

    2014-07-01

    The task of wall painting produces considerable risk to the workers, both male and female, primarily in the development of upper extremity musculoskeletal disorders. Insufficient information is currently available regarding the potential benefits of using different paint roller designs or the possible adverse effects of painting at different work heights. The aim of this study was to investigate the influence of gender, work height, and paint tool design on shoulder muscle activity and exerted forces during wall painting. Ten young adults, five male and five female, were recruited to perform simulated wall painting at three different work heights with three different paint roller designs while upper extremity muscle activity and horizontal push force were recorded. Results demonstrated that for female participants, significantly greater total average (p = 0.007) and integrated (p = 0.047) muscle activity was present while using the conventional and curly flex paint roller designs compared to the proposed design in which the load was distributed between both hands. Additionally, for both genders, the high working height imposed greater muscular demands compared to middle and low heights. These findings suggest that, if possible, avoid painting at extreme heights (low or high) and that for female painters, consider a roller that requires the use of two hands; this will reduce fatigue onset and subsequently mitigate potential musculoskeletal shoulder injury risks.

  19. Revisiting the Force-Joint Angle Relationship After Eccentric Exercise.

    PubMed

    Welsh, Molly C; Allen, David L; Batliner, Matthew E; Byrnes, William C

    2015-12-01

    The purpose of this study was to evaluate force-angle curve fitting techniques pre-eccentric exercise, quantify changes in curve characteristics postexercise, and examine the relationship between curve changes and markers of muscle damage. Fourteen males unaccustomed to eccentric exercise performed 60 eccentric muscle actions of the elbow flexors. Maximal voluntary isometric force was measured throughout a range of angles pre- (Pre1 and Pre2), immediately post (IP), and 1, 2, 4, and 7 days postexercise. Force-angle curves for each visit were constructed using second-order polynomials. Changes in curve characteristics (optimal angle, peak force, curve height), range of motion, soreness, and creatine kinase activity were quantified. Optimal joint angle and force at optimal angle were significantly correlated from Pre1 to Pre2 (ICC = 0.821 and 0.979, respectively). Optimal angle was significantly right shifted (p = 0.035) by 10.4 ± 12.9° from Pre2 to IP and was restored by 1 day post exercise. Interestingly, the r value for curve fit was significantly decreased (p < 0.001) from Pre2 (r = 0.896) to IP (r = 0.802) and 1 day post exercise (r = 0.750). Curve height was significantly decreased (39%) IP and restored to pre-exercise height by 4 days postexercise. There was no correlation between optimal angle or curve height and other damage markers. In conclusion, force-angle relationships can be accurately described using second-order polynomials. After eccentric exercise, the force-angle curve is flattened and shifted (downward and rightward), but these changes are not correlated to other markers of muscle damage. Changes in the force-angle relationship are multifaceted, but determining the physiological significance of these changes requires further investigation.

  20. Effect of Resistance Training Maintaining the Joint Angle-torque Profile Using a Haptic-based Machine on Shoulder Internal and External Rotation.

    PubMed

    Kim, Yeonghun; Lee, Kunwoo; Moon, Jeheon; Koo, Dohoon; Park, Jaewoo; Kim, Kyengnam; Hong, Daehie; Shin, Inshik

    2014-04-01

    [Purpose] The aim of this study was to present an individualized resistance training method to enable exercise while maintaining an exercise load that is set according to an individual's joint angle-torque using a haptic-based resistance training machine. [Methods] Five participants (machine group) performed individualized shoulder internal and external rotation training with a haptic resistance training machine, while another five participants performed general dumbbell-based shoulder internal and external rotation training for eight weeks. Internal and external rotation powers of subjects were measured using an isokinetic machine before and after training. [Results] The average powers of both shoulder internal and external rotation has been improved after training (25.72%, 13.62%). The improvement in power of external rotation in the machine group was significantly higher than that in the control group. [Conclusion] This study proposes a haptic-based individualized rotator cuff muscle training method. The training protocol maintaining the joint angle-torque profile showed better improvement of shoulder internal/external rotation than dumbbell training.

  1. Effect of Resistance Training Maintaining the Joint Angle-torque Profile Using a Haptic-based Machine on Shoulder Internal and External Rotation

    PubMed Central

    Kim, Yeonghun; Lee, Kunwoo; Moon, Jeheon; Koo, Dohoon; Park, Jaewoo; Kim, Kyengnam; Hong, Daehie; Shin, Inshik

    2014-01-01

    [Purpose] The aim of this study was to present an individualized resistance training method to enable exercise while maintaining an exercise load that is set according to an individual’s joint angle-torque using a haptic-based resistance training machine. [Methods] Five participants (machine group) performed individualized shoulder internal and external rotation training with a haptic resistance training machine, while another five participants performed general dumbbell-based shoulder internal and external rotation training for eight weeks. Internal and external rotation powers of subjects were measured using an isokinetic machine before and after training. [Results] The average powers of both shoulder internal and external rotation has been improved after training (25.72%, 13.62%). The improvement in power of external rotation in the machine group was significantly higher than that in the control group. [Conclusion] This study proposes a haptic-based individualized rotator cuff muscle training method. The training protocol maintaining the joint angle-torque profile showed better improvement of shoulder internal/external rotation than dumbbell training. PMID:24764626

  2. Passive Joint Forces Are Tuned to Limb Use in Insects and Drive Movements without Motor Activity

    PubMed Central

    Ache, Jan M.; Matheson, Thomas

    2013-01-01

    Summary Background Limb movements are generally driven by active muscular contractions working with and against passive forces arising in muscles and other structures. In relatively heavy limbs, the effects of gravity and inertia predominate, whereas in lighter limbs, passive forces intrinsic to the limb are of greater consequence. The roles of passive forces generated by muscles and tendons are well understood, but there has been little recognition that forces originating within joints themselves may also be important, and less still that these joint forces may be adapted through evolution to complement active muscle forces acting at the same joint. Results We examined the roles of passive joint forces in insect legs with different arrangements of antagonist muscles. We first show that passive forces modify actively generated movements of a joint across its working range, and that they can be sufficiently strong to generate completely passive movements that are faster than active movements observed in natural behaviors. We further demonstrate that some of these forces originate within the joint itself. In legs of different species adapted to different uses (walking, jumping), these passive joint forces complement the balance of strength of the antagonist muscles acting on the joint. We show that passive joint forces are stronger where they assist the weaker of two antagonist muscles. Conclusions In limbs where the dictates of a key behavior produce asymmetry in muscle forces, passive joint forces can be coadapted to provide the balance needed for the effective generation of other behaviors. PMID:23871240

  3. Adhesively-Bonded Structural Composite Joint Utilizing Shoulder-Centered Sleeves

    NASA Technical Reports Server (NTRS)

    Lukowski, Florian P., Jr. (Inventor)

    2015-01-01

    A composite joint includes a first member having a groove therein, a second member adjacent to the first member, and a connector member disposed between the second member and the first member. The connector member is received in the groove so as to bias a load path between the first member and the second member from a peripheral portion to a central portion of the connector member.

  4. Adaptation of the AnyBody™ Musculoskeletal Shoulder Model to the Nonconforming Total Shoulder Arthroplasty Context.

    PubMed

    Sins, Lauranne; Tétreault, Patrice; Hagemeister, Nicola; Nuño, Natalia

    2015-10-01

    Current musculoskeletal inverse dynamics shoulder models have two limitations to use in the context of nonconforming total shoulder arthroplasty (NC-TSA). First, the ball and socket glenohumeral (GH) joint simplification avoids any humeral head translations. Second, there is no contact at the GH joint to compute the contact area and the center of pressure (COP) between the two components of NC-TSA. In this paper, we adapted the AnyBody™ shoulder model by introducing humeral head translations and contact between the two components of an NC-TSA. Abduction in the scapular plane was considered. The main objective of this study was to adapt the AnyBody™ shoulder model to a NC-TSA context and to compare the results of our model (translations, COP, contact area, GH joint reaction forces (GH-JRFs), and muscular forces) with previous numerical, experimental, and clinical studies. Humeral head translations and contact were successfully introduced in our adapted shoulder model with strong support for our findings by previous studies. PMID:26287772

  5. Individual muscle contributions to the axial knee joint contact force during normal walking.

    PubMed

    Sasaki, Kotaro; Neptune, Richard R

    2010-10-19

    Muscles are significant contributors to the high joint forces developed in the knee during human walking. Not only do muscles contribute to the knee joint forces by acting to compress the joint, but they also develop joint forces indirectly through their contributions to the ground reaction forces via dynamic coupling. Thus, muscles can have significant contributions to forces at joints they do not span. However, few studies have investigated how the major lower-limb muscles contribute to the knee joint contact forces during walking. The goal of this study was to use a muscle-actuated forward dynamics simulation of walking to identify how individual muscles contribute to the axial tibio-femoral joint force. The simulation results showed that the vastii muscles are the primary contributors to the axial joint force in early stance while the gastrocnemius is the primary contributor in late stance. The tibio-femoral joint force generated by these muscles was at times greater than the muscle forces themselves. Muscles that do not cross the knee joint (e.g., the gluteus maximus and soleus) also have significant contributions to the tibio-femoral joint force through their contributions to the ground reaction forces. Further, small changes in walking kinematics (e.g., knee flexion angle) can have a significant effect on the magnitude of the knee joint forces. Thus, altering walking mechanics and muscle coordination patterns to utilize muscle groups that perform the same biomechanical function, yet contribute less to the knee joint forces may be an effective way to reduce knee joint loading during walking.

  6. Traction-drive force transmission for telerobotic joints

    NASA Technical Reports Server (NTRS)

    Kuban, D. P.; Williams, D. M.

    1989-01-01

    The U.S. Space Station Program is providing many technological developments to meet the increasing demands of designing such a facility. One of the key areas of research is that of telerobotics for space station assembly and maintenance. Initial implementation will be teleoperated, but long-term plans call for autonomous robotics. One of the essential components for making this transition successful is the manipulator joints mechanism. Historically, teleoperated manipulators and industrial robotics have had very different mechanisms for force transmission. This is because the design objectives are almost mutually exclusive. A teleoperator must have very low friction and inertia to minimize operator fatigue; backlash and stiffness are of secondary concern. A robot, however, must have minimum backlash, and high stiffness for accurate and rapid positioning. A joint mechanism has yet to be developed that can optimize these divergent performance objectives. A joint mechanism that approaches this optimal performance was developed for NASA Langley, Automation Technology Branch. It is a traction-drive differential that uses variable preload mechanisms. The differential provides compact, dexterous motion range with a torque density similar to geared systems. The traction drive offers high stiffness and zero backlash, for good robotic performance, and the variable loading mechanism (VLM) minimizes the drive-train friction, for improved teleoperation.

  7. Shoulder pain

    PubMed Central

    2006-01-01

    Introduction Shoulder pain covers a wide range of problems and affects up to 20% of the population. It is not a specific diagnosis. Shoulder pain can be caused by problems with the acromioclavicular joint, shoulder muscles, or referred pain from the neck. Rotator cuff problems account for 65-70% of cases of shoulder pain. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatment; topical drug treatment; local injections; non-drug treatment; and surgical treatment? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 53 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: arthroscopic laser subacromial decompression, corticosteroid injections (intra-articular), corticosteroids (oral, subacromial injection), electrical stimulation, extracorporeal shock wave therapy, guanethidine (intra-articular), ice, laser treatment, manipulation under anaesthesia (plus intra-articular injection in people with frozen shoulder), multidisciplinary biopsychosocial rehabilitation, nerve block, non-steroidal anti-inflammatory drugs (oral, topical or intra-articular injection), opioid analgesics, paracetamol, phonophoresis, physiotherapy (manual treatment, exercises), surgical arthroscopic decompression, transdermal glyceryl trinitrate, ultrasound.

  8. Dislocated shoulder - aftercare

    MedlinePlus

    ... NOT return to activities that place too much stress on your shoulder joint. Ask your provider first. These activities include most sports activities using your arms, gardening, heavy lifting, or ...

  9. Relationships between throwing mechanics and shoulder distraction in collegiate baseball pitchers.

    PubMed

    Werner, Sherry L; Guido, John A; Stewart, Gregory W; McNeice, Ryan P; VanDyke, Travis; Jones, Deryk G

    2007-01-01

    A distraction force occurs at the shoulder joint in all throwing motions. At the professional level, the relationship between this force and pitching mechanics has been explained. Three-dimensional, high-speed (240 Hz) video data were collected on fastballs from 48 collegiate baseball pitchers. Kinematic parameters related to pitching mechanics and resultant kinetics on the throwing arm elbow and shoulder joints were calculated. Multiple linear regression analysis was used to investigate the relationships between shoulder distraction and pitching mechanics. Shoulder distraction stress averaged 81% body weight for the collegiate pitchers. The mean ball velocity was 81 mph. Ten parameters of pitching mechanics accounted for 89% of the variance in shoulder distraction. Two of the variables (maximum shoulder abduction torque and elbow angle at release) previously shown to affect shoulder distraction in professional baseball pitchers appear to be important for collegiate pitchers as well. These data provide a scientific basis for clinicians, athletes, and coaches to establish methods to reduce distraction force at the shoulder joint through modification of pitching mechanics.

  10. Shoulder proprioception in baseball pitchers.

    PubMed

    Safran, M R; Borsa, P A; Lephart, S M; Fu, F H; Warner, J J

    2001-01-01

    We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation.

  11. A Thickened Coracohumeral Ligament and Superomedial Capsule Limit Internal Rotation of the Shoulder Joint: Report of Three Cases

    PubMed Central

    Koide, Masashi; Hamada, Junichiro; Hagiwara, Yoshihiro; Kanazawa, Kenji; Suzuki, Kazuaki

    2016-01-01

    Adhesive capsulitis of the shoulder (also known as frozen shoulder) is a painful and disabling disorder with an estimated prevalence ranging from 2% to 5% in the general population. Although the precise pathogenesis of frozen shoulder is unclear, thickened capsule and coracohumeral ligament (CHL) have been documented to be one of the most specific manifestations. The thickened CHL has been understood to limit external rotation of the shoulder, and restriction of internal rotation of the shoulder has been believed to be related to posterior capsular tightness. In this paper, three cases of refractory frozen shoulder treated through arthroscopic release of a contracted capsule including CHL were reported. Two cases in which there is recalcitrant severe restriction of internal rotation after manipulation under anesthesia (MUA) were finally treated with arthroscopic surgery. Although MUA could release the posterior capsule, internal rotation did not improve in our cases. After release of the thickened CHL, range of motion of internal rotation was significantly improved. This report demonstrates the role of the thickened CHL in limiting the internal rotation of the shoulder. We highlight the importance of release of thickened CHL in addition to the pancapsular release, in case of severe limitation of internal rotation of shoulder. PMID:27123353

  12. Physical examination of the shoulder.

    PubMed

    King, Joseph J; Wright, Thomas W

    2014-10-01

    This article summarizes the overall assessment of the shoulder joint and seeks to help direct clinicians to diagnose shoulder pathology using standard and specific physical examinations. The history and standard examination can prompt the examiner to focus on specific tests to further evaluate the shoulder and limit the differential diagnoses. An appropriate and directed shoulder physical examination allows the clinician to focus on further diagnostic strategies and treatment options for the patient.

  13. Unusual lesions mimicking impingement syndrome in the shoulder joint - Think medially.

    PubMed

    Singh, Rohit; Malhotra, Akshay; Cribb, Gillian; Cool, Paul; Hay, Stuart

    2016-09-01

    Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space. Magnetic Resonance Imaging (MRI) showed lesions that were present in the supra-spinatus fossa but were causing pressure effects on the sub-acromial space, namely - a ganglion cyst in one case, lipomata in two other cases, and a glomus tumour. A ganglion cyst and glomus tumour mimicking impingement syndrome is a rare reported case to our knowledge. These are unusual causes that should be considered when investigating classical impingement syndrome and particularly those who may have failed to respond to decompression surgery. They highlight the potential value of looking beyond the sub-acromial space for causal lesions and in these cases, at a time when limited ultrasound investigation has become increasingly popular; MRI has clearly played an important and was essential in planning surgery as these lesions would not have been identified on USS. Even though the symptoms were classical. PMID:27594993

  14. Functional Analysis of the Primate Shoulder

    PubMed Central

    Hohn, Bianca; Scherf, Heike; Schmidt, Manuela; Krause, Cornelia; Witzel, Ulrich

    2010-01-01

    Studies of the shoulder girdle are in most cases restricted to morphological comparisons and rarely aim at elucidating function in a strictly biomechanical sense. To fill this gap, we investigated the basic functional conditions that occur in the shoulder joint and shoulder girdle of primates by means of mechanics. Because most of nonhuman primate locomotion is essentially quadrupedal walking—although on very variable substrates—our analysis started with quadrupedal postures. We identified the mechanical situation at the beginning, middle, and end of the load-bearing stance phase by constructing force parallelograms in the shoulder joint and the scapulo-thoracal connection. The resulting postulates concerning muscle activities are in agreement with electromyographical data in the literature. We determined the magnitude and directions of the internal forces and explored mechanically optimal shapes of proximal humerus, scapula, and clavicula using the Finite Element Method. Next we considered mechanical functions other than quadrupedal walking, such as suspension and brachiation. Quadrupedal walking entails muscle activities and joint forces that require a long scapula, the cranial margin of which has about the same length as the axillary margin. Loading of the hand in positions above the head and suspensory behaviors lead to force flows along the axillary margin and so necessitate a scapula with an extended axillary and a shorter cranial margin. In all cases, the facies glenoidalis is nearly normal to the calculated joint forces. In anterior view, terrestrial monkeys chose a direction of the ground reaction force requiring (moderate) activity of the abductors of the shoulder joint, whereas more arboreal monkeys prefer postures that necessitate activity of the adductors of the forelimb even when walking along branches. The same adducting and retracting muscles are recruited in various forms of suspension. As a mechanical consequence, the scapula is in a more

  15. Pathomechanics of the throwing shoulder.

    PubMed

    Kibler, W Ben; Thomas, Stephen J

    2012-03-01

    Many anatomic, physiological, and biomechanical alterations have been observed in overhead athletes who present with painful shoulders. This is probably due to the complex kinetic chain mechanics required in the overhead throwing or serving motion. Any alteration along the kinetic chain can result in deficits in force production or increase in joint loads in other parts of the chain. The "disabled throwing shoulder" (DTS) is a general term that describes the limitations in function that exist in symptomatic overhead athletes. DTS typically results from a "cascade to injury" with alterations in the kinetic chain. Evaluation of athletes with the DTS should include examination of the local and distant anatomic injuries and screening for physiological (muscle inflexibilities, weakness, or imbalances) or biomechanical (motions, positions) alterations.

  16. Patellofemoral joint compression forces in backward and forward running

    PubMed Central

    Roos, Paulien E.; Barton, Nick; van Deursen, Robert W.M.

    2012-01-01

    Patellofemoral pain (PFP) is a common injury and increased patellofemoral joint compression forces (PFJCF) may aggravate symptoms. Backward running (BR) has been suggested for exercise with reduced PFJCF. The aims of this study were to (1) investigate if BR had reduced peak PFJCF compared to forward running (FR) at the same speed, and (2) if PFJCF was reduced in BR, to investigate which biomechanical parameters explained this. It was hypothesized that (1) PFJCF would be lower in BR, and (2) that this would coincide with a reduced peak knee moment caused by altered ground reaction forces (GRFs). Twenty healthy subjects ran in forward and backward directions at consistent speed. Kinematic and ground reaction force data were collected; inverse dynamic and PFJCF analyses were performed. PFJCF were higher in FR than BR (4.5±1.5; 3.4±1.4BW; p<0.01). The majority of this difference (93.1%) was predicted by increased knee moments in FR compared to BR (157±54; 124±51 Nm; p<0.01). 54.8% of differences in knee moments could be predicted by the magnitude of the GRF (2.3±0.3; 2.4±0.2BW), knee flexion angle (44±6; 41±7) and center of pressure location on the foot (25±11; 12±6%) at time of peak knee moment. Results were not consistent in all subjects. It was concluded that BR had reduced PFJCF compared to FR. This was caused by an increased knee moment, due to differences in magnitude and location of the GRF vector relative to the knee. BR can therefore be used to exercise with decreased PFJCF. PMID:22503882

  17. Bilateral Anterior Shoulder Dislocation

    PubMed Central

    Siu, Yuk Chuen; Lui, Tun Hing

    2014-01-01

    Introduction: Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare. Case Presentation: We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus. Conclusions: Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed. PMID:25685749

  18. Joint contact forces can be reduced by improving joint moment symmetry in below-knee amputee gait simulations.

    PubMed

    Koelewijn, Anne D; van den Bogert, Antonie J

    2016-09-01

    Despite having a fully functional knee and hip in both legs, asymmetries in joint moments of the knee and hip are often seen in gait of persons with a unilateral transtibial amputation (TTA), possibly resulting in excessive joint loading. We hypothesize that persons with a TTA can walk with more symmetric joint moments at the cost of increased effort or abnormal kinematics. The hypothesis was tested using predictive simulations of gait. Open loop controls of one gait cycle were found by solving an optimization problem that minimizes a combination of walking effort and tracking error in joint angles, ground reaction force and gait cycle duration. A second objective was added to penalize joint moment asymmetry, creating a multi-objective optimization problem. A Pareto front was constructed by changing the weights of the objectives and three solutions were analyzed to study the effect of increasing joint moment symmetry. When the optimization placed more weight on moment symmetry, walking effort increased and kinematics became less normal, confirming the hypothesis. TTA gait improved with a moderate increase in joint moment symmetry. At a small cost of effort and abnormal kinematics, the peak hip extension moment in the intact leg was decreased significantly, and so was the joint contact force in the knee and hip. Additional symmetry required a significant increase in walking effort and the joint contact forces in both hips became significantly higher than in able-bodied gait.

  19. Motor control hierarchy in joint action that involves bimanual force production

    PubMed Central

    Masumoto, Junya

    2015-01-01

    The concept of hierarchical motor control has been viewed as a means of progressively decreasing the number of variables manipulated by each higher control level. We tested the hypothesis that turning an individual bimanual force-production task into a joint (two-participant) force-production task would lead to positive correlation between forces produced by the two hands of the individual participant (symmetric strategy) to enable negative correlation between forces produced by two participants (complementary strategy). The present study consisted of individual and joint tasks that involved both unimanual and bimanual conditions. In the joint task, 10 pairs of participants produced periodic isometric forces, such that the sum of forces that they produced matched a target force cycling between 5% and 10% of maximum voluntary contraction at 1 Hz. In the individual task, individuals attempted to match the same target force. In the joint bimanual condition, the two hands of each participant adopted a symmetric strategy of force, whereas the two participants adopted a complementary strategy of force, highlighting that the bimanual action behaved as a low level of a hierarchy, whereas the joint action behaved as an upper level. The complementary force production was greater interpersonally than intrapersonally. However, whereas the coherence was highest at 1 Hz in all conditions, the frequency synchrony was stronger intrapersonally than interpersonally. Moreover, whereas the bimanual action exhibited a smaller error and variability of force than the unimanual action, the joint action exhibited a less-variable interval and force than the individual action. PMID:25904710

  20. The effect of foot progression angle on knee joint compression force during walking.

    PubMed

    Koblauch, Henrik; Heilskov-Hansen, Thomas; Alkjær, Tine; Simonsen, Erik B; Henriksen, Marius

    2013-06-01

    It is unclear how rotations of the lower limb affect the knee joint compression forces during walking. Increases in the frontal plane knee moment have been reported when walking with internally rotated feet and a decrease when walking with externally rotated feet. The aim of this study was to investigate the knee joint compressive forces during walking with internal, external and normal foot rotation and to determine if the frontal plane knee joint moment is an adequate surrogate for the compression forces in the medial and lateral knee joint compartments under such gait modifications. Ten healthy males walked at a fixed speed of 4.5 km/h under three conditions: Normal walking, internally rotated and externally rotated. All gait trials were recorded by six infrared cameras. Net joint moments were calculated by 3D inverse dynamics. The results revealed that the medial knee joint compartment compression force increased during external foot rotation and the lateral knee joint compartment compression force increased during internal foot rotation. The increases in joint loads may be a result of increased knee flexion angles. Further, these data suggest that the frontal plane knee joint moment is not a valid surrogate measure for knee joint compression forces but rather indicates the medial- to-lateral load distribution.

  1. Shoulder Joint Replacement

    MedlinePlus

    ... such as anti-inflammatory medications, cortisone injections, or physical therapy. Orthopaedic Evaluation Your family physician may refer you ... your function. Other treatment options — including medications, injections, physical therapy, or other types of surgery — will also be ...

  2. Shoulder Injuries in US Astronauts Related to EVA Suit Design

    NASA Technical Reports Server (NTRS)

    Scheuring, R. A.; McCulloch, P.; Van Baalen, Mary; Minard, Charles; Watson, Richard; Blatt, T.

    2011-01-01

    Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain

  3. Relationships between throwing mechanics and shoulder distraction in professional baseball pitchers.

    PubMed

    Werner, S L; Gill, T J; Murray, T A; Cook, T D; Hawkins, R J

    2001-01-01

    The extreme forces and torques and the high speeds and excessive ranges of motion of baseball pitching place tremendous stress on the soft tissues of the throwing shoulder. Little is known about the relationship between pitching mechanics and shoulder joint stress, especially in professional athletes. The purpose of this study was to quantify joint loads and kinematic parameters of pitching mechanics at the major league level and to study their relationships. Three-dimensional, high-speed video data were collected on 40 professional pitchers during the 1998 Cactus League spring training. A clinically significant distraction force was calculated at the shoulder joint, which reached an average peak value of 947 +/- 162 N (108% +/- 16% body weight). Descriptive statistics and a multiple linear regression analysis were used to relate shoulder distraction to kinematic and kinetic parameters of pitching mechanics. This study was undertaken not only to investigate the peak forces and torques on the shoulder, but also to identify potential areas of intervention that might prevent throwing injuries. Knowledge of joint ranges of motion, angular velocities, and joint-reaction forces can provide a scientific basis for improved preventive and rehabilitative protocols for baseball pitchers.

  4. The shoulder in sports.

    PubMed

    Cofield, R H; Simonet, W T

    1984-03-01

    Many sports activities that involve the upper extremity entail similar patterns of movement. Analysis of these activities, a better understanding of the throwing motion, and an awareness of shoulder diseases or injuries have led to a rational plan for investigation and management of shoulder problems. Evaluation often extends beyond the usual medical boundaries and must be based on information obtained from an analysis of sports mechanics, a review of training methods, and a physical examination directed at determination of flexibility, strength, endurance, and the presence of inflammation. Three common sports injuries are damage to the acromioclavicular joint (shoulder separation), instability of the glenohumeral joint, and a spectrum of pathologic changes in the rotator cuff. Sports that are commonly associated with shoulder problems include swimming, baseball, tennis, football, and gymnastics. Treatment may comprise rest, changes in training methods, an alteration of technique, and a physical rehabilitation program. Surgical treatment has a well-defined role, but it is usually optional.

  5. Intra-Articular Knee Contact Force Estimation During Walking Using Force-Reaction Elements and Subject-Specific Joint Model.

    PubMed

    Jung, Yihwan; Phan, Cong-Bo; Koo, Seungbum

    2016-02-01

    Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and -0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty.

  6. Evaluation of knee joint forces during kneeling work with different kneepads.

    PubMed

    Xu, Hang; Jampala, Sree; Bloswick, Donald; Zhao, Jie; Merryweather, Andrew

    2017-01-01

    The main purpose of this study is to determine knee joint forces resulting from kneeling work with and without kneepads to quantify how different kneepads redistribute force. Eleven healthy males simulated a tile setting task to different locations during six kneepad states (five different kneepad types and without kneepad). Peak and average forces on the anatomical landmarks of both knees were obtained by custom force sensors. The results revealed that kneepad design can significantly modify the forces on the knee joint through redistribution. The Professional Gel design was preferred among the five tested kneepads which was confirmed with both force measurements and participants' responses. The extreme reaching locations induced significantly higher joint forces on left knee or right knee depending on task. The conclusion of this study is that a properly selected kneepad for specific tasks and a more neutral working posture can modify the force distribution on the knees and likely decrease the risk of knee disorders from kneeling work. PMID:27633227

  7. Evaluation of knee joint forces during kneeling work with different kneepads.

    PubMed

    Xu, Hang; Jampala, Sree; Bloswick, Donald; Zhao, Jie; Merryweather, Andrew

    2017-01-01

    The main purpose of this study is to determine knee joint forces resulting from kneeling work with and without kneepads to quantify how different kneepads redistribute force. Eleven healthy males simulated a tile setting task to different locations during six kneepad states (five different kneepad types and without kneepad). Peak and average forces on the anatomical landmarks of both knees were obtained by custom force sensors. The results revealed that kneepad design can significantly modify the forces on the knee joint through redistribution. The Professional Gel design was preferred among the five tested kneepads which was confirmed with both force measurements and participants' responses. The extreme reaching locations induced significantly higher joint forces on left knee or right knee depending on task. The conclusion of this study is that a properly selected kneepad for specific tasks and a more neutral working posture can modify the force distribution on the knees and likely decrease the risk of knee disorders from kneeling work.

  8. Elbow and wrist joint contact forces during occupational pick and place activities.

    PubMed

    Chadwick, E K; Nicol, A C

    2000-05-01

    A three-dimensional, mathematical model of the elbow and wrist joints, including 15 muscle units, 3 ligaments and 4 joint forces, has been developed. A new strain gauge transducer has been developed to measure functional grip forces. The device measures radial forces divided into six components and forces of up to 250N per segment can be measured with an accuracy of +/-1%. Ten normal volunteers were asked to complete four tasks representing occupational activities, during which time their grip force was monitored. Together with kinematic information from the six-camera Vicon data, the moment effect of these loads at the joints was calculated. These external moments are assumed to be balanced by the internal moments, generated by the muscles, passive soft tissue and bone contact. The effectiveness of the body's internal structures in generating joint moments was assessed by studying the geometry of a simplified model of the structures, where information about the lines of action and moment arms of muscles, tendons and ligaments is contained. The assumption of equilibrium between these external and internal joint moments allows formulation of a set of equations from which muscle and joint forces can be calculated. A two stage, linear optimisation routine minimising the overall muscle stress and the sum of the joint forces has been used to overcome the force-sharing problem. Humero-ulnar forces of up to 1600N, humero-radial forces of up to 800N and wrist joint forces of up to 2800N were found for moderate level activity. The model was validated by comparison with other studies.

  9. Sleep position and shoulder pain.

    PubMed

    Zenian, John

    2010-04-01

    The overuse theory for musculoskeletal joint pain cannot explain adequately the occurrence of shoulder pain in those who do not engage in activities that involve repeated and stressful use of the shoulder since the percentage of the painful right shoulders usually does not match the percentage of dominant right arms in such individuals. An alternative hypothesis is presented to propose that shoulder pain is caused by postural immobility in the decubitus or side position during sleep. Prolonged pressure on the shoulder caused by the weight of the thorax can produce enough damage to cause subsequent shoulder pain. In order to test this hypothesis, a preliminary study was carried out to compare the laterality of shoulder pain with the laterality of sleep position. The calculated laterality ratios for sleep position and shoulder pain were found to be strikingly similar, suggesting a causal relationship between the two phenomena. However, the prevalence of shoulder pain in the general population was found to be smaller than the percentage of the time people would spend sleeping in the decubitus position. This discrepancy could be explained by the idea that in order for shoulder pain to develop subjects may have to spend longer times in the same decubitus position before changing to another position than the average person would. Additional evidence from published clinical studies also supports the postural theory of shoulder pain. More studies can be done to test this hypothesis by focusing on the sleep habits of patients with shoulder pain. According to the present hypothesis shoulder pain should for the most part occur on the side that the patient preferred to sleep on before the onset of shoulder pain. The postural theory of shoulder pain provides the possibility for a new and noninvasive method to treat shoulder pain by the modification of posture during sleep.

  10. Joint force protection advanced security system (JFPASS) "the future of force protection: integrate and automate"

    NASA Astrophysics Data System (ADS)

    Lama, Carlos E.; Fagan, Joe E.

    2009-09-01

    The United States Department of Defense (DoD) defines 'force protection' as "preventive measures taken to mitigate hostile actions against DoD personnel (to include family members), resources, facilities, and critical information." Advanced technologies enable significant improvements in automating and distributing situation awareness, optimizing operator time, and improving sustainability, which enhance protection and lower costs. The JFPASS Joint Capability Technology Demonstration (JCTD) demonstrates a force protection environment that combines physical security and Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) defense through the application of integrated command and control and data fusion. The JFPASS JCTD provides a layered approach to force protection by integrating traditional sensors used in physical security, such as video cameras, battlefield surveillance radars, unmanned and unattended ground sensors. The optimization of human participation and automation of processes is achieved by employment of unmanned ground vehicles, along with remotely operated lethal and less-than-lethal weapon systems. These capabilities are integrated via a tailorable, user-defined common operational picture display through a data fusion engine operating in the background. The combined systems automate the screening of alarms, manage the information displays, and provide assessment and response measures. The data fusion engine links disparate sensors and systems, and applies tailored logic to focus the assessment of events. It enables timely responses by providing the user with automated and semi-automated decision support tools. The JFPASS JCTD uses standard communication/data exchange protocols, which allow the system to incorporate future sensor technologies or communication networks, while maintaining the ability to communicate with legacy or existing systems.

  11. Muscle and joint forces under variable equilibrium states of the mandible.

    PubMed

    Rues, Stefan; Lenz, Jürgen; Türp, Jens C; Schweizerhof, Karl; Schindler, Hans J

    2011-10-01

    It is well established that subjects without molars have reduced ability to comminute foods. However, epidemiological studies have indicated that the masticatory system is able to functionally adapt to the absence of posterior teeth. This supports the shortened dental arch concept which, as a prosthetic option, recommends no replacement of missing molars. Biomechanical modeling, however, indicates that using more anterior teeth will result in a larger temporomandibular joint load per unit of bite force. In contrast, changing bite from incisor to molar position increases the maximum possible bite force and reduces joint loads. There have been few attempts, however, to determine realistic joint loads and corresponding muscular effort during generation of occlusal forces similar to those used during chewing with intact or shortened dental arches. Therefore, joint and cumulative muscle loads generated by vertical bite forces of submaximum magnitude moving from canine to molar region, were calculated. Calculations were based on intraoral measurement of the feedback-controlled resultant bite force, simultaneous electromyograms, individual geometrical data of the skull, lines of action, and physiological cross-sectional areas of all jaw muscles. Compared to premolar and canine biting, bilateral and unilateral molar bites reduced cumulative muscle and joint loads in a range from 14% to 33% and 25% to 53%, respectively. During unilateral molar bites, the ipsilateral joints and contralateral muscles were about 20% less loaded than the opposing ones. In conclusion, unilateral or bilateral molar biting at chewing-like force ranges caused the least muscle and joint loading.

  12. A History of Shoulder Surgery

    PubMed Central

    Iqbal, S; Jacobs, U; Akhtar, A; Macfarlane, R.J; Waseem, M

    2013-01-01

    Shoulder surgery has emerged from being a marginalised sub-speciality to being an area of much research and advancement within the last seventy years. This has been despite the complexity of the joint, and success majorly rests on parallel development of biomedical technology. This article looks at the past and present of shoulder surgery and discusses future directions in the speciality. PMID:24082968

  13. Evidence of rapid Cenozoic uplift of the shoulder escarpment of the Cenozoic West Antarctic rift system and a speculation on possible climate forcing

    USGS Publications Warehouse

    Behrendt, John C.; Cooper, A.

    1991-01-01

    The Cenozoic West Antarctic rift system, characterized by Cenozoic bimodal alkalic volcanic rocks, extends over a largely ice-covered area, from the Ross Sea nearly to the Bellingshausen Sea. Various lines of evidence lead to the following interpretation: the transantarctic Mountains part of the rift shoulder (and probably the entire shoulder) has been rising since about 60 Ma, at episodic rates of ~1 km/m.y., most recently since mid-Pliocene Time, rather than continuously at the mean rate of 100 m/m.y. Uplift rates vary along the scarp, which is cut by transverse faults. It is speculated that this uplift may have climatically forced the advance of the Antarctic ice sheet since the most recent warm period. A possible synergistic relation is suggested between episodic tectonism, mountain uplift, and volcanism in the Cenozoic West Antarctic rift system and waxing and waning of the Antarctic ice sheet beginning about earliest Oligocene time. -from Authors

  14. Shoulder pain

    MedlinePlus

    Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

  15. The effects of cycling cadence on the phases of joint power, crank power, force and force effectiveness.

    PubMed

    Ettema, Gertjan; Lorås, Håvard; Leirdal, Stig

    2009-04-01

    We examined the influence of cadence in cycling technique by quantifying phase relationships for a number of important variables at the crank and lower extremity joints. Any difference in the effect of cadence on force, effectiveness, and power phases would indicate an essential change in coordination pattern. Cycle kinetics was recorded for 10 male competitive cyclists at five cadences (60-100 rpm) at submaximal load (260 W). Joint powers were calculated using inverse dynamics methods. All data were expressed as a function of crank position. The phase of the crank mechanical profiles (total force, crank and joint power, and effectiveness) was calculated using four methods: crank angle of maximum (MA) and minimum (MI), fitting a sine wave (SI) and by cross-correlation (XC). These methods, apart from the MA method, showed the same relative phase. The variables, however, showed different phases being expressed as time lag: force effectiveness: 0.131 (+/-0.034)s; total force: 0.149 (+/-0.021)s; power: 0.098 (+/-0.027)s. The phases in joint powers hip 0.071 (+/-0.008), knee 0.082 (+/-0.009), and hip 0.077 (+/-0.012) were only well described by XC, and were somewhat lower than the crank power phase. These differences indicate the potential effect of inertia of the lower limb in phase shifts from joints to crank. Furthermore, the differences between the various crank variables indicate a change of technique with cadence.

  16. Effects of reinnervation of the biarticular shoulder-elbow muscles on joint kinematics and electromyographic patterns of the feline forelimb during downslope walking.

    PubMed

    Livingston, Beven P; Nichols, T Richard

    2014-01-01

    Full recovery of the forelimb kinematics during level and upslope walking following reinnervation of the biarticular elbow extensor suggests that the proprioceptive loss is compensated by other sensory sources or altered central drive, yet these findings have not been explored in downslope walking. Kinematics and muscle activity of the shoulder and elbow during downslope locomotion following reinnervation of the feline long head of the triceps brachii (TLo) and biceps brachii (Bi) were evaluated (1) during paralysis and (2) after the motor function was recovered but the proprioceptive feedback was permanently disrupted. The step cycle was examined in three walking conditions: level (0%), -25% grade (-14° downslope) and -50% grade (-26.6° downslope). Measurements were taken prior to and at three time points (2 weeks, and 1 and 12+ months) after transecting and suturing the radial and musculocutaneous nerves. There was an increase in the yield (increased flexion) at the elbow and less extensor activity duration of flexion during stance as the downslope grade increased. There were two notable periods of eccentric contractions (active lengthening) providing an apparent 'braking' action. Paralysis of the TLo and the Bi resulted in uncompensated alterations in shoulder-elbow kinematics and motor activity during the stance phase. However, unlike the case for the level and upslope conditions, during both paralysis and reinnervation, changes in interjoint coordination persisted for the downslope condition. The lack of complete recovery in the long term suggests that the autogenic reflexes contribute importantly to muscle and joint stiffness during active lengthening.

  17. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    PubMed Central

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  18. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces.

    PubMed

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F; Fregly, Benjamin J; Delp, Scott L; Banks, Scott A; Pandy, Marcus G; D'Lima, Darryl D; Lloyd, David G

    2013-11-15

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.

  19. A leader-follower relationship in joint action on a discrete force production task.

    PubMed

    Masumoto, Junya; Inui, Nobuyuki

    2014-11-01

    The present study examined the development of a leader-follower relationship in joint action performed by participants with different skill levels. Two participants were instructed to produce discrete isometric forces such that the sum of the forces was the target force. The task did not prescribe the onset time or share of force each participant contributed to the target force. Although novices with low force variability did not produce an earlier force than those with high force variability in the novice-novice group, experienced participants produced an earlier force than novices in the novice-experienced group. While participants with low force variability always produced a stronger force than those with high force variability in both the groups, there was no significant difference in force distributions between participants with low and high force variabilities. Although a novice-experienced pair produced force more complementarily than a novice-novice pair in the first practice block, the difference between pairs vanished after the first practice block, suggesting that leader-follower relations were not always beneficial to task performance. In addition, practice of the joint action did not transfer to individual action.

  20. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    PubMed

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A; Cates, Harold E; Zhang, Songning

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  1. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

    PubMed Central

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  2. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    PubMed

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A; Cates, Harold E; Zhang, Songning

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05). No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups.

  3. [Biomechanical analysis of locomotion patterns in the lower limb. II. Forces in joints].

    PubMed

    Gruber, K; Legal, H; Ruder, H

    1983-01-01

    After the introduction of a tri-sectional schematic model of the human body it was possible to investigate the simple dynamic locomotion pattern (braking process after a free fall); from this, the effective weight force and the ground recoil forces could be calculated. Once the external forces and the locomotion pattern are known the forces in the knee and hip joint can be determined with simplified joint structures, both for static bending of the knee as well as for the braking process during locomotion. This general calculation of internal forces is performed according to the so-called cross-section principle, since even this permits a basic comparison to be made between the forces acting at rest and during movement. The calculations show that during movement there is a relatively slight increase in the forces in the hip joint; on the other hand, following a free fall from 1.5 m and up to a kneebending angle of 100 degrees, the bearing force in the knee joint during braking increases to 21 times body weight. Thus, there is a massive increase in the internal forces during movement owing to the need for transmission of torque. Conclusions can be drawn from this concerning the development o much greater than f gonarthrosis in cases where there has been relatively little previous damage (for example), recurrent effusions, slight defects of the leg axes, slight instabilities of capsular ligaments).

  4. Hemiarthroplasty of the shoulder joint using a custom-designed high-density nano-hydroxyapatite/polyamide prosthesis with a polyvinyl alcohol hydrogel humeral head surface in rabbits.

    PubMed

    Guo, Yongwen; Guo, Jun; Bai, Ding; Wang, Hang; Zheng, Xiaohui; Guo, Weihua; Tian, Weidong

    2014-07-01

    In this study, a novel custom-designed high-density nano-hydroxyapatite/polyamide (n-HA/PA) prosthesis with a polyvinyl alcohol (PVA) hydrogel humeral head surface was employed to repair the shoulder joint head for hemiarthroplasty in rabbits. The prosthesis was fabricated using three-dimensional computed tomography and computer-aided design and computer-aided manufacturing systems for perfect fitting. Sixteen New Zealand white rabbits underwent humeral head excision, and received the composite prostheses for hemiarthroplasty. The implant sites were free from suppuration and necrosis at all periods. The X-ray results showed that there was a clear space between the prosthesis head and the glenoid surface, and the joint capsules and surfaces of the glenoid and PVA were well preserved without any damage during the whole inspection period. A high density of bone was observed around the firmware part of the prosthesis. Histological results revealed that significant osteogenesis was surrounding the firmware part, and the joint space was clear and the cartilage of the upper joint surface was basically intact. There was no visible absorption of the joint surfaces even after 3 months of continuous functional motions. The maximum tensile strength between the prosthesis and host bone reached 2.63 MPa at the 12th week postimplantation. In conclusion, the customized prosthesis by combination of PVA and high-density n-HA/PA has excellent biocompatibility and biological fixation, and offers a promising substitute for both the cartilage and the bone of the humeral head in a rabbit model as level V evidence.

  5. Hemiarthroplasty of the shoulder joint using a custom-designed high-density nano-hydroxyapatite/polyamide prosthesis with a polyvinyl alcohol hydrogel humeral head surface in rabbits.

    PubMed

    Guo, Yongwen; Guo, Jun; Bai, Ding; Wang, Hang; Zheng, Xiaohui; Guo, Weihua; Tian, Weidong

    2014-07-01

    In this study, a novel custom-designed high-density nano-hydroxyapatite/polyamide (n-HA/PA) prosthesis with a polyvinyl alcohol (PVA) hydrogel humeral head surface was employed to repair the shoulder joint head for hemiarthroplasty in rabbits. The prosthesis was fabricated using three-dimensional computed tomography and computer-aided design and computer-aided manufacturing systems for perfect fitting. Sixteen New Zealand white rabbits underwent humeral head excision, and received the composite prostheses for hemiarthroplasty. The implant sites were free from suppuration and necrosis at all periods. The X-ray results showed that there was a clear space between the prosthesis head and the glenoid surface, and the joint capsules and surfaces of the glenoid and PVA were well preserved without any damage during the whole inspection period. A high density of bone was observed around the firmware part of the prosthesis. Histological results revealed that significant osteogenesis was surrounding the firmware part, and the joint space was clear and the cartilage of the upper joint surface was basically intact. There was no visible absorption of the joint surfaces even after 3 months of continuous functional motions. The maximum tensile strength between the prosthesis and host bone reached 2.63 MPa at the 12th week postimplantation. In conclusion, the customized prosthesis by combination of PVA and high-density n-HA/PA has excellent biocompatibility and biological fixation, and offers a promising substitute for both the cartilage and the bone of the humeral head in a rabbit model as level V evidence. PMID:24404998

  6. Basic science and clinical application in the athlete's shoulder. A preventative program focusing on the glenohumeral joint.

    PubMed

    Janda, D H; Loubert, P

    1991-10-01

    This program can be implemented as either a preventative program or a rehabilitative program for the upper extremity in the throwing athlete or in nonthrowing athletes involved in overhead activities. The authors have found this program to be easily employed in a university setting. The keystone to its effectiveness is the participating individual. For optimal results, it should be performed as specifically outlined. The likelihood that shoulder symptomatology will develop is higher now that more people are participating in recreational and team sports for cardiovascular fitness. It is, therefore, imperative that a preventative program be developed in both the recreational and professional athletic population.

  7. Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study.

    PubMed

    Kim, Hyun-Min Mike; Chacon, Alexander C; Andrews, Seth H; Roush, Evan P; Cho, Edward; Conaway, William K; Kunselman, Allen R; Lewis, Gregory S

    2016-04-01

    Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion. PMID:26356804

  8. Plastic mechanism analysis of T-joints in RHS under concentrated force

    NASA Astrophysics Data System (ADS)

    Zhao, Xiao-Ling; Hancock, Gregory J.

    1991-11-01

    A new plastic mechanism is developed for T-joints in rectangular hollow sections (RHS) under concentrated loads. This model includes the plastic hinges in the web, the membrane force in the flange and the strain hardening of the material. It can predict the yield load, the post-yield response, and the ultimate load of a T-joint under concentrated force. The model developed is compared with the CIDECT model, the Kato model, and the modified Kato model. The yield load, the post-yield response, and the ultimate load determined from the present model are compared with 6 T-joint tests performed by Zhao and Hancock (1991) and 20 T-joint tests performed by Kato and Nishiyama (1979). The ratio (beta) of the T-joints tested varied from 0.291 to 0.890.

  9. American Indian Policy Review Commission Special Joint Task Force Report on Alaskan Native Issues.

    ERIC Educational Resources Information Center

    Congress of the U.S. Washington, DC. American Indian Policy Review Commission.

    Impact of the Alaskan Native Claims Settlement Act (ANCSA) on Alaskan Natives, particularly at village levels, is the focus of a joint task force report on Alaskan Native issues. Prepared for the American Indian Policy Review Commission, the report is the work of representatives from task forces on tribal government, federal, state, and tribal…

  10. Three-dimensional knee joint contact forces during walking in unilateral transtibial amputees.

    PubMed

    Silverman, Anne K; Neptune, Richard R

    2014-08-22

    Individuals with unilateral transtibial amputations have greater prevalence of osteoarthritis in the intact knee joint relative to the residual leg and non-amputees, but the cause of this greater prevalence is unclear. The purpose of this study was to compare knee joint contact forces and the muscles contributing to these forces between amputees and non-amputees during walking using forward dynamics simulations. We predicted that the intact knee contact forces would be higher than those of the residual leg and non-amputees. In the axial and mediolateral directions, the intact and non-amputee legs had greater peak tibio-femoral contact forces and impulses relative to the residual leg. The peak axial contact force was greater in the intact leg relative to the non-amputee leg, but the stance phase impulse was greater in the non-amputee leg. The vasti and hamstrings muscles in early stance and gastrocnemius in late stance were the largest contributors to the joint contact forces in the non-amputee and intact legs. Through dynamic coupling, the soleus and gluteus medius also had large contributions, even though they do not span the knee joint. In the residual leg, the prosthesis had large contributions to the joint forces, similar to the soleus in the intact and non-amputee legs. These results identify the muscles that contribute to knee joint contact forces during transtibial amputee walking and suggest that the peak knee contact forces may be more important than the knee contact impulses in explaining the high prevalence of intact leg osteoarthritis.

  11. The Business of Bundling: Joining Forces on Joint Replacement.

    PubMed

    Kaldy, Joanne

    2016-03-01

    A mandated bundled-payment program for joint replacement is in place in several regions across the country, and practitioners such as pharmacists are still sorting out their roles in this federal initiative. To get involved, pharmacists need to establish connections with area hospitals and physician groups to promote and document their ability to manage medications, reduce and eliminate medication-related problems and rehospitalizations, and work with patients to maximize adherence and improve communication for those undergoing hip and knee replacement.

  12. Evidence of rapid Cenozoic uplift of the shoulder escarpment of the Cenozoic West Antarctic rift system and a speculation on possible climate forcing

    SciTech Connect

    Behrendt, J.C. ); Cooper, A. )

    1991-04-01

    The Cenzoic West Antarctic rift system, characterized by Cenozoic bimodal alkalic volcanic rocks, extends over a largely ice-covered area, from the Ross Sea nearly to the Bellingshausen Sea. It is bounded on one side by a spectacular 4-to 5-km-high rift-shoulder scarp (maximum bedrock relief 5 to 7 km) from northern Victoria Land-Queen Maud Mountains to the Ellsworth-Whitmore-Horlick Mountains. Jurassic tholeiites crop out with the late Cenozoic volcanic rocks along the section of the Transantarctic Mountains from northern Victoria Land to the Horlick Mountains. The Cenozoic rift shoulder diverges here from the Jurassic tholeiite trend, and the tholeiites are exposed discontinuously along the lower elevation (1-2 km) section of the Transantarctic Mountains to the Weddell Sea. Various lines of evidence, no one of which is independently conclusive, lead the authors (as others have also suggested) to interpret the following. The Transantarctic Mountains part of the rift shoulder (and probably the entire shoulder) has been rising since about 60 Ma, at episodic rates of {approximately}1 km/m.y., most recently since mid-Pliocene time, rather than continuously at the mean rate of 100m/m.y. Uplift rates vary along the scarp, which is cut by transverse faults. The authors speculate that this uplift may have climatically forced the advance of the Antarctic ice sheet since the most recent warm period. They suggest a possible synergistic relation between episodic tectonism, mountain uplift, and volcanism in the Cenozoic West Antarctic rift system and waxing and waning of the Antarctic ice sheet beginning about earliest Oligocene time.

  13. A 3D mathematical model to predict spinal joint and hip joint force for trans-tibial amputees with different SACH foot pylon adjustments.

    PubMed

    Yu, Chung-huang; Hung, Yu-Cheng; Lin, Yang-Hua; Chen, Guan-Xun; Wei, Shun-Hwa; Huang, Chang-Hung; Chen, Chen-Sheng

    2014-09-01

    A solid-ankle cushioned heel (SACH) foot is a non-joint foot without natural ankle function. Trans-tibial amputees may occur toe scuffing in the late swing phase due to a lack of active dorsiflexion. To address this problem, clinical guidelines suggests shortening the pylon to produce a smooth gait. However, this causes a leg length discrepancy, induces asymmetry in the hip joint, and causes an overload of L5/S1 joint force. Therefore, this study aimed to investigate the influence of different prosthesis pylons on the hip joint and L5/S1 joint forces. Ten subjects were recruited using leg length for normalisation. Four different pylon reductions (0%, 1%, 2%, and 3%) were used for gait analysis. A Vicon system and force plates were used to collect kinematic data and ground reaction force, respectively. The software package MATLAB was used to create a mathematical model for evaluating the symmetry and force of the hip joint and the low back force of the L5/S1 joint. The model was validated by the correlation coefficient (CC=0.947) and root mean square (RMS=0.028 BW). The model estimated that the 1% group had a symmetrical hip joint force and a lower L5/S1 joint force in the vertical direction. This study indicates that a 1% pylon shortening on a SACH prosthesis is appropriate for a trans-tibial amputee.

  14. Shoulder Injuries in the Throwing Athlete.

    PubMed

    Altchek; Dines

    1995-05-01

    The throwing athlete with shoulder pain presents a diagnostic and treatment challenge to the orthopaedic surgeon. Because pitching a baseball requires the arm to accelerate at 7,000 degrees per second, tremendous forces are experienced at the shoulder joint. Electromyographic studies have shown that the larger scapular and trunk muscles are primarily responsible for arm acceleration. The smaller and more fragile rotator cuff muscles play a significant role in decelerating the arm. During the entire throwing mechanism, the rotator cuff and the capsulolabral complex act to stabilize the humeral head on the glenoid fossa. As a result, the labrum, the capsule, and the rotator cuff are frequently the site of shoulder injury in throwers. The diagnosis of injury to these structures is based on the findings from the history, physical examination, and imaging studies. The majority of throwing injuries respond well to a carefully designed rehabilitation program. Athletes who do not improve within 6 months are candidates for surgical repair. The procedure is planned so as to minimize the amount of surgical trauma and thereby to facilitate an early return to sport. Arthroscopy is a valuable first step to confirm the pathologic diagnosis. The arthroscope alone is used to perform subacromial debridement, labral repair, or debridement of undersurface partial-thickness rotator cuff tears. If the athlete has clinical evidence of shoulder instability and arthroscopic evidence of capsular stretch, an open stabilization procedure is performed.

  15. Traction-drive force transmission for telerobotic joints

    NASA Technical Reports Server (NTRS)

    Williams, D. M.; Kuban, D. P.

    1989-01-01

    A mechanism which meets the requirements of a teleoperated manipulator and those of an autonomous robot is discussed. The mechanism is a traction-drive differential that uses variable preload mechanisms. The differential provides compact design, with dextrous motion range and torque density similar to geared systems. The traction drive offers high stiffness to backlash for good robotic performance. The variable-loading mechanism (VLM) minimizes the drive-train friction for improved teleoperation. This combination provides a mechanism to allow advanced manipulation with either teleoperated control or autonomous robotic operation. The design principles of both major components of the joint mechanism are described.

  16. Is Lifelong Knee Joint Force from Work, Home, and Sport Related to Knee Osteoarthritis?

    PubMed Central

    Ratzlaff, Charles R.; Koehoorn, Mieke; Cibere, Jolanda; Kopec, Jacek A.

    2012-01-01

    Purpose. To investigate the association of cumulative lifetime knee joint force on the risk of self-reported medically-diagnosed knee osteoarthritis (OA). Methods. Exposure data on lifetime physical activity type (occupational, household, sport/recreation) and dose (frequency, intensity, duration) were collected from 4,269 Canadian men and women as part of the Physical Activity and Joint Heath cohort study. Subjects were ranked in terms of the “cumulative peak force index”, a measure of lifetime mechanical knee force. Multivariable logistic regression was conducted to obtain adjusted effects for mean lifetime knee force on the risk of knee OA. Results. High levels of total lifetime, occupational and household-related force were associated with an increased in risk of OA, with odds ratio's ranging from approximately 1.3 to 2. Joint injury, high BMI and older age were related to risk of knee OA, consistent with previous studies. Conclusions. A newly developed measure of lifetime mechanical knee force from physical activity was employed to estimate the risk of self-reported, medically-diagnosed knee OA. While there are limitations, this paper suggests that high levels of total lifetime force (all domains combined), and occupational force in men and household force in women were risk factors for knee OA. PMID:22848225

  17. A clamping force measurement system for monitoring the condition of bolted joints on railway track joints and points

    NASA Astrophysics Data System (ADS)

    Tesfa, B.; Horler, G.; Thobiani, F. Al; Gu, F.; Ball, A. D.

    2012-05-01

    Many industrial structures associated with railway infrastructures rely on a large number of bolted joint connections to ensure safe and reliable operation of the track and trackside furniture. Significant sums of money are spent annually to repair the damage caused by bolt failures and to maintain the integrity of bolted structures. In the UK, Network Rail (the organization responsible for rail network maintenance and safety) conducts corrective and preventive maintenance manually on 26,000 sets of points (each having approximately 30 bolted joints per set), in order to ensure operational success and safety for the travelling public. Such manual maintenance is costly, disruptive, unreliable and prone to human error. The aim of this work is to provide a means of automatically measuring the clamping force of each individual bolted joint, by means of an instrumented washer. This paper describes the development of a sensor means to be used in the washer, which satisfies the following criteria. Sense changes in the clamping force of the joint and report this fact. Provide compatibility with the large dynamic range of clamping force. Satisfy the limitations in terms of physical size. Provide the means to electronically interface with the washer. Provide a means of powering the washer in situ. Provide a solution at an acceptable cost. Specifically the paper focuses on requirements 1, 2 and 3 and presents the results that support further development of the proposed design and the realization of a pre-prototype system. In the paper, various options for the force sensing element (strain gage, capacitor, piezo-resistive) have been compared, using design optimization techniques. As a result of the evaluation, piezo-resistive sensors in concert with a proprietary force attenuation method, have been found to offer the best performance and cost trade-off The performance of the novel clamping force sensor has been evaluated experimentally and the results show that a smart washer

  18. Computational model of a primate arm: from hand position to joint angles, joint torques and muscle forces

    NASA Astrophysics Data System (ADS)

    Chan, Sherwin S.; Moran, Daniel W.

    2006-12-01

    Three-dimensional reaching by non-human primates is an important behavioral paradigm for investigating representations existing in motor control areas of the brain. Most studies to date have correlated neural activity to a few of the many arm motion parameters including: global hand position or velocity, joint angles, joint angular velocities, joint torques or muscle activations. So far, no single study has been able to incorporate all these parameters in a meaningful way that would allow separation of these often highly correlated variables. This paper introduces a three-dimensional, seven degree-of-freedom computational musculoskeletal model of the macaque arm that translates the coordinates of eight tracking markers placed on the arm into joint angles, joint torques, musculotendon lengths and finally into an optimized prediction of muscle forces. This paper uses this model to illustrate how the classic center-out reaching task used by many researchers over the last 20 years is not optimal in separating out intrinsic, extrinsic, kinematic and kinetic variables. However, by using the musculoskeletal model to design and test novel behavioral movement tasks, a priori, it is possible to disassociate the myriad of movement parameters in motor neurophysiological reaching studies.

  19. Comparison of joint space versus task force load distribution optimization for a multiarm manipulator system

    NASA Technical Reports Server (NTRS)

    Soloway, Donald I.; Alberts, Thomas E.

    1989-01-01

    It is often proposed that the redundancy in choosing a force distribution for multiple arms grasping a single object should be handled by minimizing a quadratic performance index. The performance index may be formulated in terms of joint torques or in terms of the Cartesian space force/torque applied to the body by the grippers. The former seeks to minimize power consumption while the latter minimizes body stresses. Because the cost functions are related to each other by a joint angle dependent transformation on the weight matrix, it might be argued that either method tends to reduce power consumption, but clearly the joint space minimization is optimal. A comparison of these two options is presented with consideration given to computational cost and power consumption. Simulation results using a two arm robot system are presented to show the savings realized by employing the joint space optimization. These savings are offset by additional complexity, computation time and in some cases processor power consumption.

  20. Canine intersegmental hip joint forces and moments before and after cemented total hip replacement.

    PubMed

    Dogan, S; Manley, P A; Vanderby, R; Kohles, S S; Hartman, L M; McBeath, A A

    1991-01-01

    Intersegmental forces and moments (i.e. resultant free body forces and moments computed at the joint centers) were studied in canine hindlimbs before and after cemented total hip replacement (THR). Five large, adult, mixed-breed dogs were selected. Their gait was recorded (while leash-walked) before surgery using high-speed cinematography and a force plate. Cemented total hip replacement was unilaterally performed on each dog. Gait was again recorded at one and four months after surgery. Segmental properties (mass, center of mass, and mass moment of inertia) of the hindlimbs were experimentally determined, and an inverse dynamics approach was used to compute intersegmental forces and moments in the sagittal plane. Significant reductions in intersegmental joint forces and moments were observed in the operated hindlimb one month after surgery, although kinematic gait parameters were unaltered. Decreases of 77.0% for vertical forces, 61.9% for craniocaudal forces, and 66.2% for extension moments were determined. Four months after surgery, the joint forces and moments had returned to their preoperative values. This experiment demonstrates that the dynamics of normal walking can be restored in a canine model by four months after THR. It also shows that kinetic (rather than kinematic) parameters are more descriptive of antalgic gait in the canine. PMID:1856240

  1. Reconstructing for joint angles on the shoulder and elbow from non-invasive electroencephalographic signals through electromyography

    PubMed Central

    Choi, Kyuwan

    2013-01-01

    In this study, first the cortical activities over 2240 vertexes on the brain were estimated from 64 channels electroencephalography (EEG) signals using the Hierarchical Bayesian estimation while 5 subjects did continuous arm reaching movements. From the estimated cortical activities, a sparse linear regression method selected only useful features in reconstructing the electromyography (EMG) signals and estimated the EMG signals of 9 arm muscles. Then, a modular artificial neural network was used to estimate four joint angles from the estimated EMG signals of 9 muscles: one for movement control and the other for posture control. The estimated joint angles using this method have the correlation coefficient (CC) of 0.807 (±0.10) and the normalized root-mean-square error (nRMSE) of 0.176 (±0.29) with the actual joint angles. PMID:24167469

  2. The biomechanical effects of variation in the maximum forces exerted by trunk muscles on the joint forces and moments in the lumbar spine: a finite element analysis.

    PubMed

    Kim, K; Lee, S K; Kim, Y H

    2010-10-01

    The weakening of trunk muscles is known to be related to a reduction of the stabilization function provided by the muscles to the lumbar spine; therefore, strengthening deep muscles might reduce the possibility of injury and pain in the lumbar spine. In this study, the effect of variation in maximum forces of trunk muscles on the joint forces and moments in the lumbar spine was investigated. Accordingly, a three-dimensional finite element model of the lumbar spine that included the trunk muscles was used in this study. The variation in maximum forces of specific muscle groups was then modelled, and joint compressive and shear forces, as well as resultant joint moments, which were presumed to be related to spinal stabilization from a mechanical viewpoint, were analysed. The increase in resultant joint moments occurred owing to decrease in maximum forces of the multifidus, interspinales, intertransversarii, rotatores, iliocostalis, longissimus, psoas, and quadratus lumborum. In addition, joint shear forces and resultant joint moments were reduced as the maximum forces of deep muscles were increased. These results from finite element analysis indicate that the variation in maximum forces exerted by trunk muscles could affect the joint forces and joint moments in the lumbar spine.

  3. [Leading symptom shoulder pain].

    PubMed

    Wittke, R

    2003-09-25

    Pain in the shoulder should prompt a systematic clinical examination that adheres closely to the functional anatomy. The basic examination of the shoulder joint comprises active and passive movements and isometric resistance tests with the aid of which external and internal rotation and abduction/adduction can be investigated. The results of these tests provide the physician with a "pattern of findings" which unequivocally identifies the pain-triggering structure. Accordingly, shoulder pain can be classified into four categories as proposed by Cyriax. As treatment, intra-articular injections of corticoids or local anesthetics as determined by findings, where necessary supported by physiotherapeutic measures. Rupture of a tendon, in particular in the case of an active patient, is an indication for surgery.

  4. A feasibility study for experimentally determining dynamic force distribution in a lap joint.

    SciTech Connect

    Mayes, Randall Lee

    2013-11-01

    Developing constitutive models of the physics in mechanical joints is currently stymied by inability to measure forces and displacements within the joint. The current state of the art estimates whole joint stiffness and energy loss per cycle from external measured force input and one or two acceleration responses. To validate constitutive models beyond this state requires a measurement of the distributed forces and displacements at the joint interface. Unfortunately, introducing measurement devices at the interface completely disrupts the desired physics. A feasibility study is presented for a non-intrusive method of solving for the interface dynamic forces from an inverse problem using full field measured responses. The responses come from the viewable surface of a beam. The noise levels associated with digital image correlation and continuous scanning laser Doppler velocimetry are evaluated from typical beam experiments. Two inverse problems are simulated. One utilizes the extended Sum of Weighted Accelerations Technique (SWAT). The second is a new approach dubbed the method of truncated orthogonal forces. These methods are much more robust if the contact patch geometry is well identified. Various approaches to identifying the contact patch are investigated, including ion marker tracking, Prussian blue and ultrasonic measurements. A typical experiment is conceived for a beam which has a lap joint at one end with a single bolt connecting it to another identical beam. In a virtual test using the beam finite element analysis, it appears that the SWAT inverse method requires evaluation of too many coefficients to adequately identify the force distribution to be viable. However, the method of truncated orthogonal forces appears viable with current digital image correlation (and probably other) imaging techniques.

  5. Minimum detectable change for knee joint contact force estimates using an EMG-driven model

    PubMed Central

    Gardinier, Emily S.; Manal, Kurt; Buchanan, Thomas S.; Snyder-Mackler, Lynn

    2013-01-01

    Adequate test–retest reliability of model estimates is a necessary precursor to examining treatment effects or longitudinal changes in individuals. Purpose The purpose of this study was to establish thresholds for minimal detectable change (MDC) for joint contact forces obtained using a patient specific EMG-driven musculoskeletal model of the knee. Design A sample of young, active individuals was selected for this study, and subjects were tested on 2 separate days. Three-dimensional motion analysis with electromyography (EMG) was used to obtain data from each subject during gait for model input. An EMG-driven modeling approach was used to estimate joint contact forces at each session. Results MDC’s for contact force variables ranged from 0.30 to 0.66 BW. The lowest MDC was for peak medial compartment force (0.30 BW) and the highest was for peak tibiofemoral contact force (0.66 BW). Test–retest reliability coefficients were also reported for comparison with previous work. Conclusions Using the present model, changes in joint contact forces between baseline and subsequent measurements that are greater than these MDCs are greater than typical day-to-day variation and can be identified as real change. PMID:23601782

  6. Neuromusculoskeletal Modeling: Estimation of Muscle Forces and Joint Moments and Movements From Measurements of Neural Command

    PubMed Central

    Buchanan, Thomas S.; Lloyd, David G.; Manal, Kurt; Besier, Thor F.

    2005-01-01

    This paper provides an overview of forward dynamic neuromusculoskeletal modeling. The aim of such models is to estimate or predict muscle forces, joint moments, and/or joint kinematics from neural signals. This is a four-step process. In the first step, muscle activation dynamics govern the transformation from the neural signal to a measure of muscle activation—a time varying parameter between 0 and 1. In the second step, muscle contraction dynamics characterize how muscle activations are transformed into muscle forces. The third step requires a model of the musculoskeletal geometry to transform muscle forces to joint moments. Finally, the equations of motion allow joint moments to be transformed into joint movements. Each step involves complex nonlinear relationships. The focus of this paper is on the details involved in the first two steps, since these are the most challenging to the biomechanician. The global process is then explained through applications to the study of predicting isometric elbow moments and dynamic knee kinetics. PMID:16467928

  7. Preserving the Illustrated Text. Report of the Joint Task Force on Text and Image.

    ERIC Educational Resources Information Center

    Commission on Preservation and Access, Washington, DC.

    The mission of the Joint Task Force on Text and Image was to inquire into the problems, needs, and methods for preserving images in text that are important for scholarship in a wide range of disciplines and to draw from that exploration a set of principles, guidelines, and recommendations for a comprehensive national strategy for image…

  8. SHOULDER DISORDERS AND OCCUPATION

    PubMed Central

    Linaker, CH; Walker-Bone, K

    2016-01-01

    Shoulder pain is very common and causes substantial morbidity. Standardised classification systems based upon presumed patho-anatomical origins have proved poorly reproducible and hampered epidemiological research. Despite this, there is evidence that exposure to combinations of physical workplace strains such as overhead working, heavy lifting and forceful work as well as working in an awkward posture increase the risk of shoulder disorders. Psychosocial risk factors are also associated. There is currently little evidence to suggest that either primary prevention or treatment strategies in the workplace are very effective and more research is required, particularly around the cost-effectiveness of different strategies. PMID:26612238

  9. Management of acromioclavicular joint injuries.

    PubMed

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  10. Measurement of force sense reproduction in the knee joint: application of a new dynamometric device.

    PubMed

    Zavieh, Minoo Khalkhali; Amirshakeri, Bahram; Rezasoltani, Asghar; Talebi, Ghadam Ali; Kalantari, Khosro Khademi; Nedaey, Vahab; Baghban, Alireza Akbarzadeh

    2016-08-01

    [Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint. PMID:27630421

  11. Measurement of force sense reproduction in the knee joint: application of a new dynamometric device.

    PubMed

    Zavieh, Minoo Khalkhali; Amirshakeri, Bahram; Rezasoltani, Asghar; Talebi, Ghadam Ali; Kalantari, Khosro Khademi; Nedaey, Vahab; Baghban, Alireza Akbarzadeh

    2016-08-01

    [Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint.

  12. Measurement of force sense reproduction in the knee joint: application of a new dynamometric device

    PubMed Central

    Zavieh,, Minoo Khalkhali; Amirshakeri,, Bahram; Rezasoltani,, Asghar; Talebi,, Ghadam Ali; Kalantari,, Khosro Khademi; Nedaey,, Vahab; Baghban,, Alireza Akbarzadeh

    2016-01-01

    [Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint.

  13. Measurement of force sense reproduction in the knee joint: application of a new dynamometric device

    PubMed Central

    Zavieh,, Minoo Khalkhali; Amirshakeri,, Bahram; Rezasoltani,, Asghar; Talebi,, Ghadam Ali; Kalantari,, Khosro Khademi; Nedaey,, Vahab; Baghban,, Alireza Akbarzadeh

    2016-01-01

    [Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint. PMID:27630421

  14. In vivo pediatric shoulder muscle volumes and their relationship to 3D strength.

    PubMed

    Im, Hyun Soo; Alter, Katharine E; Brochard, Sylvain; Pons, Christelle; Sheehan, Frances T

    2014-08-22

    In the pediatric shoulder, injury and pathology can disrupt the muscle force balance, resulting in severe functional losses. As little data exists pertaining to in vivo pediatric shoulder muscle function, musculoskeletal data are crucially needed to advance the treatment of pediatric shoulder pathology/injury. Therefore, the purpose of this study was to develop a pediatric database of in vivo volumes for the major shoulder muscles and correlate these volumes with maximum isometric flexion/extension, internal/external rotation, and abduction/adduction joint moments. A methodology was developed to derive 3D shoulder muscle volumes and to divide the deltoid into sub-units with unique torque producing capabilities, based on segmentation of three-dimensional magnetic resonance images. Eleven typically developing children/adolescents (4F/7M, 12.0 ± 3.2 years, 150.8 ± 16.7 cm, 49.2 ± 16.4 kg) participated. Correlation and regression analyses were used to evaluate the relationship between volume and maximum, voluntary, isometric joint torques. The deltoid demonstrated the largest (30.4 ± 1.2%) and the supraspinatus the smallest (4.8 ± 0.5%) percent of the total summed volume of all six muscles evaluated. The anterior and posterior deltoid sections were 43.4 ± 3.9% and 56.6 ± 3.9% of the total deltoid volume. The percent volumes were highly consistent across subjects. Individual muscle volumes demonstrated moderate-high correlations with torque values (0.70-0.94, p<0.001). This study presents a comprehensive database documenting normative pediatric shoulder muscle volume. Using these data a clear relationship between shoulder volume and the torques they produce was established in all three rotational degrees-of-freedom. This study furthers the understanding of shoulder muscle function and serves as a foundation for evaluating shoulder injury/pathology in the pediatric/adolescent population. PMID:24925254

  15. Biomechanical Considerations in the Competitive Swimmer’s Shoulder

    PubMed Central

    Heinlein, Scott A.; Cosgarea, Andrew J.

    2010-01-01

    Context: Competitive swimming has become an increasingly popular sport in the United States. In 2007, more than 250 000 competitive swimmers were registered with USA Swimming, the national governing body. The average competitive swimmer swims approximately 60 000 to 80 000 m per week. With a typical count of 8 to 10 strokes per 25-m lap, each shoulder performs 30 000 rotations each week. This places tremendous stress on the shoulder girdle musculature and glenohumeral joint, and it is why shoulder pain is the most frequent musculoskeletal complaint among competitive swimmers. Evidence Acquisition: Articles were obtained through a variety of medical search sources, including Medline, Google Scholar, and review articles from 1980 through January 2010. Results: The most common cause of shoulder pain in swimmers is supraspinatus tendinopathy. Glenohumeral instability and labral tears have also been reported, but a paucity of information remains regarding prevalence and treatment in swimmers. Conclusion: Because of the great number of stroke repetitions and force generated through the upper extremity, the shoulder is uniquely vulnerable to injury in the competitive swimmer. Comprehensive evaluation should include the entire kinetic chain, including trunk strength and core stability. PMID:23015983

  16. Relationship between muscle forces, joint loading and utilization of elastic strain energy in equine locomotion.

    PubMed

    Harrison, Simon M; Whitton, R Chris; Kawcak, Chris E; Stover, Susan M; Pandy, Marcus G

    2010-12-01

    Storage and utilization of strain energy in the elastic tissues of the distal forelimb of the horse is thought to contribute to the excellent locomotory efficiency of the animal. However, the structures that facilitate elastic energy storage may also be exposed to dangerously high forces, especially at the fastest galloping speeds. In the present study, experimental gait data were combined with a musculoskeletal model of the distal forelimb of the horse to determine muscle and joint contact loading and muscle-tendon work during the stance phase of walking, trotting and galloping. The flexor tendons spanning the metacarpophalangeal (MCP) joint - specifically, the superficial digital flexor (SDF), interosseus muscle (IM) and deep digital flexor (DDF) - experienced the highest forces. Peak forces normalized to body mass for the SDF were 7.3±2.1, 14.0±2.5 and 16.7±1.1 N kg(-1) in walking, trotting and galloping, respectively. The contact forces transmitted by the MCP joint were higher than those acting at any other joint in the distal forelimb, reaching 20.6±2.8, 40.6±5.6 and 45.9±0.9 N kg(-1) in walking, trotting and galloping, respectively. The tendons of the distal forelimb (primarily SDF and IM) contributed between 69 and 90% of the total work done by the muscles and tendons, depending on the type of gait. The tendons and joints that facilitate storage of elastic strain energy in the distal forelimb also experienced the highest loads, which may explain the high frequency of injuries observed at these sites.

  17. Forces in bolted joints: analysis methods and test results utilized for nuclear core applications (LWBR Development Program)

    SciTech Connect

    Crescimanno, P.J.; Keller, K.L.

    1981-03-01

    Analytical methods and test data employed in the core design of bolted joints for the LWBR core are presented. The effects of external working loads, thermal expansion, and material stress relaxation are considered in the formulation developed to analyze joint performance. Extensions of these methods are also provided for bolted joints having both axial and bending flexibilities, and for the effect of plastic deformation on internal forces developed in a bolted joint. Design applications are illustrated by examples.

  18. Force-velocity Relationship of Muscles Performing Multi-joint Maximum Performance Tasks.

    PubMed

    Jaric, S

    2015-08-01

    Manipulation of external loads typically provides a range of force, velocity, and power data that allows for modeling muscle mechanical characteristics. While a typical force-velocity relationship obtained from either in vitro muscles or isolated muscle groups can be described by a hyperbolic equation, the present review paper reveals the evidence that the same relationship obtained from maximum-performance multi-joint movements could be approximately linear. As a consequence, this pattern also results in a relatively simple shape of the power-velocity relationship. The parameters of the linear force-velocity relationship reveal the maximum force, velocity and power. Recent studies conducted on various functional movement tasks reveal that these parameters could be reliable, on average moderately valid, and typically sensitive enough to detect differences among populations of different physical abilities. Therefore, the linear force-velocity relationship together with the associated parabolic power-velocity relationship could provide both a new and simplified approach to studies of the design and function of human muscular system and its modeling. Regarding the practical applications, the reviewed findings also suggest that the loaded multi-joint movements could be developed into relatively simple routine tests of the force-, velocity- and power-generating capacity of the neuromuscular system.

  19. Effect of power-assisted hand-rim wheelchair propulsion on shoulder load in experienced wheelchair users: A pilot study with an instrumented wheelchair.

    PubMed

    Kloosterman, Marieke G M; Buurke, Jaap H; de Vries, Wiebe; Van der Woude, Lucas H V; Rietman, Johan S

    2015-10-01

    This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an instrumented wheelchair on a treadmill while upper-extremity kinematic, kinetic and surface electromyographical data was collected during propulsion with and without power-assist. As a result during power-assisted propulsion the peak resultant force exerted at the hand-rim decreased and was performed with significantly less abduction and internal rotation at the shoulder. At shoulder level the anterior directed force and internal rotation and flexion moments decreased significantly. In addition, posterior and the minimal inferior directed forces and the external rotation moment significantly increased. The stroke angle decreased significantly, as did maximum shoulder flexion, extension, abduction and internal rotation. Stroke-frequency significantly increased. Muscle activation in the anterior deltoid and pectoralis major also decreased significantly. In conclusion, compared to hand-rim propulsion power-assisted propulsion seems effective in reducing potential risk factors of overuse injuries with the highest gain on decreased range of motion of the shoulder joint, lower peak propulsion force on the rim and reduced muscle activity. PMID:26307457

  20. Effect of power-assisted hand-rim wheelchair propulsion on shoulder load in experienced wheelchair users: A pilot study with an instrumented wheelchair.

    PubMed

    Kloosterman, Marieke G M; Buurke, Jaap H; de Vries, Wiebe; Van der Woude, Lucas H V; Rietman, Johan S

    2015-10-01

    This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an instrumented wheelchair on a treadmill while upper-extremity kinematic, kinetic and surface electromyographical data was collected during propulsion with and without power-assist. As a result during power-assisted propulsion the peak resultant force exerted at the hand-rim decreased and was performed with significantly less abduction and internal rotation at the shoulder. At shoulder level the anterior directed force and internal rotation and flexion moments decreased significantly. In addition, posterior and the minimal inferior directed forces and the external rotation moment significantly increased. The stroke angle decreased significantly, as did maximum shoulder flexion, extension, abduction and internal rotation. Stroke-frequency significantly increased. Muscle activation in the anterior deltoid and pectoralis major also decreased significantly. In conclusion, compared to hand-rim propulsion power-assisted propulsion seems effective in reducing potential risk factors of overuse injuries with the highest gain on decreased range of motion of the shoulder joint, lower peak propulsion force on the rim and reduced muscle activity.

  1. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  2. Trunk-pelvis motion, joint loads, and muscle forces during walking with a transtibial amputation.

    PubMed

    Yoder, Adam J; Petrella, Anthony J; Silverman, Anne K

    2015-03-01

    People with unilateral, transtibial amputation (TTA) have an increased prevalence of chronic low back pain (LBP) relative to able-bodied people. However, a definitive cause of increased LBP susceptibility has not been determined. The purpose of this work was to compare dynamic trunk-pelvis biomechanics between people with (n=6) and without (n=6) unilateral TTA during walking using a computational modeling approach. A generic, muscle-actuated whole body model was scaled to each participant, and experimental walking data were used in a static optimization framework to calculate trunk-pelvis motion, L4L5 joint contact forces, and muscle forces within the trunk-pelvis region. Results included several significant between-group differences in trunk-pelvis biomechanics during different phases of the gait cycle. Most significant was greater lateral bending toward the residual side during residual single-limb stance (p<0.01), concurrent with an elevated L4L5 joint contact force (p=0.02) and greater muscle force from the intact-side obliques (p<0.01) in people with TTA relative to able-bodied people. During both double-limb support phases, people with TTA also had a greater range of axial trunk rotation away from the leading limb, concurrent with greater ranges of muscle forces in the erector spinae and obliques. In addition, a greater range of force (p=0.03) in residual-side psoas was found during early residual limb swing in people with TTA. Repeated exposure to atypical motion and joint/muscle loading in people with TTA may contribute to the development of secondary musculoskeletal disorders, including chronic, mechanical LBP.

  3. A biomechanical model correlating shoulder kinetics to pain in young baseball pitchers.

    PubMed

    Keeley, David W; Oliver, Gretchen D; Dougherty, Christopher P

    2012-10-01

    Previous work has postulated that shoulder pain may be associated with increases in both peak shoulder anterior force and peak shoulder proximal force. Unfortunately these relationships have yet to be quantified. Thus, the purpose of this study was to associate these kinetic values with reported shoulder pain in youth baseball pitchers. Nineteen healthy baseball pitchers participated in this study. Segment based reference systems and established calculations were utilized to identify peak shoulder anterior force and peak shoulder proximal force. A medical history questionnaire was utilized to identify shoulder pain. Following collection of these data, the strength of the relationships between both peak shoulder anterior force and peak shoulder proximal force and shoulder pain were analyzed. Although peak anterior force was not significantly correlated to shoulder pain, peak proximal force was. These results lead to the development of a single variable logistic regression model able to accurately predict 84.2% of all cases and 71.4% of shoulder pain cases. This model indicated that for every 1 N increase in peak proximal force, there was a corresponding 4.6% increase in the likelihood of shoulder pain. The magnitude of peak proximal force is both correlated to reported shoulder pain and capable of being used to accurately predict the likelihood of experiencing shoulder pain. It appears that those pitchers exhibiting high magnitudes of peak proximal force are significantly more likely to report experiencing shoulder pain than those who generate lower magnitudes of peak proximal force.

  4. A biomechanical model correlating shoulder kinetics to pain in young baseball pitchers.

    PubMed

    Keeley, David W; Oliver, Gretchen D; Dougherty, Christopher P

    2012-10-01

    Previous work has postulated that shoulder pain may be associated with increases in both peak shoulder anterior force and peak shoulder proximal force. Unfortunately these relationships have yet to be quantified. Thus, the purpose of this study was to associate these kinetic values with reported shoulder pain in youth baseball pitchers. Nineteen healthy baseball pitchers participated in this study. Segment based reference systems and established calculations were utilized to identify peak shoulder anterior force and peak shoulder proximal force. A medical history questionnaire was utilized to identify shoulder pain. Following collection of these data, the strength of the relationships between both peak shoulder anterior force and peak shoulder proximal force and shoulder pain were analyzed. Although peak anterior force was not significantly correlated to shoulder pain, peak proximal force was. These results lead to the development of a single variable logistic regression model able to accurately predict 84.2% of all cases and 71.4% of shoulder pain cases. This model indicated that for every 1 N increase in peak proximal force, there was a corresponding 4.6% increase in the likelihood of shoulder pain. The magnitude of peak proximal force is both correlated to reported shoulder pain and capable of being used to accurately predict the likelihood of experiencing shoulder pain. It appears that those pitchers exhibiting high magnitudes of peak proximal force are significantly more likely to report experiencing shoulder pain than those who generate lower magnitudes of peak proximal force. PMID:23486209

  5. Age and gender differences in the control of vertical ground reaction force by the hip, knee and ankle joints.

    PubMed

    Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

    2015-06-01

    [Purpose] This study examined the relationships between joint moment and the control of the vertical ground reaction force during walking in the elderly and young male and female individuals. [Subjects and Methods] Forty elderly people, 65 years old or older (20 males and 20 females), and 40 young people, 20 to 29 years old (20 males and 20 females), participated in this study. Joint moment and vertical ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Stepwise linear regression analysis determined the joint moments that predict the amplitude of the vertical ground reaction force. [Results] Knee extension moment was related to the vertical ground reaction force in the young males and females. On the other hand, in the elderly females, hip, ankle, and knee joint moments were related to the first peak and second peak forces, and the minimum value of vertical ground reaction force, respectively. [Conclusion] Our results suggest that the young males and females make use of the knee joint moment to control of the vertical ground reaction force. There were differences between the elderly and the young females with regard to the joints used for the control of the vertical ground reaction force.

  6. Age and gender differences in the control of vertical ground reaction force by the hip, knee and ankle joints

    PubMed Central

    Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

    2015-01-01

    [Purpose] This study examined the relationships between joint moment and the control of the vertical ground reaction force during walking in the elderly and young male and female individuals. [Subjects and Methods] Forty elderly people, 65 years old or older (20 males and 20 females), and 40 young people, 20 to 29 years old (20 males and 20 females), participated in this study. Joint moment and vertical ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Stepwise linear regression analysis determined the joint moments that predict the amplitude of the vertical ground reaction force. [Results] Knee extension moment was related to the vertical ground reaction force in the young males and females. On the other hand, in the elderly females, hip, ankle, and knee joint moments were related to the first peak and second peak forces, and the minimum value of vertical ground reaction force, respectively. [Conclusion] Our results suggest that the young males and females make use of the knee joint moment to control of the vertical ground reaction force. There were differences between the elderly and the young females with regard to the joints used for the control of the vertical ground reaction force. PMID:26180331

  7. Relationship Between Hand Contact Angle and Shoulder Loading During Manual Wheelchair Propulsion by Individuals with Paraplegia

    PubMed Central

    Mulroy, Sara J.; Ruparel, Puja; Hatchett, Patricia E.; Haubert, Lisa Lighthall; Eberly, Valerie J.; Gronley, JoAnne K.

    2015-01-01

    Background: Shoulder loading during manual wheelchair propulsion (WCP) contributes to the development of shoulder pain in individuals with spinal cord injury (SCI). Objective: To use regression analysis to investigate the relationships between the hand contact angle (location of the hand on the pushrim at initial contact and release during the push phase of the WCP cycle) with propulsion characteristics, pushrim forces, and shoulder kinetics during WCP in individuals with paraplegia. Methods: Biomechanical data were collected from 222 individuals (198 men and 24 women) with paraplegia from SCI during WCP on a stationary ergometer at a self-selected speed. The average age of participants was 34.7 years (±9.3), mean time since SCI was 9.3 years (±6.1), and average body weight was 74.4 kg (±15.9). The majority (n = 127; 56%) of participants had lower level paraplegia (T8 to L5) and 95 (42%) had high paraplegia (T2 to T7). Results: Increased push arc (mean = 75.3°) was associated with greater velocity (R = 0.384, P < .001) and cycle distance (R = 0.658, P < .001) and reduced cadence (R = -0.419, P < .001). Initial contact angle and hand release angles were equally associated with cycle distance and cadence, whereas a more anterior release angle was associated with greater velocity (R = 0.372, P < .001). When controlling for body weight, a more posterior initial contact angle was associated with greater posterior shoulder net joint force (R = 0.229, P = .001) and greater flexor net joint moment (R = 0.204, P = .002), whereas a more anterior hand release angle was significantly associated with increased vertical (R = 0.270, P < .001) and greater lateral (R = .293, P < .001) pushrim forces; greater shoulder net joint forces in all 3 planes — posterior (R = 0.164, P = .015), superior (R = 0.176, P = .009), and medial (R = 0.284, P < .001); and greater external rotator (R = 0.176, P = .009) and adductor (R = 0.259, P = .001) net joint moments. Conclusions: Current

  8. Normalization of ground reaction forces, joint moments, and free moments in human locomotion.

    PubMed

    Wannop, John W; Worobets, Jay T; Stefanyshyn, Darren J

    2012-12-01

    Authors who report ground reaction force (GRF), free moment (FM), and resultant joint moments usually normalize these variables by division normalization. Normalization parameters include body weight (BW), body weight x height (BWH), and body weight x leg length (BWL). The purpose of this study was to explore the appropriateness of division normalization, power curve normalization, and offset normalization on peak GRF, FM, and resultant joint moments. Kinematic and kinetic data were collected on 98 subjects who walked at 1.2 and 1.8 m/s and ran at 3.4 and 4.0 m/s. Linear curves were best fit to the data, and regression analyses performed to test the significance of the correlations. It was found that the relationship between peak force and BW, as well as joint moments and BW, BWH, and BWL, were not always linear. After division normalization, significant correlations were still found. Power curve and offset normalization, however, were effective at normalizing all variables; therefore, when attempting to normalize GRF and joint moments, perhaps nonlinear or offset methods should be implemented. PMID:23348130

  9. [Stability versus mobility of the shoulder. Biomechanical aspects in athletes].

    PubMed

    Pastor, M F; Smith, T; Struck, M; Wellmann, M

    2014-03-01

    The demand profile of athletes shoulders is high. On the one hand the shoulder has to provide a maximum active range of motion that allows rapid movements of the arm and on the other hand it has to be sufficiently stabilized to decelerate rapid movements and to neutralize the resulting translational forces. Two general types of instability can be differentiated in athletes shoulders: the macroinstability typically occurring in athletes involved in contact sports and the microinstability occurring in athletes involved in overhead sports.Repetitive abduction and external rotation movements of athletes involved in overhead sports lead to adaptation of the glenohumeral joint capsule and ligaments. The anterior capsule becomes stretched while the posterior capsule develops tightness. These adaptations can result in an anterior microinstability as well as posterosuperior impingement (PSI) which implicates a pathological contact of the posterosuperior rotator cuff with the posterior glenoid and which is also associated with SLAP lesions. In contrast the shoulders of swimmers are prone to anterosuperior impingement because the arm stroke involves a forceful combined anteflexion, adduction and internal rotation of the arm.The macroinstability of contact athletes is caused by sufficient trauma and characterized by a structural lesion of capsulolabral or bony lesion. While the empirical recurrence risk of young contact athletes is already high, it can be further impaired by bony defects of the glenoid. In suspected cases, critical glenoid defects should be quantified by computed tomography (CT) scans and treated by bony augmentation of the glenoid.

  10. Avoiding Shoulder Injury from Resistance Training.

    ERIC Educational Resources Information Center

    Durall, Chris J.; Manske, Robert C.; Davies, George J.

    2001-01-01

    Identifies shoulder exercises commonly performed in fitness centers that may contribute to or exacerbate glenohumeral joint (shoulder) injury, describing alternative exercises that may be substituted and a offering rationale for the variations. The article focuses on anterior and posterior glenohumeral instability, subacromial impingement (primary…

  11. Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis

    PubMed Central

    Tragord, Bradley S; Gill, Norman W; Silvernail, Jason L; Teyhen, Deydre S; Allison, Stephen C

    2013-01-01

    Objectives: This study determined biomechanical force parameters and reliability among clinicians performing knee joint mobilizations. Methods: Sixteen subjects with knee osteoarthritis and six therapists participated in the study. Forces were recorded using a capacitive-based pressure mat for three techniques at two grades of mobilization, each with two trials of 15 seconds. Dosage (force–time integral), amplitude, and frequency were also calculated. Analysis of variance was used to analyze grade differences, intraclass correlation coefficients determined reliability, and correlations assessed force associations with subject and rater variables. Results: Grade IV mobilizations produced higher mean forces (P<0.001) and higher dosage (P<0.001), while grade III produced higher maximum forces (P = 0.001). Grade III forces (Newtons) by technique (mean, maximum) were: extension 48, 81; flexion 41, 68; and medial glide 21, 34. Grade IV forces (Newtons) by technique (mean, maximum) were: extension 58, 78; flexion 44, 60; and medial glide 22, 30. Frequency (Hertz) ranged between 0.9–1.1 (grade III) and 1.4–1.6 (grade IV). Intra-clinician reliability was excellent (>0.90). Inter-clinician reliability was moderate for force and dosage, and poor for amplitude and frequency. Discussion: Force measurements were consistent with previously reported ranges and clinical constructs. Grade III and grade IV mobilizations can be distinguished from each other with differences for force and frequency being small, and dosage and amplitude being large. Intra-clinician reliability was excellent for all biomechanical parameters and inter-clinician reliability for dosage, the main variable of clinical interest, was moderate. This study quantified the applied forces among multiple clinicians, which may help determine optimal dosage and standardize care. PMID:24421632

  12. Frozen shoulder - aftercare

    MedlinePlus

    ... syndrome - aftercare; Pericapsulitis - aftercare; Stiff shoulder - aftercare; Shoulder pain - frozen shoulder ... Call your doctor if: The pain in your shoulder is getting worse You re-injure your arm or shoulder Your frozen shoulder is making you feel sad or depressed

  13. Analysis of applied forces and electromyography of back and shoulders muscles when performing a simulated hand scaling task.

    PubMed

    Porter, William; Gallagher, Sean; Torma-Krajewski, Janet

    2010-05-01

    Hand scaling is a physically demanding task responsible for numerous overexertion injuries in underground mining. Scaling requires the miner to use a long pry bar to remove loose rock, reducing the likelihood of rock fall injuries. The experiments described in this article simulated "rib" scaling (scaling a mine wall) from an elevated bucket to examine force generation and electromyographic responses using two types of scaling bars (steel and fiberglass-reinforced aluminum) at five target heights ranging from floor level to 176 cm. Ten male and six female subjects were tested in separate experiments. Peak and average force applied at the scaling bar tip and normalized electromyography (EMG) of the left and right pairs of the deltoid and erectores spinae muscles were obtained. Work height significantly affected peak prying force during scaling activities with highest force capacity at the lower levels. Bar type did not affect force generation. However, use of the lighter fiberglass bar required significantly more muscle activity to achieve the same force. Results of these studies suggest that miners scale points on the rock face that are below their knees, and reposition the bucket as often as necessary to do so. PMID:19800050

  14. Relationship between joint motion and flexor tendon force in the canine forelimb.

    PubMed

    Lieber, R L; Amiel, D; Kaufman, K R; Whitney, J; Gelberman, R H

    1996-11-01

    To increase in vivo tendon force and gliding after flexor tendon repair, a variety of modifications to the methods by which protective passive motion is administered have been advocated. To determine the relationship between the prime variables, wrist and digital position, muscle activation, and in vivo tendon force, a clinically relevant canine model was developed. Force was measured in the flexor tendon during several joint manipulation paradigms: single-finger flexion-extension with the wrist flexed (group 1F), single-finger flexion-extension with the wrist extended (group 1E), four-finger flexion-extension with the wrist flexed (group 4F), four-finger flexion-extension with the wrist extended (group 4E), and synergistic wrist and finger motion where wrist extension and finger flexion were performed simultaneously, followed by wrist flexion and finger extension (group SYN). In addition, tendon force was measured during electric stimulation of the proximal flexor muscle mass. Passive tendon force with the wrist extended (groups 1E and 4E) was two to three times greater than that measured with the wrist flexed, independent of the number of digits moved. With the wrist extended, peak tendon force reached 1,997 g +/- 194 g during single-digit manipulation (group 1E), compared to only 853 g +/- 104 g with the wrist flexed during the same maneuver (group 1F). Statistical comparison between means revealed that groups 1E and 4E were significantly different from groups 1F, 4F, and SYN (p < .005). There were no significant differences between groups 1E and 4E or between groups 1F, 4F, and SYN (p > .200). Active muscle force elicited by electrical stimulation and passive force varied dramatically as the wrist was flexed from full extension 3460 g +/- 766 g to full flexion 427 g +/- 239 g (p < .001). Simultaneously, passive tension decreased from 940 g +/- 143 g with wrist extended to 76 g +/- 37 g with the wrist flexed. These data indicate that wrist position has the

  15. Wrist and digital joint motion produce unique flexor tendon force and excursion in the canine forelimb.

    PubMed

    Lieber, R L; Silva, M J; Amiel, D; Gelberman, R H

    1999-02-01

    The force and excursion within the canine digital flexor tendons were measured during passive joint manipulations that simulate those used during rehabilitation after flexor tendon repair and during active muscle contraction, simulating the active rehabilitation protocol. Tendon force was measured using a small buckle placed upon the tendon while excursion was measured using a suture marker and video analysis method. Passive finger motion imposed with the wrist flexed resulted in dramatically lower tendon force (approximately 5 N) compared to passive motion imposed with the wrist extended (approximately 17 N). Lower excursions were seen at the level of the proximal interphalangeal joint with the wrist flexed (approximately 1.5 mm) while high excursion was observed when the wrist was extended or when synergistic finger and wrist motion were imposed (approximately 3.5 mm). Bivariate discriminant analysis of both force and excursion data revealed a natural clustering of the data into three general mechanical paradigms. With the wrist extended and with either one finger or four fingers manipulated, tendons experienced high loads of approximately 1500 g and high excursions of approximately 3.5 mm. In contrast, the same manipulations performed with the wrist flexed resulted in low tendon forces (4-8 N) and low tendon excursions of approximately 1.5 mm. Synergistic wrist and finger manipulation provided the third paradigm where tendon force was relatively low (approximately 4 N) but excursion was as high as those seen in the groups which were manipulated with the wrist extended. Active muscle contraction produced a modest tendon excursion (approximately 1 mm) and high or low tendon force with the wrist extended or flexed, respectively. These data provide the basis for experimentally testable hypotheses with regard to the factors that most significantly affect functional recovery after digital flexor tendon injury and define the normal mechanical operating characteristics

  16. [Muscle efficiency in total shoulder prosthesis implantation: dependence on position of the humeral head and rotator cuff function].

    PubMed

    Klages, A; Hurschler, C; Wülker, N; Windhagen, H

    2001-09-01

    Modern shoulder prostheses permit an anatomic reconstruction of the joint, although the biomechanical advantages are not proven. The goal of this study was to investigate the relationship between position of the humeral head and function of the shoulder prosthesis (muscle efficiency). Shoulder elevation-motion and rotator cuff defects were simulated in vitro in a robot-assisted shoulder simulator. The EPOCA Custom Offset shoulder prosthesis (Argomedical AG, Cham, CH) was implanted in seven normal shoulders (77 +/- 20 kg, 55 +/- 14 years). Active elevation was simulated by hydraulic cylinders, and scapulothoratic motion by a specially programmed industrial robot. Muscle efficiency (elevation-angle/muscle-force of the deltoid muscle) was measured in anatomic (ANA), medialised (MED) and lateralised (LAT) positions of the humeral head, with or without rotator cuff muscle deficiency. Medialisation increased efficiency by 0.03 +/- 0.04 deg/N (p = 0.022), lateralisation decreased it by 0.04 +/- 0.06 deg/N (p = 0.009). Supraspinatus muscle deficiency increased the deltoid force required to elevate the arm, and thus decreased efficiency (ANA p = 0.091, MED p = 0.018, LAT p = 0.028). The data confirm that the position of the humeral head affects the mechanics of total shoulder arthroplasty. Medialisation increases efficiency of the deltoid muscle and may prove useful in compensating isolated supraspinatus muscle deficiency. Lateralisation, in contrast, leads to an unfavorable situation.

  17. Frozen Shoulder

    MedlinePlus

    ... to control pain and restore motion. Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain ... Surgeons, 2010. Steroid injections. Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder ...

  18. Analysis of knee-joint forces during flexed-knee stance.

    PubMed

    Perry, J; Antonelli, D; Ford, W

    1975-10-01

    Using an instrumented cadaver lower extremity, the forces in the quadriceps, patella, and tibia during flexed-knee stance were measured and the calculated and experimental data were found to correlate with an average discrepancy of 6 per cent. The quadriceps force required to stabilize the knee was 75 per cent of the load on the femoral head at 15 degrees of knee flexion, 210 per cent at 30 degrees, and 410 per cent at 60 degrees. Stresses at the tibiofemoral and patellofemoral joint surfaces increased in similar fashion. The quadriceps force was equivalent to 20 per cent of average maximum quadriceps strength at 15 degrees and to 50 per cent at 30 degrees, as determined from torque tests on five normal subjects.

  19. Practical approach to subject-specific estimation of knee joint contact force

    PubMed Central

    Knarr, Brian A.; Higginson, Jill S.

    2015-01-01

    Compressive forces experienced at the knee can significantly contribute to cartilage degeneration. Musculoskeletal models enable predictions of the internal forces experienced at the knee, but validation is often not possible, as experimental data detailing loading at the knee joint is limited. Recently available data reporting compressive knee force through direct measurement using instrumented total knee replacements offer a unique opportunity to evaluate the accuracy of models. Previous studies have highlighted the importance of subject-specificity in increasing the accuracy of model predictions; however, these techniques may be unrealistic outside of a research setting. Therefore, the goal of our work was to identify a practical approach for accurate prediction of tibiofemoral knee contact force (KCF). Four methods for prediction of knee contact force were compared: (1) standard static optimization, (2) uniform muscle coordination weighting, (3) subject-specific muscle coordination weighting and (4) subject-specific strength adjustments. Walking trials for three subjects with instrumented knee replacements were used to evaluate the accuracy of model predictions. Predictions utilizing subject-specific muscle coordination weighting yielded the best agreement with experimental data, however this method required in vivo data for weighting factor calibration. Including subject-specific strength adjustments improved models’ predictions compared to standard static optimization, with errors in peak KCF less than 0.5 body weight for all subjects. Overall, combining clinical assessments of muscle strength with standard tools available in the OpenSim software package, such as inverse kinematics and static optimization, appears to be a practical method for predicting joint contact force that can be implemented for many applications. PMID:25952546

  20. Practical approach to subject-specific estimation of knee joint contact force.

    PubMed

    Knarr, Brian A; Higginson, Jill S

    2015-08-20

    Compressive forces experienced at the knee can significantly contribute to cartilage degeneration. Musculoskeletal models enable predictions of the internal forces experienced at the knee, but validation is often not possible, as experimental data detailing loading at the knee joint is limited. Recently available data reporting compressive knee force through direct measurement using instrumented total knee replacements offer a unique opportunity to evaluate the accuracy of models. Previous studies have highlighted the importance of subject-specificity in increasing the accuracy of model predictions; however, these techniques may be unrealistic outside of a research setting. Therefore, the goal of our work was to identify a practical approach for accurate prediction of tibiofemoral knee contact force (KCF). Four methods for prediction of knee contact force were compared: (1) standard static optimization, (2) uniform muscle coordination weighting, (3) subject-specific muscle coordination weighting and (4) subject-specific strength adjustments. Walking trials for three subjects with instrumented knee replacements were used to evaluate the accuracy of model predictions. Predictions utilizing subject-specific muscle coordination weighting yielded the best agreement with experimental data; however this method required in vivo data for weighting factor calibration. Including subject-specific strength adjustments improved models' predictions compared to standard static optimization, with errors in peak KCF less than 0.5 body weight for all subjects. Overall, combining clinical assessments of muscle strength with standard tools available in the OpenSim software package, such as inverse kinematics and static optimization, appears to be a practical method for predicting joint contact force that can be implemented for many applications.

  1. An EMG-driven Model to Estimate Muscle Forces and Joint Moments in Stroke Patients

    PubMed Central

    Shao, Qi; Bassett, Daniel N.; Manal, Kurt; Buchanan, Thomas S.

    2009-01-01

    Individuals following stroke exhibit altered muscle activation and movement patterns. Improving the efficiency of gait can be facilitated by knowing which muscles are affected and how they contribute to the pathological pattern. In this paper we present an electromyographically (EMG) driven musculoskeletal model to estimate muscle forces and joint moments. Subject specific EMG for the primary ankle plantar and dorsiflexor muscles, and joint kinematics during walking for four subjects following stroke were used as inputs to the model to predict ankle joint moments during stance. The model’s ability to predict the joint moment was evaluated by comparing the model output with the moment computed using inverse dynamics. The model did predict the ankle moment with acceptable accuracy, exhibiting an average R2 value ranging between 0.87 and 0.92, with RMS errors between 9.7% and 14.7%. The values are in line with previous results for healthy subjects, suggesting that EMG-driven modeling in this population of patients is feasible. It is our hope that such models can provide clinical insight into developing more effective rehabilitation therapies and to assess the effects of an intervention. PMID:19818436

  2. Kinematics of chiropteran shoulder girdle in flight.

    PubMed

    Panyutina, A A; Kuznetsov, A N; Korzun, L P

    2013-03-01

    New data on the mechanisms of movements of the shoulder girdle and humerus of bats are described; potential mobility is compared to the movements actually used in flight. The study was performed on the basis of morphological and functional analysis of anatomical specimens of 15 species, high speed and high definition filming of two species and X-ray survey of Rousettus aegyptiacus flight. Our observations indicate that any excursions of the shoulder girdle in bats have relatively small input in the wing amplitude. Shoulder girdle movements resemble kinematics of a crank mechanism: clavicle plays the role of crank, and scapula-the role of connecting rod. Previously described osseous "locking mechanisms" in shoulder joint of advanced bats do not affect the movements, actually used in flight. The wing beats in bats are performed predominantly by movements of humerus relative to shoulder girdle, although these movements occupy the caudal-most sector of available shoulder mobility. PMID:23381941

  3. Ground reaction forces and lower-limb joint kinetics of turning gait in typically developing children.

    PubMed

    Dixon, Philippe C; Stebbins, Julie; Theologis, Tim; Zavatsky, Amy B

    2014-11-28

    Turning is a common locomotor task essential to daily activity; however, very little is known about the forces and moments responsible for the kinematic adaptations occurring relative to straight-line gait in typically developing children. Thus, the aims of this study were to analyse ground reaction forces (GRFs), ground reaction free vertical torque (TZ), and the lower-limb joint kinetics of 90° outside (step) and inside (spin) limb turns. Step, spin, and straight walking trials from fifty-four typically developing children were analysed. All children were fit with the Plug-in Gait and Oxford Foot Model marker sets while walking over force plates embedded in the walkway. Net internal joint moments and power were computed via a standard inverse dynamics approach. All dependent variables were statistically analysed over the entire curves using the mean difference 95% bootstrap confidence band approach. GRFs were directed medially for step turns and laterally for spin turns during the turning phase. Directions were reversed and magnitudes decreased during the approach phase. Step turns showed reduced ankle power generation, while spin turns showed large TZ. Both strategies required large knee and hip coronal and transverse plane moments during swing. These kinetic differences highlight adaptations required to maintain stability and reorient the body towards the new walking direction during turning. From a clinical perspective, turning gait may better reveal weaknesses and motor control deficits than straight walking in pathological populations, such as children with cerebral palsy, and could potentially be implemented in standard gait analysis sessions.

  4. Upper limb joint kinetic analysis during tennis serve: Assessment of competitive level on efficiency and injury risks.

    PubMed

    Martin, C; Bideau, B; Ropars, M; Delamarche, P; Kulpa, R

    2014-08-01

    The aim of this work was to compare the joint kinetics and stroke production efficiency for the shoulder, elbow, and wrist during the serve between professionals and advanced tennis players and to discuss their potential relationship with given overuse injuries. Eleven professional and seven advanced tennis players were studied with an optoelectronic motion analysis system while performing serves. Normalized peak kinetic values of the shoulder, elbow, and wrist joints were calculated using inverse dynamics. To measure serve efficiency, all normalized peak kinetic values were divided by ball velocity. t-tests were used to determine significant differences between the resultant joint kinetics and efficiency values in both groups (advanced vs professional). Shoulder inferior force, shoulder anterior force, shoulder horizontal abduction torque, and elbow medial force were significantly higher in advanced players. Professional players were more efficient than advanced players, as they maximize ball velocity with lower joint kinetics. Since advanced players are subjected to higher joint kinetics, the results suggest that they appeared more susceptible to high risk of shoulder and elbow injuries than professionals, especially during the cocking and deceleration phases of the serve. PMID:23293868

  5. Understanding shoulder and elbow injuries in baseball.

    PubMed

    Limpisvasti, Orr; ElAttrache, Neal S; Jobe, Frank W

    2007-03-01

    Repetitive overhead throwing exerts significant mechanical stress on the shoulder and elbow joint; this stress can lead to developmental anatomic changes in the young thrower. Asymptomatic pathology in the shoulder and elbow joint is prevalent and, with overuse, can progress to disabling injury. Joint injury occurs as a result of the body's inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage. Identifying and preventing overuse is the key to avoiding injury, particularly in the young pitcher. Injury prevention and rehabilitation should center on optimizing pitching mechanics, core strength, scapular control, and joint range of motion.

  6. AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training.

    PubMed

    Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzutiello, Robert J

    2015-09-08

    The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear  medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics  Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.

  7. The influence of the spine on the shoulder in the throwing athlete.

    PubMed

    Young, J L; Herring, S A; Press, J M; Casazza, B A

    1996-01-01

    Analysis of shoulder dysfunction in throwing and overhead athletes can no longer be restricted to evaluation of the glenohumeral joint alone. The isolated shoulder is incapable of generating the force necessary to hurl a baseball at velocities of 90-100 miles per hour or serve a tennis ball in excess of 120 miles per hour. The purpose of this paper is to provide a literature based theoretical framework for the role of the spine during these activities. The spine is a pivotal component of the kinematic chain which functions as a transfer link between the lower and upper limbs, a force generator capable of accelerating the arm, and a force attenuator which dampens shear forces at the glenohumeral joint during the deceleration phase of the pitching motion. Side bending and rotation of the cervical spine facilitates visual acquisition of the intended target. Inflexibility of the hip musculature and weakness of the muscles which attach to the thoracolumbar fascia have profound effects upon spine function which secondarily places greater stress upon the glenohumeral joint and rotator cuff. Shoulder rehabilitation and injury prevention programs should include evaluation of and exercise regimens for the lumbar, thoracic and cervical spine. PMID:24572551

  8. The influence of the spine on the shoulder in the throwing athlete.

    PubMed

    Young, J L; Herring, S A; Press, J M; Casazza, B A

    1996-01-01

    Analysis of shoulder dysfunction in throwing and overhead athletes can no longer be restricted to evaluation of the glenohumeral joint alone. The isolated shoulder is incapable of generating the force necessary to hurl a baseball at velocities of 90-100 miles per hour or serve a tennis ball in excess of 120 miles per hour. The purpose of this paper is to provide a literature based theoretical framework for the role of the spine during these activities. The spine is a pivotal component of the kinematic chain which functions as a transfer link between the lower and upper limbs, a force generator capable of accelerating the arm, and a force attenuator which dampens shear forces at the glenohumeral joint during the deceleration phase of the pitching motion. Side bending and rotation of the cervical spine facilitates visual acquisition of the intended target. Inflexibility of the hip musculature and weakness of the muscles which attach to the thoracolumbar fascia have profound effects upon spine function which secondarily places greater stress upon the glenohumeral joint and rotator cuff. Shoulder rehabilitation and injury prevention programs should include evaluation of and exercise regimens for the lumbar, thoracic and cervical spine.

  9. The senses of force and heaviness at the human elbow joint.

    PubMed

    Brooks, Jack; Allen, Trevor J; Proske, Uwe

    2013-05-01

    The present-day view of the neural basis for the senses of muscle force and heaviness is that they are generated centrally, within the brain, from copies of motor commands. A corollary of the motor discharge generates a sense of effort which underlies these sensations. In recent experiments on force and heaviness sensations using thumb flexor muscles, a rather different explanation has been invoked: Subjects were proposed to rely predominantly on inputs of a peripheral origin, in particular, the signals of muscle spindles. The present experiments have been carried out at the elbow joint to determine whether these new ideas apply more widely. The effects of fatigue of elbow flexor muscles have been studied in force and heaviness matching tasks using three exercise regimes, a sustained maximum voluntary contraction (MVC), a maintained contraction of 35 % MVC, and a maintained contraction of 35 % MVC combined with muscle vibration at 80 Hz. In force-matching experiments, subjects were required to contract both arms and while the reference arm generated the target force under visual control, it was matched by the indicator arm without visual feedback. During the 100 % MVC exercise, force in the exercising reference arm fell rapidly to almost a half of its original value over 90 s while force in the indicator did not fall, leading to a significant overestimation of the reference force. During the 35 % MVC exercise, subjects also overestimated the reference force and this persisted at 5 and 10 min after the exercise. When 35 % MVC was combined with vibration, the amount by which the indicator arm overestimated the reference force was significantly reduced. In heaviness matching experiments, subjects could move their arms through a small range. The reference arm was loaded with a weight, and weights were added or removed from the indicator until heaviness felt the same in the two arms. There was a small, but significant fall in the matching weight used after 100 % MVC

  10. Density of muscle spindles in prosimian shoulder muscles reflects locomotor adaptation.

    PubMed

    Higurashi, Yasuo; Taniguchi, Yuki; Kumakura, Hiroo

    2006-01-01

    We examined the correlation between the density of muscle spindles in shoulder muscles and the locomotor mode in three species of prosimian primates: the slow loris (Nycticebus coucang), Garnett's galago (Otolemur garnettii), and the ring-tailed lemur (Lemur catta). The shoulder muscles (supraspinatus, infraspinatus, teres major, teres minor, and subscapularis) were embedded in celloidin and cut into transverse serial thin sections (40 microm); then, every tenth section was stained using the Azan staining technique. The relative muscle weights and the density of the muscle spindles were determined. The slow loris muscles were heavier and had sparser muscle spindles, as compared to Garnett's galago. These features suggest that the shoulder muscles of the slow loris are more adapted to generating propulsive force and stabilizing the shoulder joint during locomotion and play a less controlling role in forelimb movements. In contrast, Garnett's galago possessed smaller shoulder muscles with denser spindles that are suitable for the control of more rapid locomotor movements. The mean relative weight and the mean spindle density in the shoulder muscles of the ring-tailed lemur were between those of the other primates, suggesting that the spindle density is not simply a consequence of taxonomic status. PMID:17361082

  11. Density of muscle spindles in prosimian shoulder muscles reflects locomotor adaptation.

    PubMed

    Higurashi, Yasuo; Taniguchi, Yuki; Kumakura, Hiroo

    2006-01-01

    We examined the correlation between the density of muscle spindles in shoulder muscles and the locomotor mode in three species of prosimian primates: the slow loris (Nycticebus coucang), Garnett's galago (Otolemur garnettii), and the ring-tailed lemur (Lemur catta). The shoulder muscles (supraspinatus, infraspinatus, teres major, teres minor, and subscapularis) were embedded in celloidin and cut into transverse serial thin sections (40 microm); then, every tenth section was stained using the Azan staining technique. The relative muscle weights and the density of the muscle spindles were determined. The slow loris muscles were heavier and had sparser muscle spindles, as compared to Garnett's galago. These features suggest that the shoulder muscles of the slow loris are more adapted to generating propulsive force and stabilizing the shoulder joint during locomotion and play a less controlling role in forelimb movements. In contrast, Garnett's galago possessed smaller shoulder muscles with denser spindles that are suitable for the control of more rapid locomotor movements. The mean relative weight and the mean spindle density in the shoulder muscles of the ring-tailed lemur were between those of the other primates, suggesting that the spindle density is not simply a consequence of taxonomic status.

  12. Ability of Sagittal Kinematic Variables to Estimate Ground Reaction Forces and Joint Kinetics in Running

    PubMed Central

    Wille, Christa; Lenhart, Rachel; Wang, Sijian; Thelen, Darryl; Heiderscheit, Bryan

    2015-01-01

    Study Design Controlled laboratory study, cross sectional design. Objective To determine if sagittal kinematic variables can be used to estimate select running kinetics. Background Excessive loading during running has been implicated in a variety of injuries, yet this information is typically not assessed during a standard clinical examination. Developing a clinically feasible strategy to estimate ground reaction forces and joint kinetics may improve the ability to identify those at an increased risk of injury. Methods Three-dimensional kinematics and ground reaction forces of 45 participants were recorded during treadmill running at self-selected speed. Kinematic variables used to estimate specific kinetic metrics included: vertical excursion of the center of mass, foot inclination angle at initial contact, horizontal distance between the center of mass and heel at initial contact, knee flexion angle at initial contact, and peak knee flexion angle during stance. Linear mixed effects models were fitted to explore the association between the kinetic and kinematic measures, including step rate and gender, with final models created using backward variable selection. Results Models were developed to estimate peak knee extensor moment (R2=0.43), energy absorbed at the knee during loading response (R2=0.58), peak patellofemoral joint reaction force (R2=0.55), peak vertical ground reaction force (R2=0.48), braking impulse (R2=0.50), and average vertical loading rate (R2=0.04). Conclusions Our findings suggest that insights into important running kinetics can be obtained from a subset of sagittal plane kinematics common to a clinical running analysis. Of note, the limb posture at initial contact influenced subsequent loading patterns in stance. PMID:25156183

  13. Effects of masticatory muscle force on temporomandibular joint disc growth in rats.

    PubMed

    Sakurai, Makoto; Yonemitsu, Ikuo; Muramoto, Takeshi; Soma, Kunimichi

    2007-12-01

    Biomechanical factors in masticatory function are related to the development of the mandible and the condyle. Previous studies have reported that reduced masticatory muscle force influences mandibular bone formation and chondroblastic proliferation. We examined the importance of compressive force in temporomandibular joint (TMJ) disc growth by reducing the masticatory load. Thirty 3-week-old male Wistar rats were used in this study. In the experimental group, the masseter muscles were bilaterally resected to evaluate the influence of masticatory muscle force on morphology and composition of TMJ disc during growth. No surgery was performed in the control group. The thickness of the TMJ disc was measured to evaluate the morphological changes. The localization of type I collagen and decorin was performed by immunostaining to examine compositional change. Cell proliferation in the disc was identified by insulin-like growth factor-1 receptor (IGF-1r) immunostaining. The disc thickness at each region in the experimental group was reduced compared to the control group. While in the control group, type I collagen and decorin were identified throughout the disc, it was concentrated on the superior portion of the disc at the anterior and posterior bands in the experimental group. The expression of IGF-1r immunopositive cells in the experimental group was also significantly lower than in the control. We conclude that masticatory muscle force is closely related to TMJ disc morphology and composition during growth.

  14. Universal Resource Interface Module (URIM) for the Joint Force Protection Advanced Security System (JFPASS)

    NASA Astrophysics Data System (ADS)

    Cutler, S. H.; Cruickshanks, J. R.; Barngrover, C. M.; Kramer, T. A.; Nans, A. F.

    2009-05-01

    The Joint Force Protection Advanced Security System (JPFASS) is a Department of Defense effort to improve conventional force protection. It is sponsored and managed by Joint Program Manager - Guardian (JPM-G). The main objective of JFPASS is to provide an integrated and layered base defense system, which includes data fusion, Command and Control (C2) nodes, Common Operation Picture (COP) nodes, and full integration of a selected range of robots, sensors, cameras, weapons, tracking systems, and other C2 systems. The URIM is the main integration tool for several sensors, cameras, and weapons in JFPASS. The Universal Resource Interface Module (URIM) is an extremely flexible framework for rapidly integrating new sensors into the JFPASS. Each sensor system has its own proprietary protocol, which makes integration high cost and risk. The URIM communicates directly with each sensor system though a protocol module and maintains a generic data object representation for each sensor. The URIM then performs a translation of the data into a single protocol, in this case Systems Engineering and Integration Working Group (SEIWG) ICD-0100. With this common protocol the data can be provided to a data server for publishing. Also, this allows for network control and management of all sensor systems via any C2 node connected to the data server.

  15. An EMG-driven musculoskeletal model to estimate muscle forces and knee joint moments in vivo.

    PubMed

    Lloyd, David G; Besier, Thor F

    2003-06-01

    This paper examined if an electromyography (EMG) driven musculoskeletal model of the human knee could be used to predict knee moments, calculated using inverse dynamics, across a varied range of dynamic contractile conditions. Muscle-tendon lengths and moment arms of 13 muscles crossing the knee joint were determined from joint kinematics using a three-dimensional anatomical model of the lower limb. Muscle activation was determined using a second-order discrete non-linear model using rectified and low-pass filtered EMG as input. A modified Hill-type muscle model was used to calculate individual muscle forces using activation and muscle tendon lengths as inputs. The model was calibrated to six individuals by altering a set of physiologically based parameters using mathematical optimisation to match the net flexion/extension (FE) muscle moment with those measured by inverse dynamics. The model was calibrated for each subject using 5 different tasks, including passive and active FE in an isokinetic dynamometer, running, and cutting manoeuvres recorded using three-dimensional motion analysis. Once calibrated, the model was used to predict the FE moments, estimated via inverse dynamics, from over 200 isokinetic dynamometer, running and sidestepping tasks. The inverse dynamics joint moments were predicted with an average R(2) of 0.91 and mean residual error of approximately 12 Nm. A re-calibration of only the EMG-to-activation parameters revealed FE moments prediction across weeks of similar accuracy. Changing the muscle model to one that is more physiologically correct produced better predictions. The modelling method presented represents a good way to estimate in vivo muscle forces during movement tasks.

  16. Dynamic MR imaging and stress testing in glenohumeral instability: comparison with normal shoulders and clinical/surgical findings.

    PubMed

    Hodge, D K; Beaulieu, C F; Thabit, G H; Gold, G E; Bergman, A G; Butts, R K; Dillingham, M F; Herfkens, R J

    2001-05-01

    Our objectives were to test the hypotheses that: 1) during shoulder motion, glenohumeral alignment differs between asymptomatic shoulders and those with symptomatic instability; 2) during magnetic resonance (MR)-monitored physical exam or stress testing, glenohumeral alignment differs between asymptomatic shoulders and those with instability; and 3) glenohumeral translation during MR stress testing correlates with findings of shoulder instability by clinical exam and exam under anesthesia (EUA). Using an open-configuration 0.5 T MR imaging (MRI) system, we studied symptomatic shoulders in 11 subjects and compared them to their contralateral asymptomatic shoulders. Each shoulder was studied during abduction/adduction and internal/external rotation to determine the humeral head position on the glenoid. An examiner also performed the MR stress test on each shoulder by applying manual force on the humeral head during imaging. All shoulders were assigned an instability grade from the MR stress test, and this grade was correlated with: 1) clinical exam grade assigned during preoperative assessment by an orthopedic surgeon and 2) intraoperative instability grade by EUA immediately preceding arthroscopy. With dynamic abduction and internal/external rotation, the humeral head remained centered on the glenoid in 9 of 11 shoulders, but in two subjects there were dramatic demonstrations of subluxation. With stress testing, a trend toward more joint laxity was demonstrated in symptomatic than in asymptomatic joints (P = 0.11). MR grading of instability correlated directly with clinical grading in six cases and underestimated the degree of instability relative to clinical exam in the other cases. MR instability grading systematically underestimated instability compared with EUA in 7 of the 10 cases that underwent surgical repair. We concluded that dynamic MR evaluation of glenohumeral alignment did not demonstrate abnormalities in symptomatic shoulders in 8 of 10 patients

  17. Little league shoulder: osteochondrosis of the proximal humeral epiphysis in boy baseball pitchers.

    PubMed

    Adams, J E

    1966-07-01

    Roentgenographic changes consistent with osteochondrosis of the proximal humeral epiphysis were observed in five young baseball pitchers complaining of shoulder pain in the throwing arm. The symptoms and findings were quite similar to the previously reported involvement of the medial epicondylar epiphysis or "Little Leaguer's elbow."The act of throwing a baseball hard is an abnormal whip-like action which places a forceful repetitious traction strain on the shoulder joint. Shoulder pain in youngsters engaged in organized competitive swimming programs can also be explained in this way. Since these entities became evident with the establishment of organized baseball programs for boys in this age group, better medical supervision and rule changes to limit the amount of pitching until the epiphyses close, are urgently needed.

  18. Gimballed Shoulders for Friction Stir Welding

    NASA Technical Reports Server (NTRS)

    Carter, Robert; Lawless, Kirby

    2008-01-01

    In a proposed improvement of tooling for friction stir welding, gimballed shoulders would supplant shoulders that, heretofore, have been fixedly aligned with pins. The proposal is especially relevant to self-reacting friction stir welding. Some definitions of terms, recapitulated from related prior NASA Tech Briefs articles, are prerequisite to a meaningful description of the proposed improvement. In friction stir welding, one uses a tool that includes (1) a rotating shoulder on top (or front) of the workpiece and (2) a pin that rotates with the shoulder and protrudes from the shoulder into the depth of the workpiece. In conventional friction stir welding, the main axial force exerted by the tool on the workpiece is reacted through a ridged backing anvil under (behind) the workpiece. When conventional friction stir welding is augmented with an auto-adjustable pin-tool (APT) capability, the depth of penetration of the pin into the workpiece is varied in real time by a position- or forcecontrol system that extends or retracts the pin as needed to obtain the desired effect. In self-reacting (also known as self-reacted) friction stir welding as practiced heretofore, there are two shoulders: one on top (or front) and one on the bottom (or back) of the workpiece. In this case, a threaded shaft protrudes from the tip of the pin to beyond the back surface of the workpiece. The back shoulder is held axially in place against tension by a nut on the threaded shaft. Both shoulders rotate with the pin and remain aligned coaxially with the pin. The main axial force exerted on the workpiece by the tool and front shoulder is reacted through the back shoulder and the threaded shaft into the friction-stir-welding machine head, so that a backing anvil is no longer needed. A key transmits torque between the bottom shoulder and the threaded shaft, so that the bottom shoulder rotates with the shaft. This concludes the prerequisite definitions of terms.

  19. Static torque-angle relation of human elbow joint estimated with artificial neural network technique.

    PubMed

    Uchiyama, T; Bessho, T; Akazawa, K

    1998-06-01

    Static relations between elbow joint angle and torque at constant muscle activity in normal volunteers were investigated with the aid of an artificial neural network technique. A subject sat on a chair and moved his upper- and forearm in a horizontal plane at the height of his shoulder. The subject was instructed to maintain the elbow joint at a pre-determined angle. The wrist was then pulled to extend the elbow joint by the gravitational force of a weight hanging from a pulley. Integrated electromyograms (IEMGs), elbow and shoulder joint angles and elbow joint torque were measured. Then the relation among IEMGs, joint angles and torque was modeled with the aid of the artificial neural network, where IEMGs and joint angles were the inputs and torque was the output. After back propagation learning, we presented various combinations of IEMGs, shoulder and elbow joint angles to the model and estimated the elbow joint torque to obtain the torque-angle relation for constant muscle activation. The elbow joint torque increased and then decreased with extension of the elbow joint. This suggests that if the forearm is displaced from an equilibrium point, the torque angle relation would not act like a simple spring. In a view of the musculoskeletal structure of the elbow joint, the relation between the elbow joint angle and the moment arm of the elbow flexor muscles seems to have a dominant effect on the torque-angle relation. PMID:9755039

  20. Strength Training and Shoulder Proprioception

    PubMed Central

    Salles, José Inácio; Velasques, Bruna; Cossich, Victor; Nicoliche, Eduardo; Ribeiro, Pedro; Amaral, Marcus Vinicius; Motta, Geraldo

    2015-01-01

    Context: Proprioception is essential to motor control and joint stability during daily and sport activities. Recent studies demonstrated that athletes have better joint position sense (JPS) when compared with controls matched for age, suggesting that physical training could have an effect on proprioception. Objective: To evaluate the result of an 8-week strength-training program on shoulder JPS and to verify whether using training intensities that are the same or divergent for the shoulder's dynamic-stabilizer muscles promote different effects on JPS. Design: Randomized controlled clinical trial. Setting: We evaluated JPS in a research laboratory and conducted training in a gymnasium. Patients or Other Participants: A total of 90 men, right handed and asymptomatic, with no history of any type of injury or shoulder instability. Intervention(s): For 8 weeks, the participants performed the strength-training program 3 sessions per week. We used 4 exercises (bench press, lat pull down, shoulder press, and seated row), with 2 sets each. Main Outcome Measure(s): We measured shoulder JPS acuity by calculating the absolute error. Results: We found an interaction between group and time. To examine the interaction, we conducted two 1-way analyses of variance comparing groups at each time. The groups did not differ at pretraining; however, a difference among groups was noted posttraining. Conclusions: Strength training using exercises at the same intensity produced an improvement in JPS compared with exercises of varying intensity, suggesting that the former resulted in improvements in the sensitivity of muscle spindles and, hence, better neuromuscular control in the shoulder. PMID:25594912

  1. Joint Task Force on Undergraduate Physics Programs (J-TUPP): Overview and Major Findings

    NASA Astrophysics Data System (ADS)

    Heron, Paula

    2016-03-01

    The Joint Task Force on Undergraduate Physics Programs (JTUPP) was formed in response to growing awareness in the physics community that physics majors pursue a wide range of careers after graduation, with very few ending up in academia. The task force is charged with identifying the skills and knowledge that undergraduate physics degree holders should possess to be well prepared for a diverse set of careers, and providing guidance for physicists considering revising the undergraduate curriculum to improve the education of a diverse student population. Task force members represent large and small universities, professional societies, and industry, and have expertise in a broad range of areas including entrepreneurship, physics education research and systemic change in education. We reviewed employment data, surveys of employers, and reports generated by other disciplines. We also met with physicists in selected industries to get their views on the strengths and weaknesses of physics graduates, commissioned a series of interviews with recent physics graduates employed in the private sector, and identified exemplary programs that ensure that all of their students are well prepared to pursue a wide range of career paths. The findings and recommendations will be summarized.

  2. A Case of Septic Arthritis of Shoulder Presenting as Stiffness of the Shoulder

    PubMed Central

    Sambandam, Senthil Nathan; Atturu, Mukesh

    2016-01-01

    Introduction: Septic arthritis of the shoulder is uncommon in adults. It is a surgical emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality. Accurate diagnosis can be particularly challenging in patients with underlying liver disease. MRI is a useful adjunct in early detection of atypical causes of shoulder pain. Case report: A 43 years old male came to our outpatient department with complaints of pain and stiffness of his left shoulder. On examination, his shoulder movements were severely restricted. Further evaluation with MRI revealed septic arthritis of left gleno-humeral joint for which emergency arthroscopic debridement was done. Conclusion: Septic arthritis of shoulder may not present with classical clinical features. Hence, a through clinical and radiological evaluation will help us prognosticate and treat accordingly thereby preventing complications like septic shock, osteomyelitis.

  3. [Differential therapy for the rheumatoid shoulder].

    PubMed

    Schill, S; Thabe, H; Grifka, J

    2002-12-01

    Despite frequent involvement, the rheumatoid shoulder is neglected in operative treatment of the upper extremities. The slow course of omarthritis, the compensation mechanism of scapulothoracic motion and neighbouring joints as well as dominating disabilities of the lower extremities and the rheumatoid hand are possible explanations. The pattern of destruction of the rheumatoid shoulder is characterized by progressive joint and soft tissue deterioration. Soft tissue involvement determines the course of the shoulder joint. The subacromial space is a common and early site for rheumatoid involvement, often leading to bursitis, tenosynovitis of the biceps tendon and rotator cuff rupture. Sonography and MRI enable the early detection of subacromial and glenohumeral pathology before deterioration is visible radiologically. Surgical intervention in patients with rheumatoid arthritis of the shoulder is based on the degree of radiological destruction according to Larsen, the natural course of the shoulder joint and the soft-tissue condition. The goals of surgery are to relieve pain, increase motion and restore shoulder function. Surgery should be carried out early in the course of the disease, thus determining the long-term prognosis and the remaining surgical options. Depending on the pattern of destruction of the rheumatoid shoulder, the options for treatment can be divided into early and late procedures.Joint-preserving surgery is indicated in the early stages of radiological destruction according to Larsen classification O-III, whereas the late stages of destruction (Larsen IV-V) require reconstructive surgery. The introduction of arthroscopic and semiarthroscopic techniques has improved the acceptance of early synovectomy for the rheumatoid shoulder, but there is still a place for open synovectomy in patients with extensive soft-tissue repair and bone-remodelling procedures. Arthroscopic and open synovectomy are supplementary and noncompetitive surgical procedures for

  4. Prediction of hip joint load and translation using musculoskeletal modelling with force-dependent kinematics and experimental validation.

    PubMed

    Zhang, Xuan; Chen, Zhenxian; Wang, Ling; Yang, Wenjian; Li, Dichen; Jin, Zhongmin

    2015-07-01

    Musculoskeletal lower limb models are widely used to predict the resultant contact force in the hip joint as a non-invasive alternative to instrumented implants. Previous musculoskeletal models based on rigid body assumptions treated the hip joint as an ideal sphere with only three rotational degrees of freedom. An musculoskeletal model that considered force-dependent kinematics with three additional translational degrees of freedom was developed and validated in this study by comparing it with a previous experimental measurement. A 32-mm femoral head against a polyethylene cup was considered in the musculoskeletal model for calculating the contact forces. The changes in the main modelling parameters were found to have little influence on the hip joint forces (relative deviation of peak value < 10 BW%, mean trial deviation < 20 BW%). The centre of the hip joint translation was more sensitive to the changes in the main modelling parameters, especially muscle recruitment type (relative deviation of peak value < 20%, mean trial deviation < 0.02 mm). The predicted hip contact forces showed consistent profiles, compared with the experimental measurements, except in the lateral-medial direction. The ratio-average analysis, based on the Bland-Altman's plots, showed better limits of agreement in climbing stairs (mean limits of agreement: -2.0 to 6.3 in walking, mean limits of agreement: -0.5 to 3.1 in climbing stairs). Better agreement of the predicted hip contact forces was also found during the stance phase. The force-dependent kinematics approach underestimated the maximum hip contact force by a mean value of 6.68 ± 1.75% BW compared with the experimental measurements. The predicted maximum translations of the hip joint centres were 0.125 ± 0.03 mm in level walking and 0.123 ± 0.005 mm in climbing stairs.

  5. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    PubMed

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability.

  6. Joint Task Force Andrew: the 44th Medical Brigade mental health staff officer's after action review.

    PubMed

    Holsenbeck, L S

    1994-03-01

    The massive Department of Defense deployment in support of Hurricane Andrew relief cast the military medical departments in a new role. Military medical personnel were challenged to apply the traditional principles of combat medicine to a noncombat environment, within the continental United States, within an existing health care infrastructure, in a role subordinate to local civilian health care agencies. As a medical "subject matter expert" assigned to the Joint Task Force Andrew Surgeon's staff, the author worked at the civil-military interface. The lessons learned in his role as a special staff officer should benefit any health care provider involved in disaster relief. They focus on problem areas peculiar to the disaster relief scenario.

  7. Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

    PubMed Central

    Merolla, G; Nastrucci, G; Porcellini, G

    Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement. PMID:24251240

  8. Comparison of joint kinematics and pedaling force in the young and the elderly

    PubMed Central

    Seo, Jeong-Woo; Kim, Dae-Hyeok; Yang, Seung-Tae; Kang, Dong-Won; Choi, Jin-Seung; Tack, Gye-Rae

    2016-01-01

    [Purpose] Proper pedaling posture can improve muscle strength and cardiopulmonary function. To investigate proper pedaling posture for the elderly, this study compared the pedaling efficiency of the elderly with that of the young by using an index of effectiveness (IE) and kinematic results. [Subjects and Methods] Eight adults in their twenties and eight in their seventies participated in 3-min, 40 rpm cycle pedaling tests, with the same load and cadence. The joint angle, range of motion (ROM), and IE were compared by measuring 3-dimensional motion and 3-axis pedal-reaction force during 4 pedaling phases (Phase 1: 330–30°, Phase 2: 30–150°, Phase 3: 150–210°, and Phase 4: 210–330°). [Results] The knee and ankle ROM, maximum knee extension, and maximum ankle dorsiflexion in the elderly were significantly decreased compared with those in the young. Moreover, there were significant differences in IE for the total phase, Phase 1, and Phase 4 between the elderly and young. IE of the young was greater than that of the elderly, except in Phase 3. [Conclusion] Joint movement in the elderly during pedaling was limited. This study provides information that will facilitate the proposal of an efficient pedaling method for the elderly.

  9. Comparison of joint kinematics and pedaling force in the young and the elderly.

    PubMed

    Seo, Jeong-Woo; Kim, Dae-Hyeok; Yang, Seung-Tae; Kang, Dong-Won; Choi, Jin-Seung; Tack, Gye-Rae

    2016-08-01

    [Purpose] Proper pedaling posture can improve muscle strength and cardiopulmonary function. To investigate proper pedaling posture for the elderly, this study compared the pedaling efficiency of the elderly with that of the young by using an index of effectiveness (IE) and kinematic results. [Subjects and Methods] Eight adults in their twenties and eight in their seventies participated in 3-min, 40 rpm cycle pedaling tests, with the same load and cadence. The joint angle, range of motion (ROM), and IE were compared by measuring 3-dimensional motion and 3-axis pedal-reaction force during 4 pedaling phases (Phase 1: 330-30°, Phase 2: 30-150°, Phase 3: 150-210°, and Phase 4: 210-330°). [Results] The knee and ankle ROM, maximum knee extension, and maximum ankle dorsiflexion in the elderly were significantly decreased compared with those in the young. Moreover, there were significant differences in IE for the total phase, Phase 1, and Phase 4 between the elderly and young. IE of the young was greater than that of the elderly, except in Phase 3. [Conclusion] Joint movement in the elderly during pedaling was limited. This study provides information that will facilitate the proposal of an efficient pedaling method for the elderly. PMID:27630406

  10. Comparison of joint kinematics and pedaling force in the young and the elderly

    PubMed Central

    Seo, Jeong-Woo; Kim, Dae-Hyeok; Yang, Seung-Tae; Kang, Dong-Won; Choi, Jin-Seung; Tack, Gye-Rae

    2016-01-01

    [Purpose] Proper pedaling posture can improve muscle strength and cardiopulmonary function. To investigate proper pedaling posture for the elderly, this study compared the pedaling efficiency of the elderly with that of the young by using an index of effectiveness (IE) and kinematic results. [Subjects and Methods] Eight adults in their twenties and eight in their seventies participated in 3-min, 40 rpm cycle pedaling tests, with the same load and cadence. The joint angle, range of motion (ROM), and IE were compared by measuring 3-dimensional motion and 3-axis pedal-reaction force during 4 pedaling phases (Phase 1: 330–30°, Phase 2: 30–150°, Phase 3: 150–210°, and Phase 4: 210–330°). [Results] The knee and ankle ROM, maximum knee extension, and maximum ankle dorsiflexion in the elderly were significantly decreased compared with those in the young. Moreover, there were significant differences in IE for the total phase, Phase 1, and Phase 4 between the elderly and young. IE of the young was greater than that of the elderly, except in Phase 3. [Conclusion] Joint movement in the elderly during pedaling was limited. This study provides information that will facilitate the proposal of an efficient pedaling method for the elderly. PMID:27630406

  11. The effects of mechanical forces on bones and joints. Experimental study on the rat tail.

    PubMed

    Pazzaglia, U E; Andrini, L; Di Nucci, A

    1997-11-01

    We have used an experimental model employing the bent tail of rats to investigate the effects of mechanical forces on bones and joints. Mechanical strain could be applied to the bones and joints of the tail without direct surgical exposure or the application of pins and wires. The intervertebral disc showed stretched annular lamellae on the convex side, while the annulus fibrosus on the concave side was pinched between the inner corners of the vertebral epiphysis. In young rats with an active growth plate, a transverse fissure appeared at the level of the hypertrophic cell layer or the primary metaphyseal trabecular zone. Metaphyseal and epiphyseal trabeculae on the compressed side were thicker and more dense than those of the distracted part of the vertebra. In growing animals, morphometric analysis of hemiepiphyseal and hemimetaphyseal areas, and the corresponding trabecular bone density, showed significant differences between the compressed and distracted sides. No differences were observed in adult rats. We found no significant differences in osteoclast number between compressed and distracted sides in either age group. Our results provide quantitative evidence of the working of 'Wolff's law'. The differences in trabecular density are examples of remodelling by osteoclasts and osteoblasts; our finding of no significant difference in osteoclast numbers between the hemiepiphyses in the experimental and control groups suggests that the response of living bone to altered strain is mediated by osteoblasts.

  12. The forelimb in walking horses: 2. Net joint moments and joint powers.

    PubMed

    Clayton, H M; Hodson, E; Lanovaz, J L

    2000-07-01

    The objective was to measure the net joint moments and joint powers for the joints of the equine forelimb during the walk. Videographic and force data were combined with morphometric information using an inverse dynamics method. During stance phase the predominant joint moment was on the palmar aspect of all forelimb joints except the shoulder, where the peak moment was considerably higher than at any other joint. The entire forelimb showed net energy absorption in both stance and swing phases. The elbow was the only joint that showed net generation of energy, which was used to maintain the limb in extension in early stance as the horse's body vaults over the limb and to drive protraction and retraction of the limb during swing. The carpus aligned the limb into a supportive strut, but did not play an important role in energy absorption or generation. A small burst of positive work on the flexor aspect at the start of breakover indicated that the carpus played an active role in initiating breakover during walking. The fetlock functioned elastically to store and release strain energy during stance. The coffin joint acted as an energy damper during most of stance with a small burst of energy generation on the flexor aspect as the joint flexed during breakover. The magnitude of the peak joint power during swing decreased in a proximal to distal sequence. It is concluded that the elbow joint is the main site of energy generation. The shoulder and coffin joints act as energy dampers during stance. The distal joints had very low joint powers and appeared to be driven by inertial forces during the swing phase. This information will be applied to describe how horses compensate for different lamenesses in terms of redistributing the functions of energy generation and absorption between joints.

  13. [The effect of the motion of forefoot joint at the force exerted upon the floor during walking exercise].

    PubMed

    Maeda, A; Nishizono, H; Ebashi, H; Shibayama, H

    1993-11-01

    In walking exercise the human body is exposed to external forces. Some of them are produced by constraints such as surface, shoes or opponent. In kick action of walking, the ground reaction force (GRF) is the most important external force. The magnitude of the GRF, its direction, and point of application have an influence on the load on the human body. The purpose of this study is to clarify the role of forefoot joint (artt. metatarsophalangeae) at the force exerted upon the floor during kick action of walking. The device used in this study to analyze the GRF and its three components consists of Kistler's force platform. Output from force transducer was collected online with a TEAC data recorder and MEM-4101 minicomputer. The impact force measurements were taken from the anterior-posterior force time curves at the take-off for 1 subject walking 10 trials at 2 m/sec with 2 different pairs of shoes (Shoes 1: thin sole of 4mm, and Shoes 2: thick sole of 40mm) and without shoes. High speed (200f/sec) cinematography was also used to analyze the angular displacement of forefoot joint at the take-off of walking exercise. The force acting at the forefoot joint may produce the anterior-posterior force of the GRF which is defined as the propelling power acting on the human body during walking exercise. The result showed that the impact force peak occurred 40-60 msec before take-off and the propelling part of kick action accounted for only about 6% of the external force.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8123187

  14. Effects of EMG processing on biomechanical models of muscle joint systems: sensitivity of trunk muscle moments, spinal forces, and stability.

    PubMed

    Staudenmann, Didier; Potvin, Jim R; Kingma, Idsart; Stegeman, Dick F; van Dieën, Jaap H

    2007-01-01

    Biomechanical models are in use to estimate parameters such as contact forces and stability at various joints. In one class of these models, surface electromyography (EMG) is used to address the problem of mechanical indeterminacy such that individual muscle activation patterns are accounted for. Unfortunately, because of the stochastical properties of EMG signals, EMG based estimates of muscle force suffer from substantial estimation errors. Recent studies have shown that improvements in muscle force estimation can be achieved through adequate EMG processing, specifically whitening and high-pass (HP) filtering of the signals. The aim of this paper is to determine the effect of such processing on outcomes of a biomechanical model of the lumbosacral joint and surrounding musculature. Goodness of fit of estimated muscle moments to net moments and also estimated joint stability significantly increased with increasing cut-off frequencies in HP filtering, whereas no effect on joint contact forces was found. Whitening resulted in moment estimations comparable to those obtained from optimal HP filtering with cut-off frequencies over 250 Hz. Moreover, compared to HP filtering, whitening led to a further increase in estimated joint-stability. Based on theoretical models and on our experimental results, we hypothesize that the processing leads to an increase in pick-up area. This then would explain the improvements from a better balance between deep and superficial motor unit contributions to the signal. PMID:16765965

  15. Bite force in the extant coelacanth Latimeria: the role of the intracranial joint and the basicranial muscle.

    PubMed

    Dutel, Hugo; Herbin, Marc; Clément, Gaël; Herrel, Anthony

    2015-05-01

    The terrestrialization process involved dramatic changes in the cranial anatomy of vertebrates. The braincase, which was initially divided into two portions by the intracranial joint in sarcopterygian fishes, became consolidated into a single unit in tetrapods and lungfishes [1-3]. The coelacanth Latimeria is the only extant vertebrate that retains an intracranial joint, which is associated with a unique paired muscle: the basicranial muscle. The intracranial joint has long been thought to be involved in suction feeding by allowing an extensive elevation of the anterior portion of the skull, followed by its rapid depression driven by the basicranial muscle [4-7]. However, we recently challenged this hypothesis [8, 9], and the role of the basicranial muscle with respect to the intracranial joint thus remains unclear. Using 3D biomechanical modeling, we show here that the basicranial muscle and the intracranial joint are involved in biting force generation. By flexing the anterior portion of the skull at the level of the intracranial joint, the basicranial muscle increases the overall bite force. This likely allows Latimeria to feed on a broad range of preys [10, 11] and coelacanths to colonize a wide range of environments during their evolution [4]. The variation in the morphology of the intracranial joint observed in Devonian lobe-finned fishes would have impacted to various degrees their biting performance and might have permitted feeding specializations despite the stability in their lower jaw morphology [12]. VIDEO ABSTRACT.

  16. Mathematical Model and Calibration Experiment of a Large Measurement Range Flexible Joints 6-UPUR Six-Axis Force Sensor.

    PubMed

    Zhao, Yanzhi; Zhang, Caifeng; Zhang, Dan; Shi, Zhongpan; Zhao, Tieshi

    2016-08-11

    Nowadays improving the accuracy and enlarging the measuring range of six-axis force sensors for wider applications in aircraft landing, rocket thrust, and spacecraft docking testing experiments has become an urgent objective. However, it is still difficult to achieve high accuracy and large measuring range with traditional parallel six-axis force sensors due to the influence of the gap and friction of the joints. Therefore, to overcome the mentioned limitations, this paper proposed a 6-Universal-Prismatic-Universal-Revolute (UPUR) joints parallel mechanism with flexible joints to develop a large measurement range six-axis force sensor. The structural characteristics of the sensor are analyzed in comparison with traditional parallel sensor based on the Stewart platform. The force transfer relation of the sensor is deduced, and the force Jacobian matrix is obtained using screw theory in two cases of the ideal state and the state of flexibility of each flexible joint is considered. The prototype and loading calibration system are designed and developed. The K value method and least squares method are used to process experimental data, and in errors of kind Ι and kind II linearity are obtained. The experimental results show that the calibration error of the K value method is more than 13.4%, and the calibration error of the least squares method is 2.67%. The experimental results prove the feasibility of the sensor and the correctness of the theoretical analysis which are expected to be adopted in practical applications.

  17. Mathematical Model and Calibration Experiment of a Large Measurement Range Flexible Joints 6-UPUR Six-Axis Force Sensor

    PubMed Central

    Zhao, Yanzhi; Zhang, Caifeng; Zhang, Dan; Shi, Zhongpan; Zhao, Tieshi

    2016-01-01

    Nowadays improving the accuracy and enlarging the measuring range of six-axis force sensors for wider applications in aircraft landing, rocket thrust, and spacecraft docking testing experiments has become an urgent objective. However, it is still difficult to achieve high accuracy and large measuring range with traditional parallel six-axis force sensors due to the influence of the gap and friction of the joints. Therefore, to overcome the mentioned limitations, this paper proposed a 6-Universal-Prismatic-Universal-Revolute (UPUR) joints parallel mechanism with flexible joints to develop a large measurement range six-axis force sensor. The structural characteristics of the sensor are analyzed in comparison with traditional parallel sensor based on the Stewart platform. The force transfer relation of the sensor is deduced, and the force Jacobian matrix is obtained using screw theory in two cases of the ideal state and the state of flexibility of each flexible joint is considered. The prototype and loading calibration system are designed and developed. The K value method and least squares method are used to process experimental data, and in errors of kind Ι and kind II linearity are obtained. The experimental results show that the calibration error of the K value method is more than 13.4%, and the calibration error of the least squares method is 2.67%. The experimental results prove the feasibility of the sensor and the correctness of the theoretical analysis which are expected to be adopted in practical applications. PMID:27529244

  18. Mathematical Model and Calibration Experiment of a Large Measurement Range Flexible Joints 6-UPUR Six-Axis Force Sensor.

    PubMed

    Zhao, Yanzhi; Zhang, Caifeng; Zhang, Dan; Shi, Zhongpan; Zhao, Tieshi

    2016-01-01

    Nowadays improving the accuracy and enlarging the measuring range of six-axis force sensors for wider applications in aircraft landing, rocket thrust, and spacecraft docking testing experiments has become an urgent objective. However, it is still difficult to achieve high accuracy and large measuring range with traditional parallel six-axis force sensors due to the influence of the gap and friction of the joints. Therefore, to overcome the mentioned limitations, this paper proposed a 6-Universal-Prismatic-Universal-Revolute (UPUR) joints parallel mechanism with flexible joints to develop a large measurement range six-axis force sensor. The structural characteristics of the sensor are analyzed in comparison with traditional parallel sensor based on the Stewart platform. The force transfer relation of the sensor is deduced, and the force Jacobian matrix is obtained using screw theory in two cases of the ideal state and the state of flexibility of each flexible joint is considered. The prototype and loading calibration system are designed and developed. The K value method and least squares method are used to process experimental data, and in errors of kind Ι and kind II linearity are obtained. The experimental results show that the calibration error of the K value method is more than 13.4%, and the calibration error of the least squares method is 2.67%. The experimental results prove the feasibility of the sensor and the correctness of the theoretical analysis which are expected to be adopted in practical applications. PMID:27529244

  19. Spacecraft environmental interactions: A joint Air Force and NASA research and technology program

    NASA Technical Reports Server (NTRS)

    Pike, C. P.; Purvis, C. K.; Hudson, W. R.

    1985-01-01

    A joint Air Force/NASA comprehensive research and technology program on spacecraft environmental interactions to develop technology to control interactions between large spacecraft systems and the charged-particle environment of space is described. This technology will support NASA/Department of Defense operations of the shuttle/IUS, shuttle/Centaur, and the force application and surveillance and detection missions, planning for transatmospheric vehicles and the NASA space station, and the AFSC military space system technology model. The program consists of combined contractual and in-house efforts aimed at understanding spacecraft environmental interaction phenomena and relating results of ground-based tests to space conditions. A concerted effort is being made to identify project-related environmental interactions of concern. The basic properties of materials are being investigated to develop or modify the materials as needed. A group simulation investigation is evaluating basic plasma interaction phenomena to provide inputs to the analytical modeling investigation. Systems performance is being evaluated by both groundbased tests and analysis.

  20. Verification of joint input-state estimation for force identification by means of in situ measurements on a footbridge

    NASA Astrophysics Data System (ADS)

    Maes, K.; Nimmen, K. Van; Lourens, E.; Rezayat, A.; Guillaume, P.; Roeck, G. De; Lombaert, G.

    2016-06-01

    This paper presents a verification of a joint input-state estimation algorithm using data obtained from in situ experiments on a footbridge. The estimation of the input and the system states is performed in a minimum-variance unbiased way, based on a limited number of response measurements and a system model. A dynamic model of the footbridge is obtained using a detailed finite element model that is updated using a set of experimental modal characteristics. The joint input-state estimation algorithm is used for the identification of two impact, harmonic, and swept sine forces applied to the bridge deck. In addition to these forces, unknown stochastic forces, such as wind loads, are acting on the structure. These forces, as well as measurement errors, give rise to uncertainty in the estimated forces and system states. Quantification of the uncertainty requires determination of the power spectral density of the unknown stochastic excitation, which is identified from the structural response under ambient loading. The verification involves comparing the estimated forces with the actual, measured forces. Although a good overall agreement is obtained between the estimated and measured forces, modeling errors prohibit a proper distinction between multiple forces applied to the structure for the case of harmonic and swept sine excitation.

  1. The effect of perturbing body segment parameters on calculated joint moments and muscle forces during gait.

    PubMed

    Wesseling, Mariska; de Groote, Friedl; Jonkers, Ilse

    2014-01-22

    This study examined the effect of body segment parameter (BSP) perturbations on joint moments calculated using an inverse dynamics procedure and muscle forces calculated using computed muscle control (CMC) during gait. BSP (i.e. segment mass, center of mass location (com) and inertia tensor) of the left thigh, shank and foot of a scaled musculoskeletal model were perturbed. These perturbations started from their nominal value and were adjusted to ±40% in steps of 10%, for both individual as well as combined perturbations in BSP. For all perturbations, an inverse dynamics procedure calculated the ankle, knee and hip moments based on an identical inverse kinematics solution. Furthermore, the effect of applying a residual reduction algorithm (RRA) was investigated. Muscle excitations and resulting muscle forces were calculated using CMC. The results show only a limited effect of an individual parameter perturbation on the calculated moments, where the largest effect is found when perturbing the shank com (MS(com,shank), the ratio of absolute difference in torque and relative parameter perturbation, is maximally -7.81 N m for hip flexion moment). The additional influence of perturbing two parameters simultaneously is small (MS(mass+com,thigh) is maximally 15.2 N m for hip flexion moment). RRA made small changes to the model to increase the dynamic consistency of the simulation (after RRA MS(com,shank) is maximally 5.01 N m). CMC results show large differences in muscle forces when BSP are perturbed. These result from the underlying forward integration of the dynamic equations. PMID:24332615

  2. The effect of perturbing body segment parameters on calculated joint moments and muscle forces during gait.

    PubMed

    Wesseling, Mariska; de Groote, Friedl; Jonkers, Ilse

    2014-01-22

    This study examined the effect of body segment parameter (BSP) perturbations on joint moments calculated using an inverse dynamics procedure and muscle forces calculated using computed muscle control (CMC) during gait. BSP (i.e. segment mass, center of mass location (com) and inertia tensor) of the left thigh, shank and foot of a scaled musculoskeletal model were perturbed. These perturbations started from their nominal value and were adjusted to ±40% in steps of 10%, for both individual as well as combined perturbations in BSP. For all perturbations, an inverse dynamics procedure calculated the ankle, knee and hip moments based on an identical inverse kinematics solution. Furthermore, the effect of applying a residual reduction algorithm (RRA) was investigated. Muscle excitations and resulting muscle forces were calculated using CMC. The results show only a limited effect of an individual parameter perturbation on the calculated moments, where the largest effect is found when perturbing the shank com (MS(com,shank), the ratio of absolute difference in torque and relative parameter perturbation, is maximally -7.81 N m for hip flexion moment). The additional influence of perturbing two parameters simultaneously is small (MS(mass+com,thigh) is maximally 15.2 N m for hip flexion moment). RRA made small changes to the model to increase the dynamic consistency of the simulation (after RRA MS(com,shank) is maximally 5.01 N m). CMC results show large differences in muscle forces when BSP are perturbed. These result from the underlying forward integration of the dynamic equations.

  3. 78 FR 73884 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-Joint Task-Force...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-09

    ...''), Joint Task-Force Networked Media (``JT-NM'') has filed written notifications simultaneously with the...; Harman International, Stamford, CT; Janet West (individual member), Reading, United Kingdom, Nicole... to file additional written notifications disclosing all changes in membership. On July 10, 2013,...

  4. Shoulder Kinematics and Spatial Pattern of Trapezius Electromyographic Activity in Real and Virtual Environments

    PubMed Central

    Samani, Afshin; Pontonnier, Charles; Dumont, Georges; Madeleine, Pascal

    2015-01-01

    The design of an industrial workstation tends to include ergonomic assessment steps based on a digital mock-up and a virtual reality setup. Lack of interaction and system fidelity is often reported as a main issue in such virtual reality applications. This limitation is a crucial issue as thorough ergonomic analysis is required for an investigation of the biomechanics. In the current study, we investigated the biomechanical responses of the shoulder joint in a simulated assembly task for comparison with the biomechanical responses in virtual environments. Sixteen male healthy novice subjects performed the task on three different platforms: real (RE), virtual (VE), and virtual environment with force feedback (VEF) with low and high precision demands. The subjects repeated the task 12 times (i.e., 12 cycles). High density electromyography from the upper trapezius and rotation angles of the shoulder joint were recorded and split into the cycles. The angular trajectories and velocity profiles of the shoulder joint angles over a cycle were computed in 3D. The inter-subject similarity in terms of normalized mutual information on kinematics and electromyography was investigated. Compared with RE the task in VE and VEF was characterized by lower kinematic maxima. The inter-subject similarity in RE compared with intra-subject similarity across the platforms was lower in terms of movement trajectories and greater in terms of trapezius muscle activation. The precision demand resulted in lower inter- and intra-subject similarity across platforms. The proposed approach identifies biomechanical differences in the shoulder joint in both VE and VEF compared with the RE platform, but these differences are less marked in VE mostly due to technical limitations of co-localizing the force feedback system in the VEF platform. PMID:25768123

  5. A neural network approach for determining gait modifications to reduce the contact force in knee joint implant.

    PubMed

    Ardestani, Marzieh Mostafavizadeh; Chen, Zhenxian; Wang, Ling; Lian, Qin; Liu, Yaxiong; He, Jiankang; Li, Dichen; Jin, Zhongmin

    2014-10-01

    There is a growing interest in non-surgical gait rehabilitation treatments to reduce the loading in the knee joint. In particular, synergetic kinematic changes required for joint offloading should be determined individually for each subject. Previous studies for gait rehabilitation designs are typically relied on a "trial-and-error" approach, using multi-body dynamic (MBD) analysis. However MBD is fairly time demanding which prevents it to be used iteratively for each subject. This study employed an artificial neural network to develop a cost-effective computational framework for designing gait rehabilitation patterns. A feed forward artificial neural network (FFANN) was trained based on a number of experimental gait trials obtained from literature. The trained network was then hired to calculate the appropriate kinematic waveforms (output) needed to achieve desired knee joint loading patterns (input). An auxiliary neural network was also developed to update the ground reaction force and moment profiles with respect to the predicted kinematic waveforms. The feasibility and efficiency of the predicted kinematic patterns were then evaluated through MBD analysis. Results showed that FFANN-based predicted kinematics could effectively decrease the total knee joint reaction forces. Peak values of the resultant knee joint forces, with respect to the bodyweight (BW), were reduced by 20% BW and 25% BW in the midstance and the terminal stance phases. Impulse values of the knee joint loading patterns were also decreased by 17% BW*s and 24%BW*s in the corresponding phases. The FFANN-based framework suggested a cost-effective forward solution which directly calculated the kinematic variations needed to implement a given desired knee joint loading pattern. It is therefore expected that this approach provides potential advantages and further insights into knee rehabilitation designs.

  6. Validation of Shoulder Response of Human Body Finite-Element Model (GHBMC) Under Whole Body Lateral Impact Condition.

    PubMed

    Park, Gwansik; Kim, Taewung; Panzer, Matthew B; Crandall, Jeff R

    2016-08-01

    In previous shoulder impact studies, the 50th-percentile male GHBMC human body finite-element model was shown to have good biofidelity regarding impact force, but under-predicted shoulder deflection by 80% compared to those observed in the experiment. The goal of this study was to validate the response of the GHBMC M50 model by focusing on three-dimensional shoulder kinematics under a whole-body lateral impact condition. Five modifications, focused on material properties and modeling techniques, were introduced into the model and a supplementary sensitivity analysis was done to determine the influence of each modification to the biomechanical response of the body. The modified model predicted substantially improved shoulder response and peak shoulder deflection within 10% of the observed experimental data, and showed good correlation in the scapula kinematics on sagittal and transverse planes. The improvement in the biofidelity of the shoulder region was mainly due to the modifications of material properties of muscle, the acromioclavicular joint, and the attachment region between the pectoralis major and ribs. Predictions of rib fracture and chest deflection were also improved because of these modifications.

  7. Assessing Finger Joint Biomechanics by Applying Equal Force to Flexor Tendons In Vitro Using a Novel Simultaneous Approach

    PubMed Central

    Yang, Tai-Hua; Lu, Szu-Ching; Lin, Wei-Jr; Zhao, Kristin; Zhao, Chunfeng; An, Kai-Nan; Jou, I-Ming; Lee, Pei-Yuan

    2016-01-01

    Background The flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) are critical for finger flexion. Although research has recently focused on these tendons’ coactivity, their contributions in different tasks remain unclear. This study created a novel simultaneous approach to investigate the coactivity between the tendons and to clarify their contributions in different tasks. Methods Ten human cadaveric hands were mounted on our custom frame with the FDS and FDP of the third finger looped through a mechanical pulley connected to a force transducer. Joint range of motion, tendon excursion and loading force were recorded during individual joint motion and free joint movement from rest to maximal flexion. Each flexor tendon’s moment arm was then calculated. Results In individual motions, we found that the FDP contributed more than the FDS in proximal interphalangeal (PIP) joint motion, with an overall slope of 1.34 and all FDP-to-FDS excursion (P/S) ratios greater than 1.0 with force increase. However, the FDP contributed less than the FDS in metacarpophalangeal (MCP) joint motion, with an overall slope of 0.95 and P/S ratios smaller than 1.0 throughout the whole motion except between 1.9% and 13.1% force. In free joint movement, the FDP played a greater role than the FDS, with an overall ratio of 1.37 and all P/S ratios greater than 1.0. Conclusions The new findings include differences in finger performance and excursion amounts between the FDS and FDP throughout flexion. Such findings may provide the basis for new hand models and treatments. PMID:27513744

  8. [Management of the worker affected by shoulder pathology].

    PubMed

    Rotini, Roberto; Bonfiglioli, Roberta

    2014-01-01

    Shoulder disorders due to overexertion include joint and soft tissues chronic conditions and are an important cause of disability. Shoulder pain is one of the most common musculoskeletal disorders and has been associated to manual handling of heavy loads, high repetition jobs, exposure to hand-arm vibration and to overhead activities. Diagnosis of shoulder disorders is primarily based on clinical examination; selected cases should be referred to an orthopedic specialist and to imaging. Return to normal activities should be encouraged.

  9. The rheumatoid shoulder: current consensus on diagnosis and treatment.

    PubMed

    Thomas, Thierry; Noël, Eric; Goupille, Philippe; Duquesnoy, Bernard; Combe, Bernard

    2006-03-01

    Shoulder involvement is usually inconspicuous in patients with rheumatoid arthritis, and the clinical manifestations are nonspecific. Nevertheless, shoulder involvement should be sought routinely and detected early. Range of motion at the shoulder should be evaluated. Although normal radiographic findings do not rule out shoulder involvement, radiographs are crucial for detecting micro- and macro-geodes during follow-up. The development of glenohumeral joint space narrowing is a turning point that indicates a risk of rapid joint destruction. Magnetic resonance imaging is useful for assessing the lesions and guiding the treatment strategy. Stepwise use of local interventions as indicated by imaging findings is recommended. Joint replacement should not be left too late, and surgical procedures on the shoulder should be built into the overall treatment plan.

  10. Trunk and Shoulder Kinematic and Kinetic and Electromyographic Adaptations to Slope Increase during Motorized Treadmill Propulsion among Manual Wheelchair Users with a Spinal Cord Injury

    PubMed Central

    Champagne, Audrey

    2015-01-01

    The main objective was to quantify the effects of five different slopes on trunk and shoulder kinematics as well as shoulder kinetic and muscular demands during manual wheelchair (MWC) propulsion on a motorized treadmill. Eighteen participants with spinal cord injury propelled their MWC at a self-selected constant speed on a motorized treadmill set at different slopes (0°, 2.7°, 3.6°, 4.8°, and 7.1°). Trunk and upper limb movements were recorded with a motion analysis system. Net shoulder joint moments were computed with the forces applied to the handrims measured with an instrumented wheel. To quantify muscular demand, the electromyographic activity (EMG) of the pectoralis major (clavicular and sternal portions) and deltoid (anterior and posterior fibers) was recorded during the experimental tasks and normalized against maximum EMG values obtained during static contractions. Overall, forward trunk flexion and shoulder flexion increased as the slope became steeper, whereas shoulder flexion, adduction, and internal rotation moments along with the muscular demand also increased as the slope became steeper. The results confirm that forward trunk flexion and shoulder flexion movement amplitudes, along with shoulder mechanical and muscular demands, generally increase when the slope of the treadmill increases despite some similarities between the 2.7° to 3.6° and 3.6° to 4.8° slope increments. PMID:25793200

  11. Trunk and shoulder kinematic and kinetic and electromyographic adaptations to slope increase during motorized treadmill propulsion among manual wheelchair users with a spinal cord injury.

    PubMed

    Gagnon, Dany; Babineau, Annie-Claude; Champagne, Audrey; Desroches, Guillaume; Aissaoui, Rachid

    2015-01-01

    The main objective was to quantify the effects of five different slopes on trunk and shoulder kinematics as well as shoulder kinetic and muscular demands during manual wheelchair (MWC) propulsion on a motorized treadmill. Eighteen participants with spinal cord injury propelled their MWC at a self-selected constant speed on a motorized treadmill set at different slopes (0°, 2.7°, 3.6°, 4.8°, and 7.1°). Trunk and upper limb movements were recorded with a motion analysis system. Net shoulder joint moments were computed with the forces applied to the handrims measured with an instrumented wheel. To quantify muscular demand, the electromyographic activity (EMG) of the pectoralis major (clavicular and sternal portions) and deltoid (anterior and posterior fibers) was recorded during the experimental tasks and normalized against maximum EMG values obtained during static contractions. Overall, forward trunk flexion and shoulder flexion increased as the slope became steeper, whereas shoulder flexion, adduction, and internal rotation moments along with the muscular demand also increased as the slope became steeper. The results confirm that forward trunk flexion and shoulder flexion movement amplitudes, along with shoulder mechanical and muscular demands, generally increase when the slope of the treadmill increases despite some similarities between the 2.7° to 3.6° and 3.6° to 4.8° slope increments. PMID:25793200

  12. Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

    PubMed

    Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

    2015-12-01

    Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample.

  13. Bilateral anatomic total shoulder arthroplasty versus reverse shoulder arthroplasty.

    PubMed

    Latif, Vaqar; Denard, Patrick J; Young, Allan A; Liotard, Jean-Pierre; Walch, Gllies

    2012-04-01

    The results of anatomic total shoulder arthroplasty and reverse shoulder arthroplasty have previously been reported separately. Although the indications differ, scenarios exist in which a patient may have a total shoulder arthroplasty on 1 shoulder and a reverse shoulder arthroplasty on the contralateral shoulder.Between 1992 and 2009, twelve patients underwent bilateral sequential primary shoulder arthroplasty with a total shoulder arthroplasty on 1 side and reverse shoulder arthroplasty on the contralateral side. Constant score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, and patient satisfaction were obtained a minimum 1 year postoperatively. Mean postoperative Constant score was 77 after total shoulder arthroplasty and 73 after reverse shoulder arthroplasty (P<.2488). Mean postoperative active forward flexion was similar after total shoulder arthroplasty compared with reverse shoulder arthroplasty (P=.8910). Greater external rotation at the side (43° vs 12°; P<.0001) and internal rotation (T8 vs L1; P<.0001) were observed after total shoulder arthroplasty. Mean ASES score was 89.6 after total shoulder arthroplasty compared with 82.4 after reverse shoulder arthroplasty (P=.0125). Patient satisfaction was 92% for both prostheses, and mean subjective shoulder value was similar (85.4% vs 82.5%; P=.6333).Bilateral shoulder arthroplasty performed with a total shoulder arthroplasty and reverse shoulder arthroplasty on opposite shoulders can provide good functional outcome and high patient satisfaction. Although range of motion is better following total shoulder arthroplasty, no difference was observed in final Constant score or subjective patient assessment. PMID:22495846

  14. Fatigue Damage Evaluation of Friction Stir Spot Welded Cross-Tension Joints Under Repeated Two-Step Force Amplitudes

    NASA Astrophysics Data System (ADS)

    Joy-A-Ka, Sutep; Ogawa, Yuki; Akebono, Hiroyuki; Kato, Masahiko; Sugeta, Atsushi; Sun, Yufeng; Fujii, Hidetoshi

    2015-06-01

    This paper investigates an approach to evaluate the fatigue damage of FSSW cross-tension specimens under two-step force amplitude conditions. In fatigue tests with repeated two-step force amplitude, the fatigue limit of the welded joint disappeared. However, the fatigue damage evaluation using the modified Miner's rule erred too much on the side of safety, as the modified Miner's rule tends to overestimate the damage by applied forces below the fatigue limit. Thus, it was determined that, within the testing conditions used in this study, the fatigue damage evaluation using Haibach's method yielded an accurate evaluation. In the case where significant plastic deformation caused by the applied force occurred near the welded zone, the cumulative fatigue damage value based on Miner's rule was often larger than unity. Therefore, it is important to consider a cumulative damage estimation that takes into account the effect of pre-strain from the high force amplitude.

  15. Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

    PubMed Central

    Franco, Priscila G.; Santos, Karini B.; Rodacki, André L. F.

    2015-01-01

    Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls. Objective: To compare the performance of young and active elderly adults in three proprioceptive tests. Method: Twenty-one active elderly participants (66.9±5.5 years) and 21 healthy young participants (24.6±3.9 years) were evaluated in the following tests: perception of position of the ankle and hip joints, perceived force level of the ankle joint, and two-point discrimination of the sole of the foot. Results: No differences (p>0.05) were found between groups for the joint position and perceived force level. On the other hand, the elderly participants showed lower sensitivity in the two-point discrimination (higher threshold) when compared to the young participants (p < 0.01). Conclusion: Except for the cutaneous plantar sensitivity, the active elderly participants had maintained proprioception. Their physical activity status may explain similarities between groups for the joint position sense and perceived force level, however it may not be sufficient to prevent sensory degeneration with aging. PMID:26443978

  16. Proximal arm kinematics affect grip force-load force coordination.

    PubMed

    Vermillion, Billy C; Lum, Peter S; Lee, Sang Wook

    2015-10-01

    During object manipulation, grip force is coordinated with load force, which is primarily determined by object kinematics. Proximal arm kinematics may affect grip force control, as proximal segment motion could affect control of distal hand muscles via biomechanical and/or neural pathways. The aim of this study was to investigate the impact of proximal kinematics on grip force modulation during object manipulation. Fifteen subjects performed three vertical lifting tasks that involved distinct proximal kinematics (elbow/shoulder), but resulted in similar end-point (hand) trajectories. While temporal coordination of grip and load forces remained similar across the tasks, proximal kinematics significantly affected the grip force-to-load force ratio (P = 0.042), intrinsic finger muscle activation (P = 0.045), and flexor-extensor ratio (P < 0.001). Biomechanical coupling between extrinsic hand muscles and the elbow joint cannot fully explain the observed changes, as task-related changes in intrinsic hand muscle activation were greater than in extrinsic hand muscles. Rather, between-task variation in grip force (highest during task 3) appears to contrast to that in shoulder joint velocity/acceleration (lowest during task 3). These results suggest that complex neural coupling between the distal and proximal upper extremity musculature may affect grip force control during movements, also indicated by task-related changes in intermuscular coherence of muscle pairs, including intrinsic finger muscles. Furthermore, examination of the fingertip force showed that the human motor system may attempt to reduce variability in task-relevant motor output (grip force-to-load force ratio), while allowing larger fluctuations in output less relevant to task goal (shear force-to-grip force ratio). PMID:26289460

  17. Proximal arm kinematics affect grip force-load force coordination

    PubMed Central

    Vermillion, Billy C.; Lum, Peter S.

    2015-01-01

    During object manipulation, grip force is coordinated with load force, which is primarily determined by object kinematics. Proximal arm kinematics may affect grip force control, as proximal segment motion could affect control of distal hand muscles via biomechanical and/or neural pathways. The aim of this study was to investigate the impact of proximal kinematics on grip force modulation during object manipulation. Fifteen subjects performed three vertical lifting tasks that involved distinct proximal kinematics (elbow/shoulder), but resulted in similar end-point (hand) trajectories. While temporal coordination of grip and load forces remained similar across the tasks, proximal kinematics significantly affected the grip force-to-load force ratio (P = 0.042), intrinsic finger muscle activation (P = 0.045), and flexor-extensor ratio (P < 0.001). Biomechanical coupling between extrinsic hand muscles and the elbow joint cannot fully explain the observed changes, as task-related changes in intrinsic hand muscle activation were greater than in extrinsic hand muscles. Rather, between-task variation in grip force (highest during task 3) appears to contrast to that in shoulder joint velocity/acceleration (lowest during task 3). These results suggest that complex neural coupling between the distal and proximal upper extremity musculature may affect grip force control during movements, also indicated by task-related changes in intermuscular coherence of muscle pairs, including intrinsic finger muscles. Furthermore, examination of the fingertip force showed that the human motor system may attempt to reduce variability in task-relevant motor output (grip force-to-load force ratio), while allowing larger fluctuations in output less relevant to task goal (shear force-to-grip force ratio). PMID:26289460

  18. Assessment of a three-point restraint system with a pre-tensioned lap belt and an inflatable, force-limited shoulder belt.

    PubMed

    Kent, Richard; Lopez-Valdes, Francisco J; Dennis, Nate J; Lessley, David; Forman, Jason; Higuchi, Kazuo; Tanji, Hiromasa; Ato, Tadayuki; Kameyoshi, Hikaru; Arbogast, Kristy

    2011-11-01

    This study investigates the performance of a 3-point restraint system incorporating an inflatable shoulder belt with a nominal 2.5-kN load limiter and a non-inflatable lap belt with a pretensioner (the "Airbelt"). Frontal impacts with PMHS in a rear seat environment are presented and the Airbelt system is contrasted with an earlier 3-point system with inflatable lap and shoulder belts but no load-limiter or pretensioners, which was evaluated with human volunteers in the 1970s but not fully reported in the open literature (the "Inflataband"). Key differences between the systems include downward pelvic motion and torso recline with the Inflataband, while the pelvis moved almost horizontally and the torso pitched forward with the Airbelt. One result of these kinematic differences was an overall more biomechanically favorable restraint loading but greater maximum forward head excursion with the Airbelt. The Airbelt is shown to generate generally lower head, neck, and thoracic injury metrics and PMHS trauma than other, non-inflatable rear-seat restraint concepts (viz., a standard 3-point belt and a pre-tensioned shoulder belt with a progressive load limiter). Further study is needed to evaluate the Airbelt system for different size occupants (e.g., children), non-frontal impact vectors, and for out-of-position occupants and to allow the results with this particular system to be generalized to a broader range of Airbelt designs.

  19. Anatomy and Selected Biomechanical Aspects of the Shoulder.

    ERIC Educational Resources Information Center

    Keene, James S.

    This paper focuses on the anatomy and functions of the shoulder that are relevant to the evaluation and treatment of athletic injuries. A discussion is presented on the four basic components of the shoulder mechanism: (1) super structure--bony components; (2) moving parts--joints involved; (3) motor power--musculature; and (4) communications…

  20. Design and evaluation of prosthetic shoulder controller

    PubMed Central

    Barton, Joseph E.; Sorkin, John D.

    2015-01-01

    We developed a 2-degree-of-freedom (DOF) shoulder position transducer (sensing shoulder protraction-retraction and elevation-depression) that can be used to control two of a powered prosthetic humerus' DOFs. We also developed an evaluation protocol based on Fitts' law to assess the performance of our device. The primary motivation for this work was to support development of powered prosthetic shoulder joints of a new generation of prosthetic arms for people with shoulder disarticulation and very high-level transhumeral amputation. We found that transducers that provided resistance to shoulder movement performed better than those providing no resistance. We also found that a position control scheme, where effector position is proportional to shoulder position, performed better than a velocity control scheme, where effector velocity is proportional to shoulder position. More generally, our transducer can be used to control motion along any two DOFs. It can also be used in a more general 4-DOF control scheme by sequentially controlling two DOFs at a time. The evaluation protocol has general applicability for researchers and practitioners. Researchers can employ it to compare different prosthesis designs and control schemes, while practitioners may find the evaluation protocol useful in evaluating and training people with amputation in the use of prostheses. PMID:25357185

  1. 9. Painful shoulder complaints.

    PubMed

    Huygen, Frank; Patijn, Jacob; Rohof, Olav; Lataster, Arno; Mekhail, Nagy; van Kleef, Maarten; Van Zundert, Jan

    2010-01-01

    Painful shoulder complaints have a high incidence and prevalence. The etiology is not always clear. Clinical history and the active and passive motion examination of the shoulder are the cornerstones of the diagnostic process. Three shoulder tests are important for the examination of shoulder complaints: shoulder abduction, shoulder external rotation, and horizontal shoulder adduction. These tests can guide the examiner to the correct diagnosis. Based on this diagnosis, in most cases, primarily a conservative treatment with nonsteroidal anti-inflammatory drugs possibly in combination with manual and/or exercise therapy can be started. When conservative treatment fails, injection with local anesthetics and corticosteroids can be considered. In the case of frozen shoulder, a continuous cervical epidural infusion of local anesthetic and small doses of opioids or a pulsed radiofrequency treatment of the nervus suprascapularis can be considered.

  2. Shoulder Injuries and Disorders

    MedlinePlus

    ... bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis. Usually shoulder problems are treated with RICE. This stands for Rest, Ice, Compression and Elevation. Other treatments include exercise, medicines to reduce pain and swelling, and surgery ...

  3. Ultrasound-Guided Interventional Procedures About the Shoulder: Anatomy, Indications, and Techniques.

    PubMed

    Pourcho, Adam M; Colio, Sean W; Hall, Mederic M

    2016-08-01

    Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures. The purpose of this article is to review common indications and effective techniques for USG injections about the shoulder. PMID:27468666

  4. On the organizing role of nonmuscular forces during performance of a giant circle in gymnastics.

    PubMed

    Sevrez, Violaine; Rao, Guillaume; Berton, Eric; Bootsma, Reinoud J

    2012-02-01

    Five elite gymnasts performed giant circles on the high bar under different conditions of loading (without and with 6-kg loads attached to the shoulders, waist or ankles). Comparing the gymnasts' kinematic pattern of movement with that of a triple-pendulum moving under the sole influence of nonmuscular forces revealed qualitative similarities, including the adoption of an arched position during the downswing and a piked position during the upswing. The structuring role of nonmuscular forces in the organization of movement was further reinforced by the results of an inverse dynamics analysis, assessing the contributions of gravitational, inertial and muscular components to the net joint torques. Adding loads at the level of the shoulders, waist or ankles systematically influenced movement kinematics and net joint torques. However, with the loads attached at the level of the shoulders or waist, the load-induced changes in gravitational and inertial torques provided the required increase in net joint torque, thereby allowing the muscular torques to remain unchanged. With the loads attached at the level of the ankles, this was no longer the case and the gymnasts increased the muscular torques at the shoulder and hip joints. Together, these results demonstrate that expert gymnasts skillfully exploit the operative nonmuscular forces, employing muscle force only in the capacity of complementary forces needed to perform the task. PMID:21975422

  5. Shoulder pain in primary care: frozen shoulder.

    PubMed

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound.

  6. Rehabilitation of the shoulder in tennis players.

    PubMed

    Plancher, K D; Litchfield, R; Hawkins, R J

    1995-01-01

    The tennis player places unique demands on the shoulder by creating a high risk for overuse and overloading of the soft tissues. Tennis requires concentric work to position and move the arm, eccentric work to stabilize the shoulder, effective depression of the humeral head to avoid impingement in the overhead position, and normal stability to prevent secondary impingement. The tennis serve produces enormous angular velocities about the shoulder joint. A comprehensive rehabilitation program has been described in which the therapist, trainer, player, and physician alike need to have an understanding of the basic biomechanics of this sport. This program can be used to treat the painful shoulder, prevent injury, and enhance performance. PMID:7712546

  7. Prevention and Treatment of Swimmer's Shoulder.

    PubMed

    Tovin, Brian J

    2006-11-01

    Swimmer's shoulder is a musculoskeletal condition that results in symptoms in the area of the anterior lateral aspect of the shoulder, sometimes confined to the subacromial region. The onset of symptoms may be associated with impaired posture, glenohumeral joint mobility, neuromuscular control, or muscle performance. Additionally, training errors such as overuse, misuse, or abuse may also contribute to this condition. In extreme cases, patients with swimmer's shoulder may have soft tissue pathology of the rotator cuff, long head of the biceps, or glenoid labrum. Physical therapists involved in the treatment of competitive swimmers should focus on prevention and early treatment, addressing the impairments associated with this condition, and analyzing training methods and stroke mechanics. The purpose of this clinical commentary is to provide an overview of the biomechanics of swimming, the etiology of the clinical entity referred to as swimmer's shoulder, and strategies for injury prevention and treatment. PMID:21522219

  8. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    PubMed

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important.

  9. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    PubMed

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important. PMID:26374518

  10. Quantification of the role of tibial posterior slope in knee joint mechanics and ACL force in simulated gait.

    PubMed

    Marouane, H; Shirazi-Adl, A; Hashemi, J

    2015-07-16

    The anterior cruciate ligament (ACL) rupture is a common knee joint injury with higher prevalence in female athletes. In search of contributing mechanisms, clinical imaging studies of ACL-injured individuals versus controls have found greater medial-lateral posterior tibial slope (PTS) in injured population irrespective of the sex and in females compared to males, with stronger evidence on the lateral plateau slope. To quantify these effects, we use a lower extremity musculoskeletal model including a detailed finite element (FE) model of the knee joint to compute the role of changes in medial and/or lateral PTS by ±5° and ±10° on knee joint biomechanics, in general, and ACL force, in particular, throughout the stance phase of gait. The model is driven by reported kinematics/kinetics of gait in asymptomatic subjects. Our predictions showed, at all stance periods, a substantial increase in the anterior tibial translation (ATT) and ACL force as PTS increased with reverse trends as PTS decreased. At mid-stance, for example, ACL force increased from 181 N to 317 N and 460 N as PTS increased by 5° and 10°, respectively, while dropped to 102 N and 0 N as PTS changed by -5° and -10°, respectively. These effects are caused primarily by change in PTS at the tibial plateau that carries a larger portion of joint contact force. Steeper PTS is a major risk factor, especially under activities with large compression, in markedly increasing ACL force and its vulnerability to injury. Rehabilitation and ACL injury prevention programs could benefit from these findings.

  11. Shoulder Problems in Athletes.

    ERIC Educational Resources Information Center

    Clancy, William G., Jr.

    A description is given of typical sport-related injuries to the shoulder area. These include: (1) brachial plexus injuries; (2) peripheral nerve injuries about the shoulder; (3) acromioclavicular injuries; (4) sternoclavicular injuries; (5) shoulder dislocations; (6) recurrent traumatic subluxation/dislocations; and (7) overuse injuries.…

  12. Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement.

    PubMed

    Purevsuren, Tserenchimed; Dorj, Ariunzaya; Kim, Kyungsoo; Kim, Yoon Hyuk

    2016-04-01

    The computational modeling approach has commonly been used to predict knee joint contact forces, muscle forces, and ligament loads during activities of daily living. Knowledge of these forces has several potential applications, for example, within design of equipment to protect the knee joint from injury and to plan adequate rehabilitation protocols, although clinical applications of computational models are still evolving and one of the limiting factors is model validation. The objective of this study was to extend previous modeling technique and to improve the validity of the model prediction using publicly available data set of the fifth "Grand Challenge Competition to Predict In Vivo Knee Loads." A two-stage modeling approach, which combines conventional inverse dynamic analysis (the first stage) with a multi-body subject-specific lower limb model (the second stage), was used to calculate medial and lateral compartment contact forces. The validation was performed by direct comparison of model predictions and experimental measurement of medial and lateral compartment contact forces during normal and turning gait. The model predictions of both medial and lateral contact forces showed strong correlations with experimental measurements in normal gait (r = 0.75 and 0.71) and in turning gait trials (r = 0.86 and 0.72), even though the current technique over-estimated medial compartment contact forces in swing phase. The correlation coefficient, Sprague and Geers metrics, and root mean squared error indicated that the lateral contact forces were predicted better than medial contact forces in comparison with the experimental measurements during both normal and turning gait trials. PMID:26908641

  13. Like father, like son: assessment of the morphological affinities of A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) through a three-dimensional shape analysis of the shoulder joint.

    PubMed

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288-1 (A. afarensis), Sts 7 (A. africanus) and Omo 119-73-2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288-1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119-73-2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype. PMID:25651542

  14. Like Father, Like Son: Assessment of the Morphological Affinities of A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) through a Three-Dimensional Shape Analysis of the Shoulder Joint

    PubMed Central

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    The postcranial evidence for the Australopithecus genus indicates that australopiths were able bipeds; however, the morphology of the forelimbs and particularly that of the shoulder girdle suggests that they were partially adapted to an arboreal lifestyle. The nature of such arboreal adaptations is still unclear, as are the kind of arboreal behaviors in which australopiths might have engaged. In this study we analyzed the shape of the shoulder joint (proximal humerus and glenoid cavity of the scapula) of three australopith specimens: A.L. 288–1 (A. afarensis), Sts 7 (A. africanus) and Omo 119–73–2718 (Australopithecus sp.) with three-dimensional geometric morphometrics. The morphology of the specimens was compared with that of a wide array of living anthropoid taxa and some additional fossil hominins (the Homo erectus specimen KNM-WT 15000 and the H. neanderthalensis specimen Tabun 1). Our results indicate that A.L. 288–1 shows mosaic traits resembling H. sapiens and Pongo, whereas the Sts 7 shoulder is most similar to the arboreal apes and does not present affinities with H. sapiens. Omo 119–73–2718 exhibits morphological affinities with the more arboreal and partially suspensory New World monkey Lagothrix. The shoulder of the australopith specimens thus shows a combination of primitive and derived traits (humeral globularity, enhancement of internal and external rotation of the joint), related to use of the arm in overhead positions. The genus Homo specimens show overall affinities with H. sapiens at the shoulder, indicating full correspondence of these hominin shoulders with the modern human morphotype. PMID:25651542

  15. Chronic Long Standing Shoulder Pain, Caused by Glomus Tumor

    PubMed Central

    Geramizadeh, Bita; Khorshidi, Aseih; Hodjati, Hossein

    2015-01-01

    Chronic shoulder pain can be caused by muscle, bone and joint inflammatory and tumoral lesions; however, chronic shoulder pain secondary to benign vascular tumor called glomus tumor is an extremely rare occurrence. To the best of our knowledge less than 15 cases of chronic shoulder pain have been reported secondary to glomus tumor. Herein we report our experience with a young lady who presented with chronic shoulder pain which turned out to be caused by a soft tissue glomus tumor. This case has also been unique because if its large size (about 5 cm in greatest diameter). PMID:26266006

  16. Integration of marker and force data to compute three-dimensional joint moments of the thumb and index finger digits during pinch

    PubMed Central

    Nataraj, Raviraj; Li, Zong-Ming

    2014-01-01

    This study presents methodology to determine joint moments of the digits of the hand during pinch function. This methodology incorporates steps to identify marker-based kinematic data defining aligned coordinate systems for individual digit segments and joint center locations. The kinematic data are then transformed to a common reference frame along with the force data collected at pinch contact of a customized apparatus in three-dimensions (3-D). These methods were demonstrated with a pilot investigation to examine the static joint moments occurring during two-digit oppositional precision pinch at a particular endpoint force level applied at the digit pads. Notable abduction joint moments at the proximal joints of both digits were observed, which implicate the role of respective intrinsic and extrinsic muscles in maintaining pinch grasp. Examining differences in joint moment results when substituting select steps of this methodological approach suggested greater relative importance for joint center identification and segment coordinate system alignment. PMID:23947659

  17. Improved orthopedic arm joint

    NASA Technical Reports Server (NTRS)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  18. Arthroscopic examination of the throwing shoulder.

    PubMed

    Savoie, F H

    1993-08-01

    Throwing athletes may develop a multitude of problems in the glenohumeral joint and subacromial area. On occasions when rehabilitation is unsuccessful, diagnostic arthroscopy and arthroscopic management of these disorders may be indicated. The present study demonstrates several common injury patterns noted on arthroscopic examination of the throwing shoulder.

  19. Specific Shoulder Pathoanatomy in Semiprofessional Water Polo Players

    PubMed Central

    Klein, Maria; Tarantino, Ignazio; Warschkow, René; Berger, Claus Joachim; Zdravkovic, Vilijam; Jost, Bernhard; Badulescu, Michael

    2014-01-01

    Background: Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described. Purpose: To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group. Study Design: Cross-sectional study; Level of evidence, 3. Methods: After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects. Results: Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic. Conclusion: The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes. Clinical Relevance: The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings

  20. Dyspnea in a case of shoulder dislocation - to beware of this rare life-threatening symptom.

    PubMed

    Joshi, Satyen Praful; Challawar, Nikhil Subhash; Agrawal, Parth Vinod; Gajjar, Arpit S

    2016-01-01

    Shoulder dislocation is a common injury in orthopedic practice. In an acute presentation, closed reduction of the shoulder joint leads to an uneventful recovery. However, in the developing world neglected shoulder dislocation and treatments from quacks are not uncommon. Improper treatment and neglect can rarely become life threatening. We present one such case, emphasizing the need to investigate the symptom of dyspnea in a patient with history of shoulder dislocation. PMID:27658507

  1. Shoulder Pain and Common Shoulder Problems

    MedlinePlus

    ... and muscles around the shoulder become loose or torn, dislocations can occur repeatedly. Recurring dislocations, which may ... involve arthroscopy to remove scar tissue or repair torn tissues, or traditional, open procedures for larger reconstructions ...

  2. Motion of the Shoulder Complex During Multiplanar Humeral Elevation

    PubMed Central

    Ludewig, Paula M.; Phadke, Vandana; Braman, Jonathan P.; Hassett, Daniel R.; Cieminski, Cort J.; LaPrade, Robert F.

    2009-01-01

    Background: Many prior studies have evaluated shoulder motion, yet no three-dimensional analysis comparing the combined clavicular, scapular, and humeral motion during arm elevation has been done. We aimed to describe and compare dynamic three-dimensional motion of the shoulder complex during raising and lowering the arm across three distinct elevation planes (flexion, scapular plane abduction, and coronal plane abduction). Methods: Twelve subjects without a shoulder abnormality were enrolled. Transcortical pin placement into the clavicle, scapula, and humerus allowed electromagnetic motion sensors to be rigidly fixed. The subjects completed two repetitions of raising and lowering the arm in flexion, scapular, and abduction planes. Three-dimensional angles were calculated for sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joint motions. Joint angles between humeral elevation planes and between raising and lowering of the arm were compared. Results: General patterns of shoulder motion observed during humeral elevation were clavicular elevation, retraction, and posterior axial rotation; scapular internal rotation, upward rotation, and posterior tilting relative to the clavicle; and glenohumeral elevation and external rotation. Clavicular posterior rotation predominated at the sternoclavicular joint (average, 31°). Scapular posterior tilting predominated at the acromioclavicular joint (average, 19°). Differences between flexion and abduction planes of humerothoracic elevation were largest for the glenohumeral joint plane of elevation (average, 46°). Conclusions: Overall shoulder motion consists of substantial angular rotations at each of the four shoulder joints, enabling the multiple-joint interaction required to elevate the arm overhead. Clinical Relevance: Improved knowledge of the normal motion of the shoulder during humeral elevation will improve the assessment of patients with shoulder motion abnormalities, planning for rehabilitation

  3. Relation between isometric muscle force and surface EMG in intrinsic hand muscles as function of the arm geometry.

    PubMed

    Del Santo, Francesco; Gelli, Francesca; Ginanneschi, Federica; Popa, Traian; Rossi, Alessandro

    2007-08-13

    Evidence exists that shoulder joint geometry influences recruitment efficiency and force-generating capacity of hand muscles [Ginanneschi, F., Del Santo, F., Dominici, F., Gelli, F., Mazzocchio, R., Rossi, A., 2005. Changes in corticomotor excitability of hand muscles in relation to static shoulder positions. Exp. Brain Res. 161 (3), 374-382; Dominici, F., Popa, T., Ginanneschi, F., Mazzocchio, R., Rossi, A., 2005. Cortico-motoneural output to intrinsic hand muscles is differentially influenced by static changes in shoulder positions. Exp. Brain Res. 164 (4), 500-504]. The present study was designed to examine the impact of changing shoulder joint position on the relation between surface EMG amplitude and isometric force production of the abductor digiti minimi muscle (ADM). EMG-force relation of ADM was examined in two shoulder positions: 30 degrees adduction (ANT) and 30 degrees abduction (POST) on the horizontal plane, i.e. under higher and lower force-generating capacity, respectively. The relation was studied over the full range isometric force (10-100% of maximum force in 10% increments, 3 s duration) by analysing root mean square (RMS), median frequency (Mf) of the power spectrum and non-linear recurrence quantification analysis (percentage of determinism: %DET) of the surface EMG signals. We found that in POST, the slope of the RMS-force relation was significantly higher than in ANT, while its general shape (strictly linear) was preserved. Averaged Mf of the EMG power spectrum was significantly higher in POST that in ANT, while no difference in %DET was observed between the two shoulder positions. The higher slope of the EMG-force relation in POST than in ANT is interpreted in terms of increased gain of the excitatory drive-firing rate relation. It is concluded that discharge from sensory receptors signalling shoulder position may act to regulate the gain of the excitatory drive-firing rate relation of motoneurones in order to compensate for reduced

  4. Application of computational lower extremity model to investigate different muscle activities and joint force patterns in knee osteoarthritis patients during walking.

    PubMed

    Nha, Kyung Wook; Dorj, Ariunzaya; Feng, Jun; Shin, Jun Ho; Kim, Jong In; Kwon, Jae Ho; Kim, Kyungsoo; Kim, Yoon Hyuk

    2013-01-01

    Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

  5. US anatomy of the shoulder: Pictorial essay.

    PubMed

    Precerutti, M; Garioni, E; Madonia, L; Draghi, F

    2010-12-01

    A thorough knowledge of the anatomy of the shoulder is essential for the assessment of its condition. The purpose of this article is to provide a useful tool for the ultrasound (US) study of this joint. The shoulder girdle and upper arm are made up of a number of muscles and tendons: rotator cuff (supraspinatus, infraspinatus, teres minor and subscapularis), humeral biceps, deltoid and pectoral muscles, which can all be evaluated at US examination. Various and complex capsular ligamentous structures contribute to the stability of the shoulder, but only a few can be adequately evaluated by US and will therefore receive particular attention. Numerous serous bursae are situated among muscles, skin, subcutaneous tissues, joint capsule structures and bones to prevent friction and they can be evaluated by US only in the presence of pathologies. Subacromial-subdeltoid and subcoracoid bursa are most frequently involved and will therefore be described in detail. There are furthermore nerves and vessels providing the various components of the shoulder with innervation and vascularization, and they can also be studied by US. The shoulder girdle (humerus, scapula, clavicle and sternal manubrium) is situated in the deep layers; only the cortex of the bone can be seen at US as a continuous hyperechoic line. For a better understanding of the location and relationship between the structures which can be studied by US, magnetic resonance imaging (MRI) can be carried out as this method provides a wider and more complete view of the structures.

  6. Pharmacy Faculty Workplace Issues: Findings From the 2009-2010 COD-COF Joint Task Force on Faculty Workforce

    PubMed Central

    Peirce, Gretchen L.; Crabtree, Brian L.; Acosta, Daniel; Early, Johnnie L.; Kishi, Donald T.; Nobles-Knight, Dolores; Webster, Andrew A.

    2011-01-01

    Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy. PMID:21769139

  7. Inter-joint coupling strategy during adaptation to novel viscous loads in human arm movement.

    PubMed

    Debicki, D B; Gribble, P L

    2004-08-01

    When arm movements are perturbed by a load, how does the nervous system adjust control signals to reduce error? While it has been shown that the nervous system is capable of compensating for the effects of limb dynamics and external forces, the strategies used to adapt to novel loads are not well understood. We used a robotic exoskeleton [kinesiological instrument for normal and altered reaching movements (KINARM)] to apply novel loads to the arm during single-joint elbow flexions in the horizontal plane (shoulder rotation was allowed). Loads varied in magnitude with the instantaneous velocity of elbow flexion, and were applied to the shoulder in experiment 1 (interaction loads) and the elbow in experiment 2 (direct loads). Initial exposure to both interaction and direct loads resulted in perturbations at both joints, even though the load was applied to only a single joint. Subjects tended to correct for the kinematics of the elbow joint while perturbations at the shoulder persisted. Electromyograms (EMGs) and computed muscle torque showed that subjects modified muscle activity at the elbow to reduce elbow positional deviations. Shoulder muscle activity was also modified; however, these changes were always in the same direction as those at the elbow. Current models of motor control based on inverse-dynamics calculations and force-control, as well as models based on positional control, predict an uncoupling of shoulder and elbow muscle torques for adaptation to these loads. In contrast, subjects in this study adopted a simple strategy of modulating the natural coupling that exists between elbow and shoulder muscle torque during single-joint elbow movements.

  8. Inter-joint coupling strategy during adaptation to novel viscous loads in human arm movement.

    PubMed

    Debicki, D B; Gribble, P L

    2004-08-01

    When arm movements are perturbed by a load, how does the nervous system adjust control signals to reduce error? While it has been shown that the nervous system is capable of compensating for the effects of limb dynamics and external forces, the strategies used to adapt to novel loads are not well understood. We used a robotic exoskeleton [kinesiological instrument for normal and altered reaching movements (KINARM)] to apply novel loads to the arm during single-joint elbow flexions in the horizontal plane (shoulder rotation was allowed). Loads varied in magnitude with the instantaneous velocity of elbow flexion, and were applied to the shoulder in experiment 1 (interaction loads) and the elbow in experiment 2 (direct loads). Initial exposure to both interaction and direct loads resulted in perturbations at both joints, even though the load was applied to only a single joint. Subjects tended to correct for the kinematics of the elbow joint while perturbations at the shoulder persisted. Electromyograms (EMGs) and computed muscle torque showed that subjects modified muscle activity at the elbow to reduce elbow positional deviations. Shoulder muscle activity was also modified; however, these changes were always in the same direction as those at the elbow. Current models of motor control based on inverse-dynamics calculations and force-control, as well as models based on positional control, predict an uncoupling of shoulder and elbow muscle torques for adaptation to these loads. In contrast, subjects in this study adopted a simple strategy of modulating the natural coupling that exists between elbow and shoulder muscle torque during single-joint elbow movements. PMID:15056688

  9. Development and performance evaluation of a multi-PID muscle loading driven in vitro active-motion shoulder simulator and application to assessing reverse total shoulder arthroplasty.

    PubMed

    Giles, Joshua William; Ferreira, Louis Miguel; Athwal, George Singh; Johnson, James Andrew

    2014-12-01

    In vitro active shoulder motion simulation can provide improved understanding of shoulder biomechanics; however, accurate simulators using advanced control theory have not been developed. Therefore, our objective was to develop and evaluate a simulator which uses real-time kinematic feedback and closed loop proportional integral differential (PID) control to produce motion. The simulator's ability to investigate a clinically relevant variable-namely muscle loading changes resulting from reverse total shoulder arthroplasty (RTSA)-was evaluated and compared to previous findings to further demonstrate its efficacy. Motion control of cadaveric shoulders was achieved by applying continuously variable forces to seven muscle groups. Muscle forces controlling each of the three glenohumeral rotational degrees of freedom (DOF) were modulated using three independent PID controllers running in parallel, each using measured Euler angles as their process variable. Each PID controller was configured and tuned to control the loading of a set of muscles which, from previous in vivo investigations, were found to be primarily responsible for movement in the PID's DOF. The simulator's ability to follow setpoint profiles for abduction, axial rotation, and horizontal extension was assessed using root mean squared error (RMSE) and average standard deviation (ASD) for multiple levels of arm mass replacement. A specimen was then implanted with an RTSA, and the effect of joint lateralization (0, 5, 10 mm) on the total deltoid force required to produce motion was assessed. Maximum profiling error was <2.1 deg for abduction and 2.2 deg for horizontal extension with RMSE of <1 deg. The nonprofiled DOF were maintained to within 5.0 deg with RMSE <1.0 deg. Repeatability was high, with ASDs of <0.31 deg. RMSE and ASD were similar for all levels of arm mass replacement (0.73-1.04 and 0.14-0.22 deg). Lateralizing the joint's center of rotation (CoR) increased total deltoid force by up to 8.5% body

  10. Increase in joint stability at the expense of energy efficiency correlates with force variability during a fatiguing task.

    PubMed

    Cashaback, Joshua G A; Cluff, Tyler

    2015-02-26

    Empirical evidence suggests that our nervous system considers many objectives when performing various tasks. With the progression of fatigue, researchers have noted increase in both joint moment variability and muscular cocontraction during isometric force production tasks. Muscular cocontraction increases joint stability, but is metabolically costly. Thus, our nervous system must select a compromise between joint stability and energy efficiency. Interestingly, the continuous increase in cocontraction with fatigue suggests there may be a shift in the relative weighting of these objectives. Here we test the notion of dynamic objective weightings. Using multi-objective optimization, we found a shift in objective weighting that favoured joint stability at the expense of energy efficiency during fatigue. This shift was highly correlated with muscular cocontraction (R(2)=0.78, p<0.001) and elbow moment variability in the time (R(2)=0.56, p<0.01) and frequency (R(2)=0.57, p<0.01) domains. By considering a dynamic objective weighting we obtained strong correlations with predicted and collected muscle activity (R(2)=0.94, p<0.001).

  11. The Bennett lesion of the shoulder.

    PubMed

    De Maeseneer, M; Jaovisidha, S; Jacobson, J A; Tam, W; Schils, J P; Sartoris, D J; Fronek, J; Resnick, D

    1998-01-01

    In this article we review the imaging features and significance of the Bennett lesion of the shoulder. Standard radiographic, computed arthrotomographic, and MR findings in three baseball pitchers diagnosed with Bennett lesions of the shoulder are discussed. A crescent-shaped region of mineralization at the posteroinferior aspect of the glenoid rim, consistent with a Bennett lesion, arises at the insertion of the posterior joint capsule. The diagnosis of this lesion, typically in baseball pitchers, should raise suspicion for associated labral and rotator cuff abnormalities.

  12. Psychophysical testing of visual prosthetic devices: a call to establish a multi-national joint task force

    NASA Astrophysics Data System (ADS)

    Rizzo, Joseph F., III; Ayton, Lauren N.

    2014-04-01

    Recent advances in the field of visual prostheses, as showcased in this special feature of Journal of Neural Engineering , have led to promising results from clinical trials of a number of devices. However, as noted by these groups there are many challenges involved in assessing vision of people with profound vision loss. As such, it is important that there is consistency in the methodology and reporting standards for clinical trials of visual prostheses and, indeed, the broader vision restoration research field. Two visual prosthesis research groups, the Boston Retinal Implant Project (BRIP) and Bionic Vision Australia (BVA), have agreed to work cooperatively to establish a multi-national Joint Task Force. The aim of this Task Force will be to develop a consensus statement to guide the methods used to conduct and report psychophysical and clinical results of humans who receive visual prosthetic devices. The overarching goal is to ensure maximum benefit to the implant recipients, not only in the outcomes of the visual prosthesis itself, but also in enabling them to obtain accurate information about this research with ease. The aspiration to develop a Joint Task Force was first promulgated at the inaugural 'The Eye and the Chip' meeting in September 2000. This meeting was established to promote the development of the visual prosthetic field by applying the principles of inclusiveness, openness, and collegiality among the growing body of researchers in this field. These same principles underlie the intent of this Joint Task Force to enhance the quality of psychophysical research within our community. Despite prior efforts, a critical mass of interested parties could not congeal. Renewed interest for developing joint guidelines has developed recently because of a growing awareness of the challenges of obtaining reliable measurements of visual function in patients who are severely visually impaired (in whom testing is inherently noisy), and of the importance of

  13. Rehabilitation of the pitching shoulder.

    PubMed

    Pappas, A M; Zawacki, R M; McCarthy, C F

    1985-01-01

    Shoulder pain is a common complaint among baseball pitchers. Frequently, the nature of shoulder pathology can be traced to lack of flexibility and muscular imbalance. This paper describes: the normal biomechanics of a properly functioning shoulder during a baseball pitch, pathomechanics of shoulder problems, flexibility requirements of the throwing shoulder, and the muscular balance necessary for an effective throwing shoulder. Appropriate examination procedures are described along with remedial exercises which ensure normal glenohumeral motion and integrated muscle action.

  14. Active Vibration Control of a Large Flexible Manipulator by Inertial Force and Joint Torque. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Lee, Soo Han

    1988-01-01

    The efficiency and positional accuracy of a lightweight flexible manipulator are limited by its flexural vibrations, which last after a gross motion is completed. The vibration delays subsequent operations. In the proposed work, the vibration is suppressed by inertial force of a small arm in addition to the joint actuators and passive damping treatment. The proposed approach is: (1) Dynamic modeling of a combined system, a large flexible manipulator and a small arm, (2) Determination of optimal sensor location and controller algorithm, and (3) Verification of the fitness of model and the performance of controller.

  15. Delayed onset muscle soreness in neck/shoulder muscles.

    PubMed

    Nie, Hongling; Kawczynski, Adam; Madeleine, Pascal; Arendt-Nielsen, Lars

    2005-12-01

    The aim of the present study is to: (1) induce delayed onset muscle soreness (DOMS) in the neck and shoulder muscles; (2) compare the pressure pain sensitivity of muscle belly with that of musculotendinous tissue after DOMS; (3) examine the gender differences in the development of DOMS. An eccentric shoulder exercise was developed to induce DOMS on neck/shoulder muscles using a specially designed dynamometer. Eccentric shoulder contraction consisted of 5 bouts, each bout lasted 3min, with 3min rest period between each bout. The right shoulder was elevating against a downward pressure force of 110% maximal voluntary contraction force exerted by the dynamometer. Pressure pain thresholds (PPT) of 11 sites (seven sites measured were muscle belly and four sites were myotendinous area) on neck/shoulder region were measured before, immediately after, 24 and 48h after exercise. Pain intensity, pain area and index of McGill pain questionnaire were assessed and all were increased after exercise. DOMS was induced in the shoulder muscles. PPT was significantly decreased and reached lowest values at 24h. The muscle belly sites are more sensitive to pain than the musculotendinous sites. No gender differences were found in any of the parameters used to assess the development of DOMS. DOMS did not distribute evenly in the neck/shoulder region. Soreness after exercise in the neck and shoulder seems not to be among the conditions that produce predominant musculoskeletal pain in females.

  16. [Triple fracture of the shoulder suspensory complex].

    PubMed

    Tamimi Mariño, I; Martin Rodríguez, I; Mora Villadeamigo, J

    2013-01-01

    The superior suspensory complex of the shoulder (SSCS) is a ring shaped structure composed of bones and soft tissues that play a fundamental role in the stability of the shoulder joint. Isolated injuries of the SSCS are relatively common, but injuries that affect 3 components are extremely unusual. We present a triple injury of the SSCS in a 26 year old patient with a Neer type ii clavicular fracture, a Kuhn type iii acromion fracture and an Ogawa type i coracoid fracture. An open reduction and stabilization of the clavicle was performed with 2 Kirschner nails. The acromial fracture was synthesized with 2 cannulated screws, and the coracoid fracture was treated conservatively. After 24 months of follow up the patient had an excellent functional outcome according to the Constat-Murley shoulder score and QuickDASH scoring system, and all the fractures healed correctly.

  17. Ten questions on prosthetic shoulder infection.

    PubMed

    Pinder, Elizabeth M; Ong, Joshua Cy; Bale, R Stephen; Trail, Ian A

    2016-07-01

    Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty. A structured approach is necessary when assessing patients for prosthetic shoulder joint infection. This includes history, examination, serum inflammatory markers, plain radiology and aspiration and/or biopsy. A classification for the likelihood of prosthetic shoulder infection has been described based on culture, pre-operative and intra-operative findings. Treatment options include antibiotic suppression, debridement with component retention, one-stage revision, two-stage revision and excision arthroplasty. Revision arthroplasty is associated with the best outcomes. PMID:27583013

  18. Physical examination of the overhead athlete's shoulder.

    PubMed

    Sewick, Amy; Kelly, John D; Rubin, Ben

    2012-03-01

    Overhead athletes seek the services of an orthopedic surgeon because of pain and/or dysfunction. It is important to address the cause of the symptoms more so than the source of the patient's pain, so that treatment will eliminate the problem rather than merely ameliorate symptoms temporarily. In order to accomplish a thorough assessment of shoulder function, the examiner must expand his/her view from isolated assessment of the glenohumeral joint range of motion, stability, assessment of rotator cuff strength, palpation and provocative maneuvers, and add assessment of the shoulder in the context of the kinetic chain. The examination of the thrower's shoulder, coupled with a thorough history, will usually provide a solid functional diagnosis and provide a good idea as to the presence of structural damage. As a result, the value of rehabilitation and the benefit of surgical intervention are made more predictable.

  19. Ten questions on prosthetic shoulder infection

    PubMed Central

    Pinder, Elizabeth M; Ong, Joshua CY; Bale, R Stephen

    2016-01-01

    Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty. A structured approach is necessary when assessing patients for prosthetic shoulder joint infection. This includes history, examination, serum inflammatory markers, plain radiology and aspiration and/or biopsy. A classification for the likelihood of prosthetic shoulder infection has been described based on culture, pre-operative and intra-operative findings. Treatment options include antibiotic suppression, debridement with component retention, one-stage revision, two-stage revision and excision arthroplasty. Revision arthroplasty is associated with the best outcomes. PMID:27583013

  20. Physical examination of the overhead athlete's shoulder.

    PubMed

    Sewick, Amy; Kelly, John D; Rubin, Ben

    2012-03-01

    Overhead athletes seek the services of an orthopedic surgeon because of pain and/or dysfunction. It is important to address the cause of the symptoms more so than the source of the patient's pain, so that treatment will eliminate the problem rather than merely ameliorate symptoms temporarily. In order to accomplish a thorough assessment of shoulder function, the examiner must expand his/her view from isolated assessment of the glenohumeral joint range of motion, stability, assessment of rotator cuff strength, palpation and provocative maneuvers, and add assessment of the shoulder in the context of the kinetic chain. The examination of the thrower's shoulder, coupled with a thorough history, will usually provide a solid functional diagnosis and provide a good idea as to the presence of structural damage. As a result, the value of rehabilitation and the benefit of surgical intervention are made more predictable. PMID:22311287

  1. Calculation of joint moments following foot contact across two force plates.

    PubMed

    Wong, Andrew Y C; Sangeux, Morgan; Baker, Richard

    2010-02-01

    This study aimed to quantify the effect of combining the measurements from force plates when a subject's foot comes in contact with more than one force plate. A 3-Dimensional Gait Analysis (3DGA) was performed on a subject walking barefoot. Ten gait trials (good both) were captured where both subject's feet hit a single force plate. Then 20 gait trials (two force plates) were captured where either the right or left subject's foot was in contact with two force plates at a time. Kinematics were computed with VICON Plugin Gait and kinetics with a BodyLanguage (VICON, Oxford, UK) model that allowed the combination of force plate measurements. The kinetics traces from both sets of data were compared using variance component analysis. Results suggest that effects of how the moments were calculated were at most a third of those arising from stride to stride variability. This suggests that development of automated systems for determining foot contact coupled with arrays of more and smaller force plates than are commonly used might be useful to ensure the capture of good quality kinetic data in a wide range of patients.

  2. Psychophysical testing of visual prosthetic devices: a call to establish a multi-national joint task force

    NASA Astrophysics Data System (ADS)

    Rizzo, Joseph F., III; Ayton, Lauren N.

    2014-04-01

    Recent advances in the field of visual prostheses, as showcased in this special feature of Journal of Neural Engineering , have led to promising results from clinical trials of a number of devices. However, as noted by these groups there are many challenges involved in assessing vision of people with profound vision loss. As such, it is important that there is consistency in the methodology and reporting standards for clinical trials of visual prostheses and, indeed, the broader vision restoration research field. Two visual prosthesis research groups, the Boston Retinal Implant Project (BRIP) and Bionic Vision Australia (BVA), have agreed to work cooperatively to establish a multi-national Joint Task Force. The aim of this Task Force will be to develop a consensus statement to guide the methods used to conduct and report psychophysical and clinical results of humans who receive visual prosthetic devices. The overarching goal is to ensure maximum benefit to the implant recipients, not only in the outcomes of the visual prosthesis itself, but also in enabling them to obtain accurate information about this research with ease. The aspiration to develop a Joint Task Force was first promulgated at the inaugural 'The Eye and the Chip' meeting in September 2000. This meeting was established to promote the development of the visual prosthetic field by applying the principles of inclusiveness, openness, and collegiality among the growing body of researchers in this field. These same principles underlie the intent of this Joint Task Force to enhance the quality of psychophysical research within our community. Despite prior efforts, a critical mass of interested parties could not congeal. Renewed interest for developing joint guidelines has developed recently because of a growing awareness of the challenges of obtaining reliable measurements of visual function in patients who are severely visually impaired (in whom testing is inherently noisy), and of the importance of

  3. Total Shoulder Arthroplasty

    PubMed Central

    Sanchez-Sotelo, Joaquin

    2011-01-01

    Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function. PMID:21584206

  4. Little Leaguer's shoulder.

    PubMed

    Fleming, J L; Hollingsworth, C L; Squire, D L; Bisset, G S

    2004-06-01

    A case of Little Leaguer's shoulder in a skeletally immature patient is described with a review of the English literature. This entity manifests as widening of the proximal humeral physis and is well known to our orthopedic colleagues. To our knowledge, however, there is little in the current radiologic literature describing Little Leaguer's shoulder. We describe such a case.

  5. Evaluation of elbow and shoulder problems in professional baseball pitchers.

    PubMed

    Grana, William A; Boscardin, James B; Schneider, Herman J; Takao, Scott H; Vera, Tomas; Goin, Scott G

    2007-06-01

    When a professional athlete injures an elbow or shoulder, the uninjured joint must receive as much attention as the injured joint. Is there a relationship between injury of one joint and subsequent injury of the other joint? In the prospective study reported here, we created a database (a) to determine whether injury to one joint was more likely to result in a problem with the other joint and (b) to analyze for trends and correlations. A survey was administered to all pitchers on a professional baseball team to collect data about shoulder and elbow problems during their careers. Eighty-four pitchers (737 seasons of experience, 52 index injuries) were evaluated. Of the injured players, 27 were treated surgically. Risk for later injury was 4.6 times larger for players who had an index surgery than for those who had not. Of the players who had ulnar collateral ligament (UCL) reconstruction, 42% later sustained a shoulder injury. No player with rotator cuff surgery sustained a subsequent elbow or shoulder injury. There were significantly more upper extremity injuries with right-handed throwers. An elbow injury was more likely to result in shoulder problems, specifically after UCL reconstruction. Players who required surgery were almost 5 times more likely to have a later injury or surgery than players who did not require surgery.

  6. Hemiplegic shoulder pain.

    PubMed

    Griffin, J W

    1986-12-01

    This article reviews the literature relevant to the possible causes, prevention, and treatment of hemiplegic shoulder pain. Shoulder pain and stiffness impede the rehabilitation of patients with hemiplegia. The cause of this complication is unknown, but it may be related to the severity of neurological deficits, preexisting or posthemiplegic soft tissue injury, subluxation, brachial plexus injury, or shoulder-hand syndrome. Shoulder pain may be preventable if risk factors can be identified and appropriate prophylaxis applied. Resolution of the condition depends on diagnosis and effective treatment at the onset of the symptoms. More clinical research is needed to clarify the cause of hemiplegic shoulder pain and to document the efficacy of prophylactic and treatment methods.

  7. CURRENT CONCEPTS IN SHOULDER EXAMINATION OF THE OVERHEAD ATHLETE

    PubMed Central

    Ellenbecker, Todd

    2013-01-01

    Examination of the shoulder complex has long been described as challenging. This is particularly true in the examination of the overhead athlete who has structural differences when compared to a shoulder patient who is a non‐athlete. Complexity with the examination is due to unique biomechanical and structural changes, multiple joint articulations, multiple pain patterns, and the potential of injury to structures both inside (intra‐articular) and outside (extra‐articular) the glenohumeral joint. Repetitive stresses placed on the shoulders of overhead athletes may affect range of motion, strength, scapular position, and ultimately, the integrity of soft tissue and bony structures in any of the joints that comprise the shoulder complex. Furthermore, many shoulder examination tests thought to be unique to a single structure, joint, or condition can be positive in multiple conditions. The examination of the overhead athletes shoulder, coupled with a thorough medical history will provide a solid foundation to allow a functional physical therapy diagnosis and provide clues as to the presence of the lesion (s) causing disability. The purpose of this clinical commentary is to assist the reader to understand the unique physical characteristics of the overhead athlete, which will lead to a more accurate and reproducible evaluation of athletes who sustain injuries while participating in overhead sports. Level of Evidence: 5 PMID:24175138

  8. Biomechanics of Reverse Shoulder Arthroplasty: 
Current Concepts.

    PubMed

    Lorenzetti, Adam J; Stone, Geoffrey P; Simon, Peter; Frankle, Mark A

    2016-01-01

    The evolution of reverse shoulder arthroplasty has provided surgeons with new solutions for many complex shoulder problems. A primary goal of orthopaedics is the restoration or re-creation of functional anatomy to reduce pain and improve function, which can be accomplished by either repairing injured structures or replacing them as anatomically as possible. If reconstructible tissue is lacking or not available, which is seen in patients who have complex shoulder conditions such as an irreparable rotator cuff-deficient shoulder, cuff tear arthropathy, or severe glenoid bone loss, substantial problems may arise. Historically, hemiarthroplasty or glenoid grafting with total shoulder arthroplasty yielded inconsistent and unsatisfactory results. Underlying pathologies in patients who have an irreparable rotator cuff-deficient shoulder, cuff tear arthropathy, or severe glenoid bone loss can considerably alter the mechanical function of the shoulder and create treatment dilemmas that are difficult to overcome. A better biomechanical understanding of these pathologic adaptations has improved treatment options. In the past three decades, reverse total shoulder arthroplasty was developed to treat these complex shoulder conditions not by specifically re-creating the anatomy but by using the remaining functional tissue to improve shoulder balance. Reverse total shoulder arthroplasty has achieved reliable improvements in both pain and function. Initial implant designs lacked scientific evidence to support the design rationale, and many implants failed because surgeons did not completely understand the forces involved or the pathology being treated. Implant function and clinical results will continue to improve as surgeons' biomechanical understanding of shoulder disease and reverse shoulder arthroplasty implants increases. PMID:27049186

  9. Effects of the Index Finger Position and Force Production on the Flexor Digitorum Superficialis Moment Arms at the Metacarpophalangeal Joints- an Magnetic Resonance Imaging Study

    PubMed Central

    Martin, Joel R.; Latash, Mark L.; Zatsiorsky, Vladimir M.

    2011-01-01

    Background The purpose of this study was to use magnetic resonance imaging to measure the moment arm of the flexor digitorum superficialis tendon about the metacarpophalangeal joint of the index, middle, ring, and little fingers when the position and force production level of the index finger was altered. A secondary goal was to create regression models using anthropometric data to predict moment arms of the flexor digitorum superficialis about the metacarpophalangeal joint of each finger. Methods The hands of subjects were scanned using a 3.0T magnetic resonance imaging scanner. The metacarpophalangeal joint of the index finger was placed in: flexion, neutral, and extension. For each joint configuration subjects produced no active force (passive condition) and exerted a flexion force to resist a load at the fingertip (active condition). Results The following was found: (1) The moment arm of the flexor digitorum superficialis at the metacarpophalangeal joint of the index finger (a) increased with the joint flexion and stayed unchanged with finger extension; and (b) decreased with the increase of force at the neutral and extended finger postures and did not change at the flexed posture. (2) The moment arms of the flexor digitorum superficialis tendon of the middle, ring, and little fingers (a) did not change when the index metacarpophalangeal joint position changed (p > 0.20); and (b) The moment arms of the middle and little fingers increased when the index finger actively produced force at the flexed metacarpophalangeal joint posture. (4) The moment arms showed a high correlation with anthropometric measurements. Interpretation Moment arms of the flexor digitorum superficialis change due to both changes in joint angle and muscle activation; they scale with various anthropometric measures. PMID:22192658

  10. An EMG-driven Modeling Approach to Muscle Force and Joint Load Estimations: Case Study in Knee Osteoarthritis

    PubMed Central

    Kumar, Deepak; Rudolph, Katherine S.; Manal, Kurt T.

    2011-01-01

    Summary It is important to know the magnitude and patterns of joint loading in people with knee osteoarthritis (OA), since altered loads are implicated in onset and progression of the disease. We used an EMG-driven forward dynamics model to estimate joint loads during walking in a subject with knee OA and a healthy control subject. Kinematic, kinetic, and surface EMG data were used to predict muscle forces using a Hill-type muscle model. The muscle forces were used to balance the frontal plane moment to obtain medial and lateral condylar loads. Loads were normalized to body weight (BWs) and the mean of three trials taken. The OA subject had greater medial and lower lateral loads compared to the control subject. 75 to 80% of the total load was borne on the medial compartment in the control subject, compared to 90 to 95% in the OA subject. In fact, complete lateral unloading occurred during midstance for the OA subject. Loading for the healthy subject was consistent with the data from instrumented knee studies. In the future, the model can be used to analyze the impact of various interventions to reduce the loads on the medial compartment in people with knee OA. PMID:21901754

  11. Force.

    ERIC Educational Resources Information Center

    Gamble, Reed

    1989-01-01

    Discusses pupil misconceptions concerning forces. Summarizes some of Assessment of Performance Unit's findings on meaning of (1) force, (2) force and motion in one dimension and two dimensions, and (3) Newton's second law. (YP)

  12. The evaluation of the failed shoulder arthroplasty.

    PubMed

    Wiater, Brett P; Moravek, James E; Wiater, J Michael

    2014-05-01

    As the incidence of shoulder arthroplasty continues to rise, the orthopedic shoulder surgeon will be increasingly faced with the difficult problem of evaluating a failed shoulder arthroplasty. The patient is usually dissatisfied with the outcome of the previous arthroplasty as a result of pain, but may complain of poor function due to limited range of motion or instability. A thorough and systematic approach is necessary so that the most appropriate treatment pathway can be initiated. A comprehensive history and physical examination are the first steps in the evaluation. Diagnostic studies are numerous and include laboratory values, plain radiography, computed tomography, ultrasound imaging, joint aspiration, nuclear scans, and electromyography. Common causes of early pain after shoulder arthroplasty include technical issues related to the surgery, such as malposition or improper sizing of the prosthesis, periprosthetic infection, neurologic injury, and complex regional pain syndrome. Pain presenting after a symptom-free interval may be related to chronic periprosthetic infection, component wear and loosening, glenoid erosion, rotator cuff degeneration, and fracture. Poor range of motion may result from inadequate postoperative rehabilitation, implant-related factors, and heterotopic ossification. Instability is generally caused by rotator cuff deficiency and implant-related factors. Unfortunately, determining the cause of a failed shoulder arthroplasty can be difficult, and in many situations, the source of pain and disability is multifactorial.

  13. Functional outcomes assessment in shoulder surgery

    PubMed Central

    Wylie, James D; Beckmann, James T; Granger, Erin; Tashjian, Robert Z

    2014-01-01

    The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient’s perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the joint-specific and condition specific measures utilized in evaluating patients with shoulder conditions. Advances in computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed. PMID:25405091

  14. Epinephrine-enhanced computed tomographic arthrography of the canine shoulder.

    PubMed

    De Rycke, Lieve; van Bree, Henri; Van Caelenberg, Annemie; Polis, Ingeborgh; Duchateau, Luc; Gielen, Ingrid

    2015-10-01

    The aim of this study was to investigate the effect of epinephrine-enhanced computed tomographic arthrography (CTA) on the image sharpness of the lateral and medial glenohumeral ligaments (LGHL and MGHL, respectively), biceps tendon (BT) and joint cartilage (JC) in the canine shoulder. The shoulders of eight normal dogs were examined using a 4-slice helical CT scanner. The right shoulders were injected with Iohexol and the left shoulders with a mixture of Iohexol and epinephrine. CTA images were obtained after 1, 3, 5, 9, 13, 20 and 30 min and the image sharpness of the intra-articular structures in both shoulders was graded for visibility. The attenuation values were measured to examine the persistence of contrast appearance. Admixture of epinephrine and Iohexol significantly improved the image sharpness of the LGHL and the BT, especially on delayed CTA images. The use of epinephrine did not negatively affect post-CTA recovery. PMID:26412512

  15. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  16. Employment of a joint medical task force in a counterinsurgency operational environment.

    PubMed

    Avery, Scott; Holman, Vincent

    2008-01-01

    To understand the complexity of the medical task force mission in support of Operation Iraqi Freedom, we must first understand the operational environment and its impact on the military healthcare system and the medical task force charged with its execution in theater. Historically the medical task force has focused almost exclusively on delivering a robust and accessible set of level II and III care and force health protection support since operations began in Iraq. Consequently, after 5 years of stable positioning, security, and infrastructure within our bases there were no discernable standardization of healthcare support, clinical quality, or medical equipment beyond what the units had chosen to adopt. Task Force 62 Medical Brigade has taken advantage of this unique time in history to place a concerted focus on institutionalizing our combat healthcare system and meeting the challenges of the counterinsurgency operational environment. Whereas our predecessors rightly focused on delivering combat health support during their tenure, we focused on the future, laying the foundation for the eventual transition to an environment similar to that in the Republic of Korea as the security situation improves. The foundation laid during Operation Iraqi Freedom 07-09 can be the foundation for the Army and the military healthcare system's vision in creating and modifying the delivery of US standard healthcare in a combat theater. PMID:20088053

  17. Friction force and pressure calculations for time-dependent impulsive intelligent lubrication of human hip joint.

    PubMed

    Wierzcholski, Krzysztof

    2010-01-01

    The core of the present problem was to indicate the values of the optimum synovial fluid velocity and friction forces appearing near the cartilage cells of cooperating surfaces, as well as to find the ways of controlling the friction forces between particles of the liquid and the cells of the biobearing cooperating bodies in the thin boundary layer. In the research, we used a numerical method. Investigations of the physical and strength features are expected to be performed for various kinds of biobearing superficial layer and for damage to biobearings. In order to begin treating the surface structure of a superficial layer on the cooperating biobearing surfaces it is absolutely necessary to build a proper model of a liquid flow in the thin layer and to obtain the proper values of friction forces.

  18. Conference-EC-US Task Force Joint US-EU Workshop on Metabolomics and Environmental Biotechnology

    SciTech Connect

    PI: Lily Y. Young Co-PI: Gerben J. Zylstra

    2009-06-04

    Since 1990, the EC-US Task Force on Biotechnology Research has been coordinating transatlantic efforts to guide and exploit the ongoing revolution in biotechnology and the life sciences. The Task Force was established in June 1990 by the European Commission and the White House Office of Science and Technology Policy. The Task Force has acted as an effective forum for discussion, coordination, and development of new ideas for the last 18 years. Task Force members are European Commission and US Government science and technology administrators who meet annually to enhance communication across the Atlantic, and to encourage collaborative research. Through sponsoring workshops, and other activities, the Task Force also brings together scientific leaders and early career researchers from both sides of the Atlantic to forecast research challenges and opportunities and to promote better links between researchers. Over the years, by keeping a focus on the future of science, the Task Force has played a key role in establishing a diverse range of emerging scientific fields, including biodiversity research, neuroinformatics, genomics, nanobiotechnology, neonatal immunology, transkingdom molecular biology, biologically-based fuels, and environmental biotechnology. The EC-US Task Force has sponsored a number of Working Groups on topics of mutual transatlantic interest. The idea to create a Working Group on Environmental Biotechnology research was discussed in the Task Force meeting of October 1993. The EC-US Working Group on Environmental Biotechnology set as its mission 'To train the next generation of leaders in environmental biotechnology in the United States and the European Union to work collaboratively across the Atlantic.' Since 1995, the Working Group supported three kinds of activities, all of which focus one early career scientists: (1) Workshops on the use of molecular methods and genomics in environmental biotechnology; (2) Short courses with theoretical, laboratory

  19. Pathology of Gray Wolf Shoulders: Lessons in Species and Aging.

    PubMed

    Lawler, Dennis; Becker, Julia; Reetz, Jennifer; Goodmann, Pat; Evans, Richard; Rubin, David; Tangredi, Basil; Widga, Christopher; Sackman, Jill; Martin, Terrence; Kohn, Luci; Smith, Gail

    2016-10-01

    We examined scapula glenoids (n = 14) and proximal articular humeri (n = 14) of seven gray wolves that were maintained in a sanctuary park setting. Immediately after death, observations were made visually in situ and by radiography. Further observations were made in a museum laboratory setting, prior to and following clearing of soft tissues. Selected dry bone specimens were evaluated using computed tomography. Significant cartilage erosion and osteoarthropathy were identified in all shoulder joints. No single evaluation method yielded maximal information. Plain film radiography revealed only more severe changes. Computed tomography yielded more detail and clarity than standard radiography. Direct examination of articular cartilage informed about joint soft tissue, and dry bone informed about externally visible bone pathology. These data provide a basis for biological, biomedical, ecological, and archaeological scientists to improve retrospective interpretations of bone lesions. They further support developing plausible differential diagnoses for features of ancient and modern animal bones. We noted a dog-like capacity for wolf longevity in a non-free-roaming environment. However, aged wolves' life spans far exceeded those of similar-sized domestic dogs and breeds, suggesting the possibility of an important species difference that should be explored. We suggest also a hypothesis that the driving force for joint pathology in sheltered non-domestic species may relate significantly to achieving the longevity that is possible biologically, but is uncommon in the wild because of differential stochastic influences. Anat Rec, 299:1338-1347, 2016. © 2016 Wiley Periodicals, Inc. PMID:27415465

  20. Stochastic estimation of human shoulder impedance with robots: an experimental design.

    PubMed

    Park, Kyungbin; Chang, Pyung Hun

    2011-01-01

    Previous studies assumed the shoulder as a hinge joint during human arm impedance measurement. This is obviously a vast simplification since the shoulder is a complex of several joints with multiple degrees of freedom. In the present work, a practical methodology for more general and realistic estimation of human shoulder impedance is proposed and validated with a spring array. It includes a gravity compensation scheme, which is developed and used for the experiments with a spatial three degrees of freedom PUMA-type robot. The experimental results were accurate and reliable, and thus it has shown a strong potential of the proposed methodology in the estimation of human shoulder impedance.

  1. A comparison of static and dynamic optimization muscle force predictions during wheelchair propulsion.

    PubMed

    Morrow, Melissa M; Rankin, Jeffery W; Neptune, Richard R; Kaufman, Kenton R

    2014-11-01

    The primary purpose of this study was to compare static and dynamic optimization muscle force and work predictions during the push phase of wheelchair propulsion. A secondary purpose was to compare the differences in predicted shoulder and elbow kinetics and kinematics and handrim forces. The forward dynamics simulation minimized differences between simulated and experimental data (obtained from 10 manual wheelchair users) and muscle co-contraction. For direct comparison between models, the shoulder and elbow muscle moment arms and net joint moments from the dynamic optimization were used as inputs into the static optimization routine. RMS errors between model predictions were calculated to quantify model agreement. There was a wide range of individual muscle force agreement that spanned from poor (26.4% Fmax error in the middle deltoid) to good (6.4% Fmax error in the anterior deltoid) in the prime movers of the shoulder. The predicted muscle forces from the static optimization were sufficient to create the appropriate motion and joint moments at the shoulder for the push phase of wheelchair propulsion, but showed deviations in the elbow moment, pronation-supination motion and hand rim forces. These results suggest the static approach does not produce results similar enough to be a replacement for forward dynamics simulations, and care should be taken in choosing the appropriate method for a specific task and set of constraints. Dynamic optimization modeling approaches may be required for motions that are greatly influenced by muscle activation dynamics or that require significant co-contraction. PMID:25282075

  2. A comparison of static and dynamic optimization muscle force predictions during wheelchair propulsion.

    PubMed

    Morrow, Melissa M; Rankin, Jeffery W; Neptune, Richard R; Kaufman, Kenton R

    2014-11-01

    The primary purpose of this study was to compare static and dynamic optimization muscle force and work predictions during the push phase of wheelchair propulsion. A secondary purpose was to compare the differences in predicted shoulder and elbow kinetics and kinematics and handrim forces. The forward dynamics simulation minimized differences between simulated and experimental data (obtained from 10 manual wheelchair users) and muscle co-contraction. For direct comparison between models, the shoulder and elbow muscle moment arms and net joint moments from the dynamic optimization were used as inputs into the static optimization routine. RMS errors between model predictions were calculated to quantify model agreement. There was a wide range of individual muscle force agreement that spanned from poor (26.4% Fmax error in the middle deltoid) to good (6.4% Fmax error in the anterior deltoid) in the prime movers of the shoulder. The predicted muscle forces from the static optimization were sufficient to create the appropriate motion and joint moments at the shoulder for the push phase of wheelchair propulsion, but showed deviations in the elbow moment, pronation-supination motion and hand rim forces. These results suggest the static approach does not produce results similar enough to be a replacement for forward dynamics simulations, and care should be taken in choosing the appropriate method for a specific task and set of constraints. Dynamic optimization modeling approaches may be required for motions that are greatly influenced by muscle activation dynamics or that require significant co-contraction.

  3. Analysis of joint force and torque for the human and non-human ape foot during bipedal walking with implications for the evolution of the foot

    PubMed Central

    Wang, Weijie; Abboud, Rami J; Günther, Michael M; Crompton, Robin H

    2014-01-01

    The feet of apes have a different morphology from those of humans. Until now, it has merely been assumed that the morphology seen in humans must be adaptive for habitual bipedal walking, as the habitual use of bipedal walking is generally regarded as one of the most clear-cut differences between humans and apes. This study asks simply whether human skeletal proportions do actually enhance foot performance during human-like bipedalism, by examining the influence of foot proportions on force, torque and work in the foot joints during simulated bipedal walking. Skeletons of the common chimpanzee, orangutan, gorilla and human were represented by multi-rigid-body models, where the components of the foot make external contact via finite element surfaces. The models were driven by identical joint motion functions collected from experiments on human walking. Simulated contact forces between the ground and the foot were found to be reasonably comparable with measurements made during human walking using pressure- and force-platforms. Joint force, torque and work in the foot were then predicted. Within the limitations of our model, the results show that during simulated human-like bipedal walking, (1) the human and non-human ape (NHA) feet carry similar joint forces, although the distributions of the forces differ; (2) the NHA foot incurs larger joint torques than does the human foot, although the human foot has higher values in the first tarso-metatarsal and metatarso-phalangeal joints, whereas the NHA foot incurs higher values in the lateral digits; and (3) total work in the metatarso-phalangeal joints is lower in the human foot than in the NHA foot. The results indicate that human foot proportions are indeed well suited to performance in normal human walking. PMID:24925580

  4. Distribution of joint local and total size and of extension for avalanches in the Brownian force model

    NASA Astrophysics Data System (ADS)

    Delorme, Mathieu; Le Doussal, Pierre; Wiese, Kay Jörg

    2016-05-01

    The Brownian force model is a mean-field model for local velocities during avalanches in elastic interfaces of internal space dimension d , driven in a random medium. It is exactly solvable via a nonlinear differential equation. We study avalanches following a kick, i.e., a step in the driving force. We first recall the calculation of the distributions of the global size (total swept area) and of the local jump size for an arbitrary kick amplitude. We extend this calculation to the joint density of local and global sizes within a single avalanche in the limit of an infinitesimal kick. When the interface is driven by a single point, we find new exponents τ0=5 /3 and τ =7 /4 , depending on whether the force or the displacement is imposed. We show that the extension of a "single avalanche" along one internal direction (i.e., the total length in d =1 ) is finite, and we calculate its distribution following either a local or a global kick. In all cases, it exhibits a divergence P (ℓ ) ˜ℓ-3 at small ℓ . Most of our results are tested in a numerical simulation in dimension d =1 .

  5. Distribution of joint local and total size and of extension for avalanches in the Brownian force model.

    PubMed

    Delorme, Mathieu; Le Doussal, Pierre; Wiese, Kay Jörg

    2016-05-01

    The Brownian force model is a mean-field model for local velocities during avalanches in elastic interfaces of internal space dimension d, driven in a random medium. It is exactly solvable via a nonlinear differential equation. We study avalanches following a kick, i.e., a step in the driving force. We first recall the calculation of the distributions of the global size (total swept area) and of the local jump size for an arbitrary kick amplitude. We extend this calculation to the joint density of local and global sizes within a single avalanche in the limit of an infinitesimal kick. When the interface is driven by a single point, we find new exponents τ_{0}=5/3 and τ=7/4, depending on whether the force or the displacement is imposed. We show that the extension of a "single avalanche" along one internal direction (i.e., the total length in d=1) is finite, and we calculate its distribution following either a local or a global kick. In all cases, it exhibits a divergence P(ℓ)∼ℓ^{-3} at small ℓ. Most of our results are tested in a numerical simulation in dimension d=1.

  6. Distribution of joint local and total size and of extension for avalanches in the Brownian force model.

    PubMed

    Delorme, Mathieu; Le Doussal, Pierre; Wiese, Kay Jörg

    2016-05-01

    The Brownian force model is a mean-field model for local velocities during avalanches in elastic interfaces of internal space dimension d, driven in a random medium. It is exactly solvable via a nonlinear differential equation. We study avalanches following a kick, i.e., a step in the driving force. We first recall the calculation of the distributions of the global size (total swept area) and of the local jump size for an arbitrary kick amplitude. We extend this calculation to the joint density of local and global sizes within a single avalanche in the limit of an infinitesimal kick. When the interface is driven by a single point, we find new exponents τ_{0}=5/3 and τ=7/4, depending on whether the force or the displacement is imposed. We show that the extension of a "single avalanche" along one internal direction (i.e., the total length in d=1) is finite, and we calculate its distribution following either a local or a global kick. In all cases, it exhibits a divergence P(ℓ)∼ℓ^{-3} at small ℓ. Most of our results are tested in a numerical simulation in dimension d=1. PMID:27300864

  7. Dyspnea in a case of shoulder dislocation – to beware of this rare life-threatening symptom

    PubMed Central

    Joshi, Satyen Praful; Challawar, Nikhil Subhash; Agrawal, Parth Vinod; Gajjar, Arpit S.

    2016-01-01

    Shoulder dislocation is a common injury in orthopedic practice. In an acute presentation, closed reduction of the shoulder joint leads to an uneventful recovery. However, in the developing world neglected shoulder dislocation and treatments from quacks are not uncommon. Improper treatment and neglect can rarely become life threatening. We present one such case, emphasizing the need to investigate the symptom of dyspnea in a patient with history of shoulder dislocation. PMID:27658507

  8. [Arthroscopic treatment for osteoarthritis: knee and shoulder].

    PubMed

    Almazán, Arturo; Cruz, Francisco; Pérez, Francisco; Bravo, César; Ibarra, Clemente

    2007-10-01

    We discuss the role of arthroscopy in the treatment of knee and shoulder osteoarthritis. The most widely used arthroscopic techniques used in these joints for the treatment of osteoarthritis are arthroscopic lavage, arthroscopic debridement, abrasion arthrosplasty and microfractures. Even though arthroscopic techniques are only useful for a specific group of patients and that the procedure does not modify disease's natural history, it is an accessible therapeutic option.

  9. Development of a Finite Element Model of the Human Shoulder to Investigate the Mechanical Responses and Injuries in Side Impact

    NASA Astrophysics Data System (ADS)

    Iwamoto, Masami; Miki, Kazuo; Yang, King H.

    Previous studies in both fields of automotive safety and orthopedic surgery have hypothesized that immobilization of the shoulder caused by the shoulder injury could be related to multiple rib fractures, which are frequently life threatening. Therefore, for more effective occupant protection, it is important to understand the relationship between shoulder injury and multiple rib fractures in side impact. The purpose of this study is to develop a finite element model of the human shoulder in order to understand this relationship. The shoulder model included three bones (the humerus, scapula and clavicle) and major ligaments and muscles around the shoulder. The model also included approaches to represent bone fractures and joint dislocations. The relationships between shoulder injury and immobilization of the shoulder are discussed using model responses for lateral shoulder impact. It is also discussed how the injury can be related to multiple rib fractures.

  10. Shoulder MRI scan

    MedlinePlus

    ... an imaging test that uses energy from powerful magnets and to create pictures of the shoulder area. ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed in the room ...

  11. SHOULDER ARTHROPLASTY RECORDS

    PubMed Central

    Filho, Geraldo Motta; Galvão, Marcus Vinicius; Monteiro, Martim; Cohen, Marcio; Brandão, Bruno

    2015-01-01

    The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. Methodology: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. Results: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus fracture. 12% of the cases required total arthroplasties and 88% partial arthroplasties. Five major complications were observed on early postoperative period. Conclusion: Shoulder arthroplasties have become a common procedure in orthopaedic practice. Surgical records are important in evidencing progressive evolution and in enabling future clinical outcomes evaluation. PMID:26998463

  12. What Are Shoulder Problems?

    MedlinePlus

    ... between the collarbone and the shoulder blade are torn. The injury is most often caused by a ... others can be very painful. Treatment for a torn rotator cuff depends on age, health, how severe ...

  13. Exercise and Shoulder Pain

    MedlinePlus

    ... of four small muscles (known as the rotator cuff) and another five muscles that stabilize the scapula ( ... Adequate strength and endurance of both the rotator cuff and shoulder blade stabilizing muscles (trapezius, levator scapula, ...

  14. Simultaneous measurement of human joint force, surface electromyograms, and functional MRI-measured brain activation.

    PubMed

    Liu, J Z; Dai, T H; Elster, T H; Sahgal, V; Brown, R W; Yue, G H

    2000-08-15

    Functional magnetic resonance imaging (fMRI) has been increasingly used in studying human brain function given its non-invasive feature and good spatial resolution. However, difficulties in acquiring data from peripheral (e.g. information from muscle) during fMRI studies of motor function hinder interpretation of fMRI data and designing more sophisticated investigations. Here we describe a system that was designed to concurrently measure handgrip force, surface electromyograms (EMG) of finger flexor and extensor muscles, and fMRI of human brain. The system included a pressure transducer built in a hydraulic environment, a heavily shielded EMG recording element, and a visual feedback structure for online monitoring of force and/or EMG signal, by the subject positioned in the scanner during an fMRI experiment. System evaluation and subsequent fMRI motor function studies have indicated that by using this system, high quality force and EMG signals can be recorded without sacrificing the quality of the fMRI data. PMID:10967361

  15. Directional variability of the isometric force vector produced by the human hand in multijoint planar tasks.

    PubMed

    Friedman, Jason; Latash, Mark L; Zatsiorsky, Vladimir M

    2011-01-01

    Numerous studies have examined control of force magnitude, but relatively little research has considered force direction control. The subjects applied isometric forces to a handle and the authors compared within-trial variability when force is produced in different directions. The standard deviation of the force parallel to the prescribed direction of force production increased linearly with the targeted force level, as did the standard deviation of the force perpendicular to the instructed direction. In contrast, the standard deviation of the angle of force production decreased with increased force level. In the 4 (of 8) instructed force directions where the endpoint force was generated due to a joint torque in only 1 joint (either the shoulder or elbow) the principal component axes in force space were well aligned with the prescribed direction of force production. In the other directions, the variance was approximately equal along the 2 force axes. The variance explained by the first principal component was significantly larger in torque space compared to the force space, and mostly corresponded to positive correlation between the joint torques. Such coordinated changes suggest that the torque variability was mainly due to the variability of the common drive to the muscles serving 2 joints, although this statement needs to be supported by direct studies of muscle activation in the future. PMID:22017526

  16. Kinetic chain abnormalities in the athletic shoulder.

    PubMed

    Sciascia, Aaron; Thigpen, Charles; Namdari, Surena; Baldwin, Keith

    2012-03-01

    Overhead activities require the shoulder to be exposed to and sustain repetitive loads. The segmental activation of the body's links, known as the kinetic chain, allows this to occur effectively. Proper muscle activation is achieved through generation of energy from the central segment or core, which then transfers the energy to the terminal links of the shoulder, elbow, and hand. The kinetic chain is best characterized by 3 components: optimized anatomy, reproducible efficient motor patterns, and the sequential generation of forces. However, tissue injury and anatomic deficits such as weakness and/or tightness in the leg, pelvic core, or scapular musculature can lead to overuse shoulder injuries. These injuries can be prevented and maladaptations can be detected with a thorough understanding of biomechanics of the kinetic chain as it relates to overhead activity.

  17. Effect of a redesigned two-wheeled container for refuse collecting on mechanical loading of low back and shoulders.

    PubMed

    Kuijer, P Paul F M; Hoozemans, Marco J M; Kingma, Idsart; Van Dieën, Jaap H; De Vries, Wiebe H K; Veeger, Dirk Jan; Van der Beek, Allard J; Visser, Bart; Frings-Dresen, Monique H W

    2003-05-15

    The objective of this study was to compare the mechanical and perceived workload when working with a redesigned two-wheeled container and working with a standard two-wheeled container for refuse collecting. The three changes in the design of the container were a displacement of the position of the centre of mass in the direction of the axis of the wheels, a slight increase in the height of the handle and a slight increase in the horizontal distance between the handle and the wheel-axis, and an increase in the diameter of the wheels. The volume of the container remained 0.240 m3. Nine refuse collectors performed some of their most frequent daily activities with both types of containers in the laboratory. Kinematics and exerted hand forces were assessed as input for detailed 3D biomechanical models of the low back and shoulder to estimate net moments at the low back and shoulders, compressive forces at the low back and contact forces at the glenohumeral joint. Also, the refuse collectors rated the ease of handling the two-wheeled containers on a five point scale. The use of the redesigned container resulted in a decrease of the exerted hand forces of 27%, decreases in the net moments at the low back and shoulders of 8% and 20%, respectively, and a decrease of 32% of the contact force at the glenohumeral joint when compared to the standard container. However, pulling an empty redesigned container on to the pavement resulted in an increase of the shoulder moment of more than 100%. No differences between container types were found for the compressive forces at the low back. Pushing and pulling with the redesigned container was rated as easier than pushing and pulling with the standard container. No differences in subjective ratings were found for the tasks of turning the container or pulling an empty container onto the pavement. It is concluded that, provided that empty containers are placed back onto the pavement as infrequently as possible, the introduction of the

  18. The painful shoulder: when to inject and when to refer.

    PubMed

    Codsi, Michael J

    2007-07-01

    Physicians can usually diagnose the cause of shoulder pain by performing a focused history and physical examination and ordering anteroposterior and lateral radiographs. Treatment depends on the cause and can include physical therapy, injections of corticosteroids into the joint space or bursa, and surgery. This paper reviews the diagnosis and treatment of impingement syndrome, adhesive capsulitis, rotator cuff tears, and arthritis of the glenohumeral joint and acromioclavicular (AC) joint.

  19. Micro- and nanodomain imaging in uniaxial ferroelectrics: Joint application of optical, confocal Raman, and piezoelectric force microscopy

    SciTech Connect

    Shur, V. Ya. Zelenovskiy, P. S.

    2014-08-14

    The application of the most effective methods of the domain visualization in model uniaxial ferroelectrics of lithium niobate (LN) and lithium tantalate (LT) family, and relaxor strontium-barium niobate (SBN) have been reviewed in this paper. We have demonstrated the synergetic effect of joint usage of optical, confocal Raman, and piezoelectric force microscopies which provide extracting of the unique information about formation of the micro- and nanodomain structures. The methods have been applied for investigation of various types of domain structures with increasing complexity: (1) periodical domain structure in LN and LT, (2) nanodomain structures in LN, LT, and SBN, (3) nanodomain structures in LN with modified surface layer, (4) dendrite domain structure in LN. The self-assembled appearance of quasi-regular nanodomain structures in highly non-equilibrium switching conditions has been considered.

  20. Impact of the Joint Task Force on Undergraduate Physics Programs for Innovation and Entrepreneurship Education in Physics

    NASA Astrophysics Data System (ADS)

    Arion, Douglas

    The Joint Task Force on Undergraduate Physics Programs has worked diligently to develop recommendations for what physics programs could and should be doing to prepare graduates for 21st century careers. While the `traditional' physics curriculum has served for many years, the demands of the new workforce, and the recognition that only a few percent of physics students actually become faculty - the vast majority entering the workforce and applying their skills to a very diverse range of problems, projects, and products - implies that a review of the education undergraduates receives is in order. The outcomes of this study point to the need to provide greater connection between the education process and the actual skills, knowledge, and abilities that the workplace demands. This presentation will summarize these considerations, and show how entrepreneurship and innovation programs and curricula are a particularly effective means of bringing these elements to physics students.

  1. Implantable sensor technology: measuring bone and joint biomechanics of daily life in vivo

    PubMed Central

    2013-01-01

    Stresses and strains are major factors influencing growth, remodeling and repair of musculoskeletal tissues. Therefore, knowledge of forces and deformation within bones and joints is critical to gain insight into the complex behavior of these tissues during development, aging, and response to injury and disease. Sensors have been used in vivo to measure strains in bone, intraarticular cartilage contact pressures, and forces in the spine, shoulder, hip, and knee. Implantable sensors have a high impact on several clinical applications, including fracture fixation, spine fixation, and joint arthroplasty. This review summarizes the developments in strain-measurement-based implantable sensor technology for musculoskeletal research. PMID:23369655

  2. Force Protection Joint Experiment (FPJE) Battlefield Anti-Intrusion System (BAIS) sensors data analysis and filtering metrics

    NASA Astrophysics Data System (ADS)

    Barngrover, C. M.; Laird, R. T.; Kramer, T. A.; Cruickshanks, J. R.; Cutler, S. H.

    2009-04-01

    The FPJE was an experiment to consider the best way to develop and evaluate a system of systems approach to Force Protection. It was sponsored by Physical Security Equipment Action Group (PSEAG) and Joint Program Manager - Guardian (JPM-G), and was managed by the Product Manager - Force Protection Systems (PM-FPS). The experiment was an effort to utilize existing technical solutions from all branches of the military in order to provide more efficient and effective force protection. The FPJE consisted of four separate Integration Assessments (IA), which were intended as opportunities to assess the status of integration, automation and fusion efforts, and the effectiveness of the current configuration and "system" components. The underlying goal of the FPJE was to increase integration, automation, and fusion of the many different sensors and their data to provide enhanced situational awareness and a common operational picture. One such sensor system is the Battlefield Anti-Intrusion System (BAIS), which is a system of seismic and acoustic unmanned ground sensors. These sensors were originally designed for employment by infantry soldiers at the platoon level to provide early warning of personnel and vehicle intrusion in austere environments. However, when employed around airfields and high traffic areas, the sensitivity of these sensors can cause an excessive number of detections. During the second FPJE-IA all of the BAIS detections and the locations of all Opposing Forces were logged and analyzed to determine the accuracy rate of the sensors. This analysis revealed that with minimal filtering of detections, the number of false positives and false negatives could be reduced substantially to manageable levels while using the sensors within extreme operational acoustic and seismic noise conditions that are beyond the design requirements.

  3. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release

    PubMed Central

    Arce, Guillermo

    2015-01-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  4. Posterior instability caused by batter's shoulder.

    PubMed

    Kang, Richard W; Mahony, Gregory T; Harris, Thomas C; Dines, Joshua S

    2013-10-01

    In summary, batter’s shoulder is a rare and only recently recognized entity. This condition is posterior shoulder instability caused by a missed attempt at hitting a pitch, especially with an outside pitch. The lack of counterforce from hitting a ball produces increased forces imparted on the posterior capsulolabral complex of the lead shoulder during batting. If the player fails conservative management, she or he can undergo an arthroscopic posterior labral repair instead of debridement. After treatment, the player can expect to return to play after approximately 6 to 7 months. Initial results from a small, retrospective series demonstrate greater than 90% excellent results. These findings are similar to current literature for arthroscopic treatment of posterior instability, which reports success rates that range from 75% to 91%. Longer-term follow-up will be needed to determine the natural history and prognosis or batter’s shoulder. Based on initial results, the authors predict good to excellent results for most players with batter’s shoulder who undergo proper treatment. Additionally, with the exception of switch hitters, the nonthrowing arm is affected. This can also improve the athlete’s return to play.

  5. Posterior instability caused by batter's shoulder.

    PubMed

    Kang, Richard W; Mahony, Gregory T; Harris, Thomas C; Dines, Joshua S

    2013-10-01

    In summary, batter’s shoulder is a rare and only recently recognized entity. This condition is posterior shoulder instability caused by a missed attempt at hitting a pitch, especially with an outside pitch. The lack of counterforce from hitting a ball produces increased forces imparted on the posterior capsulolabral complex of the lead shoulder during batting. If the player fails conservative management, she or he can undergo an arthroscopic posterior labral repair instead of debridement. After treatment, the player can expect to return to play after approximately 6 to 7 months. Initial results from a small, retrospective series demonstrate greater than 90% excellent results. These findings are similar to current literature for arthroscopic treatment of posterior instability, which reports success rates that range from 75% to 91%. Longer-term follow-up will be needed to determine the natural history and prognosis or batter’s shoulder. Based on initial results, the authors predict good to excellent results for most players with batter’s shoulder who undergo proper treatment. Additionally, with the exception of switch hitters, the nonthrowing arm is affected. This can also improve the athlete’s return to play. PMID:24079435

  6. Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities

    PubMed Central

    Trepczynski, Adam; Kutzner, Ines; Bergmann, Georg; Taylor, William R; Heller, Markus O

    2014-01-01

    Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities. Methods The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. Results Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R2 value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed, the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. Conclusion The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. PMID:24470261

  7. Shouldering the load, maximising value.

    PubMed

    Baillie, Jonathan

    2015-02-01

    In mid-November last year Ryhurst signed what it dubbed 'a ground-breaking strategic estates partnership' agreement with the Isle of Wight NHS Trust (HEJ - January 2015). Under the Wight Life Partnership, the two organisations will work in partnership 'to comprehensively review the estate across all the Trust's sites to ensure that buildings and grounds are being fully utilised, and suitable for modern healthcare'. This is Ryhurst's third such 'whole estate' joint-venture agreement with the NHS, and the first with a non-Foundation Trust, harnessing an approach that sees the company shoulder a considerable part of the burden of making optimum use of, and deriving 'maximum value' from, large healthcare estates. HEJ editor, Jonathan Baillie, reports. PMID:26268015

  8. Shouldering the load, maximising value.

    PubMed

    Baillie, Jonathan

    2015-02-01

    In mid-November last year Ryhurst signed what it dubbed 'a ground-breaking strategic estates partnership' agreement with the Isle of Wight NHS Trust (HEJ - January 2015). Under the Wight Life Partnership, the two organisations will work in partnership 'to comprehensively review the estate across all the Trust's sites to ensure that buildings and grounds are being fully utilised, and suitable for modern healthcare'. This is Ryhurst's third such 'whole estate' joint-venture agreement with the NHS, and the first with a non-Foundation Trust, harnessing an approach that sees the company shoulder a considerable part of the burden of making optimum use of, and deriving 'maximum value' from, large healthcare estates. HEJ editor, Jonathan Baillie, reports.

  9. Is there a low-back cost to hip-centric exercise? Quantifying the lumbar spine joint compression and shear forces during movements used to overload the hips.

    PubMed

    Frost, David M; Beach, Tyson; Fenwick, Chad; Callaghan, Jack; McGill, Stuart

    2012-05-01

    The aim of this study was to quantify joint compression and shear forces at L4/L5 during exercises used to overload the hips. Nine men performed 36 "walking" trials using two modalities: (1) sled towing and (2) exercise bands placed around the ankles. Participants completed forward, backward, and lateral trials with bent and straight legs at three separate loads. Surface electromyography (EMG) was recorded bilaterally from eight torso and thigh sites, upper body and lumbar spine motion were quantified, and hand forces were measured. An EMG-driven musculoskeletal model was used to estimate the muscular contribution to joint compression and shear. Peak reaction, muscle and joint compression and shear forces, and peak gluteus medius and maximus activity were calculated. Significant differences were noted in each dependent measure; however, they were dependent on direction of travel, leg position, and load. The highest joint compression and shear forces for the sled and band conditions were 4378 N and 626 N, and 3306 N and 713 N, respectively. In general, increasing the band tension had little effect on all dependent measures, although a load-response was found during the sled conditions. Before using any exercise to improve hip function, the potential benefits should be weighed against "costs" to neighbouring joints.

  10. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

    PubMed Central

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-01-01

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  11. The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force.

    PubMed

    Zenan, Joan S

    2003-04-01

    The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task force. The history, work, challenges, and accomplishments of the Joint MLA/AAHSL Legislative Task Force, formed in 1985, are discussed.

  12. The Joint Commission has provided a tool to change your work force: are you paying attention?

    PubMed

    Decker, P J; Strader, M K

    1998-03-01

    Most health care managers wonder how to change employee "attitudes" so that their staff will be more accountable for patient satisfaction, cost reduction, and quality of care. Employees were trained to function in an industry where the power players were the physician and the administrator and now it is exceedingly difficult to get them to switch their attention to the patient and the payer in a market-driven economy. For hospital managers, the answer may be right at their fingertips: The Joint Commission on Accreditation of Healthcare Organizations' standards demanding that employee competence be objectively measured, proven, tracked & trended, improved, and age specific. A comprehensive competence assessment system can save the health care manager enormous work in measuring fewer things, focusing performance assessment on the 20 percent of things that are true problems, and helping to specifically define certain competencies such as customer focus and cost consciousness so that coaching, training, and giving performance feedback is easier. Developing a comprehensive competence assessment system is a powerful tool to change the culture of organizations. Consequently, it is important that managers be aware of those possibilities before they embark on developing "competencies" or before their organizations get too carried away on redesigning systems to satisfy standards. PMID:10177390

  13. The Joint Commission has provided a tool to change your work force: are you paying attention?

    PubMed

    Decker, P J; Strader, M K

    1998-03-01

    Most health care managers wonder how to change employee "attitudes" so that their staff will be more accountable for patient satisfaction, cost reduction, and quality of care. Employees were trained to function in an industry where the power players were the physician and the administrator and now it is exceedingly difficult to get them to switch their attention to the patient and the payer in a market-driven economy. For hospital managers, the answer may be right at their fingertips: The Joint Commission on Accreditation of Healthcare Organizations' standards demanding that employee competence be objectively measured, proven, tracked & trended, improved, and age specific. A comprehensive competence assessment system can save the health care manager enormous work in measuring fewer things, focusing performance assessment on the 20 percent of things that are true problems, and helping to specifically define certain competencies such as customer focus and cost consciousness so that coaching, training, and giving performance feedback is easier. Developing a comprehensive competence assessment system is a powerful tool to change the culture of organizations. Consequently, it is important that managers be aware of those possibilities before they embark on developing "competencies" or before their organizations get too carried away on redesigning systems to satisfy standards.

  14. Problems With Large Joints: Shoulder Conditions.

    PubMed

    Campbell, Michael

    2016-07-01

    Age-related macular degeneration (AMD) causes a progressive loss of photoreceptors in the macula. It is the most common cause of legal blindness in the United States, and some form of AMD is thought to affect more than 9 million individuals. Risk factors include older age, smoking, dyslipidemia, obesity, white race, female sex, and a family history of AMD. There are two types of advanced AMD: nonexudative (dry or geographic atrophy) and exudative (wet or neovascular). Both cause progressive central vision loss with intact peripheral vision. Nonexudative AMD accounts for 80% to 90% of all advanced cases, and more than 90% of patients with severe vision loss have exudative AMD. On ophthalmoscopic examination, early findings include drusen (ie, yellow deposits in the retina). Prominent choroidal vessels, subretinal edema, and/or hemorrhage are seen in wet AMD. Regular eye examinations, visual field testing, fluorescein angiography, and optical coherence tomography are used for diagnosis and to guide management. There is no specific therapy for dry AMD, but antioxidant supplementation may be helpful. Intravitreal injection of a vascular endothelial growth factor inhibitor is the treatment of choice for wet AMD. Optical aids and devices can help to maximize function for patients with AMD.

  15. Problems With Large Joints: Shoulder Conditions.

    PubMed

    Campbell, Michael

    2016-07-01

    Age-related macular degeneration (AMD) causes a progressive loss of photoreceptors in the macula. It is the most common cause of legal blindness in the United States, and some form of AMD is thought to affect more than 9 million individuals. Risk factors include older age, smoking, dyslipidemia, obesity, white race, female sex, and a family history of AMD. There are two types of advanced AMD: nonexudative (dry or geographic atrophy) and exudative (wet or neovascular). Both cause progressive central vision loss with intact peripheral vision. Nonexudative AMD accounts for 80% to 90% of all advanced cases, and more than 90% of patients with severe vision loss have exudative AMD. On ophthalmoscopic examination, early findings include drusen (ie, yellow deposits in the retina). Prominent choroidal vessels, subretinal edema, and/or hemorrhage are seen in wet AMD. Regular eye examinations, visual field testing, fluorescein angiography, and optical coherence tomography are used for diagnosis and to guide management. There is no specific therapy for dry AMD, but antioxidant supplementation may be helpful. Intravitreal injection of a vascular endothelial growth factor inhibitor is the treatment of choice for wet AMD. Optical aids and devices can help to maximize function for patients with AMD. PMID:27403865

  16. Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill.

    PubMed

    Jensen, Bente R; Hovgaard-Hansen, Line; Cappelen, Katrine L

    2016-08-01

    Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMGpeak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle). It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force.

  17. Joint Task Force on Undergraduate Physics Programs: Implications for physics programs and why you should care

    NASA Astrophysics Data System (ADS)

    Hodapp, Theodore

    2016-03-01

    The content of undergraduate physics programs has not changed appreciably in 50 years, however, the jobs our students take have changed dramatically. Preparing students for careers they are likely to encounter requires physics programs to rethink and in some cases retool to provide an education that will not only educate an individual in the habits of mind and keen sense of how to solve complex technical problems, but also what related skills they will need to be effective in those careers. Do you teach your student how to read or create a budget? How about dealing with a low-performing member of an R&D team? This talk will explore driving forces behind this report, potential implications for physics departments, and practical steps faculty members can take to continue to consider improvements in experiences for our students. This work is supported in part by the National Science Foundation (NSF-1540570).

  18. Bilateral shoulder septic arthritis in a fit and well 47-year-old man.

    PubMed

    Hotonu, Sesi Ayodele; Khan, Shoaib; Jeavons, Richard

    2015-01-01

    Bilateral septic arthritis of the shoulder is uncommon in the immunocompetent patient with no previous risk factors for joint infection, and is thus easily missed. Septic arthritis is associated with significant rates of morbidity and mortality. Early diagnosis and management is the key to a favourable outcome; septic arthritis should be considered as a differential diagnosis in the unwell patient presenting with shoulder pain and reduced range of joint movement. We present a case of a 47-year-old previously fit and well man with bilateral shoulder septic arthritis. We will also review the current literature on management and long-term outcomes of patients with septic arthritis of the glenohumeral joint.

  19. Computational analysis of polyethylene wear in anatomical and reverse shoulder prostheses.

    PubMed

    Quental, C; Folgado, J; Fernandes, P R; Monteiro, J

    2015-02-01

    The wear of ultra-high molecular weight polyethylene, UHMWPE, components has been associated with the failure of joint prostheses in the hip, knee, and shoulder. Considering that in vitro experiments are generally too expensive and time-consuming, computational models are an attractive alternative to study the wear behavior of UHMWPE components. The objective of the present study was to develop a computational wear model to evaluate the wear resistance of anatomical and reverse shoulder prostheses. The effects of the wear law and the updating of the UHMWPE surface on the prediction of wear were also considered. Apart from Archard's law, a new wear law, so-called second generation law, which includes the concept of cross-shear and a pressure-independent wear factor, was considered. The wear analyses were performed considering three shoulder joint motions. The muscle and joint reaction forces applied were estimated by an inverse biomechanical model of the upper limb. The results show that abrasive wear is as important for the reverse components as it is for the anatomical. Nevertheless, the volumetric wears estimated over 1 year are within the range considered clinically desirable to reduce the risk of osteolysis. For the anatomical components, the predictions from Archard's law compare better, than those of the second generation law, to the experimental and clinical data available in the literature. Yet, the opposite result is obtained for the reverse components. From the numerical point of view, an updating procedure for the UHMWPE surface is mandatory to improve the numerical predictions. PMID:25362522

  20. Anterior Shoulder Dislocations in Busy Emergency Departments

    PubMed Central

    Janitzky, Angelika A.; Akyol, Can; Kesapli, Mustafa; Gungor, Faruk; Imak, Arefe; Hakbilir, Oktay

    2015-01-01

    Abstract Shoulder joint is the most common joint requiring reduction by emergency physicians. Successful reduction is based on the overcoming of resistance of the shoulder muscles. Pain is the most important factor in resistance increase and sedation; analgesia and, in certain cases, intra-articular anesthesia are preferred for reduction. The external rotation (ER) method can provide successful reduction without causing an increase in muscle resistance if applied slowly and gently. The aim of this study was, therefore, to determine the usefulness of the ERWOSA method in the reduction of acute anterior shoulder dislocations (AASDs). This was a retrospective descriptive study. The records of patients admitted to the emergency department with anterior shoulder dislocation between 2009 and 2011 were reviewed for demographic data, sedation, analgesia, and discharge times. Patients were then divided into ERWOSA (n = 80) and external rotation and sedation-analgesia (ERASA, n = 59) groups, with regard to the application of SA (sedation-analgesia). The study data were analyzed using SPSS version 22.0 software for Windows. Numerical data were presented as mean ± standard deviation and categorical data as rates. A total of 139 patients were included in the study. The patients’ average age was 35 ± 14 years, 108 (77.7%) were male. Successful reduction rates for 59 male and 21 female patients in the ERWOSA group were 83% and 66.7% (78.7% total success), respectively. Successful reduction rates for 49 male and 10 female patients in the ERASA group were 87.7% and 90% (88.1% total success), respectively. The length of stay of the ERWOSA and ERASA groups in emergency services were found to be significantly different, with 55 ± 17 and 118 ± 23 minutes for each group, respectively. There were no complications. The ER method can be used in reduction of anterior shoulder dislocations without sedation and analgesia, if applied slowly enough to overcome

  1. Testing thread compounds for rotary-shouldered connections

    SciTech Connect

    Bailey, E.I. ); Smith, J.E. )

    1993-09-01

    Trouble-free rotary-shouldered-connection performance depends on proper joint makeup. Joints must be tight enough to prevent shoulder separation under bending and tensile loads but not so tight that their tensile capacity decreases or the pin or box is damaged. The preload in a connection from tightening depends on the makeup torque and frictional properties of the thread compound. In 1957, Farr developed and published a simplified torque formula to calculate makeup torque: T[sub mu] = ([sigma]A/12)[(p/2[pi])+(r[sub t]K[sub f]/cos [Theta])+r[sub s]K[sub f

  2. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies. PMID:25129166

  3. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies.

  4. Detailed shoulder MRI findings in manual wheelchair users with shoulder pain.

    PubMed

    Morrow, Melissa M B; Van Straaten, Meegan G; Murthy, Naveen S; Braman, Jonathan P; Zanella, Elia; Zhao, Kristin D

    2014-01-01

    Shoulder pain and pathology are common in manual wheelchair (MWC) users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging assessments were performed using our standardized MRI Assessment of the Shoulder (MAS) guide. The tendon most commonly torn was the supraspinatus at the insertion site in the anterior portion in either the intrasubstance or articular region. Additionally, widespread tendinopathy, CA ligament thickening, subacromial bursitis, labral tears, and AC joint degenerative arthrosis and edema were common. Further reporting of detailed shoulder imaging findings is needed to confirm patterns of tears in MWC users regarding probable tendon tear zone, region, and portion. This investigation was a small sample observational study and did not yield data that can define patterns of pathology. However, synthesis of detailed findings from multiple studies could define patterns of pathological MRI findings allowing for associations of imaging findings to risk factors including specific activities. PMID:25180192

  5. Changes in the Flexor Digitorum Profundus Tendon Geometry in the Carpal Tunnel Due to Force Production and Posture of Metacarpophalangeal Joint of the Index Finger: an MRI Study

    PubMed Central

    Martin, Joel R.; Paclet, Florent; Latash, Mark. L.; Zatsiorsky, Vladimir M.

    2012-01-01

    Background Carpal tunnel syndrome is a disorder caused by increased pressure in the carpal tunnel associated with repetitive, stereotypical finger actions. Little is known about in vivo geometrical changes in the carpal tunnel caused by motion at the finger joints and exerting a fingertip force. Methods The hands and forearms of five subjects were scanned using a 3.0T magnetic resonance imaging scanner. The metacarpophalangeal joint of the index finger was placed in: flexion, neutral and extension. For each joint posture subjects either produced no active force (passive condition) or exerted a flexion force to resist a load (~4.0 N) at the fingertip (active condition). Changes in the radii of curvature, position and transverse plane area of the flexor digitorum profundus tendons at the carpal tunnel level were measured. Results The radius of curvature of the flexor digitorum profundus tendons, at the carpal tunnel level, was significantly affected by posture of the index finger metacarpophalangeal joint (p<0.05) and the radii was significantly different between fingers (p<0.05). Actively producing force caused a significant shift (p<0.05) in the flexor digitorum profundus tendons in the ventral (palmar) direction. No significant change in the area of an ellipse containing the flexor digitorum profundus tendons was observed between conditions. Interpretation The results show that relatively small changes in the posture and force production of a single finger can lead to significant changes in the geometry of all the flexor digitorum profundus tendons in the carpal tunnel. Additionally, voluntary force production at the fingertip increases the moment arm of the FDP tendons about the wrist joint. PMID:23219762

  6. Estimation of joint forces and moments for the in-run and take-off in ski jumping based on measurements with wearable inertial sensors.

    PubMed

    Logar, Grega; Munih, Marko

    2015-05-13

    This study uses inertial sensors to measure ski jumper kinematics and joint dynamics, which was until now only a part of simulation studies. For subsequent calculation of dynamics in the joints, a link-segment model was developed. The model relies on the recursive Newton-Euler inverse dynamics. This approach allowed the calculation of the ground reaction force at take-off. For the model validation, four ski jumpers from the National Nordic center performed a simulated jump in a laboratory environment on a force platform; in total, 20 jumps were recorded. The results fit well to the reference system, presenting small errors in the mean and standard deviation and small root-mean-square errors. The error is under 12% of the reference value. For field tests, six jumpers participated in the study; in total, 28 jumps were recorded. All of the measured forces and moments were within the range of prior simulated studies. The proposed system was able to indirectly provide the values of forces and moments in the joints of the ski-jumpers' body segments, as well as the ground reaction force during the in-run and take-off phases in comparison to the force platform installed on the table. Kinematics assessment and estimation of dynamics parameters can be applied to jumps from any ski jumping hill.

  7. Clinical Measures of Shoulder Mobility in the Professional Baseball Player.

    PubMed

    Downar, Jacquelyn M; Sauers, Eric L

    2005-03-01

    Context: Professional baseball players must achieve a delicate balance between shoulder mobility and stability to attain optimal sports performance. The sport-specific demands of repetitive overhead throwing may result in an altered mobility-stability relationship.Objective: To evaluate clinical measures of shoulder mobility in professional baseball players in order to examine differences between the throwing and the nonthrowing shoulders and to describe chronic adaptations to throwing.Design: Descriptive.Setting: The athletic training room at Maryvale Baseball Park, Phoenix, AZ.Patients or Other Participants: Twenty-seven professional baseball players (20 pitchers, 7 position players; age = 20 +/- 1.6 years, height = 190.5 +/- 4.8 cm, mass = 91.6 +/- 9.6 kg) with no previous history of shoulder or elbow injury.Main Outcome Measure(s): We recorded scapular upward rotation at 4 levels of humeral elevation in the scapular plane (rest, 60 degrees , 90 degrees , 120 degrees ); posterior shoulder tightness; and passive, isolated glenohumeral joint internal and external range of motion.Results: Scapular upward rotation was significantly greater in the throwing shoulder (14.2 +/- 6.5 degrees ) than in the nonthrowing shoulder (10.6 +/- 6.1 degrees ) at 90 degrees of humeral elevation (P = .04). We observed no statistically significant difference in posterior shoulder tightness between the throwing (30.2 +/- 4.6 cm) and the nonthrowing (28.0 +/- 4.8 cm) shoulder (P = .09). In addition, the throwing shoulder exhibited a statistically significant decrease in isolated glenohumeral internal rotation (56.6 +/- 12.5 degrees ) compared with the nonthrowing shoulder (68.6 +/- 12.6 degrees ) (P = .001), with a concomitant increase in isolated glenohumeral external rotation (throwing = 108.9 +/- 9.0 degrees , nonthrowing = 101.9 +/- 5.9 degrees , P = .0014). An analysis of the total arc of motion (internal rotation + external rotation) revealed no statistically significant

  8. Comparisons of knee and ankle joint angles and ground reaction force according to functional differences during single-leg drop landing

    PubMed Central

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-01-01

    [Purpose] The purpose of this study was to determine potential predictors of functional instability of the knee and ankle joints during single-leg drop landing based on the prior history of injury. [Subjects and Methods] The subjects were 24 collegiate soccer players without pain or dysfunction. To compare the differences between the stable and unstable sides during single-leg drop landing, 8 motion analysis cameras and a force plate were used. The Cortex 4 software was used for a biomechanical analysis of 3 events. An independent t-test was used for statistical comparison between both sides; p<0.05 indicated significance. [Results] The knee joint movements showed gradual flexion in the sagittal plane. The unstable-side ankle joint showed plantar flexion of approximately 2° relative to the stable side. In the coronal plane, the unstable-side knee joint differed from the stable side in its tendency for valgus movement. The unstable-side ankle joint showed contrasting movement compared with the stable side, and the difference was significant. Regarding the vertical ground reaction force, the stable side showed maximum knee flexion that was approximately 0.1 BW lower than that of the unstable side. [Conclusion] Increasing the flexion angle of the knee joint can help prevent injury during landing. PMID:27190444

  9. Association between Propionibacterium acnes and frozen shoulder: a pilot study

    PubMed Central

    Bunker, Tim D; Gallacher, Sian; Auckland, Cressida R; Kitson, Jeff; Smith, Chris D

    2014-01-01

    Background Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids. Methods A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat. The biopsies and controls were examined with extended culture and PCR for microbial nucleic acid. Results Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium acnes was present. Conclusions The findings mean that we must reject the null hypothesis that there is no relationship between infection and frozen shoulder. More studies are urgently needed to confirm or refute these findings. If they are confirmed, this could potentially lead to new and effective treatments for this common, painful and disabling condition. Could P. acnes be the Helicobacter of frozen shoulder? PMID:27582943

  10. MRI findings in throwing shoulders: abnormalities in professional handball players.

    PubMed

    Jost, Bernhard; Zumstein, Matthias; Pfirrmann, Christian W A; Zanetti, Marco; Gerber, Christian

    2005-05-01

    Shoulders of throwing athletes are highly stressed joints and likely to have more structural abnormalities seen on magnetic resonance imaging scans. Prevalence and type of structural abnormalities, especially abnormalities of the rotator cuff tendons and the superolateral humeral head, and correlation of magnetic resonance imaging findings with symptoms and clinical tests, are not well known. Throwing and nonthrowing (symptomatic and asymptomatic) shoulders of 30 fully competitive professional handball players and 20 dominant shoulders of randomly selected volunteers were evaluated for comparison clinically and with magnetic resonance imaging. An average of seven abnormal magnetic resonance imaging findings was observed in the throwing shoulders; more than in the nonthrowing and the control shoulders. Although 93% of the throwing shoulders had abnormal magnetic resonance imaging findings, only 37% were symptomatic. Partial rotator cuff tears and mainly superolateral osteochondral defects of the humeral head were identified as typical throwing lesions. Symptoms correlated poorly with abnormalities seen on magnetic resonance imaging scans and findings from clinical tests. This suggests that the evaluation of an athlete's throwing shoulder should be done very thoroughly and should not be based mainly on abnormalities seen on magnetic resonance imaging scans.

  11. Shoulder Problems Motivate Innovative Solutions.

    PubMed

    Lubowitz, James H; Brand, Jefferson C; Rossi, Michael J; Provencher, Matthew T

    2016-09-01

    Shoulder arthroscopic and related surgeons may require expertise in use of the 70° arthroscope, biologic patch augmentation, repair of massive rotator cuff tears, the Latarjet procedure and related glenoid bone augmentation, and reverse total shoulder arthroplasty. PMID:27594323

  12. Using your shoulder after surgery

    MedlinePlus

    ... you it is ok. If you had rotator cuff surgery or other ligament or labral surgery, you ... Saunders; 2009:chap 20. Read More Osteoarthritis Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain ...

  13. Epidemiologic perspective on shoulder injuries.

    PubMed

    Hill, J A

    1983-07-01

    The type and incidence of shoulder injuries in baseball, swimming, football, and wrestling are discussed in detail; also mentioned are shoulder injuries in tennis, basketball, skiing, and javelin throwing.

  14. Anatomic and biomechanical fundamentals of the thrower shoulder.

    PubMed

    Eckenrode, Brian J; Kelley, Martin J; Kelly, John D

    2012-03-01

    The act of throwing requires proper functioning and timing of the entire kinetic chain musculature to generate a coordinated movement pattern for ball delivery. The role of the shoulder complex is vital in the transmission of force from the lower extremities and trunk to the arm and hand. A review of the anatomic and biomechanical factors of the shoulder girdle will be discussed as it pertains to the thrower. An understanding of the relationship of the muscles, ligaments, and osseous structures is essential to the successful diagnosis and treatment of shoulder pathology and dysfunction.

  15. Consistent accuracy in whole-body joint kinetics during gait using wearable inertial motion sensors and in-shoe pressure sensors.

    PubMed

    Khurelbaatar, Tsolmonbaatar; Kim, Kyungsoo; Lee, SuKyoung; Kim, Yoon Hyuk

    2015-06-01

    To analyze human motion such as daily activities or sports outside of the laboratory, wearable motion analysis systems have been recently developed. In this study, the joint forces and moments in whole-body joints during gait were evaluated using a wearable motion analysis system consisting of an inertial motion measurement system and an in-shoe pressure sensor system. The magnitudes of the joint forces and the moments in nine joints (cervical, thoracic, lumbar, right shoulder, right elbow, right wrist, right hip, right knee, and right ankle) during gait were calculated using the wearable system and the conventional system, respectively, based on a standard inverse dynamics analysis. The averaged magnitudes of the joint forces and moments of five subjects were compared between the wearable and conventional systems in terms of the Pearson's correlation coefficient and the normalized root mean squared error to the maximum value from the conventional system. The results indicated that both the joint forces and joint moments in human whole body joints using wearable inertial motion sensors and in-shoe pressure sensors were feasible for normal motions with a low speed such as walking, although the lower extremity joints showed the strongest correlation and overall the joint moments were associated with relatively smaller correlation coefficients and larger normalized root mean squared errors in comparison with the joint forces. The portability and mobility of this wearable system can provide wide applicability in both clinical and sports motion analyses. PMID:25957652

  16. Consistent accuracy in whole-body joint kinetics during gait using wearable inertial motion sensors and in-shoe pressure sensors.

    PubMed

    Khurelbaatar, Tsolmonbaatar; Kim, Kyungsoo; Lee, SuKyoung; Kim, Yoon Hyuk

    2015-06-01

    To analyze human motion such as daily activities or sports outside of the laboratory, wearable motion analysis systems have been recently developed. In this study, the joint forces and moments in whole-body joints during gait were evaluated using a wearable motion analysis system consisting of an inertial motion measurement system and an in-shoe pressure sensor system. The magnitudes of the joint forces and the moments in nine joints (cervical, thoracic, lumbar, right shoulder, right elbow, right wrist, right hip, right knee, and right ankle) during gait were calculated using the wearable system and the conventional system, respectively, based on a standard inverse dynamics analysis. The averaged magnitudes of the joint forces and moments of five subjects were compared between the wearable and conventional systems in terms of the Pearson's correlation coefficient and the normalized root mean squared error to the maximum value from the conventional system. The results indicated that both the joint forces and joint moments in human whole body joints using wearable inertial motion sensors and in-shoe pressure sensors were feasible for normal motions with a low speed such as walking, although the lower extremity joints showed the strongest correlation and overall the joint moments were associated with relatively smaller correlation coefficients and larger normalized root mean squared errors in comparison with the joint forces. The portability and mobility of this wearable system can provide wide applicability in both clinical and sports motion analyses.

  17. The Rotator Interval of the Shoulder

    PubMed Central

    Frank, Rachel M.; Taylor, Dean; Verma, Nikhil N.; Romeo, Anthony A.; Mologne, Timothy S.; Provencher, Matthew T.

    2015-01-01

    Biomechanical studies have shown that repair or plication of rotator interval (RI) ligamentous and capsular structures decreases glenohumeral joint laxity in various directions. Clinical outcomes studies have reported successful outcomes after repair or plication of these structures in patients undergoing shoulder stabilization procedures. Recent studies describing arthroscopic techniques to address these structures have intensified the debate over the potential benefit of these procedures as well as highlighted the differences between open and arthroscopic RI procedures. The purposes of this study were to review the structures of the RI and their contribution to shoulder instability, to discuss the biomechanical and clinical effects of repair or plication of rotator interval structures, and to describe the various surgical techniques used for these procedures and outcomes. PMID:26779554

  18. Common Shoulder Injuries in American Football Athletes.

    PubMed

    Gibbs, Daniel B; Lynch, T Sean; Nuber, Erika D; Nuber, Gordon W

    2015-01-01

    American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes.

  19. Shoulder replacement - discharge

    MedlinePlus

    ... include a stem made of metal and a metal ball that fits on the top of the stem. A plastic piece is used as the new surface of the shoulder blade. You received pain medicine. You also learned how to manage swelling around ...

  20. Alterations in intermediate filaments expression in disc cells from the rat temporomandibular joint following exposure to continuous compressive force.

    PubMed

    Magara, Jin; Nozawa-Inoue, Kayoko; Suzuki, Akiko; Kawano, Yoshiro; Ono, Kazuhiro; Nomura, Shuichi; Maeda, Takeyasu

    2012-06-01

    The articular disc in the temporomandibular joint (TMJ) that serves in load relief and stabilizing in jaw movements is a dense collagenous tissue consisting of extracellular matrices and disc cells. The various morphological configurations of the disc cells have given us diverse names, such as fibroblasts, chondrocyte-like cells and fibrochondrocytes; however, the characteristics of these cells have remained to be elucidated in detail. The disc cells have been reported to exhibit heterogeneous immunoreaction patterns for intermediate filaments including glial fibrillary acidic protein (GFAP), nestin and vimentin in the adult rat TMJ. Because these intermediate filaments accumulate in the disc cells as tooth eruption proceeds during postnatal development, it might be surmised that the expression of these intermediate filaments in the disc cells closely relates to mechanical stress. The present study was therefore undertaken to examine the effect of a continuous compressive force on the immunoexpression of these intermediate filaments and an additional intermediate filament - muscle-specific desmin - in the disc cells of the TMJ disc using a rat experimental model. The rats wore an appliance that exerts a continuous compressive load on the TMJ. The experimental period with the appliance was 5 days as determined by previous studies, after which some experimental animals were allowed to survive another 5 days after removal of the appliance. Histological observations demonstrated that the compressive force provoked a remarkable acellular region and a decrease in the thickness of the condylar cartilage of the mandible, and a sparse collagen fiber distribution in the articular disc. The articular disc showed a significant increase in the number of desmin-positive cells as compared with the controls. In contrast, immunopositive cells for GFAP, nestin and vimentin remained unchanged in number as well as intensity. At 5 days after removal of the appliance, both the disc and

  1. A Kinetic Chain Approach for Shoulder Rehabilitation

    PubMed Central

    McMullen, John; Uhl, Timothy L.

    2000-01-01

    Objective: To introduce an approach to shoulder rehabilitation that integrates the kinetic chain throughout the rehabilitation program while providing the theoretical rationale for this program. Background: The focus of a typical rehabilitation program is to identify and treat the involved structures. However, in activities of sport and daily life, the body does not operate in isolated segments but rather works as a dynamic unit. Recently, rehabilitation programs have emphasized closed kinetic chain exercises, core-stabilization exercises, and functional programs. These components are implemented as distinct entities and are used toward the end of the rehabilitation program. Description: Kinetic chain shoulder rehabilitation incorporates the kinetic link biomechanical model and proximal-to-distal motor-activation patterns with proprioceptive neuromuscular facilitation and closed kinetic chain exercise techniques. This approach focuses on movement patterns rather than isolated muscle exercises. Patterns sequentially use the leg, trunk, and scapular musculature to activate weakened shoulder musculature, gain active range of motion, and increase strength. The paradigm of kinetic chain shoulder rehabilitation suggests that functional movement patterns and closed kinetic chain exercises should be incorporated throughout the rehabilitation process. Clinical Advantages: The exercises in this approach are consistent with biomechanical models, apply biomechanical and motor control theory, and work toward sport specificity. The exercises are designed to stimulate weakened tissue by motion and force production in the adjacent kinetic link segments. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8. PMID:16558646

  2. Long-latency reflexes of elbow and shoulder muscles suggest reciprocal excitation of flexors, reciprocal excitation of extensors, and reciprocal inhibition between flexors and extensors.

    PubMed

    Kurtzer, Isaac; Meriggi, Jenna; Parikh, Nidhi; Saad, Kenneth

    2016-04-01

    Postural corrections of the upper limb are required in tasks ranging from handling an umbrella in the changing wind to securing a wriggling baby. One complication in this process is the mechanical interaction between the different segments of the arm where torque applied at one joint induces motion at multiple joints. Previous studies have shown the long-latency reflexes of shoulder muscles (50-100 ms after a limb perturbation) account for these mechanical interactions by integrating information about motion of both the shoulder and elbow. It is less clear whether long-latency reflexes of elbow muscles exhibit a similar capability and what is the relation between the responses of shoulder and elbow muscles. The present study utilized joint-based loads tailored to the subjects' arm dynamics to induce well-controlled displacements of their shoulder and elbow. Our results demonstrate that the long-latency reflexes of shoulder and elbow muscles integrate motion from both joints: the shoulder and elbow flexors respond to extension at both joints, whereas the shoulder and elbow extensors respond to flexion at both joints. This general pattern accounts for the inherent flexion-extension coupling of the two joints arising from the arm's intersegmental dynamics and is consistent with spindle-based reciprocal excitation of shoulder and elbow flexors, reciprocal excitation of shoulder and elbow extensors, and across-joint inhibition between the flexors and extensors.

  3. Acromioclavicular joint injury in competitive golfers.

    PubMed

    Mallon, W J; Colosimo, A J

    1995-01-01

    We reviewed a series of professional and competitive low-handicap golfers with shoulder pain. All but one player (34/35) had pain in the left shoulder. A high incidence of problems (53%) related to the acromioclavicular joint was noted in these golfers with left shoulder pain. With proper treatment all but one (17/18 [94%]) of the golfers with acromioclavicular joint problems was able to return to competitive golf. By studying the mechanics of the golf swing, a possible mechanism for this high incidence of acromioclavicular joint problems is given.

  4. Incidence of joint replacement among active component service members, U.S. Armed Forces, 2004-2014.

    PubMed

    Daniele, Denise O; Taubman, Stephen B; Clark, Leslie L

    2015-05-01

    In the U.S., joint replacements have become more common and the average age of individuals who undergo joint replacements has decreased. Joint replacements among active component service members increased 10.5% during 2004-2009, then 61.9% during 2009-2014. Knees and hips were the most frequently replaced joints among service members. During the surveillance period (and particularly after 2009), incidence rates increased in each age group of service members 30 years or older. Relative to their respective counterparts, rates of joint replacement overall--and of the hip and knee specifically--were higher among service members who were black, non-Hispanic; officers; and healthcare workers. One year after joint replacement, 18.2% had retired; 5.2% had been medically disqualified from service; 6.3% had otherwise left service; and 70.3% were still in service. By 2 years post-joint replacement, 30.2% had retired; 13.0% had been medically disqualified; 10.0% had otherwise left service; and 46.8% were still in service. Service members aged 30-44 years were the most likely to remain in service post-joint replacement. Given the increases in the frequency of joint replacement among younger service members, the number of service members who remain in service post-joint replacement may continue to increase. PMID:25996170

  5. Bilateral posterior shoulder dislocation after electrical shock: A case report

    PubMed Central

    Ketenci, Ismail Emre; Duymus, Tahir Mutlu; Ulusoy, Ayhan; Yanik, Hakan Serhat; Mutlu, Serhat; Durakbasa, Mehmet Oguz

    2015-01-01

    Introduction Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction. Presentation of case This report presents a case of bilateral posterior shoulder dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and humeral head impression defects were minor. Our treatment in this case consisted of closed reduction under general anesthesia and applying of orthoses which kept the shoulders in abduction and external rotation. A rehabilitation program was begun after 3 weeks of immobilization. After 6 months of injury the patient has returned to work. 20 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities. Discussion The amount of bilateral shoulder dislocations after electrical injury is not reported but is known to be very rare. The aim of this case presentation is to report an example for this rare entity, highlight the difficulties in diagnosis and review the treatment options. Conclusion Physical examination and radiographic evaluation are important for quick and accurate diagnosis. PMID:26904192

  6. A healthy patient with bilateral frozen hips preceding bilateral frozen shoulders: a cautionary tale.

    PubMed

    Miller, Abigail R; Arnot, Dean; Wake, Melissa

    2015-01-01

    Adhesive capsulitis of the shoulder (frozen shoulder) is a common disease characterised by spontaneous onset of pain and restriction of movement, followed by 'thawing', with complete or near-complete resolution. Adhesive capsulitis of the hip has been reported in around a dozen patients. This report describes an otherwise-healthy middle-aged woman with apparent sequential resolving adhesive capsulitis of all four ball-and-socket joints over a 9-year period, initially affecting each hip and then each shoulder sequentially. The likely hip diagnosis became clear only retrospectively with development of the second frozen shoulder, 5 years after the first pain. All joints subsequently resolved within the expected timeframe and the patient remains healthy, other than having mild hypertension. This case illustrates that, when hip precedes shoulder involvement, there is the potential for the frozen hip to receive alternate diagnoses for which invasive open hip surgery could unnecessarily be recommended. PMID:26564111

  7. First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

    PubMed Central

    Sedeek, Sedeek Mohamed; Bin Abd Razak, Hamid Rahmatullah; Ee, Gerard WW; Tan, Andrew HC

    2014-01-01

    The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilisation for 4–6 weeks, followed by functional rehabilitation. However, in view of the high recurrence rates associated with this traditional approach, there has been an escalating interest in determining whether immediate surgical intervention can lower the rate of recurrent shoulder dislocation, improving the patient’s quality of life. This review article aims to provide an overview of the nature and pathogenesis of first-time primary anterior shoulder dislocations, the widely accepted management modalities, and the efficacy of primary surgical intervention in first-time primary anterior shoulder dislocations. PMID:25631890

  8. Lower extremity extension force and electromyography properties as a function of knee angle and their relation to joint torques: implications for strength diagnostics.

    PubMed

    Hahn, Daniel

    2011-06-01

    The purpose of this study was to evaluate whether and how isometric multijoint leg extension strength can be used to assess athletes' muscular capability within the scope of strength diagnosis. External reaction forces (Fext) and kinematics were measured (n = 18) during maximal isometric contractions in a seated leg press at 8 distinct joint angle configurations ranging from 30 to 100° knee flexion. In addition, muscle activation of rectus femoris, vastus medialis, biceps femoris c.l., gastrocnemius medialis, and tibialis anterior was obtained using surface electromyography (EMG). Joint torques for hip, knee, and ankle joints were computed by inverse dynamics. The results showed that unilateral Fext decreased significantly from 3,369 ± 575 N at 30° knee flexion to 1,015 ± 152 N at 100° knee flexion. Despite maximum voluntary effort, excitation of all muscles as measured by EMG root mean square changed with knee flexion angles. Moreover, correlations showed that above-average Fext at low knee flexion is not necessarily associated with above-average Fext at great knee flexion and vice versa. Similarly, it is not possible to deduce high joint torques from high Fext just as above-average joint torques in 1 joint do not signify above-average torques in another joint. From these findings, it is concluded that an evaluation of muscular capability by means of Fext as measured for multijoint leg extension is strongly limited. As practical recommendation, we suggest analyzing multijoint leg extension strength at 3 distinct knee flexion angles or at discipline-specific joint angles. In addition, a careful evaluation of muscular capacity based on measured Fext can be done for knee flexion angles ≥ 80°. For further and detailed analysis of single muscle groups, the use of inverse dynamic modeling is recommended.

  9. Subacromial space in the rheumatoid shoulder: a radiographic 15-year follow-up study of 148 shoulders.

    PubMed

    Lehtinen, J T; Belt, E A; Lybäck, C O; Kauppi, M J; Kaarela, K; Kautiainen, H J; Lehto, M U

    2000-01-01

    A cohort of 74 patients with rheumatoid arthritis was monitored prospectively for 15 years. At the end of the study 148 shoulders were radiographed with a standard method. The subacromial space was examined from the radiographs with a method where the acromiohumeral interval was measured from the dense cortical bone marking the inferior aspect of the acromion to a point directly above the head of the humerus. The smallest distance was recorded, and negative values were used when the original articular surface of the humerus exceeded the inferior surface of the acromion. Destruction of the glenohumeral (GH) joints was assessed by the Larsen method on a scale of 0 to 5. The relation of subacromial space measurement to the grade of destruction of GH joints was examined. The mean subacromial space was 6.7 (SD 4.4), range from -13 to 12 mm: 6.1 mm (SD 5.6) in men and 6.9 mm (SD 4.0) in women. The mean of nonaffected (Larsen grade 0 or 1) shoulders (n = 77) was 8.6 mm (SD 1.5), and the corresponding mean of the affected (Larsen grade > or =2) shoulders (n = 71) was 4.6 mm (SD 5.5). Previously reported pathologic criterion (<6 mm) indicating rotator cuff involvement was fulfilled in 30 (20%) of 148 shoulders: in 8 (22%) of 36 shoulders in men and in 22 (20%) of 112 shoulders in women. All the shoulders with severe rheumatoid destruction (Larsen grade 4 or 5) fulfilled the pathologic limit. The subacromial space had a significant negative correlation with the GH joint destruction (Larsen grade) in both sides: right r = -.63 (95% CI -.75 to -.47), left r = -.71 (95% CI -.81 to -.58). Progressive upward migration is an inevitable consequence of rheumatoid destruction in the GH joint. A significant step in this process occurred between the Larsen grades of 3 and 4, where the mean distance turned negative, indicating rotator cuff disease. A patient with rheumatoid arthritis and painful shoulder and upward migration of the humerus on the shoulder radiograph should be evaluated

  10. Extending simulation-based acquisition (SBA) to the warfighter with the Air Force Joint Synthetic Battlespace (JSB-AF)

    NASA Astrophysics Data System (ADS)

    Faye, Phil; Andrew, Emily B.; Lee, Jayson

    2001-09-01

    The Air Force has vectored in a new direction to expand its investment in advanced simulation technologies to improve our readiness, lower costs, and dominate the battles of tomorrow. One of the critical initiatives in this direction is the Joint Synthetic Battlespace (JSB). The JSB will provide an integrated Modeling and Simulation (M&S) environment that brings together analysis, training, and simulations into a coherent whole. The ultimate goal is to develop a JSB simulation capability that will provide a new level of realism in synthetic mission and battlespace environments. This capability will be used to evaluate not only specific systems characteristics but also the associated tactics and procedures. The feature that distinguishes the JSB will be the its ability to realistically represent the real-world mission environment and provide the warfighter with real-time feedback on a system's expected performance. This unprecedented level of realism and response will enable the warfighter to evaluate mission effectiveness and conduct course of action analyses. At the same time, the JSB will increase the acquisition community's ability to build or modify systems to meet users' needs and expectations by making the warfighter the focus and direct participant in the acquisition process. As a detailed engineering and trades tool, the JSB will provide a completely scaleable environment for controlled executions of experiments to support analyses that require repeatability and controlled variations in the simulated environment. The government will also be able to ensure the configuration, control, and consistency of the JSB environment, while the users will develop their own plans and scenarios for their analyses. This will provide a standardized synthetic environment for acquisition programs that can be used as either a distributed or stand-alone application.

  11. Anatomy and biomechanics of the shoulder in throwing, swimming, gymnastics, and tennis.

    PubMed

    Perry, J

    1983-07-01

    As the most mobile joint in the body, the shoulder is structurally insecure. The ball-shaped humeral head rotates and glides on a shallow scapular cup. A limited amount of passive stability is provided by the glenoid labrum, which slightly deepens the scapular cup, and by ligaments reinforcing the capsule on its superior and anterior surfaces. At peak maturity ligamentous restraint equals 50 to 80 kg. These structural limitations indicate that the primary source of joint stability must be balanced muscle control. Joint compression is the major factor. This is supplemented by active tangential restraint, which selectively opposes anterior, posterior, or superior displacement. The large external muscles used for purposeful motion and speed often create subluxating shear forces in addition to the desired actions. Impingement and attrition syndromes are common consequences. To counter this, as well as to provide selective rotation, there are the four muscles that constitute the rotator cuff. Joint compression is the major force generated by the supraspinatus and infraspinatus. The latter (accompanied by the teres minor) also provides a downward pull to oppose the upward displacement of early deltoid action. Anterior protection against excessive external rotation or extension is offered by the subscapularis. Athletic who use the arm for a propelling force strain the extremes of joint range in their drive for maximum performance. The threat of injury can be minimized by two actions, namely, modifying motion patterns, which may avoid impingement or make it a less frequent experience, and active protection, which is gained through specific strengthening of the rotator cuff muscles. PMID:9697636

  12. Energy-related optimal control accounts for gravitational load: comparing shoulder, elbow, and wrist rotations.

    PubMed

    Gaveau, Jérémie; Berret, Bastien; Demougeot, Laurent; Fadiga, Luciano; Pozzo, Thierry; Papaxanthis, Charalambos

    2014-01-01

    We permanently deal with gravity force. Experimental evidences revealed that moving against gravity strongly differs from moving along the gravity vector. This directional asymmetry has been attributed to an optimal planning process that optimizes gravity force effects to minimize energy. Yet, only few studies have considered the case of vertical movements in the context of optimal control. What kind of cost is better suited to explain kinematic patterns in the vertical plane? Here, we aimed to understand further how the central nervous system (CNS) plans and controls vertical arm movements. Our reasoning was the following: if the CNS optimizes gravity mechanical effects on the moving limbs, kinematic patterns should change according to the direction and the magnitude of the gravity torque being encountered in the motion. Ten subjects carried out single-joint movements, i.e., rotation around the shoulder (whole arm), elbow (forearm), and wrist (hand) joints, in the vertical plane. Joint kinematics were analyzed and compared with various theoretical optimal model predictions (minimum absolute work-jerk, jerk, torque change, and variance). We found both direction-dependent and joint-dependent variations in several kinematic parameters. Notably, directional asymmetries decreased according to a proximodistal gradient. Numerical simulations revealed that our experimental findings could be attributed to an optimal motor planning (minimum absolute work-jerk) that integrates the direction and the magnitude of gravity torque and minimizes the absolute work of forces (energy-related cost) around each joint. Present results support the general idea that the CNS implements optimal solutions according to the dynamic context of the action.

  13. Swimmer's Shoulder: Painful Shoulder in the Competitive Swimmer.

    PubMed

    Matzkin, Elizabeth; Suslavich, Kaytelin; Wes, David

    2016-08-01

    Swimmer's shoulder is a broad term often used to diagnose shoulder injury in swimmers. However, research has elucidated several specific shoulder injuries that often are incurred by the competitive swimmer. Hyperlaxity, scapular dyskinesis, subacromial impingement, labral damage, os acromiale, suprascapular nerve entrapment, and glenohumeral rotational imbalances all may be included within a differential diagnosis for shoulder pain in the competitive swimmer. An understanding of the mechanics of the swim stroke, in combination with the complex static and dynamic properties of the shoulder, is essential to the comprehension and identification of the painful swimmer's shoulder. It is important for the athlete, coach, and clinician to be aware of the discerning characteristics among these different injuries to ensure a proper diagnosis and treatment plan to aid the swimmer in his or her return to competition.

  14. Patterns of shoulder flexibility among college baseball players.

    PubMed

    Johnson, L

    1992-01-01

    In this study, I investigated and analyzed the various joint motions in the shoulders of college baseball players. Twenty-six players (age=20.38+/-1.36 yr) from two colleges were examined for upper extremity range of motion (ROM), including shoulder flexion, extension, internal rotation at 90 degrees abduction, and external rotation at 90 degrees abduction. Joint motions were measured using a JAMAR(R), six-inch, double-arm goniometer. Pitchers demonstrated 22 degrees more shoulder flexion and 21 degrees more external rotation at 90 degrees abduction than infield position players, and 17 degrees more shoulder flexion than outfield position players. There was no significant difference between the dominant arm flexibility of infield and outfield position players. When comparing the dominant to nondominant arm relative to the position, infield position players demonstrated 5 degrees less shoulder flexion and 6 degrees more external rotation on the dominant side at 90 degrees abduction. Pitchers did not demonstrate any significant difference between the dominant and nondominant arm. There was, however, an indication that pitchers had a tendency to exhibit greater flexibility during flexion and external rotation at 90 degrees abduction in the dominant side than in the nondominant side.

  15. Myositis ossificans around shoulder following military training programme

    PubMed Central

    Kir, Mustafa C; Ozdemir, Mehmet T

    2011-01-01

    The myositis ossificans around shoulder in military recruits are not reported yet. Three young male soldiers presented with complaints of palpable mass at the anterior aspect of shoulder; tenderness around the superior part of deltopectoral groove close to acromioclavicular joint; and restriction of shoulder motion. They also noticed ecchymosis and pain around the coracoid process and anterior shoulder region during regular firing exercises. Plain X-rays and computerized tomography showed extra-capsular, dense, irregular structure in the space between pectoralis and deltoid muscles which correlated with heterotopic bone. One patient refused surgical intervention because of the completion of his military serving period. Surgical excision was performed for the other two patients. During surgical exploration, both ossified masses were found in deltopectoral region and mostly in fibers of clavicular and acromial parts of deltoid muscle. Pathological reports confirmed the structure of masses as mature trabecular bone. Postoperatively indomethacin treatment and active shoulder exercises were started until the full range of motion was regained. Mini soft bag was used on the rifle contact area of the shoulder. No complications or recurrences were observed during the 24 months of followup period. PMID:22144755

  16. Shoulder injuries attributed to resistance training: a brief review.

    PubMed

    Kolber, Morey J; Beekhuizen, Kristina S; Cheng, Ming-Shun S; Hellman, Madeleine A

    2010-06-01

    The popularity of resistance training (RT) is evident by the more than 45 million Americans who engage in strength training regularly. Although the health and fitness benefits ascribed to RT are generally agreed upon, participation is not without risk. Acute and chronic injuries attributed to RT have been cited in the epidemiological literature among both competitive and recreational participants. The shoulder complex in particular has been alluded to as one of the most prevalent regions of injury. The purpose of this manuscript is to present an overview of documented shoulder injuries among the RT population and where possible discern mechanisms of injury and risk factors. A literature search was conducted in the PUBMED, CINAHL, SPORTDiscus, and OVID databases to identify relevant articles for inclusion using combinations of key words: resistance training, shoulder, bodybuilding, weightlifting, shoulder injury, and shoulder disorder. The results of the review indicated that up to 36% of documented RT-related injuries and disorders occur at the shoulder complex. Trends that increased the likelihood of injury were identified and inclusive of intrinsic risk factors such as joint and muscle imbalances and extrinsic risk factors, namely, that of improper attention to exercise technique. A majority of the available research was retrospective in nature, consisting of surveys and descriptive epidemiological reports. A paucity of research was available to identify predictive variables leading to injury, suggesting the need for future prospective-based investigations.

  17. Little Leaguer's shoulder.

    PubMed

    Popkin, Charles A; Posada, Alejandro; Clifford, Paul D

    2006-01-01

    A case of Little Leaguer's shoulder (LLS) in a 12-year-old male is presented. Classically, LLS is an overuse injury affecting adolescent pitchers. The diagnosis is the result of a thorough history, physical examination, and radiographic evaluation. Clinicians unfamiliar with LLS may fail to detect this injury and order a magnetic resonance imaging (MRI) study without radiographs. The objective of this case report is to help radiologists become more familiar with the MRI and radiographic findings of LLS.

  18. Ultrasound-guided interventional procedures around the shoulder.

    PubMed

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion-clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder. PMID:26313499

  19. Enhanced crosslimb transfer of force-field learning for dynamics that are identical in extrinsic and joint-based coordinates for both limbs.

    PubMed

    Carroll, Timothy J; de Rugy, Aymar; Howard, Ian S; Ingram, James N; Wolpert, Daniel M

    2016-01-01

    Humans are able to adapt their motor commands to make accurate movements in novel sensorimotor environments, such as when wielding tools that alter limb dynamics. However, it is unclear to what extent sensorimotor representations, obtained through experience with one limb, are available to the opposite, untrained limb and in which form they are available. Here, we compared crosslimb transfer of force-field compensation after participants adapted to a velocity-dependent curl field, oriented either in the sagittal or the transverse plane. Due to the mirror symmetry of the limbs, the force field had identical effects for both limbs in joint and extrinsic coordinates in the sagittal plane but conflicting joint-based effects in the transverse plane. The degree of force-field compensation exhibited by the opposite arm in probe trials immediately after initial learning was significantly greater after sagittal (26 ± 5%) than transverse plane adaptation (9 ± 4%; P < 0.001), irrespective of whether participants learned initially with the left or the right arm or via abrupt or gradual exposure to the force field. Thus transfer was impaired when the orientation of imposed dynamics conflicted in intrinsic coordinates for the two limbs. The data reveal that neural representations of novel dynamics are only partially available to the opposite limb, since transfer is incomplete even when force-field perturbation is spatially compatible for the two limbs, according to both intrinsic and extrinsic coordinates.

  20. Forced-air warming and ultra-clean ventilation do not mix: an investigation of theatre ventilation, patient warming and joint replacement infection in orthopaedics.

    PubMed

    McGovern, P D; Albrecht, M; Belani, K G; Nachtsheim, C; Partington, P F; Carluke, I; Reed, M R

    2011-11-01

    We investigated the capacity of patient warming devices to disrupt the ultra-clean airflow system. We compared the effects of two patient warming technologies, forced-air and conductive fabric, on operating theatre ventilation during simulated hip replacement and lumbar spinal procedures using a mannequin as a patient. Infection data were reviewed to determine whether joint infection rates were associated with the type of patient warming device that was used. Neutral-buoyancy detergent bubbles were released adjacent to the mannequin's head and at floor level to assess the movement of non-sterile air into the clean airflow over the surgical site. During simulated hip replacement, bubble counts over the surgical site were greater for forced-air than for conductive fabric warming when the anaesthesia/surgery drape was laid down (p = 0.010) and at half-height (p < 0.001). For lumbar surgery, forced-air warming generated convection currents that mobilised floor air into the surgical site area. Conductive fabric warming had no such effect. A significant increase in deep joint infection, as demonstrated by an elevated infection odds ratio (3.8, p = 0.024), was identified during a period when forced-air warming was used compared to a period when conductive fabric warming was used. Air-free warming is, therefore, recommended over forced-air warming for orthopaedic procedures.

  1. Enhanced crosslimb transfer of force-field learning for dynamics that are identical in extrinsic and joint-based coordinates for both limbs

    PubMed Central

    de Rugy, Aymar; Howard, Ian S.; Ingram, James N.; Wolpert, Daniel M.

    2015-01-01

    Humans are able to adapt their motor commands to make accurate movements in novel sensorimotor environments, such as when wielding tools that alter limb dynamics. However, it is unclear to what extent sensorimotor representations, obtained through experience with one limb, are available to the opposite, untrained limb and in which form they are available. Here, we compared crosslimb transfer of force-field compensation after participants adapted to a velocity-dependent curl field, oriented either in the sagittal or the transverse plane. Due to the mirror symmetry of the limbs, the force field had identical effects for both limbs in joint and extrinsic coordinates in the sagittal plane but conflicting joint-based effects in the transverse plane. The degree of force-field compensation exhibited by the opposite arm in probe trials immediately after initial learning was significantly greater after sagittal (26 ± 5%) than transverse plane adaptation (9 ± 4%; P < 0.001), irrespective of whether participants learned initially with the left or the right arm or via abrupt or gradual exposure to the force field. Thus transfer was impaired when the orientation of imposed dynamics conflicted in intrinsic coordinates for the two limbs. The data reveal that neural representations of novel dynamics are only partially available to the opposite limb, since transfer is incomplete even when force-field perturbation is spatially compatible for the two limbs, according to both intrinsic and extrinsic coordinates. PMID:26581867

  2. On the mechanical power of joint extensions as affected by the change in muscle force (or cross-sectional area), ceteris paribus.

    PubMed

    Minetti, Alberto E

    2002-02-01

    This paper offers a reference prediction for the changes of mechanical power generated during a maximal (vertical, horizontal or inclined) joint extension, as a consequence of just the changes of muscle force or cross-sectional area (CSA). Ceteris paribus (all other things being equal), for a given joint, the exponents at which the force changes have to be raised to predict the duration, final speed and power of the maximal extension are -0.5, 0.5, and 1.5, respectively, for horizontal movements. For example, a force decrease of 30% leads to an increase of 19.5% of the duration of the extension and to a decrease of 16.3% and of 41.4% of its final speed and power. The equations for vertical or inclined extension performances are subject to the same exponents. However, the actual prediction is dependent upon the ratio between muscle strength and body weight, reflecting the fraction of the muscle strength (or CSA) acting against gravity during the manoeuvre. For instance, during a vertical extension, a force decrease of 30% leads to an increase of 30.9% of the duration of the extension and to a decrease of 29.3% and of 50.5% of its final speed and power. Based on the proposed model, a methodology is also described to detect the effects on the extension power of other determinants, in addition to CSA, of the useful force change (e.g. neuromuscular factors, motor control). PMID:11990751

  3. Normal shoulder ultrasound: anatomy and technique.

    PubMed

    Gupta, Harun; Robinson, Philip

    2015-07-01

    Shoulder ultrasound (US) is one of the most common applications of musculoskeletal US due to the high incidence of rotator cuff disorders. It can be used effectively for the diagnosis of rotator cuff diseases, and several studies have shown very high sensitivity and specificity for rotator cuff tears comparable with that of MRI. Shoulder US has several advantages over MRI such as lower cost, comparatively easier availability, short examination duration, dynamic capability, and ability to perform guided injection at the same appointment. However, it depends on the skill of the operator and therefore requires a standardized detailed protocol to avoid errors in diagnosis. A symptomatic area-only focused examination should not be performed because it is not uncommon to have symptoms away from the actual site of pathology. Detailed understanding of what anatomy can be evaluated is required, and this article discusses the relevant anatomy covering the rotator cuff, subacromial bursa, and acromioclavicular joint. The equipment requirements and technique of examination of different anatomical structures with transducer positions and normal sonographic appearances are described. Pitfalls and artifacts associated with shoulder US are covered; understanding them is crucial to avoid misinterpretation of findings.

  4. Unsteady hydrodynamic forces acting on a robotic hand and its flow field.

    PubMed

    Takagi, Hideki; Nakashima, Motomu; Ozaki, Takashi; Matsuuchi, Kazuo

    2013-07-26

    This study aims to clarify the mechanism of generating unsteady hydrodynamic forces acting on a hand during swimming in order to directly measure the forces, pressure distribution, and flow field around the hand by using a robotic arm and particle image velocimetry (PIV). The robotic arm consisted of the trunk, shoulder, upper arm, forearm, and hand, and it was independently computer controllable in five degrees of freedom. The elbow-joint angle of the robotic arm was fixed at 90°, and the arm was moved in semicircles around the shoulder joint in a plane perpendicular to the water surface. Two-component PIV was used for flow visualization around the hand. The data of the forces and pressure acting on the hand were sampled at 200Hz and stored on a PC. When the maximum resultant force acting on the hand was observed, a pair of counter-rotating vortices appeared on the dorsal surface of the hand. A vortex attached to the hand increased the flow velocity, which led to decreased surface pressure, increasing the hydrodynamic forces. This phenomenon is known as the unsteady mechanism of force generation. We found that the drag force was 72% greater and the lift force was 4.8 times greater than the values estimated under steady flow conditions. Therefore, it is presumable that swimmers receive the benefits of this unsteady hydrodynamic force.

  5. Forces loading the tarsal joint in the hind limb of the horse, determined from in vivo strain measurements of the third metatarsal bone.

    PubMed

    Schamhardt, H C; Hartman, W; Lammertink, J L

    1989-05-01

    Strain gauge rosettes were bonded to the dorsal, lateral, medial, and plantar aspects of the third metatarsal bone in the hind limbs of 6 ponies. The maximal compressive principal strain was approximately -600 X 10(-6) m/m, and exceeded the amplitudes of the tensile strains at all aspects of the bone. After transformation, the shear strain and the principal strains parallel and perpendicular to the bone were obtained. The first peak in the bending strain was higher in the dorsal and lateral aspects, and the second peak was higher in the medial and plantar aspects. Young modulus of elasticity was determined in a 4-point bending test at the dorsal and plantar sides; it averaged 19.5 GPa in tension and compression. Applying linear bending theory, the eccentricity of an axial force parallel or a bending force perpendicular to the bone were calculated. The position where the total force penetrated the tarsometatarsal joint surface was largely within the joint surface, indicating that the joint is merely loaded in (eccentric) compression.

  6. MR evaluation of synovial injury in shoulder trauma.

    PubMed

    Chalian, Majid; Soldatos, Theodoros; Faridian-Aragh, Neda; Andreisek, Gustav; McFarland, Edward G; Carrino, John A; Chhabra, Avneesh

    2011-10-01

    The purpose of this study was to determine magnetic resonance imaging (MRI) findings relevant to synovial injury of the shoulder in patients with and without acute shoulder trauma. Three hundred and nine consecutive shoulder MRI studies (185-male, 124-female, 50 ± 15 years old) were retrospectively evaluated for findings suggestive of synovial injury including rupture and/or diverticulum of the joint capsule, bursa, and biceps tendon sheath (BTS), ganglion/synovial cyst, geyser phenomenon, and sequel of previous shoulder dislocation (Hill-Sachs deformity). Patients with one or more of these findings were included in the MR-positive group, whereas the remaining subjects were used as MR negatives. Based on their medical records, patients were also divided into trauma and non-trauma groups, and statistical analysis was performed to evaluate the association between the aforementioned MRI findings and history of shoulder trauma. Fifty-six patients were included in the MR-positive group and 253 in the MR-negative group. In MR-positive group, the incidence of capsular rupture (CR) and subacromial/subdeltoid (SASD) bursal rupture was higher in trauma patients, whereas the incidence of BTS diverticulum and ganglion cyst was higher in subjects without trauma. Significant association was found between the history of acute trauma and CR, SASD bursal rupture, BTS rupture, and Hill-Sachs deformity. In shoulder MR examination, presence of CR and/or SASD bursal rupture is strongly suggestive of acute shoulder trauma. In addition, BTS rupture and Hill-Sachs deformity are more prevalent in patients with acute shoulder trauma. The presence of these features should alert MRI readers to assess for additional trauma-related internal derangements, if a respective history has not been provided.

  7. MR evaluation of synovial injury in shoulder trauma.

    PubMed

    Chalian, Majid; Soldatos, Theodoros; Faridian-Aragh, Neda; Andreisek, Gustav; McFarland, Edward G; Carrino, John A; Chhabra, Avneesh

    2011-10-01

    The purpose of this study was to determine magnetic resonance imaging (MRI) findings relevant to synovial injury of the shoulder in patients with and without acute shoulder trauma. Three hundred and nine consecutive shoulder MRI studies (185-male, 124-female, 50 ± 15 years old) were retrospectively evaluated for findings suggestive of synovial injury including rupture and/or diverticulum of the joint capsule, bursa, and biceps tendon sheath (BTS), ganglion/synovial cyst, geyser phenomenon, and sequel of previous shoulder dislocation (Hill-Sachs deformity). Patients with one or more of these findings were included in the MR-positive group, whereas the remaining subjects were used as MR negatives. Based on their medical records, patients were also divided into trauma and non-trauma groups, and statistical analysis was performed to evaluate the association between the aforementioned MRI findings and history of shoulder trauma. Fifty-six patients were included in the MR-positive group and 253 in the MR-negative group. In MR-positive group, the incidence of capsular rupture (CR) and subacromial/subdeltoid (SASD) bursal rupture was higher in trauma patients, whereas the incidence of BTS diverticulum and ganglion cyst was higher in subjects without trauma. Significant association was found between the history of acute trauma and CR, SASD bursal rupture, BTS rupture, and Hill-Sachs deformity. In shoulder MR examination, presence of CR and/or SASD bursal rupture is strongly suggestive of acute shoulder trauma. In addition, BTS rupture and Hill-Sachs deformity are more prevalent in patients with acute shoulder trauma. The presence of these features should alert MRI readers to assess for additional trauma-related internal derangements, if a respective history has not been provided. PMID:21735271

  8. The shoulder in competitive swimming.

    PubMed

    Richardson, A B; Jobe, F W; Collins, H R

    1980-01-01

    Shoulder pain is the most common orthopaedic problem in competitive swimming. In a group of 137 of this country's best swimmers, 58 had had symptoms of "swimmer's shoulder." Population characteristics of this group indicated that symptoms increased with the caliber of the athlete, were slightly more common in men, and were related to sprint rather than distance swimming. The use of hand-paddle training exacerbated symptoms, which were more common during the early and middle season. Consideration of shoulder mechanics in swimming reveals that freestyle, butterfly, and backstroke require similar motions; a swimmer using any of these strokes is susceptible to developing shoulder pain. Swimmer's shoulder represents chronic irritation of the humeral head and rotator cuff on the coracoacromial arch during abduction of the shoulder, the so-called impingement syndrome. Treatment included stretching, rest, ice therapy, oral antiinflammatory agents, judicious use of injectable steroids, and surgery as a last resort. PMID:7377446

  9. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks

    PubMed Central

    Bertomeu-Motos, Arturo; Lledó, Luis D.; Díez, Jorge A.; Catalan, Jose M.; Ezquerro, Santiago; Badesa, Francisco J.; Garcia-Aracil, Nicolas

    2015-01-01

    This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG) device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM) of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints’ estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster. PMID:26690160

  10. Posterior dislocation of the sternoclavicular joint leading to mediastinal compression.

    PubMed

    Jougon, J B; Lepront, D J; Dromer, C E

    1996-02-01

    Dislocations of the sternoclavicular joint are uncommon, and the posterior variety have a potential for considerable morbidity. We report a case with compression of the vital structures within the superior mediastinum. It was a rugby player getting run over by the scrum. The mechanism was an indirect force exerted forward and laterally against the shoulder. The patient complained of pain and dysphagia. A systolic right cervical murmur was heard. Angiography was normal and esophagography showed extrinsic esophageal compression. Surgical reduction was performed because there was a slight pneumomediastinum on the computed tomography. This case report demonstrates the mechanism, complications, and treatment of such a lesion. PMID:8572795

  11. EMG-Driven Forward-Dynamic Estimation of Muscle Force and Joint Moment about Multiple Degrees of Freedom in the Human Lower Extremity

    PubMed Central

    Sartori, Massimo; Reggiani, Monica; Farina, Dario; Lloyd, David G.

    2012-01-01

    This work examined if currently available electromyography (EMG) driven models, that are calibrated to satisfy joint moments about one single degree of freedom (DOF), could provide the same musculotendon unit (MTU) force solution, when driven by the same input data, but calibrated about a different DOF. We then developed a novel and comprehensive EMG-driven model of the human lower extremity that used EMG signals from 16 muscle groups to drive 34 MTUs and satisfy the resulting joint moments simultaneously produced about four DOFs during different motor tasks. This also led to the development of a calibration procedure that allowed identifying a set of subject-specific parameters that ensured physiological behavior for the 34 MTUs. Results showed that currently available single-DOF models did not provide the same unique MTU force solution for the same input data. On the other hand, the MTU force solution predicted by our proposed multi-DOF model satisfied joint moments about multiple DOFs without loss of accuracy compared to single-DOF models corresponding to each of the four DOFs. The predicted MTU force solution was (1) a function of experimentally measured EMGs, (2) the result of physiological MTU excitation, (3) reflected different MTU contraction strategies associated to different motor tasks, (4) coordinated a greater number of MTUs with respect to currently available single-DOF models, and (5) was not specific to an individual DOF dynamics. Therefore, our proposed methodology has the potential of producing a more dynamically consistent and generalizable MTU force solution than was possible using single-DOF EMG-driven models. This will help better address the important scientific questions previously approached using single-DOF EMG-driven modeling. Furthermore, it might have applications in the development of human-machine interfaces for assistive devices. PMID:23300725

  12. Anterior instability in the throwing shoulder.

    PubMed

    Savoie, Felix H; O'Brien, Michael J

    2014-06-01

    The disabled throwing shoulder is a multifactorial problem. Laxity of the glenohumeral joint is necessary to achieve a satisfactory velocity. Normal wear and tear with throwing may convert this normal amount of excessive translation into instability. Instability in the throwing athlete manifests itself in 2 forms: traumatic anterior instability that happens to occur in a throwing athlete and excessive anterior subluxation because of overuse that occurs in conjunction with the disabled throwing shoulder. In most cases, it is difficult to determine by physical examination or imaging how much laxity is too much; therefore, the managing physician should always err on the side of caution. A trial of rest and rehabilitation should always be attempted before any consideration of surgery. The multifactorial issues in the disabled throwing athlete should be corrected during this phase of treatment, including assessment and treatment of hip abnormalities, restoration of satisfactory core strength, correction of scapular dyskinesis, and an evaluation and correction of any biomechanical abnormalities in the throwing mechanism. Surgical management of anterior instability in the throwing shoulder depends on the mechanism of injury. The traumatic anterior instability patient is managed by acute surgical repair without a shift, utilizing mattress sutures to prevent suture chondromalacia on the humeral head or glenoid. The anterior laxity management centers on the posterior superior labrum, although occasionally the anterior labrum or capsule may be involved as well. Overall, symptomatic anterior instability is less common in the throwing shoulder. Jobe and colleagues are credited with the first successful technique for the correction of anterior instability in the throwing athlete, the anterior capsulolabral reconstruction by a subscapularis split. The success of this technique paved the way for the adoption of the current arthroscopic techniques that are utilized to correct

  13. Reverse polarity shoulder replacement: Current concepts and review of literature

    PubMed Central

    Lee, Ling Hong; Desai, Aravind

    2014-01-01

    Shoulder replacement in cuff tear arthropathy (CTA) is an unsolved challenge. CTA poses a soft tissue deficiency in an arthritic glenohumeral joint which the anatomical total shoulder replacement and hemiarthroplasty cannot reliably provide stability, range of movement, function or satisfactory long term outcome. In the past two decades since the introduction of the reverse shoulder replacement, the prosthesis has evolved and has shown promising results. It is a partially constraint joint by virtue of its design features. The reversal of the concavity and convexity of the joint to the proximal humerus and the glenoid, respectively, also shifts and improves its center of rotation onto the osseous surface of the glenoid with less exposure to shear stress. It is a successful pain relieving procedure, offering good outcome in patients with irreparable massive rotator cuff tear with or without osteoarthritis. Consequently, this has led to wider use and expansion of its indication to include more complex elective and trauma cases. Whereas originally used in the more elderly patients, there is increasingly more demand in the younger patients. It is important to have good quality long term data to support these increasing indications. Therefore, we review the literature on the concepts of reverse shoulder replacement and the contemporary evidence. PMID:25035828

  14. The shoulder-hand syndrome after stroke: a prospective clinical trial.

    PubMed

    Braus, D F; Krauss, J K; Strobel, J

    1994-11-01

    Shoulder-hand syndrome developed in 36 (27%) of 132 hemiplegic patients in a prospective study. Subluxation, paresis of the shoulder girdle, moderate spasticity, and deficits in confrontation visual field testing were the major risk factors. In a placebo-controlled, nonblinded trial, 31 of the 36 patients became almost symptom free within 10 days' treatment with low doses of oral corticosteroids. Shoulder joint capsules taken at autopsy of 7 patients showed signs of previous trauma of the affected shoulder. In the second part of this study on another 86 patients, early awareness of potential injuries to shoulder joint structures reduced the frequency of shoulder-hand syndrome from 27 to 8%. These clinical findings suggest that shoulder-hand syndrome in hemiplegia is initiated by peripheral lesions. A self-perpetuating vicious cycle may be established, followed by the clinical picture of a "reflex sympathetic dystrophy." In the majority of stroke patients, this clinical phenomenon seems to be preventable by avoiding shoulder trauma.

  15. Comparison between ultrasound and plain X-ray in evaluating the cause of shoulder pain.

    PubMed

    Salek, K M; Mannan, M; Chowdhury, A Z; Haque, M A; Kaiser, M S; Nabi, S; Ferdousee, R A; Paul, B K; Ahmed, S M; Khan, M; Begum, M

    2011-01-01

    Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. For evaluating conditions of shoulder joint, X-ray has been regarded as only method of choice for long time. Magnetic resonance imaging (MRI) is an alternative procedure but the cost limits its utilization especially in Bangladesh. Ultrasonography is an effective imaging modality in the evaluation of both rotator and non-rotator cuff disorders. Because of low cost and availability, it can be an alternative procedure for the diagnosis of painful shoulder. The present study was conducted to assess ultrasonography as a useful modality in evaluating cases of shoulder pain and to compare the findings with X-ray findings. Thirty two patients with shoulder pain were evaluated by X-ray and Ultrasonography (USG). Clinical diagnosis was done for correlation. To identify the cause of shoulder pain, 100% patients were found normal in plain X-ray. On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive.

  16. The athlete's shoulder.

    PubMed

    Jobe, F W; Pink, M

    1994-01-01

    Throughout the ages, instability has been noted to be the underlying problem in shoulder dysfunction of the young, overhand-throwing athlete. Impingement and rotator cuff tears are progressive symptoms of this instability. The classic theory of impingement describes a mechanism for "outside impingement," which is most often seen in the older, nonathletic population. The mechanism for "inside impingement" in the younger, athletic population is a pinching of the cuff undersurface on the posterosuperior glenoid labrum. In this younger group, the first treatment of choice is rehabilitation. If that fails, the surgical procedure with successful outcome is the ACLR coupled with a progressive rehabilitation program.

  17. The thrower's shoulder.

    PubMed

    Kinsella, Stuart D; Thomas, Stephen J; Huffman, G Russell; Kelly, John D

    2014-07-01

    Throwers, or athletes who engage in repetitive overhead motions, are a unique subset of athletes that experience distinct shoulder injuries. Athletes engaged in baseball comprise the majority of patients seeking orthopedic care for throwing related injuries. Injuries specific to throwers most commonly involve the labrum and the undersurface of the rotator cuff. In addition, tissue changes in both the anterior and posterior glenohumeral capsule are common with repetitive overhead motions. These capsular changes alter. This article will examine the pathomechanics of injuries to throwers, elaborate means of diagnoses of cuff and labral injury and discuss recent advances in both non-operative and operative interventions, including preventative principles.

  18. Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study

    PubMed Central

    Lee, Byung-Ki

    2015-01-01

    This study was conducted to examine the influence of combined exercise using proprioceptive neuromuscular facilitation (PNF) and deep breathing exercise on range of motion (ROM) and visual analog scale (VAS) score in acute frozen shoulder patient. The subject of this study was woman complained disabilities in daily routine due as a frozen left shoulder. The exercise program was composed of 11 sessions and continued four weeks. The program was composed of PNF and deep breathing exercise, and the subject was compared by passive ROM (shoulder flexion, abduction, and internal and external rotation) test and VAS score in shoulder movement before and after the exercise. The results showed that patient who practiced this program, the ROM of the shoulder joint increased and the VAS score decreased. Thus, this program was shown to be effective in suppressing pain and increasing the ROM of the shoulder joint in acute frozen shoulder patient. PMID:26535219

  19. Mid-range shoulder instability modeled as a cam-follower mechanism.

    PubMed

    Willemot, Laurent; Thoreson, Andrew; Ryan Breighner; Hooke, Alexander; Verborgt, Olivier; An, Kai-Nan

    2015-07-16

    In this paper, we model a simplified glenohumeral joint as a cam-follower mechanism during experimental simulated dislocation. Thus, humeral head trajectory and translational forces are predicted using only contact surface geometry and compressive forces as function inputs. We demonstrate this new interpretation of glenohumeral stability and verify the accuracy of the method by physically testing a custom-molded, idealized shoulder model and comparing data to the output of the 2D mathematical model. Comparison of translational forces between experimental and mathematical approaches resulted in r(2) of 0.88 and 0.90 for the small and large humeral head sizes, respectively. Comparison of the lateral displacement resulted in r(2) of 0.99 and 0.98 for the small and larger humeral head sizes, respectively. Comparing translational forces between experiments and the mathematical model when varying the compressive force to 30 N, 60 N, and 90 N resulted in r(2) of 0.90, 0.82, and 0.89, respectively. The preliminary success of this study is motivation to introduce the effects of soft tissue such as cartilage and validation with a cadaver model. The use of simple mathematical models such as this aid in the set-up and understanding of experiments in stability research and avoid unnecessary depletion of cadaveric resources. PMID:25865644

  20. Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst - A Case Report

    PubMed Central

    Shaarani, Shahril R; Mullett, Hannan

    2014-01-01

    Massive acromioclavicular joint (ACJ) cysts are an extremely rare cause of shoulder impairment and with limited consensus in its management. We present the first published case report of a patient with a massive ACJ cyst treated with a reverse total shoulder replacement with minimal ACJ excision arthroplasty. PMID:25279019

  1. The use of computed tomography to diagnose chronic shoulder arthritis in an American white pelican (Pelecanus erythrorhynchos)

    PubMed Central

    Whitehead, Michelle C.; Parker, Dennilyn L.

    2015-01-01

    An American white pelican was presented with a complete left wing droop and no abnormal findings on conventional radiography. Computed tomography was used to diagnose chronic shoulder arthritis as a sequela to a suspected traumatic compressive fracture. This is the first case report to describe use of computed tomography to evaluate the avian shoulder joint. PMID:25750446

  2. An Overview of Shoulder Instability and its Management

    PubMed Central

    Farrar, Nicholas Greville; Malal, Joby Jacob George; Fischer, Jochen; Waseem, Mohammed

    2013-01-01

    The assessment and management of patients with instability of the shoulder joint can be challenging, due to the varying ways patients present, the array of different classification systems, the confusing terminology used and the differing potential management strategies. This review article aims to provide a clear explanation of the common concepts in shoulder instability and how they relate to the assessment and management of patients. There are sections covering the mechanisms of shoulder stability, the clinical assessment of patients and imaging techniques. Beyond that there is a discussion on the common classifications systems used and the typical management options. Some patients fall into reasonably well defined categories of classification and in these cases, the management plan is relatively easy to define. Unfortunately, other patients can elude simple classification and in these instances their management requires very careful consideration. Further research may help to facilitate a better understanding of management of the patients in this latter group. PMID:24082972

  3. [New options in the treatment of painful shoulder syndrome].

    PubMed

    Esparza Miñana, J M; Londoño Parra, M; Villanueva Pérez, V L; De Andrés Ibáñez, J

    2012-01-01

    Shoulder pain is a common complaint in clinical practice in Primary Care and affects 20% of the general population. The usual form of treatment is based on NSAIDs, rest, rehabilitation and, as an alternative, a local injection into the joint. There are also radiofrequency techniques on the suprascapular nerve in the cases of refractory pain to these therapies. Radiofrequency can be used in two ways: Conventional Radiofrequency, using high temperatures to the target tissue with the aim of producing a thermal neurolysis and Pulsed Radiofrequency where the temperatures are lower and produces a temporary non-destructive blockage; the latter being the most common technique in the management of shoulder pain. Although the analgesic mechanism of action of Radiofrequency is unknown, recent studies have shown that it is safe, effective and Lasting. Radiofrequency of the suprascapular nerve is a valid, effective and with few complications in the treatment of shoulder pain refractory to other therapies.

  4. SHOULDER POSTERIOR INTERNAL IMPINGEMENT IN THE OVERHEAD ATHLETE

    PubMed Central

    Grant‐Nierman, Meggan; Lucas, Brennen

    2013-01-01

    Posterior internal impingement (PII) of the glenohumeral joint is a common cause of shoulder complex pain in the overhead athlete. This impingement is very different from standard outlet impingement seen in shoulder patients. Internal impingement is characterized by posterior shoulder pain when the athlete places the humerus in extreme external rotation and abduction as in the cocking phase of pitching or throwing. Impingement in this position occurs between the supraspinatus and or infraspinatus and the glenoid rim. Understanding regarding this pathology continues to evolve. Definitive understanding of precipitating factors, causes, presentation and methods of treatment have yet to be determined. A high index of suspicion should be used when attempting to make this diagnosis. This current concepts review presents the current thinking regarding pathophysiology, evaluation, and treatment of this condition. Level of Evidence: 5 PMID:23593557

  5. Reduction of frontal-plane hip joint reaction force via medio-lateral foot center of pressure manipulation: a pilot study.

    PubMed

    Solomonow-Avnon, Deborah; Wolf, Alon; Herman, Amir; Rozen, Nimrod; Haim, Amir

    2015-02-01

    Footwear-generated biomechanical manipulation of lower-limb joints has been shown to influence lower-limb biomechanics. Numerous studies report the influence of such interventions on the knee, however little is known about the influence of these interventions on the hip. The present study analyzed kinetic and kinematic changes about the hip of 12 healthy young males who underwent biomechanical manipulation utilizing the APOS biomechanical device (APOS-Medical and Sports Technologies Ltd., Herzliya, Israel) allowing controlled foot center of pressure manipulation. Subjects underwent gait testing in four para-sagittal device configurations: Medial, lateral, neutral, and regular shoes. In the medial configuration, subjects demonstrated no change in step width (i.e., distance between right and left foot center of pressure), however inter-malleolar distance significantly increased. Likewise with the medial setting, greater hip abduction was recorded, while hip adduction moment and joint reaction force decreased significantly. We speculate that subjects adopt a modified gait pattern aimed to maintain constant base of support. As a result, hip abductor muscle moment arm increases and adduction moment and joint reaction force decreases. To the best of our knowledge this is the first study to show this relationship. These results contribute to the understanding of lower-limb biomechanics and warrant further investigation.

  6. Endurance time is joint-specific: A modelling and meta-analysis investigation

    PubMed Central

    Law, Laura A. Frey; Avin, Keith G.

    2010-01-01

    Static task intensity–endurance time (ET) relationships (e.g. Rohmert's curve) were first reported decades ago. However, a comprehensive meta-analysis to compare experimentally-observed ETs across bodily regions has not been reported. We performed a systematic literature review of ETs for static contractions, developed joint-specific power and exponential models of the intensity–ET relationships, and compared these models between each joint (ankle, trunk, hand/grip, elbow, knee, and shoulder) and the pooled data (generalised curve). 194 publications were found, representing a total of 369 data points. The power model provided the best fit to the experimental data. Significant intensity-dependent ET differences were predicted between each pair of joints. Overall, the ankle was most fatigue-resistant, followed by the trunk, hand/grip, elbow, knee and finally the shoulder was most fatigable. We conclude ET varies systematically between joints, in some cases with large effect sizes. Thus, a single generalised ET model does not adequately represent fatigue across joints. Statement of Relevance Rohmert curves have been used in ergonomic analyses of fatigue, as there are limited tools available to accurately predict force decrements. This study provides updated endurance time–intensity curves using a large meta-analysis of fatigue data. Specific models derived for five distinct joint regions should further increase prediction accuracy. PMID:20069487

  7. The effects of stretching and stabilization exercise on the improvement of spastic shoulder function in hemiplegic patients.

    PubMed

    You, Young Youl; Her, Jin Gang; Woo, Ji-Hea; Ko, Taesung; Chung, Sin Ho

    2014-04-01

    [Purpose] This study investigated the effects of stretching and joint stabilization exercises applied to spastic shoulder joints on improving shoulder dysfunction in hemiplegic patients. [Subjects and Methods] Hemiplegic patients were classified into three groups: one group received 30 min of traditional exercise therapy for the spastic shoulder joint; one group received 30 min stretching; and one group received 15 min of stretching and 15 min of joint stabilization exercises. The exercises were performed once a day, five times per week for eight weeks. Changes in the pathologic thickness of tendons and recovery of shoulder function were compared among the three groups. Differences among the three groups before the experiment, at four weeks, and at eight weeks were analyzed using repeated measures ANOVA. [Results] The stretching and joint stabilization exercise therapy group showed greater improvement in shoulder function than the traditional exercise therapy group and the stretching only group. This group also showed greater decreases in the pathologic thickness of tendons, than the other groups. [Conclusion] This study demonstrated that an exercise therapy program that combined stretching and joint stabilization exercise was more effective than other exercises for improvement of spastic shoulder joint dysfunction in hemiplegic patients.

  8. Optimal management of shoulder impingement syndrome

    PubMed Central

    Escamilla, Rafael F; Hooks, Todd R; Wilk, Kevin E

    2014-01-01

    Shoulder impingement is a progressive orthopedic condition that occurs as a result of altered biomechanics and/or structural abnormalities. An effective nonoperative treatment for impingement syndrome is aimed at addressing the underlying causative factor or factors that are identified after a complete and thorough evaluation. The clinician devises an effective rehabilitation program to regain full glenohumeral range of motion, reestablish dynamic rotator cuff stability, and implement a progression of resistive exercises to fully restore strength and local muscular endurance in the rotator cuff and scapular stabilizers. The clinician can introduce stresses and forces via sport-specific drills and functional activities to allow a return to activity. PMID:24648778

  9. A comprehensive three-dimensional dynamic model of the human head and trunk for estimating lumbar and cervical joint torques and forces from upper body kinematics.

    PubMed

    Vette, Albert H; Yoshida, Takashi; Thrasher, T Adam; Masani, K; Popovic, Milos R

    2012-06-01

    Linked-segment representations of human body dynamics have been used extensively in biomechanics, ergonomics, and rehabilitation research to systemize thinking, make predictions, and suggest novel experiments. In the scope of upper body biomechanics, these models play an even more essential role as the human spine dynamics are difficult to study in vivo. No study exists to date, however, that specifically disseminates the technical details of a comprehensive three-dimensional model of the upper body for the purpose of estimating spinal joint torques and forces for a wide range of scenarios. Consequently, researchers are still bound to develop and implement their own models. Therefore, the objective of this study was to design a dynamic model of the upper body that can comprehensively estimate spinal joint torques and forces from upper body kinematics. The proposed three-dimensional model focuses on the actions of the lumbar and cervical vertebrae and consists of five lumbar segments (L1 to L5), the thorax, six cervical segments (C2 to C7), and the head. Additionally, the model: (1) is flexible regarding the kinematic nature of the spinal joints (free, constrained, or fixed); (2) incorporates all geometric and mass-inertia parameters from a single, high-resolution source; and (3) can be feasibly implemented via different inverse dynamics formulations. To demonstrate its practicality, the model was finally employed to estimate the lumbar and cervical joint torques during perturbed sitting using experimental motion data. Considering the growing importance of mathematical predictions, the developed model should become an important resource for researchers in different fields.

  10. Wear simulation strategies for reverse shoulder arthroplasty implants.

    PubMed

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty.

  11. Wear simulation strategies for reverse shoulder arthroplasty implants.

    PubMed

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty. PMID:27160563

  12. Clinical assessment and magnetic resonance imaging of the shoulder of patients with spinal cord injury

    PubMed Central

    Alves, Alex Pereira; Terrabuio Junior, Alberto Antonio; Pimenta, Ciro Jabur; Medina, Giovanna Ignácio Subirá; Rimkus, Carolina de Medeiros; Cliquet Júnior, Alberto

    2012-01-01

    Objective To study the shoulder of this group of patients using magnetic resonance imaging to detect clinical and subclinical disorders and establish a rehabilitation program. Methods Nine patients with spinal cord injury followed in the Laboratory of Biomechanics and Rehabilitation of the Locomotive System at HC/UNICAMP were divided into two groups according to the presence of paraplegia and tetraplegia and were clinically assessed for correlation with the imaging exams. Results Normal results were found in 41% of the shoulders. Most common injuries were tendinopathy of the supraspinatus and acromioclavicular joint degeneration. Eighty percent of injured shoulders had combined lesions. Conclusion A great variety of causes of shoulder pain was identified in paraplegic and tetraplegic subjects. Routine clinical assessment and imaging studies of the shoulder may contribute to the evolution of rehabilitation and reduction of pain and musculoskeletal disorders. Level of Evidence II, Development of Diagnostic Criteria on Consecutive Patients, With Universally Applied Reference "Gold" Standard. PMID:24453620

  13. Overhead throwing injuries of the shoulder and elbow.

    PubMed

    Anderson, Mark W; Alford, Bennett A

    2010-11-01

    Injuries to the shoulder and elbow are common in athletes involved in sporting activities that require overhead motion of the arm. An understanding of the forces involved in the throwing motion, the anatomic structures most at risk, and the magnetic resonance imaging appearances of the most common associated injuries can help to improve diagnostic accuracy when interpreting imaging studies in these patients. PMID:21094403

  14. Overhead throwing injuries of the shoulder and elbow.

    PubMed

    Anderson, Mark W; Alford, Bennett A

    2010-11-01

    Injuries to the shoulder and elbow are common in athletes involved in sporting activities that require overhead motion of the arm. An understanding of the forces involved in the throwing motion, the anatomic structures most at risk, and the magnetic resonance imaging appearances of the most common associated injuries can help to improve diagnostic accuracy when interpreting imaging studies in these patients.

  15. The influence of rotator cuff pathology on functional outcome in total shoulder replacement

    PubMed Central

    Ahearn, Nathanael; McCann, Philip A; Tasker, Andrew; Sarangi, Partha P

    2013-01-01

    Introduction: Total shoulder replacement (TSR) is a reliable treatment for glenohumeral osteoarthritis. In addition to proper component orientation, successful arthroplasty requires accurate restoration of soft tissues forces around the joint to maximize function. We hypothesized that pathological changes within the rotator cuff on preoperative magnetic resonance imaging (MRI) adversely affect the functional outcome following TSR. Materials and Methods: A retrospective analysis of case notes and MRI of patients undergoing TSR for primary glenohumeral osteoarthritis over a 4-year period was performed. Patients were divided into three groups based upon their preoperative MRI findings: (1) normal rotator cuff, (2) the presence of tendonopathy within the rotator cuff, or (3) the presence of a partial thickness rotator cuff tear. Intra-operatively tendonopathy was addressed with debridement and partial thickness tears with repair. Functional outcome was assessed with the Oxford Shoulder Score (OSS), and quick disabilities of the arm, shoulder and hand score (quick-DASH). Results: We had a full dataset of complete case-notes, PACS images, and patient reported outcome measures available for 43 patients, 15 in group 1, 14 in group 2, and 14 in group 3. Quick-DASH and OSS were calculated at a minimum of 24 months following surgery. There was no statistically significant difference between the results obtained between the three groups of either the OSS (P = 0.45), or quick-DASH (P = 0.46). Conclusions: TSR is an efficacious treatment option for patients with primary glenohumeral osteoarthritis in the medium term, even in the presence of rotator cuff tendonopathy or partial tearing. Minor changes within the cuff do not significantly affect functional outcome following TSR. PMID:24403759

  16. Partitioning of knee joint internal forces in gait is dictated by the knee adduction angle and not by the knee adduction moment.

    PubMed

    Adouni, M; Shirazi-Adl, A

    2014-05-01

    Medial knee osteoarthritis is a debilitating disease. Surgical and conservative interventions are performed to manage its progression via reduction of load on the medial compartment or equivalently its surrogate measure, the external adduction moment. However, some studies have questioned a correlation between the medial load and adduction moment. Using a musculoskeletal model of the lower extremity driven by kinematics-kinetics of asymptomatic subjects at gait midstance, we aim here to quantify the relative effects of changes in the knee adduction angle versus changes in the adduction moment on the joint response and medial/lateral load partitioning. The reference adduction rotation of 1.6° is altered by ±1.5° to 3.1° and 0.1° or the knee reference adduction moment of 17Nm is varied by ±50% to 25.5Nm and 8.5Nm. Quadriceps, hamstrings and tibiofemoral contact forces substantially increased as adduction angle dropped and diminished as it increased. The medial/lateral ratio of contact forces slightly altered by changes in the adduction moment but a larger adduction rotation hugely increased this ratio from 8.8 to a 90 while in contrast a smaller adduction rotation yielded a more uniform distribution. If the aim in an intervention is to diminish the medial contact force and medial/lateral load ratio, a drop of 1.5° in adduction angle is much more effective (causing respectively 12% and 80% decreases) than a reduction of 50% in the adduction moment (causing respectively 4% and 13% decreases). Substantial role of changes in adduction angle is due to the associated alterations in joint nonlinear passive resistance. These findings explain the poor correlation between knee adduction moment and tibiofemoral compartment loading during gait suggesting that the internal load partitioning is dictated by the joint adduction angle.

  17. Crossing Boundaries. The Urban Education Imperative: A Report from the Joint Task Force for Urban/Metropolitan Schools

    ERIC Educational Resources Information Center

    American Association of State Colleges and Universities, 2004

    2004-01-01

    This report of the Task Force on Urban/Metropolitan Schools begins with several key assumptions. The Task Force, a creation of two higher education presidential associations, assumes, like No Child Left Behind, that all children in this country deserve a good education, no matter where their school is located. Furthermore, and this is a key…

  18. Shoulder injuries in soccer players

    PubMed Central

    Longo, Umile Giuseppe; Loppini, Mattia; Berton, Alessandra; Martinelli, Nicolò; Maffulli, Nicola; Denaro, Vincenzo

    2012-01-01

    Summary Even though soccer is the most popular sport of the world, no review is available at present to resume the available data on shoulder injuries in soccer. The aim of this review is to report the available epidemiological data on shoulder specific injuries in soccer players and to describe the common mechanisms of shoulder injuries in soccer. Studies published through September 15, 2011, were identified by using MEDLINE, EMBASE, CINAHL and Pre-CINAHL, Pub-Med, Web of Science, and the full Cochrane Library. Reference lists of included studies were searched by hand. Studies were included if they reported on shoulder injuries in soccer players. Limits were not placed on year of publication, status of publication, or language. The journal, authors, and author affiliations of included studies were masked from 2 reviewers. We planned to perform a study on the epidemiology, mechanisms and management of shoulder injuries in elite soccer players. We also planned to use Review Manager (RevMan. Version 5 for Windows) to calculate the magnitude of treatment effect. No studies on clinical outcome of shoulder injuries in elite soccer athletes were found. No studies on the mechanism of shoulder injury in elite soccer players were found. The results of the available studies on epidemiology are reported. Despite soccer is the world’s game, few studies focused on shoulder injuries in soccer players, and therefore no definitive conclusions can be drawn. Further research is warranted to clarify the epidemiology, mechanisms and management of shoulder injuries in elite soccer players. PMID:23289025

  19. Septic arthritis of the shoulder in a dental patient.

    PubMed

    Dolin, Elana; Perlmutter, Leigh D; Segelnick, Stuart L; Weinberg, Mea A; Schoor, Robert

    2014-11-01

    Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.

  20. Septic arthritis of the shoulder in a dental patient.

    PubMed

    Dolin, Elana; Perlmutter, Leigh D; Segelnick, Stuart L; Weinberg, Mea A; Schoor, Robert

    2014-11-01

    Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics. PMID:25647886

  1. Shoulder Injuries in Pediatric Athletes.

    PubMed

    Moyer, James E; Brey, Jennifer M

    2016-10-01

    Shoulder injuries in pediatric athletes are typically caused by acute or overuse injuries. The developing structures of the shoulder lead to injury patterns that are distinct from those of adult athletes. Overuse injuries often affect the physeal structures of the proximal humerus and can lead to pain and loss of sports participation. Shoulder instability is common in pediatric athletes, and recurrence is also a concern in this population. Fractures of the proximal humerus and clavicle are typically treated with conservative management, but there is a trend toward surgical intervention. PMID:27637662

  2. Does Prior Shoulder Surgery Negatively Impact Shoulder Arthroplasty Outcomes?

    PubMed Central

    Frank, Rachel M.; Aiyash, Sal; Kupfer, Noam; Tilton, Annemarie K.; Cole, Brian J.; Verma, Nikhil N.; Nicholson, Gregory P.; Romeo, Anthony A.

    2015-01-01

    Objectives: Several studies have shown a negative correlation between prior knee arthroscopy and ultimate knee arthroplasty outcomes compared to patients without prior arthroscopy. The purpose of this study was to determine the effects of prior shoulder surgery on patients undergoing total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) compared to patients without prior shoulder surgery. Methods: A retrospective review of prospectively collected data was performed on 107 patients undergoing TSA or rTSA. All medical records were analyzed for demographic variables, type of prior shoulder surgery, and type of arthroplasty. All patients underwent a clinical follow-up evaluation, and were evaluated with the American Shoulder and Elbow Society (ASES), Simple Shoulder Test (SST), and Visual Analog Scale (VAS) outcomes scores. Complications, failures, and reoperations were also recorded an analyzed. Results: A total of 107 patients (47 males, 60 females) were included with an average follow-up of 24 months (minimum 12 months). Seventy-one patients (underwent arthroplasty without prior surgery (30 rTSA, 41 TSA) while 50 patients underwent arthroplasty with a history of at least one prior shoulder surgery (27 rTSA, 9 TSA). Prior surgeries included a mix of both open and arthroscopic procedures, including open and arthroscopic rotator cuff repair, open and arthroscopic stabilization (with and without bone augmentation), arthroscopic capsular release, and arthroscopic debridement. Following arthroplasty, both groups experienced significant improvements in ASES, SST, and VAS scores compared to preoperative scores (P<0.05 for all). There was a statistically significant difference in postoperative ASES scores in the no-surgery group compared to the prior-surgery group (84.49 versus 71.67, P=0.0003) as well as in the SST scores (8.97 versus 5.47, P<0.0001); there were no differences in the VAS score (0.83 vs 1.40, P=0.104). Conclusion: Shoulder

  3. The acromioclavicular joint.

    PubMed

    Montellese, Phyllis; Dancy, Timothy

    2004-12-01

    Acute injuries of the AC joint have a limited differential diagnosis. A thorough examination and appropriate radiographs can identify nearly all problems while ruling out tumors as a causal factor. AC injury frequently occurs with other fractures, dislocations, or soft tissue injury around the shoulder. The single unifying diagnosis one searches for in medical conditions is frequently absent in musculoskeletal injury. For effective management of AC separations, the primary care physician need only distinguish type I, II, and III injuries from surgically treated type IV, V, and VI injuries. Types I, II, and III injuries should be treated with pain control and progressive rehabilitation as described previously. Patients who have types IV, V, and VI injuries should be referred to an orthopedic surgeon. Chronic injuries of the AC joint are also clearly diagnosed by appropriate physical examination and radiographs. Steroid injections can aid in the diagnosis and management of these conditions. Injury to one shoulder component predisposes to other shoulder injuries. A thorough examination will reveal these other associated abnormalities that may not be part of the presenting complaint. With practice in the examination of the shoulder and intra-articular injections, the primary care physician can effectively treat most common AC conditions. Only after conservative measures fail is it necessary to refer the patient for surgical management.

  4. A method for shoulder range-of-motion estimation using a single wireless sensor node.

    PubMed

    Thiemjarus, Surapa; Marukatat, Sanparith; Poomchoompol, Pongwat

    2013-01-01

    This study proposes a method for range-of-motion (ROM) estimation based on the acceleration and geomagnetic data acquired using a single miniaturized wireless sensor node. An experiment on eight shoulder rehabilitation protocols in real human subjects has been conducted, with a sensor placed on user's left and right upper arms and wrists. The experimental results demonstrate the limitations of estimation methods that use sensors placed on skin surface and that, despite being a different body segment, the wrist is a better placement position for sensor-based shoulder joint ROM measurement than the shoulder itself. PMID:24111083

  5. Intertester reliability of shoulder complaints diagnoses in primary health care

    PubMed Central

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Conclusions Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key Points Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we

  6. Generalized Ligamentous Laxity: An Important Predisposing Factor for Shoulder Injuries in Athletes

    PubMed Central

    Saremi, Hossein; Yavarikia, Alireza; Jafari, Nasibeh

    2016-01-01

    Background Generalized ligamentous laxity is defined as an increased range of joint motion compared to that of the general population. It is a predisposing factor for sports injuries, especially in the lower extremities. Nevertheless, there is little evidence about the relationship between generalized ligamentous laxity and sports injuries in the upper extremities. Objectives To evaluate the relationship of generalized ligamentous laxity with acute and chronic shoulder injuries in athletes. Patients and Methods Our study comprised 118 volunteer athletes with a history of at least six months of sports activities and a shoulder injury in the three years prior to participation in our study. The athletes were divided into two groups: those with or without generalized ligamentous laxity. Acute and chronic shoulder injuries, shoulder pain, shoulder instability, and functional status assessed via the QuickDASH measure were determined and compared between the two groups. A P value of less than 0.05 was considered significant. Results Group A (with ligamentous laxity) consisted of 43 participants (36.4%) and group B (without ligamentous laxity) consisted of 75 participants (63.6%). The athletes in group A had more shoulder pain (P = 0.016), chronic shoulder injuries (P = 0.032), and shoulder instability (P = 0.004), and less functionality (P = 0.030) than those in group B. If fracture were not considered an acute injury in both groups, the athletes with generalized ligamentous laxity would have had more acute shoulder injuries. Conclusions Generalized ligamentous laxity is an important predisposing factor for acute and chronic shoulder injuries in athletes. Prescreening programs for beginners and rehabilitation shoulder programs for sports athletes at high risk are strongly recommended. PMID:27621940

  7. Shoulder problems in overhead sports. Part I - biomechanics of throwing.

    PubMed

    Kaczmarek, Piotr Krzysztof; Lubiatowski, Przemysław; Cisowski, Paweł; Grygorowicz, Monika; Łepski, Marcin; Długosz, Jan; Ogrodowicz, Piotr; Dudziński, Witold; Nowak, Maciej; Romanowski, Leszek

    2014-05-15

    The article discusses the biomechanical processes that occur during an overhead throw. This activity is highly specialized and requires full and proper function from the shoulder joint. It consists of active and passive stabilization and synchronous work of the accelerating and decelerating muscles. The process of the overhead throw can be divided into several phases that differ from each other in biomechanical parameters and involvement of specific muscles.

  8. An unusual presentation of metastatic melanoma in the shoulder.

    PubMed

    Branford White, Harriet A; Mourant, Philipa; Woods, David A

    2016-07-01

    A 72-year-old lady underwent a Copeland hemiarthoplasty of the shoulder for rotator cuff arthropathy with a good functional outcome. Her past medical history included previous management of a malignant melanoma. Several years following arthroplasty surgery, she acutely developed signs and symptoms of prosthetic joint infection. The present case report describes the metastatic spread of malignant melanoma mimicking that of prosthetic sepsis. PMID:27583015

  9. An unusual presentation of metastatic melanoma in the shoulder

    PubMed Central

    Mourant, Philipa; Woods, David A

    2016-01-01

    A 72-year-old lady underwent a Copeland hemiarthoplasty of the shoulder for rotator cuff arthropathy with a good functional outcome. Her past medical history included previous management of a malignant melanoma. Several years following arthroplasty surgery, she acutely developed signs and symptoms of prosthetic joint infection. The present case report describes the metastatic spread of malignant melanoma mimicking that of prosthetic sepsis. PMID:27583015

  10. Shoulder proprioception is not related to throwing speed or accuracy in elite adolescent male baseball players.

    PubMed

    Freeston, Jonathan; Adams, Roger D; Rooney, Kieron

    2015-01-01

    Understanding factors that influence throwing speed and accuracy is critical to performance in baseball. Shoulder proprioception has been implicated in the injury risk of throwing athletes, but no such link has been established with performance outcomes. The purpose of this study was to describe any relationship between shoulder proprioception acuity and throwing speed or accuracy. Twenty healthy elite adolescent male baseball players (age, 19.6 ± 2.6 years), who had represented the state of New South Wales in the past 18 months, were assessed for bilateral active shoulder proprioception (shoulder rotation in 90° of arm abduction moving toward external rotation using the active movement extent discrimination apparatus), maximal throwing speed (MTS, meters per second measured via a radar gun), and accuracy (total error in centimeters determined by video analysis) at 80 and 100% of MTS. Although proprioception in the dominant and nondominant arms was significantly correlated with each other (r = 0.54, p < 0.01), no relationship was found between shoulder proprioception and performance. Shoulder proprioception was not a significant determinant of throwing performance such that high levels of speed and accuracy were achieved without a high degree of proprioception. There is no evidence to suggest therefore that this particular method of shoulder proprioception measurement should be implemented in clinical practice. Consequently, clinicians are encouraged to consider proprioception throughout the entire kinetic chain rather than the shoulder joint in isolation as a determining factor of performance in throwing athletes. PMID:24936898

  11. Clinical Usefulness of Shoulder Stability Exercises for Middle-aged Women

    PubMed Central

    Choi, Seok-Hwa; Lee, Byoung-Hee

    2013-01-01

    [Purpose] This study examined the clinical usefulness of shoulder stability exercises and the effect of stability exercise on the shoulder pain of middle-aged women. [Subjects] Twenty-two middle-aged female subjects were randomly divided into two groups: a shoulder stability exercise group (Experimental group, n=11) and a control group (n=11). [Methods] Subjects in the experimental group performed a shoulder stability exercise, which was designed to correct abnormal location of the scapula, for 40 minutes per day, three times per week, over a period of four weeks. Range of motion, muscle strength, and grasping power were measured to determine the effect of the shoulder stability exercise. The measured parameters were evaluated before and after four weeks of exercise. [Results] Following intervention, range of motion, muscle strength, and grasping power showed greater improvements in the experimental group than in the control group. [Conclusion] The results of this study show that shoulder stability exercise can improve the shoulder function of middle-aged women, and prevent damage to the shoulder joint. We consider this exercise would be useful in clinical rehabilitation. PMID:24259767

  12. Shoulder proprioception is not related to throwing speed or accuracy in elite adolescent male baseball players.

    PubMed

    Freeston, Jonathan; Adams, Roger D; Rooney, Kieron

    2015-01-01

    Understanding factors that influence throwing speed and accuracy is critical to performance in baseball. Shoulder proprioception has been implicated in the injury risk of throwing athletes, but no such link has been established with performance outcomes. The purpose of this study was to describe any relationship between shoulder proprioception acuity and throwing speed or accuracy. Twenty healthy elite adolescent male baseball players (age, 19.6 ± 2.6 years), who had represented the state of New South Wales in the past 18 months, were assessed for bilateral active shoulder proprioception (shoulder rotation in 90° of arm abduction moving toward external rotation using the active movement extent discrimination apparatus), maximal throwing speed (MTS, meters per second measured via a radar gun), and accuracy (total error in centimeters determined by video analysis) at 80 and 100% of MTS. Although proprioception in the dominant and nondominant arms was significantly correlated with each other (r = 0.54, p < 0.01), no relationship was found between shoulder proprioception and performance. Shoulder proprioception was not a significant determinant of throwing performance such that high levels of speed and accuracy were achieved without a high degree of proprioception. There is no evidence to suggest therefore that this particular method of shoulder proprioception measurement should be implemented in clinical practice. Consequently, clinicians are encouraged to consider proprioception throughout the entire kinetic chain rather than the shoulder joint in isolation as a determining factor of performance in throwing athletes.

  13. American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Report on omalizumab-associated anaphylaxis.

    PubMed

    Cox, Linda; Platts-Mills, Thomas A E; Finegold, Ira; Schwartz, Lawrence B; Simons, F Estelle R; Wallace, Dana V

    2007-12-01

    The American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology Executive Committees formed the Omalizumab Joint Task Force with the purpose of reviewing the Genentech Xolair (omalizumab) clinical trials and postmarketing surveillance data on anaphylaxis and anaphylactoid reactions. Using the definition of anaphylaxis proposed at a 2005 multidisciplinary symposia, the Omalizumab Joint Task Force concluded that 35 patients had 41 episodes of anaphylaxis associated with Xolair (omalizumab) administration between June 1, 2003, and December 31, 2005. With 39,510 patients receiving Xolair (omalizumab) during the same period of time, this would correspond to an anaphylaxis-reporting rate of 0.09% of patients. Of those 36 events for which the time of reaction was known, 22 (61%) reactions occurred in the first 2 hours after one of the first 3 doses. Five (14%) of the events after the fourth or later doses occurred within 30 minutes. Considering the timing of these 36 events, an observation period of 2 hours for the first 3 injections and 30 minutes for subsequent injections would have captured 75% of the anaphylactic reactions. The OJTF report provides recommendations for physicians who prescribe Xolair (omalizumab) on (1) the suggested wait periods after administration and (2) patient education regarding anaphylaxis.

  14. Inter-joint coupling and joint angle synergies of human catching movements.

    PubMed

    Bockemühl, Till; Troje, Nikolaus F; Dürr, Volker

    2010-02-01

    A central question in motor control is how the central nervous system (CNS) deals with redundant degrees of freedom (DoFs) inherent in the musculoskeletal system. One way to simplify control of a redundant system is to combine several DoFs into synergies. In reaching movements of the human arm, redundancy occurs at the kinematic level because there is an unlimited number of arm postures for each position of the hand. Redundancy also occurs at the level of muscle forces because each arm posture can be maintained by a set of muscle activation patterns. Both postural and force-related motor synergies may contribute to simplify the control problem. The present study analyzes the kinematic complexity of natural, unrestrained human arm movements, and detects the amount of kinematic synergy in a vast variety of arm postures. We have measured inter-joint coupling of the human arm and shoulder girdle during fast, unrestrained, and untrained catching movements. Participants were asked to catch a ball launched towards them on 16 different trajectories. These had to be reached from two different initial positions. Movement of the right arm was recorded using optical motion capture and was transformed into 10 joint angle time courses, corresponding to 3 DoFs of the shoulder girdle and 7 of the arm. The resulting time series of the arm postures were analyzed by principal components analysis (PCA). We found that the first three principal components (PCs) always captured more than 97% of the variance. Furthermore, subspaces spanned by PC sets associated with different catching positions varied smoothly across the arm's workspace. When we pooled complete sets of movements, three PCs, the theoretical minimum for reaching in 3D space, were sufficient to explain 80% of the data's variance. We assumed that the linearly correlated DoFs of each significant PC represent cardinal joint angle synergies, and showed that catching movements towards a multitude of targets in the arm's workspace

  15. Development of a mathematical model for predicting electrically elicited quadriceps femoris muscle forces during isovelocity knee joint motion

    PubMed Central

    Perumal, Ramu; Wexler, Anthony S; Binder-Macleod, Stuart A

    2008-01-01

    Background Direct electrical activation of skeletal muscles of patients with upper motor neuron lesions can restore functional movements, such as standing or walking. Because responses to electrical stimulation are highly nonlinear and time varying, accurate control of muscles to produce functional movements is very difficult. Accurate and predictive mathematical models can facilitate the design of stimulation patterns and control strategies that will produce the desired force and motion. In the present study, we build upon our previous isometric model to capture the effects of constant angular velocity on the forces produced during electrically elicited concentric contractions of healthy human quadriceps femoris muscle. Modelling the isovelocity condition is important because it will enable us to understand how our model behaves under the relatively simple condition of constant velocity and will enable us to better understand the interactions of muscle length, limb velocity, and stimulation pattern on the force produced by the muscle. Methods An additional term was introduced into our previous isometric model to predict the force responses during constant velocity limb motion. Ten healthy subjects were recruited for the study. Using a KinCom dynamometer, isometric and isovelocity force data were collected from the human quadriceps femoris muscle in response to a wide range of stimulation frequencies and patterns. % error, linear regression trend lines, and paired t-tests were used to test how well the model predicted the experimental forces. In addition, sensitivity analysis was performed using Fourier Amplitude Sensitivity Test to obtain a measure of the sensitivity of our model's output to changes in model parameters. Results Percentage RMS errors between modelled and experimental forces determined for each subject at each stimulation pattern and velocity showed that the errors were in general less than 20%. The coefficients of determination between the measured