Does "hidden undercuffing" occur among obese patients? Effect of arm sizes and other predictors of the difference between wrist and upper arm blood pressures.

PubMed

Doshi, Hardik; Weder, Alan B; Bard, Robert L; Brook, Robert D

2010-02-01

Arm size can affect the accuracy of blood pressure (BP) measurement, and "undercuffing" of large upper arms is likely to be a growing problem. Therefore, the authors investigated the relationship between upper arm and wrist readings. Upper arm and wrist circumferences and BP were measured in 261 consecutive patients. Upper arm auscultation and wrist BP was measured in triplicate, rotating measurements every 30 seconds between sites. Upper arm BP was 131.9+/-20.6/71.6+/-12.6 mm Hg in an obese population (body mass index, 30.6+/-6.6 kg/m(2)) with mean upper arm size of 30.7+/-5.1 cm. Wrist BP was higher (2.6+/-9.2 mm Hg and 4.9+/-6.6 mm Hg, respectively, P<.001); however, there was moderate concordance for the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) strata (kappa value=0.27-0.71), and the difference was >or=5 mm Hg in 72% of the patients. The authors conclude that there was poor concordance between arm and wrist BP measurement and found no evidence that "hidden undercuffing" was associated with obesity; therefore, they do not support routine use of wrist BP measurements.

Polymyalgia Rheumatica

MedlinePlus

... symptom) Aches or pain in your neck, upper arms, buttocks, hips or thighs Stiffness in affected areas, ... two times more likely to develop the disorder. Race and geographic region. Polymyalgia rheumatica is most common ...

Role of contralesional hemisphere in paretic arm reaching in patients with severe arm paresis due to stroke: A preliminary report.

PubMed

Mohapatra, Sambit; Harrington, Rachael; Chan, Evan; Dromerick, Alexander W; Breceda, Erika Y; Harris-Love, Michelle

2016-03-23

Stroke is highly prevalent and a leading cause of serious, long-term disability among American adults. Impaired movement (i.e. paresis) of the stroke-affected arm is a major contributor to post-stroke disability, yet the mechanisms of upper extremity motor recovery are poorly understood, particularly in severely impaired patients who lack hand function. To address this problem, we examined the functional relevance of the contralesional hemisphere in paretic arm motor performance in individuals with severe arm paresis. Twelve individuals with severe stroke-induced arm paresis (Upper Extremity Fugl-Meyer Assessment=17.1 ± 8.5; maximum score=66) participated in the study. Participants performed a reaching response time task with their paretic arm. At varying time intervals following a 'Go' cue, a pair of transcranial magnetic stimulation (TMS) pulses were delivered to contralesional hemisphere primary motor (M1) or dorsal pre-motor cortex (PMd) to momentarily disrupt the pattern of neural firing. Response time components and hand-path characteristics were compared across the 2 sites for trials with and without TMS disruption. There was no significant effect of TMS disruption on overall Response time or Reaction time, but Movement time was significantly longer (i.e. slower) with disruption of the contralesional hemisphere (p=0.015), regardless of which area was stimulated. Peak hand-path velocity and hand-path smoothness were also significantly lower (p=0.005 and p<0.0001, respectively) with TMS disruption of the contralesional hemisphere. The data from this study provide evidence supporting a functionally relevant role of contralesional hemisphere motor areas in paretic arm reaching movements in individuals with severe post-stroke arm impairment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm with the patient supine or with the head of the bed raised 45 degrees: a follow-up study.

PubMed

Schell, Kathleen; Lyons, Denise; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Wakai, Sandra; Carson, Elizabeth; Waterhouse, Julie; Chichester, Melanie; Bartell, Deborah; Foraker, Theresa; Simpson, E Kathleen

2006-03-01

Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient's arm. Evidence supporting this practice is limited. To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45 degrees . Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers' recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45 degrees and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects. Paired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45 degrees . The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects. Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45 degrees .

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

PubMed Central

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

2015-01-01

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

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

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

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

Towards a body hair atlas of women of caucasian ethnicity.

PubMed

Schweiger, D; Hoff, A; Scheede, S; Fischer, F; Tilsner, J; Lüttke, J; Neumann, Y; Hagens, R

2016-08-01

A preliminary study was conducted in 17 female volunteers (mean age 29.8 years) to gain deeper insights into the characteristics of terminal Caucasian female body hair of different body parts. The focus on Caucasian women was driven by the high number of different scalp hair phenotypes in this ethnicity and intended to identify relevant differences between body areas to improve body hair removal approaches. Multiple growth parameters and structural parameters were assessed for hair on the upper arm, forearm, upper leg, lower leg, axilla and intimate area and compared to scalp data. In particular, macroscopic and much less microscopic or hair surface properties differ strikingly in the investigated body areas. Hair density on the body is much lower than on scalp with the highest hair density in the axilla and intimate area. Multihair follicular units are described for scalp but were also found to a smaller proportion in the axilla and the intimate area. Substantial percentages of hair triplets are only found on the scalp and intimate area. Hair diameter is highest in the intimate area, followed by axillary and lower leg hair and correlates with a faster hair growth rate. The angle of emerging hair is smallest in the intimate area, axilla and on the lower leg. Hair shafts on the lower leg and in the axilla have most overlapping cuticle layers, but independent of body region, no significant differences in the mean thickness of cuticle layers were detectable. In addition, no differences were found in the mean distance between cuticle layer edges along the hair shaft and the hair surface roughness. Hair on the scalp, forearm, upper arm and upper leg had an almost round shape, whereas hair of the lower leg, intimate area and axilla had more elliptical shape. Hairs on the arm showed the highest luminance values and no visible medulla. The darkest hairs were in the axilla and intimate area containing the highest level of visible medulla in hair shafts. To our knowledge, this is the first systematic study comparing terminal hair properties in all cosmetically relevant body regions in Caucasian women. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

PubMed Central

Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

2011-01-01

Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

The Contribution of Upper Body Movements to Dynamic Balance Regulation during Challenged Locomotion

PubMed Central

Boström, Kim J.; Dirksen, Tim; Zentgraf, Karen; Wagner, Heiko

2018-01-01

Recent studies suggest that in addition to movements between ankle and hip joints, movements of the upper body, in particular of the arms, also significantly contribute to postural control. In line with these suggestions, we analyzed regulatory movements of upper and lower body joints supporting dynamic balance regulation during challenged locomotion. The participants walked over three beams of varying width and under three different verbally conveyed restrictions of arm posture, to control the potential influence of arm movements on the performance: The participants walked (1) with their arms stretched out perpendicularly in the frontal plane, (2) spontaneously, i.e., without restrictions to the arm movements, and (3) with their hands on their thighs. After applying an inverse-dynamics analysis to the measured joint kinematics, we investigated the contribution of upper and lower body joints to balance regulation in terms of torque amplitude and variation. On the condition with the hands on the thighs, the contribution of the upper body remains significantly lower than the contribution of the lower body irrespective of beam widths. For spontaneous arm movements and for outstretched arms we find that the upper body (including the arms) contributes to the balancing to a similar extent as the lower body. Moreover, when the task becomes more difficult, i.e., for narrower beam widths, the contribution of the upper body increases, while the contribution of the lower body remains nearly constant. These findings lend further support to the hypothetical existence of an “upper body strategy” complementing the ankle and hip strategies especially during challenging dynamic balance tasks. PMID:29434544

Deodorants: a clinical provocation study in fragrance-sensitive individuals.

PubMed

Johansen, J D; Rastogi, S C; Bruze, M; Andersen, K E; Frosch, P; Dreier, B; Lepoittevin, J P; White, I; Menné, T

1998-10-01

Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance-sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance-mix-sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in those deodorants. 14 eczema patients performed a 7-day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 applications per day were made in the axilla and simultaneously on a 25 cm2 area on the upper arm. A total of 20 deodorants were tested among the 14 patients. Afterwards, the deodorants were subjected to quantitative chemical analysis identifying constituents of the fragrance mix. 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both in the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis revealed that 18/19 deodorants contained between 1 and 6 of the fragrance-mix constituents, on average 3 being found. The mean concentration of fragrance-mix constituents was generally higher in the deodorants causing a positive use test, as compared with those giving a negative reaction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use test on the upper arm and a strong clinical suspicion.

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

PubMed Central

2014-01-01

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

Dislocated Shoulder: Symptoms and Causes

MedlinePlus

... arm bone pops out of the cup-shaped socket that's part of your shoulder blade. The shoulder ... your upper arm bone out of your shoulder socket. Partial dislocation — in which your upper arm bone ...

Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

PubMed

Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

2018-06-01

Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

Upper Arm Central Venous Port Implantation: A 6-Year Single Institutional Retrospective Analysis and Pictorial Essay of Procedures for Insertion

PubMed Central

Shiono, Masatoshi; Takahashi, Shin; Kakudo, Yuichi; Takahashi, Masanobu; Shimodaira, Hideki; Kato, Shunsuke; Ishioka, Chikashi

2014-01-01

Background The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe and comfortable method in our unit. Here we report our experience and discuss the procedure and its potential advantages. Methods All CV port implantations (n = 599) performed in our unit from January 2006 to December 2011 were analyzed. Procedural success and complication rates between subclavian and upper arm groups were compared. Results Both groups had similar patient characteristics. Upper arm CV port and subclavian implantations were equivalently successful and safe. Although we only retrospectively analyzed data from a single center, the upper arm group had a significantly lower overall postprocedural complication rate than the subclavian group. No pneumothorax risk, less risk of arterial puncture by ultrasound, feasibility of stopping potential arterial bleeding, and prevention of accidental arterial cannulation by targeting the characteristic solitary basilic vein were the identified advantages of upper arm CV port implantation. In addition to the aforementioned advantages, there is no risk of “pinch-off syndrome,” possibly less patient fear of manipulation, no scars on the neck and chest, easier accessibility, and compatibility with the “peripherally inserted central catheter” technique. Conclusions Upper arm implantation may benefit clinicians and patients with respect to safety and comfort. We also introduce our methods for upper arm CV port implantation with the videos. PMID:24614412

Integration of Visual and Proprioceptive Limb Position Information in Human Posterior Parietal, Premotor, and Extrastriate Cortex.

PubMed

Limanowski, Jakub; Blankenburg, Felix

2016-03-02

The brain constructs a flexible representation of the body from multisensory information. Previous work on monkeys suggests that the posterior parietal cortex (PPC) and ventral premotor cortex (PMv) represent the position of the upper limbs based on visual and proprioceptive information. Human experiments on the rubber hand illusion implicate similar regions, but since such experiments rely on additional visuo-tactile interactions, they cannot isolate visuo-proprioceptive integration. Here, we independently manipulated the position (palm or back facing) of passive human participants' unseen arm and of a photorealistic virtual 3D arm. Functional magnetic resonance imaging (fMRI) revealed that matching visual and proprioceptive information about arm position engaged the PPC, PMv, and the body-selective extrastriate body area (EBA); activity in the PMv moreover reflected interindividual differences in congruent arm ownership. Further, the PPC, PMv, and EBA increased their coupling with the primary visual cortex during congruent visuo-proprioceptive position information. These results suggest that human PPC, PMv, and EBA evaluate visual and proprioceptive position information and, under sufficient cross-modal congruence, integrate it into a multisensory representation of the upper limb in space. The position of our limbs in space constantly changes, yet the brain manages to represent limb position accurately by combining information from vision and proprioception. Electrophysiological recordings in monkeys have revealed neurons in the posterior parietal and premotor cortices that seem to implement and update such a multisensory limb representation, but this has been difficult to demonstrate in humans. Our fMRI experiment shows that human posterior parietal, premotor, and body-selective visual brain areas respond preferentially to a virtual arm seen in a position corresponding to one's unseen hidden arm, while increasing their communication with regions conveying visual information. These brain areas thus likely integrate visual and proprioceptive information into a flexible multisensory body representation. Copyright © 2016 the authors 0270-6474/16/362582-08$15.00/0.

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

PubMed

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

2012-01-01

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

Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.

PubMed

Watson, Sheri; Aguas, Marita; Colegrove, Pat; Foisy, Nancy; Jondahl, Bonnie; Anastas, Zoe

2017-02-01

The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Prosthesis Prescription Protocol of the Arm (PPP-Arm): The implementation of a national prosthesis prescription protocol.

PubMed

Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

2018-02-01

In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers. All stakeholders (rehabilitation teams, orthopedic workshops, patients, and insurance companies) were involved in development and implementation. A national project coordinator and knowledge brokers in each team were essential for the project. PPP-Arm was successfully developed and implemented in nine Dutch rehabilitation teams. The protocol improved team collaboration, structure, and completeness of prosthesis prescriptions and treatment uniformity and might be interesting for other countries as well. Clinical relevance A national protocol to prescribe upper limb prostheses can be helpful to create uniformity in treatment of patients with upper limb defects. Such a protocol improves quality of care for all patients in the country.

Exercise effect with the wheelchair aerobic fitness trainer on conditioning and metabolic function in disabled persons: a pilot study.

PubMed

Midha, M; Schmitt, J K; Sclater, M

1999-03-01

To determine the effect of exercise with the wheelchair aerobic fitness trainer (WAFT) on anthropometric indices, conditioning, and endocrine and metabolic parameters in persons with lower extremity disability. Exercise sessions with the WAFT lasted 20 to 30 minutes for two to three sessions. Tertiary-care Veterans Administration medical center. Twelve subjects (3 with quadriplegia, 7 with paraplegia, 1 with cerebrovascular accident, 1 with bilateral above-knee amputation). Anthropometric indices (heart rate, blood pressure, weight, oxygen utilization, body mass index, upper arm and abdominal circumference, arm power) and endocrine and metabolic parameters (fasting serum glucose, lipids, and thyroid function) were determined before and after 10 weeks of exercise with the WAFT. All patients noted improved feelings of well-being after training. Mean resting heart rate, upper arm fat area, and fasting serum cholesterol level decreased significantly. Peak oxygen consumption, midarm circumference, and free thyroxine index increased significantly with training. WAFT improves quality of life, conditioning, and endocrine-metabolic parameters in disabled persons.

Comparison of upper arm and forearm blood pressure.

PubMed

Domiano, Kathy L; Hinck, Susan M; Savinske, Debra L; Hope, Kathryn L

2008-11-01

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

The Influence of Dopaminergic Striatal Innervation on Upper Limb Locomotor Synergies

PubMed Central

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

2012-01-01

To determine the role of striatal dopaminergic innervation on upper limb synergies during walking, we measured arm kinematics in 13 subjects with Parkinson disease. Patients were recruited according to several inclusion criteria to represent the best possible in vivo model of dopaminergic denervation. Of relevance, we included only subjects with normal spatio-temporal parameters of the stride and gait speed to avoid an impairment of upper limbs locomotor synergies as a consequence of gait impairment per se. Dopaminergic innervation of the striatum was measured by FP-CIT and SPECT. All patients showed a reduction of gait-associated arms movement. No linear correlation was found between arm ROM reduction and contralateral dopaminergic putaminal innervation loss. Still, a partition analysis revealed a 80% chance of reduced arm ROM when putaminal dopamine content loss was >47%. A significant correlation was described between the asymmetry indices of the swinging of the two arms and dopaminergic striatal innervation. When arm ROM was reduced, we found a positive correlation between upper-lower limb phase shift modulation (at different gait velocities) and striatal dopaminergic innervation. These findings are preliminary evidence that dopaminergic striatal tone plays a modulatory role in upper-limb locomotor synergies and upper-lower limb coupling while walking at different velocities. PMID:23236504

Vascular Accesses for Haemodialysis in the Upper Arm Cause Greater Reduction in the Carotid-Brachial Stiffness than Those in the Forearm: Study of Gender Differences

PubMed Central

Bia, Daniel; Cabrera-Fischer, Edmundo I.; Zócalo, Yanina; Galli, Cintia; Graf, Sebastián; Valtuille, Rodolfo; Pérez-Cámpos, Héctor; Saldías, María; Álvarez, Inés; Armentano, Ricardo L.

2012-01-01

Purpose. To evaluate in chronically haemodialysed patients (CHPs), if: (1) the vascular access (VA) position (upper arm or forearm) is associated with differential changes in upper limb arterial stiffness; (2) differences in arterial stiffness exist between genders associated with the VA; (3) the vascular substitute (VS) of choice, in biomechanical terms, depends on the previous VA location and CHP gender. Methods. 38 CHPs (18 males; VA in upper arm: 18) were studied. Left and right carotid-brachial pulse wave velocity (PWVc-b) was measured. In in vitro studies, PWV was obtained in ePTFE prostheses and in several arterial and venous homografts obtained from donors. The biomechanical mismatch (BM) between CHP native vessel (NV) and VS was calculated. Results/Conclusions. PWVc-b in upper limbs with VA was lower than in the intact contralateral limbs (P < 0.05), and differences were higher (P < 0.05) when the VA was performed in the upper arm. Differences between PWVc-b in upper limbs with VA (in the upper arm) with respect to intact upper limbs were higher (P < 0.05) in males. Independently of the region in which the VA was performed, the homograft that ensured the minimal BM was the brachial artery. The BM was highly dependent on gender and the location in the upper limb in which the VA was performed. PMID:22567282

[Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

PubMed

Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

1995-09-01

Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly measuring arterial blood pressure remains the measurement at the upper arm site, which nevertheless showed a systolic pseudohypertension (deviation of more than 10 mm Hg) in comparison to the invasively measured values in 15% of our selected patients and a diastolic pseudohypertension (deviation of more than 15 mm Hg) in 23% of the patients.

Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

PubMed

Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

2016-06-01

Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, <20 kg/m), middle BMI (BMI, 20-25 kg/m), and high BMI (BMI, >25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P < 0.001]. There was no significant difference in UEL index between BMI groups [low BMI vs middle BMI vs high BMI, 97.2 (4.2) vs 96.6 (4.6) vs 96.7 (9.9), P > 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

Hand dominance in intravenous drug using patients does not affect peripheral venous access sites identified by ultrasound.

PubMed

Kaban, Nicole L; Avitabile, Nicholas C; Siadecki, Sebastian D; Saul, Turandot

2016-06-01

The peripheral veins in the arms and forearms of patients with a history of intravenous (IV) drug use may be sclerosed, calcified, or collapsed due to damage from previous injections. These patients may consequently require alternative, more invasive types of vascular access including central venous or intraosseous catheters. We investigated the relationship between hand dominance and the presence of patent upper extremity (UE) veins specifically in patients with a history of IV drug-use. We predicted that injection into the non-dominant UE would occur with a higher frequency than the dominant UE, leading to fewer damaged veins in the dominant UE. If hand dominance affects which upper extremity has more patent veins, providers could focus their first vascular access attempt on the dominant upper extremity. Adult patients were approached for enrollment if they provided a history of IV drug use into one of their upper extremities. Each upper extremity was examined with a high frequency linear transducer in 3 areas: the antecubital crease, forearm and the proximal arm. The number of fully compressible veins ≥1.8 mm in diameter was recorded for each location. The mean vein difference between the numbers of veins in the dominant versus the non-dominant UE was -1.5789. At a .05 significance level, there was insufficient evidence to suggest the number of compressible veins between patients' dominant and non-dominant arms was significantly different (P = .0872.) The number of compressible veins visualized with ultrasound was not greater in the dominant upper extremity as expected. Practitioners may gain more information about potential peripheral venous access sites by asking patients their previous injection practice patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

Primary tumor sites in relation to ultraviolet radiation exposure and skin visibility correlate with survival in cutaneous melanoma.

PubMed

Gordon, Daniela; Hansson, Johan; Eloranta, Sandra; Gordon, Max; Gillgren, Peter; Smedby, Karin E

2017-10-01

The prognostic value of detailed anatomic site and ultraviolet radiation (UVR) exposure patterns has not been fully determined in cutaneous melanoma. Thus, we reviewed medical records for detailed site in a population-based retrospective Swedish patient cohort diagnosed with primary invasive melanoma 1976-2003 (n = 5,973). We followed the patients from date of diagnosis until death, emigration or December 31 st 2013, and evaluated melanoma-specific survival by subsite in a multivariable regression model adjusting for established prognostic factors. We found that melanoma on chronic UVR exposure sites (face, dorsum of hands; adjusted HR 0.6; CI 0.4-0.7) and moderately intermittent UVR sites (lateral arms, lower legs, dorsum of feet; HR 0.7; CI 0.6-0.8) were associated with a favorable prognosis compared with highly intermittent sites (chest, back, neck, shoulders and thighs). Further, melanoma on poorly visible skin sites upon self-examination (scalp, retroauricular area, back, posterior upper arms and thighs, buttocks, pubic area; HR 1.3; CI 1.1-1.5) had a worse prognosis than those on easily visible sites (face, chest, abdomen, anterior upper arms and thighs, lower arms and legs, dorsum of hands and feet, palms). In conclusion, highly intermittent UVR exposure sites and poor skin visibility presumably correlate with reduced melanoma survival, independent of established tumor characteristics. A limitation of the study was the lack of information on actual individual UVR exposure. © 2017 UICC.

Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI)

PubMed Central

Cao, Bangming; Wang, Haipeng; Zhang, Chi; Xia, Ming

2018-01-01

Background The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Material/Methods Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation. Peripheral venous blood samples were collected before PCI and at 0.5, 8, 24, 48, and 72 hours after PCI. Levels of creatine kinase-MB (CK-MB), serum creatinine (Cr), nitric oxide (NO), and stromal cell-derived factor-1α (SDF-1α) were measured. The rates of acute kidney injury (AKI) and the estimated glomerular filtration rate (eGFR) were calculated. Results Patients in the primary PCI+RIPC group, compared with the primary PCI group, had significantly lower peak CK-MB concentrations (P<0.01), a significantly increased left ventricular ejection fraction (LVEF) (P=0.01), a significantly lower rate of AKI (P<0.01) a significantly increased eGFR (P<0.01), and decreased area under the curve (AUC) of CK-MB, NO and SDF-1α. Conclusions RIPC of the upper arm following primary PCI in patients with acute STEMI might provide cardiac and renal protection from ischemia-reperfusion injury via the actions of SDF-1α, and NO. PMID:29456238

Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI).

PubMed

Cao, Bangming; Wang, Haipeng; Zhang, Chi; Xia, Ming; Yang, Xiangjun

2018-02-19

BACKGROUND The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). MATERIAL AND METHODS Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation. Peripheral venous blood samples were collected before PCI and at 0.5, 8, 24, 48, and 72 hours after PCI. Levels of creatine kinase-MB (CK-MB), serum creatinine (Cr), nitric oxide (NO), and stromal cell-derived factor-1α (SDF-1α) were measured. The rates of acute kidney injury (AKI) and the estimated glomerular filtration rate (eGFR) were calculated. RESULTS Patients in the primary PCI+RIPC group, compared with the primary PCI group, had significantly lower peak CK-MB concentrations (P<0.01), a significantly increased left ventricular ejection fraction (LVEF) (P=0.01), a significantly lower rate of AKI (P<0.01) a significantly increased eGFR (P<0.01), and decreased area under the curve (AUC) of CK-MB, NO and SDF-1α. CONCLUSIONS RIPC of the upper arm following primary PCI in patients with acute STEMI might provide cardiac and renal protection from ischemia-reperfusion injury via the actions of SDF-1α, and NO.

UAE population reference standard charts for body mass index and skinfold thickness, at ages 0-18 years.

PubMed

Abdulrazzaq, Yousef M; Nagelkerke, Nico; Moussa, Mohamed A

2011-11-01

To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness. A national cross-sectional growth survey of children, 0-18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age-sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children. BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13-17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurate. A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.

Household food insecurity is associated with both body mass index and middle upper-arm circumference of mothers in northwest Ethiopia: a comparative study.

PubMed

Motbainor, Achenef; Worku, Alemayehu; Kumie, Abera

2017-01-01

Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia. This was a community-based comparative cross-sectional study conducted May 24-July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia's Productive Safety Net Programme was used for grouping the study areas. A food-security access scale developed by the Food and Nutrition Technical Assistant project was used to measure food security. Sociodemographic data were collected using a structured questionnaire. A binary logistic regression model was used to assess the association of food insecurity and maternal undernutrition. From the total participants, 12.6% (95% confidence interval [CI] 11.6%-13.6%) had a body mass index (BMI) <18.5 kg/m 2 . Comparison of maternal undernutrition in the two study areas revealed 8.8% (95% CI 7.6%-10.2%) in the program area and 16.4% (95% CI 14.8%-18.1%) in nonprogram areas were undernourished. Severe food insecurity was significantly associated with BMI of mothers (adjusted odds ratios [AORs] 3.6 and 2.31, 95% CI 2.32-5.57 and 1.52-3.5, respectively) in both program and nonprogram areas. Mild (AOR 1.77, 95% CI 1.21-2.6) and moderate (AOR 1.6, 95% CI 1.18-2.16) food insecurity significantly associated with maternal undernutrition in nonprogram areas. In the same way, all forms of food insecurity significantly associated with maternal middle upper-arm circumference in both program and nonprogram areas. The odds of mothers who did not exercise decision-making practice on the household income was also 4.13 times higher than those who did (AOR 4.13, 95% CI 2.2-7.77) in the program area. Food insecurity significantly associated with both maternal BMI and middle upper-arm circumference in both study areas. Female authority also significantly associated with BMI of the mothers in the program area. Maternal nutrition-intervention programs should focus on women-empowerment strategies that enable them to decide on the income for household-nutrition provision.

Early manifestation of arm-leg coordination during stepping on a surface in human neonates.

PubMed

La Scaleia, Valentina; Ivanenko, Y; Fabiano, A; Sylos-Labini, F; Cappellini, G; Picone, S; Paolillo, P; Di Paolo, A; Lacquaniti, F

2018-04-01

The accomplishment of mature locomotor movements relies upon the integrated coordination of the lower and upper limbs and the trunk. Human adults normally swing their arms and a quadrupedal limb coordination persists during bipedal walking despite a strong corticospinal control of the upper extremities that allows to uncouple this connection during voluntary activities. Here we investigated arm-leg coordination during stepping responses on a surface in human neonates. In eight neonates, we found the overt presence of alternating arm-leg oscillations, the arms moving up and down in alternation with ipsilateral lower limb movements. These neonates moved the diagonal limbs together, and the peak of the arm-to-trunk angle (i.e., maximum vertical excursion of the arm) occurred around the end of the ipsilateral stance phase, as it occurs during typical adult walking. Although episodes of arm-leg coordination were sporadic in our sample of neonates, their presence provides significant evidence for a neural coupling between the upper and lower limbs during early ontogenesis of locomotion in humans.

Arm posture-dependent changes in corticospinal excitability are largely spinal in origin.

PubMed

Nuzzo, James L; Trajano, Gabriel S; Barry, Benjamin K; Gandevia, Simon C; Taylor, Janet L

2016-04-01

Biceps brachii motor evoked potentials (MEPs) from cortical stimulation are influenced by arm posture. We used subcortical stimulation of corticospinal axons to determine whether this postural effect is spinal in origin. While seated at rest, 12 subjects assumed several static arm postures, which varied in upper-arm (shoulder flexed, shoulder abducted, arm hanging to side) and forearm orientation (pronated, neutral, supinated). Transcranial magnetic stimulation over the contralateral motor cortex elicited MEPs in resting biceps and triceps brachii, and electrical stimulation of corticospinal tract axons at the cervicomedullary junction elicited cervicomedullary motor evoked potentials (CMEPs). MEPs and CMEPs were normalized to the maximal compound muscle action potential (Mmax). Responses in biceps were influenced by upper-arm and forearm orientation. For upper-arm orientation, biceps CMEPs were 68% smaller (P= 0.001), and biceps MEPs 31% smaller (P= 0.012), with the arm hanging to the side compared with when the shoulder was flexed. For forearm orientation, both biceps CMEPs and MEPs were 34% smaller (both P< 0.046) in pronation compared with supination. Responses in triceps were influenced by upper-arm, but not forearm, orientation. Triceps CMEPs were 46% smaller (P= 0.007) with the arm hanging to the side compared with when the shoulder was flexed. Triceps MEPs and biceps and triceps MEP/CMEP ratios were unaffected by arm posture. The novel finding is that arm posture-dependent changes in corticospinal excitability in humans are largely spinal in origin. An interplay of multiple reflex inputs to motoneurons likely explains the results. Copyright © 2016 the American Physiological Society.

Arm posture-dependent changes in corticospinal excitability are largely spinal in origin

PubMed Central

Nuzzo, James L.; Trajano, Gabriel S.; Barry, Benjamin K.; Gandevia, Simon C.

2016-01-01

Biceps brachii motor evoked potentials (MEPs) from cortical stimulation are influenced by arm posture. We used subcortical stimulation of corticospinal axons to determine whether this postural effect is spinal in origin. While seated at rest, 12 subjects assumed several static arm postures, which varied in upper-arm (shoulder flexed, shoulder abducted, arm hanging to side) and forearm orientation (pronated, neutral, supinated). Transcranial magnetic stimulation over the contralateral motor cortex elicited MEPs in resting biceps and triceps brachii, and electrical stimulation of corticospinal tract axons at the cervicomedullary junction elicited cervicomedullary motor evoked potentials (CMEPs). MEPs and CMEPs were normalized to the maximal compound muscle action potential (Mmax). Responses in biceps were influenced by upper-arm and forearm orientation. For upper-arm orientation, biceps CMEPs were 68% smaller (P = 0.001), and biceps MEPs 31% smaller (P = 0.012), with the arm hanging to the side compared with when the shoulder was flexed. For forearm orientation, both biceps CMEPs and MEPs were 34% smaller (both P < 0.046) in pronation compared with supination. Responses in triceps were influenced by upper-arm, but not forearm, orientation. Triceps CMEPs were 46% smaller (P = 0.007) with the arm hanging to the side compared with when the shoulder was flexed. Triceps MEPs and biceps and triceps MEP/CMEP ratios were unaffected by arm posture. The novel finding is that arm posture-dependent changes in corticospinal excitability in humans are largely spinal in origin. An interplay of multiple reflex inputs to motoneurons likely explains the results. PMID:26864764

Validity of the Acti4 software using ActiGraph GT3X+accelerometer for recording of arm and upper body inclination in simulated work tasks.

PubMed

Korshøj, Mette; Skotte, Jørgen H; Christiansen, Caroline S; Mortensen, Pelle; Kristiansen, Jesper; Hanisch, Christiana; Ingebrigtsen, Jørgen; Holtermann, Andreas

2014-01-01

The validity of inclinometer measurements by ActiGraph GT3X+ (AG) accelerometer, when analysed with the Acti4 customised software, was examined by comparison of inclinometer measurements with a reference system (TrakStar) in a protocol with standardised arm movements and simulated working tasks. The sensors were placed at the upper arm (distal to the deltoid insertion) and at the spine (level of T1-T2) on eight participants. Root mean square errors (RMSEs) values of inclination between the two systems were low for the slow- and medium-speed standardised arm movements and in simulated working tasks. Fast arm movements caused the inclination estimated by the AG to deviate from the reference measurements (RMSE values up to ∼10°). Furthermore, it was found that AG positioned at the upper arm provided inclination data without bias compared to the reference system. These findings indicate that the AG provides valid estimates of arm and upper body inclination in working participants. Being inexpensive, small, water-resistant and without wires, ActiGraph GT3X+ seems to be a valid mean for direct long-term field measurements of arm and trunk inclinations when analysed by the Acti4 customised software.

Quantitative estimation of muscle shear elastic modulus of the upper trapezius with supersonic shear imaging during arm positioning.

PubMed

Leong, Hio-Teng; Ng, Gabriel Yin-Fat; Leung, Vivian Yee-Fong; Fu, Siu Ngor

2013-01-01

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87-0.97) and inter-observer (ICC = 0.78-0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders.

Quantitative Estimation of Muscle Shear Elastic Modulus of the Upper Trapezius with Supersonic Shear Imaging during Arm Positioning

PubMed Central

Leong, Hio-Teng; Ng, Gabriel Yin-fat; Leung, Vivian Yee-fong; Fu, Siu Ngor

2013-01-01

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87–0.97) and inter-observer (ICC = 0.78–0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders. PMID:23825641

The arm posture in children with unilateral Cerebral Palsy is mainly related to antero-posterior gait instability.

PubMed

Meyns, Pieter; Duysens, Jacques; Desloovere, Kaat

2016-09-01

In this observational case-control study we aimed to determine whether altered arm postures in children with unilateral CP (uniCP) are related to gait instability in a specific direction. Antero-posterior and medio-lateral Foot Placement Estimator instability measures and arm posture measures (vertical and antero-posterior hand position, sagittal and frontal upper arm elevation angle) were determined in eleven uniCP (7 years-10 months) and twenty-four typically developing children (9 years-6 months) at two walking speeds. Spearman-rank correlation analyses were made to examine the relationship between antero-posterior and medio-lateral arm posture and gait instability. Arm posture in both planes was related to antero-posterior instability (e.g. sagittal and frontal upper arm elevation angle correlated moderately with antero-posterior instability; R=0.41, p<0.001, R=-0.47, p<0.001). In uniCP, increased antero-posterior instability was associated with a higher (R=-0.62, p=0.002) and more frontal position of the hemiplegic hand (R=-0.58, p=0.005), while the non-hemiplegic upper arm was rotated more backward (R=0.63, p=0.002) and both upper arms rotated more sideways (hemiplegic: R=-0.58, p=0.004; non-hemiplegic: R=-0.55, p=0.008). The altered non-hemiplegic (sagittal and frontal) arm posture in uniCP may be a compensation to reduce antero-posterior gait instability. Copyright © 2016 Elsevier B.V. All rights reserved.

Temporal arteritis

MedlinePlus

... the blood vessels that supply blood to the head, neck, upper body and arms. It is also called ... the blood vessels that supply blood to the head, neck, upper body, and arms. It most commonly occurs ...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

49 CFR 572.15 - General description.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Assembly SA 103C 030 Torso Assembly SA 103C 041 Upper Arm Assembly Left SA 103C 042 Upper Arm Assembly Right SA 103C 051 Forearm Hand Assembly Left SA 103C 052 Forearm Hand Assembly Right SA 103C 061Upper Leg Assembly Left SA 103C 062 Upper Leg Assembly Right SA 103C 071 Lower Leg Assembly Left SA 103C 072...

Influence of gravity compensation training on synergistic movement patterns of the upper extremity after stroke, a pilot study

PubMed Central

2012-01-01

Background The majority of stroke patients have to cope with impaired arm function. Gravity compensation of the arm instantaneously affects abnormal synergistic movement patterns. The goal of the present study is to examine whether gravity compensated training improves unsupported arm function. Methods Seven chronic stroke patients received 18 half-hour sessions of gravity compensated reach training, in a period of six weeks. During training a motivating computer game was played. Before and after training arm function was assessed with the Fugl-Meyer assessment and a standardized, unsupported circle drawing task. Synergistic movement patterns were identified based on concurrent changes in shoulder elevation and elbow flexion/extension angles. Results Median increase of Fugl-Meyer scores was 3 points after training. The training led to significantly increased work area of the hemiparetic arm, as indicated by the normalized circle area. Roundness of the drawn circles and the occurrence of synergistic movement patterns remained similar after the training. Conclusions A decreased strength of involuntary coupling might contribute to the increased arm function after training. More research is needed to study working mechanisms involved in post stroke rehabilitation training. The used training setup is simple and affordable and is therefore suitable to use in clinical settings. PMID:22824488

The efficacy of SMART Arm training early after stroke for stroke survivors with severe upper limb disability: a protocol for a randomised controlled trial.

PubMed

Brauer, Sandra G; Hayward, Kathryn S; Carson, Richard G; Cresswell, Andrew G; Barker, Ruth N

2013-07-02

Recovery of upper limb function after stroke is poor. The acute to subacute phase after stroke is the optimal time window to promote the recovery of upper limb function. The dose and content of training provided conventionally during this phase is however, unlikely to be adequate to drive functional recovery, especially in the presence of severe motor disability. The current study concerns an approach to address this shortcoming, through evaluation of the SMART Arm, a non-robotic device that enables intensive and repetitive practice of reaching by stroke survivors with severe upper limb disability, with the aim of improving upper limb function. The outcomes of SMART Arm training with or without outcome-triggered electrical stimulation (OT-stim) to augment movement and usual therapy will be compared to usual therapy alone. A prospective, assessor-blinded parallel, three-group randomised controlled trial is being conducted. Seventy-five participants with a first-ever unilateral stroke less than 4 months previously, who present with severe arm disability (three or fewer out of a possible six points on the Motor Assessment Scale [MAS] Item 6), will be recruited from inpatient rehabilitation facilities. Participants will be randomly allocated to one of three dose-matched groups: SMART Arm training with OT-stim and usual therapy; SMART Arm training without OT-stim and usual therapy; or usual therapy alone. All participants will receive 20 hours of upper limb training over four weeks. Blinded assessors will conduct four assessments: pre intervention (0-weeks), post intervention (4-weeks), 26 weeks and 52 weeks follow-up. The primary outcome measure is MAS item 6. All analyses will be based on an intention-to-treat principle. By enabling intensive and repetitive practice of a functional upper limb task during inpatient rehabilitation, SMART Arm training with or without OT-stim in combination with usual therapy, has the potential to improve recovery of upper limb function in those with severe motor disability. The immediate and long-term effects of SMART Arm training on upper limb impairment, activity and participation will be explored, in addition to the benefit of training with or without OT-stim to augment movement when compared to usual therapy alone. ACTRN12608000457347.

3D Measurement of Forearm and Upper Arm during Throwing Motion using Body Mounted Sensor

NASA Astrophysics Data System (ADS)

Koda, Hideharu; Sagawa, Koichi; Kuroshima, Kouta; Tsukamoto, Toshiaki; Urita, Kazutaka; Ishibashi, Yasuyuki

The aim of this study is to propose the measurement method of three-dimensional (3D) movement of forearm and upper arm during pitching motion of baseball using inertial sensors without serious consideration of sensor installation. Although high accuracy measurement of sports motion is achieved by using optical motion capture system at present, it has some disadvantages such as the calibration of cameras and limitation of measurement place. Whereas the proposed method for 3D measurement of pitching motion using body mounted sensors provides trajectory and orientation of upper arm by the integration of acceleration and angular velocity measured on upper limb. The trajectory of forearm is derived so that the elbow joint axis of forearm corresponds to that of upper arm. Spatial relation between upper limb and sensor system is obtained by performing predetermined movements of upper limb and utilizing angular velocity and gravitational acceleration. The integration error is modified so that the estimated final position, velocity and posture of upper limb agree with the actual ones. The experimental results of the measurement of pitching motion show that trajectories of shoulder, elbow and wrist estimated by the proposed method are highly correlated to those from the motion capture system within the estimation error of about 10 [%].

Test Results of Air-Permeable Charcoal Impregnated Suits to Challenge by Chemical and Biological Warfare Agents and Simulants: Summary Report

DTIC Science & Technology

2002-09-01

Area M ) + 0.4(Thigh Area M ) + 0.05(Upper Arm Seam M ) + 0.05(Lower Leg Seam M ) + 0.1(Crotch Area M ). f f f f f 428 53971 61240 454 24385 ...Public Health, San Antonio, TX • Annetta P. Watson, Ph.D., Life Sciences Div., Oak Ridge National Laboratories, Oak Ridge, TN • Leo F . Saubier...TOMPS) ……………………….. 35 F Giat NBC SWAT Suit

The relationships between height and arm span, mid-upper arm and waist circumferences and sum of four skinfolds in Ellisras rural children aged 8-18 years.

PubMed

Monyeki, Kotsedi Daniel; Sekhotha, Michael Matome

2016-05-01

Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether arm span, mid-upper arm and waist circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8-18 years. The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, arm span, mid-upper arm circumference, waist circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models. Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa. Boys (n 911) and girls (n 858) aged 8-18 years. Mean height was higher than arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and arm span was high (ranging from 0·74 to 0·91) with P<0·001. The correlation between height and mid-upper arm circumference, waist circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P<0·00 among girls in the 15-18 years age group. Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist circumference showed a negative significant association in the same groups.

Color Doppler Sonographic and Cadaveric Study of the Arterial Vascularity of the Lateral Upper Arm Flap.

PubMed

Sun, Ruimei; Ding, Yu; Sun, Chuanzheng; Li, Xiaojiang; Wang, Jinde; Li, Lei; Yang, Jie; Ren, Yanxin; Zhong, Zhaoming

2016-04-01

To determine the importance of adequate preoperative assessment with color Doppler sonography to assist in the successful transfer of lateral upper arm flaps by studying the lateral upper arm flap with color Doppler sonography and analyzing the anatomic features of the radial collateral artery. A clinical case-control study was performed. The radial collateral artery was studied with color Doppler sonography in 15 healthy volunteers. The origins, courses, variations, and locations of the perforators of the radial collateral artery were recorded. The results and data from the color Doppler sonographic investigation were compared with an anatomic study that was performed on 22 adult cadaveric upper limb specimens. The volunteer group (14 of 15 volunteers) and the cadaveric group (19 of 22 upper arm specimens) clearly showed that the branch pattern of the arterial supply was as follows: brachial artery → deep brachial artery → radial collateral artery → posterior radial collateral artery → myocutaneous perforator. Variations in the origin of the radial collateral artery were identified in 1 volunteer bilaterally and in 3 upper arm specimens. The diameters of the artery and vein measured at the distal insertion of the deltoid and the origin of the deep brachial artery were not significantly different between the volunteer and cadaver groups (P > .05). Due to the difference in measuring methods, the length of the vascular pedicles was significantly different between the groups (P < .05). Color Doppler sonography can facilitate the preoperative assessment of the origin, course, variations, and locations of the radial collateral artery and therefore may increase the success rate of lateral upper arm flap transfer. © 2016 by the American Institute of Ultrasound in Medicine.

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau.

PubMed

Aaby, P; Gomes, J; Fernandes, M; Djana, Q; Lisse, I; Jensen, H

1999-10-02

To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Follow up study of 3 months. Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. 422 children aged 9-23 months in 30 clusters. Mid-upper arm circumference and survival in relation to residence status. During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee's stay in Prabis compared with the period after the departure of the refugees. In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability.

Dorsal scapular nerve neuropathy: a narrative review of the literature

PubMed Central

Muir, Brad

2017-01-01

Objective The purpose of this paper is to elucidate this little known cause of upper back pain through a narrative review of the literature and to discuss the possible role of the dorsal scapular nerve (DSN) in the etiopathology of other similar diagnoses in this area including cervicogenic dorsalgia (CD), notalgia paresthetica (NP), SICK scapula and a posterolateral arm pain pattern. Background Dorsal scapular nerve (DSN) neuropathy has been a rarely thought of differential diagnosis for mid scapular, upper to mid back and costovertebral pain. These are common conditions presenting to chiropractic, physiotherapy, massage therapy and medical offices. Methods The methods used to gather articles for this paper included: searching electronic databases; and hand searching relevant references from journal articles and textbook chapters. Results One hundred-fourteen articles were retrieved. After removing duplicates, there were 57 articles of which 29 were retrieved. There were 26 articles and textbook chapters retrieved by hand searching equaling 55 articles retrieved of which 47 relevant articles were used in this report. Discussion The anatomy, pathway and function of the dorsal scapular nerve can be varied and exceptionally rarely may include a sensory component. The signs and symptoms, therefore, may include pain, atrophy, scapular winging, and dysesthesia. The mechanism of injury to the DSN is also quite varied ranging from postural to overuse in overhead work and sport. Other conditions in this area, including CD, NP, SICK scapula and a posterolateral arm pain pattern bear a striking resemblance to DSN neuropathy. Conclusion DSN neuropathy should be included in the list of common differential diagnoses of upper and mid-thoracic pain, stiffness, dysesthesia and dysfunction. The study also brings forward interesting connections between DSN neuropathy, CD, NP, SICK scapula and a posterolateral arm pain pattern. PMID:28928496

19. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD AND ENDPOST CONNECTION U-19, LOOKING SOUTHWEST - Jackson's Ferry Bridge, Route 52 over New River, 6.3 miles south of Route 94, Austinville, Wythe County, VA

Survey of upper extremity injuries among martial arts participants.

PubMed

Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

2013-01-01

To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

Optimal Body Size and Limb Length Ratios Associated with 100-m Personal-Best Swim Speeds.

PubMed

Nevill, Alan M; Oxford, Samuel W; Duncan, Michael J

2015-08-01

This study aims to identify optimal body size and limb segment length ratios associated with 100-m personal-best (PB) swim speeds in children and adolescents. Fifty national-standard youth swimmers (21 males and 29 females age 11-16 yr; mean ± SD age, 13.5 ± 1.5 yr) participated in the study. Anthropometry comprised stature; body mass; skinfolds; maturity offset; upper arm, lower arm, and hand lengths; and upper leg, lower leg, and foot lengths. Swimming performance was taken as the PB time recorded in competition for the 100-m freestyle swim. To identify the optimal body size and body composition components associated with 100-m PB swim speeds (having controlled for age and maturity offset), we adopted a multiplicative allometric log-linear regression model, which was refined using backward elimination. Lean body mass was the singularly most important whole-body characteristic. Stature and body mass did not contribute to the model, suggesting that the advantage of longer levers was limb-specific rather than a general whole-body advantage. The allometric model also identified that having greater limb segment length ratios [i.e., arm ratio = (low arm)/(upper arm); foot-to-leg ratio = (foot)/(lower leg)] was key to PB swim speeds. It is only by adopting multiplicative allometric models that the above mentioned ratios could have been derived. The advantage of having a greater lower arm is clear; however, having a shorter upper arm (achieved by adopting a closer elbow angle technique or by possessing a naturally endowed shorter upper arm), at the same time, is a new insight into swimming performance. A greater foot-to-lower-leg ratio suggests that a combination of larger feet and shorter lower leg length may also benefit PB swim speeds.

20. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD, POST, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. DETAIL OF SOUTH CANTILEVER ANCHOR ARM UPPER CHORD, POST, AND DIAGONAL CONNECTION U-17, LOOKING NORTHWEST - Jackson's Ferry Bridge, Route 52 over New River, 6.3 miles south of Route 94, Austinville, Wythe County, VA

An iPhone application for upper arm posture and movement measurements.

PubMed

Yang, Liyun; Grooten, Wilhelmus J A; Forsman, Mikael

2017-11-01

There is a need for objective methods for upper arm elevation measurements for accurate and convenient risk assessments. The aims of this study were (i) to compare a newly developed iOS application (iOS) for measuring upper arm elevation and angular velocity with a reference optical tracking system (OTS), and (ii) to compare the accuracy of the iOS incorporating a gyroscope and an accelerometer with using only an accelerometer, which is standard for inclinometry. The iOS-OTS limits of agreement for static postures (9 subjects) were -4.6° and 4.8°. All root mean square differences in arm swings and two simulated work tasks were <6.0°, and all mean correlation coefficients were >0.98. The mean absolute iOS-OTS difference of median angular velocity was <13.1°/s, which was significantly lower than only using an accelerometer (<43.5°/s). The accuracy of this iOS application compares well to that of today's research methods and it can be useful for practical upper arm measurements. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

VO2 Max in Variable Type Exercise Among Well-Trained Upper Body Athletes.

ERIC Educational Resources Information Center

Seals, Douglas R.; Mullin, John P.

1982-01-01

The maximal oxygen consumption (VO2 max) of well-trained upper body athletes was compared to that of untrained individuals in four types of exercise: arm cranking, legs only cycling, graded treadmill running, and combined arm cranking and leg cycling. Results of the study showed that well-trained upper body athletes attained a significantly higher…

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review.

PubMed

Irving, Greg; Holden, John; Stevens, Richard; McManus, Richard J

2016-11-03

To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria. MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. Cross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included. 4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement. BP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

PubMed Central

Holden, John

2016-01-01

Objective To determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference. Design Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria. Data sources MEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched. Eligibility criteria Cross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included. Results 4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement. Conclusions BP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered. PMID:27810973

Cold Gas Content and Morphology: Scaling Relationships and Gas Deficiencies

NASA Astrophysics Data System (ADS)

Zhang, Helen; Crocker, Alison

2018-01-01

Spiral arms are a key feature of spiral galaxies. They are areas of higher gas density, and thus more stars are actively being formed in these regions. Two armed spirals are commonly referred to as ‘grand design’ spirals. In constrast, many armed spirals have three or more arms that are often less distinct. Here we present the cold gas mass per unit of stellar mass (cold gas fraction) in grand design spirals versus many armed spiral galaxies using Galaxy Zoo 2 for our morphological classifications. The masses of HI and H2 gas are taken from the COLDGASS survey, which included nondetections in the form of upper limits. Through our analysis, we found that grand design galaxies have a lower cold gas fraction of both HI and H2. This is a surprising result, given that earlier studies have shown that they have comparable rates of star formation. Combined with our result, this means that grand design galaxies must be more efficient at converting H2 gas to stars.

SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol

PubMed Central

2011-01-01

Background Recovery patterns of upper extremity motor function have been described in several longitudinal studies, but most of these studies have had selected samples, short follow up times or insufficient outcomes on motor function. The general understanding is that improvements in upper extremity occur mainly during the first month after the stroke incident and little if any, significant recovery can be gained after 3-6 months. The purpose of this study is to describe the recovery of upper extremity function longitudinally in a non-selected sample initially admitted to a stroke unit with first ever stroke, living in Gothenburg urban area. Methods/Design A sample of 120 participants with a first-ever stroke and impaired upper extremity function will be consecutively included from an acute stroke unit and followed longitudinally for one year. Assessments are performed at eight occasions: at day 3 and 10, week 3, 4 and 6, month 3, 6 and 12 after onset of stroke. The primary clinical outcome measures are Action Research Arm Test and Fugl-Meyer Assessment for Upper Extremity. As additional measures, two new computer based objective methods with kinematic analysis of arm movements are used. The ABILHAND questionnaire of manual ability, Stroke Impact Scale, grip strength, spasticity, pain, passive range of motion and cognitive function will be assessed as well. At one year follow up, two patient reported outcomes, Impact on Participation and Autonomy and EuroQol Quality of Life Scale, will be added to cover the status of participation and aspects of health related quality of life. Discussion This study comprises a non-selected population with first ever stroke and impaired arm function. Measurements are performed both using traditional clinical assessments as well as computer based measurement systems providing objective kinematic data. The ICF classification of functioning, disability and health is used as framework for the selection of assessment measures. The study design with several repeated measurements on motor function will give us more confident information about the recovery patterns after stroke. This knowledge is essential both for optimizing rehabilitation planning as well as providing important information to the patient about the recovery perspectives. Trial registration ClinicalTrials.gov: NCT01115348 PMID:21612620

Upper-arm anthropometry: an alternative indicator of nutritional health to body mass index in unilateral lower-extremity amputees?

PubMed

Miller, Michelle; Wong, Wing Ki; Wu, Jing; Cavenett, Sally; Daniels, Lynne; Crotty, Maria

2008-10-01

To evaluate the utility of body mass index (BMI) and corrected-arm-muscle area (CAMA) as measures of nutritional health for lower-limb amputees attending prosthetics clinics. Cross-sectional study. Prosthetics clinic in Australia. Unilateral lower-extremity amputees (N=58; age range, 21-91y; 37 transtibial, 21 transfemoral) attending a regional prosthetics clinic between May and November 2003. Not applicable. Weight (without prosthesis), corrected and uncorrected for the amputated limb was used with height estimated from knee height to calculate corrected BMI (cBMI) and uncorrected BMI (uBMI). CAMA was calculated using the mean of triplicate mid-upper-arm circumference (MUAC) and triceps skinfold thickness (TST) measurements. The Mini Nutritional Assessment (MNA) and Assessment of Quality of Life were administered according to recommended protocols. The Pearson correlation was used to determine the strength and significance of associations between variables, and bivariate regression analyses were performed to determine whether an association existed between the nutritional variables (BMI, CAMA, MNA) and quality of life (QOL). There were no statistically significant differences in the measures of nutritional health according to site (transtibial, transfemoral) of amputation. MUAC, TST, and CAMA all showed moderate to high positive correlations (r range, .541-.782) with both cBMI and uBMI. The strength of the relationship between the MNA and cBMI/uBMI was weaker (r=.383, r=.380, respectively) but remained positive and statistically significant (P=.003). QOL was not associated with cBMI or uBMI but was related to CAMA (beta=-.132; P=.030) and MNA (beta=-.561; P=.017). For persons with unilateral lower-extremity amputation, measurement of upper-arm anthropometry may be a more useful indicator of nutritional health and its consequences than BMI.

Influence of basal ganglia on upper limb locomotor synergies. Evidence from deep brain stimulation and L-DOPA treatment in Parkinson's disease.

PubMed

Crenna, P; Carpinella, I; Lopiano, L; Marzegan, A; Rabuffetti, M; Rizzone, M; Lanotte, M; Ferrarin, M

2008-12-01

Clinical evidence of impaired arm swing while walking in patients with Parkinson's disease suggests that basal ganglia and related systems play an important part in the control of upper limb locomotor automatism. To gain more information on this supraspinal influence, we measured arm and thigh kinematics during walking in 10 Parkinson's disease patients, under four conditions: (i) baseline (no treatment), (ii) therapeutic stimulation of the subthalamic nucleus (STN), (iii)L-DOPA medication and (iv) combined STN stimulation and L-DOPA. Ten age-matched controls provided reference data. Under baseline conditions the range of patients' arm motion was severely restricted, with no correlation with the excursion of the thigh. In addition, the arm swing was abnormally coupled in time with oscillation of the ipsilateral thigh. STN stimulation significantly increased the gait speed and improved the spatio-temporal parameters of arm and thigh motion. The kinematic changes as a function of gait speed changes, however, were significantly smaller for the upper than the lower limb, in contrast to healthy controls. Arm motion was also less responsive after L-DOPA. Simultaneous deep brain stimulation and L-DOPA had additive effects on thigh motion, but not on arm motion and arm-thigh coupling. The evidence that locomotor automatisms of the upper and lower limbs display uncorrelated impairment upon dysfunction of the basal ganglia, as well as different susceptibility to electrophysiological and pharmacological interventions, points to the presence of heterogeneously distributed, possibly partially independent, supraspinal control channels, whereby STN and dopaminergic systems have relatively weaker influence on the executive structures involved in the arm swing and preferential action on those for lower limb movements. These findings might be considered in the light of phylogenetic changes in supraspinal control of limb motion related to primate bipedalism.

Activity of upper limb muscles during human walking.

PubMed

Kuhtz-Buschbeck, Johann P; Jing, Bo

2012-04-01

The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery.

PubMed

Sebbag, Ilana; Massey, Simon R; Albert, Arianne Y K; Dube, Alison; Gunka, Vit; Douglas, M Joanne

2015-09-01

Shivering is common during cesarean delivery (CD) under neuraxial anesthesia and may disrupt the measurement of noninvasive blood pressure (BP). BP measured at the wrist may be less affected by shivering. There have been no studies comparing trends in BP measured on the upper arm and wrist. We hypothesized that wrist systolic blood pressure (sBP) would accurately trend with upper arm sBP measurements (agree within a limit of ±10%) in parturients undergoing elective CD under spinal anesthesia or combined spinal-epidural anesthesia. After initiation of spinal anesthesia, BP measurements were obtained simultaneously from the upper arm and wrist on opposite arms. The interval between measurements was 1 to 2 minutes, and data were collected for 20 minutes or until delivery. The primary outcome was agreement in dynamic changes in sBP measurements between the upper arm and the wrist. Bland-Altman plots indicating the levels of agreement between the methods were drawn for baseline measurements, over multiple measurements, and over multiple measurements on percentage change from baseline. Forty-nine patients were recruited and completed the study. The wrist sBP tended to overestimate the upper sBP for both baseline data (sBP bias = 13.4 mm Hg; 95% confidence interval = +10.4 to +16.4 mm Hg) and data obtained over multiple measurements (sBP bias = 12.8 mm Hg; 95% confidence interval = +9.3 to +16.3 mm Hg). For change in sBP from baseline over multiple measurements, the mean difference between the wrist and the arm sBP was -0.2 percentage points (99% limits of agreement -25 to +25 percentage points). The wrist measurement overestimated the reading relative to the upper arm measurement for multiple measurements over time. However, when the time series for each subject was examined for percentage change from baseline, the 2 methods mirrored each other in most cases. Nevertheless, our hypothesis was rejected as the limits of agreement were higher than ±10%. This finding suggests that wrist BP may not be an accurate method of detecting hypotension or hypertension during spinal or combined spinal-epidural anesthesia for CD.

Comparison study of upper arm and forearm non-invasive blood pressures in adult Emergency Department patients.

PubMed

Schimanski, Karen; Jull, Andrew; Mitchell, Nancy; McLay, Jessica

2014-12-01

Forearm blood pressures have been suggested as an alternative site to measure blood pressures when the upper arm is unavailable. However there is little evidence utilising clinical populations to support this substitution. To determine agreement between blood pressures measured in the left upper arm and forearm using a singular oscillometric non-invasive device in adult Emergency Department patients. The secondary objective was to explore the relationship of blood pressure differences with age, sex, ethnicity, smoking history and obesity. Single centre comparison study. Adult Emergency Department, Tertiary Trauma Centre. Forty-four participants who met inclusion/exclusion criteria selected sequentially from the Emergency Department arrival board. A random assignment of order of measurement for left upper arm and forearm blood pressures was utilised. Participants were eligible if they were aged 18 years or older, had been assigned an Australasian Triage Scale code of 2, 3, 4, or 5, were able to consent, and able to have blood pressures measured on their left arm whilst lying at a 45° angle. The Bland-Altman method of statistical analysis was used, with the level of agreement for clinical acceptability for the systolic, diastolic and mean arterial pressure defined as ±10 mmHg. The forearm measure overestimated systolic (mean difference 2.2 mmHg, 95% limits of agreement ±19 mmHg), diastolic (mean difference 3.4 mmHg, 95% limits of agreement ±14.4 mmHg), and mean arterial pressures (mean difference 4.1 mmHg, 95% limits of agreement ±13.7 mmHg). The systolic measure was not significantly different from zero. Evidence of better agreement was found with upper arm/forearm systolic measures below 140 mmHg compared to systolic measures above 140 mmHg using the Levene's test (p=0.002, F-statistic=11.09). Blood pressure disparity was not associated with participant characteristics. Forearm measures cannot routinely replace upper arm measures for blood pressure measurement. If the clinical picture requires use of forearm blood pressure, the potential variance from an upper arm measure is ±19 mmHg for systolic pressure, although the variability may be close to ±10 mmHg if the systolic blood pressure is below 140 mmHg. Copyright © 2014 Elsevier Ltd. All rights reserved.

Persistent arm pain is distinct from persistent breast pain following breast cancer surgery.

PubMed

Langford, Dale J; Paul, Steven M; West, Claudia; Abrams, Gary; Elboim, Charles; Levine, Jon D; Hamolsky, Deborah; Luce, Judith A; Kober, Kord M; Neuhaus, John M; Cooper, Bruce A; Aouizerat, Bradley E; Miaskowski, Christine

2014-12-01

Persistent pain following breast cancer surgery is well documented. However, it is not well characterized in terms of the anatomic site affected (ie, breast, arm). In 2 separate growth mixture modeling analyses, we identified subgroups of women (N = 398) with distinct breast pain and arm pain trajectories. The fact that these latent classes differed by anatomic site, types of tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. The purposes of this companion study were to identify demographic and clinical characteristics that differed between the 2 arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection sites, pain qualities, pain interference, and hand and arm function, as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the moderate arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and axillary lymph node dissection site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility. For persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

PERSISTENT ARM PAIN IS DISTINCT FROM PERSISTENT BREAST PAIN FOLLOWING BREAST CANCER SURGERY

PubMed Central

Langford, Dale J.; Paul, Steven M.; West, Claudia; Abrams, Gary; Elboim, Charles; Levine, Jon D.; Hamolsky, Deborah; Luce, Judith A.; Kober, Kord M.; Neuhaus, John M.; Cooper, Bruce A.; Aouizerat, Bradley E.; Miaskowski, Christine

2014-01-01

Persistent pain following breast cancer surgery is well-documented. However, it is not well characterized in terms of the anatomic site effected (i.e., breast, arm). In two separate growth mixture modeling analyses, we identified subgroups of women (n=398) with distinct breast pain and arm pain trajectories. Based on the fact that these latent classes differed by anatomic site, types if tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. Purposes of this companion study were to identify demographic and clinical characteristics that differed between the two arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection (ALND) sites, pain qualities, pain interference, and hand and arm function; as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the Moderate Arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and ALND site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility. Perspective: For persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women. PMID:25439319

Estimation of regional cutaneous cold sensitivity by analysis of the gasping response.

PubMed

Burke, W E; Mekjavić, I B

1991-11-01

Regional cutaneous sensitivity to cooling was assessed in males by separately immersing four discrete skin regions in cold water (15 degrees C) during head-out immersion. The response measured was gasping at the onset of immersion; the gasping response appears to be the result of a nonthermoregulatory neurogenic drive from cutaneous cold receptors. Subjects of similar body proportions wore a neoprene "dry" suit modified to allow exposure to the water of either the arms, upper torso, lower torso, or legs, while keeping the unexposed skin regions thermoneutral. Each subject was immersed to the sternal notch in all four conditions of partial exposure plus one condition of whole body exposure. The five cold water conditions were matched by control immersions in lukewarm (34 degrees C) water, and trials were randomized. The magnitude of the gasping response was determined by mouth occlusion pressure (P0.1). For each subject, P0.1 values for the 1st min of immersion were integrated, and control trial values, although minimal, were subtracted from their cold water counterpart to account for any gasping due to the experimental design. Results were averaged and showed that the highest P0.1 values were elicited from whole body exposure, followed in descending order by exposures of the upper torso, legs, lower torso, and arms. Correction of the P0.1 response for differences in exposed surface area (A) and cooling stimulus (delta T) between regions gave a cold sensitivity index [CSI, P0.1/(A.delta T)] for each region and showed that the index for the upper torso was significantly higher than that for the arms or legs; no significant difference was observed between the indexes for the upper and lower torso.(ABSTRACT TRUNCATED AT 250 WORDS)

Imaging-guided thoracoscopic resection of a ground-glass opacity lesion in a hybrid operating room equipped with a robotic C-arm CT system.

PubMed

Hsieh, Chen-Ping; Hsieh, Ming-Ju; Fang, Hsin-Yueh; Chao, Yin-Kai

2017-05-01

The intraoperative identification of small pulmonary nodules through video-assisted thoracoscopic surgery remains challenging. Although preoperative CT-guided nodule localization is commonly used to detect tumors during video-assisted thoracoscopic surgery (VATS), this approach carries inherent risks. We report the case of a patient with stage I lung cancer presenting as an area of ground-glass opacity (GGO) in the right upper pulmonary lobe. He successfully underwent a single-stage, CT-guided localization and removal of the pulmonary nodule within a hybrid operating room (OR) equipped with a robotic C-arm.

Mid-upper arm circumference is associated with biochemically determined nutritional status indicators among adolescent girls in Central Mozambique.

PubMed

Kulathinal, Sangita; Freese, Riitta; Korkalo, Liisa; Ismael, Carina; Mutanen, Marja

2016-08-01

Biochemically determined nutritional status measurements in low-income countries are often too expensive. Therefore, we hypothesized that some anthropometrical or functional measurements (handgrip) could reflect nutritional status measured by specific biochemical indicators. We did a population-based study from 1 urban area and 2 rural districts in Zambézia Province of Mozambique. The participants (n=386) were non-pregnant adolescent girls between 15 and 18 years of age. 96% had a normal BMI-for-age score. Weight and mid-upper arm circumference (MUAC) were highly correlated (r>0.8) with each other and with total body muscle mass, body mass index (BMI), and with waist circumference, as well as with skinfolds (r>0.6). Upper and total arm lengths were correlated (r>0.7) with height and with each other, and right and left handgrip were correlated only with each other, as were triceps and subscapular skinfolds (r>0.7). Serum albumin correlated negatively with waist circumference (P<.001) and positively with MUAC (P=.007). Stepwise regressions showed that waist circumference, MUAC, weight, and handgrip were important nutritional status indicators in the models using hemoglobin, serum albumin, ferritin, zinc, and plasma retinol concentrations as dependent variables. MUAC could be a valuable anthropometric marker of the overall nutritional status of adolescent girls in low-income countries. When nutrition transition proceeds, waist circumference together with MUAC could form tools for the prediction of worsening of nutritional status. Copyright © 2016 Elsevier Inc. All rights reserved.

Upper arm circumference development in Chinese children and adolescents: a pooled analysis.

PubMed

Tong, Fang; Fu, Tong

2015-05-30

Upper arm development in children is different in different ethnic groups. There have been few reports on upper arm circumference (UAC) at different stages of development in children and adolescents in China. The purpose of this study was to provide a reference for growth with weighted assessment of the overall level of development. Using a pooled analysis, an authoritative journal database search and reports of UAC, we created a new database on developmental measures in children. In conducting a weighted analysis, we compared reference values for 0~60 months of development according to the World Health Organization (WHO) statistics considering gender and nationality and used Z values as interval values for the second sampling to obtain an exponential smooth curve to analyze the mean, standard deviation, and sites of attachment. Ten articles were included in the pooled analysis, and these articles included participants from different areas of China. The point of intersection with the WHO curve was 3.5 years with higher values at earlier ages and lower values at older ages. Boys curve was steeper after puberty. The curves in the studies had a merged line compatible. The Z values of exponential smoothing showed the curves were similar for body weight and had a right normal distribution. The integrated index of UAC in Chinese children and adolescents indicated slightly variations with regions. Exponential curve smoothing was suitable for assessment at different developmental stages.

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke.

PubMed

Levin, Mindy F; Liebermann, Dario G; Parmet, Yisrael; Berman, Sigal

2016-08-01

Background The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. Objectives To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion. Methods Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed. Results Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. Conclusions The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke. © The Author(s) 2015.

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An MR-compatible gyroscope-based arm movement tracking system.

PubMed

Shirinbayan, S Iman; Rieger, Jochem W

2017-03-15

Functional magnetic resonance imaging is well suited to link neural population activation with movement parameters of complex natural arm movements. However, currently existing MR-compatible arm tracking devices are not constructed to measure arm joint movement parameters of unrestricted movements. Therefore, to date most research focuses on simple arm movements or includes very little knowledge about the actual movement kinematics. We developed a low cost gyroscope-based arm movement tracking system (GAMTS) that features MR-compatibility. The system consists of dual-axis analogue gyroscopes that measure rotations of upper and lower arm joints. After MR artifact reduction, the rotation angles of the individual arm joints are calculated and used to animate a realistic arm model that is implemented in the OpenSim platform. The OpenSim platform can then provide the kinematics of any point on the arm model. In order to demonstrate the capabilities of the system, we first assessed the quality of reconstructed wrist movements in a low-noise environment where typical MR-related problems are absent and finally, we validated the reconstruction in the MR environment. The system provides the kinematics of the whole arm when natural unrestricted arm movements are performed inside the MR-scanner. The GAMTS is reliably capable of reconstructing the kinematics of trajectories and the reconstruction error is small in comparison with the movement induced variation of speed, displacement, and rotation. Moreover, the system can be used to probe brain areas for their correlation with movement kinematics. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between intramuscular fat in the arm following arm training and INSIG2.

PubMed

Popadic Gacesa, J Z; Secher, N H; Momcilovic, M; Grujic, N G

2014-12-01

Insulin-induced gene 2 (INSIG2) single-nucleotide polymorphism (SNP rs7566605) is linked to lipid metabolism, and this study assessed its potential influence on fat in the upper arm following arm training. Twenty healthy sedentary volunteers (22.0 ± 1.1 years, body mass index 25.4 ± 4.0 kg/m(2) ; mean ± standard deviation) carried out a 12-week two-arm elbow extensor training (10 maximal extensions with 1 min recovery between bouts) five times per day, five times per week. For 17 volunteers, upper arm muscle and adipose tissue [subcutaneous (SCAT) and intramuscular (IMAT)] volumes were evaluated by magnetic resonance imaging before, immediately after, and 12 months after training and variables were related to the subjects' INSIG2 SNP rs7566605 genotype. Muscle volume and SCAT for the upper arm, as the decrease in IMAT during training were not related to INSIG2 SNP rs7566605: GG: %IMAT 1.0 ± 0.9%; GC/CC: %IMAT 0.6 ± 0.5% (P > 0.05). However, in the year following the training, accumulation of upper arm IMAT was twice as large in participants homozygous for the G allele (GG: Δ%IMAT +2.5 ± 0.8%; GC/CC: Δ%IMAT +1.1 ± 0.7%; P < 0.01). This study suggests that the G allele in the INSIG2 SNP rs7566605 is more relevant for changes in IMAT following training than for the amount of subcutaneous fat. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements.

PubMed

Siu, Aaron; Schinkel-Ivy, Alison; Drake, Janessa Dm

2016-10-01

To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

PubMed

Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin

2017-10-01

The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

The Perioperative Educational Program for Improving Upper Arm Dysfunction in Patients with Breast Cancer at 1-Year Follow-Up: A Prospective, Controlled Trial.

PubMed

Sato, Fumiko; Arinaga, Yoko; Sato, Naoko; Ishida, Takanori; Ohuchi, Noriaki

2016-03-01

The many women with breast cancer who underwent axillary lymph node dissection (ALND) suffer from the upper arm dysfunction. In this study, we investigated the effectiveness of a perioperative educational program for improving upper arm dysfunction in breast cancer patients following ALND. This study was a sub-analysis of a previous controlled trial with an educational program. The subjects of this analysis included 64 patients following ALND who completed measurements at 12 months. The perioperative educational program consisted of monitoring of arm dysfunction, exercises, massage, and lifestyle adjustments. The intervention group (37 patients) received this perioperative educational program over 12 months, while 27 patients in the control group received written information about shoulder exercise from on-site staff only before surgery. Primary outcomes were shoulder range of motion (ROM), arm girth, and grip strength. Secondary outcomes were evaluated with the Subjective Perception of Post-Operative Functional Impairment of the Arm (SPOFIA) scores, the Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the Medical Outcome Study 36-Item Short-Form Health Survey v2 (SF-36v2). The SF-36v2 measures health-related quality of life (QOL). Primary and secondary outcomes were compared between groups at 1 week (after drainage tube removal) and 12 months after surgery, using the Mann-Whitney U test. The horizontal extension was significantly improved only in the intervention group. Moreover, the SPOFIA score was significantly improved in the intervention group, and other scores of the secondary outcomes were similar between the two groups. The perioperative educational program may improve postoperative upper arm dysfunction and symptoms.

Inertial Sensor Measurements of Upper-Limb Kinematics in Stroke Patients in Clinic and Home Environment.

PubMed

Held, Jeremia P O; Klaassen, Bart; Eenhoorn, Albert; van Beijnum, Bert-Jan F; Buurke, Jaap H; Veltink, Peter H; Luft, Andreas R

2018-01-01

Upper-limb impairments in stroke patients are usually measured in clinical setting using standard clinical assessment. In addition, kinematic analysis using opto-electronic systems has been used in the laboratory setting to map arm recovery. Such kinematic measurements cannot capture the actual function of the upper extremity in daily life. The aim of this study is to longitudinally explore the complementarity of post-stroke upper-limb recovery measured by standard clinical assessments and daily-life recorded kinematics. The study was designed as an observational, single-group study to evaluate rehabilitation progress in a clinical and home environment, with a full-body sensor system in stroke patients. Kinematic data were recorded with a full-body motion capture suit during clinical assessment and self-directed activities of daily living. The measurements were performed at three time points for 3 h: (1) 2 weeks before discharge of the rehabilitation clinic, (2) right after discharge, and (3) 4 weeks after discharge. The kinematic analysis of reaching movements uses the position and orientation of each body segment to derive the joint angles. Newly developed metrics for classifying activity and quality of upper extremity movement were applied. The data of four stroke patients (three mildly impaired, one sever impaired) were included in this study. The arm motor function assessment improved during the inpatient rehabilitation, but declined in the first 4 weeks after discharge. A change in the data (kinematics and new metrics) from the daily-life recording was seen in in all patients. Despite this worsening patients increased the number of reaches they performed during daily life in their home environment. It is feasible to measure arm kinematics using Inertial Measurement Unit sensors during daily life in stroke patients at the different stages of rehabilitation. Our results from the daily-life recordings complemented the data from the clinical assessments and illustrate the potential to identify stroke patient characteristics, based on kinematics, reaching counts, and work area. https://clinicaltrials.gov, identifier NCT02118363.

CNTF 1357 G -> A polymorphism and the muscle strength response to resistance training.

PubMed

Walsh, Sean; Kelsey, Bethany K; Angelopoulos, Theodore J; Clarkson, Priscilla M; Gordon, Paul M; Moyna, Niall M; Visich, Paul S; Zoeller, Robert F; Seip, Richard L; Bilbie, Steve; Thompson, Paul D; Hoffman, Eric P; Price, Thomas B; Devaney, Joseph M; Pescatello, Linda S

2009-10-01

The present study examined associations between the ciliary neurotrophic factor (CNTF) 1357 G --> A polymorphism and the muscle strength response to a unilateral, upper arm resistance-training (RT) program among healthy, young adults. Subjects were 754 Caucasian men (40%) and women (60%) who were genotyped and performed a training program of the nondominant (trained) arm with the dominant (untrained) arm as a comparison. Peak elbow flexor strength was measured with one repetition maximum, isometric strength with maximum voluntary contraction, and bicep cross-sectional area with MRI in the trained and untrained arms before and after training. Women with the CNTF GG genotype gained more absolute isometric strength, as measured by MVC (6.5 +/- 0.3 vs. 5.2 +/- 0.5 kg), than carriers of the CNTF A1357 allele in the trained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. Women with the CNTF GG genotype gained more absolute dynamic (1.0 +/- 0.1 vs. 0.6 +/- 0.1 kg) and allometric (0.022 +/- 0.0 vs. 0.015 +/- 0.0 kg/kg(-0.67)) strength, as measured by 1 RM, than carriers of the CNTF A1357 allele in the untrained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. No significant associations, as measured by cross-sectional area, were seen in men or women. The CNTF 1357 G --> A polymorphism explains only a small portion of the variability in the muscle strength response to training in women.

Brachial artery protected by wrapped latissimus dorsi muscle flap in high voltage electrical injury

PubMed Central

Gencel, E.; Eser, C.; Kokacya, O.; Kesiktas, E.; Yavuz, M.

2016-01-01

Summary High voltage electrical injury can disrupt the vascular system and lead to extremity amputations. It is important to protect main vessels from progressive burn necrosis in order to salvage a limb. The brachial artery should be totally isolated from the burned area by a muscle flap to prevent vessel disruption. In this study, we report the use of a wrap-around latissimus dorsi muscle flap to protect a skeletonized brachial artery in a high voltage electrical injury in order to salvage the upper extremity and restore function. The flap wrapped around the exposed brachial artery segment and luminal status of the artery was assessed using magnetic resonance angiography. No vascular intervention was required. The flap survived completely with good elbow function. Extremity amputation was not encountered. This method using a latissimus dorsi flap allows the surgeon to protect the main upper extremity artery and reconstruct arm defects, which contributes to restoring arm function in high voltage electrical injury. PMID:28149236

Brachial artery protected by wrapped latissimus dorsi muscle flap in high voltage electrical injury.

PubMed

Gencel, E; Eser, C; Kokacya, O; Kesiktas, E; Yavuz, M

2016-06-30

High voltage electrical injury can disrupt the vascular system and lead to extremity amputations. It is important to protect main vessels from progressive burn necrosis in order to salvage a limb. The brachial artery should be totally isolated from the burned area by a muscle flap to prevent vessel disruption. In this study, we report the use of a wrap-around latissimus dorsi muscle flap to protect a skeletonized brachial artery in a high voltage electrical injury in order to salvage the upper extremity and restore function. The flap wrapped around the exposed brachial artery segment and luminal status of the artery was assessed using magnetic resonance angiography. No vascular intervention was required. The flap survived completely with good elbow function. Extremity amputation was not encountered. This method using a latissimus dorsi flap allows the surgeon to protect the main upper extremity artery and reconstruct arm defects, which contributes to restoring arm function in high voltage electrical injury.

Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis.

PubMed

Yeşilyaprak, Sevgi Sevi; Yüksel, Ertuğrul; Kalkan, Serpil

2016-05-01

Although a relationship between short pectoralis minor and upper trapezius and scapular dyskinesis has been postulated, no studies have investigated this theory. Understanding the effect of these muscle lengths on observable scapular dyskinesis may aid in determining risks and therefore making treatment decisions. Being aware of the magnitude of this effect would help gauge the significance of risks involved. Our aim was to evaluate the influence of pectoralis minor and upper trapezius lengths on scapular dyskinesis. Cross-sectional study. University research laboratory. Asymptomatic participants (n = 148; 296 arms) were evaluated. Scapular Dyskinesis Test (SDT) was used to identify scapular dyskinesis, Pectoralis Minor Index (PMI) and Upper Trapezius Length Testing were used to determine muscle length. SDT+ arms had shorter pectoralis minor resting length (PMI: 7.49 ± 0.38) (p < 0.001) and greater incidence of short upper trapezius (ISUT) (66.7%) (p < 0.001) compared to SDT- arms (PMI:8.58 ± 0.75, ISUT:22.5%). With each decrease in PMI, the likelihood of having scapular dyskinesis increased 96% (p < 0.001). Arms with short upper trapezius were 2.049 times more likely to exhibit scapular dyskinesis than those with normal length (p = 0.042). Having a shorter pectoralis minor and upper trapezius length substantially increased the likelihood of having visually observable scapular dyskinesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Correlations of Handgrip Strength with Selected Hand-Arm-Anthropometric Variables in Indian Inter-university Female Volleyball Players

PubMed Central

Koley, Shyamal; Pal Kaur, Satinder

2011-01-01

Purpose The purpose of this study was to estimate the dominant handgrip strength and its correlations with some hand and arm anthropometric variables in 101 randomly selected Indian inter-university female volleyball players aged 18-25 years (mean age 20.52±1.40) from six Indian universities. Methods Three anthropometric variables, i.e. height, weight, BMI, two hand anthropometric variables, viz. right and left hand width and length, four arm anthropometric variables, i.e. upper arm length, lower arm length, upper extremity length, upper arm circumference and dominant right and non-dominant handgrip strength were measured among Indian inter-university female volleyball players by standard anthropometric techniques. Results The findings of the present study indicated that Indian female volleyball players had higher mean values in eleven variables and lesser mean values in two variables than their control counterparts, showing significant differences (P<0.032-0.001) in height (t=2.63), weight (t=8.66), left hand width (t=2.10), left and right hand length (t=9.99 and 10.40 respectively), right upper arm length (t=8.48), right forearm length (t=5.41), dominant (right) and non-dominant (left) handgrip strength (t=9.37 and 6.76 respectively). In female volleyball players, dominant handgrip strength had significantly positive correlations (P=0.01) with all the variables studied. Conclusion It may be concluded that dominant handgrip strength had strong positive correlations with all the variables studied in Indian inter-university female volleyball players. PMID:22375242

Isometric Arm Strength and Subjective Rating of Upper Limb Fatigue in Two-Handed Carrying Tasks

PubMed Central

Li, Kai Way; Chiu, Wen-Sheng

2015-01-01

Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks. PMID:25794159

Isometric arm strength and subjective rating of upper limb fatigue in two-handed carrying tasks.

PubMed

Li, Kai Way; Chiu, Wen-Sheng

2015-01-01

Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks.

Short-Term Upper Limb Immobilization Affects Action-Word Understanding

ERIC Educational Resources Information Center

Bidet-Ildei, Christel; Meugnot, Aurore; Beauprez, Sophie-Anne; Gimenes, Manuel; Toussaint, Lucette

2017-01-01

The present study aimed to investigate whether well-established associations between action and language can be altered by short-term upper limb immobilization. The dominant arm of right-handed participants was immobilized for 24 hours with a rigid splint fixed on the hand and an immobilization vest restraining the shoulder, arm, and forearm. The…

Non-contact versus contact-based sensing methodologies for in-home upper arm robotic rehabilitation.

PubMed

Howard, Ayanna; Brooks, Douglas; Brown, Edward; Gebregiorgis, Adey; Chen, Yu-Ping

2013-06-01

In recent years, robot-assisted rehabilitation has gained momentum as a viable means for improving outcomes for therapeutic interventions. Such therapy experiences allow controlled and repeatable trials and quantitative evaluation of mobility metrics. Typically though these robotic devices have been focused on rehabilitation within a clinical setting. In these traditional robot-assisted rehabilitation studies, participants are required to perform goal-directed movements with the robot during a therapy session. This requires physical contact between the participant and the robot to enable precise control of the task, as well as a means to collect relevant performance data. On the other hand, non-contact means of robot interaction can provide a safe methodology for extracting the control data needed for in-home rehabilitation. As such, in this paper we discuss a contact and non-contact based method for upper-arm rehabilitation exercises that enables quantification of upper-arm movements. We evaluate our methodology on upper-arm abduction/adduction movements and discuss the advantages and limitations of each approach as applied to an in-home rehabilitation scenario.

Wii™-habilitation of upper extremity function in children with cerebral palsy. An explorative study.

PubMed

Winkels, Diny G M; Kottink, Anke I R; Temmink, Rutger A J; Nijlant, Juliëtte M M; Buurke, Jaap H

2013-01-01

Commercially available virtual reality systems can possibly support rehabilitation objectives in training upper arm function in children with Cerebral Palsy (CP). The present study explored the effect of the Nintendo Wii™ training on upper extremity function in children with CP. During six weeks, all children received twice a week training with the Wii™, with their most affected arm. The Melbourne Assessment of Upper Limb Function and ABILHAND-Kids were assessed pre- and post- training. In addition, user satisfaction of both children and health professionals was assessed after training. Enjoyment in gaming was scored on a visual analogue scale scale after each session by the children. Fifteen children with CP participated in the study. The quality of upper extremity movements did not change (-2.1, p > 0.05), while a significant increase of convenience in using hands/arms during performance of daily activities was found (0.6, p < 0.05). Daily activities seem to be easier performed after Wii™ training for most of the included children with CP.

Design and development of an upper extremity motion capture system for a rehabilitation robot.

PubMed

Nanda, Pooja; Smith, Alan; Gebregiorgis, Adey; Brown, Edward E

2009-01-01

Human robot interaction is a new and rapidly growing field and its application in the realm of rehabilitation and physical care is a major focus area of research worldwide. This paper discusses the development and implementation of a wireless motion capture system for the human arm which can be used for physical therapy or real-time control of a robotic arm, among many other potential applications. The system is comprised of a mechanical brace with rotary potentiometers inserted at the different joints to capture position data. It also contains surface electrodes which acquire electromyographic signals through the CleveMed BioRadio device. The brace interfaces with a software subsystem which displays real time data signals. The software includes a 3D arm model which imitates the actual movement of a subject's arm under testing. This project began as part of the Rochester Institute of Technology's Undergraduate Multidisciplinary Senior Design curriculum and has been integrated into the overall research objectives of the Biomechatronic Learning Laboratory.

Gravity-supported exercise with computer gaming improves arm function in chronic stroke.

PubMed

Jordan, Kimberlee; Sampson, Michael; King, Marcus

2014-08-01

To investigate the effect of 4 to 6 weeks of exergaming with a computer mouse embedded within an arm skate on upper limb function in survivors of chronic stroke. Intervention study with a 4-week postintervention follow-up. In home. Survivors (N=13) of chronic (≥6 mo) stroke with hemiparesis of the upper limb with stable baseline Fugl-Meyer assessment scores received the intervention. One participant withdrew, and 2 participants were not reassessed at the 4-week follow-up. No participants withdrew as a result of adverse effects. Four to 6 weeks of exergaming using the arm skate where participants received either 9 (n=5) or 16 (n=7) hours of game play. Upper limb component of the Fugl-Meyer assessment. There was an average increase in the Fugl-Meyer upper limb assessment score from the beginning to end of the intervention of 4.9 points. At the end of the 4-week period after the intervention, the increase was 4.4 points. A 4- to 6-week intervention using the arm skate significantly improved arm function in survivors of chronic stroke by an average of 4.9 Fugl-Meyer upper limb assessment points. This research shows that a larger-scale randomized trial of this device is warranted and highlights the potential value of using virtual reality technology (eg, computer games) in a rehabilitation setting. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rotary Series Elastic Actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2013-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

Rotary series elastic actuator

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Mehling, Joshua S. (Inventor); Parsons, Adam H. (Inventor); Griffith, Bryan Kristian (Inventor); Radford, Nicolaus A. (Inventor); Permenter, Frank Noble (Inventor); Davis, Donald R. (Inventor); Ambrose, Robert O. (Inventor); Junkin, Lucien Q. (Inventor)

2012-01-01

A rotary actuator assembly is provided for actuation of an upper arm assembly for a dexterous humanoid robot. The upper arm assembly for the humanoid robot includes a plurality of arm support frames each defining an axis. A plurality of rotary actuator assemblies are each mounted to one of the plurality of arm support frames about the respective axes. Each rotary actuator assembly includes a motor mounted about the respective axis, a gear drive rotatably connected to the motor, and a torsion spring. The torsion spring has a spring input that is rotatably connected to an output of the gear drive and a spring output that is connected to an output for the joint.

A prospective randomised double-blind placebo-controlled trial to assess the effect of diuretics on shockwave lithotripsy of calculi.

PubMed

Sabharwal, Sagar; Jeyaseelan, L; Panda, Arabind; Gnanaraj, Lionel; Kekre, Nitin S; Devasia, Antony

2017-12-01

To assess the effect of diuretics with shockwave lithotripsy (SWL) on the treatment of renal and upper ureteric calculi. Adult patients with a solitary non-obstructive radio-opaque renal or upper ureteric calculus with normal renal function were included. They were prospectively randomised to receive either SWL with placebo or SWL with diuretics (40 mg parenteral furosemide) in a double-blind manner with a sample size of 48 patients in each arm. The primary outcomes were the SWL success and failure rates. The secondary outcomes were the number of shocks and sessions. Complete fragmentation was achieved in 89.6% of the patients in the furosemide arm as compared to 81.3% in the placebo arm. Clearance was achieved in 77.1% of the patients in the furosemide arm as compared to 70.8% in the placebo arm. The number of shocks and the number of sessions were higher in the placebo arm. These differences were not statistically significant. The use of diuretics along with SWL treatment of renal and upper ureteric calculi does not show a statistically significant improvement in fragmentation or clearance.

Sensory-Feedback Exoskeletal Arm Controller

NASA Technical Reports Server (NTRS)

An, Bin; Massie, Thomas H.; Vayner, Vladimir

2004-01-01

An electromechanical exoskeletal arm apparatus has been designed for use in controlling a remote robotic manipulator arm. The apparatus, called a force-feedback exoskeleton arm master (F-EAM) is comfortable to wear and easy to don and doff. It provides control signals from the wearer s arm to a robot arm or a computer simulator (e.g., a virtual-reality system); it also provides force and torque feedback from sensors on the robot arm or from the computer simulator to the wearer s arm. The F-EAM enables the wearer to make the robot arm gently touch objects and finely manipulate them without exerting excessive forces. The F-EAM features a lightweight design in which the motors and gear heads that generate force and torque feedback are made smaller than they ordinarily would be: this is achieved by driving the motors to power levels greater than would ordinarily be used in order to obtain higher torques, and by providing active liquid cooling of the motors to prevent overheating at the high drive levels. The F-EAM (see figure) includes an assembly that resembles a backpack and is worn like a backpack, plus an exoskeletal arm mechanism. The FEAM has five degrees of freedom (DOFs) that correspond to those of the human arm: 1. The first DOF is that of the side-to-side rotation of the upper arm about the shoulder (rotation about axis 1). The reflected torque for this DOF is provided by motor 1 via drum 1 and a planar four-bar linkage. 2. The second DOF is that of the up-and-down rotation of the arm about the shoulder. The reflected torque for this DOF is provided by motor 2 via drum 2. 3. The third DOF is that of twisting of the upper arm about its longitudinal axis. This DOF is implemented in a cable remote-center mechanism (CRCM). The reflected torque for this DOF is provided by motor 3, which drives the upper-arm cuff and the mechanism below it. A bladder inflatable by gas or liquid is placed between the cuff and the wearer s upper arm to compensate for misalignment between the exoskeletal mechanism and the shoulder. 4. The fourth DOF is that of flexion and extension of the elbow. The reflected torque for this DOF is provided by motor 4 and drum 4, which are mounted on a bracket that can slide longitudinally by a pin-and-slot engagement with the upper-arm cuff to compensate for slight variations in the position of the kinematic center of the elbow. Attached to drum 4 is an adapter plate to which is attached a CRCM for the lower arm. 5. The lower-arm CRCM implements the fifth DOF, which is the twist of the forearm about its longitudinal axis. Motor 5 provides the reflected torque for this DOF by driving the lower-arm cuff. A rod transmits twist and torsion between the lower-arm cuff and the hand cuff. With this system, the motion of the wearer s joints and the reflected torques applied to these joints can be measured and controlled in a relatively simple manner. This is because the anthropomorphic design of the mechanism imitates the kinematics of the human arm, eliminating the need for kinematic conversion of joint-torque and joint-angle data.

The appropriateness of the length of insulin needles based on determination of skin and subcutaneous fat thickness in the abdomen and upper arm in patients with type 2 diabetes.

PubMed

Sim, Kang Hee; Hwang, Moon Sook; Kim, Sun Young; Lee, Hye Mi; Chang, Ji Yeun; Lee, Moon Kyu

2014-04-01

Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

Application and comparison of different implanted ports in malignant tumor patients.

PubMed

Li, Yanhong; Cai, Yonghua; Gan, Xiaoqin; Ye, Xinmei; Ling, Jiayu; Kang, Liang; Ye, Junwen; Zhang, Xingwei; Zhang, Jianwei; Cai, Yue; Hu, Huabin; Huang, Meijin; Deng, Yanhong

2016-09-23

The current study aims to compare the application and convenience of the upper arm port with the other two methods of implanted ports in the jugular vein and the subclavian vein in patients with gastrointestinal cancers. Currently, the standard of practice is placement of central venous access via an internal jugular vein approach. Perioperative time, postoperative complications, and postoperative comfort level in patients receiving an implanted venous port in the upper arm were retrospectively compared to those in the jugular vein and the subclavian vein from April 2013 to November 2014. Three hundred thirty-four patients are recruited for this analysis, consisting of 107 in the upper arm vein group, 70 in the jugular vein group, and 167 in the subclavian vein group. The occurrence of catheter misplacement in the upper arm vein is higher than that in the other two groups (13.1 vs. 2.9 vs. 5.4 %, respectively, P = 0.02), while the other complications in the perioperative period were not significantly different. The occurrence of transfusion obstacle of the upper arm vein group is significantly lower than that of the jugular and subclavian groups (0.9 vs. 7.1 vs. 7.2 %, P = 0.01). The occurrence of thrombus is also lower than that of other two groups (0.9 vs. 4.3 vs. 3.6 %, P = 0.03). Regarding the postoperative comfort, the influences of appearance (0 vs. 7.1 vs. 2.9 %, P = 0.006) and sleep (0.9 vs. 4.2 vs. 10.7 %, P = 0.003) are significantly better than those of the jugular and subclavian vein groups. Compared to the jugular and the subclavian vein groups, the implanted venous port in the upper arm vein has fewer complications and more convenience and comfort, and might be a superior novel choice for patients requiring long-term chemotherapy or parenteral nutrition.

The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes

PubMed Central

Sim, Kang Hee; Kim, Sun Young; Lee, Hye Mi; Chang, Ji Yeun; Lee, Moon Kyu

2014-01-01

Background Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. Methods First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. Results The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. Conclusion It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes. PMID:24851206

Anthropometric Measurements: Options for Identifying Low Birth Weight Newborns in Kumasi, Ghana

PubMed Central

Otupiri, Easmon; Wobil, Priscilla; Nguah, Samuel Blay; Hindin, Michelle J.

2014-01-01

Background In Ghana, 32% of deliveries take place outside a health facility, and birth weight is not measured. Low birth weight (LBW) newborns who are at increased risk of death and disability, are not identified; 13%–14% of newborns in Ghana are LBW. We aimed at determining whether alternative anthropometrics could be used to identify LBW newborns when weighing scales are not available to measure birth weight. Methods We studied 973 mother and newborn pairs at the Komfo Anokye Teaching and the Suntreso Government hospitals between November 2011 and October 2012. We used standard techniques to record anthropometric measurements of newborns within 24 hours of birth; low birth weight was defined as birth weight <2.5kg. Pearson's correlation coefficient and the area under the curve were used to determine the best predictors of low birth weight. The sensitivity, specificity and predictive values were reported with 95% confidence intervals at generated cut-off values. Results One-fifth (21.7%) of newborns weighed less than 2.5 kg. Among LBW newborns, the following measurements had the highest correlations with birth weight: chest circumference (r = 0.69), mid-upper arm circumference (r = 0.68) and calf circumference (r = 0.66); the areas under the curves of these three measurements demonstrated the highest accuracy in determining LBW newborns. Chest, mid-upper arm and calf circumferences at cut-off values of ≤29.8 cm, ≤9.4 cm and ≤9.5 cm respectively, had the best combination of maximum sensitivity, specificity and predictive values for identifying newborns with LBW. Conclusions Anthropometric measurements, such as the chest circumference, mid-upper arm circumference and calf circumference, offer an opportunity for the identification of and subsequent support for LBW newborns in settings in Ghana, where birth weights are not measured by standardized weighing scales. PMID:25226505

Disease and Non-Battle Injuries among Navy and Marine Corps Personnel during Operation Desert Shield/Desert Storm

DTIC Science & Technology

1991-10-01

KNEE I SHOULDER V SHIN /CALF 357 OTITIS EXTERNA 17 HEAT EXHAUSTION J, UPPER ARM W ANKLE T358 OITIS MEDIA K ELBOW X FOOT 0 337 CONJUNCTIVITIS - 18...OTHER, SPECIFY:__ 17 HEAT EXHAUSTION a CHEST T UPPER LEG S18 HEAT STROKE H RIBS U KNEE EYEAR: _ 19 LACERATION I SHOULDER V SHIN ,-LF 0 38010...GROINoGENITAL 03 ALERT 0 VERBAL RESPONSE I SHOULDER V UPPER LEG C3 PAIN RESPONSE 0’ UNRESPONSIVE J UPPER ARM W KNEE K ELBOW X SHIN /CALF MEDICATION L

The correlation between body mass index, limb circumferences and blood pressure cuff fit in bariatric surgical patients.

PubMed

Schumann, R; Alyamani, O; Viswanath, A; Bonney, I

2016-01-01

The purpose of this study was to determine the correlation between body mass index (BMI) and upper and lower arm as well as lower leg circumferences and the frequency of correct blood pressure (BP) cuff fit. We explored recommendations for the most likely BP cuff size and location for the three BMI categories. Following IRB approval we retrospectively analyzed a research database of bariatric surgical patients with a BMI of ≥40 kg/m(2). Data included patients' characteristics, upper and lower arm as well as lower leg circumferences. Patients were divided into three groups based on BMI (kg/m(2), Group I: <45, Group II: 45-55, and Group III: >55). Appropriate cuff fit using a standard or large adult BP cuff (CRITIKON(®), GE Healthcare, Waukesha, Wisconsin, USA) on the upper and lower arm, and lower leg was determined. We analyzed the percent proportion of proper cuff fit for cuff sizes and locations between groups using appropriate nonparametric testing. Limb circumference correlated significantly with BMI (P = 0.01), and the upper arm correlated most closely (r = 0.76). A standard adult BP cuff on the lower arm fit properly in >90% and >80% and in Groups I and II, respectively. A large cuff on the lower arm was appropriate in 87% of Group III. In two participants, a large cuff fit properly on the lower leg. Limb circumference significantly correlated with BMI. Recommendations for proper cuff fit in different BMI categories can be made.

Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke.

PubMed

Ekstrand, Elisabeth; Lexell, Jan; Brogårdh, Christina

2015-09-01

To evaluate the test-retest reliability of isometric and isokinetic muscle strength measurements in the upper extremity after stroke. A test-retest design. Forty-five persons with mild to moderate paresis in the upper extremity > 6 months post-stroke. Isometric arm strength (shoulder abduction, elbow flexion), isokinetic arm strength (elbow extension/flexion) and isometric grip strength were measured with electronic dynamometers. Reliability was evaluated with intra-class correlation coefficients (ICC), changes in the mean, standard error of measurements (SEM) and smallest real differences (SRD). Reliability was high (ICCs: 0.92-0.97). The absolute and relative (%) SEM ranged from 2.7 Nm (5.6%) to 3.0 Nm (9.4%) for isometric arm strength, 2.6 Nm (7.4%) to 2.9 Nm (12.6%) for isokinetic arm strength, and 22.3 N (7.6%) to 26.4 N (9.2%) for grip strength. The absolute and relative (%) SRD ranged from 7.5 Nm (15.5%) to 8.4 Nm (26.1%) for isometric arm strength, 7.1 Nm (20.6%) to 8.0 Nm (34.8%) for isokinetic arm strength, and 61.8 N (21.0%) to 73.3 N (25.6%) for grip strength. Muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. Isometric measurements yield smaller measurement errors than isokinetic measurements and might be preferred, but the choice depends on the research question.

22. View showing main anchor arm, as viewed from main ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. View showing main anchor arm, as viewed from main cantilever arm looking south. Note upper chord eyebar arrangement. - Williamstown-Marietta Bridge, Spanning Ohio River between Williamstown & Marietta, Williamstown, Wood County, WV

Profiles of muscularity in junior Olympic weight lifters.

PubMed

Kanehisa, H; Funato, K; Abe, T; Fukunaga, T

2005-03-01

This study aimed to investigate the muscularity of strength-trained junior athletes. Muscle thickness (Mt) values at 10 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, abdomen, back, anterior thigh, posterior thigh, anterior lower leg, and posterior lower leg) were determined in junior Olympic weight lifters (OWL, n=7, 15.1+/-0.3 y, mean+/-SD) and non-athletes (CON, n=13, 15.1+/-0.3 y) using a brightness mode ultrasonography. Skeletal age assessed with the Tanner-Whitehouse II method (20 hand-wrist bones) was similar in OWL (16.4+/-0.7 y) and CON (16.3+/-0.6 y). At the 6 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, back and anterior thigh), OWL showed significantly greater Mt values than CON even in terms of Mt relative to body mass(1/3) Mt x BM(-1/3). On the other hand, there were no significant differences between the 2 groups in the Mt ratios of the anterior to posterior site in the upper arm, thigh and lower leg and those of the back to either the chest or abdomen in the trunk. For OWL only, skeletal age was significantly correlated to Mt x BM(-1/3) at the abdomen (r=0.869, p<0.05) and anterior thigh (r=0.883, p<0.05). The findings here indicate that 1) as compared to adolescent non-athletes, junior Olympic weight lifters show a greater muscularity in the upper body and anterior thigh without predominant development in either of anterior and posterior sites within the same body segment, 2) for junior Olympic weight lifters, the muscularity of abdominal and knee extensor muscles is influenced by the biological maturation.

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

PubMed

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

2014-07-01

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

Appropriateness of advanced upper limb prosthesis prescription for a patient with cognitive impairment: a case report.

PubMed

Barredo, Jennifer; Acluche, Frantzy; Disla, Roxanne; Fantini, Christopher; Fishelis, Leah; Sasson, Nicole; Resnik, Linda

2017-08-01

To describe a participant with scapulo-thoracic amputation and cognitive impairment trained to use the DEKA Arm and discuss factors relevant to the determination that he was not an appropriate candidate for independent home use of the device. The participant underwent 40 h of in-laboratory training with the DEKA Arm Advanced Upper Limb Prosthesis. Pre-training neuropsychological measures of cognition were collected. Qualitative and quantitative data related to functional performance, quality of life and pain were collected after 10 h of training, and at the conclusion of training. Using a constant comparative approach, data were binned into major themes; elements within each theme were identified. Six themes were relevant to the determination that the participant was inappropriate for home use of the DEKA Arm: physical and mental health; learning, memory and cognition; adult role function; functional performance; user safety and judgement and capacity for independent device use. Issues contraindicating unsupervised device use included: uncontrolled health symptoms, poor knowledge application, safety concerns, absenteeism and performance degradation under stress. The findings have implications for training with and prescription of the DEKA Arm and other complex upper limb prostheses. Further research is needed to develop a model to guide prescription of technologically complex upper limb prostheses. Implications for Rehabilitation Advanced upper limb prostheses, like the DEKA Arm, promise greater functionality, but also may be cognitively demanding, raising questions of when, and if, prescription is appropriate for patients with cognitive impairment. At this time, no formal criteria exist to guide prescription of advanced upper limb prostheses. Each clinical team applies their own informal standards in decision-making. In this case report, we described six factors that were considered in determining whether or not a research participant, with scapulo-thoracic amputation and cognitive impairment was appropriate for home use of a complex upper limb prosthesis. The findings have implications for training with and prescription of the DEKA Arm, and highlights the need for further research to develop prescription guidelines for advanced assistive devices.

Predicting Directly Measured Trunk and Upper Arm Postures in Paper Mill Work From Administrative Data, Workers' Ratings and Posture Observations.

PubMed

Heiden, Marina; Garza, Jennifer; Trask, Catherine; Mathiassen, Svend Erik

2017-03-01

A cost-efficient approach for assessing working postures could be to build statistical models for predicting results of direct measurements from cheaper data, and apply these models to samples in which only the latter data are available. The present study aimed to build and assess the performance of statistical models predicting inclinometer-assessed trunk and arm posture among paper mill workers. Separate models were built using administrative data, workers' ratings of their exposure, and observations of the work from video recordings as predictors. Trunk and upper arm postures were measured using inclinometry on 28 paper mill workers during three work shifts each. Simultaneously, the workers were video filmed, and their postures were assessed by observation of the videos afterwards. Workers' ratings of exposure, and administrative data on staff and production during the shifts were also collected. Linear mixed models were fitted for predicting inclinometer-assessed exposure variables (median trunk and upper arm angle, proportion of time with neutral trunk and upper arm posture, and frequency of periods in neutral trunk and upper arm inclination) from administrative data, workers' ratings, and observations, respectively. Performance was evaluated in terms of Akaike information criterion, proportion of variance explained (R2), and standard error (SE) of the model estimate. For models performing well, validity was assessed by bootstrap resampling. Models based on administrative data performed poorly (R2 ≤ 15%) and would not be useful for assessing posture in this population. Models using workers' ratings of exposure performed slightly better (8% ≤ R2 ≤ 27% for trunk posture; 14% ≤ R2 ≤ 36% for arm posture). The best model was obtained when using observational data for predicting frequency of periods with neutral arm inclination. It explained 56% of the variance in the postural exposure, and its SE was 5.6. Bootstrap validation of this model showed similar expected performance in other samples (5th-95th percentile: R2 = 45-63%; SE = 5.1-6.2). Observational data had a better ability to predict inclinometer-assessed upper arm exposures than workers' ratings or administrative data. However, observational measurements are typically more expensive to obtain. The results encourage analyses of the cost-efficiency of modeling based on administrative data, workers' ratings, and observation, compared to the performance and cost of measuring exposure directly. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients.

PubMed

Daunoraviciene, Kristina; Adomaviciene, Ausra; Grigonyte, Agne; Griškevičius, Julius; Juocevicius, Alvydas

2018-05-18

The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. To identify the effect of robot training on functional recovery of the arm. A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (P< 0.05) and ACER (P< 0.05). The calculated treatment effect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.

Monitoring the adequacy of catch-up growth among moderately malnourished children receiving home-based therapy using mid-upper arm circumference in Southern Malawi

USDA-ARS?s Scientific Manuscript database

Each year more children die from moderate than severe malnutrition. Home-based therapy (HBT) using Ready-to-Use Therapeutic Foods (RUTF) has proven to successfully treat uncomplicated childhood malnutrition on an outpatient basis. This study attempts to discern if Mid-upper Arm Circumference (MUAC) ...

[A man with a painful upper arm after bench press exercise].

PubMed

Sijtsma, Ben C T; van der Veen, Hugo C; van Raay, Jos J A M

2015-01-01

A 22-year-old male bodybuilder presented with pain and a haematoma of his right upper arm after bench press exercises. Suspicion of a pectoralis muscle tear was confirmed by MRI and surgical repair was performed. Ruptures of the pectoralis major muscle are rare, but may occur in young male bodybuilders, typically after bench press exercises.

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

49 CFR 572.86 - Test conditions and dummy adjustment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... lying on a horizontal surface and the neck assembly mounted and shoulders on the edge of the surface... surface with the shoulders on the edge of the surface, mount the head and tighten the head bolt and nut... upper arm and tighten firmly the adjustment bolts for the shoulder joint with the upper arm placed in a...

Skin tightening with a combined unipolar and bipolar radiofrequency device.

PubMed

Mayoral, Flor A

2007-02-01

Monopolar radiofrequency (RF) devices are well established treatment modalities for tightening facial skin. A 60-year-old woman presented with a desire to tighten the lax skin and improve the appearance of both upper arms. A combination unipolar and bipolar RF device may provide volume reduction as well as skin tightening in the upper arm.

Nutritional status in parasitized and nonparasitized children from two districts of Buenos Aires, Argentina.

PubMed

Orden, Alicia B; Apezteguía, María C; Ciarmela, María L; Molina, Nora B; Pezzani, Betina C; Rosa, Diana; Minvielle, Marta C

2014-01-01

The Program for the Control of Intestinal Parasites and Nutrition was designed to intervene in small communities to prevent and control the effects of parasitic infections on children's health. To analyze the association between nutritional status and parasitic infection in suburban and rural children from Buenos Aires, Argentina. Nutritional status was assessed by anthropometric (weight, height, BMI, skinfolds, upper arm circumference, muscle, and fat upper arm areas) and biochemical (Hb, Ca, Mg, Zn, and Cu) indicators. Parasitological analysis were made on both serial stool and perianal swab samples. A total of 708 children aged 3-11 were measured. The biochemical analysis included 217 blood samples and the parasitological study included 284 samples. Anthropometric status was similar in both settings with low rates of underweight and stunting (<6%), and high rates of overweight (~17%) and obesity (~12%). Ca deficiency was significantly higher in suburban children where 80% of them were hypocalcemic. Around 70% of fecal samples contained parasites. Among infected children, the most prevalent species were Blastocystis hominis and Enterobius vermicularis (~43%) followed by Giardia lamblia (~17%). Differences in parasitological status between districts were not significant. In the suburban district parasitized children were lighter, shorter, and had a lower upper arm circumference than their non-infected peers. No differences in anthropometric status were seen among infected and uninfected rural children. The results suggest an association between intestinal parasites and physical growth in suburban children. Rural children seem to be protected against the effects of parasitic infection. Copyright © 2013 Wiley Periodicals, Inc.

Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial.

PubMed

Kim, TaeHoon; Kim, SeongSik; Lee, ByoungHee

2016-03-01

The purpose of this study was to investigate whether action observational training (AOT) plus brain-computer interface-based functional electrical stimulation (BCI-FES) has a positive influence on motor recovery of paretic upper extremity in patients with stroke. This was a hospital-based, randomized controlled trial with a blinded assessor. Thirty patients with a first-time stroke were randomly allocated to one of two groups: the BCI-FES group (n = 15) and the control group (n = 15). The BCI-FES group administered to AOT plus BCI-FES on the paretic upper extremity five times per week during 4 weeks while both groups received conventional therapy. The primary outcomes were the Fugl-Meyer Assessment of the Upper Extremity, Motor Activity Log (MAL), Modified Barthel Index and range of motion of paretic arm. A blinded assessor evaluated the outcomes at baseline and 4 weeks. All baseline outcomes did not differ significantly between the two groups. After 4 weeks, the Fugl-Meyer Assessment of the Upper Extremity sub-items (total, shoulder and wrist), MAL (MAL-Activity of Use and Quality of Movement), Modified Barthel Index and wrist flexion range of motion were significantly higher in the BCI-FES group (p < 0.05). AOT plus BCI-based FES is effective in paretic arm rehabilitation by improving the upper extremity performance. The motor improvements suggest that AOT plus BCI-based FES can be used as a therapeutic tool for stroke rehabilitation. The limitations of the study are that subjects had a certain limited level of upper arm function, and the sample size was comparatively small; hence, it is recommended that future large-scale trials should consider stratified and lager populations according to upper arm function. Copyright © 2015 John Wiley & Sons, Ltd.

The development of an arm activity survey for breast cancer survivors using the Protection Motivation Theory.

PubMed

Lee, Teresa S; Kilbreath, Sharon L; Sullivan, Gerard; Refshauge, Kathryn M; Beith, Jane M

2007-05-08

Current research evidence indicates that women should return to normal use of their arm after breast cancer surgery. However, it appears some women continue to hold the view that they are supposed to protect their arm from strenuous activities because of the risk of lymphoedema. Many factors contribute to women's perceptions about lymphoedema and their ability to use their affected arm, and it is the aim of this study to explore and understand these perceptions. A survey, based on the Protection Motivation Theory, has been developed and tested. The survey assesses whether subjective norms, fear and/or coping attributes predict women's intention to use their affected arm. In addition, the survey includes questions regarding cancer treatment and demographic characteristics, arm and chest symptoms, and arm function. Recruitment of 170 breast cancer survivors has begun at 3 cancer treatment sites in Sydney, Australia. This study will identify perceptions that help predict the extent women use their affected arm. The results will also determine whether upper limb impairments arise secondary to over-protection of the affected arm. Identification of factors that limit arm use will enable appropriate prevention and better provision of treatment to improve upper limb outcomes.

Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.

PubMed

Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

2016-12-01

We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure. Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups. We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %). Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

Brachioplasty outcomes: a review of a multipractice cohort.

PubMed

Zomerlei, Terri A; Neaman, Keith C; Armstrong, Shannon D; Aitken, Marguerite E; Cullen, William T; Ford, Ronald D; Renucci, John D; VanderWoude, Douglas L

2013-04-01

Upper arm deformities secondary to massive weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures such as brachioplasty. The records of all patients who underwent a brachioplasty procedure from a multipractice medical center were reviewed. Outcomes measured included patient demographics, operative interventions, and postoperative course. Ninety-six patients were analyzed. Fifty-three patients (55.2 percent) underwent a concomitant procedure, with 53.1 percent undergoing arm liposuction at the time of brachioplasty. Major and minor complications rates were 17.7 percent and 44.8 percent, respectively. Common complications included hypertrophic scarring (24.0 percent) and infection (14.6 percent). The total revision rate was 22.9 percent, with residual contour deformity (40.9 percent of revisions) and hypertrophic scarring (36.4 percent of revisions) representing the most common causes for revision. Patients who underwent a previous bariatric procedure were at an increased risk of developing a major complication (p = 0.02). Concomitant upper arm liposuction and concomitant procedures were not associated with a significantly increased complication rate. Brachioplasty, despite being an effective treatment for contour irregularities of the upper arm, is associated with significant revision and complication rates. Post-bariatric surgery patients should be informed of the potential for increased complications. Additional procedures performed at the time of brachioplasty do not significantly increase complications. Liposuction of the upper arm can be performed safely in conjunction with brachioplasty.

Identification and classification of upper limb motions using PCA.

PubMed

Veer, Karan; Vig, Renu

2018-03-28

This paper describes the utility of principal component analysis (PCA) in classifying upper limb signals. PCA is a powerful tool for analyzing data of high dimension. Here, two different input strategies were explored. The first method uses upper arm dual-position-based myoelectric signal acquisition and the other solely uses PCA for classifying surface electromyogram (SEMG) signals. SEMG data from the biceps and the triceps brachii muscles and four independent muscle activities of the upper arm were measured in seven subjects (total dataset=56). The datasets used for the analysis are rotated by class-specific principal component matrices to decorrelate the measured data prior to feature extraction.

Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.

PubMed

Hoe, Victor C W; Urquhart, Donna M; Kelsall, Helen L; Sim, Malcolm R

2012-08-15

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.

A strategy for computer-assisted mental practice in stroke rehabilitation.

PubMed

Gaggioli, Andrea; Meneghini, Andrea; Morganti, Francesca; Alcaniz, Mariano; Riva, Giuseppe

2006-12-01

To investigate the technical and clinical viability of using computer-facilitated mental practice in the rehabilitation of upper-limb hemiparesis following stroke. A single-case study. Academic-affiliated rehabilitation center. A 46-year-old man with stable motor deficit of the upper right limb following subcortical ischemic stroke. Three computer-enhanced mental practice sessions per week at the rehabilitation center, in addition to usual physical therapy. A custom-made virtual reality system equipped with arm-tracking sensors was used to guide mental practice. The system was designed to superimpose over the (unseen) paretic arm a virtual reconstruction of the movement registered from the nonparetic arm. The laboratory intervention was followed by a 1-month home-rehabilitation program, making use of a portable display device. Pretreatment and posttreatment clinical assessment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment and the Action Research Arm Test. Performance of the affected arm was evaluated using the healthy arm as the control condition. The patient's paretic limb improved after the first phase of intervention, with modest increases after home rehabilitation, as indicated by functional assessment scores and sensors data. Results suggest that technology-supported mental training is a feasible and potentially effective approach for improving motor skills after stroke.

Effects of wrist tendon vibration on targeted upper-arm movements in poststroke hemiparesis.

PubMed

Conrad, Megan O; Scheidt, Robert A; Schmit, Brian D

2011-01-01

Impaired motor control of the upper extremity after stroke may be related to lost sensory, motor, and integrative functions of the brain. Artificial activation of sensory afferents might improve control of movement by adding excitatory drive to sensorimotor control structures. The authors evaluated the effect of wrist tendon vibration (TV) on paretic upper-arm stability during point-to-point planar movements. TV (70 Hz) was applied to the forearm wrist musculature of 10 hemiparetic stroke patients as they made center-out planar arm movements. End-point stability, muscle activity, and grip pressure were compared as patients stabilized at the target position for trials completed before, during, and after the application of the vibratory stimulus. Prior to vibration, hand position fluctuated as participants attempted to maintain the hand at the target after movement termination. TV improved arm stability, as evidenced by decreased magnitude of hand tangential velocity at the target. Improved stability was accompanied by a decrease in muscle activity throughout the arm as well as a mean decrease in grip pressure. These results suggest that vibratory stimulation of the distal wrist musculature enhances stability of the proximal arm and can be studied further as a mode for improving end-point stability during reaching in hemiparetic patients.

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Thorax without arm. 572.196 Section 572.196... Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Thorax without arm. 572.196 Section 572.196... Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Thorax without arm. 572.196 Section 572.196... Test Dummy, Small Adult Female § 572.196 Thorax without arm. (a) The thorax is part of the upper torso... (drawing 180-0000) with the arm (180-6000) on the impacted side removed. The dummy's thorax is equipped...

Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses.

PubMed

Akhtar, Aadeel; Aghasadeghi, Navid; Hargrove, Levi; Bretl, Timothy

2017-08-01

In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R 2 =0.72) and mirrored bilateral (R 2 =0.72) reaches and of forearm pronation/supination during unilateral (R 2 =0.77) and mirrored bilateral (R 2 =0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R 2 =0.82) and mirrored bilateral (R 2 =0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R 2 =0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R 2 =0.88) for these subjects, a contradictory result that merits further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel nonrobotic device: a randomized clinical trial.

PubMed

Barker, Ruth N; Brauer, Sandra G; Carson, Richard G

2008-06-01

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting stroke survivors with severe paresis to practice a constrained reaching task. A single-blind, randomized clinical trial was conducted with 42 stroke survivors with severe and chronic paresis. Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electromyography-triggered electrical stimulation, 13 received training using the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 1-hour sessions over 4 weeks. The primary outcome measure was "upper arm function," item 6 of the Motor Assessment Scale. Secondary outcome measures included impairment measures; triceps muscle strength, reaching force, modified Ashworth scale; and activity measures: reaching distance and Motor Assessment Scale. Assessments were administered before (0 weeks) and after training (4 weeks) and at 2 months follow-up (12 weeks). Both SMART Arm groups demonstrated significant improvements in all impairment and activity measures after training and at follow-up. There was no significant difference between these 2 groups. There was no change in the control group. Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis, highlighting the benefits of intensive task-oriented practice, even in the context of severe paresis.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1988-03-15

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, John R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are dowelled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector.

Piezoelectric film load cell robot collision detector

DOEpatents

Lembke, J.R.

1989-04-18

A piezoelectric load cell which can be utilized for detecting collisions and obstruction of a robot arm end effector includes a force sensing element of metallized polyvinylidene fluoride (PVDF) film. The piezoelectric film sensing element and a resilient support pad are clamped in compression between upper and lower plates. The lower plate has a central recess in its upper face for supporting the support pad and sensing element, while the upper plate has a corresponding central projection formed on its lower face for bearing on the sensing element and support pad. The upper and lower plates are doweled together for concentric alignment and screwed together. The upper and lower plates are also adapted for mounting between the robot arm wrist and end effector. 3 figs.

Development of a robotic patient positioning system with a wide beam-angle range for fixed-beam particle therapy

NASA Astrophysics Data System (ADS)

Choi, Hongseok; Park, Jong-Oh; Ko, Seong Young; Park, Sukho; Cho, Sungho; Jung, Won-Gyun; Park, Yong Kyun; Kang, Jung Suk

2016-10-01

This paper describes a robotic patient positioning system (PPS) for a fixed-beam heavy-ion therapy system. In order to extend the limited irradiation angle range of the fixed beam, we developed a 6-degree-of-freedom (6-DOF) serial-link robotic arm and used it as the robotic PPS for the fixed-beam heavy-ion therapy system. This research aims to develop a robotic PPS for use in the Korea Heavy Ion Medical Accelerator (KHIMA) system, which is under development at the Korea Institute of Radiological & Medical Sciences (KIRAMS). In particular, we select constraints and criteria that will be used for designing and evaluating the robotic PPS through full consultation with KIRAMS. In accordance with the constraints and criteria, we develop a 6-DOF serial-link robotic arm that consists of six revolute joints for the robotic PPS, where the robotic arm covers the upper body of a patient as a treatment area and achieves a 15 ° roll and pitch angle in the treatment area without any collision. Various preliminary experiments confirm that the robotic PPS can meet all criteria for extension of the limited irradiation angle range in the treatment area and has a positioning repeatability of 0.275 mm.

The Sirte Basin province of Libya; Sirte-Zelten total petroleum system

USGS Publications Warehouse

Ahlbrandt, Thomas S.

2001-01-01

The Sirte (Sirt) Basin province ranks 13th among the world?s petroleum provinces, having known reserves of 43.1 bil-lion barrels of oil equivalent (36.7 billion barrels of oil, 37.7 tril-lion cubic feet of gas, 0.1 billion barrels of natural gas liquids). It includes an area about the size of the Williston Basin of the north-ern United States and southern Canada (?490,000 square kilome-ters). The province contains one dominant total petroleum system, the Sirte-Zelten, based on geochemical data. The Upper Cretaceous Sirte Shale is the primary hydrocarbon source bed. Reservoirs range in rock type and age from fractured Precam-brian basement, clastic reservoirs in the Cambrian-Ordovician Gargaf sandstones, and Lower Cretaceous Nubian (Sarir) Sand-stone to Paleocene Zelten Formation and Eocene carbonates commonly in the form of bioherms. More than 23 large oil fields (>100 million barrels of oil equivalent) and 16 giant oil fields (>500 million barrels of oil equivalent) occur in the province. Abstract 1 Production from both clastic and carbonate onshore reservoirs is associated with well-defined horst blocks related to a triple junc-tion with three arms?an eastern Sarir arm, a northern Sirte arm, and a southwestern Tibesti arm. Stratigraphic traps in combina-tion with these horsts in the Sarir arm are shown as giant fields (for example, Messla and Sarir fields in the southeastern portion of the province). Significant potential is identified in areas marginal to the horsts, in the deeper grabens and in the offshore area. Four assessment units are defined in the Sirte Basin prov-ince, two reflecting established clastic and carbonate reservoir areas and two defined as hypothetical units. Of the latter, one is offshore in water depths greater than 200 meters, and the other is onshore where clastic units, mainly of Mesozoic age, may be res-ervoirs for laterally migrating hydrocarbons that were generated in the deep-graben areas. The Sirte Basin reflects significant rifting in the Early Cre-taceous and syn-rift sedimentary filling during Cretaceous through Eocene time, and post-rift deposition in the Oligocene and Miocene. Multiple reservoirs are charged largely by verti-cally migrating hydrocarbons along horst block faults from Upper Cretaceous source rocks that occupy structurally low posi-tions in the grabens. Evaporites in the middle Eocene, mostly post-rift, provide an excellent seal for the Sirte-Zelten hydrocarbon system. The offshore part of the Sirte Basin is complex, with subduction occurring to the northeast of the province boundary, which is drawn at the 2,000-meter isobath. Possible petroleum systems may be present in the deep offshore grabens on the Sirte Rise such as those involving Silurian and Eocene rocks; however, potential of these systems remains speculative and was not assessed.

The Effect of High-Intensity Interval Cycling Sprints Subsequent to Arm-Curl Exercise on Upper-Body Muscle Strength and Hypertrophy.

PubMed

Kikuchi, Naoki; Yoshida, Shou; Okuyama, Mizuki; Nakazato, Koichi

2016-08-01

Kikuchi, N, Yoshida, S, Okuyama, M, and Nakazato, K. The effect of high-intensity interval cycling sprints subsequent to arm-curl exercise on upper-body muscle strength and hypertrophy. J Strength Cond Res 30(8): 2318-2323, 2016-The purpose of this study was to examine whether lower limb sprint interval training (SIT) after arm resistance training (RT) influences training response of arm muscle strength and hypertrophy. Twenty men participated in this study. We divided subjects into RT group (n = 6) and concurrent training group (CT, n = 6). The RT program was designed to induce muscular hypertrophy (3 sets × 10 repetitions [reps] at 80% 1 repetition maximum [1RM] of arm-curl exercise) and was performed in an 8-week training schedule performed 3 times per week on nonconsecutive days. Subjects assigned to the CT group performed identical protocols as strength training and modified SIT (4 sets of 30-s maximal effort, separated in 4 m 30-s rest intervals) on the same day. Pretest and posttest maximal oxygen consumption (V[Combining Dot Above]O2max), muscle cross-sectional area (CSA), and 1RM were measured. Significant increase in V[Combining Dot Above]O2max from pretest to posttest was observed in the CT group (p = 0.010, effect size [ES] = 1.84) but not in the RT group (p = 0.559, ES = 0.35). Significant increase in CSA from pretest to posttest was observed in the RT group (p = 0.030, ES = 1.49) but not in the CT group (p = 0.110, ES = 1.01). Significant increase in 1RM from pretest to posttest was observed in the RT group (p = 0.021, ES = 1.57) but not in the CT group (p = 0.065, ES = 1.19). In conclusion, our data indicate that concurrent lower limb SIT interferes with arm muscle hypertrophy and strength.

Transcranial direct current stimulation (tDCS) of the primary motor cortex and robot-assisted arm training in chronic incomplete cervical spinal cord injury: A proof of concept sham-randomized clinical study.

PubMed

Yozbatiran, Nuray; Keser, Zafer; Davis, Matthew; Stampas, Argyrios; O'Malley, Marcia K; Cooper-Hay, Catherine; Frontera, Joel; Fregni, Felipe; Francisco, Gerard E

2016-07-15

After cervical spinal cord injury, current options for treatment of upper extremity motor functions have been limited to traditional approaches. However, there is a substantial need to explore more rigorous alternative treatments to facilitate motor recovery. To demonstrate whether anodal-primary motor cortex (M1) excitability enhancement (with cathodal-supra orbital area) (atDCS) combined with robot-assisted arm training (R-AAT) will provide greater improvement in contralateral arm and hand motor functions compared to sham stimulation (stDCS) and R-AAT in patients with chronic, incomplete cervical spinal cord injury (iCSCI). In this parallel-group, double-blinded, randomized and sham-controlled trial, nine participants with chronic iCSCI (AIS C and D level) were randomized to receive 10 sessions of atDCS or stDSC combined with R-AAT. Feasibility and tolerability was assessed with attrition rate and occurrence of adverse events, Changes in arm and hand function were assessed with Jebson Taylor Hand Function Test (JTHFT). Amount of Use Scale of Motor Activity Log (AOU-MAL), American Spinal Injury Association Upper Extremity Motor Score and Modified Ashworth Scale (MAS) at baseline, after treatment, and at two-month follow-up. None of the participants missed a treatment session or dropped-out due to adverse events related to the treatment protocol. Participants tended to perform better in JTHFT and AOU-MAL after treatment. Active group at post-treatment and two-month follow-up demonstrated better arm and hand performance compared to sham group. These preliminary findings support that modulating excitatory input of the corticospinal tracts on spinal circuits may be a promising strategy in improving arm and hand functions in persons with incomplete tetraplegia. Further study is needed to explore the underlying mechanisms of recovery.

Weight-for-height values and limb anthropometric composition of tube-fed children with quadriplegic cerebral palsy.

PubMed

Kong, Chi-Keung; Wong, Heung-Sang Stephen

2005-12-01

Research has shown that growth retardation among children with quadriplegic cerebral palsy (CP) is often attributed to feeding dysfunction and malnutrition. The study compared weight-for-height values and limb anthropometric composition of nasogastric and gastrostomy tube-fed children with quadriplegic CP with those of orally fed children with quadriplegic CP and normal children, to examine the plausible effects of tube feeding on weight-for-height, fat, and muscle values for children with quadriplegic CP. Triceps, anterior mid-thigh, and medial calf skinfold thicknesses and the corresponding circumferences of the right or less affected side were measured. The subjects consisted of 119 normal children and 62 orally fed and 48 tube-fed children with quadriplegic CP. Body weight and height were recorded. For children with CP whose height could not be measured, height was estimated from the ulna length. Weight-for-height z scores, limb skinfold thicknesses, fat areas, skinfold-corrected muscle girths, and muscle areas of the children were compared. Tube-fed children with CP had normal mean weight-for-height z scores. Weight-for-height z scores of the orally fed children with CP were significantly below those of normal children and tube-fed children with CP. For children with CP, whereas triceps skinfold thickness seemed to predict the mid-upper arm fat area correctly, leg skinfold thicknesses seemed to overestimate the corresponding fat areas. Stepwise multiple regression analysis showed that triceps skinfold thicknesses had good correlation (r = 0.86) and the presence of CP had nonsignificant correlation with mid-upper arm fat areas. Multiple regression analysis of fat areas with skinfold thicknesses and the presence of CP, however, showed that CP was correlated negatively (partial correlation of CP: thigh, -0.45; calf, -0.53) with thigh and calf fat areas. Although skinfold-corrected mid-upper arm muscle girths of children with CP were quite similar to those of normal children, leg muscle girths were much reduced for both orally fed and tube-fed children with CP. The apparent thickening of leg skinfold thicknesses among children with CP probably was attributable to disproportional leg muscle wasting, with resulting reduced internal circumference of the subcutaneous fat layer. For tube-fed children with CP, skinfold thicknesses and fat areas were increased significantly, although their leg skinfold-corrected muscle girths and areas remained reduced. Skinfold thickness may overestimate the fat area in the affected limb with significant muscle wasting for children with CP. The condition was particularly obvious in the leg, where muscle wasting was prominent. Because leg muscles represent approximately one quarter of the normal body weight, low weight-for-height values among children with CP can be caused by leg muscle wasting attributable to disuse atrophy, which is unlikely to be correctable with tube feeding. Tube feeding may improve body weight mainly through fat deposition.

Reliability of the Inverse Water Volumetry Method to Measure the Volume of the Upper Limb.

PubMed

Beek, Martinus A; te Slaa, Alexander; van der Laan, Lijckle; Mulder, Paul G H; Rutten, Harm J T; Voogd, Adri C; Luiten, Ernest J T; Gobardhan, Paul D

2015-06-01

Lymphedema of the upper extremity is a common side effect of lymph node dissection or irradiation of the axilla. Several techniques are being applied in order to examine the presence and severity of lymphedema. Measurement of circumference of the upper extremity is most frequently performed. An alternative is the water-displacement method. The aim of this study was to determine the reliability and the reproducibility of the "Inverse Water Volumetry apparatus" (IWV-apparatus) for the measurement of arm volumes. The IWV-apparatus is based on the water-displacement method. Measurements were performed by three breast cancer nurse practitioners on ten healthy volunteers in three weekly sessions. The intra-class correlation coefficient, defined as the ratio of the subject component to the total variance, equaled 0.99. The reliability index is calculated as 0.14 kg. This indicates that only changes in a patient's arm volume measurement of more than 0.14 kg would represent a true change in arm volume, which is about 6% of the mean arm volume of 2.3 kg. The IWV-apparatus proved to be a reliable and reproducible method to measure arm volume.

Forearm versus upper arm grafts for vascular access.

PubMed

Gage, Shawn M; Lawson, Jeffrey H

2017-03-06

Forearm and upper arm arteriovenous grafts perform similarly in terms of patency and complications. Primary patency at 1 year for forearm arteriovenous grafts versus upper arm grafts ranges from 22%-50% versus 22%-42%, and secondary patency at 1 year ranges from 78%-89% versus 52%-67%), respectively. Secondary patency at 2 years, ranges from 30%-64% versus 35%-60% for forearm and upper arteriovenous graft, respectively. Ample pre-operative planning is essential to improved clinical success and the decision to place a graft at one location versus the other should be based solely on previous access history, physical exam, appropriate venous imaging, and other factors that make up the clinical picture. Operative implant strategies and risk of complications are very similar between the two configurations. Postoperative ischemia due to steal syndrome is a potential complication that requires immediate attention. Utilization of the proximal radial or ulnar artery for inflow for the graft can minimize risk of clinically relevant steal syndrome.

The Effect of Restricted Arm Swing on Energy Expenditure in Healthy Men

ERIC Educational Resources Information Center

Yizhar, Ziva; Boulos, Spiro; Inbar, Omri; Carmeli, Eli

2009-01-01

Arm swing in human walking is an active natural motion involving the upper extremities. Earlier studies have described the interrelationship between arms and legs during walking, but the effect of arm swing on energy expenditure and dynamic parameters during normal gait, is inconclusive. The aim of this study was to investigate the effect of…

CT dose modulation using automatic exposure control in whole-body PET/CT: effects of scout imaging direction and arm positioning.

PubMed

Inoue, Yusuke; Nagahara, Kazunori; Kudo, Hiroko; Itoh, Hiroyasu

2018-01-01

Automatic exposure control (AEC) modulates tube current and consequently X-ray exposure in CT. We investigated the behavior of AEC systems in whole-body PET/CT. CT images of a whole-body phantom were acquired using AEC on two scanners from different manufactures. The effects of scout imaging direction and arm positioning on dose modulation were evaluated. Image noise was assessed in the chest and upper abdomen. On one scanner, AEC using two scout images in the posteroanterior (PA) and lateral (Lat) directions provided relatively constant image noise along the z-axis with the arms at the sides. Raising the arms increased tube current in the head and neck and decreased it in the body trunk. Image noise increased in the upper abdomen, suggesting excessive reduction in radiation exposure. AEC using the PA scout alone strikingly increased tube current and reduced image noise in the shoulder. Raising the arms did not substantially influence dose modulation and decreased noise in the abdomen. On the other scanner, AEC using the PA scout alone or Lat scout alone resulted in similar dose modulation. Raising the arms increased tube current in the head and neck and decreased it in the trunk. Image noise was higher in the upper abdomen than in the middle and lower chest, and was not influenced by arm positioning. CT dose modulation using AEC may vary greatly depending on scout direction. Raising the arms tended to decrease radiation exposure; however, the effect depends on scout direction and the AEC system.

Human arm joints reconstruction algorithm in rehabilitation therapies assisted by end-effector robotic devices.

PubMed

Bertomeu-Motos, Arturo; Blanco, Andrea; Badesa, Francisco J; Barios, Juan A; Zollo, Loredana; Garcia-Aracil, Nicolas

2018-02-20

End-effector robots are commonly used in robot-assisted neuro-rehabilitation therapies for upper limbs where the patient's hand can be easily attached to a splint. Nevertheless, they are not able to estimate and control the kinematic configuration of the upper limb during the therapy. However, the Range of Motion (ROM) together with the clinical assessment scales offers a comprehensive assessment to the therapist. Our aim is to present a robust and stable kinematic reconstruction algorithm to accurately measure the upper limb joints using only an accelerometer placed onto the upper arm. The proposed algorithm is based on the inverse of the augmented Jaciobian as the algorithm (Papaleo, et al., Med Biol Eng Comput 53(9):815-28, 2015). However, the estimation of the elbow joint location is performed through the computation of the rotation measured by the accelerometer during the arm movement, making the algorithm more robust against shoulder movements. Furthermore, we present a method to compute the initial configuration of the upper limb necessary to start the integration method, a protocol to manually measure the upper arm and forearm lengths, and a shoulder position estimation. An optoelectronic system was used to test the accuracy of the proposed algorithm whilst healthy subjects were performing upper limb movements holding the end effector of the seven Degrees of Freedom (DoF) robot. In addition, the previous and the proposed algorithms were studied during a neuro-rehabilitation therapy assisted by the 'PUPArm' planar robot with three post-stroke patients. The proposed algorithm reports a Root Mean Square Error (RMSE) of 2.13cm in the elbow joint location and 1.89cm in the wrist joint location with high correlation. These errors lead to a RMSE about 3.5 degrees (mean of the seven joints) with high correlation in all the joints with respect to the real upper limb acquired through the optoelectronic system. Then, the estimation of the upper limb joints through both algorithms reveal an instability on the previous when shoulder movement appear due to the inevitable trunk compensation in post-stroke patients. The proposed algorithm is able to accurately estimate the human upper limb joints during a neuro-rehabilitation therapy assisted by end-effector robots. In addition, the implemented protocol can be followed in a clinical environment without optoelectronic systems using only one accelerometer attached in the upper arm. Thus, the ROM can be perfectly determined and could become an objective assessment parameter for a comprehensive assessment.

The effects of virtual reality-based bilateral arm training on hemiplegic children's upper limb motor skills.

PubMed

Do, Ji-Hye; Yoo, Eun-Young; Jung, Min-Ye; Park, Hae Yean

2016-01-01

Hemiplegic cerebral palsy is a neurological symptom appearing on the unilateral arm and leg of the body that causes affected upper/lower limb muscle weakening and dysesthesia and accompanies tetany and difficulties in postural control due to abnormal muscle tone, and difficulties in body coordination. The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability. The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs. The study's results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after completion of the intervention, during the baseline regression period, revealed that upper limb motor skills on the affected side and bilateral coordination ability were better than in the baseline period for all subjects. This study confirmed that for children with hemiplegic with cerebral palsy, bilateral arm training based on virtual reality can be an effective intervention method for enhancing the upper limb motor skills on the affected side, as well as bilateral coordination ability.

Development of a parent‐reported questionnaire evaluating upper limb activity limitation in children with cerebral palsy

PubMed Central

Preston, N.; Levesley, M.; Mon‐Williams, M.; O'Connor, R.J.

2017-01-01

Abstract Background and purpose Upper limb activity measures for children with cerebral palsy have a number of limitations, for example, lack of validity and poor responsiveness. To overcome these limitations, we developed the Children's Arm Rehabilitation Measure (ChARM), a parent‐reported questionnaire validated for children with cerebral palsy aged 5–16 years. This paper describes both the development of the ChARM items and response categories and its psychometric testing and further refinement using the Rasch measurement model. Methods To generate valid items for the ChARM, we collected goals of therapy specifically developed by therapists, children with cerebral palsy, and their parents for improving activity limitation of the upper limb. The activities, which were the focus of these goals, formed the basis for the items. Therapists typically break an activity into natural stages for the purpose of improving activity performance, and these natural orders of achievement formed each item's response options. Items underwent face validity testing with health care professionals, parents of children with cerebral palsy, academics, and lay persons. A Rasch analysis was performed on ChARM questionnaires completed by the parents of 170 children with cerebral palsy from 12 hospital paediatric services. The ChARM was amended, and the procedure repeated on 148 ChARMs (from children's mean age: 10 years and 1 month; range: 4 years and 8 months to 16 years and 11 months; 85 males; Manual Ability Classification System Levels I = 9, II = 26, III = 48, IV = 45, and V = 18). Results The final 19‐item unidimensional questionnaire displayed fit to the Rasch model (chi‐square p = .18), excellent reliability (person separation index = 0.95, α = 0.95), and no floor or ceiling effects. Items showed no response bias for gender, distribution of impairment, age, or learning disability. Discussion The ChARM is a psychometrically sound measure of upper limb activity validated for children with cerebral palsy aged 5–16 years. The ChARM is freely available for use to clinicians and nonprofit organisations. PMID:28112465

Upper arm elevation and repetitive shoulder movements: a general population job exposure matrix based on expert ratings and technical measurements.

PubMed

Dalbøge, Annett; Hansson, Gert-Åke; Frost, Poul; Andersen, Johan Hviid; Heilskov-Hansen, Thomas; Svendsen, Susanne Wulff

2016-08-01

We recently constructed a general population job exposure matrix (JEM), The Shoulder JEM, based on expert ratings. The overall aim of this study was to convert expert-rated job exposures for upper arm elevation and repetitive shoulder movements to measurement scales. The Shoulder JEM covers all Danish occupational titles, divided into 172 job groups. For 36 of these job groups, we obtained technical measurements (inclinometry) of upper arm elevation and repetitive shoulder movements. To validate the expert-rated job exposures against the measured job exposures, we used Spearman rank correlations and the explained variance[Formula: see text] according to linear regression analyses (36 job groups). We used the linear regression equations to convert the expert-rated job exposures for all 172 job groups into predicted measured job exposures. Bland-Altman analyses were used to assess the agreement between the predicted and measured job exposures. The Spearman rank correlations were 0.63 for upper arm elevation and 0.64 for repetitive shoulder movements. The expert-rated job exposures explained 64% and 41% of the variance of the measured job exposures, respectively. The corresponding calibration equations were y=0.5%time+0.16×expert rating and y=27°/s+0.47×expert rating. The mean differences between predicted and measured job exposures were zero due to calibration; the 95% limits of agreement were ±2.9% time for upper arm elevation >90° and ±33°/s for repetitive shoulder movements. The updated Shoulder JEM can be used to present exposure-response relationships on measurement scales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Upper limb discomfort profile due to intermittent isometric pronation torque at different postural combinations of the shoulder-arm system.

PubMed

Mukhopadhyay, Prabir; O'Sullivan, Leonard W; Gallwey, Timothy J

2009-05-01

Twenty-seven right-handed male university students participated in this study, which comprised a full factorial model consisting of three forearm rotation angles (60% prone and supine and neutral range of motion), three elbow angles (45 degrees , 90 degrees and 135 degrees ), three upper arm angles (45 degrees flexion/extension and neutral), one exertion frequency (15 per min) and one level of pronation torque (20% maximum voluntary contraction (MVC) relative to MVC at each articulation). Discomfort rating after the end of each 5 min treatment was recorded on a visual analogue scale. Results of a repeated measures analysis of covariance on discomfort score, with torque endurance time as covariate, indicated that none of the factors was significant including torque endurance time (p = 0.153). An initial data collection phase preceded the main experiment in order to ensure that participants exerted exactly 20% MVC of the particular articulation. In this phase MVC pronation torque was measured at each articulation. The data revealed a significant forearm rotation angle effect (p = 0.001) and participant effect (p = 0.001). Of the two-way interactions, elbow*participant (p = 0.004), forearm*participant (p = 0.001) and upper arm*participant (p = 0.005) were the significant factors. Electromyographic activity of the pronator teres and biceps brachii muscles revealed no significant change in muscle activity in most of the articulations. Industrial jobs involving deviated upper arm postures are typical in industry but have a strong association with injury. Data from this study will enable better understanding of the effects of deviated upper arm postures on musculoskeletal disorders and can also be used to identify and control high-risk tasks in industry.

Homolateral ataxia and crural paresis: a crossed cerebral-cerebellar diaschisis.

PubMed Central

Giroud, M; Creisson, E; Fayolle, H; Gras, P; Vion, P; Brunotte, F; Dumas, R

1994-01-01

A patient developed weakness of the right leg and homolateral ataxia of the arm, caused by a subcortical infarct in the area supplied by the anterior cerebral artery in the left paracentral region, demonstrated by CT and MRI. Cerebral blood flow studied by technetium-labelled hexamethyl-propylene-amine oxime using single photon emission computed tomography showed decreased blood flow in the left lateral frontal cortex and in the right cerebellar hemisphere ("crossed cerebral-cerebellar diaschisis"). The homolateral ataxia of the arm may be caused by decreased function of the right cerebellar hemisphere, because of a lesion of the corticopontine-cerebellar tracts, whereas crural hemiparesis is caused by a lesion of the upper part of the corona radiata. Images PMID:8126511

The development of an arm activity survey for breast cancer survivors using the Protection Motivation Theory

PubMed Central

Lee, Teresa S; Kilbreath, Sharon L; Sullivan, Gerard; Refshauge, Kathryn M; Beith, Jane M

2007-01-01

Background Current research evidence indicates that women should return to normal use of their arm after breast cancer surgery. However, it appears some women continue to hold the view that they are supposed to protect their arm from strenuous activities because of the risk of lymphoedema. Many factors contribute to women's perceptions about lymphoedema and their ability to use their affected arm, and it is the aim of this study to explore and understand these perceptions. Methods/design A survey, based on the Protection Motivation Theory, has been developed and tested. The survey assesses whether subjective norms, fear and/or coping attributes predict women's intention to use their affected arm. In addition, the survey includes questions regarding cancer treatment and demographic characteristics, arm and chest symptoms, and arm function. Recruitment of 170 breast cancer survivors has begun at 3 cancer treatment sites in Sydney, Australia. Discussion This study will identify perceptions that help predict the extent women use their affected arm. The results will also determine whether upper limb impairments arise secondary to over-protection of the affected arm. Identification of factors that limit arm use will enable appropriate prevention and better provision of treatment to improve upper limb outcomes. PMID:17488497

Everyday movement and use of the arms: Relationship in children with hemiparesis differs from adults.

PubMed

Sokal, Brad; Uswatte, Gitendra; Vogtle, Laura; Byrom, Ezekiel; Barman, Joydip

2015-01-01

In adults with hemiparesis amount of movement of the more-affected arm is related to its amount of use in daily life. In children, little is known about everyday arm use. This report examines the relationships between everyday movement of the more-affected arm and its (a) everyday use and (b) motor capacity in children with hemiparesis. Participants were 28 children with a wide range of upper-extremity hemiparesis subsequent to cerebral palsy due to pre- or peri-natal stroke. Everyday movement of the more-affected arm was assessed by putting accelerometers on the children's forearms for three days. Everyday use of that arm and its motor capacity were assessed with the Pediatric Motor Activity Log-Revised and Pediatric Arm Function Test, respectively. Intensity of everyday movement of the more-affected arm was correlated with its motor capacity (rs ≥ 0.52, ps ≤ 0.003). However, everyday movement of that arm was not correlated with its everyday use (rs ≤ 0.30, ps ≥ $ 0.126). In children with upper-extremity hemiparesis who meet the study intake criteria amount of movement of the more-affected arm in daily life is not related to its amount to use, suggesting that children differ from adults in this respect.

Effects of Robot-Assisted Therapy for the Upper Limb After Stroke.

PubMed

Veerbeek, Janne M; Langbroek-Amersfoort, Anneli C; van Wegen, Erwin E H; Meskers, Carel G M; Kwakkel, Gert

2017-02-01

Robot technology for poststroke rehabilitation is developing rapidly. A number of new randomized controlled trials (RCTs) have investigated the effects of robot-assisted therapy for the paretic upper limb (RT-UL). To systematically review the effects of poststroke RT-UL on measures of motor control of the paretic arm, muscle strength and tone, upper limb capacity, and basic activities of daily living (ADL) in comparison with nonrobotic treatment. Relevant RCTs were identified in electronic searches. Meta-analyses were performed for measures of motor control (eg, Fugl-Meyer Assessment of the arm; FMA arm), muscle strength and tone, upper limb capacity, and basic ADL. Subgroup analyses were applied for the number of joints involved, robot type, timing poststroke, and treatment contrast. Forty-four RCTs (N = 1362) were included. No serious adverse events were reported. Meta-analyses of 38 trials (N = 1206) showed significant but small improvements in motor control (~2 points FMA arm) and muscle strength of the paretic arm and a negative effect on muscle tone. No effects were found for upper limb capacity and basic ADL. Shoulder/elbow robotics showed small but significant effects on motor control and muscle strength, while elbow/wrist robotics had small but significant effects on motor control. RT-UL allows patients to increase the number of repetitions and hence intensity of practice poststroke, and appears to be a safe therapy. Effects on motor control are small and specific to the joints targeted by RT-UL, whereas no generalization is found to improvements in upper limb capacity. The impact of RT-UL started in the first weeks poststroke remains unclear. These limited findings could mainly be related to poor understanding of robot-induced motor learning as well as inadequate designing of RT-UL trials, by not applying an appropriate selection of stroke patients with a potential to recovery at baseline as well as the lack of fixed timing of baseline assessments and using an insufficient treatment contrast early poststroke.

Numerical analysis of stress distribution in the upper arm tissues under an inflatable cuff: Implications for noninvasive blood pressure measurement

NASA Astrophysics Data System (ADS)

Deng, Zhipeng; Liang, Fuyou

2016-10-01

An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement. However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element (FE) models were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evidence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm surface and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In particular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pressure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.

Vibrations transmitted from human hands to upper arm, shoulder, back, neck, and head.

PubMed

Xu, Xueyan S; Dong, Ren G; Welcome, Daniel E; Warren, Christopher; McDowell, Thomas W; Wu, John Z

2017-12-01

Some powered hand tools can generate significant vibration at frequencies below 25 Hz. It is not clear whether such vibration can be effectively transmitted to the upper arm, shoulder, neck, and head and cause adverse effects in these substructures. The objective of this study is to investigate the vibration transmission from the human hands to these substructures. Eight human subjects participated in the experiment, which was conducted on a 1-D vibration test system. Unlike many vibration transmission studies, both the right and left hand-arm systems were simultaneously exposed to the vibration to simulate a working posture in the experiment. A laser vibrometer and three accelerometers were used to measure the vibration transmitted to the substructures. The apparent mass at the palm of each hand was also measured to help in understanding the transmitted vibration and biodynamic response. This study found that the upper arm resonance frequency was 7-12 Hz, the shoulder resonance was 7-9 Hz, and the back and neck resonances were 6-7 Hz. The responses were affected by the hand-arm posture, applied hand force, and vibration magnitude. The transmissibility measured on the upper arm had a trend similar to that of the apparent mass measured at the palm in their major resonant frequency ranges. The implications of the results are discussed. Musculoskeletal disorders (MSDs) of the shoulder and neck are important issues among many workers. Many of these workers use heavy-duty powered hand tools. The combined mechanical loads and vibration exposures are among the major factors contributing to the development of MSDs. The vibration characteristics of the body segments examined in this study can be used to help understand MSDs and to help develop more effective intervention methods.

Vibrations transmitted from human hands to upper arm, shoulder, back, neck, and head

PubMed Central

Xu, Xueyan S.; Dong, Ren G.; Welcome, Daniel E.; Warren, Christopher; McDowell, Thomas W.; Wu, John Z.

2016-01-01

Some powered hand tools can generate significant vibration at frequencies below 25 Hz. It is not clear whether such vibration can be effectively transmitted to the upper arm, shoulder, neck, and head and cause adverse effects in these substructures. The objective of this study is to investigate the vibration transmission from the human hands to these substructures. Eight human subjects participated in the experiment, which was conducted on a 1-D vibration test system. Unlike many vibration transmission studies, both the right and left hand-arm systems were simultaneously exposed to the vibration to simulate a working posture in the experiment. A laser vibrometer and three accelerometers were used to measure the vibration transmitted to the substructures. The apparent mass at the palm of each hand was also measured to help in understanding the transmitted vibration and biodynamic response. This study found that the upper arm resonance frequency was 7–12 Hz, the shoulder resonance was 7–9 Hz, and the back and neck resonances were 6–7 Hz. The responses were affected by the hand-arm posture, applied hand force, and vibration magnitude. The transmissibility measured on the upper arm had a trend similar to that of the apparent mass measured at the palm in their major resonant frequency ranges. The implications of the results are discussed. Relevance to industry Musculoskeletal disorders (MSDs) of the shoulder and neck are important issues among many workers. Many of these workers use heavy-duty powered hand tools. The combined mechanical loads and vibration exposures are among the major factors contributing to the development of MSDs. The vibration characteristics of the body segments examined in this study can be used to help understand MSDs and to help develop more effective intervention methods. PMID:29123326

Effectiveness of Functional Electrical Stimulation in Improving Clinical Outcomes in the Upper Arm following Stroke: A Systematic Review and Meta-Analysis

PubMed Central

Vafadar, Amir K.; Côté, Julie N.; Archambault, Philippe S.

2015-01-01

Background. Different therapeutic methods are being used to prevent or decrease long-term impairments of the upper arm in stroke patients. Functional electrical stimulation (FES) is one of these methods, which aims to stimulate the nerves of the weakened muscles so that the resulting muscle contractions resemble those of a functional task. Objectives. The objective of this study was to review the evidence for the effect of FES on (1) shoulder subluxation, (2) pain, and (3) upper arm motor function in stroke patients, when added to conventional therapy. Methods. From the 727 retrieved articles, 10 (9 RCTs, 1 quasi-RCT) were selected for final analysis and were rated based on the PEDro (Physiotherapy Evidence Database) scores and the Sackett's levels of evidence. A meta-analysis was performed for all three considered outcomes. Results. The results of the meta-analyses showed a significant difference in shoulder subluxation in experimental groups compared to control groups, only if FES was applied early after stroke. No effects were found on pain or motor function outcomes. Conclusion. FES can be used to prevent or reduce shoulder subluxation early after stroke. However, it should not be used to reduce pain or improve upper arm motor function after stroke. PMID:25685805

Anthropometric and body frame size characteristics in relation to body mass index and percentage body fat among adult Bengalee male brick-kiln workers from Murshidabad, West Bengal, India.

PubMed

Banik, Sudip Datta; Ghosh, Mihir; Bose, Kaushik

2016-11-01

Anthropometric and body frame size parameters (ABFSP) are used to interpret body mass and to evaluate nutritional status. Objective of the present study was to investigate the interrelationships between ABFSP, percentage body fat (BF%) and body mass index (BMI). The study was carried out in a sample of 141 adult Bengalee healthy male brick-kiln workers (age range 18-59 years) from Murshidabad district in West Bengal, India. Body weight was recorded; anthropometric measurements included height, breadth (elbow, wrist, hand, foot, ankle, knee), circumferences (mid-upper arm, chest, waist, hip, thigh, medial calf) and skinfolds (biceps, triceps, subscapular, suprailiac). Derived ABFSP included sum of breadth and circumferences, frame index, BMI, BF%, sum of skinfolds, ratio of central and peripheral skinfolds, arm muscle area, arm muscle circumference, arm fat area and brachial adipo-muscular ratio. Correlations (age-controlled) between ABFSP, BMI and BF% were highly significant ( p < 0.001). The ABFSP and BF% varied significantly ( p < 0.0001) in relation to BMI-based nutritional status (BNS). Multinomial logistic regression analysis (age-adjusted) showed ABFSP had statistically significant ( p < 0.01) relationships with BNS. There were strong interrelationships between ABFSP, BMI and BF% independent of age. The ABFSP in individuals with normal BMI, suffering from undernutrition (low BMI) or overweight are different.

Quantifying anti-gravity torques for the design of a powered exoskeleton.

PubMed

Ragonesi, Daniel; Agrawal, Sunil K; Sample, Whitney; Rahman, Tariq

2013-03-01

Designing an upper extremity exoskeleton for people with arm weakness requires knowledge of the joint torques due to gravity and joint stiffness, as well as, active residual force capabilities of users. The objective of this research paper is to describe the characteristics of the upper limb of children with upper limb impairment. This paper describes the experimental measurements of the torque on the upper limb due to gravity and joint stiffness of three groups of subjects: able-bodied adults, able-bodied children, and children with neuromuscular disabilities. The experiment involves moving the arm to various positions in the sagittal plane and measuring the resultant force at the forearm. This force is then converted to torques at the elbow and shoulder. These data are compared to a two-link lumped mass model based on anthropomorphic data. Results show that the torques based on anthropometry deviate from experimentally measured torques as the arm goes through the range. Subjects with disabilities also maximally pushed and pulled against the force sensor to measure maximum strength as a function of arm orientation. For all subjects, the maximum voluntary applied torque at the shoulder and elbow in the sagittal plane was found to be lower than gravity torques throughout the disabled subjects' range of motion. This experiment informs designers of upper limb orthoses on the contribution of passive human joint torques due to gravity and joint stiffness and the strength capability of targeted users.

The effect of arm support combined with rehabilitation games on upper-extremity function in subacute stroke: a randomized controlled trial.

PubMed

Prange, Gerdienke B; Kottink, Anke I R; Buurke, Jaap H; Eckhardt, Martine M E M; van Keulen-Rouweler, Bianca J; Ribbers, Gerard M; Rietman, Johan S

2015-02-01

Use of rehabilitation technology, such as (electro)mechanical devices or robotics, could partly relieve the increasing strain on stroke rehabilitation caused by an increasing prevalence of stroke. Arm support (AS) training showed improvement of unsupported arm function in chronic stroke. To examine the effect of weight-supported arm training combined with computerized exercises on arm function and capacity, compared with dose-matched conventional reach training in subacute stroke patients. In a single-blind, multicenter, randomized controlled trial, 70 subacute stroke patients received 6 weeks of training with either an AS device combined with computerized exercises or dose-matched conventional training (CON). Arm function was evaluated pretraining and posttraining by Fugl-Meyer assessment (FM), maximal reach distance, Stroke Upper Limb Capacity Scale (SULCS), and arm pain via Visual Analogue Scale, in addition to perceived motivation by Intrinsic Motivation Inventory posttraining. FM and SULCS scores and reach distance improved significantly within both groups. These improvements and experienced pain did not differ between groups. The AS group reported higher interest/enjoyment during training than the CON group. AS training with computerized exercises is as effective as conventional therapy dedicated to the arm to improve arm function and activity in subacute stroke rehabilitation, when applied at the same dose. © The Author(s) 2014.

Irritant contact dermatitis from an ornamental Euphorbia.

PubMed

Worobec, S M; Hickey, T A; Kinghorn, A D; Soejarto, D D; West, D

1981-01-01

An ornamental succulent plant sold in many plant stores in the Chicago area has been identified as Euphorbia hermentiana Lem. Open and closed patch testing using undiluted latex from this species was performed on five Caucasian volunteers. Open testing on flexor forearms resulted in irritant follicular dermatitis, while closed testing to the flexor surfaces of both upper arms in each subject produced bullae and vesiculation with residual desquamation and hyperpigmentation. Dermatological signs persisted for over a week following latex application.

Nutritional status and dietary intake of children with acute leukaemia during induction or consolidation chemotherapy.

PubMed

Tan, S Y; Poh, B K; Nadrah, M H; Jannah, N A; Rahman, J; Ismail, M N

2013-07-01

The assessment of nutritional status among paediatric patients is important for the planning and execution of nutritional strategies that strive to optimise the quality of life and growth among sick children. The present study aimed to evaluate the nutritional status and dietary intake among children with acute leukaemia. This cross-sectional study included 53 paediatric patients aged 3-12 years old, who were diagnosed with either acute lymphoblastic leukaemia or acute myelogenous leukaemia and were undergoing chemotherapy treatments (induction or consolidation phase). Patients were matched for sex, age (±6 months) and ethnicity with healthy children as controls. Weight, height, body mass index, waist circumference, mid-upper arm circumference, triceps skinfold thickness, mid-upper arm muscle area and fat area were determined. Dietary intake was assessed using 3-day food records. Anthropometric variables were generally higher among patients compared to controls, although the differences were not statistically significant (P > 0.05). The prevalence of overnutrition among patients according to body mass index-for-age, waist circumference-for-age, mid-upper arm circumference-for-age and triceps skinfold-for-age were 24.5%, 29.1%, 17.0% and 30.2%, respectively. Mean energy [5732 ± 1958 kJ (1370 ± 468 kcal) versus 6945 ± 1970 kJ (1660 ± 471 kcal), P < 0.01], protein (50.0 ± 19.7 g versus 62.3 ± 22.3 g, P < 0.01) and fat (43.6 ± 18.9 g versus 58.3 ± 16.7, P < 0.001) intakes of patients were significantly lower than controls. The prevalence of being overweight and obesity in children with acute leukaemia was higher despite lower energy intake compared to controls. Studies assessing physical activity, the complex interaction and the effects of treatment drugs are warranted to better manage malnutrition among paediatric patients. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

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

PubMed

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

2011-01-01

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

A review of bilateral training for upper extremity hemiparesis.

PubMed

Stoykov, Mary Ellen; Corcos, Daniel M

2009-01-01

Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. (c) 2009 John Wiley & Sons, Ltd.

CRUX: a Compliant Robotic Upper-Extremity eXosuit for Lightweight, Portable, Multi-DoF Muscular Augmentation

NASA Technical Reports Server (NTRS)

Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Teodorescu, Mircea; Kurniawan,Sri; Agogino, Adrian; Kurniawan, Sri

2017-01-01

Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the users movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the complexity of the underlying human body. In this paper, we present a compliant, robotic exosuit for upper-extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible design for portability. We also show how CRUX maintains full flexibility of the upper-extremities for its users while providing multi- DoF augmentative strength to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

Appearance of burning abdominal pain during cesarean section under spinal anesthesia in a patient with complex regional pain syndrome: a case report.

PubMed

Kato, Jitsu; Gokan, Dai; Hirose, Noriya; Iida, Ryoji; Suzuki, Takahiro; Ogawa, Setsuro

2013-02-01

The mechanism of complex regional pain syndrome (CRPS) was reported as being related to both the central and peripheral nervous systems. Recurrence of CRPS was, reportedly, induced by hand surgery in a patient with upper limb CRPS. However, there is no documentation of mechanical allodynia and burning abdominal pain induced by Cesarean section under spinal anesthesia in patients with upper limb CRPS. We report the case of a patient who suffered from burning abdominal pain during Cesarean section under spinal anesthesia 13 years after the occurrence of venipuncture-induced CRPS of the upper arm. The patient's pain characteristics were similar to the pain characteristics of her right arm during her previous CRPS episode 13 years earlier. In addition, mechanical allodynia around the incision area was confirmed after surgery. We provided ultrasound-guided rectus sheath block using 20 mL of 0.4% ropivacaine under ultrasound guidance twice, which resulted in the disappearance of the spontaneous pain and allodynia. The pain relief was probably related to blockade of the peripheral input by this block, which in turn would have improved her central sensitization. Our report shows that attention should be paid to the appearance of neuropathic pain of the abdomen during Cesarean section under spinal anesthesia in patients with a history of CRPS. Wiley Periodicals, Inc.

Preclinical study of transcervical upper mediastinal dissection for esophageal malignancy by robot-assisted surgery.

PubMed

Mori, Kazuhiko; Yoshimura, Shuntaro; Yamagata, Yukinori; Aikou, Susumu; Seto, Yasuyuki

2017-06-01

Robotic surgical systems are potentially applicable to transcervical mediastinal lymph dissection for esophageal malignancy. Robot-assisted surgery was performed on a male fresh-frozen human cadaver. Devices for single-port laparoscopic surgery were deployed via one small incision in the left clavicular area. The task for the robot-assisted surgery was the upper mediastinal dissection to the level of the left main bronchus and en bloc harvest of the lymph nodes adherent to the left recurrent laryngeal nerve. An up-angled 30° scope in the 6 o'clock port and two robotic arms from the 3 and 9 o'clock ports worked effectively together. No collisions of the devices inside the cadaveric body or unexpected traumatic events occurred. The robotic surgical system can be used safely for the upper mediastinal dissection. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

No impaired hemoglobin oxygenation in forearm muscles of patients with chronic CRPS-1.

PubMed

Brunnekreef, Jaap J J; Oosterhof, Jan; Wolff, André P; Crul, Ben J P; Wilder-Smith, Oliver H G; Oostendorp, Rob A B

2009-01-01

Physiotherapy is considered an important treatment option in patients with upper limb complex regional pain syndrome type-1 (CRPS-1). In case of chronic CRPS-1, exercise therapy of the affected limb forms an important part of the physiotherapeutic program. We investigated whether muscle loading in chronic CRPS-1 patients is associated with impairments in muscle circulation of the forearm of the affected limb. Thirty patients with chronic CRPS-1 unilaterally affecting their upper limbs, and 30 age-matched and sex-matched control participants were included in this study. Local muscle blood flow and hemoglobin oxygenation were measured by near infrared spectroscopy within the muscles of the forearm at rest, after 1-minute isometric handgrip exercises, and after arterial occlusion. Main outcome parameters were: local muscle blood flow, O2 consumption (mVO2), and postischemic reoxygenation (ReOx). We found no differences in baseline muscle blood flow, mVO2, and ReOx between the affected CRPS-1, unaffected CRPS-1, and control arms. After exercise, mVO2 of the affected CRPS-1 arms was not different from the clinically unaffected CRPS-1 arms. Furthermore, in comparison with the control arms, unaffected CRPS-1 arms showed no difference in mVO2 or ReOx. Muscle loading does not seems to be related to impairments in muscle oxygen uptake in forearm muscles of upper limbs affected by chronic CRPS-1. Our results suggest that exercise therapy can be safely used in physiotherapeutic training programs for chronic CRPS-1 of the upper limb.

A method to determine the orientation of the upper arm about its longitudinal axis during dynamic motions.

PubMed

Gordon, Brian J; Dapena, Jesús

2013-01-04

Inaccuracy in determining the orientation of the upper arm about its longitudinal axis (twist orientation) has been a pervasive problem in sport biomechanics research. The purpose of this study was to develop a method to improve the calculation of the upper arm twist orientation in dynamic sports activities. The twist orientation of the upper arm is defined by the orientation of its mediolateral axis. The basis for the new method is that at any angle in the flexion/extension range of an individual's elbow, it is possible to define a true mediolateral axis and also a surrogate mediolateral axis perpendicular to the plane containing the shoulder, elbow and wrist joints. The difference between the twist orientations indicated by these two versions of the mediolateral axis will vary from one elbow angle to another, but if the elbow joint deforms equally in different activities, for any given subject the difference should be constant at any given value of the elbow angle. Application of the new method required individuals to execute sedate elbow extension trials prior to the dynamic trials. Three-dimensional motion analysis of the sedate extension trials allowed quantification of the difference between the true and surrogate mediolateral axes for all angles in the entire flexion/extension range of an individual's elbow. This made it possible to calculate in any dynamic trial the twist orientation defined by the true mediolateral axis from the twist orientation defined by the surrogate mediolateral axis. The method was tested on a wooden model of the arm. Copyright © 2012 Elsevier Ltd. All rights reserved.

76 FR 40905 - Turnagain Arm Tidal Electric Energy Project; Notice of Intent To File License Application, Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 13509-001] Turnagain Arm Tidal Electric Energy Project; Notice of Intent To File License Application, Filing of Pre-Application.... Name of Project: Turnagain Arm Tidal Electric Energy Project. f. Location: Of the Upper Cook Inlet off...

Localized Arm Volume Index: A New Method for Body Type-Corrected Evaluation of Localized Arm Lymphedematous Volume Change.

PubMed

Yamamoto, Takumi; Yamamoto, Nana; Yoshimatsu, Hidehiko

2017-10-01

Volume measurement is a common evaluation for upper extremity lymphedema. However, volume comparison between different patients with different body types may be inappropriate, and it is difficult to evaluate localized limb volume change using arm volume. Localized arm volumes (Vk, k = 1-5) and localized arm volume indices (LAVIk) at 5 points (1, upper arm; 2, elbow; 3, forearm; 4, wrist; 5, hand) of 106 arms of 53 examinees with no arm edema were calculated based on physical measurements (arm circumferences and lengths and body mass index [BMI]). Interrater and intrarater reliabilities of LAVIk were assessed, and Vk and LAVIk were compared between lower BMI (BMI, <22 kg/m) group and higher BMI (BMI, ≥22 kg/m) group. Interrater and intrarater reliabilities of LAVIk were all high (all, r > 0.98). Between lower and higher BMI groups, significant differences were observed in all Vk (V1 [P = 6.8 × 10], V2 [P = 3.1 × 10], V3 [P = 1.1 × 10], V4 [P = 8.3 × 10], and V5 [P = 3.0 × 10]). Regarding localized arm volume index (LAVI) between groups, significant differences were seen in LAVI1 (P = 9.7 × 10) and LAVI5 (P = 1.2 × 10); there was no significant difference in LAVI2 (P = 0.60), LAVI3 (P = 0.61), or LAVI4 (P = 0.22). Localized arm volume index is a convenient and highly reproducible method for evaluation of localized arm volume change, which is less affected by body physique compared with arm volumetry.

Prediction of stemless humeral implant micromotion during upper limb activities.

PubMed

Favre, Philippe; Henderson, Adam D

2016-07-01

Adequate primary stability is essential for the long term success of uncemented stemless shoulder implants. The goal of this study was to evaluate the micromotion of a stemless humeral implant during various upper limb activities. A finite element model was validated by reproducing experimental primary stability testing. Loading from an instrumented prosthesis representing a set of 29 upper limb activities were applied within the validated FE model. Peak micromotion and percentage area for different micromotion thresholds were considered. In all simulated activities, at least 99% of the implant surface experienced micromotion below 150μm. Micromotion depended strongly on loading with large discrepancies between upper limb activities. Carrying no external weight and keeping the arm at lower angles induced lower micromotion. Activities representative of demanding manual labor generally led to higher micromotion. Axilla crutches led to lower micromotion than forearm crutches. Micromotion increased when a wheelchair was used on slopes above 2% inclination. Micromotions below the 150μm threshold below which bone ingrowth occurs were measured over at least 99% of the implant surface for all simulated activities. Peak micromotion dependence on activity type demonstrates the need to consider physiologic in vivo loading and the full contact interface in primary stability evaluations. Focusing on activities with no hand weight and low arm motions during the rehabilitation period may enhance primary stability. For patients unable to walk without aids, axilla crutches and motorized wheelchairs might be more beneficial than forearm crutches and manual drive wheelchairs respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pilot study to test effectiveness of video game on reaching performance in stroke.

PubMed

Acosta, Ana Maria; Dewald, Hendrik A; Dewald, Jules P A

2011-01-01

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject's success rate increases.

Pilot study to test effectiveness of video game on reaching performance in stroke

PubMed Central

Acosta, Ana Maria; Dewald, Hendrik A.; Dewald, Jules P. A.

2012-01-01

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject’s success rate increases. PMID:21674392

Characterization of Upper-Troposphere Water Vapor Measurements during AFWEX Using LASE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferrare, Richard; Browell, E. V.; Ismail, S.

Water vapor profiles from NASA's Lidar Atmospheric Sensing Experiment (LASE) system acquired during the ARM/FIRE Water Vapor Experiment (AFWEX) are used to characterize upper troposphere water vapor (UTWV) measured by ground-based Raman lidars, radiosondes, and in situ aircraft sensors over the Department of Energy Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site in northern Oklahoma. LASE was deployed from the NASA DC-8 aircraft and measured water vapor over the ARM SGP Central Facility (CF) site during seven flights between November 27 and December 10, 2000. Initially, the DOE ARM SGP Cloud and Radiation Testbed (CART) Raman lidar (CARL) UTWVmore » profiles were about 5-7% wetter than LASE in the upper troposphere, and the Vaisala RS80-H radiosonde profiles were about 10% drier than LASE between 8-12 km. Scaling the Vaisala water vapor profiles to match the precipitable water vapor (PWV) measured by the ARM SGP microwave radiometer (MWR) did not change these results significantly. By accounting for an overlap correction of the CARL water vapor profiles and by employing schemes designed to correct the Vaisala RS80-H calibration method and account for the time response of the Vaisala RS80H water vapor sensor, the average differences between the CARL and Vaisala radiosonde upper troposphere water vapor profiles are reduced to about 5%, which is within the ARM goal of mean differences of less than 10%. The LASE and DC-8 in situ Diode Laser Hygrometer (DLH) UTWV measurements generally agreed to within about 3 to 4%. The DC-8 in situ frost point cryogenic hygrometer and Snow White chilled mirror measurements were drier than the LASE, Raman lidars, and corrected Vaisala RS80H measurements by about 10-25% and 10-15%, respectively. Sippican (formerly VIZ manufacturing) carbon hygristor radiosondes exhibited large variabilities and poor agreement with the other measurements. PWV derived from the LASE profiles agreed to within about 3% on average with PWV derived from the ARM SGP microwave radiometer. The agreement between the LASE and MWR PWV and the LASE and CARL UTWV measurements supports the hypotheses that MWR measurements of the 22 GHz water vapor line can accurately constrain the total water vapor amount and that the CART Raman lidar, when calibrated using the MWR PWV, can provide an accurate, stable reference for characterizing upper troposphere water vapor.« less

Mechanical energy and power flow of the upper extremity in manual wheelchair propulsion.

PubMed

Guo, Lan-Yuen; Su, Fong-Chin; Wu, Hong-Wen; An, Kai-Nan

2003-02-01

To investigate the characteristics of mechanical energy and power flow of the upper limb during wheelchair propulsion. Mechanical energy and power flow of segments were calculated. Very few studies have taken into account the mechanical energy and power flow of the musculoskeletal system during wheelchair propulsion. Mechanical energy and power flow have proven to be useful tools for investigating locomotion disorders during human gait. Twelve healthy male adults (mean age, 23.5 years) were recruited for this study. Three-dimensional kinematic and kinetic data of the upper extremity were collected during wheelchair propulsion using a Hi-Res Expert Vision system and an instrumented wheel, respectively. During the initiation of the propulsion phase, joint power is generated in the upper arm or is transferred from the trunk downward to the forearm and hand to propel the wheel forward. During terminal propulsion, joint power is transferred upward to the trunk from the forearm and upper arm. The rate of change of mechanical energy and power flow for the forearm and hand have similar patterns, but the upper arm values differ. Joint power plays an important role in energy transfer as well as the energy generated and absorbed by muscles spanning the joints during wheelchair propulsion. Energy and power flow information during wheelchair propulsion allows us to gain a better understanding of the coordination of the movement by the musculoskeletal system.

Upper limb joint muscle/tendon injury and anthropometric adaptations in French competitive tennis players.

PubMed

Rogowski, Isabelle; Creveaux, Thomas; Genevois, Cyril; Klouche, Shahnaz; Rahme, Michel; Hardy, Philippe

2016-01-01

The purpose of this study was to examine the relationship between the upper limb anthropometric dimensions and a history of dominant upper limb injury in tennis players. Dominant and non-dominant wrist, forearm, elbow and arm circumferences, along with a history of dominant upper limb injuries, were assessed in 147 male and female players, assigned to four groups based on location of injury: wrist (n = 9), elbow (n = 25), shoulder (n = 14) and healthy players (n = 99). From anthropometric dimensions, bilateral differences in circumferences and in proportions were calculated. The wrist group presented a significant bilateral difference in arm circumference, and asymmetrical bilateral proportions between wrist and forearm, as well as between elbow and arm, compared to the healthy group (6.6 ± 3.1% vs. 4.9 ± 4.0%, P < 0.01; -3.6 ± 3.0% vs. -0.9 ± 2.9%, P < 0.05; and -2.2 ± 2.2% vs. 0.1 ± 3.4%, P < 0.05, respectively). The elbow group displayed asymmetrical bilateral proportions between forearm and arm compared to the healthy group (-0.4 ± 4.3% vs. 1.5 ± 4.0%, P < 0.01). The shoulder group showed significant bilateral difference in elbow circumference, and asymmetrical bilateral proportions between forearm and elbow when compared to the healthy group (5.8 ± 4.7% vs. 3.1 ± 4.8%, P < 0.05 and -1.7 ± 4.5% vs. 1.4 ± 4.3%, P < 0.01, respectively). These findings suggest that players with a history of injury at the upper limb joint present altered dominant upper limb proportions in comparison with the non-dominant side, and such asymmetrical proportions would appear to be specific to the location of injury. Further studies are needed to confirm the link between location of tennis injury and asymmetry in upper limb proportions using high-tech measurements in symptomatic tennis players.

Integrative rehabilitation of elderly stroke survivors: the design and evaluation of the BrightArm™.

PubMed

Rabin, Bryan A; Burdea, Grigore C; Roll, Doru T; Hundal, Jasdeep S; Damiani, Frank; Pollack, Simcha

2012-07-01

To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations.

Integrative rehabilitation of elderly stroke survivors: The design and evaluation of the BrightArm™

PubMed Central

Rabin, Bryan A.; Burdea, Grigore C.; Roll, Doru T.; Hundal, Jasdeep S.; Damiani, Frank; Pollack, Simcha

2011-01-01

Purpose To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. Method The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Results Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Conclusions Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations. PMID:22107353

Determination of Large-Scale Cloud Ice Water Concentration by Combining Surface Radar and Satellite Data in Support of ARM SCM Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Guosheng

2013-03-15

Single-column modeling (SCM) is one of the key elements of Atmospheric Radiation Measurement (ARM) research initiatives for the development and testing of various physical parameterizations to be used in general circulation models (GCMs). The data required for use with an SCM include observed vertical profiles of temperature, water vapor, and condensed water, as well as the large-scale vertical motion and tendencies of temperature, water vapor, and condensed water due to horizontal advection. Surface-based measurements operated at ARM sites and upper-air sounding networks supply most of the required variables for model inputs, but do not provide the horizontal advection term ofmore » condensed water. Since surface cloud radar and microwave radiometer observations at ARM sites are single-point measurements, they can provide the amount of condensed water at the location of observation sites, but not a horizontal distribution of condensed water contents. Consequently, observational data for the large-scale advection tendencies of condensed water have not been available to the ARM cloud modeling community based on surface observations alone. This lack of advection data of water condensate could cause large uncertainties in SCM simulations. Additionally, to evaluate GCMs cloud physical parameterization, we need to compare GCM results with observed cloud water amounts over a scale that is large enough to be comparable to what a GCM grid represents. To this end, the point-measurements at ARM surface sites are again not adequate. Therefore, cloud water observations over a large area are needed. The main goal of this project is to retrieve ice water contents over an area of 10 x 10 deg. surrounding the ARM sites by combining surface and satellite observations. Built on the progress made during previous ARM research, we have conducted the retrievals of 3-dimensional ice water content by combining surface radar/radiometer and satellite measurements, and have produced 3-D cloud ice water contents in support of cloud modeling activities. The approach of the study is to expand a (surface) point measurement to an (satellite) area measurement. That is, the study takes the advantage of the high quality cloud measurements (particularly cloud radar and microwave radiometer measurements) at the point of the ARM sites. We use the cloud ice water characteristics derived from the point measurement to guide/constrain a satellite retrieval algorithm, then use the satellite algorithm to derive the 3-D cloud ice water distributions within an 10° (latitude) x 10° (longitude) area. During the research period, we have developed, validated and improved our cloud ice water retrievals, and have produced and archived at ARM website as a PI-product of the 3-D cloud ice water contents using combined satellite high-frequency microwave and surface radar observations for SGP March 2000 IOP and TWP-ICE 2006 IOP over 10 deg. x 10 deg. area centered at ARM SGP central facility and Darwin sites. We have also worked on validation of the 3-D ice water product by CloudSat data, synergy with visible/infrared cloud ice water retrievals for better results at low ice water conditions, and created a long-term (several years) of ice water climatology in 10 x 10 deg. area of ARM SGP and TWP sites and then compared it with GCMs.« less

Round-Horizon Version of Curiosity Low-Angle Selfie at Buckskin

NASA Image and Video Library

2015-08-19

This version of a self-portrait of NASA's Curiosity Mars rover at a drilling site called "Buckskin" on lower Mount Sharp is presented as a stereographic projection, which shows the horizon as a circle. It is a mosaic assembled from the same set of 92 component raw images used for the flatter-horizon version at PIA19807. The component images were taken by Curiosity's Mars Hand Lens Imager (MAHLI) on Aug. 5, 2015, during the 1,065th Martian day, or sol, of the rover's work on Mars. Curiosity drilled the hole at Buckskin during Sol 1060 (July 30, 2015). Two patches of pale, powdered rock material pulled from inside Buckskin are visible in this scene, in front of the rover. The patch closer to the rover is where the sample-handling mechanism on Curiosity's robotic arm dumped collected material that did not pass through a sieve in the mechanism. Sieved sample material was delivered to laboratory instruments inside the rover. The patch farther in front of the rover, roughly triangular in shape, shows where fresh tailings spread downhill from the drilling process. The drilled hole, 0.63 inch (1.6 centimeters) in diameter, is at the upper point of the tailings. The rover is facing northeast, looking out over the plains from the crest of a 20-foot (6-meter) hill that it climbed to reach the "Marias Pass" area. The upper levels of Mount Sharp are visible behind the rover, while Gale Crater's northern rim dominates most of the rest of the horizon.the horizon on the left and right of the mosaic. MAHLI is mounted at the end of the rover's robotic arm. For this self-portrait, the rover team positioned the camera lower in relation to the rover body than for any previous full self-portrait of Curiosity. The assembled mosaic does not include the rover's arm beyond a portion of the upper arm held nearly vertical from the shoulder joint. Shadows from the rest of the arm and the turret of tools at the end of the arm are visible on the ground. With the wrist motions and turret rotations used in pointing the camera for the component images, the arm was positioned out of the shot in the frames or portions of frames used in this mosaic. MAHLI was built by Malin Space Science Systems, San Diego. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology in Pasadena, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington. JPL designed and built the project's Curiosity rover. http://photojournal.jpl.nasa.gov/catalog/PIA19806

A novel upper limb rehabilitation system with self-driven virtual arm illusion.

PubMed

Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

2014-01-01

This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

Radial nerve dysfunction (image)

MedlinePlus

The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson's disease.

PubMed

He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

2015-12-01

Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson's disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during tremor in PD patients. 11 idiopathic, tremor dominant PD subjects participated in this study. Joint kinematics during tremor in the upper extremity was recorded along with EMGs of six upper arm muscles using a novel experimental apparatus. The apparatus provided support for the upper extremity on a horizontal surface with reduced friction, so that resting tremor in the arm can be recorded with a MotionMonitor II system. In each subject, the frequencies of rhythmic firings in upper arm muscles were determined using spectral analysis. Paired and pool-averaged coherence analyses of EMGs for the group of muscles were performed to correlate the level of inter-muscular synchronization to tremor amplitudes at shoulder and elbow. The phase shift between synchronized antagonistic muscle pairs was calculated to aid coherence analysis in the muscle pool. Recorded EMG revealed that rhythmic firings were present in most recorded muscles, which were either synchronized to form phase-locked bursting cycles at a subject specific frequency, or unsynchronized with a random phase distribution. Paired coherence showed a stronger synchronization among a subset of recorded arm muscles at tremor frequency than that at double tremor frequency. Furthermore, the number of synchronized muscles in the arm was positively correlated to tremor amplitudes at elbow and shoulder. Pool-averaged coherence at tremor frequency also showed a better correlation with the amplitude of resting tremor than that of double tremor frequency, indicating that the neuromechanical coupling in peripheral neuromuscular system was stronger at tremor frequency. Both paired and pool-averaged coherences are more consistent indexes to correlate to tremor intensity in a group of upper extremity muscles of PD patients. The central drive at tremor frequency contributes mainly to synchronize peripheral muscles in the modulation of tremor intensity.

Efficacy of mid-upper arm circumference in identification, follow-up and discharge of malnourished children during nutrition rehabilitation.

PubMed

Mogendi, Joseph Birundu; De Steur, Hans; Gellynck, Xavier; Saeed, Hibbah Araba; Makokha, Anselimo

2015-06-01

Although it is crucial to identify those children likely to be treated in an appropriate nutrition rehabilitation programme and discharge them at the appropriate time, there is no golden standard for such identification. The current study examined the appropriateness of using Mid-Upper Arm Circumference for the identification, follow-up and discharge of malnourished children. We also assessed its discrepancy with the Weight-for-Height based diagnosis, the rate of recovery, and the discharge criteria of the children during nutrition rehabilitation. The study present findings from 156 children (aged 6-59 months) attending a supplementary feeding programme at Makadara and Jericho Health Centres, Eastern District of Nairobi, Kenya. Records of age, weight, height and mid-upper arm circumference were selected at three stages of nutrition rehabilitation: admission, follow-up and discharge. The values obtained were then used to calculate z-scores as defined by WHO Anthro while estimating different diagnostic indices. Mid-upper arm circumference single cut-off (< 12.5 cm) was found to exhibit high values of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio at both admission and discharge. Besides, children recorded higher rate of recovery at 86 days, an average increment of 0.98 cm at the rate of 0.14mm/day, and a weight gain of 13.49gm/day, albeit higher in female than their male counterparts. Nevertheless, children admitted on basis of low MUAC had a significantly higher MUAC gain than WH at 0.19mm/day and 0.13mm/day respectively. Mid-upper arm circumference can be an appropriate tool for identifying malnourished children for admission to nutrition rehabilitation programs. Our results confirm the appropriateness of this tool for monitoring recovery trends and discharging the children thereafter. In principle the tool has potential to minimize nutrition rehabilitation costs, particularly in community therapeutic centres in developing countries.

Reliability, Validity, and Responsiveness of the QuickDASH in Patients With Upper Limb Amputation.

PubMed

Resnik, Linda; Borgia, Matthew

2015-09-01

To examine the internal consistency, test-retest reliability, validity, and responsiveness of the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in persons with upper limb amputation. Cross-sectional and longitudinal. Three sites participating in the U.S. Department of Veterans Affairs Home Study of the DEKA Arm. A convenience sample of upper limb amputees (N=44). Training with a multifunction upper limb prosthesis. Multiple outcome measures including the QuickDASH were administered twice within 1 week, and for a subset of 20 persons, after completion of in-laboratory training with the DEKA Arm. Scale alphas and intraclass correlation coefficient type 3,1 (ICC3,1) were used to examine reliability. Minimum detectable change (MDC) scores were calculated. Analyses of variance, comparing QuickDASH scores by the amount of prosthetic use and amputation level, were used for known-group validity analyses with alpha set at .05. Pairwise correlations between QuickDASH and other measures were used to examine concurrent validity. Responsiveness was measured by effect size (ES) and standardized response mean (SRM). QuickDASH alpha was .83, and ICC was .87 (95% confidence interval, .77-.93). MDC at the 95% confidence level (MDC95%) was 17.4. Full- or part-time prosthesis users had better QuickDASH scores compared with nonprosthesis users (P=.021), as did those with more distal amputations at both baseline (P=.042) and with the DEKA Arm (P=.024). The QuickDASH was correlated with concurrent measures of activity limitation as expected. The ES and SRM after training with the DEKA Arm were 0.6. This study provides evidence of reliability and validity of the QuickDASH in persons with upper limb amputation. Results provide preliminary evidence of responsiveness to prosthetic device type/training. Further research with a larger sample is needed to confirm results. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2005-12-01

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

The relationship between consistency of propulsive cycles and maximum angular velocity during wheelchair racing.

PubMed

Wang, Yong Tai; Vrongistinos, Konstantinos Dino; Xu, Dali

2008-08-01

The purposes of this study were to examine the consistency of wheelchair athletes' upper-limb kinematics in consecutive propulsive cycles and to investigate the relationship between the maximum angular velocities of the upper arm and forearm and the consistency of the upper-limb kinematical pattern. Eleven elite international wheelchair racers propelled their own chairs on a roller while performing maximum speeds during wheelchair propulsion. A Qualisys motion analysis system was used to film the wheelchair propulsive cycles. Six reflective markers placed on the right shoulder, elbow, wrist joints, metacarpal, wheel axis, and wheel were automatically digitized. The deviations in cycle time, upper-arm and forearm angles, and angular velocities among these propulsive cycles were analyzed. The results demonstrated that in the consecutive cycles of wheelchair propulsion the increased maximum angular velocity may lead to increased variability in the upper-limb angular kinematics. It is speculated that this increased variability may be important for the distribution of load on different upper-extremity muscles to avoid the fatigue during wheelchair racing.

Exposure to Upper Arm Elevation During Work Compared to Leisure Among 12 Different Occupations Measured with Triaxial Accelerometers.

PubMed

Palm, Peter; Gupta, Nidhi; Forsman, Mikael; Skotte, Jørgen; Nordquist, Tobias; Holtermann, Andreas

2018-06-26

Regarding prevention of neck and shoulder pain (NSP), unsupported arm elevation is one factor that should be taken into account when performing work risk assessment. Triaxial accelerometers can be used to measure arm elevation over several days but it is not possible to differentiate between supported and unsupported arm elevation from accelerometers only. Supported arm elevation is more likely to exist during sitting than standing. The aim of the study was to evaluate the use of whole workday measurements of arm elevation with accelerometers to assess potentially harmful work exposure of arm elevation, by comparing arm elevation at work with arm elevation during leisure, in a population with diverse work tasks, and to assess how the exposure parameters were modified when upper arm elevation during sitting time was excluded. The participants, 197 workers belonging to 12 occupational groups with diverse work tasks, wore triaxial accelerometers on the dominant arm, hip, and back for 1-4 days to measure arm elevation and periods of sitting. None of the groups were found to have higher exposure to arm elevation during work compared to leisure. Even though some occupations where known to have work tasks that forced them to work with elevated arms to a large extent. A high proportion of arm elevation derived from sitting time, especially so during leisure. When arm elevation during sitting time was excluded from the analysis, arm elevation was significantly higher at work than during leisure among construction workers, garbage collectors, manufacturing workers, and domestic cleaners. Together this illustrates that it is not suitable to use whole workday measurments of arm elevation with accelerometer as a sole information source when assessing the risk for NSP due to arm elevation. Information on body posture can provide relevant contextual information in exposure assessments when it is known that the potential harmful exposure is performed in standing or walking.

Laser-assisted lipolysis for arm contouring in Teimourian grades I and II: a prospective study of 45 patients.

PubMed

Leclère, Franck Marie; Alcolea, Justo M; Vogt, Peter; Moreno-Moraga, Javier; Mordon, Serge; Casoli, Vincent; Trelles, Mario A

2015-04-01

Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures. We conducted this study to objectively assess if, in Teimourian low-grade upper arm remodelling, one session of laser-assisted lypolisis (LAL) could result in full patient satisfaction. Between 2011 and 2013, 45 patients were treated for unsightly fat arm Teimourian grade I (15 patients), grade IIa (15 patients) and grade IIb (15 patients) with one session of LAL. The laser used in this study was a 1470-nm diode laser (Alma Lasers, Cesarea, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600-μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Treatment parameters and adverse effects were recorded.The arm circumference and skin pinch measurements were assessed pre and postoperatively. Patients were asked to file a satisfaction questionnaire. Pain during the anaesthesia and discomfort after the procedure were minimal. Complications included prolonged oedema in 11 patients. The average arm circumference decreased by 4.9 ± 0.4 cm in the right arm (p < 0.01) and 4.7 ± 0.5 cm in the left arm (p < 0.01) in grade I patients, 5.5 ± 0.6 cm in the right arm (p < 0.01) and 5.2 ± 0.5 cm in the left arm (p < 0.01) in grade IIa patients and 5.4 ± 0.5 cm in the right arm (p < 0.01) and 5.3 ± 0.5 cm in the left arm (p < 0.01) in grade IIB patients. The skin tightening effect was confirmed by the reduction of the skin calliper measurements in all three groups. Overall mean opinion of treatment was high for both patients and investigators. Of the 45 patients, all but one would recommend this treatment. A single session of LAL in upper arm remodelling for Teimourian grades I to IIb is a safe and reproducible technique. The procedure allows reduction in the amount of adipose deposits while providing full skin tightening.

Gravity compensation of an upper extremity exoskeleton.

PubMed

Moubarak, S; Pham, M T; Moreau, R; Redarce, T

2010-01-01

This paper presents a new gravity compensation method for an upper extremity exoskeleton mounted on a wheel chair. This new device is dedicated to regular and efficient rehabilitation training for post-stroke and injured people without the continuous presence of a therapist. The exoskeleton is a wearable robotic device attached to the human arm. The user provides information signals to the controller by means of the force sensors around the wrist and the arm, and the robot controller generates the appropriate control signals for different training strategies and paradigms. This upper extremity exoskeleton covers four basic degrees of freedom of the shoulder and the elbow joints with three additional adaptability degrees of freedom in order to match the arm anatomy of different users. For comfortable and efficient rehabilitation, a new heuristic method have been studied and applied on our prototype in order to calculate the gravity compensation model without the need to identify the mass parameters. It is based on the geometric model of the robot and accurate torque measurements of the prototype's actuators in a set of specifically chosen joint positions. The weight effect has been successfully compensated so that the user can move his arm freely while wearing the exoskeleton without feeling its mass.

Military Personnel: Army Needs to Focus on Cost-Effective Use of Financial Incentives and Quality Standards in Managing Force Growth

DTIC Science & Technology

2009-05-01

diplomas and who score in the upper half on the Armed Forces Qualification Test. The Army implemented some new programs to increase the market of...quality of its enlisted personnel, we analyzed data from OSD on educational credentials and aptitude test scores for these personnel, and we collected...recruits to have high-school diplomas and at least 60 percent to have scores in the upper half on the Armed Forces Qualification Test (AFQT). In fiscal

User Evaluation of a Dynamic Arm Orthosis for People With Neuromuscular Disorders.

PubMed

Gunn, Margaret; Shank, Tracy M; Eppes, Marissa; Hossain, Jobayer; Rahman, Tariq

2016-12-01

This paper presents the results of an online survey conducted with users of a functional upper extremity orthosis called the Wilmington Robotic EXoskeleton (WREX). The WREX is a passive anti-gravity arm orthosis that allows people with neuromuscular disabilities to move their arms in three dimensions. The paper also describes the design of a novel lightweight 3-D printed WREX used for ambulatory children. Three different versions of the WREX are now offered to patients. Two can be mounted on a wheelchair and one to a body jacket for ambulatory patients. An online user survey with 55 patients was conducted to determine the benefits of the various WREXs. The survey asked ten questions related to upper extremity function with and without the WREX as well as subjective impressions of the device. Results show a statistically significant improvement in arm function for everyday tasks with the WREX.

Mechanical Impedance Modeling of Human Arm: A survey

NASA Astrophysics Data System (ADS)

Puzi, A. Ahmad; Sidek, S. N.; Sado, F.

2017-03-01

Human arm mechanical impedance plays a vital role in describing motion ability of the upper limb. One of the impedance parameters is stiffness which is defined as the ratio of an applied force to the measured deformation of the muscle. The arm mechanical impedance modeling is useful in order to develop a better controller for system that interacts with human as such an automated robot-assisted platform for automated rehabilitation training. The aim of the survey is to summarize the existing mechanical impedance models of human upper limb so to justify the need to have an improved version of the arm model in order to facilitate the development of better controller of such systems with ever increase in complexity. In particular, the paper will address the following issue: Human motor control and motor learning, constant and variable impedance models, methods for measuring mechanical impedance and mechanical impedance modeling techniques.

Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage.

PubMed

Chadwell, Alix; Kenney, Laurence; Granat, Malcolm; Thies, Sibylle; Head, John S; Galpin, Adam

2018-02-01

Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously, 1 we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Methodology development. To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1 week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (≈20-40 min/week compared to ≈350 min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users. Clinical relevance Activity monitoring offers an objective method for the assessment of upper limb prosthesis users' (PUs) activity outside of the clinic. By plotting data using Archimedean spirals, it is possible to visualise, in detail, the temporal patterns of upper limb activity. Further work is needed to explore the relationship between traditional functional outcome measures and real-world prosthesis activity.

Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults: A prospective longitudinal study.

PubMed

Sanson, Gianfranco; Bertocchi, Luca; Dal Bo, Eugenia; Di Pasquale, Carmen Luisa; Zanetti, Michela

2018-06-01

Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identifying malnourished patients at hospital admission and effectively monitoring their food intake. The primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. Prospective observational longitudinal study. Internal Medicine Ward of an Academic Teaching University Hospital. Acute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference <23.5 cm or impaired self-feeding ability) at admission. The effective energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. Eighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p < 0.01), and experienced longer hospital stays (p ≤ 0.04) and higher in-hospital and 30-day post-discharge mortality (p < 0.001). In the multivariate analysis, lower middle-upper arm circumference, higher C-reactive protein/albumin ratio, and impaired self-feeding at admission were independently associated with critically reduced energy and protein intake. Middle-upper arm circumference, C-reactive protein/albumin ratio, and impaired self-feeding are easily obtainable indicators of impaired energy and protein intake and poor clinical outcomes. Such parameters should be adopted as screening criteria to assess the risk for critically reduced energy/protein intake in hospitalized older adults. These findings are relevant to improve clinical practice through the implementation of multidisciplinary strategies, given the adverse clinical outcomes related to hospital malnutrition. Copyright © 2018 Elsevier Ltd. All rights reserved.

Perception and action in swimming: Effects of aquatic environment on upper limb inter-segmental coordination.

PubMed

Guignard, Brice; Rouard, Annie; Chollet, Didier; Ayad, Omar; Bonifazi, Marco; Dalla Vedova, Dario; Seifert, Ludovic

2017-10-01

This study assessed perception-action coupling in expert swimmers by focusing on their upper limb inter-segmental coordination in front crawl. To characterize this coupling, we manipulated the fluid flow and compared trials performed in a swimming pool and a swimming flume, both at a speed of 1.35ms -1 . The temporal structure of the stroke cycle and the spatial coordination and its variability for both hand/lower arm and lower arm/upper arm couplings of the right body side were analyzed as a function of fluid flow using inertial sensors positioned on the corresponding segments. Swimmers' perceptions in both environments were assessed using the Borg rating of perceived exertion scale. Results showed that manipulating the swimming environment impacts low-order (e.g., temporal, position, velocity or acceleration parameters) and high-order (i.e., spatial-temporal coordination) variables. The average stroke cycle duration and the relative duration of the catch and glide phases were reduced in the flume trial, which was perceived as very intense, whereas the pull and push phases were longer. Of the four coordination patterns (in-phase, anti-phase, proximal and distal: when the appropriate segment is leading the coordination of the other), flume swimming demonstrated more in-phase coordination for the catch and glide (between hand and lower arm) and recovery (hand/lower arm and lower arm/upper arm couplings). Conversely, the variability of the spatial coordination was not significantly different between the two environments, implying that expert swimmers maintain consistent and stable coordination despite constraints and whatever the swimming resistances. Investigations over a wider range of velocities are needed to better understand coordination dynamics when the aquatic environment is modified by a swimming flume. Since the design of flumes impacts significantly the hydrodynamics and turbulences of the fluid flow, previous results are mainly related to the characteristics of the flume used in the present study (or a similar one), and generalization is subject to additional investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

Control of the seven-degree-of-freedom upper limb exoskeleton for an improved human-robot interface

NASA Astrophysics Data System (ADS)

Kim, Hyunchul; Kim, Jungsuk

2017-04-01

This study analyzes a practical scheme for controlling an exoskeleton robot with seven degrees of freedom (DOFs) that supports natural movements of the human arm. A redundant upper limb exoskeleton robot with seven DOFs is mechanically coupled to the human body such that it becomes a natural extension of the body. If the exoskeleton robot follows the movement of the human body synchronously, the energy exchange between the human and the robot will be reduced significantly. In order to achieve this, the redundancy of the human arm, which is represented by the swivel angle, should be resolved using appropriate constraints and applied to the robot. In a redundant 7-DOF upper limb exoskeleton, the pseudoinverse of the Jacobian with secondary objective functions is widely used to resolve the redundancy that defines the desired joint angles. A secondary objective function requires the desired joint angles for the movement of the human arm, and the angles are estimated by maximizing the projection of the longest principle axis of the manipulability ellipsoid for the human arm onto the virtual destination toward the head region. Then, they are fed into the muscle model with a relative damping to achieve more realistic robot-arm movements. Various natural arm movements are recorded using a motion capture system, and the actual swivel-angle is compared to that estimated using the proposed swivel angle estimation algorithm. The results indicate that the proposed algorithm provides a precise reference for estimating the desired joint angle with an error less than 5°.

CRUX: A compliant robotic upper-extremity exosuit for lightweight, portable, multi-joint muscular augmentation.

PubMed

Lessard, Steven; Pansodtee, Pattawong; Robbins, Ash; Baltaxe-Admony, Leya Breanna; Trombadore, James M; Teodorescu, Mircea; Agogino, Adrian; Kurniawan, Sri

2017-07-01

Wearable robots can potentially offer their users enhanced stability and strength. These augmentations are ideally designed to actuate harmoniously with the user's movements and provide extra force as needed. The creation of such robots, however, is particularly challenging due to the underlying complexity of the human body. In this paper, we present a compliant, robotic exosuit for upper extremities called CRUX. This exosuit, inspired by tensegrity models of the human arm, features a lightweight (1.3 kg), flexible multi-joint design for portable augmentation. We also illustrate how CRUX maintains the full range of motion of the upper-extremities for its users while providing multi-DoF strength amplification to the major muscles of the arm, as evident by tracking the heart rate of an individual exercising said arm. Exosuits such as CRUX may be useful in physical therapy and in extreme environments where users are expected to exert their bodies to the fullest extent.

Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders--A case-control ultrasound speckle tracking analysis.

PubMed

Landén Ludvigsson, Maria; Peterson, Gunnel; Jull, Gwendolen; Trygg, Johan; Peolsson, Anneli

2016-02-01

Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep). The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01). This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. Clinical Trials.gov, Number: NCT01547624. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intra-Cyclic Phases of Arm-Leg Movement and Index of Coordination in Relation to Sprint Breaststroke Swimming in Young Swimmers

PubMed Central

Strzala, Marek; Krezalek, Piotr; Glab, Grzegorz; Kaca, Marcin; Ostrowski, Andrzej; Stanula, Arkadiusz; Tyka, Anna K.

2013-01-01

Despite the limitations set by FINA regulations, execution technique in breaststroke swimming is being improved thanks to more and more advanced analyses of the efficiency of the swimmer’s movements. The aim of this study was to detect the parameters of the time structure of the cycle correlated with the maximal swimming speed at the of 50 meters distance, in order to focus to specific technical aspects in the breaststroke training. In the group of 23 participants, between the age of 15.0 ± 1.17, the breaststroke cycle movement of the arms and legs was divided into two phases: propulsive or non-propulsive. In addition, indices characterizing the temporal coordination of movements of the upper limbs in relation to the lower limbs were distinguished: 1) Arm-Leg Lag - determines the interval between the phases of propulsion generated by upper and lower limbs; 2) Glide or Overlap - the inter-cyclic glide or overlap of the propulsive movement of the upper on lower limbs. Significant dependence was noted between the swim speed (V50surface breast) and the percentage of time of the arm propulsive in-sweep phase 0.64, p < 0.01. A significant correlation was observed between the V50surface breast with the percentage of partially surfaced hand phase of arm recovery 0.54, p < 0.01. Correlation between total leg propulsion and non-propulsion phases with V50surface breast was 0.49 and -0.49 respectively, both p < 0.01. The Glide or Overlap index was significantly related to the swimming speed V50surface breast 0.48, p < 0.05. This type of analysis suggests how to refine the swimming technique, with the goal to improve the current speed capabilities; furthermore the results also indicate the direction of its development in the future swimmers of the group studied. Key Points This study investigated the influence of the inter- and intra-cyclic time structure of the movements in sprint breaststroke swimming. The distinction of the operations phases of the upper limbs in the propulsive movement shows significant correlation 0.64, p <0.01 between the swimming speed V50surface breast and the execution time of the in-sweep phase in the movement cycle. Significant relationship was noted between minimizing the first non-propulsive phase of arm recovery with higher contribution of the next, partially immersed sliding phase of arm recovery. The specification of the inter-cyclic coordination index of the upper and lower limbs during the movement cycle shows influence of the overlap of the propulsive movement of the upper limbs on the propulsive movement of the lower limbs on V50surface breast with correlation 0.48, p <0.05 for young swimmers. PMID:24421728

A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery

PubMed Central

House, Gregory; Burdea, Grigore; Grampurohit, Namrata; Polistico, Kevin; Roll, Doru; Damiani, Frank; Hundal, Jasdeep; Demesmin, Didier

2016-01-01

Background: Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. Objectives: The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. Methods: BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20–50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. Results: Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). Conclusion: This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression. PMID:27867508

A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery.

PubMed

House, Gregory; Burdea, Grigore; Grampurohit, Namrata; Polistico, Kevin; Roll, Doru; Damiani, Frank; Hundal, Jasdeep; Demesmin, Didier

2016-11-01

Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20-50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression.

Physiologically Relevant Prosthetic Limb Movement Feedback for Upper and Lower Extremity Amputees

DTIC Science & Technology

2016-10-01

upper arm (elbow movement), Upper leg (knee movement) and lower leg ( ankle movement) to provide a physiologically relevant sense of limb movement...Additionally a BOA cable tensioning system is passed through these plates and anchored to the external surface of the socket. When tension is applied the

Comparison of skin responses from macroscopic and microscopic UV challenges

NASA Astrophysics Data System (ADS)

Seo, InSeok; Bargo, Paulo R.; Chu, Melissa; Ruvolo, Eduardo; Kollias, Nikiforos

2011-03-01

The minimal erythema dose induced by solar-simulated radiation is a useful measure of UV sensitivity of skin. Most skin phototests have been conducted by projecting a flat field of UV radiation onto the skin in an area greater than 15 cm × 15 cm with an increment of radiation doses. In this study, we investigated the responses of human skin to solar-simulated radiation of different field sizes. Twelve human subjects of skin phototype I-IV were exposed to solar-simulated radiation (SSR) on their upper inner arm or on their lower back with a series of doses in increments of 20% in order to determine the threshold dose to induce a minimal perceptible erythema response (MED). Each dose was delivered with a liquid light guide (8 mm diameter on the back or 6 mm on the upper inner arm) and with quartz optical fibers of 200 μm diameter. The resulting skin responses were evaluated visually and investigated with a reflectance confocal microscope and imaging. The erythema response to the microscopic challenge was always diffuse with no clear boundaries extending to several times the exposed site diameter at doses greater than 2 MED. The skin returned to normal appearance from the microscopic challenge after two weeks of exposure while change in appearance for the larger areas persisted for several weeks to months. This new modality of testing provides the possibility to study skin at the microscopic level with a rapid recovery following challenge.

Electrical burns of the abdomen.

PubMed

Srivastava, Rakesh Kumar; Kumar, Ritesh

2013-09-01

A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

Age Differences in Energy Absorption in the Upper Extremity During a Descent Movement: Implications for Arresting a Fall

PubMed Central

Stotz, Paula J.; Normandin, Sarah C.; Robinovitch, Stephen N.

2010-01-01

Background Falls are the number one cause of unintentional injury in older adults. The protective response of “breaking the fall” with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Methods Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15° to 90°. Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. Results On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 ± 0.5% vs 3.1 ± 0.4% of their body weight × body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. Conclusions During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall. PMID:19861641

Age differences in energy absorption in the upper extremity during a descent movement: implications for arresting a fall.

PubMed

Sran, Meena M; Stotz, Paula J; Normandin, Sarah C; Robinovitch, Stephen N

2010-03-01

Falls are the number one cause of unintentional injury in older adults. The protective response of "breaking the fall" with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15 degrees to 90 degrees . Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 +/- 0.5% vs 3.1 +/- 0.4% of their body weight x body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall.

Intermanual transfer in training with an upper-limb myoelectric prosthesis simulator: a mechanistic, randomized, pretest-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2013-01-01

Intermanual transfer may improve prosthetic handling and acceptance if used in training soon after an amputation. The purpose of this study was to determine whether intermanual transfer effects can be detected after training with a myoelectric upper-limb prosthesis simulator. A mechanistic, randomized, pretest-posttest design was used. A total of 48 right-handed participants (25 women, 23 men) who were able-bodied were randomly assigned to an experimental group or a control group. The experimental group performed a training program of 5 days' duration using the prosthesis simulator. To determine the improvement in skill, a test was administered before, immediately after, and 6 days after training. The control group only performed the tests. Training was performed with the unaffected arm, and tests were performed with the affected arm (the affected arm simulating an amputated limb). Half of the participants were tested with the dominant arm and half with the nondominant arm. Initiation time was defined as the time from starting signal until start of the movement, movement time was defined as the time from the beginning of the movement until completion of the task, and force control was defined as the maximal applied force on a deformable object. The movement time decreased significantly more in the experimental group (F₂,₉₂=7.42, P=.001, η²(G)=.028) when compared with the control group. This finding is indicative of faster handling of the prosthesis. No statistically significant differences were found between groups with regard to initiation time and force control. We did not find a difference in intermanual transfer between the dominant and nondominant arms. The training utilized participants who were able-bodied in a laboratory setting and focused only on transradial amputations. Intermanual transfer was present in the affected arm after training the unaffected arm with a myoelectric prosthesis simulator, and this effect did not depend on laterality. This effect may improve rehabilitation of patients with an upper-limb amputation.

Deficits in Upper Limb Position Sense of Children with Spastic Hemiparetic Cerebral Palsy Are Distance-Dependent

ERIC Educational Resources Information Center

Smorenburg, Ana R. P.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

2012-01-01

This study examined the arm position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and typically developing children (TD) by means of a contralateral matching task. This task required participants to match the position of one arm with the position of the other arm for different target distances and from different starting…

The clinical aspects of the upper extremity exoskeleton "EXAR" use

NASA Astrophysics Data System (ADS)

Vorobiev, A. A.; Krivonozhkina, P. S.; Andryushchenko, F. A.; Zasypkina, O. A.

2015-11-01

The article considers some of indications and contraindications for the use of the exoskeleton "EXAR". Our experience with the present construction use shows that the exoskeleton "EXAR" is able to make up the following lost or disturbed muscle functions:- an arm raise; a drawing of the arm aside from the trunk;- a bending of the arm in shoulder or elbow joints.

Blood pressure measurement in obese patients: comparison between upper arm and forearm measurements.

PubMed

Pierin, Angela M G; Alavarce, Débora C; Gusmão, Josiane L; Halpern, Alfredo; Mion, Décio

2004-06-01

It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms. To compare arm blood pressure measurements with an appropriate cuff and forearm blood pressure measurements (BPM) with a standard cuff, and both measurements by the Photopletismography (Finapres) method. One hundred and twenty-nine obese patients were studied (body mass index=40+/-7 kg/m2). The patients had three arm BPM taken by an automatic oscillometric device using an appropriate cuff and three forearm BPM with a standard cuff in the sitting position after a five-minute rest. Data were analysed by the analysis of variance. The correction values were obtained by the linear regression test. Systolic and diastolic arm BPM with an appropriate cuff were significantly lower (p<0.05) than forearm BPM with a standard cuff. The measurements obtained by Finapres were significantly lower (p<0.05) than those found for forearm systolic and diastolic blood pressures and upper arm diastolic blood pressure. The equation to correct BPM in forearm in obese patients with arm circumference between 32-44 cm was: systolic BPM=33.2+/-0.68 x systolic forearm BPM, and diastolic BPM=25.2+0.59 x forearm diastolic BPM. This study showed that forearm blood pressure measurement overestimates the values of arm blood pressure measurement. In addition, it is possible to correct forearm BPM with an equation.

Certolizumab Pegol-Induced Folliculitis-Like Lichenoid Sarcoidosis in a Patient with Rheumatoid Arthritis

PubMed Central

Sakai, Hiroyuki; Nomura, Wakana; Sugawara, Motoshi

2017-01-01

Anti-tumor necrosis factor α (TNF-α) biologic agents are used for treating refractory sarcoidosis. However, sarcoidosis-like epithelioid cell granulomas may develop during anti-TNF-α treatment. A 63-year-old man suffering from rheumatoid arthritis was treated with oral methotrexate and methylprednisolone for 4 years. He subsequently started biweekly subcutaneous injections of certolizumab pegol. Three months later, light red follicular papules developed on his chest and they spread over the trunk and bilateral upper arms. Histopathology of a lesion showed a sharply demarcated noncaseating epithelioid cell granuloma with multi-nucleated giant cells in the upper perifollicular area. The follicular papules subsided following discontinuation of certolizumab pegol. Folliculitis-like lichenoid sarcoidosis should be included among the adverse cutaneous reactions of anti-TNF-α treatment. PMID:29033821

Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period.

PubMed

Çiçek, Betül; Öztürk, Ahmet; Mazıcıoğlu, Mustafa Mümtaz; Kurtoğlu, Selim

2014-12-01

Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period. The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method. In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls. The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

Effect of eight weeks of upper-body plyometric training during the competitive season on professional female volleyball players.

PubMed

Valades, David; Palao, José M; Femia, Pedro; Ureña, Aurelio

2017-07-25

The purpose of this study was to assess the effect of incorporating specific upper-body plyometric training for the spike into the competitive season of a women's professional volleyball team. A professional team from the Spanish first division participated in the study. An A-B-A' quasi-experimental design with experimental and control groups was used. The independent variable was the upper-body plyometric training for eight weeks during the competitive season. The dependent variables were the spiked ball's speed (Km/h); the player's body weight (Kg), BMI (Kg/m2), and muscle percentage in arms (%); 1 repetition maximum (1RM) in the bench press (Kg); 1RM in the pullover (Kg); and overhead medicine ball throws of 1, 2, 3, 4, and 5 kg (m). Inter-player and inter-group statistical analyses of the results were carried out (Wilcoxon test and linear regression model). The experimental group significantly improved their spike speed 3.8% from phase A to phase B, and they maintained this improvement after the retention phase. No improvements were found in the control group. The experimental group presented a significant improvement from phase A to phase B in dominant arm muscle area (+10.8%), 1RM for the bench press (+8.41%), 1RM for the pullover (+14.75%), and overhead medicine ball throws with 1 kg (+7.19%), 2 kg (+7.69%), and 3 kg (+5.26%). The control group did not present differences in these variables. Data showed the plyometric exercises that were tested could be used by performance-level volleyball teams to improve spike speed. The experimental group increased their upper-body maximal strength, their power application, and spike speed.

Ultrasound-Guided Selective Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves: A Randomized Clinical Trial.

PubMed

Magazzeni, Philippe; Jochum, Denis; Iohom, Gabriella; Mekler, Gérard; Albuisson, Eliane; Bouaziz, Hervé

2018-06-13

For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN. Eighty-four patients, undergoing upper limb surgery, were randomized to receive either USG (n = 42) or conventional (n = 42) block of the MBCN and the ICBN with 1% mepivacaine. Sensory block was evaluated using light-touch on the upper and lower half of the anteromedial and posteromedial surfaces of the upper arm at 5, 10, 15, 20 minutes after nerve blocks. The primary outcome was the proportion of patients who had no sensation in all 4 regions innervated by the MBCN and the ICBN at 20 minutes. Secondary outcomes were onset time of complete anesthesia, volume of local anesthetic, tourniquet tolerance, and quality of ultrasound images. In the USG group, 37 patients (88%) had no sensation at 20 minutes in any of the 4 areas tested versus 8 patients (19%) in the conventional group (P < 0.001). When complete anesthesia was obtained, it occurred within 10 minutes in more than 90% of patients, in both groups. Mean total volumes of local anesthetic used for blocking the MBCN and the ICBN were similar in the 2 groups. Ultrasound images were of good quality in only 20 (47.6%) of 42 patients. Forty-one patients (97.6%) who received USG block were comfortable with the tourniquet versus 16 patients (38.1%) in the conventional group (P < 0.001). Ultrasound guidance improved the efficacy of the MBCN and ICBN blocks. This study was registered at ClinicalTrials.gov, identifier NCT02940847.

Serum testosterone levels in non-dosed females after secondary exposure to 1.62% testosterone gel: effects of clothing barrier on testosterone absorption.

PubMed

Stahlman, Jodi; Britto, Margaret; Fitzpatrick, Sherahe; McWhirter, Cecilia; Testino, Samuel A; Brennan, John J; Zumbrunnen, Troy L

2012-02-01

To evaluate secondary exposure of testosterone transferred to females from a male partner, dosed with 1.62% testosterone gel after direct skin-to-skin contact with the application site, and to investigate the effect of wearing a t-shirt on testosterone transfer. Across three studies, a total of 72 healthy males applied 5.0 g 1.62% testosterone gel to their abdomen alone, upper arms/shoulders alone, or a combination of their upper arms/shoulders and abdomen (single dose or once daily for 7 days). Male-female contact occurred 2 or 12 hours after testosterone gel application, with males either wearing or not wearing a t-shirt. There were 15 minutes of supervised contact with the application site between the male and his female partner. Blood samples were collected over a 24 hour period in females for assessment of serum testosterone levels at baseline and after contact. Pharmacokinetic parameters included C(max) (maximum serum concentration), AUC(0-24) (area under the serum concentration-time curve from 0-24 hours), and C(av) (time-averaged concentration over the 24-hour period post-contact). Subjects were monitored for adverse events. CLINICAL TRIAL REGISTRATION NCT NUMBERS: Study 1 was not registered (first subject enrolled 8 March 2007); Study 2: 00998933; Study 3, 01130298. Testosterone levels (C(av) and C(max)) in females increased 86-185% from baseline after direct abdominal skin contact, although C(av) levels remained within female eugonadal range. Testosterone concentrations returned to baseline within 48 hours after last skin contact. A t-shirt barrier reduced testosterone transfer by approximately 40-48% when 5.0 g of testosterone gel was applied to the abdomen alone. A t-shirt barrier prevented transfer when 5.0 g of testosterone gel was applied to the upper arms and shoulders or to a combination of the upper arms and shoulders and the abdomen (C(max) and C(av) increased by approximately 5-11%). No major safety events were observed during the studies. There is a risk of testosterone transfer from males using 1.62% testosterone gel to others who come in contact with the application site for at least 12 hours after application. Secondary exposure can be mitigated by means of a t-shirt barrier. Women for these studies were not selected by menopausal status. The study designs were intended to simulate exaggerated conditions of transfer.

Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury.

PubMed

Kankipati, Padmaja; Boninger, Michael L; Gagnon, Dany; Cooper, Rory A; Koontz, Alicia M

2015-07-01

Repeated measures design. This study compared the upper extremity (UE) joint kinetics between three transfer techniques. Research laboratory. Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers. Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique. Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement.

The Arm is Not the Leg: Pathophysiology, Diagnosis, and Management of Upper Extremity Deep Vein Thrombosis.

PubMed

Noyes, Adam M; Dickey, John

2017-05-01

Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT. Thus, education on recognition, classification and management is critical to avoid long-term sequelae and mortality from UEDVT. [Full article available at http://rimed.org/rimedicaljournal-2017-05.asp].

Accessory superficial ulnar artery: a case report.

PubMed

Solan, Shweta

2013-12-01

Variations in the arterial system of the upper limb have been well documented. A thorough knowledge on variations of arteries of upper extremity is necessary during performance of vascular and reconstructive surgeries and also, during evaluation of angiographic images. A case of accessory superficial ulnar artery was reported. The ulnar artery had a high origin from the brachial artery, in the upper third of the arm and it proceeded superficially and lateral to ulnar nerve in forearm, but it had a normal termination in the hand. The brachial artery had a usual course in the arm, but in the cubital fossa, it divided into the radial and deep ulnar arteries. This deep ulnar artery ended by dividing into ulnar recurrent and common interosseous arteries. Knowledge on this variation is important for the radiologists, orthopaedic and plastic surgeons, for appropriate planning of operative procedures involving the arteries of the upper limb.

Accessory Superficial Ulnar Artery: A Case Report

PubMed Central

Solan, Shweta

2013-01-01

Variations in the arterial system of the upper limb have been well documented. A thorough knowledge on variations of arteries of upper extremity is necessary during performance of vascular and reconstructive surgeries and also, during evaluation of angiographic images. A case of accessory superficial ulnar artery was reported. The ulnar artery had a high origin from the brachial artery, in the upper third of the arm and it proceeded superficially and lateral to ulnar nerve in forearm, but it had a normal termination in the hand. The brachial artery had a usual course in the arm, but in the cubital fossa, it divided into the radial and deep ulnar arteries. This deep ulnar artery ended by dividing into ulnar recurrent and common interosseous arteries. Knowledge on this variation is important for the radiologists, orthopaedic and plastic surgeons, for appropriate planning of operative procedures involving the arteries of the upper limb. PMID:24551682

Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis.

PubMed

Tellis, V A; Kohlberg, W I; Bhat, D J; Driscoll, B; Veith, F J

1979-01-01

In a retrospective study of 66 PTFE arteriovenous fistulae and 71 BCH arteriovenous fistulae for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures.

Quantifying anti-gravity torques in the design of a powered exoskeleton.

PubMed

Ragonesi, Daniel; Agrawal, Sunil; Sample, Whitney; Rahman, Tariq

2011-01-01

Designing an upper extremity exoskeleton for people with arm weakness requires knowledge of the passive and active residual force capabilities of users. This paper experimentally measures the passive gravitational torques of 3 groups of subjects: able-bodied adults, able bodied children, and children with neurological disabilities. The experiment involves moving the arm to various positions in the sagittal plane and measuring the gravitational force at the wrist. This force is then converted to static gravitational torques at the elbow and shoulder. Data are compared between look-up table data based on anthropometry and empirical data. Results show that the look-up torques deviate from experimentally measured torques as the arm reaches up and down. This experiment informs designers of Upper Limb orthoses on the contribution of passive human joint torques.

New Exoskeleton Arm Concept Design And Actuation For Haptic Interaction With Virtual Objects

NASA Astrophysics Data System (ADS)

Chakarov, D.; Veneva, I.; Tsveov, M.; Tiankov, T.

2014-12-01

In the work presented in this paper the conceptual design and actuation of one new exoskeleton of the upper limb is presented. The device is designed for application where both motion tracking and force feedback are required, such as human interaction with virtual environment or rehabilitation tasks. The choice is presented of mechanical structure kinematical equivalent to the structure of the human arm. An actuation system is selected based on braided pneumatic muscle actuators. Antagonistic drive system for each joint is shown, using pulley and cable transmissions. Force/displacement diagrams are presented of two antagonistic acting muscles. Kinematics and dynamic estimations are performed of the system exoskeleton and upper limb. Selected parameters ensure in the antagonistic scheme joint torque regulation and human arm range of motion.

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau

PubMed Central

Aaby, Peter; Gomes, Joaquim; Fernandes, Manuel; Djana, Queba; Lisse, Ida; Jensen, Henrik

1999-01-01

Objective To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Design Follow up study of 3 months. Setting Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. Participants 422 children aged 9-23 months in 30 clusters. Main outcome measures Mid-upper arm circumference and survival in relation to residence status. Results During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee’s stay in Prabis compared with the period after the departure of the refugees. Conclusion In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability. Key messagesDuring the war in Guinea-Bissau, most of the population fled from the capital and moved in with relatives, friends, or strangersInternational agencies insisted on only providing help to refugees (internally displaced people)During the first month of conflict, there were already profound effects on the nutritional status and mortality of young childrenFood consumption was higher in resident families, but resident children were more malnourished and had higher mortality than refugee childrenNutritional status and survival improved for both refugee and resident children once the refugees returned to Bissau PMID:10506040

Design and pilot validation of A-gear: a novel wearable dynamic arm support.

PubMed

Kooren, Peter N; Dunning, Alje G; Janssen, Mariska M H P; Lobo-Prat, Joan; Koopman, Bart F J M; Paalman, Micha I; de Groot, Imelda J M; Herder, Just L

2015-09-18

Persons suffering from progressive muscular weakness, like those with Duchenne muscular dystrophy (DMD), gradually lose the ability to stand, walk and to use their arms. This hinders them from performing daily activities, social participation and being independent. Wheelchairs are used to overcome the loss of walking. However, there are currently few efficient functional substitutes to support the arms. Arm supports or robotic arms can be mounted to wheelchairs to aid in arm motion, but they are quite visible (stigmatizing), and limited in their possibilities due to their fixation to the wheelchair. The users prefer inconspicuous arm supports that are comfortable to wear and easy to control. In this paper the design, characterization, and pilot validation of a passive arm support prototype, which is worn on the body, is presented. The A-gear runs along the body from the contact surface between seat and upper legs via torso and upper arm to the forearm. Freedom of motion is accomplished by mechanical joints, which are nearly aligned with the human joints. The system compensates for the arm weight, using elastic bands for static balance, in every position of the arm. As opposed to existing devices, the proposed kinematic structure allows trunk motion and requires fewer links and less joint space without compromising balancing precision. The functional prototype has been validated in three DMD patients, using 3D motion analysis. Measurements have shown increased arm performance when the subjects were wearing the prototype. Upward and forward movements were easier to perform. The arm support is easy to put on and remove. Moreover, the device felt comfortable for the subjects. However, downward movements were more difficult, and the patients would prefer the device to be even more inconspicuous. The A-gear prototype is a step towards inconspicuousness and therefore well-received dynamic arm supports for people with muscular weakness.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Tectonic study of the extension of the New Madrid fault zone near its intersection with the 38th parallel lineament

DOE Office of Scientific and Technical Information (OSTI.GOV)

Braile, L.W.; Hinze, W.J.; Sexton, J.L.

1982-06-01

Gravity, magnetic, geologic, and seismicity data have been combined in a seismotectonic analysis of the New Madrid seismic zone. Previous studies have presented evidence for several rift zones in this area (Upper Mississippi enmbayment), including the Reelfoot rift, a late precambrian-early Paleozoic failed arm which extends north-northeast from the ancient continental margin. We suggest that the northern terminus of the Reelfoot rift forms a rift complex, with arms extending northeast into southwestern Indiana, northwest along the Mississippi River, and east into western Kentucky, which appears to correlate well with the seismicity in the area. This correlation suggests that faults associatedmore » with this rift complex are being reactivated in the contemporary stress field (east-northeast compression). If this interpretation is valid, it represents a seismotectonic model which can be used to predict the extent of future seismicity in the New Madrid seismic zone. The proposed rift complex also provides a coherent model for the tectonic development of this region of the North American midcontinent.« less

Grip strength and body composition in Turkana pastoralist children and adolescents.

PubMed

Little, Michael A

2017-03-01

In an earlier study, age changes and sex differences in grip strength were documented for adult Turkana pastoralists of Kenya (Little and Johnson, 1986). The objective here is to characterize age changes and sex differences in grip strength of Turkana children and adolescents in the context of arm lean tissue composition, and in comparison with other African, African-American, and non-Western populations. Anthropometric measurements, derived body composition values, and grip strength measures (maximum voluntary contraction) were taken on a sample of 232 nomadic Turkana pastoralist children (94 boys and 138 girls) aged 3 to 21 years. Relationships were tested between grip strength (in Newtons) and mid-upper arm (brachium) lean tissue cross-sectional areas. Comparisons were made among several different ethnic groups. Turkana children and adolescents had low arm muscle (derived lean tissue) and grip strength values when compared with U.S. NHANES percentile references. Girls' percentile rankings were greater than boys' percentile rankings for muscle and for grip strength. Both boys and girls were intermediate when compared with other non-Western populations and U.S. strength grip reference values. Correlations between grip strength and arm lean tissue areas were highly significant for both boys and girls. The greater relative muscle size and grip strength values of late adolescent girls compared to boys is consistent with an earlier study of adults. The difference is likely to result from greater physical subsistence activity and greater access to food in girls than in boys. Several suggestions are given to explain why Turkana youths have relatively small muscle sizes. © 2016 Wiley Periodicals, Inc.

Microvascular responses to (hyper-)gravitational stress by short-arm human centrifuge: arteriolar vasoconstriction and venous pooling.

PubMed

Habazettl, H; Stahn, Alexander; Nitsche, Andrea; Nordine, Michael; Pries, A R; Gunga, H-C; Opatz, O

2016-01-01

We hypothesized that lower body microvessels are particularly challenged during exposure to gravity and hypergravity leading to failure of resistance vessels to withstand excessive transmural pressure during hypergravitation and gravitation-dependent microvascular blood pooling. Using a short-arm human centrifuge (SAHC), 12 subjects were exposed to +1Gz, +2Gz and +1Gz, all at foot level, for 4 min each. Laser Doppler imaging and near-infrared spectroscopy were used to measure skin perfusion and tissue haemoglobin concentrations, respectively. Pretibial skin perfusion decreased by 19% during +1Gz and remained at this level during +2Gz. In the dilated area, skin perfusion increased by 24 and 35% during +1Gz and +2Gz, respectively. In the upper arm, oxygenated haemoglobin (Hb) decreased, while deoxy Hb increased with little change in total Hb. In the calf muscle, O2Hb and deoxy Hb increased, resulting in total Hb increase by 7.5 ± 1.4 and 26.6 ± 2.6 µmol/L at +1Gz and +2Gz, respectively. The dynamics of Hb increase suggests a fast and a slow component. Despite transmural pressures well beyond the upper myogenic control limit, intact lower body resistance vessels withstand these pressures up to +2Gz, suggesting that myogenic control may contribute only little to increased vascular resistance. The fast component of increasing total Hb indicates microvascular blood pooling contributing to soft tissue capacitance. Future research will have to address possible alterations of these acute adaptations to gravity after deconditioning by exposure to micro-g.

Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.

PubMed

Lee, Daegu; Hwang, Ji Hye; Chu, Inho; Chang, Hyun Ju; Shim, Young Hun; Kim, Jung Hyun

2015-08-01

The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema. Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups. Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores. Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.

Relationship between self-reported upper limb disability and quantitative tests in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2007-03-15

To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS). A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire. PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%. Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.

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

PubMed

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

2011-01-01

A novel system has been developed which combines robotic therapy with electrical stimulation (ES) for upper limb stroke rehabilitation. This technology, termed SAIL: Stimulation Assistance through Iterative Learning, employs advanced model-based iterative learning control (ILC) algorithms to precisely assist participant's completion of 3D tracking tasks with their impaired arm. Data is reported from a preliminary study with unimpaired participants, and also from a single hemiparetic stroke participant with reduced upper limb function who has used the system in a clinical trial. All participants completed tasks which involved moving their (impaired) arm to follow an image of a slowing moving sphere along a trajectory. The participants' arm was supported by a robot and ES was applied to the triceps brachii and anterior deltoid muscles. During each task, the same tracking trajectory was repeated 6 times and ILC was used to compute the stimulation signals to be applied on the next iteration. Unimpaired participants took part in a single, one hour training session and the stroke participant undertook 18, 1 hour treatment sessions composed of tracking tasks varying in length, orientation and speed. The results reported describe changes in tracking ability and demonstrate feasibility of the SAIL system for upper limb rehabilitation. © 2011 IEEE

Network of movement and proximity sensors for monitoring upper-extremity motor activity after stroke: proof of principle.

PubMed

Sokal, Brad; Uswatte, Gitendra; Barman, Joydip; Brewer, Michael; Byrom, Ezekiel; Latten, Jessica; Joseph, Jeethu; Serafim, Camila; Ghaffari, Touraj; Sarkar, Nilanjan

2014-03-01

To test the convergent validity of an objective method, Sensor-Enabled Radio-frequency Identification System for Monitoring Arm Activity (SERSMAA), that distinguishes between functional and nonfunctional activity. Cross-sectional study. Laboratory. Participants (N=25) were ≥0.2 years poststroke (median, 9) with a wide range of severity of upper-extremity hemiparesis. Not applicable. After stroke, laboratory tests of the motor capacity of the more-affected arm poorly predict spontaneous use of that arm in daily life. However, available subjective methods for measuring everyday arm use are vulnerable to self-report biases, whereas available objective methods only provide information on the amount of activity without regard to its relation with function. The SERSMAA consists of a proximity-sensor receiver on the more-affected arm and multiple units placed on objects. Functional activity is signaled when the more-affected arm is close to an object that is moved. Participants were videotaped during a laboratory simulation of an everyday activity, that is, setting a table with cups, bowls, and plates instrumented with transmitters. Observers independently coded the videos in 2-second blocks with a validated system for classifying more-affected arm activity. There was a strong correlation (r=.87, P<.001) between time that the more-affected arm was used for handling objects according to the SERSMAA and functional activity according to the observers. The convergent validity of SERSMAA for measuring more-affected arm functional activity after stroke was supported in a simulation of everyday activity. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Extrinsic and intrinsic index finger muscle attachments in an OpenSim upper-extremity model.

PubMed

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

2015-04-01

Musculoskeletal models allow estimation of muscle function during complex tasks. We used objective methods to determine possible attachment locations for index finger muscles in an OpenSim upper-extremity model. Data-driven optimization algorithms, Simulated Annealing and Hook-Jeeves, estimated tendon locations crossing the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints by minimizing the difference between model-estimated and experimentally-measured moment arms. Sensitivity analysis revealed that multiple sets of muscle attachments with similar optimized moment arms are possible, requiring additional assumptions or data to select a single set of values. The most smooth muscle paths were assumed to be biologically reasonable. Estimated tendon attachments resulted in variance accounted for (VAF) between calculated moment arms and measured values of 78% for flex/extension and 81% for ab/adduction at the MCP joint. VAF averaged 67% at the PIP joint and 54% at the DIP joint. VAF values at PIP and DIP joints partially reflected the constant moment arms reported for muscles about these joints. However, all moment arm values found through optimization were non-linear and non-constant. Relationships between moment arms and joint angles were best described with quadratic equations for tendons at the PIP and DIP joints.

Constrained handgrip force decreases upper extremity muscle activation and arm strength.

PubMed

Smets, Martin P H; Potvin, James R; Keir, Peter J

2009-09-01

Many industrial tasks require repetitive shoulder exertions to be performed with concurrent physical and mental demands. The highly mobile nature of the shoulder predisposes it to injury. The purpose of this study was to determine the effects of simultaneous gripping, at a specified magnitude, on muscle activity and maximal arm force in various directions. Ten female subjects performed maximal arm exertions at two different heights and five directions using both specified (30% maximum voluntary grip) and preferred (self-selected) grip forces. Electromyography was recorded from eight muscles of the right upper extremity. The preferred grip condition produced grip forces that were dependent on the combination of arm height and force direction and were significantly greater (arm force down), lower (to left, up and push forward), or similar to the specified grip condition. Regardless of the magnitude of the preferred grip force, specifying the grip resulted in decreased maximal arm strength (by 18-25%) and muscle activity (by 15-30%) in all conditions, indicating an interfering effect when the grip force was specified by visual target force-matching. Task constraints, such as specific gripping demands, may decrease peak force levels attainable and alter muscle activity. Depending on the nature of task, the amount of relative demand may differ, which should be considered when determining safety thresholds.

Movement quality of conventional prostheses and the DEKA Arm during everyday tasks

PubMed Central

Cowley, Jeffrey; Resnik, Linda; Wilken, Jason; Walters, Lisa Smurr; Gates, Deanna

2017-01-01

Background Conventional prosthetic devices fail to restore the function and characteristic movement quality of the upper limb. The DEKA Arm is a new, advanced prosthesis featuring a compound, powered wrist and multiple grip configurations. Objectives The purpose of this study was to determine if the DEKA Arm improved the movement quality of upper limb prosthesis users compared to conventional prostheses. Study design Case series. Methods Three people with transradial amputation completed tasks of daily life with their conventional prosthesis and with the DEKA Arm. A total of 10 healthy controls completed the same tasks. The trajectory of the wrist joint center was analyzed to determine how different prostheses affected movement duration, speed, smoothness, and curvature compared to patients’ own intact limbs and controls. Results Movement quality decreased with the DEKA Arm for two participants, and increased for the third. Prosthesis users made slower, less smooth, more curved movements with the prosthetic limb compared to the intact limb and controls, particularly when grasping and manipulating objects. Conclusion The effects of one month of training with the DEKA Arm on movement quality varied with participants’ skill and experience with conventional prostheses. Future studies should examine changes in movement quality after long-term use of advanced prostheses. PMID:26932980

A Mirror Therapy-Based Action Observation Protocol to Improve Motor Learning After Stroke.

PubMed

Harmsen, Wouter J; Bussmann, Johannes B J; Selles, Ruud W; Hurkmans, Henri L P; Ribbers, Gerard M

2015-07-01

Mirror therapy is a priming technique to improve motor function of the affected arm after stroke. To investigate whether a mirror therapy-based action observation (AO) protocol contributes to motor learning of the affected arm after stroke. A total of 37 participants in the chronic stage after stroke were randomly allocated to the AO or control observation (CO) group. Participants were instructed to perform an upper-arm reaching task as fast and as fluently as possible. All participants trained the upper-arm reaching task with their affected arm alternated with either AO or CO. Participants in the AO group observed mirrored video tapes of reaching movements performed by their unaffected arm, whereas participants in the CO group observed static photographs of landscapes. The experimental condition effect was investigated by evaluating the primary outcome measure: movement time (in seconds) of the reaching movement, measured by accelerometry. Movement time decreased significantly in both groups: 18.3% in the AO and 9.1% in the CO group. Decrease in movement time was significantly more in the AO compared with the CO group (mean difference = 0.14 s; 95% confidence interval = 0.02, 0.26; P = .026). The present study showed that a mirror therapy-based AO protocol contributes to motor learning after stroke. © The Author(s) 2014.

Feedforward control strategies of subjects with transradial amputation in planar reaching.

PubMed

Metzger, Anthony J; Dromerick, Alexander W; Schabowsky, Christopher N; Holley, Rahsaan J; Monroe, Brian; Lum, Peter S

2010-01-01

The rate of upper-limb amputations is increasing, and the rejection rate of prosthetic devices remains high. People with upper-limb amputation do not fully incorporate prosthetic devices into their activities of daily living. By understanding the reaching behaviors of prosthesis users, researchers can alter prosthetic devices and develop training protocols to improve the acceptance of prosthetic limbs. By observing the reaching characteristics of the nondisabled arms of people with amputation, we can begin to understand how the brain alters its motor commands after amputation. We asked subjects to perform rapid reaching movements to two targets with and without visual feedback. Subjects performed the tasks with both their prosthetic and nondisabled arms. We calculated endpoint error, trajectory error, and variability and compared them with those of nondisabled control subjects. We found no significant abnormalities in the prosthetic limb. However, we found an abnormal leftward trajectory error (in right arms) in the nondisabled arm of prosthetic users in the vision condition. In the no-vision condition, the nondisabled arm displayed abnormal leftward endpoint errors and abnormally higher endpoint variability. In the vision condition, peak velocity was lower and movement duration was longer in both arms of subjects with amputation. These abnormalities may reflect the cortical reorganization associated with limb loss.

An EMG-based robot control scheme robust to time-varying EMG signal features.

PubMed

Artemiadis, Panagiotis K; Kyriakopoulos, Kostas J

2010-05-01

Human-robot control interfaces have received increased attention during the past decades. With the introduction of robots in everyday life, especially in providing services to people with special needs (i.e., elderly, people with impairments, or people with disabilities), there is a strong necessity for simple and natural control interfaces. In this paper, electromyographic (EMG) signals from muscles of the human upper limb are used as the control interface between the user and a robot arm. EMG signals are recorded using surface EMG electrodes placed on the user's skin, making the user's upper limb free of bulky interface sensors or machinery usually found in conventional human-controlled systems. The proposed interface allows the user to control in real time an anthropomorphic robot arm in 3-D space, using upper limb motion estimates based only on EMG recordings. Moreover, the proposed interface is robust to EMG changes with respect to time, mainly caused by muscle fatigue or adjustments of contraction level. The efficiency of the method is assessed through real-time experiments, including random arm motions in the 3-D space with variable hand speed profiles.

Professional tennis players' serve: correlation between segmental angular momentums and ball velocity.

PubMed

Martin, Caroline; Kulpa, Richard; Delamarche, Paul; Bideau, Benoit

2013-03-01

The purpose of the study was to identify the relationships between segmental angular momentum and ball velocity between the following events: ball toss, maximal elbow flexion (MEF), racket lowest point (RLP), maximal shoulder external rotation (MER), and ball impact (BI). Ten tennis players performed serves recorded with a real-time motion capture. Mean angular momentums of the trunk, upper arm, forearm, and the hand-racket were calculated. The anteroposterior axis angular momentum of the trunk was significantly related with ball velocity during the MEF-RLP, RLP-MER, and MER-BI phases. The strongest relationships between the transverse-axis angular momentums and ball velocity followed a proximal-to-distal timing sequence that allows the transfer of angular momentum from the trunk (MEF-RLP and RLP-MER phases) to the upper arm (RLP-MER phase), forearm (RLP-MER and MER-BI phases), and the hand-racket (MER-BI phase). Since sequence is crucial for ball velocity, players should increase angular momentums of the trunk during MEF-MER, upper arm during RLP-MER, forearm during RLP-BI, and the hand-racket during MER-BI.

SAR Observation and Modeling of Gap Winds in the Prince William Sound of Alaska.

PubMed

Liu, Haibo; Olsson, Peter Q; Volz, Karl

2008-08-22

Alaska's Prince William Sound (PWS) is a unique locale tending to have strong gap winds, especially in the winter season. To characterize and understand these strong surface winds, which have great impacts on the local marine and aviation activities, the surface wind retrieval from the Synthetic Aperture Radar data (SAR-wind) is combined with a numerical mesoscale model. Helped with the SAR-wind observations, the mesoscale model is used to study cases of strong winds and relatively weak winds to depict the nature of these winds, including the area of extent and possible causes of the wind regimes. The gap winds from the Wells Passage and the Valdez Arm are the most dominant gap winds in PWS. Though the Valdez Arm is north-south trending and Wells Passage is east-west oriented, gap winds often develop simultaneously in these two places when a low pressure system is present in the Northern Gulf of Alaska. These two gap winds often converge at the center of PWS and extend further out of the Sound through the Hinchinbrook Entrance. The pressure gradients imposed over these areas are the main driving forces for these gap winds. Additionally, the drainage from the upper stream glaciers and the blocking effect of the banks of the Valdez Arm probably play an important role in enhancing the gap wind.

Arm mechanical efficiency and arm exercise capacity are relatively preserved in chronic obstructive pulmonary disease.

PubMed

Franssen, Frits M E; Wouters, Emiel F M; Baarends, Erica M; Akkermans, Marco A; Schols, Annemie M W J

2002-10-01

Previous studies indicate that energy expenditure related to physical activity is enhanced and that mechanical efficiency of leg exercise is reduced in patients with chronic obstructive pulmonary disease (COPD). However, it is yet unclear whether an inefficient energy expenditure is also present during other activities in COPD. This study was carried out to examine arm efficiency and peak arm exercise performance relative to leg exercise in 33 (23 male) patients with COPD ((mean +/- SEM) age: 61 +/- 2 yr; FEV : 40 +/- 2% of predicted) and 20 sex- and age-matched healthy controls. Body composition, pulmonary function, resting energy expenditure (REE), and peak leg and arm exercise performance were determined. To calculate mechanical efficiency, subjects performed submaximal leg and arm ergometry at 50% of achieved peak loads. During exercise testing, metabolic and ventilatory parameters were measured. In contrast to a reduced leg mechanical efficiency in patients compared with controls (15.6 +/- 0.6% and 22.5 +/- 0.6%, respectively; < 0.001), arm mechanical efficiency was comparable in both groups (COPD: 18.3 +/- 0.9%, controls: 21.0 +/- 1.2%; NS). Arm efficiency was not related to leg efficiency, pulmonary function, work of breathing, or REE. Also, arm exercise capacity was relatively preserved in patients with COPD (ratio arm peak work rate/leg peak work rate in patients: 89% vs 53% in controls; < 0.001). Mechanical efficiency and exercise capacity of the upper and lower limbs are not homogeneously affected in COPD, with a relative preservation of the upper limbs. This may have implications for screening of exercise tolerance and prescription of training interventions in patients with COPD. Future studies need to elucidate the mechanism behind this observation.

Upper quadrant port placement for robot-assisted renal surgery: implementation of the Floating Arm and the XL Protype.

PubMed

Totonchi, Samer; Elgin, Robert; Monahan, Michael; Johnston, William K

2014-08-01

Abstract Background and Purpose: Placement of the fourth arm (4th arm) in the lower quadrant (LQ) is commonly described for robot-assisted renal surgical procedures but has anatomic restrictions and limited ergonomics. An alternative, upper quadrant (UQ) location is desirable, but patient habitus and spacing may restrict robotic attachment. We investigate current trends in 4th arm port placement and propose an alternative method at attaching the robot-the "Floating Arm" (FLA). Robotic surgeons from the Endourological Society were surveyed. A 20-cm extra-long (XL Protype) da Vinci instrument was developed for the FLA technique. A dry lab allowed quantitative comparison of spacing and ranges of motion for standard da Vinci ports (dVP), bariatric dVP, telescoping dVP, and FLA. There were 108 respondents who participated. Half of the respondents avoid using the 4th arm (30% lack of need and 20% because of interference). The majority (90%) typically positions the 4th arm in the LQ, but many reported limitations in this location. Few (5%) place 4th arm in the UQ, while most (73%) have never heard of UQ placement. Existing techniques may increase shoulder height clearance but inversely shorten the working length of the instrument intracorporeally. Alternatively, the XL Protype significantly increased the shoulder length and maintained available working distances intracorporeally. Adjacent arm interference angle was essentially identical (27 degrees) for all ports except a greater range of movement for the XL Protype (35 degrees). Few surgeons are using an UQ positioning or use techniques to improve attachment of the 4th arm. The greatest freedom may be obtained by implementing the FLA, but this necessitates production of a longer instrument.

Robotic Technologies and Rehabilitation: New Tools for Stroke Patients' Therapy

PubMed Central

Poli, Patrizia; Morone, Giovanni; Rosati, Giulio; Masiero, Stefano

2013-01-01

Introduction. The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.” Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. Conclusions. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment. PMID:24350244

Curiosity Low-Angle Self-Portrait at Buckskin Drilling Site on Mount Sharp

NASA Image and Video Library

2015-08-19

This low-angle self-portrait of NASA's Curiosity Mars rover shows the vehicle above the "Buckskin" rock target, where the mission collected its seventh drilled sample. The site is in the "Marias Pass" area of lower Mount Sharp. The scene combines dozens of images taken by Curiosity's Mars Hand Lens Imager (MAHLI) on Aug. 5, 2015, during the 1,065th Martian day, or sol, of the rover's work on Mars. The 92 component images are among MAHLI Sol 1065 raw images at http://mars.nasa.gov/msl/multimedia/raw/?s=1065&camera=MAHLI. For scale, the rover's wheels are 20 inches (50 centimeters) in diameter and about 16 inches (40 centimeters) wide. Curiosity drilled the hole at Buckskin during Sol 1060 (July 30, 2015). Two patches of pale, powdered rock material pulled from Buckskin are visible in this scene, in front of the rover. The patch closer to the rover is where the sample-handling mechanism on Curiosity's robotic arm dumped collected material that did not pass through a sieve in the mechanism. Sieved sample material was delivered to laboratory instruments inside the rover. The patch farther in front of the rover, roughly triangular in shape, shows where fresh tailings spread downhill from the drilling process. The drilled hole, 0.63 inch (1.6 centimeters) in diameter, is at the upper point of the tailings. The rover is facing northeast, looking out over the plains from the crest of a 20-foot (6-meter) hill that it climbed to reach the Marias Pass area. The upper levels of Mount Sharp are visible behind the rover, while Gale Crater's northern rim dominates the horizon on the left and right of the mosaic. A portion of this selfie cropped tighter around the rover is at PIA19808. Another version of the wide view, presented in a projection that shows the horizon as a circle, is at PIA19806. MAHLI is mounted at the end of the rover's robotic arm. For this self-portrait, the rover team positioned the camera lower in relation to the rover body than for any previous full self-portrait of Curiosity. This yielded a view that includes the rover's "belly," as in a partial self-portrait (PIA16137) taken about five weeks after Curiosity's August 2012 landing inside Mars' Gale Crater. Before sending Curiosity the arm-positioning commands for this Buckskin belly panorama, the team previewed the low-angle sequence of camera pointings on a test rover in California. A mosaic from that test is at PIA19810. This selfie at Buckskin does not include the rover's robotic arm beyond a portion of the upper arm held nearly vertical from the shoulder joint. Shadows from the rest of the arm and the turret of tools at the end of the arm are visible on the ground. With the wrist motions and turret rotations used in pointing the camera for the component images, the arm was positioned out of the shot in the frames or portions of frames used in this mosaic. This process was used previously in acquiring and assembling Curiosity self-portraits taken at sample-collection sites "Rocknest" (PIA16468), "John Klein" (PIA16937), "Windjana" (PIA18390) and "Mojave" (PIA19142). MAHLI was built by Malin Space Science Systems, San Diego. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology in Pasadena, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington. JPL designed and built the project's Curiosity rover. http://photojournal.jpl.nasa.gov/catalog/PIA19807

Implementation of a smartphone as a wireless gyroscope platform for quantifying reduced arm swing in hemiplegie gait with machine learning classification by multilayer perceptron neural network.

PubMed

LeMoyne, Robert; Mastroianni, Timothy

2016-08-01

Natural gait consists of synchronous and rhythmic patterns for both the lower and upper limb. People with hemiplegia can experience reduced arm swing, which can negatively impact the quality of gait. Wearable and wireless sensors, such as through a smartphone, have demonstrated the ability to quantify various features of gait. With a software application the smartphone (iPhone) can function as a wireless gyroscope platform capable of conveying a gyroscope signal recording as an email attachment by wireless connectivity to the Internet. The gyroscope signal recordings of the affected hemiplegic arm with reduced arm swing arm and the unaffected arm are post-processed into a feature set for machine learning. Using a multilayer perceptron neural network a considerable degree of classification accuracy is attained to distinguish between the affected hemiplegic arm with reduced arm swing arm and the unaffected arm.

Disorders of Upper Limb Movements in Ataxia-Telangiectasia

PubMed Central

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

2013-01-01

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

Disorders of Upper Limb Movements in Ataxia-Telangiectasia.

PubMed

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

2013-01-01

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

Stump sensibility in children with upper limb reduction deficiency.

PubMed

Reinkingh, Marianne; Reinders-Messelink, Heleen A; Dijkstra, Pieter U; Maathuis, Karel G B; van der Sluis, Corry K

2014-01-01

To compare stump sensibility in children with upper limb reduction deficiency with sensibility of the unaffected arm and hand. In addition, to evaluate the associations between stump sensibility, stump length and activity level. Cross-sectional study. Children and young adults aged 6-25 years with upper limb reduction deficiency. Threshold of touch was measured with Semmes-Weinstein monofilaments, stereognosis was measured with the Shape-Texture Identification test and kinaesthesia and activity level was measured with the Child Amputee Prosthetics Project - Functional Status Inventory and the Prosthetic Upper Extremity Functional Index. A total of 31 children with upper limb reduction deficiency (mean age 15 years, 3 prosthesis wearers) were investigated. The threshold of touch of the stump circumference was lower (indicating higher sensibility) than of the unaffected arm (p = 0.006), hand (p = 0.004) and stump end-point (p = < 0.001). Long stumps had higher threshold of touch (indicating lower sensibility) than short stumps (p = 0.046). Twenty-nine children recognized 1 or more shapes or textures with the stump. Kinaesthesia in the affected and unaffected sides was comparable. Sensibility was not correlated with activity level. Threshold of touch, stereognosis and kinaesthesia of the affected sides were excellent. Threshold of touch of the stump circumference was lower (indicating higher sensibility) than of the unaffected arm and hand. High stump sensibility may clarify good functioning in the children without prostheses and contribute to prosthesis rejection.

Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls.

PubMed

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-11-01

Previous studies have indicated that neck pain patients feel increased symptoms following upper limb activities, and altered axioscapular muscle function has been proposed as a contributing factor. Pain sensitivity and muscle activity, during arm movements, were assessed in neck pain patients and controls. Patients with ongoing insidious-onset neck pain (IONP, N = 16) and whiplash-associated disorders (WAD, N = 9) were included along with sex- and age-matched controls (N = 25). Six series of repeated arm abductions were performed during electromyographic (EMG) recordings from eight bilateral muscles. The first and last three series were separated by 8 min and 42 s, respectively. Each series consisted of three slow and three fast movements. Pressure pain thresholds (PPTs) were recorded bilaterally from neck, head and arm at baseline, after the third and sixth movement series. Pain intensity was recorded on an electronic visual analogue scale (VAS). Larger pain areas and higher VAS scores were found in patients compared with controls (p < 0.001), and in patients, the VAS scores increased in the course of movements (p < 0.02). PPTs were lower in patients compared with controls at all sites (p < 0.03), and these decreased during arm movements in the IONP group (p < 0.03), while increasing at head and neck sites in controls (p < 0.04). During the slow movements, increasing serratus anterior EMG activity was found in the series with short breaks in-between for the WAD group compared with IONP and controls (p < 0.001). Axioscapular movement caused different responses in pain sensitivity and muscle activity between neck pain patient groups compared with controls. Neck pain patients report increased symptoms following upper limb activities. This study shows that repeated arm movements caused differentiated responses in pain sensitivity and muscle activity between subgroups of neck pain patient and asymptomatic controls. Such findings may be of great clinical significance when planning rehabilitation for this patient population. © 2017 European Pain Federation - EFIC®.

Design & control of a 3D stroke rehabilitation platform.

PubMed

Cai, Z; Tong, D; Meadmore, K L; Freeman, C T; Hughes, A M; Rogers, E; Burridge, J H

2011-01-01

An upper limb stroke rehabilitation system is developed which combines electrical stimulation with mechanical arm support, to assist patients performing 3D reaching tasks in a virtual reality environment. The Stimulation Assistance through Iterative Learning (SAIL) platform applies electrical stimulation to two muscles in the arm using model-based control schemes which learn from previous trials of the task. This results in accurate movement which maximises the therapeutic effect of treatment. The principal components of the system are described and experimental results confirm its efficacy for clinical use in upper limb stroke rehabilitation. © 2011 IEEE

The Use of B-Mode Ultrasound for Measuring Subcutaneous Fat Thickness on the Upper Arms.

ERIC Educational Resources Information Center

Weiss, Lawrence W.; Clark, Frank C.

1985-01-01

A study was carried out to investigate the potential use of B-mode ultrasound for measuring subcutaneous fat thickness at two arm sites. B-mode sonograms and skinfold measurements were found to be highly correlated for both men and women. (Author/MT)

Packaging Of Control Circuits In A Robot Arm

NASA Technical Reports Server (NTRS)

Kast, William

1994-01-01

Packaging system houses and connects control circuitry mounted on circuit boards within shoulder, upper section, and lower section of seven-degree-of-freedom robot arm. Has modular design that incorporates surface-mount technology, multilayer circuit boards, large-scale integrated circuits, and multi-layer flat cables between sections for compactness. Three sections of robot arm contain circuit modules in form of stardardized circuit boards. Each module contains two printed-circuit cards, one of each face.

Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury

PubMed Central

Kankipati, Padmaja; Boninger, Michael L.; Gagnon, Dany; Cooper, Rory A.; Koontz, Alicia M.

2015-01-01

Study design Repeated measures design. Objective This study compared the upper extremity (UE) joint kinetics between three transfer techniques. Setting Research laboratory. Methods Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head–hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers. Results Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique. Conclusion Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement. PMID:25130053

Validation of the Andon KD-5917 automatic upper arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Guo, Wan-Gang; Li, Bing-Ling; He, Yong; Xue, Yu-Sheng; Wang, Hai-Yan; Zheng, Qiang-Sun; Xiang, Ding-Cheng

2014-08-01

To validate the Andon KD-5917 automatic upper arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Sequential same-left-arm measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained in 33 participants using the mercury sphygmomanometer and the test device. According to the validation protocol, 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 73, 98, and 99 measurements within 5, 10, and 15 mmHg for SBP and 86, 98, and 99 for DBP, respectively. The mean ± SD device-observer difference was 3.07 ± 3.68 mmHg for SBP and -0.89 ± 3.72 mmHg for DBP. The number of patients with two or three of the device-observer difference within 5 mmHg was 26 for SBP and 29 for DBP, and no patient had a device-observer difference within 5 mmHg. The Andon KD-5917 automatic upper arm blood pressure monitor can be recommended for clinical use and self-measurement in an adult population on the basis of the European Society of Hypertension International Protocol revision 2010.

RMS upper boom framed by aft flight deck viewing window W10

NASA Technical Reports Server (NTRS)

1983-01-01

Remote Manipulator System (RMS) upper arm boom (tear in multilayer beta cloth) deployed during dynamic interaction test using Payload Flight Test Article (PFTA) is visible outside aft viewing window W10. RMS 'Canada' insignia or logo appears on boom.

Skin Barrier Function and Staphylococcus aureus Colonization in Vestibulum Nasi and Fauces in Healthy Infants and Infants with Eczema: A Population-Based Cohort Study.

PubMed

Berents, Teresa Løvold; Carlsen, Karin Cecilie Lødrup; Mowinckel, Petter; Skjerven, Håvard Ove; Kvenshagen, Bente; Rolfsjord, Leif Bjarte; Bradley, Maria; Lieden, Agne; Carlsen, Kai-Håkon; Gaustad, Peter; Gjersvik, Petter

2015-01-01

Atopic eczema (AE) is associated with Staphylococcus aureus (S. aureus) colonization and skin barrier dysfunction, often measured by increased transepidermal water loss (TEWL). In the present study, the primary aim was to see whether S. aureus colonization in the vestibulum nasi and/or fauces was associated with increased TEWL in infants with healthy skin and infants with eczema. Secondarily, we aimed to investigate whether TEWL measurements on non-lesional skin on the lateral upper arm is equivalent to volar forearm in infants. In 167 of 240 infants, recruited from the general population, TEWL measurements on the lateral upper arm and volar forearm, using a DermaLab USB, fulfilled our environmental requirements. The mean of three TEWL measurements from each site was used for analysis. The infants were diagnosed with no eczema (n = 110), possible AE (n = 28) or AE (n = 29). DNA samples were analysed for mutations in the filaggrin gene (FLG). Bacterial cultures were reported positive with the identification of at least one culture with S. aureus from vestibulum nasi and/or fauces. S. aureus colonization, found in 89 infants (53%), was not associated with increased TEWL (i.e. TEWL in the upper quartile), neither on the lateral upper arm or volar forearm (p = 0.08 and p = 0.98, respectively), nor with AE (p = 0.10) or FLG mutation (p = 0.17). TEWL was significantly higher on both measuring sites in infants with AE compared to infants with possible AE and no eczema. FLG mutation was significantly associated with increased TEWL, with a 47% difference in TEWL. We conclude that S. aureus in vestibulum nasi and/or fauces was not associated with TEWL, whereas TEWL measurements on the lateral upper arm and volar forearm appear equally appropriate in infants.

Non-elite gymnastics participation is associated with greater bone strength, muscle size, and function in pre- and early pubertal girls.

PubMed

Burt, L A; Naughton, G A; Greene, D A; Courteix, D; Ducher, G

2012-04-01

Recent reports indicate an increase in forearm fractures in children. Bone geometric properties are an important determinant of bone strength and therefore fracture risk. Participation in non-elite gymnastics appears to contribute to improving young girls' musculoskeletal health, more specifically in the upper body. The primary aim of this study was to determine the association between non-elite gymnastics participation and upper limb bone mass, geometry, and strength in addition to muscle size and function in young girls. Eighty-eight pre- and early pubertal girls (30 high-training gymnasts [HGYM, 6-16 hr/ wk], 29 low-training gymnasts [LGYM, 1-5 h r/wk] and 29 non-gymnasts [NONGYM]), aged 6-11 years were recruited. Upper limb lean mass, BMD and BMC were derived from a whole body DXA scan. Forearm volumetric BMD, bone geometry, estimated strength, and muscle CSA were determined using peripheral QCT. Upper body muscle function was investigated with muscle strength, explosive power, and muscle endurance tasks. HGYM showed greater forearm bone strength compared with NGYM, as well as greater arm lean mass, BMC, and muscle function (+5% to +103%, p < 0.05). LGYM displayed greater arm lean mass, BMC, muscle power, and endurance than NGYM (+4% to +46%, p < 0.05); however, the difference in bone strength did not reach significance. Estimated fracture risk at the distal radius, which accounted for body weight, was lower in both groups of gymnasts. Compared with NONGYM, HGYM tended to show larger skeletal differences than LGYM; yet, the two groups of gymnasts only differed for arm lean mass and muscle CSA. Non-elite gymnastics participation was associated with musculoskeletal benefits in upper limb bone geometry, strength and muscle function. Differences between the two gymnastic groups emerged for arm lean mass and muscle CSA, but not for bone strength.

Combined treatment of botulinumtoxin and robot-assisted rehabilitation therapy on poststroke, upper limb spasticity

PubMed Central

Lee, So Young; Jeon, Young Tae; Kim, Bo Ryun; Han, Eun Young

2017-01-01

Abstract Rationale: Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke. Patient concerns: Two subacute stroke patients were transferred to the Department of Rehabilitation. Diagnoses: Patients demonstrated spasticity in the upper extremity on the affected side. Interventions: BoNT-A was injected into the paretic muscles of the shoulder, arm, and forearm of the 2 patients at the subacute stage. Conventional rehabilitation therapy and robot-assisted upper limb training were performed during the rehabilitation period. Outcomes: Manual dexterity, grip strength, muscle tone, and activities of daily living function were improved after multidisciplinary rehabilitation treatment. Lessons: BoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery. PMID:29390585

A Pilot Study: Comparison of Arm Versus Ankle Noninvasive Blood Pressure Measurement at 2 Different Levels of Backrest Elevation.

PubMed

Henley, Nicole; Quatrara, Beth D; Conaway, Mark

2015-01-01

Standard practice for obtaining noninvasive blood pressure includes arm blood pressure (BP) cuff placement at the level of the heart; however, some critical care patients cannot have BPs taken in their arm because of various conditions, and ankle BPs are frequently used as substitutes. The aim of this study was to determine if there was a significant variation between upper arm and ankle BP measurements at different backrest elevations with consideration of peripheral edema factors. After institutional review board approval was obtained, a pilot study was implemented to evaluate noninvasive BP measurements of the arm and ankle with backrest elevation at 0° and 30° in a population of medical intensive care unit patients. Participants served as their own controls and were randomly assigned to left- versus right-side BP readings. Data were also collected on presence of arm versus ankle edema. A total of 30 participants enrolled in the study and provided 120 BP measurements. Blood pressure readings were analyzed in terms of diastolic and systolic findings as well as backrest elevations and edema presence. Thirteen participants presented with either arm or ankle edema. There was a statistical difference between the systolic arm and ankle BP measurements in the 0° (P = .008) and 30° (P < .001) backrest elevation positions. The correlation between arm and ankle diastolic BP is greater for participants without ankle edema (P = .038, r = 0.54) than for participants with ankle edema (P = .650, r = 0.14), but it is not statistically significant (P = .47). Even though ankle BPs are often substituted for arm BPs when the arm is unable to be used, ankle BPs and arm BPs are not interchangeable. Adjustments in backrest elevation and considerations of edema do not normalize the differences. Blood pressures obtained from the ankle are significantly greater than those obtained from the arm. This information needs to be considered when arms are not available and legs are used as surrogates for the upper arm.

Meta-analysis: identification of low birthweight by other anthropometric measurements at birth in developing countries.

PubMed

Goto, Eita

2011-01-01

Low birthweight should be identified early, even in developing countries where birthweight cannot be easily measured due to the absence of scales and trained staff. This meta-analysis evaluated and compared the use of other anthropometric measurements at birth to predict low birthweight. All studies of medium to high quality (Quality Assessment of Diagnostic Accuracy Studies score ≥8) published in English were included. Bivariate random-effects meta-analysis and hierarchical summary receiver operating characteristic curves were used. A total of 69 studies evaluated foot length or the circumference of the chest, (mid-upper) arm, or thigh (n = 8, 25, 30, and 6, respectively). Chest circumference and arm circumference had areas under the curve >0.9 (0.95 for both), pooled positive likelihood ratios >5 (8.7 and 10.3, respectively), and negative likelihood ratios <0.2 (0.13 and 0.17, respectively); thigh circumference and foot length were less accurate. There was no substantial difference between chest and arm circumference with respect to pooled sensitivity (0.88 vs. 0.84, P = 0.505), specificity (0.90 vs. 0.92, P = 0.565), or diagnostic odds ratio (67 vs. 60, P = 0.552). However, as compared with arm circumference, chest circumference showed greater clustering of observations on the hierarchical summary receiver operating characteristic curve and narrower 95% confidence and prediction regions. Chest circumference and arm circumference have similarly high, although not confirmative, accuracy in predicting low birthweight; however, chest circumference appears to be more precise.

Responsiveness of outcome measures for upper limb prosthetic rehabilitation.

PubMed

Resnik, Linda; Borgia, Matthew

2016-02-01

There is limited research on responsiveness of prosthetic rehabilitation outcome measures. To examine responsiveness of the Box and Block test, Jebsen-Taylor Hand Function tests, Upper Extremity Functional Scale, University of New Brunswick skill and spontaneity tests, Activity Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale. This was a quasi-experimental study with repeated measurements in a convenience sample of upper limb amputees. Measures were collected before, during, and after training with the DEKA Arm. Largest effect sizes were observed for Patient-Specific Functional Scale (effect size: 1.59, confidence interval: 1.00, 2.14), Activity Measure for Upper Limb Amputation (effect size: 1.33, confidence interval: 0.73, 1.90), and University of New Brunswick skill test (effect size: 1.18, confidence interval: 0.61, 1.73). Other measures that were responsive to change were Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, and University of New Brunswick spontaneity test. Responsiveness and pattern of responsiveness varied by prosthetic level. The Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, University of New Brunswick skill and spontaneity tests, Activities Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale were responsive to change during prosthetic training. These findings have implications for choice of measures for research and practice and inform clinicians about the amount of training necessary to maximize outcomes with the DEKA Arm. Findings on responsiveness of outcome measures have implications for the choice of measures for clinical trials and practice. Findings regarding the responsiveness to change over the course of training can inform clinicians about the amount of training that may be necessary to maximize specific outcomes with the DEKA Arm. © The International Society for Prosthetics and Orthotics 2014.

Transcutaneous Auricular Vagus Nerve Stimulation with Concurrent Upper Limb Repetitive Task Practice for Poststroke Motor Recovery: A Pilot Study.

PubMed

Redgrave, Jessica N; Moore, Lucy; Oyekunle, Tosin; Ebrahim, Maryam; Falidas, Konstantinos; Snowdon, Nicola; Ali, Ali; Majid, Arshad

2018-03-23

Invasive vagus nerve stimulation (VNS) has the potential to enhance the effects of physiotherapy for upper limb motor recovery after stroke. Noninvasive, transcutaneous auricular branch VNS (taVNS) may have similar benefits, but this has not been evaluated in stroke recovery. We sought to determine the feasibility of taVNS delivered alongside upper limb repetitive task-specific practice after stroke and its effects on a range of outcome measures evaluating limb function. Thirteen participants at more than 3 months postischemic stroke with residual upper limb dysfunction were recruited from the community of Sheffield, United Kingdom (October-December 2016). Participants underwent 18 × 1-hour sessions over 6 weeks in which they made 30-50 repetitions of 8-10 arm movements concurrently with taVNS (NEMOS; Cerbomed, Erlangen, Germany, 25 Hz, .1-millisecond pulse width) at maximum tolerated intensity (mA). An electrocardiogram and rehabilitation outcome scores were obtained at each visit. Qualitative interviews determined the acceptability of taVNS to participants. Median time after stroke was 1.16 years, and baseline median/interquartile range upper limb Fugl-Meyer (UFM) score was 63 (54.5-99.5). Participants attended 92% of the planned treatment sessions. Three participants reported side effects, mainly fatigue, but all performed mean of more than 300 arm repetitions per session with no serious adverse events. There was a significant change in the UFM score with a mean increase per participant of 17.1 points (standard deviation 7.8). taVNS is feasible and well-tolerated alongside upper limb repetitive movements in poststroke rehabilitation. The motor improvements observed justify a phase 2 trial in patients with residual arm weakness. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Locomotor-Like Leg Movements Evoked by Rhythmic Arm Movements in Humans

PubMed Central

Sylos-Labini, Francesca; Ivanenko, Yuri P.; MacLellan, Michael J.; Cappellini, Germana; Poppele, Richard E.; Lacquaniti, Francesco

2014-01-01

Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG) activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs. PMID:24608249

[Women boxing athletes' EMG of upper limbs and lumbar muscles in the training of air striking of straight punch].

PubMed

Zhang, Ri-Hui; Kang, Zhi-Xin

2011-05-01

To study training effect of upper limbs and lumbar muscles in the proceed of air striking of straight punch by analyzing boxing athletes' changes of electromyogram (EMG). We measured EMG of ten women boxing athletes' upper arm biceps (contractor muscle), upper arm triceps (antagonistic muscle), forearm flexor muscle (contractor muscle), forearm extensor muscle (antagonistic muscle), and lumbar muscles by ME6000 (Mega Electronics Ltd.). The stipulated exercise was to do air striking of straight punch with loads of 2.5 kg of dumbbell in the hand until exhausted. In the proceed of exercise-induce exhausted, the descend magnitude and speed of median frequency (MF) in upper limb antagonistic muscle exceeded to contracting muscle, moreover, the work percentage showed that contractor have done a larger percentage of work than antagonistic muscle. Compared with world champion's EMG, the majority of ordinary athletes' lumbar muscles MF revealed non-drop tendency, and the work percentage showed that lumbar muscles had a very little percentage of work. After comparing the EMG test index in upper limb and lumbar muscle of average boxing athletes with that of the world champion, we find the testees lack of the training of upper limb antagonistic muscle and lumbar muscle, and more trainings aimed at these muscles need to be taken.

Cognitive predictors of skilled performance with an advanced upper limb multifunction prosthesis: a preliminary analysis.

PubMed

Hancock, Laura; Correia, Stephen; Ahern, David; Barredo, Jennifer; Resnik, Linda

2017-07-01

Purpose The objectives were to 1) identify major cognitive domains involved in learning to use the DEKA Arm; 2) specify cognitive domain-specific skills associated with basic versus advanced users; and 3) examine whether baseline memory and executive function predicted learning. Method Sample included 35 persons with upper limb amputation. Subjects were administered a brief neuropsychological test battery prior to start of DEKA Arm training, as well as physical performance measures at the onset of, and following training. Multiple regression models controlling for age and including neuropsychological tests were developed to predict physical performance scores. Prosthetic performance scores were divided into quartiles and independent samples t-tests compared neuropsychological test scores of advanced scorers and basic scorers. Baseline neuropsychological test scores were used to predict change in scores on physical performance measures across time. Results Cognitive domains of attention and processing speed were statistically significantly related to proficiency of DEKA Arm use and predicted level of proficiency. Conclusions Results support use of neuropsychological tests to predict learning and use of a multifunctional prosthesis. Assessment of cognitive status at the outset of training may help set expectations for the duration and outcomes of treatment. Implications for Rehabilitation Cognitive domains of attention and processing speed were significantly related to level of proficiencyof an advanced multifunctional prosthesis (the DEKA Arm) after training. Results provide initial support for the use of neuropsychological tests to predict advanced learningand use of a multifunctional prosthesis in upper-limb amputees. Results suggest that assessment of patients' cognitive status at the outset of upper limb prosthetictraining may, in the future, help patients, their families and therapists set expectations for theduration and intensity of training and may help set reasonable proficiency goals.

Predictors of the risk of malnutrition among children under the age of 5 years in Somalia.

PubMed

Kinyoki, Damaris K; Berkley, James A; Moloney, Grainne M; Kandala, Ngianga-Bakwin; Noor, Abdisalan M

2015-12-01

To investigate the predictors of wasting, stunting and low mid-upper arm circumference among children aged 6-59 months in Somalia using data from household cross-sectional surveys from 2007 to 2010 in order to help inform better targeting of nutritional interventions. Cross-sectional nutritional assessment surveys using structured interviews were conducted among communities in Somalia each year from 2007 to 2010. A two-stage cluster sampling methodology was used to select children aged 6-59 months from households across three livelihood zones (pastoral, agro-pastoral and riverine). Predictors of three anthropometric measures, weight-for-height (wasting), height-for-age (stunting) and mid-upper arm circumference, were analysed using Bayesian binomial regression, controlling for both spatial and temporal dependence in the data. The study was conducted in randomly sampled villages, representative of three livelihood zones in Somalia. Children between the ages of 6 and 59 months in Somalia. The estimated national prevalence of wasting, stunting and low mid-upper arm circumference in children aged 6-59 months was 21 %, 31 % and 36 %, respectively. Although fever, diarrhoea, sex and age of the child, household size and access to foods were significant predictors of malnutrition, the strongest association was observed between all three indicators of malnutrition and the enhanced vegetation index. A 1-unit increase in enhanced vegetation index was associated with a 38 %, 49 % and 59 % reduction in wasting, stunting and low mid-upper arm circumference, respectively. Infection and climatic variations are likely to be key drivers of malnutrition in Somalia. Better health data and close monitoring and forecasting of droughts may provide valuable information for nutritional intervention planning in Somalia.

Impact of a cash-for-work programme on food consumption and nutrition among women and children facing food insecurity in rural Bangladesh.

PubMed

Mascie-Taylor, C G N; Marks, M K; Goto, R; Islam, R

2010-11-01

To determine whether a cash-for-work programme during the annual food insecurity period in Bangladesh improved nutritional status in poor rural women and children. The panel study involved a random sample of 895 households from over 50,000 enrolled in a cash-for-work programme between September and December 2007 and 921 similar control households. The height, weight and mid-upper arm circumference of one woman and child aged less than 5 years from each household were measured at baseline and at the end of the study (mean time: 10 weeks). Women reported 7-day household food expenditure and consumption on both occasions. Changes in parameters were compared between the two groups. At baseline, no significant difference existed between the groups. By the study end, the difference in mean mid-upper arm circumference between women in the intervention and control groups had widened by 2.29 mm and the difference in mean weight, by 0.88 kg. Among children, the difference in means between the two groups had also widened in favour of the intervention group for: height (0.08 cm; P<0.05), weight (0.22 kg; P<0.001), mid-upper arm circumference (1.41 mm; P<0.001) and z-scores for height-for-age (0.02; P<0.001), weight-for-age (0.17; P<0.001), weight-for-height (0.23; P<0.001) and mid-upper arm circumference (0.12; P<0.001). Intervention households spent more on food and consumed more protein-rich food at the end of the study. The cash-for-work programme led to greater household food expenditure and consumption and women's and children's nutritional status improved.

Validation of the Omron M6 (HEM-7001-E) upper arm blood pressure measuring device according to the International Protocol in elderly patients.

PubMed

Altunkan, Sekip; Iliman, Nevzat; Altunkan, Erkan

2008-04-01

Despite the widespread use of automated self-measurement monitors, there is limited published evidence on their accuracy and reliability on different patient groups. The objective of this study was to evaluate the accuracy and reliability of the Omron M6 (HEM-7001-E) upper-arm blood pressure (BP) device against mercury sphygmomanometer on elderly patients according to the criteria of the International Protocol. Thirty-three patients above 65 years of age, who were classified based on the BP categories of the International Protocol, were recruited for the study. BP measurements at the upper arm with the Omron M6 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential BP measurements were taken. During the validation study, 99 measurements were obtained from 33 patients for comparison. The first phase was carried out on 15 patients and if the device passed this phase, 18 more patients were selected. Mean discrepancies and standard deviations of the device sphygmomanometer were 1.4+/-5.3 mmHg for systolic BP (SBP) and -1.4+/-4.5 mmHg for diastolic BP (DBP) in the study group. The device passed phase 1 in 15 patients. In phase 2.1, from the total 99 comparisons, 76, 92, and 97 for SBP and 77, 94, and 99 for DBP were less than 5, 10, and 15 mmHg, respectively. The Omron M6 passed phases 2.1 and 2.2 in the elderly group of patients. The Omron M6 (HEM-7001-E) upper-arm BP monitor passed according to the International Protocol criteria and can be recommended for use in elderly patients.

Mirror therapy enhances motor performance in the paretic upper limb after stroke: a pilot randomized controlled trial.

PubMed

Samuelkamaleshkumar, Selvaraj; Reethajanetsureka, Stephen; Pauljebaraj, Paul; Benshamir, Bright; Padankatti, Sanjeev Manasseh; David, Judy Ann

2014-11-01

To investigate the effectiveness of mirror therapy (MT) combined with bilateral arm training and graded activities to improve motor performance in the paretic upper limb after stroke. Randomized, controlled, assessor-blinded study. Inpatient stroke rehabilitation center of a tertiary care teaching hospital. Patients with first-time ischemic or hemorrhagic stroke (N=20), confined to the territory of the middle cerebral artery, occurring <6 months before the commencement of the study. The MT and control group participants underwent a patient-specific multidisciplinary rehabilitation program including conventional occupational therapy, physical therapy, and speech therapy for 5 d/wk, 6 h/d, over 3 weeks. The participants in the MT group received 1 hour of MT in addition to the conventional stroke rehabilitation. The Upper Extremity Fugl-Meyer Assessment for motor recovery, Brunnstrom stages of motor recovery for the arm and hand, Box and Block Test for gross manual hand dexterity, and modified Ashworth scale to assess the spasticity. After 3 weeks of MT, mean change scores were significantly greater in the MT group than in the control group for the Fugl-Meyer Assessment (P=.008), Brunnstrom stages of motor recovery for the arm (P=.003) and hand (P=.003), and the Box and Block Test (P=.022). No significant difference was found between the groups for modified Ashworth scale (P=.647). MT when combined with bilateral arm training and graded activities was effective in improving motor performance of the paretic upper limb after stroke compared with conventional therapy without MT. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Ecology of selected marine communities in Glacier Bay: Zooplankton, forage fish, seabirds and marine mammals

USGS Publications Warehouse

Robards, Martin D.; Drew, Gary S.; Piatt, John F.; Anson, Jennifer Marie; Abookire, Alisa A.; Bodkin, James L.; Hooge, Philip N.; Speckman, Suzann G.

2003-01-01

We studied oceanography (including primary production), secondary production, small schooling fish (SSF), and marine bird and mammal predators in Glacier Bay during 1999 and 2000. Results from these field efforts were combined with a review of current literature relating to the Glacier Bay environment. Since the conceptual model developed by Hale and Wright (1979) ‘changes and cycles’ continue to be the underlying theme of the Glacier Bay ecosystem. We found marked seasonality in many of the parameters that we investigated over the two years of research, and here we provide a comprehensive description of the distribution and relative abundance of a wide array of marine biota. Glacier Bay is a tidally mixed estuary that leads into basins, which stratify in summer, with the upper arms behaving as traditional estuaries. The Bay is characterized by renewal and mixing events throughout the year, and markedly higher primary production than in many neighboring southeast Alaska fjords (Hooge and Hooge, 2002). Zooplankton diversity and abundance within the upper 50 meters of the water column in Glacier Bay is similar to communities seen throughout the Gulf of Alaska. Zooplankton in the lower regions of Glacier Bay peak in abundance in late May or early June, as observed at Auke Bay and in the Gulf of Alaska. The key distinction between the lower Bay and other estuaries in the Gulf of Alaska is that a second smaller peak in densities occurs in August. The upper Bay behaved uniformly in temporal trends, peaking in July. Densities had begun to decline in August, but were still more than twice those observed in that region in May. The highest density of zooplankton observed was 17,870 organisms/m3 in Tarr Inlet during July. Trends in zooplankton community abundance and diversity within the lower Bay were distinct from upper-Glacier Bay trends. Whereas the lower Bay is strongly influenced by Gulf of Alaska processes, local processes are the strongest influence in the upper-Bay.We identified 55 species of fish during this study (1999 and 2000) from beach seines, mid-water trawls, and rod and line catches. The diversity of physical, oceanographic, and glacial chronological conditions within Glacier Bay contribute a suite of factors that influence the distribution and abundance of fish. Accordingly, we observed significant differences in the abundance and distribution of fish within the Bay. Most significantly, abundance and diversity (primarily juvenile fish including walleye Pollock, eelblennies, and capelin) were greatest at the head of both the east and west arms where zooplankton abundance was greatest – in close proximity to tidewater glaciers and freshwater runoff. All of Glacier Bay and Icy Strait were surveyed hydroacoustically for plankton and fish during June 1999 surveys. Acoustically determined forage biomass was concentrated in relatively few important areas such as Pt. Adolphus, Berg Bay, on the Geikie-Scidmore shelf, around the Beardslee/Marble islands, and the upper arms of Glacier Bay. Forage biomass (primarily small schooling fish and euphausiids) was concentrated in shallow, nearshore waters; 50 % of acoustic biomass was found at depths < 35m, 80 % of biomass at depths < 80m. During our sampling, high density patches of prey were very rare, and less than 8 % of the area surveyed in Glacier Bay contained patch densities suitable (e.g., > 0.01 fish/m3) for seabirds foraging on zooplankton and small schooling fish. Less than 1 % of the area contained patches suitable (e.g., >0.1 fish/m3) for whales foraging on zooplankton and small schooling fish. High-density aggregations of 0.1-10 fish/m3 were comprised mostly of schools containing capelin, pollock, herring or euphausiids (0.1-1 kg/m3).During predator surveys (1999-2000), we observed 63 species of birds and 7 species of marine mammals. Seasonal distribution and abundance of these “apex” predators was highly variable by species. Glacier Bay supports high numbers of seabirds and marine mammals that consume zooplankton and small schooling fish. Nearshore areas had higher densities of both birds and marine mammals. Several areas, such as Pt. Adolphus, Berg Bay, on the Geikie-Scidmore shelf, the Beardslee/Marble islands, and the upper arms of Glacier Bay were focal points of small schooling fish and zooplankton consuming marine birds and mammals. Comparisons between surveys and a prior study (1991) suggested that the assemblage of birds and marine mammals in the Bay is undergoing change. Most notable was a clear decline in Brachyramphus spp. murrelets while other apex species are increasing or remaining stable.It should be noted that many of the birds and mammals observed during this project, e.g. mergansers, do not forage on zooplankton and small schooling fish; rather they forage on benthic fish and sessile invertebrates. While distribution and sampling data for these marine predator species are valid, this study did not sample benthic fish and sessile invertebrates. Thus, recommendations made by this project should be interpreted as generally specific to the zooplankton/small schooling fish marine food web components of the Glacier Bay Ecosystem.

Developing Non-Somatotopic Phantom Finger Sensation to Comparable Levels of Somatotopic Sensation through User Training With Electrotactile Stimulation.

PubMed

Chai, Guohong; Zhang, Dingguo; Zhu, Xiangyang

2017-05-01

Cutaneous electrical stimulation can provide tactile feedback for upper-limb amputees through somatotopic feedback (SF) or non-somatotopic feedback (NF). The SF delivers electrotactile stimulus to projection finger maps (PFMs) on the stumps of amputees, which outperforms NF that transfers stimulus to other human intact skin areas in general. However, the SF areas on stumps are very limited and often occupied by electromyography (EMG) sensors in application of myoelectric prosthesis. This work aims at improving NF performance on human upper arms through user training with electrotactile stimulation. The experiments were conducted over seven consecutive days on nine able-bodied subjects and two forearm amputees. The performance measures of NF/SF included the correct identification rates (CIR s ), the response time and the NASA-TLX questionnaire. The between-day CIR s on NF sites increased logarithmically with a mean course of 3-day rapid-improving phase and plateaued in the relative-steady phase. The response time and NASA-TLX scores could also rapidly reduce to the comparable levels of the SF areas during the same mean period of 3-day rapid-improving phase, respectively. These results indicated that the performance of NF could be highly improved to the equivalent level as that of SF through 3-day electrotactile training, which we named as "3-day effect". It provides important insights that intact skin areas without phantom sensations can effectively replace SF sites to transfer tactile feedback after continuous user training, which validates effectiveness of non-invasive interfaces of tactile feedback for upper-limb amputees in practice.

Changes in neuromuscular activity during motor training with a body-machine interface after spinal cord injury.

PubMed

Pierella, C; De Luca, A; Tasso, E; Cervetto, F; Gamba, S; Losio, L; Quinland, E; Venegoni, A; Mandraccia, S; Muller, I; Massone, A; Mussa-Ivaldi, F A; Casadio, M

2017-07-01

Body machine interfaces (BMIs) are used by people with severe motor disabilities to control external devices, but they also offer the opportunity to focus on rehabilitative goals. In this study we introduced in a clinical setting a BMI that was integrated by the therapists in the rehabilitative treatments of 2 spinal cord injured (SCI) subjects for 5 weeks. The BMI mapped the user's residual upper body mobility onto the two coordinates of a cursor on a screen. By controlling the cursor, the user engaged in playing computer games. The BMI allowed the mapping between body and cursor spaces to be modified, gradually challenging the user to exercise more impaired movements. With this approach, we were able to change our subjects' behavior, who initially used almost exclusively their proximal upper body-shoulders and arms - for using the BMI. By the end of training, cursor control was shifted toward more distal body regions - forearms instead of upper arms - with an increase of mobility and strength of all the degrees of freedom involved in the control. The clinical tests and the electromyographic signals from the main muscles of the upper body confirmed the positive effect of the training. Encouraging the subjects to explore different and sometimes unusual movement combinations was beneficial for recovering distal arm functions and for increasing their overall mobility.

A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Instruments

PubMed Central

Adam, Garret; Wang, Kevin; Demaree, Christopher J.; Jiang, Jenny S.; Cheung, Mathew; Bechara, Carlos F.

2018-01-01

Thoracic outlet syndrome (TOS) is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST) and Upper Limb Tension Test (ULTT) were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG) tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%), viola (33%), and cello (27%). Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively (p = 0.03). Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects (p = 0.03). TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms. PMID:29370085

The role of upper torso and pelvis rotation in driving performance during the golf swing.

PubMed

Myers, Joseph; Lephart, Scott; Tsai, Yung-Shen; Sell, Timothy; Smoliga, James; Jolly, John

2008-01-15

While the role of the upper torso and pelvis in driving performance is anecdotally appreciated by golf instructors, their actual biomechanical role is unclear. The aims of this study were to describe upper torso and pelvis rotation and velocity during the golf swing and determine their role in ball velocity. One hundred recreational golfers underwent a biomechanical golf swing analysis using their own driver. Upper torso and pelvic rotation and velocity, and torso-pelvic separation and velocity, were measured for each swing. Ball velocity was assessed with a golf launch monitor. Group differences (groups based on ball velocity) and moderate relationships (r > or = 0.50; P < 0.001) were observed between an increase in ball velocity and the following variables: increased torso-pelvic separation at the top of the swing, maximum torso-pelvic separation, maximum upper torso rotation velocity, upper torso rotational velocity at lead arm parallel and last 40 ms before impact, maximum torso-pelvic separation velocity and torso-pelvic separation velocity at both lead arm parallel and at the last 40 ms before impact. Torso-pelvic separation contributes to greater upper torso rotation velocity and torso-pelvic separation velocity during the downswing, ultimately contributing to greater ball velocity. Golf instructors can consider increasing ball velocity by maximizing separation between the upper torso and pelvis at the top of and initiation of the downswing.

Glove box on vehicular instrument panel

DOEpatents

Atarashi, Kazuya

1985-01-01

A glove box for the upper surface of an automobile dashboard whereby it may be positioned close to the driver. The glove box lid is pivotally supported by arms extending down either side to swing forwardly for opening. A hook is pivotally support adjacent an arm and weighted to swing into engagement with the arm to prevent opening of the lid during abrupt deceleration. A toggle spring assists in maintaining the lid in either the open or closed position.

Physical Fitness as It Pertains to Sustained Military Operations

DTIC Science & Technology

1986-05-01

Vogel and his colleagues (Vogel et al., 1983, Murphy et al., 1985) measured initial V02 max, and 2-mile run time, anaerobic power of the arms and...trial, and troop performance was evaluated by observers. Vogel and his co-workers found arm strength and arm anaerobic p,4er to decrease following...defense from infantry ground attack. Measurements of isometric, handgrip strength and upper and lower body anaerobic power (using the Wingate test) were

Invited commentary on comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial.

PubMed

Kwakkel, Gert; van Wegen, Erwin E; Meskers, Carel M

2015-06-01

In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[The Activation of Interlimb Interactions Increase the Motor Output in Legs in Healthy Subjects under the Conditions of Arm and Leg Unloading].

PubMed

Selionov, V A; Solopova, I A; Zhvansky, D S

2016-01-01

We studied the effect of arm movements and movements of separate arm joints on the electrophysiological and kinematic characteristics of voluntary and vibration-triggered stepping-like leg movements under the conditions of horizontal support of upper and lower limbs. The horizontal support of arms provided a significantly increase in the rate of activation of locomotor automatism by non-invasive impact on tonic sensory inputs. The addition of active arm movements during involuntary rhytmic stepping-like leg movements led to an increase in EMG activity of hip muscles and was accompanied by an increase in the amplitude of hip and shin movements. Passive arm movements had the same effect on induced leg movements. The movement of the shoulder joints led to an increase in the activity of hip muscles and an increase in the amplitude of movements of the knee and hip joints. At the same time, the movement of forearms. and wrists had similar facilitating effect on electrophysiological and kinematic characteristics of rhytmic stepping-like movements, but influenced the distal segments of legs to a greater extent. Under the conditions of sub-threshold vibration of leg muscles, voluntary arm movements led to the activation of involuntary rhytmic stepping movements. During voluntary leg movements, the addition of arm movements had a significantly smaller impact on the parameters of rhytmic stepping than during involuntary leg movements. Thus, the simultaneous movements of upper and lower limbs are an effective method of activation of neural networks connecting the rhythm generators of arms and legs. Under the conditions of arm and leg unloading, the interactions between the cervical and lumbosacral segments of the spinal cord seem to play the major role in the impact of arm movements on the patterns of leg movements. The described methods of activation of interlimb interactions can be used in the rehabilitation of post-stroke patients and patients with spinal cord injuries, Parkinson's disease and other neurological diseases.

Role of fine needle aspiration cytology in diagnosing filarial arm cysts.

PubMed

Tandon, Nishi; Bansal, Cherry; Sharma, Richa; Irfan, Sumaiya

2013-05-17

Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes: Wuchereria bancrofti and Brugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology and peripheral blood findings. FNA provides definitive diagnosis and is an important tool for diagnosing soft tissue swellings owing to filariasis.

Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis.

PubMed Central

Tellis, V A; Kohlberg, W I; Bhat, D J; Driscoll, B; Veith, F J

1979-01-01

In a retrospective study of 66 PTFE arteriovenous fistulae and 71 BCH arteriovenous fistulae for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures. Images Fig. 3. PMID:758853

The Effect of Three Methods of Supporting the Double Bass on Muscle Tension.

ERIC Educational Resources Information Center

Dennis, Allan

1984-01-01

Using different methods of holding the double bass, college students performed Beethoven's Symphony No. 9. Audio recordings of performance were rated. Muscle tension readings from the left arm, right arm, upper back, and lower back were taken, using electromyography. Results suggest nonsignificant differences in both performance quality and muscle…

Upper Limb Asymmetries in the Perception of Proprioceptively Determined Dynamic Position Sense

ERIC Educational Resources Information Center

Goble, Daniel J.; Brown, Susan H.

2010-01-01

Recent studies of position-related proprioceptive sense have provided evidence of a nonpreferred left arm advantage in right-handed individuals. The present study sought to determine whether similar asymmetries might exist in "dynamic position" sense. Thirteen healthy, right-handed adults were blindfolded and seated with arms placed on…

Characterization of Upper Troposphere Water Vapor Measurements during AFWEX using LASE

NASA Technical Reports Server (NTRS)

Ferrare, R. A.; Browell, E. V.; Ismail, S.; Kooi, S.; Brasseur, L. H.; Brackett, V. G.; Clayton, M.; Barrick, J.; Linne, H.; Lammert, A.

2002-01-01

Water vapor profiles from NASA's Lidar Atmospheric Sensing Experiment (LASE) system acquired during the ARM/FIRE Water Vapor Experiment (AFWEX) are used to characterize upper troposphere water vapor (UTWV) measured by ground-based Raman lidars, radiosondes, and in situ aircraft sensors. Initial comparisons showed the average Vaisala radiosonde measurements to be 5-15% drier than the average LASE, Raman lidar, and DC-8 in situ diode laser hygrometer measurements. We show that corrections to the Raman lidar and Vaisala measurements significantly reduce these differences. Precipitable water vapor (PWV) derived from the LASE water vapor profiles agrees within 3% on average with PWV derived from the ARM ground-based microwave radiometer (MWR). The agreement among the LASE, Raman lidar, and MWR measurements demonstrates how the LASE measurements can be used to characterize both profile and column water vapor measurements and that ARM Raman lidar, when calibrated using the MWR PWV, can provide accurate UTWV measurements.

[Manufacture of upholstered furniture and work-related upper limb musculoskeletal disorders: an industrial sector prevention project].

PubMed

Di Leone, G; Carino, M; Nicoletti, S; Trani, G; Ambrosi, L

2008-01-01

In cooperation with the IRCCS Fondazione Maugeri and the IRCCS Fondazione Ospedale Maggiore Policlinico - EPM-CEMOC, of Milan, the Local Health Unit in Bari, Italy carried out a research project, sponsored partly by the Italian Ministry of Health, on upper limb work-related musculoskeletal disorders (UL-WMSDs) in a specific manufacturing sector, the upholstered furniture industry. This "sofa district" is widely represented with approximately 14,000 workers and 500 factories over a wide geographic area of southern Italy. Advanced technology in the manufacturing process is combined with workers performing intensive arm-hand tasks. The aim of the study included: a) assessment of exposure to repetitive strain and movements of the upper limb in a representative sample of the factories using the OCRA method, b) analysis of the annual prevalence and incidence rates, c) definition of possible improvement via ergonomic solutions in the various factories. Via a network of occupational physicians a total of more than 6000 subjects were examined over a 5-year period. Case-definition was assessed through standardized procedures. A detailed description of the manufacturing process of the upholstered furniture industry and of the characteristics of the working population is provided Exposed groups at risk were:filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Data collected in private companies of different size in this extensive industrial "sofa area" emphasize the importance of prevention through adequate ergonomic solutions and the need to improve training programmes covering the whole area.

Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis.

PubMed

Merians, Alma S; Fluet, Gerard G; Qiu, Qinyin; Saleh, Soha; Lafond, Ian; Davidow, Amy; Adamovich, Sergei V

2011-05-16

Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training.

Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis

PubMed Central

2011-01-01

Background Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Methods Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. Results The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Conclusions Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training. PMID:21575185

Effect of application site, clothing barrier, and application site washing on testosterone transfer with a 1.62% testosterone gel.

PubMed

Stahlman, Jodi; Britto, Margaret; Fitzpatrick, Sherahe; McWhirter, Cecilia; Testino, Samuel A; Brennan, John J; Zumbrunnen, Troy L

2012-02-01

To evaluate the effect of application site location, clothing barrier, and application site washing on testosterone transfer from males dosed with 1.62% testosterone gel to female partners. Open-label, randomized, parallel group, crossover study performed in 24 healthy male/female couples. 2.5 or 5.0 g of gel was applied to upper arms and shoulders or abdomens of male subjects. Skin contact occurred 2 hours after gel application between male and female subjects to compare the effect of wearing or not wearing a t-shirt, washing or not washing before contact, and the effect of differing application sites. Treatments were separated by a 1-week washout period. On each dosing day, 15 minutes of supervised skin contact occurred between the dosed male and female partner. Contact was either abdomen to abdomen (male to female), or upper arms/shoulders (male) to upper arms/shoulders, wrists and hands (female), depending on the male application site. Serum samples were collected from females at baseline and after contact to assess secondary testosterone exposure. C(max) (maximum serum concentration), AUC(0-24) (area under serum concentration-time curve from 0-24 hours), and C(av) (time-averaged concentration over 24-hour post-contact period) were assessed. Subjects were monitored for adverse events. Testosterone exposure (C(av) and C(max)) in females increased by up to 27% (2.5 g) or up to 280% (5.0 g) from baseline after direct skin contact at 2 hours after gel application, although C(av) remained within the female eugonadal range. Transfer from the abdomen was prevented when a t-shirt was worn (2.5-g dose). When the application site was washed before contact, mean C(av) was comparable to baseline, and C(max) was slightly higher (14%). Transfer was higher after direct skin-to-skin contact when the application and contact sites were upper arms/shoulders versus the abdomen. Testosterone concentrations returned to baseline within 48 hours after last skin contact. There is a risk of testosterone transfer from males using 1.62% testosterone gel to others who come into direct skin contact with the application site. This can be prevented by covering the application site with a t-shirt (2.5-g dose), or washing the application site before contact. Women for these studies were not selected by menopausal status. The study was conducted under circumstances that were intended to simulate exaggerated conditions of contact and may not represent average contact under normal conditions. CLINICAL TRIAL REGISTRATION NCT NUMBERS: Study was not registered (first subject enrolled 28 November 2007).

A robotic workstation for stroke rehabilitation of the upper extremity using FES.

PubMed

Freeman, C T; Hughes, A-M; Burridge, J H; Chappell, P H; Lewin, P L; Rogers, E

2009-04-01

An experimental test facility is developed for use by stroke patients in order to improve sensory-motor function of their upper limb. Subjects are seated at the workstation and their task is to repeatedly follow reaching trajectories that are projected onto a target above their arm. To do this they use voluntary control with the addition of electrical stimulation mediated by advanced control schemes applied to muscles in their impaired shoulder and arm. Full details of the design of the workstation and its periphery systems are given, together with a description of its use during the treatment of stroke patients.

The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb

PubMed Central

Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A.

2016-01-01

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation. PMID:27583121

The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb.

PubMed

Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A; Danish, Qazi

2016-09-01

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

Validation of the Andon KD-5851 upper arm blood pressure monitor, for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Wu, Lili; Jiao, Yinghui; Wang, Chengdong; Chen, Lei; Di, Dalin; Zhang, Haiyan

2015-08-01

This study aimed to validate the Andon KD-5851 upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. A total of 33 eligible participants were included in the study. Sequential measurements of BPs were performed using a mercury sphygmomanometer and the device, and the data analysis was carried out following precisely the ESH-IP revision 2010. The device had 82, 98, and 99 measurements within 5, 10, and 15 mmHg for systolic blood pressure and 85, 95, and 99 measurements for diastolic blood pressure, respectively. The average device-observer difference was -0.53±4.00 mmHg for systolic blood pressure and -1.15±4.06 mmHg for diastolic blood pressure. The device passed all the criteria according to the ESH-IP revision 2010. According to the validation results on the basis of the ESH-IP revision 2010, the Andon KD-5851 upper arm BP monitor can be recommended for self/home measurement in adults. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Validation of the Medisana MTP Plus upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Erdem, Emre; Aydogdu, Türkan; Akpolat, Tekin

2011-02-01

Standard validation protocols are objective guides for healthcare providers, physicians, and patients. The purpose of this study was to test validation of the Medisana MTP Plus upper arm blood pressure (BP) measuring monitor for self-measurement according to the European Society of Hypertension International Protocol (ESH-IP2) in adults. The Medisana MTP Plus monitor is an automated and oscillometric upper arm device for home BP monitoring. Nine consecutive measurements were made according to the ESH-IP2. Overseen by an independent supervisor, measurements were recorded by two observers blinded from both each other's readings and from the device readings. The Medisana MTP Plus device fulfills the validation criteria of the ESH-IP2 for the general population. The mean (standard deviation) of the difference between the observers and the device measurements was 0.6 mmHg (5.1 mmHg) for systolic and 2.7 mmHg (3.4 mmHg) for diastolic pressures, respectively. As the Medisana MTP Plus device has achieved the required standards, it is recommended for home BP monitoring in an adult population.

Validation of the SEJOY BP-1307 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Lei, Lei; Chen, Yi; Chen, Qi; Li, Yan; Wang, Ji-Guang

2017-12-01

The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor SEJOY BP-1307 (also called JOYTECH DBP-1307) for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese individuals (13 women, 45.1 years of mean age) using a mercury sphygmomanometer (two observers) and the SEJOY BP-1307 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The average±SD of the device-observer differences was 0.2±4.1 and -1.7±4.7 mmHg for systolic and diastolic blood pressure, respectively. The SEJOY BP-1307 device achieved the criteria in both part 1 and part 2 of the validation study. The SEJOY upper-arm blood pressure monitor BP-1307 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

The influence of breast support on torso, pelvis and arm kinematics during a five kilometer treadmill run.

PubMed

Milligan, Alexandra; Mills, Chris; Corbett, Jo; Scurr, Joanna

2015-08-01

Many women wear sports bras due to positive benefits associated with these garments (i.e. reduction in breast movement and breast pain), however the effects these garments have on upper body running kinematics has not been investigated. Ten female participants (32 DD or 34 D) completed two five kilometer treadmill runs (9 km h(-1)), once in a low and once in a high breast support. The range of motion (ROM) and peak torso, pelvis, and upper arm Cardan joint angles were calculated over five gait cycles during a five kilometer run. Peak torso yaw, peak rotation of the pelvis, peak pelvis obliquity, ROM in rotation of the pelvis, and ROM in upper arm extension were significant, but marginally reduced when participants ran in the high breast support. The running kinematics reported in the high breast support condition more closely align with economical running kinematics previously defined in the literature, therefore, running in a high breast support may be more beneficial to female runners, with a high breast support advocated for middle distance runners. Copyright © 2015 Elsevier B.V. All rights reserved.

Monitoring elbow isometric contraction by novel wearable fabric sensing device

NASA Astrophysics Data System (ADS)

Wang, Xi; Tao, Xiaoming; So, Raymond C. H.; Shu, Lin; Yang, Bao; Li, Ying

2016-12-01

Fabric-based wearable technology is highly desirable in sports, as it is light, flexible, soft, and comfortable with little interference to normal sport activities. It can provide accurate information on the in situ deformation of muscles in a continuous and wireless manner. During elbow flexion in isometric contraction, upper arm circumference increases with the contraction of elbow flexors, and it is possible to monitor the muscles’ contraction by limb circumferential strains. This paper presents a new wireless wearable anthropometric monitoring device made from fabric strain sensors for the human upper arm. The materials, structural design and calibration of the device are presented. Using an isokinetic testing system (Biodex3®) and the fabric monitoring device simultaneously, in situ measurements were carried out on elbow flexors in isometric contraction mode with ten subjects for a set of positions. Correlations between the measured values of limb circumferential strain and normalized torque were examined, and a linear relationship was found during isometric contraction. The average correlation coefficient between them is 0.938 ± 0.050. This wearable anthropometric device thus provides a useful index, the limb circumferential strain, for upper arm muscle contraction in isometric mode.

Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

PubMed

Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

2011-10-01

To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004) was associated with increased DASH scores. Upper-limb loss clearly affects physical function. DASH score limitation profiles may be useful in individual clinical assessments. Targeted clinical examination may indicate patients with extra rehabilitational needs. Such examinations may be of special importance in relation to prosthesis function. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

THE RESPONSE OF X-IRRADIATED LIMBS OF ADULT URODELES TO NORMAL TISSUE GRAFTS. I. EFFECTS OF AUTOGRAFTS OF SIXTY-DAY FOREARM REGENERATES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stinson, B.D.

1963-06-01

Results are reported of autoplastic transplantation of parts of nonirradiated, regenerated forelimb to the contralateral x-irradiated forelimb in adult Triturus viridescens. The right forelimbs were exposed to various doses of localized irradiation (1000 to 5000 r) followed by amputation of both left and right forelimbs through the mid forearm. Left limbs regenerated normally, but irradiated right limbs failed to exhibit any significant degree of regenerative activity over a 3-month period. Both forelimbs were reamputated through the distal humerus and observed for an additional two months. Left limbs produced normal regenerates, but irradiated right limbs gave no gross evidence of regenerationmore » at any of the radiation dose levels. Normal left regenerates were reamputated immediately distal to the elbow on the 60th day after the second amputation; the severed forearm was trimmed with scissors along anterior and posterior borders and denuded of skin over its proximal half, leaving an essentially complete forearm region as a normal autograft. This was implanted into the irradiated right upper arm stump, after ablation of the distal half of its humerus, with normal proximodistal polarity in all cases. The irradiated stump was reamputated through the distal portion of the implanted normal autograft two weeks after implantation, and was observed for four months. Periodic gross observations showed that over 90% of irradiated upper arms formed regenerates at a rate which paralleled that of nonirradiated controls. However, regenerates formed on irradiated upper arms exhibited a restriction of morphogenetic capacity, only 60% attaining 3- and 4-digit stages. Most of the morphologically more complex regenerates which developed on the irradiated upper arm stumps manifested left limb asymmetry despite their formation on right irradiated stumps, suggesting a relation between the asymmetry of the normal graft and that of the resulting regenerate. All regenerates which developed on irradiated upper arms showed marked deficiencies in the restoration of a complete proximodistal structural pattern appropriate to the level of amputation through the irradiated stump. However, the actual pattern produced was appropriate to the level of amputation through the implanted normal autograft. These findings support the hypothesis that normal grafts promote the formation of regenerates on irradiated limbs through the autonomous developmental activity of the transected graft. (BBB)« less

Risk factors for generally reduced productivity--a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms.

PubMed

Boström, Maria; Dellve, Lotta; Thomée, Sara; Hagberg, Mats

2008-04-01

This study prospectively assessed the importance of individual conditions and computer use during school or work and leisure time as risk factors for self-reported generally reduced productivity due to musculoskeletal complaints among young adults with musculoskeletal symptoms in the neck or upper extremities. A cohort of 2914 young adults (18-25 years, vocational school and college or university students) responded to an internet-based questionnaire concerning musculoskeletal symptoms related to individual conditions and computer use during school or work and leisure time that possibly affected general productivity. Prevalence ratios (PR) were used to assess prospective risk factors for generally reduced productivity. The selected study sample (N=1051) had reported neck or upper-extremity symptoms. At baseline, 280 of them reported reduced productivity. A follow-up of the 771 who reported no reduced productivity was carried out after 1 year. Risk factors for self-reported generally reduced productivity for those followed-up were symptoms in two or three locations or dimensions for the upper back or neck and the shoulders, arms, wrists, or hands [PR 2.30, 95% confidence interval (95% CI) 1.40-3.78], symptoms persisting longer than 90 days in the shoulders, arms, wrists, or hands (PR 2.50, 95% CI 1.12-5.58), current symptoms in the shoulders, arms, wrists, or hands (PR 1.78, 95% CI 1.10-2.90) and computer use 8-14 hours/week during leisure time (PR 2.32, 95% CI 1.20-4.47). A stronger relationship was found if three or four risk factors were present. For women, a relationship was found between generally reduced productivity and widespread and current symptoms in the upper extremities. The main risk factors for generally reduced productivity due to musculoskeletal symptoms among young adults in this study were chronic symptoms in the upper extremities and widespread symptoms in the neck and upper extremities.

What is the most effective posture to conduct vibration from the lower to the upper extremities during whole-body vibration exercise?

PubMed Central

Tsukahara, Yuka; Iwamoto, Jun; Iwashita, Kosui; Shinjo, Takuma; Azuma, Koichiro; Matsumoto, Hideo

2016-01-01

Background Whole-body vibration (WBV) exercise is widely used for training and rehabilitation. However, the optimal posture for training both the upper and lower extremities simultaneously remains to be established. Objectives The objective of this study was to search for an effective posture to conduct vibration from the lower to the upper extremities while performing WBV exercises without any adverse effects. Methods Twelve healthy volunteers (age: 22–34 years) were enrolled in the study. To measure the magnitude of vibration, four accelerometers were attached to the upper arm, back, thigh, and calf of each subject. Vibrations were produced using a WBV platform (Galileo 900) with an amplitude of 4 mm at two frequencies, 15 and 30 Hz. The following three postures were examined: posture A, standing posture with the knees flexed at 30°; posture B, crouching position with no direct contact between the knees and elbows; and posture C, crouching position with direct contact between the knees and elbows. The ratio of the magnitude of vibration at the thigh, back, and upper arm relative to that at the calf was used as an index of vibration conduction. Results Posture B was associated with a greater magnitude of vibration to the calf than posture A at 15 Hz, and postures B and C were associated with greater magnitudes of vibration than posture A at 30 Hz. Posture C was associated with a vibration conduction to the upper arm that was 4.62 times and 8.26 times greater than that for posture A at 15 and 30 Hz, respectively. Conclusion This study revealed that a crouching position on a WBV platform with direct contact between the knees and elbows was effective for conducting vibration from the lower to the upper extremities. PMID:26793008

"Ballistic Six" Upper-Extremity Plyometric Training for the Pediatric Volleyball Players.

PubMed

Turgut, Elif; Cinar-Medeni, Ozge; Colakoglu, Filiz F; Baltaci, Gul

2017-09-19

The Ballistic Six exercise program includes commonly used upper-body exercises, and the program is recommended for overhead throwing athletes. The purpose of the current study was to investigate the effects of a 12-week the Ballistic Six upper-extremity plyometric training program on upper-body explosive power, endurance, and reaction time in pediatric overhead athletes. Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into 2 study groups: an intervention group (upper-extremity plyometric training in addition to the volleyball training; n = 14) and a control group (the volleyball training only; n = 14). All the participants were assessed before and after a 12-week training program for upper-body power, strength and endurance, and reaction time. Statistical comparison was performed using an analysis of variance test. Comparisons showed that after a 12-week training program, the Ballistic Six upper-body plyometric training program resulted in more improvements in an overhead medicine ball throwing distance and a push-up performance, as well as greater improvements in the reaction time in the nonthrowing arm when compared with control training. In addition, a 12-week training program was found to be effective in achieving improvements in the reaction time in the throwing arm for both groups similarly. Compared with regular training, upper-body plyometric training resulted in additional improvements in upper-body power and strength and endurance among pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

OUTCOME AND NUTRITIONAL ASSESSMENT OF CHRONIC LIVER DISEASE PATIENTS USING ANTHROPOMETRY AND SUBJECTIVE GLOBAL ASSESSMENT.

PubMed

Nunes, Gonçalo; Santos, Carla Adriana; Barosa, Rita; Fonseca, Cristina; Barata, Ana Teresa; Fonseca, Jorge

2017-01-01

Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined. In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition/CLD severity and malnutrition/outcome. Observational, prospective study. Consecutive CLD ambulatory/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded. A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease ( P <0.001) and worst nutritional status defined by BMI ( P =0.002), mid upper arm circumference ( P <0.001), mid arm muscular circumference ( P <0.001), triceps skinfold ( P =0.07) and subjective global assessment ( P <0.001). A third presented deficient/low handgrip strength. Alcohol consumption ( P =0.03) and malnutrition detected by BMI ( P =0.03), mid upper arm circumference ( P =0.001), triceps skinfold ( P =0.06), mid arm muscular circumference ( P =0.02) and subjective global assessment ( P <0.001) were associated with CLD severity. From 25 patients deceased during follow-up, 17 patients were severely malnourished according with triceps skinfold. Malnutrition defined by triceps skinfold predicted mortality ( P <0.001). Protein-calorie malnutrition is common in CLD patients and alcohol plays an important role. Triceps skinfold is the most efficient anthropometric parameter and is associated with mortality. Nutritional assessment should be considered mandatory in the routine care of CLD patients.

Design and testing of a model CELSS chamber robot

NASA Astrophysics Data System (ADS)

Davis, Mark; Dezego, Shawn; Jones, Kinzy; Kewley, Christopher; Langlais, Mike; McCarthy, John; Penny, Damon; Bonner, Tom; Funderburke, C. Ashley; Hailey, Ruth

1994-08-01

A robot system for use in an enclosed environment was designed and tested. The conceptual design will be used to assist in research performed by the Controlled Ecological Life Support System (CELSS) project. Design specifications include maximum load capacity, operation at specified environmental conditions, low maintenance, and safety. The robot system must not be hazardous to the sealed environment, and be capable of stowing and deploying within a minimum area of the CELSS chamber facility. This design consists of a telescoping robot arm that slides vertically on a shaft positioned in the center of the CELSS chamber. The telescoping robot arm consists of a series of links which can be fully extended to a length equal to the radius of the working envelope of the CELSS chamber. The vertical motion of the robot arm is achieved through the use of a combination ball screw/ball spline actuator system. The robot arm rotates cylindrically about the vertical axis through use of a turntable bearing attached to a central mounting structure fitted to the actuator shaft. The shaft is installed in an overhead rail system allowing the entire structure to be stowed and deployed within the CELSS chamber. The overhead rail system is located above the chamber's upper lamps and extends to the center of the CELSS chamber. The mounting interface of the actuator shaft and rail system allows the entire actuator shaft to be detached and removed from the CELSS chamber. When the actuator shaft is deployed, it is held fixed at the bottom of the chamber by placing a square knob on the bottom of the shaft into a recessed square fitting in the bottom of the chamber floor. A support boot ensures the rigidity of the shaft. Three student teams combined into one group designed a model of the CELSS chamber robot that they could build. They investigated materials, availability, and strength in their design. After the model arm and stand were built, the class performed pre-tests on the entire system. A stability pre-test was used to determine whether the model robot arm would tip over on the stand when it was fully extended. Results showed the stand tipped when 50 Newtons were applied horizontally to the top of the vertical shaft while the arm was fully extended.

Design and testing of a model CELSS chamber robot

NASA Technical Reports Server (NTRS)

Davis, Mark; Dezego, Shawn; Jones, Kinzy; Kewley, Christopher; Langlais, Mike; Mccarthy, John; Penny, Damon; Bonner, Tom; Funderburke, C. Ashley; Hailey, Ruth

1994-01-01

A robot system for use in an enclosed environment was designed and tested. The conceptual design will be used to assist in research performed by the Controlled Ecological Life Support System (CELSS) project. Design specifications include maximum load capacity, operation at specified environmental conditions, low maintenance, and safety. The robot system must not be hazardous to the sealed environment, and be capable of stowing and deploying within a minimum area of the CELSS chamber facility. This design consists of a telescoping robot arm that slides vertically on a shaft positioned in the center of the CELSS chamber. The telescoping robot arm consists of a series of links which can be fully extended to a length equal to the radius of the working envelope of the CELSS chamber. The vertical motion of the robot arm is achieved through the use of a combination ball screw/ball spline actuator system. The robot arm rotates cylindrically about the vertical axis through use of a turntable bearing attached to a central mounting structure fitted to the actuator shaft. The shaft is installed in an overhead rail system allowing the entire structure to be stowed and deployed within the CELSS chamber. The overhead rail system is located above the chamber's upper lamps and extends to the center of the CELSS chamber. The mounting interface of the actuator shaft and rail system allows the entire actuator shaft to be detached and removed from the CELSS chamber. When the actuator shaft is deployed, it is held fixed at the bottom of the chamber by placing a square knob on the bottom of the shaft into a recessed square fitting in the bottom of the chamber floor. A support boot ensures the rigidity of the shaft. Three student teams combined into one group designed a model of the CELSS chamber robot that they could build. They investigated materials, availability, and strength in their design. After the model arm and stand were built, the class performed pre-tests on the entire system. A stability pre-test was used to determine whether the model robot arm would tip over on the stand when it was fully extended. Results showed the stand tipped when 50 Newtons were applied horizontally to the top of the vertical shaft while the arm was fully extended. This proved that it was stable. Another pre-test was the actuator slip test used to determine if there is an adequate coefficient of friction between the actuator drive wheels and drive cable to enable the actuator to fully extend and retract the arm. This pre-test revealed that the coefficient of friction was not large enough to prevent slippage. Sandpaper was glued to the drive wheel and this eliminated the slippage problem. The class preformed a fit test in the CELSS chamber to ensure that the completed robot arm is capable of reaching the entire working envelope. The robot was centered in the chamber and the arm was fully extended to the sides of the chamber. The arm was also able to retract to clear the drain pipes separating the upper and lower plant trays.

DEET Insect Repellent: Effects on Thermoregulatory Sweating and Physiological Strain

DTIC Science & Technology

2011-01-01

local measures of mean sweat rate of upper arm and forearm during 70 min of cycling exercise in *44C. They reported a significant increase in rectal...right arm of four volunteers and the left arm of the remaining five. The mid-point of the ventral forearm , between the antecubital space and the wrist...acclimation (45_C, 20% rh; 545 watts; 100 min/day) and performed three trials: control (CON); DEET applied to forearm (DEETLOC, 12 cm2 ); and DEET

Razorback sucker movements and habitat use in the San Juan River inflow, Lake Powell, Utah, 1995-1997

USGS Publications Warehouse

Karp, C.A.; Mueller, G.

2002-01-01

Seventeen subadult, hatchery-reared razorback suckers (Xyrauchen texanus; (x̄ = 456 mm total length) were implanted with sonic transmitters and tracked for 23 months in the lower 89.6 km of the San Juan River (San Juan arm of Lake Powell, Utah). Fish were released at 2 sites, and 9 made extensive up-and downstream movements (x = 47.8 km; contact was lost with 4, and 4 others presumably died or lost their transmitters). The San Juan arm is primarily inundated canyon; however, most fish contacts occurred in shallow coves and shoreline with thick stands of flooded salt cedar in the upper inflow area. Eight fish frequented the Piute Farms river/lake mixing zone, and at least 4 moved upstream into the San Juan River. Seven fish were found in 2 aggregations in spring (3 fish in Neskahi Bay in 1996 and 4 fish just downstream of Piute Farms in 1997), and these may have been associated with spawning activity. Continued presence of razorback suckers in the Piute Farms area and lower San Juan River suggests the San Juan inflow to Lake Powell could be used as an alternate stocking site for reintroduction efforts.

Mapping of the human upper arm muscle activity with an electrode matrix.

PubMed

Côté, J; Mathieu, P A

2000-06-01

Surface electrode matrices allow measurement of muscle activity while avoiding certain hazardous risks and inconvenience associated with invasive techniques. Major challenges of such equipment involve optimizing spatial resolution, and designing simple acquisition systems able to record simultaneously many potentials over large anatomical areas. We present a surface electromyography acquisition system comprising of 3 x 8 Ag-AgCl electrodes mounted onto an elastic band, which can be adjusted to fit an entire human upper limb segment. Using this equipment, we acquired a simultaneous representation of muscular activity from a segment of the upper limb surface of 6 healthy subjects during isometric contractions at various intensities. We found that the location of regions of highest activity depended on elbow torque direction but also varied among subjects. Signals obtained with such equipment can be used to solve the inverse problem and help optimize the electrode configuration in volume conduction studies. The efficacy of decision algorithms of multi-functional myoelectric prostheses can be tested with the global muscle activity patterns gathered. The electrode cuff could also be used in the investigation of fatigue and injury mechanisms during occupational activities.

Quantitative evaluation of toothbrush and arm-joint motion during tooth brushing.

PubMed

Inada, Emi; Saitoh, Issei; Yu, Yong; Tomiyama, Daisuke; Murakami, Daisuke; Takemoto, Yoshihiko; Morizono, Ken; Iwasaki, Tomonori; Iwase, Yoko; Yamasaki, Youichi

2015-07-01

It is very difficult for dental professionals to objectively assess tooth brushing skill of patients, because an obvious index to assess the brushing motion of patients has not been established. The purpose of this study was to quantitatively evaluate toothbrush and arm-joint motion during tooth brushing. Tooth brushing motion, performed by dental hygienists for 15 s, was captured using a motion-capture system that continuously calculates the three-dimensional coordinates of object's motion relative to the floor. The dental hygienists performed the tooth brushing on the buccal and palatal sides of their right and left upper molars. The frequencies and power spectra of toothbrush motion and joint angles of the shoulder, elbow, and wrist were calculated and analyzed statistically. The frequency of toothbrush motion was higher on the left side (both buccal and palatal areas) than on the right side. There were no significant differences among joint angle frequencies within each brushing area. The inter- and intra-individual variations of the power spectrum of the elbow flexion angle when brushing were smaller than for any of the other angles. This study quantitatively confirmed that dental hygienists have individual distinctive rhythms during tooth brushing. All arm joints moved synchronously during brushing, and tooth brushing motion was controlled by coordinated movement of the joints. The elbow generated an individual's frequency through a stabilizing movement. The shoulder and wrist control the hand motion, and the elbow generates the cyclic rhythm during tooth brushing.

Predictors of retention and attrition in a study of an advanced upper limb prosthesis: implications for adoption of the DEKA Arm.

PubMed

Resnik, Linda; Cancio, Jill; Klinger, Shana; Latlief, Gail; Sasson, Nicole; Smurr-Walters, Lisa

2018-02-01

The purpose was to identify factors associated with completion of the VA home study of the DEKA Arm. Design and methodological procedures used: Differences between groups were examined using chi-square and t-tests. A multivariable logistic regression model predicting completion was generated and odds ratios (OR) for significant variables calculated. Post-hoc analysis was performed to plot the receiver operating characteristics (ROC) curve. Participants who completed were more likely to be prosthesis users at study onset (p = .03), and less likely to have a history of musculoskeletal problems (p = .047). There were no statistically significant differences between groups who completed and those who did not in gender, race, veteran status, age, body mass index (BMI), weight, height, musculoskeletal pain at baseline, satisfaction with current prosthesis, type of prosthesis, or months of prosthesis use. Two variables, prosthesis use and history of musculoskeletal problems were significant at p < .10. The area under the curve (AUC) accuracy index was 0.78. We considered completion of the home use study a reasonable proxy for participant willingness to adopt the device; and believe that findings can be extrapolated to guide DEKA Arm prescription recommendations. Participants most likely to complete the study were already using a personal prosthesis, and without pre-existing musculoskeletal problems. Implications for rehabilitation Data from the VA Study of the DEKA Arm were analysed to determine which factors were associated with likely successful adoption of the DEKA Arm. Participants most likely to complete the study were those who already using a personal prosthesis, and those without pre-existing chronic or re-occurring musculoskeletal problems. This information may be useful when attempting to identify and target the most appropriate candidates for DEKA Arm prescription.

49 CFR 572.181 - General description.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assembly Drawing number Head Assembly 175-1000 Neck Assembly Test/Cert 175-2000 Neck Bracket Including..., dated February 2008. (c) Weights of body segments (head, neck, upper and lower torso, arms and upper and... the convenience of the user, the added and revised text is set forth as follows: § 572.181 General...

Allometric associations between body size, shape, and 100-m butterfly speed performance.

PubMed

Sammoud, Senda; Nevill, Alan M; Negra, Yassine; Bouguezzi, Raja; Chaabene, Helmi; Hachana, Younés

2018-05-01

This study aimed to estimate the optimal body size, limb-segment length, and girth or breadth ratios associated with 100-m butterfly speed performance in swimmers. One-hundred-sixty-seven swimmers as subjects (male: N.=103; female: N.=64). Anthropometric measurements comprised height, body-mass, skinfolds, arm-span, upper-limb-length, upper-arm, forearm, hand-lengths, lower-limb-length, thigh-length, leg-length, foot-length, arm-relaxed-girth, forearm-girth, wrist-girth, thigh-girth, calf-girth, ankle-girth, biacromial and biiliocristal-breadths. To estimate the optimal body size and body composition components associated with 100-m butterfly speed performance, we adopted a multiplicative allometric log-linear regression model, which was refined using backward elimination. Fat-mass was the singularly most important whole-body characteristic. Height and body-mass did not contribute to the model. The allometric model identified that having greater limb segment length-ratio (arm-ratio = [arm-span]/[forearm]) and limb girth-ratio (girth-ratio = [calf-girth]/[ankle-girth]) were key to butterfly speed performance. A greater arm-span to forearm-length ratio and a greater calf to ankle-girth-ratio suggest that a combination of larger arm-span and shorter forearm-length and the combination of larger calves and smaller ankles-girth may benefit butterfly swim speed performance. In addition having greater biacromial and biliocristal breadths is also a major advantage in butterfly swimming speed performance. Finally, the estimation of these ratios was made possible by adopting a multiplicative allometric model that was able to confirm, theoretically, that swim speeds are nearly independent of total body size. The 100-m butterfly speed performance was strongly negatively associated with fat mass and positively associated with the segment length ratio (arm-span/forearm-length) and girth ratio (calf-girth)/(ankle-girth), having controlled for the developmental changes in age.

Overtaking method based on sand-sifter mechanism: Why do optimistic value functions find optimal solutions in multi-armed bandit problems?

PubMed

Ochi, Kento; Kamiura, Moto

2015-09-01

A multi-armed bandit problem is a search problem on which a learning agent must select the optimal arm among multiple slot machines generating random rewards. UCB algorithm is one of the most popular methods to solve multi-armed bandit problems. It achieves logarithmic regret performance by coordinating balance between exploration and exploitation. Since UCB algorithms, researchers have empirically known that optimistic value functions exhibit good performance in multi-armed bandit problems. The terms optimistic or optimism might suggest that the value function is sufficiently larger than the sample mean of rewards. The first definition of UCB algorithm is focused on the optimization of regret, and it is not directly based on the optimism of a value function. We need to think the reason why the optimism derives good performance in multi-armed bandit problems. In the present article, we propose a new method, which is called Overtaking method, to solve multi-armed bandit problems. The value function of the proposed method is defined as an upper bound of a confidence interval with respect to an estimator of expected value of reward: the value function asymptotically approaches to the expected value of reward from the upper bound. If the value function is larger than the expected value under the asymptote, then the learning agent is almost sure to be able to obtain the optimal arm. This structure is called sand-sifter mechanism, which has no regrowth of value function of suboptimal arms. It means that the learning agent can play only the current best arm in each time step. Consequently the proposed method achieves high accuracy rate and low regret and some value functions of it can outperform UCB algorithms. This study suggests the advantage of optimism of agents in uncertain environment by one of the simplest frameworks. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The effects of below-elbow immobilization on driving performance.

PubMed

Jones, Evan M; Barrow, Aaron E; Skordas, Nic J; Green, David P; Cho, Mickey S

2017-02-01

There is limited research to guide physicians and patients in deciding whether it is safe to drive while wearing various forms of upper extremity immobilization. The purpose of this study is to evaluate the effect of below-elbow removable splints and fiberglass casts on automobile driving performance. 20 healthy subjects completed 10 runs through a closed, cone-marked driving course while wearing a randomized sequence of four different types of immobilization on each extremity (short arm thumb spica fiberglass cast, short arm fiberglass cast, short arm thumb spica splint, and short arm wrist splint). The first and last driving runs were without immobilization and served as controls. Performance was measured based on evaluation by a certified driving instructor (pass/fail scoring), cones hit, run time, and subject-perceived driving difficulty (1-10 analogue scoring). The greatest number of instructor-scored failures occurred while immobilized in right arm spica casts (n=6; p=0.02) and left arm spica casts (n=5; p=0.049). The right arm spica cast had the highest subject-perceived difficulty (5.2±1.9; p<0.001). All forms of immobilization had significantly increased perceived difficulty compared to control, except for the left short arm splint (2.5±1.6; p>0.05). There was no significant difference in number of cones hit or driving time between control runs and runs with any type of immobilization. Drivers should use caution when wearing any of the forms of upper extremity immobilization tested in this study. All forms of immobilization, with exception of the left short arm splint significantly increased perceived driving difficulty. However, only the fiberglass spica casts (both left and right arm), significantly increased drive run failures due to loss of vehicle control. We recommend against driving when wearing a below-elbow fiberglass spica cast on either extremity. Copyright © 2016. Published by Elsevier Ltd.

Influence of a variation in the position of the arms on the sagittal connection of the gravity line with the spinal structures.

PubMed

Legaye, Jean; Duval-Beaupere, Ginette

2017-11-01

To evaluate the influence of the position of the arms on the location of the body's gravity line. The sagittal balance of the pelvi-spinal unit is organized so that the gravity line is localized in a way that limits the mechanical loads and the muscle efforts. This position of the gravity line was analyzed in vivo, in standing position, the arms dangling, by the barycentremeter, a gamma rays scanner. Then, several teams had the same purpose but using a force platform combined with radiographies. Their results differed significantly among themselves and with the data of the barycentremetry. However, in these studies, the positions of the arms varied noticeably, either slightly bent forwards on a support, or the fingers on the clavicles or on the cheeks. We estimated, for each varied posture of the arms, the sagittal coordinates of the masses of the upper limbs and their influence on the anatomical position of the gravity line of the whole body. Using a simple equation and the data of the barycentremeter, we observed that the variations in the location of the gravity line were proportionally connected to the changes of the sagittal position of the mass of the upper limbs induced by the various positions of the arms. We conclude in a validation of the data of the barycentremeter, as well as of the data obtained by the force platforms as long as the artifact of the position of the arms is taken into account.

A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home.

PubMed

Fife, Caroline E; Davey, Suzanne; Maus, Erik A; Guilliod, Renie; Mayrovitz, Harvey N

2012-12-01

Pneumatic compression devices (PCDs) are used in the home setting as adjunctive treatment for lymphedema after acute treatment in a clinical setting. PCDs range in complexity from simple to technologically advanced. The objective of this prospective, randomized study was to determine whether an advanced PCD (APCD) provides better outcomes as measured by arm edema and tissue water reductions compared to a standard PCD (SPCD) in patients with arm lymphedema after breast cancer treatment. Subjects were randomized to an APCD (Flexitouch system, HCPCS E0652) or SPCD (Bio Compression 2004, HCPCS E0651) used for home treatment 1 h/day for 12 weeks. Pressure settings were 30 mmHg for the SPCD and upper extremity treatment program (UE01) with standard pressure for the APCD. Thirty-six subjects (18 per group) with unilateral upper extremity lymphedema with at least 5% arm edema volume at the time of enrollment, completed treatments over the 12-week period. Arm volumes were determined from arm girth measurements and suitable model calculations, and tissue water was determined based on measurements of the arm tissue dielectric constant (TDC). The APCD-treated group experienced an average of 29% reduction in edema compared to a 16% increase in the SPCD group. Mean changes in TDC values were a 5.8% reduction for the APCD group and a 1.9% increase for the SPCD group. This study suggests that for the home maintenance phase of treatment of arm lymphedema secondary to breast cancer therapy, the adjuvant treatment with an APCD provides better outcomes than with a SPCD.

Parental education and living environmental influence on physical development, nutritional habits as well as level of physical activity in Polish children and adolescents.

PubMed

Suliga, Edyta

2010-01-01

The aim of this work was to evaluate the physical development and nutritional status, the nutrition habits as well as level of physical activity of boys and girls in relation to the socio-economic status of their families. The study was conducted on a group of 529 boys and 535 girls aged 7-16 years from Swietokrzyskie Province in Poland. Boys and girls from high SES families had the greatest body height, BMI, upper arm muscle area, as well as upper arm fat tissue area, while the lowest values of these features occurred among those studied coming from families of a low SES. The higher the family SES, the higher habitual frequency of consuming vegetables and fruit as well as fish. The diet of children coming from higher SES families was also linked with a higher total protein content as well as animal protein, all analysed minerals and some vitamins, but there were no significant differences of energetic value in daily food rations as well as fat content. The longer time spent on some sedentary activities was connected with a higher family SES. The girls coming from a high status families also declared a higher level of physical activity, whereas such relationship was not observed among boys. A more rational set of nutritional habits observed among children from a higher SES families can be the basic reason for their higher advancement in development. A shorter time devoted to sedentary activities is assumed to be the main cause of a smaller relative body mass and less obesity among girls and boys from low SES families.

Effect of synbiotic supplementation in children and adolescents with cystic fibrosis: a randomized controlled clinical trial.

PubMed

de Freitas, Maiara Brusco; Moreira, Emilia Addison Machado; Oliveira, Diane de Lima; Tomio, Camila; da Rosa, Julia Salvan; Moreno, Yara Maria Franco; Barbosa, Eliana; Ludwig Neto, Norberto; Buccigrossi, Vittoria; Guarino, Alfredo; Fröde, Tânia Silvia

2018-05-01

Cystic fibrosis (CF) is characterized by excessive activation of immune processes. The aim of this study was to evaluate the effect of synbiotic supplementation on the inflammatory response in children/adolescents with CF. A randomized, placebo-controlled, double-blind, clinical-trial was conducted with control group (CG, n = 17), placebo-CF-group (PCFG, n = 19), synbiotic CF-group (SCFG, n = 22), PCFG negative (n = 8) and positive (n = 11) bacteriology, and SCFG negative (n = 12) and positive (n = 10) bacteriology. Markers of lung function (FEV 1 ), nutritional status [body mass index-for age (BMI/A), height-for-age (H/A), weight-for-age (W/A), upper-arm fat area (UFA), upper-arm muscle area (UMA), body fat (%BF)], and inflammation [interleukin (IL)-12, tumor necrosis factor-alpha (TNF-α), IL-10, IL-6, IL-1β, IL-8, myeloperoxidase (MPO), nitric oxide metabolites (NOx)] were evaluated before and after 90-day of supplementation with a synbiotic. No significance difference was found between the baseline and end evaluations of FEV 1 and nutricional status markers. A significant interaction (time vs. group) was found for IL-12 (p = 0.010) and myeloperoxidase (p = 0.036) between PCFG and SCFG, however, the difference was not maintained after assessing the groups individually. NOx diminished significantly after supplementation in the SCFG (p = 0.030). In the SCFG with positive bacteriology, reductions were found in IL-6 (p = 0.033) and IL-8 (p = 0.009) after supplementation. Synbiotic supplementation shown promise at diminishing the pro-inflammatory markers IL-6, IL-8 in the SCFG with positive bacteriology and NOx in the SCFG in children/adolescents with CF.

Relationships Between Propulsion and Anthropometry in Paralympic Swimmers.

PubMed

Dingley, Andrew A; Pyne, David B; Burkett, Brendan

2015-11-01

To characterize relationships between propulsion, anthropometry, and performance in Paralympic swimming. A cross-sectional study of swimmers (13 male, 15 female) age 20.5 ± 4.4 y was conducted. Subject locomotor categorizations were no physical disability (n = 8, classes S13-S14) and low-severity (n = 11, classes S9-S10) or midseverity disability (n = 9, classes S6-S8). Full anthropometric profiles estimated muscle mass and body fat, a bilateral swim-bench ergometer quantified upper-body power production, and 100-m time trials quantified swimming performance. Correlations between ergometer mean power and swimming performance increased with degree of physical disability (low-severity male r = .65, ± 0.56, and female r = .68, ± 0.64; midseverity, r = .87, ± 0.41, and r = .79, ± 0.75). The female midseverity group showed nearperfect (positive) relationships for taller swimmers' (with a greater muscle mass and longer arm span) swimming faster, while for female no- and low-severity-disability groups, greater muscle mass was associated with slower velocity (r = .78, ± 0.43, and r = .65, ± 0.66). This was supported with lighter females (with less frontal surface area) in the low-severity group being faster (r = .94, ± 0.24). In a gender contrast, low-severity males with less muscle mass (r = -.64, ± 0.56), high skinfolds (r = .78, ± 0.43), a longer arm span (r = .58, ± 0.60) or smaller frontal surface area (r = -.93, ± 0.19) were detrimental to swimming-velocity production. Low-severity male and midseverity female Paralympic swimmers should be encouraged to develop muscle mass and upper-body power to enhance swimming performance. The generalized anthropometric measures appear to be a secondary consideration for coaches.

Muscle development in healthy children evaluated by bioelectrical impedance analysis.

PubMed

Uchiyama, Tomoka; Nakayama, Takahiro; Kuru, Satoshi

2017-02-01

This study aimed to use bioelectrical impedance analysis (BIA) to generate a new muscle density index (MDI), the MDI_BIA, to evaluate muscle development, and to demonstrate the changes that occur in the BIA-based muscle cross-sectional area index (MCAI_BIA) that accompany growth. We also sought to determine the traceability of chronological changes in the MDI_BIA and MCAI_BIA. Healthy children (n=112) aged 8.68±3.16years (0.33-14.00years) underwent bioelectrical impedance (BI) measurements of their upper arms, thighs, and lower legs. The MDI_BIA and MCAI_BIA were calculated, and cross-sectional investigations were conducted into the changes in these indices that accompanied growth. Data collected after 1.10±0.08years from 45 participants determined the traceability of the chronological changes in the MDI_BIA and MCAI_BIA. The MDI_BIA and MCAI_BIA were significantly positively correlated with age and height at all locations (P<0.01). The relationships between the locations and the MDI_BIA and MCAI_BIA differed, indicating that these indices evaluated the muscles from different perspectives. Except for the upper arm MDI_BIA, both indices at all locations regardless of age, showed significant chronological increases after an average period of 1.10years. The MDI_BIA and MCAI_BIA were significantly correlated with age and height in healthy children, and they showed significant chronological increases. Hence, these indices could be used to represent muscle development and muscle mass increases. BIA is non-invasive, convenient, and economical and it may be useful in evaluating muscle development and muscle cross-sectional areas in children. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Nutritional status and morbidity on an irrigation project in Turkana District, Kenya.

PubMed

Brainard, Jean

1990-01-01

The research reported on here was undertaken to identify the most important contributors to continuing high mortality on a small-scale irrigation project at Nakwamoru in Turkana District, Kenya. The health status of project settlers had not been assessed prior to the present study, which was undertaken in 1978-79, a decade after the project was started. The purpose of the study was to estimate the nutritional status of project children and the major causes of morbidity in the Nakwamoru area. Nutritional status was derived from cross-sectional anthropometric measurements, including weights, heights, triceps skinfolds, and upper arm circumferences, taken on approximately 60% of project children (n = 236) aged 1-10 years. The major causes of morbidity in project settlers of all ages for the period 1973-78 were estimated from outpatient records from the local primary care facility. Age/sex patterns of clinic use were obtained through interviews. Stunting was found to be prevalent, especially in children aged 1-4, while wasting was only observed in a small proportion of the sample, indicating a seasonal pattern of malnutrition. Derived cross-sectional areas of upper arm muscle and fat were found to be low by comparison with U.S. standards, suggesting both energy and protein deficits in project children. Malaria and acute respiratory infections were found to be the major causes of illness in the local population, and both are likely to have contributed to the generally poor nutritional status of project children. Despite free biomedical care, 15% of the local population in general and 23% of adult females had never used clinic services. Copyright © 1990 Wiley-Liss, Inc., A Wiley Company.

Respiratory muscle function in patients with cystic fibrosis.

PubMed

Dassios, Theodore; Katelari, Anna; Doudounakis, Stavros; Mantagos, Stefanos; Dimitriou, Gabriel

2013-09-01

Respiratory muscle function in patients with cystic fibrosis (CF) can be assessed by measurement of maximal inspiratory pressure (Pimax ), maximal expiratory pressure (Pemax ), and pressure-time index of the respiratory muscles (PTImus ). We investigated the differences in maximal respiratory pressures and PTImus between CF patients with no gross hyperinflation and healthy controls and described the effects of pulmonary function and nutrition impairment on respiratory muscle function in this group of CF patients. Forced expiratory volume in 1 sec (FEV1 ), forced vital capacity (FVC) and maximal expiratory flow between 25% and 75% of VC (MEF25-75 ), body mass index (BMI), upper arm muscle area (UAMA), Pimax , Pemax , and PTImus were assessed in 140 CF patients and in a control group of 140 healthy subjects matched for age and gender. Median Pimax and Pemax were significantly lower in CF patients compared to the controls [Pimax  = 74 (57-94) in CF vs. 84 (66-102) in controls, P = 0.009], [Pemax  = 71 (50-95) in CF vs. 84 (66-102) in controls, P < 0.001]. Median PTImus in CF patients compared to controls was significantly increased [PTImus  = 0.110 (0.076-0.160) in CF vs. 0.094 (0.070-0.137) in controls, P = 0.049] and it was significantly higher in CF patients with impaired pulmonary function. In CF patients, PTImus was significantly negatively related to upper arm muscle area (r = 0.184, P = 0.031). These findings suggest that CF patients with no severe lung disease compared to healthy subjects exhibit impaired respiratory muscle function, while CF patients with impaired pulmonary function and nutrition indices exhibit higher PTImus values. Copyright © 2012 Wiley Periodicals, Inc.

Intensive virtual reality-based training for upper limb motor function in chronic stroke: a feasibility study using a single case experimental design and fMRI.

PubMed

Schuster-Amft, Corina; Henneke, Andrea; Hartog-Keisker, Birgit; Holper, Lisa; Siekierka, Ewa; Chevrier, Edith; Pyk, Pawel; Kollias, Spyros; Kiper, Daniel; Eng, Kynan

2015-01-01

To evaluate feasibility and neurophysiological changes after virtual reality (VR)-based training of upper limb (UL) movements. Single-case A-B-A-design with two male stroke patients (P1:67 y and 50 y, 3.5 and 3 y after onset) with UL motor impairments, 45-min therapy sessions 5×/week over 4 weeks. Patients facing screen, used bimanual data gloves to control virtual arms. Three applications trained bimanual reaching, grasping, hand opening. Assessments during 2-week baseline, weekly during intervention, at 3-month follow-up (FU): Goal Attainment Scale (GAS), Chedoke Arm and Hand Activity Inventory (CAHAI), Chedoke-McMaster Stroke Assessment (CMSA), Extended Barthel Index (EBI), Motor Activity Log (MAL). Functional magnetic resonance imaging scans (FMRI) before, immediately after treatment and at FU. P1 executed 5478 grasps (paretic arm). Improvements in CAHAI (+4) were maintained at FU. GAS changed to +1 post-test and +2 at FU. P2 executed 9835 grasps (paretic arm). CAHAI improvements (+13) were maintained at FU. GAS scores changed to -1 post-test and +1 at FU. MAL scores changed from 3.7 at pre-test to 5.5 post-test and 3.3 at FU. The VR-based intervention was feasible, safe, and intense. Adjustable application settings maintained training challenge and patient motivation. ADL-relevant UL functional improvements persisted at FU and were related to changed cortical activation patterns. Implications for Rehabilitation YouGrabber trains uni- and bimanual upper motor function. Its application is feasible, safe, and intense. The control of the virtual arms can be done in three main ways: (a) normal (b) virtual mirror therapy, or (c) virtual following. The mirroring feature provides an illusion of affected limb movements during the period when the affected upper limb (UL) is resting. The YouGrabber training led to ADL-relevant UL functional improvements that were still assessable 12 weeks after intervention finalization and were related to changed cortical activation patterns.

Profiles of musculoskeletal development in limbs of college Olympic weightlifters and wrestlers.

PubMed

Kanehisa, H; Fukunaga, T

1999-04-01

To investigate the event-related profiles of musculoskeletal development in weight-categorized athletes, we measured the cross-sectional areas (CSA) of bone and muscle in the forearm, upper arm, lower leg and thigh, using a B-mode ultrasound apparatus, in college Olympic weightlifters (OWL, n = 19) and wrestlers (WR, n = 17) and untrained men (UM, n = 24), whose body masses were within the range from 55 kg to 78 kg. Both bone and muscle CSA at all sites were significantly correlated to the two-thirds power of fat-free mass (FFM(2/3)) with correlation coefficients of 0.430-40.741 (P < 0.05) and 0.608-0.718 (P < 0.05), respectively. Moreover, there were significant correlations between bone and muscle CSA at all sites (r = 0.664-0.829, P < 0.05). Even when bone and muscle CSA were expressed relative value to FFM(2/3), both OWL and WR showed significantly greater values than UM at all sites except for the lower leg. Furthermore, the comparison of the lean (bone + muscle) CSA ratio from site to site indicated a higher distribution of lean tissues in the upper extremities in OWL and WR compared to UM. While there was no significant difference between the two athlete groups in FFM(2/3), OWL showed significantly larger values than WR in the bone CSA of the upper arm and thigh and in the muscle CSA of the lower leg and thigh. However, lean CSA ratios of the upper extremities to the lower ones were significantly higher in WR than in OWL. Thus, the present results indicated that, compared to UM, OWL and WR had a greater lean tissue CSA in limbs, especially in the upper extremities, even when the difference in FFM was normalized. Moreover, the relative distribution of lean tissues in limbs differed between the two weight-categorized athletes in spite of there being no difference in FFM, which may be attributable to their own training regimens and/or competition style.

Kinematics of pointing movements made in a virtual versus a physical 3-dimensional environment in healthy and stroke subjects.

PubMed

Knaut, Luiz A; Subramanian, Sandeep K; McFadyen, Bradford J; Bourbonnais, Daniel; Levin, Mindy F

2009-05-01

To compare kinematics of 3-dimensional pointing movements performed in a virtual environment (VE) displayed through a head-mounted display with those made in a physical environment. Observational study of movement in poststroke and healthy subjects. Motion analysis laboratory. Adults (n=15; 4 women; 59+/-15.4y) with chronic poststroke hemiparesis were recruited. Participants had moderate upper-limb impairment with Chedoke-McMaster Arm Scores ranging from 3 to 6 out of 7. Twelve healthy subjects (6 women; 53.3+/-17.1y) were recruited from the community. Not applicable. Arm and trunk kinematics were recorded in similar virtual and physical environments with an Optotrak System (6 markers; 100Hz; 5s). Subjects pointed as quickly and as accurately as possible to 6 targets (12 trials/target in a randomized sequence) placed in arm workspace areas requiring different arm movement patterns and levels of difficulty. Movements were analyzed in terms of performance outcome measures (endpoint precision, trajectory, peak velocity) and arm and trunk movement patterns (elbow and shoulder ranges of motion, elbow/shoulder coordination, trunk displacement, rotation). For healthy subjects, precision and trajectory straightness were higher in VE when pointing to contralateral targets, and movements were slower for all targets in VE. Stroke participants made less accurate and more curved movements in VE and used less trunk displacement. Elbow/shoulder coordination differed when pointing to the lower ipsilateral target. There were no group-by-environment interactions. Movements in both environments were sufficiently similar to consider VE a valid environment for clinical interventions and motor control studies.

Performing Complex Tasks by Users With Upper-Extremity Disabilities Using a 6-DOF Robotic Arm: A Study.

PubMed

Al-Halimi, Reem K; Moussa, Medhat

2017-06-01

In this paper, we report on the results of a study that was conducted to examine how users suffering from severe upper-extremity disabilities can control a 6 degrees-of-freedom (DOF) robotics arm to complete complex activities of daily living. The focus of the study is not on assessing the robot arm but on examining the human-robot interaction patterns. Three participants were recruited. Each participant was asked to perform three tasks: eating three pieces of pre-cut bread from a plate, drinking three sips of soup from a bowl, and opening a right-handed door with lever handle. Each of these tasks was repeated three times. The arm was mounted on the participant's wheelchair, and the participants were free to move the arm as they wish to complete these tasks. Each task consisted of a sequence of modes where a mode is defined as arm movement in one DOF. Results show that participants used a total of 938 mode movements with an average of 75.5 (std 10.2) modes for the eating task, 70 (std 8.8) modes for the soup task, and 18.7 (std 4.5) modes for the door opening task. Tasks were then segmented into smaller subtasks. It was found that there are patterns of usage per participant and per subtask. These patterns can potentially allow a robot to learn from user's demonstration what is the task being executed and by whom and respond accordingly to reduce user effort.

Workplace management of upper limb disorders: a systematic review.

PubMed

Dick, F D; Graveling, R A; Munro, W; Walker-Bone, K

2011-01-01

Upper limb pain is common among working-aged adults and a frequent cause of absenteeism. To systematically review the evidence for workplace interventions in four common upper limb disorders. Systematic review of English articles using Medline, Embase, Cinahl, AMED, Physiotherapy Evidence Database PEDro (carpal tunnel syndrome and non-specific arm pain only) and Cochrane Library. Study inclusion criteria were randomized controlled trials, cohort studies or systematic reviews employing any workplace intervention for workers with carpal tunnel syndrome, non-specific arm pain, extensor tenosynovitis or lateral epicondylitis. Papers were selected by a single reviewer and appraised by two reviewers independently using methods based on Scottish Intercollegiate Guidelines Network (SIGN) methodology. 1532 abstracts were identified, 28 papers critically appraised and four papers met the minimum quality standard (SIGN grading + or ++) for inclusion. There was limited evidence that computer keyboards with altered force displacement characteristics or altered geometry were effective in reducing carpal tunnel syndrome symptoms. There was limited, but high quality, evidence that multi-disciplinary rehabilitation for non-specific musculoskeletal arm pain was beneficial for those workers absent from work for at least four weeks. In adults with tenosynovitis there was limited evidence that modified computer keyboards were effective in reducing symptoms. There was a lack of high quality evidence to inform workplace management of lateral epicondylitis. Further research is needed focusing on occupational management of upper limb disorders. Where evidence exists, workplace outcomes (e.g. successful return to pre-morbid employment; lost working days) are rarely addressed.

[Upper extremities, neck and back symptoms in office employees working at computer stations].

PubMed

Zejda, Jan E; Bugajska, Joanna; Kowalska, Małgorzata; Krzych, Lukasz; Mieszkowska, Marzena; Brozek, Grzegorz; Braczkowska, Bogumiła

2009-01-01

To obtain current data on the occurrence ofwork-related symptoms of office computer users in Poland we implemented a questionnaire survey. Its goal was to assess the prevalence and intensity of symptoms of upper extremities, neck and back in office workers who use computers on a regular basis, and to find out if the occurrence of symptoms depends on the duration of computer use and other work-related factors. Office workers in two towns (Warszawa and Katowice), employed in large social services companies, were invited to fill in the Polish version of Nordic Questionnaire. The questions included work history and history of last-week symptoms of pain of hand/wrist, elbow, arm, neck and upper and lower back (occurrence and intensity measured by visual scale). Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences (chi-square test) were verified by multivariate analysis (GLM). The prevalence of symptoms in individual body parts was as follows: neck, 55.6%; arm, 26.9%; elbow, 13.3%; wrist/hand, 29.9%; upper back, 49.6%; and lower back, 50.1%. Multivariate analysis confirmed the effect of gender, age and years of computer use on the occurrence of symptoms. Among other determinants, forearm support explained pain of wrist/hand, wrist support of elbow pain, and chair adjustment of arm pain. Association was also found between low back pain and chair adjustment and keyboard position. The findings revealed frequent occurrence of symptoms of pain in upper extremities and neck in office workers who use computers on a regular basis. Seating position could also contribute to the frequent occurrence of back pain in the examined population.

Advances in upper extremity prosthetics.

PubMed

Zlotolow, Dan A; Kozin, Scott H

2012-11-01

Until recently, upper extremity prostheses had changed little since World War II. In 2006, the Defense Advanced Research Projects Agency responded to an increasing number of military amputees with the Revolutionizing Prosthetics program. The program has yielded several breakthroughs both in the engineering of new prosthetic arms and in the control of those arms. Direct brain-wave control of a limb with 22° of freedom may be within reach. In the meantime, advances such as individually powered digits have opened the door to multifunctional full and partial hand prostheses. Restoring sensation to the prosthetic limb remains a major challenge to full integration of the limb into a patient's self-image. Copyright © 2012 Elsevier Inc. All rights reserved.

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

PubMed

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

2013-11-01

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

Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting.

PubMed

Sivan, Manoj; Gallagher, Justin; Makower, Sophie; Keeling, David; Bhakta, Bipin; O'Connor, Rory J; Levesley, Martin

2014-12-12

Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness. hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND. Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 - 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes. The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently for eight weeks in their own homes with minimal supervision from healthcare professionals. Statistically significant improvements were observed in the kinematic and clinical outcomes in the study.

49 CFR 572.196 - Thorax without arm.

Code of Federal Regulations, 2010 CFR

2010-10-01

... orientation. (4) Push the dummy at the knees and at mid-sternum of the upper torso with just sufficient horizontally oriented force towards the seat back until the back of the upper torso is in contact with the seat back. (5) While maintaining the dummy's position as specified in paragraphs (b)(3) and (4) of this...

49 CFR 572.195 - Thorax with arm.

Code of Federal Regulations, 2010 CFR

2010-10-01

... dummy is in vertical orientation. (4) Push the dummy at the knees and at mid-sternum of the upper torso with just sufficient horizontally oriented force towards the seat back until the back of the upper torso is in contact with the seat back. (5) While maintaining the dummy's position as specified in...

Preliminary research of a novel center-driven robot for upper extremity rehabilitation.

PubMed

Cao, Wujing; Zhang, Fei; Yu, Hongliu; Hu, Bingshan; Meng, Qiaoling

2018-01-19

Loss of upper limb function often appears after stroke. Robot-assisted systems are becoming increasingly common in upper extremity rehabilitation. Rehabilitation robot provides intensive motor therapy, which can be performed in a repetitive, accurate and controllable manner. This study aims to propose a novel center-driven robot for upper extremity rehabilitation. A new power transmission mechanism is designed to transfer the power to elbow and shoulder joints from three motors located on the base. The forward and inverse kinematics equations of the center-driven robot (CENTROBOT) are deduced separately. The theoretical values of the scope of joint movements are obtained with the Denavit-Hartenberg parameters method. A prototype of the CENTROBOT is developed and tested. The elbow flexion/extension, shoulder flexion/extension and shoulder adduction/abduction can be realized of the center-driven robot. The angles value of joints are in conformity with the theoretical value. The CENTROBOT reduces the overall size of the robot arm, the influence of motor noise, radiation and other adverse factors by setting all motors on the base. It can satisfy the requirements of power and movement transmission of the robot arm.

Measuring up: A Simple Lesson That Engages Students in Scientific Practices and Mathematics

ERIC Educational Resources Information Center

Capps, Daniel

2012-01-01

A well-known lesson taught by many upper-elementary and early-middle-school teachers at the beginning of the school year asks students to compare how arm span relates to height. Students measure their height and arm span and compare their measurements to those of their classmates. This lesson gets students measuring, graphing, and practicing…

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

PubMed

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

2013-05-01

Arm impairments in patients post stroke involve the shoulder, elbow and wrist simultaneously. It is not very clear how patients develop spasticity and reduced range of motion (ROM) at the multiple joints and the abnormal couplings among the multiple joints and the multiple degrees-of-freedom (DOF) during passive movement. It is also not clear how they lose independent control of individual joints/DOFs and coordination among the joints/DOFs during voluntary movement. An upper limb exoskeleton robot, the IntelliArm, which can control the shoulder, elbow, and wrist, was developed, aiming to support clinicians and patients with the following integrated capabilities: 1) quantitative, objective, and comprehensive multi-joint neuromechanical pre-evaluation capabilities aiding multi-joint/DOF diagnosis for individual patients; 2) strenuous and safe passive stretching of hypertonic/deformed arm for loosening up muscles/joints based on the robot-aided diagnosis; 3) (assistive/resistive) active reaching training after passive stretching for regaining/improving motor control ability; and 4) quantitative, objective, and comprehensive neuromechanical outcome evaluation at the level of individual joints/DOFs, multiple joints, and whole arm. Feasibility of the integrated capabilities was demonstrated through experiments with stroke survivors and healthy subjects.

Mechanical arm trainer for the treatment of the severely affected arm after a stroke: a single-blinded randomized trial in two centers.

PubMed

Hesse, S; Werner, C; Pohl, M; Mehrholz, J; Puzich, U; Krebs, H I

2008-10-01

To test whether training with a new mechanical arm trainer leads to better outcomes than electrical stimulation of the paretic wrist extensors in subacute stroke patients with severe upper limb paresis. Electrical stimulation is a standard and reimbursable form of therapy in Germany. Randomized controlled trial of 54 inpatients enrolled 4-8 wks from stroke onset, mean upper-extremity subsection of Fugl-Meyer assessment (0-66) at admission less than 18. In addition to standard care, all patients practiced 20-30 mins arm trainer or electrical stimulation every workday for 6 wks, totaling 30 sessions. Primary outcome was the Fugl-Meyer assessment, secondary outcomes were the Box and Block test, the Medical Research Council and the modified Ashworth scale, blindly assessed at enrollment, after 6 wks, and at 3-mo follow-up. Both groups were homogeneous at study onset. Shoulder pain occurred in two arm trainer patients. The primary Fugl-Meyer assessment outcome improved for both groups over time (P < 0.001), but this improvement did not differ between groups. The initial (terminal) mean Fugl-Meyer assessment scores were 8.8 +/- 4.8 (19.2 +/- 14.5) for the arm trainer and 8.6 +/- 3.5 (13.6 +/- 7.9) for the electrical stimulation group. No patient could transport a block initially, but at completion significantly more arm trainer patients were able to transport at least three blocks (five vs. zero, P = 0.023). No significant differences were observed between the groups on the secondary Box and Block outcome at follow-up (eight vs. four patients). All Box and Block responders had an initial Fugl-Meyer assessment > or =10. Arm trainer training did not lead to a superior primary outcome over electrical stimulation training. However, "good performers" on the secondary outcome seemed to benefit more from the arm trainer training.

Professional musicians with craniomandibular dysfunctions treated with oral splints.

PubMed

Steinmetz, Anke; Ridder, Paul H; Methfessel, Götz; Muche, Burkhard

2009-10-01

Craniomandibular dysfunction (CMD) symptoms occur frequently in violin/viola and wind players and can be associated with pain in the neck, shoulders and arm. In the current study, the effect of oral splint treatment of CMD on reducing pain and symptoms especially in these areas was investigated. Thirty (30) musicians undergoing CMD treatment with oral splints participated in this study. They completed a questionnaire that addressed CMD symptoms, localization of pain, and subjective changes in symptoms. Pain in the shoulder and/or upper extremity was the most frequent symptom reported by 83% of subjects, followed by neck pain (80%) and pain in the teeth/TMJ regions (63%). Treatment with oral splints contributed to a significant decrease in neck pain in 91%, teeth/TMJ pain in 83%, and shoulder and upper extremity pain in 76% of the musicians. Eighty percent (80%) of the patients reported improvement of their predominant symptoms. CMD can be a potential cause for pain in the neck, shoulders, and upper extremities of musicians. It is paramount that musicians with musculoskeletal problems be examined for CMD symptoms. Treatment with oral splints seems to be valuable. Further prospective, randomized controlled studies are necessary to confirm efficacy of oral splint treatment in CMD-associated pain and problems in the neck, shoulder, and the upper extremities in musicians.

Ethnic differences in stratum corneum functions between Chinese and Thai infants residing in Bangkok, Thailand.

PubMed

Fujimura, Tsutomu; Miyauchi, Yuki; Shima, Kyoko; Hotta, Mitsuyuki; Tsujimura, Hisashi; Kitahara, Takashi; Takema, Yoshinori; Palungwachira, Pakhawadee; Laohathai, Diane; Chanthothai, Jetchawa; Nararatwanchai, Thamthiwat

2018-01-01

Ethnic and racial differences in infant skin have not been well characterized. The purpose of this study was to establish whether there are ethnic differences and similarities in the stratum corneum (SC) functions of Thai and Chinese infants. Healthy infants 6 to 24 months of age (N = 60; 30 Thai, 30 Chinese) who resided in Bangkok, Thailand, were enrolled. Transepidermal water loss (TEWL) and SC hydration (capacitance) on the thigh, buttock, and upper arm were measured. Ceramide content was determined in the SC on the upper arm. SC hydration was not remarkably different between the two ethnicities at any site measured, but TEWL was significantly higher in Chinese infants than in Thai infants at all sites. Hydration of the SC was not significantly correlated with age in either ethnicity. TEWL had significant but weak correlations with age on the thigh and upper arm in Thai infants. Ceramide content was significantly higher in Chinese SC than in Thai SC. No relationship between ceramide content and TEWL or hydration was observed in either ethnicity. The significant differences in TEWL and ceramide contents between Chinese and Thai infant skin could prove useful in designing skin care and diapering products that are best suited for each ethnicity. © 2017 Wiley Periodicals, Inc.

Disability in the upper extremity and quality of life in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2005-11-30

To investigate whether hand-arm vibration syndrome (HAVS) leads to disability in the upper extremity or deficit in quality of life (QoL) using validated questionnaire tools, and to establish whether these effects are related to the Stockholm Workshop Staging (SWS). This was a postal cross-sectional questionnaire study with a 50% response rate. Four hundred and forty-four males, who had been diagnosed and staged according to the SWS were sent the Disability in the Arm, Shoulder and Hand (DASH) and the SF-36v2 QoL questionnaires. HAVS cases had significantly greater DASH disability scores and reduced QoL physical and mental component scores compared to published normal values. Those HAVS cases with a presumptive diagnosis of Carpal Tunnel Syndrome(CTS) had even higher disability scores. There was a clear, linear relationship between both the DASH disability score and the physical component of the QoL and sensorineural SWS, but not with the vascular SWS. HAVS has a significant effect on an individual's perceived ability to perform everyday tasks involving the upper extremity, and their quality of life. Physical capability may be further compromised in those individuals who have a presumptive diagnosis of CTS. These findings may have important implications regarding management of the affected worker.

Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

PubMed Central

Timmermans, Annick AA; Seelen, Henk AM; Willmann, Richard D; Kingma, Herman

2009-01-01

Background It is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning. Methods A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997–2007). Results One hundred and eighty seven scientific papers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on environmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems. Conclusion This review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabilitation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with patient-tailored feedback to support (re) learning of motor skills. PMID:19154570

Reference values of anthropometric measurements in Dutch children. The Oosterwolde Study.

PubMed

Gerver, W J; Drayer, N M; Schaafsma, W

1989-03-01

In the period 1979-1980 the following anthropometric measurements were recorded in 2351 healthy Dutch children from 0-17 years of age: height, weight, sitting height, arm span, lengths of upper-arm, lower-arm and hand, tibial length, foot length, biacromial diameter, biiliacal diameter, and head circumference. Corresponding percentile values were constructed on the basis of normality assumptions, the mean and standard deviation at age t being determined by a cubic spline approximation. The results are compared with other studies and given in the form of growth charts.

Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial

PubMed Central

Polatajko, Helene; Baum, Carolyn; Rios, Jorge; Cirone, Dianne; Doherty, Meghan; McEwen, Sara

2016-01-01

The purpose of this study was to estimate the effect of Cognitive Orientation to Daily Occupational Performance (CO–OP) compared with usual occupational therapy on upper-extremity movement, cognitive flexibility, and stroke impact in people less than 3 mo after stroke. An exploratory, single-blind randomized controlled trial was conducted with people referred to outpatient occupational therapy services at two rehabilitation centers. Arm movement was measured with the Action Research Arm Test, cognitive flexibility with the Delis–Kaplan Executive Function System Trail Making subtest, and stroke impact with subscales of the Stroke Impact Scale. A total of 35 participants were randomized, and 26 completed the intervention. CO–OP demonstrated measurable effects over usual care on all measures. These data provide early support for the use of CO–OP to improve performance and remediate cognitive and arm movement impairments after stroke over usual care; however, future study is warranted to confirm the effects observed in this trial. PMID:26943113

Characterization of upper troposphere water vapor measurements during AFWEX using LASE.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferrare, R. A.; Browell, E. V.; Ismail, I.

2002-07-15

Water vapor profiles from NASA's Lidar Atmospheric Sensing Experiment (LASE) system acquired during the ARM/FIRE Water Vapor Experiment (AFWEX) are used to characterize upper troposphere (UT) water vapor measured by ground-based Raman lidars, radiosondes, and in situ aircraft sensors. Initial comparisons showed the average Vaisala radiosonde measurements to be 5-15% drier than the average LASE, Raman lidar, and DC-8 in situ diode laser hygrometer measurements. They show that corrections to the Raman lidar and Vaisala measurements significantly reduce these differences. Precipitable water vapor (PWV) derived from the LASE water vapor profiles agrees within 3% on average with PWV derived frommore » the ARM ground-based microwave radiometer (MWR). The agreement among the LASE, Raman lidar, and MWR measurements demonstrates how the LASE measurements can be used to characterize both profile and column water vapor measurements and that ARM Raman lidar, when calibrated using the MWR PWV, can provide accurate UT water vapor measurements.« less

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems

PubMed Central

Blana, Dimitra; Hincapie, Juan G.; Chadwick, Edward K.; Kirsch, Robert F.

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs:motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model-calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems. PMID:18420213

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems.

PubMed

Blana, Dimitra; Hincapie, Juan G; Chadwick, Edward K; Kirsch, Robert F

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs: motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems.

Arm and neck pain in ultrasonographers.

PubMed

Claes, Frank; Berger, Jan; Stassijns, Gaëtane

2015-03-01

The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society.

Beneficial Effect of the Nutritional Support in Children Who Underwent Hematopoietic Stem Cell Transplant.

PubMed

Koç, Nevra; Gündüz, Mehmet; Tavil, Betül; Azik, M Fatih; Coşkun, Zeynep; Yardımcı, Hülya; Uçkan, Duygu; Tunç, Bahattin

2017-08-01

The aim of this study was to evaluate nutritional status in children who underwent hematopoietic stem cell transplant compared with a healthy control group. A secondary aim was to utilize mid-upper arm circumference as a measure of nutritional status in these groups of children. Our study group included 40 children (18 girls, 22 boys) with mean age of 9.2 ± 4.6 years (range, 2-17 y) who underwent hematopoietic stem cell transplant. Our control group consisted of 20 healthy children (9 girls, 11 boys). The children were evaluated at admission to the hospital and followed regularly 3, 6, 9, and 12 months after discharge from the hospital. In the study group, 27 of 40 patients (67.5%) received nutritional support during hematopoietic stem cell transplant, with 15 patients (56%) receiving enteral nutrition, 6 (22%) receiving total parenteral nutrition, and 6 (22%) receiving enteral and total parenteral nutrition. Chronic malnutrition rate in the study group was 47.5% on admission to the hospital, with the control group having a rate of 20%. One year after transplant, the rate decreased to 20% in the study group and 5% in the control group. The mid-upper arm circumference was lower in children in the study group versus the control group at the beginning of the study (P < .05). However, there were no significant differences in mid-upper arm circumference measurements between groups at follow-up examinations (P > .05). During follow-up, all anthropometric measurements increased significantly in both groups. Monitoring nutritional status and initiating appropriate nutritional support improved the success of hematopoietic stem cell transplant and provided a more comfortable process during the transplant period. Furthermore, mid-upper arm circumference is a more sensitive, useful, and safer parameter that can be used to measure nutritional status of children who undergo hematopoietic stem cell transplant.

Patient-Specific Computational Modeling of Upper Extremity Arteriovenous Fistula Creation: Its Feasibility to Support Clinical Decision-Making

PubMed Central

Bosboom, E. Marielle H.; Kroon, Wilco; van der Linden, Wim P. M.; Planken, R. Nils; van de Vosse, Frans N.; Tordoir, Jan H. M.

2012-01-01

Introduction Inadequate flow enhancement on the one hand, and excessive flow enhancement on the other hand, remain frequent complications of arteriovenous fistula (AVF) creation, and hamper hemodialysis therapy in patients with end-stage renal disease. In an effort to reduce these, a patient-specific computational model, capable of predicting postoperative flow, has been developed. The purpose of this study was to determine the accuracy of the patient-specific model and to investigate its feasibility to support decision-making in AVF surgery. Methods Patient-specific pulse wave propagation models were created for 25 patients awaiting AVF creation. Model input parameters were obtained from clinical measurements and literature. For every patient, a radiocephalic AVF, a brachiocephalic AVF, and a brachiobasilic AVF configuration were simulated and analyzed for their postoperative flow. The most distal configuration with a predicted flow between 400 and 1500 ml/min was considered the preferred location for AVF surgery. The suggestion of the model was compared to the choice of an experienced vascular surgeon. Furthermore, predicted flows were compared to measured postoperative flows. Results Taken into account the confidence interval (25th and 75th percentile interval), overlap between predicted and measured postoperative flows was observed in 70% of the patients. Differentiation between upper and lower arm configuration was similar in 76% of the patients, whereas discrimination between two upper arm AVF configurations was more difficult. In 3 patients the surgeon created an upper arm AVF, while model based predictions allowed for lower arm AVF creation, thereby preserving proximal vessels. In one patient early thrombosis in a radiocephalic AVF was observed which might have been indicated by the low predicted postoperative flow. Conclusions Postoperative flow can be predicted relatively accurately for multiple AVF configurations by using computational modeling. This model may therefore be considered a valuable additional tool in the preoperative work-up of patients awaiting AVF creation. PMID:22496816

Finger muscle attachments for an OpenSim upper-extremity model.

PubMed

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

2015-01-01

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

Finger Muscle Attachments for an OpenSim Upper-Extremity Model

PubMed Central

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

2015-01-01

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

Sex and genetic effects on upper and lower body fat and associations with diabetes in multigenerational families of African heritage.

PubMed

Miljkovic-Gacic, Iva; Wang, Xiaojing; Kammerer, Candace M; Bunker, Clareann H; Patrick, Alan L; Wheeler, Victor W; Kuller, Lewis H; Evans, Rhobert W; Zmuda, Joseph M

2008-06-01

Very few studies have comprehensively defined the genetic and environmental influences on body fat storage in the arms and legs and their association with diabetes, especially in families of African heritage. We analyzed body fat distribution by dual-energy x-ray absorptiometry (percentage total fat, percentage trunk fat, percentage arm fat, and percentage leg fat) and fasting serum glucose in 471 individuals (mean age, 43 years) from 8 multigenerational Afro-Caribbean families (mean family size = 51; 3535 relative pairs). Diabetes was inversely associated with percentage leg fat (P = .009) and, to some extent, positively associated with percentage arm fat independent of age, sex, and body size (P = .08), but not with anthropometric or dual-energy x-ray absorptiometric measures of total and central adiposity. Furthermore, percentage leg fat was inversely, whereas percentage arm fat was positively, associated with body mass index, waist circumference, and serum glucose (P < .01). Residual heritability (h2r) for arm and leg fat was significant (P < .01) and high: 62% (for percentage arm fat) and 40% (for percentage leg fat). Moreover, sex-specific h2r for leg fat was considerably higher (P = .02) in women than in men (h2r values, 58% vs 17%, respectively). Genetic correlation (rho(G)) between arm and leg fat was -0.61 (P < .01), suggesting that only 37% of the covariation between these 2 adipose tissue depots may be due to shared genetic influences. This study provides new evidence for a strong genetic and sex contribution to upper and lower body fat, with relatively little covariation between these traits due to shared genes. Our findings also suggest that, in this population, leg fat is associated with diabetes independent of overall adiposity.

Validation of the Omron M6 (HEM-7001-E) upper-arm blood pressure measuring device according to the International Protocol in adults and obese adults.

PubMed

Altunkan, Sekip; Ilman, Nevzat; Kayatürk, Nur; Altunkan, Erkan

2007-08-01

Electronic blood pressure (BP) measurement devices are the preferred choice of patients owing to their user-friendly nature; however, there is a requirement to investigate the accuracy and reliability of these devices. The objective of this study is to evaluate the accuracy of the Omron M6 upper-arm BP device against the mercury sphygmomanometer in adults and obese adults according to the International Protocol criteria. One hundred and twenty-one patients, older than 30 years of age, were studied and classified on the basis of the range of the International Protocol. BP measurements at the upper arm with the Omron M6 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential BP measurements were taken. A total of 33 participants were selected for each validation study. During the validation study, 99 measurements were performed on 33 participants for comparison. The first phase was performed on 15 participants, and if the device passed this phase, 18 more participants were selected. Having a two-fold purpose, this study was conducted on both adult and obese adult patients. Mean discrepancies and standard deviations of the monitor-mercury sphygmomanometer were 1.1+/-4.0 mmHg for systolic BP (SBP) and -0.5+/-3.5 mmHg for diastolic BP (DBP) in the adult group. The device passed phase 1 in 15 participants. In phase 2.1, out of a total of 99 comparisons, 88, 96, and 97 for SBP, and 88, 98, and 99 for DBP were <5, <10, and <15 mmHg, respectively. Mean discrepancies and standard deviations of the monitor-mercury sphygmomanometer were 1.7+/-4.8 mmHg for SBP and -0.8+/-4.3 mmHg for DBP in the obese adult group. The device passed phase 1 in 15 participants. In phase 2.1, out of a total of 99 comparisons, 82, 90, and 97 for SBP, and 80, 97, and 99 for DBP were <5, <10, and <15 mmHg, respectively. It was found that the Omron M6 automatic monitor, which measures BP at the upper arm, produced results in accordance with the criteria of phases 2.1 and 2.2 in both SBP and DBP, when applied to adults and to obese adults. It was concluded that the Omron M6 device, which measures BP at the upper arm, was deemed to be in accordance with the International Protocol criteria and can be recommended for use by adults and obese adults.

Torsionally rigid support apparatus for marine seismic transducer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Myers, W.J.; Cole, J.H.

1989-11-14

This patent describes apparatus for supporting a marine seismic transducer from a vessel. It comprises: an elongated substantially rigid towing arm; a connector means for connecting the transducer to a lower end of the towing arm; a swivel member which is secured to the vessel and is pivotable about a generally horizontal first axis transverse to a length of the vessel; and a support means for pivotally connecting an upper end of the towing arm to the swivel member. The support means being pivotal relative to the swivel member about a second axis transverse to a longitudinal axis of themore » towing arm. The support means being substantially rigid so as to prevent any substantial rotation of the towing arm about its the longitudinal axis.« less

Factors Associated With Anthropometric Indicators of Nutritional Status in Children With Chronic Kidney Disease Undergoing Peritoneal Dialysis, Hemodialysis, and After Kidney Transplant.

PubMed

García De Alba Verduzco, Julieta; Hurtado López, Erika Fabiola; Pontón Vázquez, Consuelo; de la Torre Serrano, Adriana; Romero Velarde, Enrique; Vásquez Garibay, Edgar Manuel

2018-05-11

The objective of the study was to demonstrate that there are differences in the factors associated with anthropometric indicators of nutritional status, with particular emphasis on arm indicators, in children with end-stage kidney disease undergoing peritoneal dialysis (PD), hemodialysis (HD), and after kidney transplant (KT). An analytical cross-sectional study of consecutive cases included 130 children and adolescents with end-stage kidney disease undergoing substitutive treatment: 49 patients who underwent KT, 33 undergoing PD, and 47 undergoing HD. Socioeconomic data were obtained from all the 3 groups; anthropometric indicators of nutritional status were calculated. Student's t-test and analysis of variance were used for parametric variables. Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and odds ratio (OR) were used for nonparametric variables. The number of parents living as couples was higher for patients who underwent KT (OR = 3.5 [95% confidence interval {CI} 1.34-9.0]) and undergoing PD (OR = 3.0 [95% CI 1.06-8.8]) than those undergoing HD. The number of mothers who worked outside the home was higher for patients who underwent KT and undergoing PD than the mothers of patients undergoing HD (OR = 13.7 [95% CI: 4.56-41.05]; OR = 15.4 [CI 95% 4.8-49], respectively). Family income was higher for patients who underwent KT and undergoing PD (P = .019, P = .093, respectively). More than 40% of patients in all the 3 groups had growth impairment. Body mass index, mid-upper arm circumference, tricipital and subscapular skinfolds, total arm area, and arm fat area were affected in HD and PD groups (9 to 40%), while of the patients who underwent KT, 36.7% were overweight or obese. More than 50% of patients who underwent KT and undergoing HD and PD had involvement in the arm muscular area. Socioeconomic conditions are more influential for children in the HD program. The nutritional status of children after KT improves; however, not all anthropometric indicators are fully recovered. Children after KT are up to 9 times more likely to be overweight or obese. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The effect of arm sling on balance in patients with hemiplegia.

PubMed

Acar, Merve; Karatas, Gulcin Kaymak

2010-10-01

The aim of this study was to investigate the effect of an arm sling on balance in patients with, hemiplegia following a stroke. Twenty-six patients with hemiplegia (11 men, 15 women) who had, shoulder subluxation were enrolled in the study. Balance was evaluated by the Berg Balance Scale, the, Functional Reach test, and a static balance index which was measured by the Kinesthetic Ability, Trainer 3000. Balance tests were performed twice, with arm sling and without arm sling use. Results of, this study show that the Berg Balance Scores and static balance index ameliorated with arm sling use (p=0.005 and p=0.004, respectively). Likewise, the Functional Reach test was better when performed with an arm sling (p=0.039). In conclusion, arm slings have a beneficial effect on balance in patients, with hemiplegia. An arm sling may be applied for its possible beneficial effect on balance especially in, the early phases of stroke rehabilitation while the upper extremity is still flaccid and arm swing is, reduced. Copyright © 2010 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Ergonomic stressors and upper extremity disorders in vehicle manufacturing: cross sectional exposure-response trends

PubMed Central

Punnett, L.

1998-01-01

OBJECTIVE: To evaluate the association between upper extremity soft tissue disorders and exposure to preventable ergonomic stressors in vehicle manufacturing operations. METHODS: A cross sectional study was conducted in one vehicle stamping plant and one engine assembly plant. A standardised physical examination of the upper extremities was performed on all subjects. An interviewer administered questionnaire obtained data on demographics, work history, musculoskeletal symptoms, non-occupational covariates, and psycho-physical (relative intensity) ratings of ergonomic stressors. The primary exposure score was computed by summing the responses to the psychophysical exposure items. Multivariate regression analysis was used to model the prevalence of disorders of the shoulders or upper arms, wrists or hands, and all upper extremity regions (each defined both by symptoms and by physical examination plus symptoms) as a function of exposure quartile. RESULTS: A total of 1315 workers (85% of the target population) was examined. The prevalence of symptom disorders was 22% for the wrists or hands and 15% for the shoulders or upper arms; cases defined on the basis of a physical examination were about 80% as frequent. Disorders of the upper extremities, shoulders, and wrists or hands all increased markedly with exposure score, after adjustment for plant, acute injury, sex, body mass index, systemic disease, and seniority. CONCLUSIONS: Musculoskeletal disorders of the upper extremities were strongly associated with exposure to combined ergonomic stressors. The exposure- response trend was very similar for symptom cases and for physical examination cases. It is important to evaluate all dimensions of ergonomic exposure in epidemiological studies, as exposures often occur in combination in actual workplaces.   PMID:9764102

Characterisation and Outcomes of Upper Extremity Amputations

DTIC Science & Technology

2014-06-01

military service members from 1 October 2001 to 30 July 2011 was conducted. Data from the Department of Defense Trauma Registry, the Armed Forces... Trauma Registry, the Armed Forces Health Longitudinal Technology Application, and the Physical Evaluation Board Liaison Offices were queried in order to...without associated lower extremity amputation. This cohort was cross-referenced with the Department of Defense Trauma Registry (DoDTR, Joint Base

A hybrid BMI-based exoskeleton for paresis: EMG control for assisting arm movements

NASA Astrophysics Data System (ADS)

Kawase, Toshihiro; Sakurada, Takeshi; Koike, Yasuharu; Kansaku, Kenji

2017-02-01

Objective. Brain-machine interface (BMI) technologies have succeeded in controlling robotic exoskeletons, enabling some paralyzed people to control their own arms and hands. We have developed an exoskeleton asynchronously controlled by EEG signals. In this study, to enable real-time control of the exoskeleton for paresis, we developed a hybrid system with EEG and EMG signals, and the EMG signals were used to estimate its joint angles. Approach. Eleven able-bodied subjects and two patients with upper cervical spinal cord injuries (SCIs) performed hand and arm movements, and the angles of the metacarpophalangeal (MP) joint of the index finger, wrist, and elbow were estimated from EMG signals using a formula that we derived to calculate joint angles from EMG signals, based on a musculoskeletal model. The formula was exploited to control the elbow of the exoskeleton after automatic adjustments. Four able-bodied subjects and a patient with upper cervical SCI wore an exoskeleton controlled using EMG signals and were required to perform hand and arm movements to carry and release a ball. Main results. Estimated angles of the MP joints of index fingers, wrists, and elbows were correlated well with the measured angles in 11 able-bodied subjects (correlation coefficients were 0.81  ±  0.09, 0.85  ±  0.09, and 0.76  ±  0.13, respectively) and the patients (e.g. 0.91  ±  0.01 in the elbow of a patient). Four able-bodied subjects successfully positioned their arms to adequate angles by extending their elbows and a joint of the exoskeleton, with root-mean-square errors  <6°. An upper cervical SCI patient, empowered by the exoskeleton, successfully carried a ball to a goal in all 10 trials. Significance. A BMI-based exoskeleton for paralyzed arms and hands using real-time control was realized by designing a new method to estimate joint angles based on EMG signals, and these may be useful for practical rehabilitation and the support of daily actions.

A hybrid BMI-based exoskeleton for paresis: EMG control for assisting arm movements.

PubMed

Kawase, Toshihiro; Sakurada, Takeshi; Koike, Yasuharu; Kansaku, Kenji

2017-02-01

Brain-machine interface (BMI) technologies have succeeded in controlling robotic exoskeletons, enabling some paralyzed people to control their own arms and hands. We have developed an exoskeleton asynchronously controlled by EEG signals. In this study, to enable real-time control of the exoskeleton for paresis, we developed a hybrid system with EEG and EMG signals, and the EMG signals were used to estimate its joint angles. Eleven able-bodied subjects and two patients with upper cervical spinal cord injuries (SCIs) performed hand and arm movements, and the angles of the metacarpophalangeal (MP) joint of the index finger, wrist, and elbow were estimated from EMG signals using a formula that we derived to calculate joint angles from EMG signals, based on a musculoskeletal model. The formula was exploited to control the elbow of the exoskeleton after automatic adjustments. Four able-bodied subjects and a patient with upper cervical SCI wore an exoskeleton controlled using EMG signals and were required to perform hand and arm movements to carry and release a ball. Estimated angles of the MP joints of index fingers, wrists, and elbows were correlated well with the measured angles in 11 able-bodied subjects (correlation coefficients were 0.81  ±  0.09, 0.85  ±  0.09, and 0.76  ±  0.13, respectively) and the patients (e.g. 0.91  ±  0.01 in the elbow of a patient). Four able-bodied subjects successfully positioned their arms to adequate angles by extending their elbows and a joint of the exoskeleton, with root-mean-square errors  <6°. An upper cervical SCI patient, empowered by the exoskeleton, successfully carried a ball to a goal in all 10 trials. A BMI-based exoskeleton for paralyzed arms and hands using real-time control was realized by designing a new method to estimate joint angles based on EMG signals, and these may be useful for practical rehabilitation and the support of daily actions.

Lack of association between venous hemodynamics, venous morphology and the postthrombotic syndrome after upper extremity deep venous thrombosis.

PubMed

Czihal, M; Paul, S; Rademacher, A; Bernau, C; Hoffmann, U

2015-03-01

To explore the association of the postthrombotic syndrome with venous hemodynamics and morphological abnormalities after upper extremity deep venous thrombosis. Thirty-seven patients with a history of upper extremity deep venous thrombosis treated with anticoagulation alone underwent a single study visit (mean time after diagnosis: 44.4 ± 28.1 months). Presence and severity postthrombotic syndrome were classified according to the modified Villalta score. Venous volume and venous emptying were determined by strain-gauge plethysmography. The arm veins were assessed for postthrombotic abnormalities by ultrasonography. The relationship between postthrombotic syndrome and hemodynamic and morphological sequelae was evaluated using univariate significance tests and Spearman's correlation analysis. Fifteen of 37 patients (40.5%) developed postthrombotic syndrome. Venous volume and venous emptying of the arm affected by upper extremity deep venous thrombosis did not correlate with the Villalta score (rho = 0.17 and 0.19; p = 0.31 and 0.25, respectively). Residual morphological abnormalities, as assessed by ultrasonography, did not differ significantly between patients with and without postthrombotic syndrome (77.3% vs. 86.7%, p = 0.68). Postthrombotic syndrome after upper extremity deep venous thrombosis is not associated with venous hemodynamics or residual morphological abnormalities. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Innovative approaches to the rehabilitation of upper extremity hemiparesis using virtual environments

PubMed Central

MERIANS, A. S.; TUNIK, E.; FLUET, G. G.; QIU, Q.; ADAMOVICH, S. V.

2017-01-01

Aim Upper-extremity interventions for hemiparesis are a challenging aspect of stroke rehabilitation. Purpose of this paper is to report the feasibility of using virtual environments (VEs) in combination with robotics to assist recovery of hand-arm function and to present preliminary data demonstrating the potential of using sensory manipulations in VE to drive activation in targeted neural regions. Methods We trained 8 subjects for 8 three hour sessions using a library of complex VE’s integrated with robots, comparing training arm and hand separately to training arm and hand together. Instrumented gloves and hand exoskeleton were used for hand tracking and haptic effects. Haptic Master robotic arm was used for arm tracking and generating three-dimensional haptic VEs. To investigate the use of manipulations in VE to drive neural activations, we created a “virtual mirror” that subjects used while performing a unimanual task. Cortical activation was measured with functional MRI (fMRI) and transcranial magnetic stimulation. Results Both groups showed improvement in kinematics and measures of real-world function. The group trained using their arm and hand together showed greater improvement. In a stroke subject, fMRI data suggested virtual mirror feedback could activate the sensorimotor cortex contralateral to the reflected hand (ipsilateral to the moving hand) thus recruiting the lesioned hemisphere. Conclusion Gaming simulations interfaced with robotic devices provide a training medium that can modify movement patterns. In addition to showing that our VE therapies can optimize behavioral performance, we show preliminary evidence to support the potential of using specific sensory manipulations to selectively recruit targeted neural circuits. PMID:19158659

[Effects of massage on delayed-onset muscle soreness].

PubMed

Bakowski, Paweł; Musielak, Bartosz; Sip, Paweł; Biegański, Grzegorz

2008-01-01

Delayed onset muscle soreness (DOMS) is the pain or discomfort often felt 12 to 24 hours after exercising and subsides generally within 4 to 6 days. Once thought to be caused by lactic acid buildup, a more recent theory is that it is caused by inflammatory process or tiny tears in the muscle fibers caused by eccentric contraction, or unaccustomed training levels. Exercises that involve many eccentric contractions will result in the most severe DOMS. Fourteen healthy men with no history of upper arm injury and no experience in resistance training were recruited. The mean age, height, and mass of the subjects were 22.8 +/- 1.2 years, 178.3 +/- 10.3 cm, and 75.0 +/- 14.2 kg, respectively. Subjects performed 8 sets of concentric and eccentric actions of the elbow flexors with each arm according to Stay protocol. One arm received 10 minutes of massage 30 minutes after exercise, the contralateral arm received no treatment. Measurements were taken at 9 assessment times: pre-exercise and postexercise at 10 min, 6, 12, 24, 36, 48, 72 and 96 hours. Dependent variables were range of motion, perceived soreness and upper arm circumference. There was noticed difference in perceived soreness across time between groups. The analysis indicated that massage resulted in a 10% to 20% decrease in the severity of soreness, but the differences were not significant. Difference in range of motion and arm circumference was not observed. Massage administered 30 minutes after exercises could have a beneficial influence on DOMS but without influence on muscle swelling and range of motion.

Kinematics of preferred and non-preferred handballing in Australian football.

PubMed

Parrington, Lucy; Ball, Kevin; MacMahon, Clare

2015-01-01

In Australian football (AF), handballing proficiently with both the preferred and non-preferred arm is important at elite levels; yet, little information is available for handballing on the non-preferred arm. This study compared preferred and non-preferred arm handballing techniques. Optotrak Certus (100 Hz) collected three-dimensional data for 19 elite AF players performing handballs with the preferred and non-preferred arms. Position data, range of motion (ROM), and linear and angular velocities were collected and compared between preferred and non-preferred arms using dependent t-tests. The preferred arm exhibited significantly greater forearm and humerus ROM and angular velocity and significantly greater shoulder angular velocity at ball contact compared to the non-preferred arm. In addition, the preferred arm produced a significantly greater range of lateral bend and maximum lower-trunk speed, maximum strike-side hip speed and hand speed at ball contact than the non-preferred arm. The non-preferred arm exhibited a significantly greater shoulder angle and lower- and upper-trunk orientation angle, but significantly lower support-elbow angle, trunk ROM, and trunk rotation velocity compared to the preferred arm. Reduced ROM and angular velocities found in non-preferred arm handballs indicates a reduction in the degrees of freedom and a less developed skill. Findings have implication for development of handballing on the non-preferred arm.

Maintained physical activity and physiotherapy in the management of distal upper limb pain – a protocol for a randomised controlled trial (the arm pain trial)

PubMed Central

2014-01-01

Background Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Methods/Design Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire. We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Discussion Results from this trial will contribute to the evidence base underpinning the clinical management of patients with distal upper limb pain, and in particular, will provide guidance on whether they should be advised to rest the arm or remain active within the limits imposed by their symptoms. Trial registration Registered on http://www.controlled-trials.com (reference number: ISRCTN79085082). PMID:24612447

Maintained physical activity and physiotherapy in the management of distal upper limb pain - a protocol for a randomised controlled trial (the arm pain trial).

PubMed

Jones, Gareth T; Mertens, Kathrin; Macfarlane, Gary J; Palmer, Keith T; Coggon, David; Walker-Bone, Karen; Burton, Kim; Heine, Peter J; McCabe, Candy; McNamee, Paul; McConnachie, Alex

2014-03-10

Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire.We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Results from this trial will contribute to the evidence base underpinning the clinical management of patients with distal upper limb pain, and in particular, will provide guidance on whether they should be advised to rest the arm or remain active within the limits imposed by their symptoms. Registered on http://www.controlled-trials.com (reference number: ISRCTN79085082).

The Impact of Model Configuration and Large-Scale, Upper-Level Forcing on CRM-Simulated Convective Systems

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Zeng, X.; Shie, C.-L.; Starr, D.; Simpson, J.

2004-01-01

Real clouds and cloud systems are inherently three-dimensional (3D). Because of the limitations in computer resources, however, most cloud-resolving models (CRMs) today are still two-dimensional (2D, see a brief review by Tao 2003). Only recently have 3D experiments been performed for multi-day periods for tropical cloud systems with large horizontal domains at the National Center for Atmospheric Research, at NOAA GFDL, at the U. K. Met. Office, at Colorado State University and at NASA Goddard Space Flight Center (Tao 2003). At Goddard, a 3D Goddard Cumulus Ensemble (GCE) model was used to simulate periods during TOGA COARE (December 19-27, 1992), GATE (September 1-7, 1974), SCSMEX (June 2-11, 1998), ARM (June 26-30, 1997) and KWAJEX (August 7-13, August 18-21, and August 29-September 12, 1999) using a 512 km domain (with 2-kilometer resolution). The results indicate that surface precipitation and latent heating profiles are similar between the 2D and 3D GCE model simulations. However, there are difference in radiation, surface fluxes and precipitation characteristics. The 2D GCE model was used to perform a long-term integration on ARM/GCSS case 4 (22 days at the ARM southern Great Plains site in March 2000). Preliminary results showed a large temperature bias in the upper troposphere that had not been seen in previous tropical cases. The major objectives of this paper are: (1) to determine the sensitivities to model configuration (ie., 2D in west-east, south-north or 3D), (2) to identify the differences and similarities in the organization and entrainment rates of convection between 2D- and 3D-simulated ARM cloud systems, and (3) assess the impact of upper tropospheric forcing on tropical and ARM case 4 cases.

The Impact of Model Configuration and Large-Scale, Upper-Level Forcing on CRM- Simulated Convective Systems

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Zeng, X.; Shie, C.-L.; Starr, D.; Simpson, J.

2004-01-01

Real clouds and cloud systems are inherently three-dimensional (3D). Because of the limitations in computer resources, however, most cloud-resolving models (CRMs) today are still two-dimensional (2D, see a brief review by Tao 2003). Only recently have 3D experiments been performed for multi-day periods for tropical cloud systems with large horizontal domains at the National Center for Atmospheric Research, at NOAA GFDL, at the U. K. Met. Office, at Colorado State University and at NASA Goddard Space Flight Center (Tao 2003). At Goddard, a 3D Goddard Cumulus Ensemble (GCE) model was used to simulate periods during TOGA COARE (December 19-27, 1992), GATE (September 1-7, 1974), SCSMEX (June 2-11, 1998), ARM (June 26-30, 1997) and KWAJEX (August 7-13, August 18-21, and August 29-September 12, 1999) using a 512 by 512 km domain (with 2-km resolution). The results indicate that surface precipitation and latent heating profiles are similar between the 2D and 3D GCE model simulations. However, there are difference in radiation, surface fluxes and precipitation characteristics. The 2D GCE model was used to perform a long-term integration on ARM/GCSS case 4 (22 days at the ARM Southern Great Plains site in March 2000). Preliminary results showed a large temperature bias in the upper troposphere that had not been seen in previous tropical cases. The major objectives of this paper are: (1) to determine the sensitivities to model configuration (i.e., 2D in west-east, south-north or 3D), (2) to identify the differences and similarities in the organization and entrainment rates of convection between 2D- and 3D-simulated ARM cloud systems, and (3) assess the impact of upper tropospheric forcing on tropical and ARM case 4 cases.

Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows.

PubMed

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2018-03-01

We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate if exposure to hand-arm vibration (HAV) is an independent risk factor. We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register-based occupational codes (1993-2007) to a general population job exposure matrix to obtain year-by-year exposure intensities on measurement scales for force, upper arm elevation >90° and repetition and expert rated intensities of exposure to HAV. For 10-year exposure time windows, we calculated the duration of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. We found indications of safe exposure intensities for repetition (median angular velocity <45°/s), while force exertion ≥10% of maximal voluntary electrical activity and upper arm elevation >90° >2 min/day implied an increased risk reaching ORs of 1.7 and 1.5 after 10 years at low intensities. No associations were found for HAV. We found indications of safe exposure intensities for repetition. Any intensities of force and upper arm elevation >90° above minimal implied an increased risk across 10-year exposure time windows. No independent associations were found for HAV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Thermal Nondestructive Evaluation Report: Inspection of the Refurbished Manipulator Arm System in the Manipulator Development Facility at Johnson Space Center 10-12 January 2001

NASA Technical Reports Server (NTRS)

Cramer, K. Elliott

2002-01-01

On 4 December 2002, a failure of the Refurbished Manipulator Arm System (RMAS) occurred in the Manipulator Development Facility (MDF) at Johnson Space Center. When the Test Director commanded a should pitch maneuver to lift the arm from its payload bay pedestal, the yaw controls failed. This, coupled with a gravitational forces (due to the angle of the shoulder joint with respect to vertical), resulted in uncontrolled arm motion. The shoulder yaw joint moved approximately 20 degrees, causing the extended arm to strike and severely damage the port side MDF catwalk handrails. The arm motion stopped after impact with the handrails. On 10-12 January 2001, inspections were performed on the port face of the lower and upper arms of the RMAS using a infrared thermography developed at Langley Research Center. This paper presents the results of those nondestructive inspections and provides a complete description of the anomalies found and their locations.

Kinect-based virtual rehabilitation and evaluation system for upper limb disorders: A case study.

PubMed

Ding, W L; Zheng, Y Z; Su, Y P; Li, X L

2018-04-19

To help patients with disabilities of the arm and shoulder recover the accuracy and stability of movements, a novel and simple virtual rehabilitation and evaluation system called the Kine-VRES system was developed using Microsoft Kinect. First, several movements and virtual tasks were designed to increase the coordination, control and speed of the arm movements. The movements of the patients were then captured using the Kinect sensor, and kinematics-based interaction and real-time feedback were integrated into the system to enhance the motivation and self-confidence of the patient. Finally, a quantitative evaluation method of upper limb movements was provided using the recorded kinematics during hand-to-hand movement. A preliminary study of this rehabilitation system indicates that the shoulder movements of two participants with ataxia became smoother after three weeks of training (one hour per day). This case study demonstrated the effectiveness of the designed system, which could be promising for the rehabilitation of patients with upper limb disorders.

A structural comparison of female-male and female-female mounting in Japanese macaques (Macaca fuscata).

PubMed

Ottenheimer Carrier, Lydia; Leca, Jean-Baptiste; Pellis, Sergio; Vasey, Paul L

2015-10-01

In certain populations, female Japanese macaques (Macaca fuscata) mount both males and females. Vasey (2007) proposed that female-female sexual mounting in Japanese macaques may be a neutral evolutionary by-product of a purported adaptation, namely, female-male mounting. In this study, we aim to further examine the proposed link between female-male and female-female mounting in Japanese macaques by comparing the structural characteristics that define both forms of mounting. We do so using Eshkol-Wachman Movement Notation (EWMN), a globographic reference system that can be used to describe the position of body segments. No significant differences were observed in the female mounters' positioning of eight different body segments (i.e., lower torso, mid-torso, upper torso, upper arm, lower arm, upper leg, lower leg, and foot) during female-male and female-female mounting. This finding lends support to the conclusion that female-female and female-male mounting are structurally, and thus, evolutionarily, related. Copyright © 2015 Elsevier B.V. All rights reserved.

Similar metabolic response to lower- versus upper-body interval exercise or endurance exercise.

PubMed

Francois, Monique E; Graham, Matthew J; Parr, Evelyn B; Rehrer, Nancy J; Lucas, Samuel J E; Stavrianeas, Stasinos; Cotter, James D

2017-03-01

To compare energy use and substrate partitioning arising from repeated lower- versus upper-body sprints, or endurance exercise, across a 24-h period. Twelve untrained males (24±4 y) completed three trials in randomized order: (1) repeated sprints (five 30-s Wingate, 4.5-min recovery) on a cycle ergometer (SIT Legs ); (2) 50-min continuous cycling at 65% V̇O 2 max (END); (3) repeated sprints on an arm-crank ergometer (SIT Arms ). Respiratory gas exchange was assessed before and during exercise, and at eight points across 22h of recovery. Metabolic rate was elevated to greater extent in the first 8h after SIT Legs than SIT Arms (by 0.8±1.1kJ/min, p=0.03), and tended to be greater than END (by 0.7±1.3kJ/min, p=0.08). Total 24-h energy use (exercise+recovery) was equivalent between SIT Legs and END (p = 0.55), and SIT Legs and SIT Arms (p=0.13), but 24-h fat use was higher with SIT Legs than END (by 26±38g, p=0.04) and SIT Arms (by 27±43g, p=0.05), whereas carbohydrate use was higher with SIT Arms than SIT Legs (by 32±51g, p=0.05). Plasma volume-corrected post-exercise and fasting glucose and lipid concentrations were unchanged. Despite much lower energy use during five sprints than 50-min continuous exercise, 24-h energy use was not reliably different. However, (i) fat metabolism was greater after sprints, and (ii) carbohydrate metabolism was greater in the hours after sprints with arms than legs, while 24-h energy usage was comparable. Thus, sprints using arms or legs may be an important adjunct exercise mode for metabolic health. Copyright © 2016 Elsevier Inc. All rights reserved.

Attrition and retention in upper limb prosthetics research: experience of the VA home study of the DEKA arm.

PubMed

Resnik, Linda; Klinger, Shana

2017-11-01

(1) Describe study attrition; (2) identify reasons for attrition, and (3) discuss implications for prosthetic prescription and design of future device studies. Design and methodological procedures used: Completion phase (during in-laboratory training, after training, or home use) was identified for 42 participants. Qualitative data were analyzed to identify attrition reasons. Reasons were classified as related to the DEKA arm, or not. Study attrition was 57%, with 43% completing the full study. Attrition during the in-laboratory portion was 21%. Reasons for attrition were related to the DEKA arm entirely or in-part for 42%, 25%, respectively. Most common reasons were scheduling/personal (54%); device weight (29%); and dissatisfaction with device (25%). About 21% withdrew because of concerns about compliance with study protocol. This study had a high attrition rate with evidence of selective attrition due to device characteristics. Strategies to minimize attrition and the importance of tracking reasons for withdrawal are discussed. Given that retention could be an indicator of willingness to adopt the DEKA arm, findings suggest that it would be prudent to provide patients with the opportunity to train with the DEKA arm before a decision is made regarding the appropriateness of the device for the patient. Implications for Rehabilitation This study of a new upper limb prosthesis, the DEKA arm, had a 57% attrition rate with evidence of selective attrition due to characteristics of the DEKA arm. Findings point to the need for strategies to minimize attrition in future studies. Findings also illustrate the importance of tracking reasons for subject withdrawal in longitudinal prosthesis device studies. Because participant retention in longitudinal device studies may be an indicator of future willingness to adopt a device, our findings suggest that it would be prudent to provide patients with the opportunity to train with the DEKA arm before a final decision is made regarding the appropriateness of the device for the patient.

Rationale of subdermal superficial liposuction related to the anatomy of subcutaneous fat and the superficial fascial system.

PubMed

Gasperoni, C; Salgarello, M

1995-01-01

The liposuction technique has changed greatly over the years. In 1989, the authors presented subdermal superficial liposuction which treats the superficial fat layer and yields better skin retraction. With this technique the surgeon can treat thin adipose layers to obtain better results in more cases than the traditional liposuction technique. The technique can be used in cases with difficult skin adjustment and in secondary cases when "deep only" liposuction has been performed and there were residual adiposities. Subdermal superficial liposuction evolved so that one could obtain good skin retraction by performing massive liposuction of all the fat layers. The authors named this technique MALL (Massive All Layer Liposuction). The technique is applied in body areas where the fat layer is very thick and stretches the skin because of its volume and weight such as in the abdomen, posterior arms, and internal surface of the upper third of the thighs. MALL liposuction drastically reduces the indications for abdominoplasty and inner thigh and arm dermolipectomies. Knowledge of the anatomy of the subcutaneous fat and the superficial fascial system allows one to explain the subdermal superficial liposuction from an anatomical point of view, to perform a more rational and effective procedure, and to differentiate the technique depending on the area of the body.

Improvement on upper limb body-powered prostheses (1921-2016): A systematic review.

PubMed

Hashim, Nur Afiqah; Abd Razak, Nasrul Anuar; Abu Osman, Noor Azuan; Gholizadeh, Hossein

2018-01-01

Body-powered prostheses are known for their advantages of cost, reliability, training period, maintenance, and proprioceptive feedback. This study primarily aims to analyze the work related to the improvement of upper limb body-powered prostheses prior to 2016. A systematic review conducted via the search of the Web of Science electronic database, Google Scholar, and Google Patents identified 155 papers from 1921 to 2016. Sackett's initial rules of evidence were used to determine the levels of evidence, and only papers categorized in the design and development category and patents were analyzed. A total of 40 papers in the sixth level of "Design and Development" of an upper limb body-powered prosthesis were found. Approximately 81% were categorized under mechanical alteration. Most papers were patent-type documents (48%), with the Journal of Rehabilitation Research and Development publishing most of the articles related to the design and development of body-powered prostheses. Papers in the scope of the study were published once every 3 years in almost a century, proving that only a few studies were conducted to improve body-powered arms compared with myoelectric technology. Further research should be carried out mainly in areas that have received less attention.

Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study.

PubMed

Chaput, J-P; Katzmarzyk, P T; Barnes, J D; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tudor-Locke, C; Zhao, P; Tremblay, M S

2017-12-01

No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data. In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings. © 2016 World Obesity Federation.

Nutritional aspects of Noonan syndrome and Noonan-related disorders.

PubMed

da Silva, Fernanda Marchetto; Jorge, Alexander Augusto; Malaquias, Alexandra; da Costa Pereira, Alexandre; Yamamoto, Guilherme Lopes; Kim, Chong Ae; Bertola, Debora

2016-06-01

Rasopathies are a group of rare disorders characterized by neurocardiofaciocutaneous involvement, and caused by mutations in several genes of the RAS/MAPK pathway. In the present study, we characterized growth parameters, body composition, and nutritional aspects of children and adults (n = 62) affected by these disorders, mainly Noonan syndrome, using an indirect method-anthropometry-and a 24-hr recall questionnaire. The growth parameters in our cohort showed short stature, especially in individuals with RAF1 and SHOC2 mutations, lower obesity rates compared to the control population, and BMI scores highest in individuals with BRAF mutations and lowest in individuals with SHOC2. Body composition showed a compromise in the upper arm muscle circumference, with a statistically significant difference in the z-score of triceps skinfold (P = 0.0204) and upper arm fat area (P = 0.0388) between BRAF and SHOC2 groups and in the z-score of triceps skinfold between RAF1 and SHOC2 (P = 0.0218). The pattern of macronutrient consumption was similar to the control population. Our study is the first to address body composition in RASopathy individuals and the data indicate a compromise not only in adipose tissue, but also in muscle mass. Studies using different techniques, such as dual-energy X-ray absorptiometry or imaging studies, which give a more precise delineation of fat and non-fat mass, are required to confirm our results, ultimately causing an impact on management strategies. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial.

PubMed

Rodgers, Helen; Shaw, Lisa; Bosomworth, Helen; Aird, Lydia; Alvarado, Natasha; Andole, Sreeman; Cohen, David L; Dawson, Jesse; Eyre, Janet; Finch, Tracy; Ford, Gary A; Hislop, Jennifer; Hogg, Steven; Howel, Denise; Hughes, Niall; Krebs, Hermano Igo; Price, Christopher; Rochester, Lynn; Stamp, Elaine; Ternent, Laura; Turner, Duncan; Vale, Luke; Warburton, Elizabeth; van Wijck, Frederike; Wilkes, Scott

2017-07-20

Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke. Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation. NHS stroke services. adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation. Randomisation groups: 1. Robot-assisted training using the InMotion robotic gym system for 45 min, three times/week for 12 weeks 2. Enhanced upper limb therapy for 45 min, three times/week for 12 weeks 3. Usual NHS care in accordance with local clinical practice Randomisation: individual participant randomisation stratified by centre, time since stroke, and severity of upper limb impairment. upper limb function measured by the Action Research Arm Test (ARAT) at 3 months post randomisation. upper limb impairment (Fugl-Meyer Test), activities of daily living (Barthel ADL Index), quality of life (Stroke Impact Scale, EQ-5D-5L), resource use, cost per quality-adjusted life year and adverse events, at 3 and 6 months. Blinding: outcomes are undertaken by blinded assessors. Economic analysis: micro-costing and economic evaluation of interventions compared to usual NHS care. A within-trial analysis, with an economic model will be used to extrapolate longer-term costs and outcomes. Process evaluation: semi-structured interviews with participants and professionals to seek their views and experiences of the rehabilitation that they have received or provided, and factors affecting the implementation of the trial. allowing for 10% attrition, 720 participants provide 80% power to detect a 15% difference in successful outcome between each of the treatment pairs. Successful outcome definition: baseline ARAT 0-7 must improve by 3 or more points; baseline ARAT 8-13 improve by 4 or more points; baseline ARAT 14-19 improve by 5 or more points; baseline ARAT 20-39 improve by 6 or more points. The results from this trial will determine whether robot-assisted training improves upper limb function post stroke. ISRCTN, identifier: ISRCTN69371850 . Registered 4 October 2013.

Mechanisms of Injury and Countermeasures for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeff; Hoffman, Ron; Harvey, Craig; Bowen, C. K.; Hudy, C. E.; Tuxhorn, Jennifer; Gernhardt, Mike; Scheuring, Richard A.

2007-01-01

The goal of this study is to determine the role that moisture plays in the injury to the fingers and fingernails during EVA training operations in the Neutral Buoyancy Laboratory. Current Extravehicular Mobility Unit (EMU, with a PLSS) as configured in the NBL was used for all testing and a vent tube was extended down a single arm of the crewmember during the test; vent tube was moved between left and right arm to serve as experimental condition being investigated and the other arm served as control condition.

The quest for the bionic arm.

PubMed

Hutchinson, Douglas T

2014-06-01

The current state of research of upper extremity prosthetic devices is focused on creating a complete prosthesis with full motor and sensory function that will provide amputees with a near-normal human arm. Although advances are being made rapidly, many hurdles remain to be overcome before a functional, so-called bionic arm is a reality. Acquiring signals via nerve or muscle inputs will require either a reliable wireless device or direct wiring through an osseous-integrated implant. The best way to tap into the "knowledge" present in the peripheral nerve is yet to be determined. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

Equivalence Reliability among the FITNESSGRAM[R] Upper-Body Tests of Muscular Strength and Endurance

ERIC Educational Resources Information Center

Sherman, Todd; Barfield, J. P.

2006-01-01

This study was designed to investigate the equivalence reliability between the suggested FITNESSGRAM[R] muscular strength and endurance test, the 90[degrees] push-up (PSU), and alternate FITNESSGRAM[R] tests of upper-body strength and endurance (i.e., modified pull-up [MPU], flexed-arm hang [FAH], and pull-up [PU]). Children (N = 383) in Grades 3…

Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.

PubMed

Carpinella, Ilaria; Cattaneo, Davide; Bertoni, Rita; Ferrarin, Maurizio

2012-05-01

In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation.

A standard set of upper extremity tasks for evaluating rehabilitation interventions for individuals with complete arm paralysis

PubMed Central

Cornwell, Andrew S.; Liao, James Y.; Bryden, Anne M.; Kirsch, Robert F.

2013-01-01

We have developed a set of upper extremity functional tasks to guide the design and test the performance of rehabilitation technologies that restore arm motion in people with high tetraplegia. Our goal was to develop a short set of tasks that would be representative of a much larger set of activities of daily living while also being feasible for a unilateral user of an implanted Functional Electrical Stimulation (FES) system. To compile this list of tasks, we reviewed existing clinical outcome measures related to arm and hand function, and were further informed by surveys of patient desires. We ultimately selected a set of five tasks that captured the most common components of movement seen in these tasks, making them highly relevant for assessing FES-restored unilateral arm function in individuals with high cervical spinal cord injury (SCI). The tasks are intended to be used when setting design specifications and for evaluation and standardization of rehabilitation technologies under development. While not unique, this set of tasks will provide a common basis for comparing different interventions (e.g., FES, powered orthoses, robotic assistants) and testing different user command interfaces (e.g., sip-and-puff, head joysticks, brain-computer interfaces). PMID:22773199

Incorporating haptic effects into three-dimensional virtual environments to train the hemiparetic upper extremity

PubMed Central

Adamovich, Sergei; Fluet, Gerard G.; Merians, Alma S.; Mathai, Abraham; Qiu, Qinyin

2010-01-01

Current neuroscience has identified several constructs to increase the effectiveness of upper extremity rehabilitation. One is the use of progressive, skill acquisition-oriented training. Another approach emphasizes the use of bilateral activities. Building on these principles, this paper describes the design and feasibility testing of a robotic / virtual environment system designed to train the arm of persons who have had strokes. The system provides a variety of assistance modes, scalable workspaces and hand-robot interfaces allowing persons with strokes to train multiple joints in three dimensions. The simulations utilize assistance algorithms that adjust task difficulty both online and offline in relation to subject performance. Several distinctive haptic effects have been incorporated into the simulations. An adaptive master-slave relationship between the unimpaired and impaired arm encourages active movement of the subject's hemiparetic arm during a bimanual task. Adaptive anti-gravity support and damping stabilize the arm during virtual reaching and placement tasks. An adaptive virtual spring provides assistance to complete the movement if the subject is unable to complete the task in time. Finally, haptically rendered virtual objects help to shape the movement trajectory during a virtual placement task. A proof of concept study demonstrated this system to be safe, feasible and worthy of further study. PMID:19666345

Safety of radiofrequency treatment over human skin previously injected with medium-term injectable soft-tissue augmentation materials: a controlled pilot trial.

PubMed

Alam, Murad; Levy, Ross; Pajvani, Urvi; Pavjani, Urvi; Ramierez, James A; Guitart, Joan; Veen, Heather; Gladstone, Hayes B

2006-03-01

Several soft-tissue augmentation materials are now available for reduction of nasolabial fold creases and perioral rhytides. Nasolabial folds and perioral rhytides can also be improved by skin tightening delivered by non-ablative radiofrequency (RF) treatment. The purpose of this study was to assess the safety of RF treatment over skin areas recently injected with medium-term injectable soft-tissue augmentation materials. Five subjects were assigned to the experimental arm (augmentation materials plus RF) and one to the control arm (augmentation materials alone). Each subject received injections of 0.3 mL of hyaluronic acid derivative (Restylane) and calcium hydroxylapatite (Radiesse) 3 cm apart on the upper inner arm. Two weeks later, two non-overlapping passes of RF (Thermage ThermaCool TC) were delivered at 63.5 setting with medium-fast 1.5 cm2 tip over injected sites in all of the experimental subjects. Punch skin biopsies were obtained 3 days later from each of the two injection sites on each subject. Light microscopy and digital photomicrographs obtained at low, medium, and high power showed no difference between filler materials in experimental and control subjects. In both cases filler was evident at the deep dermal-subcutaneous junction. Nodule formation, foreign body extravasation, or hemorrhage/clot was not observed grossly or histologically. Subjects and physicians did not report any difference in signs and symptoms between the experimental and control arms. Slightly increased transitory pain was noted when RF was delivered over filler versus over normal skin. Applying RF treatment over the same area 2 weeks after deep dermal injection with hyaluronic acid derivatives or calcium hydroxylapatite does not appear to cause gross morphological changes in the filler material or surrounding skin. Further studies with different parameters are necessary to confirm these findings. 2006 Wiley-Liss, Inc.

Reproducibility and validity of the Nintendo Wii Balance Board for measuring shoulder sensorimotor control in prone lying.

PubMed

Eshoj, H; Juul-Kristensen, Birgit; Jørgensen, Rene Gam Bender; Søgaard, Karen

2017-02-01

For the lower limbs, the Nintendo Wii Balance Board (NWBB) has been widely used to measure postural control. However, this has not been performed for upper limb measurements. Further, the NWBB has shown to produce more background noise with decreasing loads, which may be of concern when used for upper limb testing. The aim was to investigate reproducibility and validity of the NWBB. A test-retest design was performed with 68 subjects completing three different prone lying, upper limb weight-bearing balance tasks on a NWBB: two-arms, eyes closed (1) one-arm, non-dominant/non-injured (2) and one-arm, dominant/injured (3). Each task was repeated three times over the course of two test sessions with a 30-min break in between. Further, the level of background noise from a NWBB was compared with a force platform through systematic loading of both boards with increasing deadweights ranging from 5 to 90kg. Test-retest reproducibility was high with ICCs ranging from 0.95 to 0.97 (95% CI 0.92 to 0.98). However, systematic bias and tendencies for funnel effects in the Bland Altman plots for both one-armed tests were present. The concurrent validity of the NWBB was low (CCC 0.17 (95% CI 0.12-0.22)) due to large differences between the NWBB and force platform in noise sensitivity at low deadweights (especially below 50kg). The NWBB prone lying, shoulder sensorimotor control test was highly reproducible. Though, concurrent validity of the NWBB was poor compared to a force platform. Further investigation of the impact of the background noise, especially at low loads, is needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Improvement of upper trunk posture during walking in hemiplegic patients after injections of botulinum toxin into the arm.

PubMed

Hefter, Harald; Rosenthal, Dietmar

2017-03-01

It has been hypothesized that altered trunk movements during gait in post-stroke patients or children with cerebral palsy are compensatory to lower limb impairment. Improvement of trunk movements and posture after injections of botulinum toxin into the affected arm would be at variance with this hypothesis and hint towards a multifactorial trunk control deficit. Clinical gait analysis was performed in 11 consecutively recruited hemiplegic patients immediately before and 4weeks after a botulinum toxin type A-injection into the affected arm. Kinematic data were collected using an 8 camera optical motion-capturing system and reflective skin-markers were attached according to a standard plug-in-gait model. Deviation of the trunk in lateral and forward direction and the trajectory of the C7-marker in a sacrum-fixed horizontal plane were analyzed in addition to classical gait parameters. The Wilson-signed-rank test was used for pre/post-botulinum toxin comparisons. After botulinum toxin injections a significant improvement of forearm flexion scores from 2.57 to 2.0 (p<0.014), and a reduced lateral deviation of the upper trunk from 3.5degrees to 2.5degrees (p<0.014) were observed. Free-walkers tended to walk faster (p<0.046, 1-sided), with reduced pre-swing duration of both legs and an increased step length of the non-affected leg. The C7-marker trajectory was shifted towards the midline. Injections of botulinum toxin into the affected arm of hemiplegic patients improve abnormal trunk lateral flexion. This shift of the center of mass of the upper body towards the midline improves various gait parameters including gait speed. Copyright © 2017. Published by Elsevier Ltd.

Arnica Ointment 10% Does Not Improve Upper Blepharoplasty Outcome: A Randomized, Placebo-Controlled Trial.

PubMed

van Exsel, Denise C E; Pool, Shariselle M W; van Uchelen, Jeroen H; Edens, Mireille A; van der Lei, Berend; Melenhorst, Wynand B W H

2016-07-01

It has been suggested that arnica can reduce postoperative edema and ecchymosis associated with cosmetic surgical procedures and improve outcome. Despite a high incidence of arnica use among upper blepharoplasty patients, evidence to support its treatment effect is lacking. The authors performed a randomized, double-blind, placebo-controlled trial to investigate the efficacy of arnica ointment after upper blepharoplasty. One hundred thirty-six bilateral upper blepharoplasty patients were randomized between arnica ointment 10% and placebo ointment. In both study arms, one periorbital area was designated as the treatment side (either arnica or placebo ointment), and the contralateral side served as an untreated (no ointment) internal control. As the primary endpoint, the overall periorbital appearance as based on light photography and judged by a medical and nonmedical panel, was assessed after 3 days, 7 days, and 6 weeks. Secondary endpoints were swelling, ecchymosis, erythema, pain, and patient satisfaction with recovery and outcome. There was no significant difference between arnica and placebo in overall judgment of periorbital appearance 3 days, 7 days, and 6 weeks after surgery. Furthermore, swelling, ecchymosis, erythema, pain, and patient satisfaction with recovery and outcome did not differ between arnica and placebo. Postoperative outcome in untreated eyelids was not different from eyelids treated with either arnica or placebo on any of the studied outcome measures. The authors' study demonstrates that topical arnica ointment after upper blepharoplasty does not improve postoperative outcome. Therapeutic, II.

Efficacy of Slimming Cream Containing 3.5% Water-Soluble Caffeine and Xanthenes for the Treatment of Cellulite: Clinical Study and Literature Review

PubMed Central

Byun, Sang-Young; Kwon, Soon-Hyo; Heo, Su-Hak; Shim, Jae-Seong; Du, Mi-Hee

2015-01-01

Background Cellulite is a 'cottage cheese-like' cutaneous change caused by subcutaneous fat bulging into the dermis that usually leads to cosmetic problems. Slimming cream containing 3.5% water-soluble caffeine and xanthenes exhibits a lipolytic effect with penetration into the dermis. Objective To evaluate the efficacy and safety of slimming cream for the treatment of cellulite. Methods Fifteen subjects with cellulite applied slimming cream to the thighs and inner side of the upper arms twice daily for 6 weeks. Efficacy was assessed using a standard visual scale, changes in the circumferences of the thighs and upper arms, and patient satisfaction by a questionnaire at baseline, week 3, and week 6. Safety was assessed by inquiring about adverse events through questionnaires. Results The standard visual scale score improved significantly by 0.49 points (19.8%) at week 6. Thigh and upper-arm circumferences decreased by 0.7 cm (1.7%) and 0.8 cm (2.3%), respectively, at week 6. Slight itching and transient flushing were commonly reported, but no serious adverse event occurred. Conclusion The slimming cream tested appears to be effective for the treatment of cellulitis without serious adverse effects. However, additional large clinical trials are required to confirm the efficacy and safety of slimming cream for the treatment of cellulitis. PMID:26082579

Validation of the Omron M3 Intellisense (HEM-7051-E) upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010 in a stage 3-5 chronic kidney disease population.

PubMed

Akpolat, Tekin; Erdem, Emre; Aydogdu, Türkan

2012-01-01

Encouragement of home blood pressure (BP) monitoring has a great potential to improve hypertension control rates. The purpose of this study was to test validation of the Omron M3 Intellisense (HEM-7051-E) upper arm BP measuring monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) in stage 3-5 chronic kidney disease (CKD) patients. 66 patients having CKD stage 3-5 were included in the study. Nine consecutive measurements were made according to the ESH-IP2 protocol. The Omron M3 Intellisense device fulfills the validation criteria of the ESH-IP2 for stage 3-5 CKD patients. Although arterial stiffness can affect accurate BP measurement, there are limited data regarding the use of automated oscillometric devices in CKD. To our knowledge, this is the first study investigating validation of an oscillometric device in stage 3-5 predialysis CKD patients. This study validates the Omron M3 Intellisense upper arm device for stage 3-5 CKD patients. New validation studies investigating other oscillometric sphygmomanometers for CKD patients and involvement of nephrologists in these studies have great potential to increase patient care in CKD. Copyright © 2011 S. Karger AG, Basel.

Validation of the iHealth BP5 wireless upper arm blood pressure monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Shang, Fujun; Zhu, Yizheng; Zhu, Zhenlai; Liu, Lei; Wan, Yi

2013-10-01

The aim of this study was to validate the iHealth BP5 wireless upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for validation of BP measuring devices in adults was followed precisely. A total of 99 pairs of test device and reference BP measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 71, 89, and 97 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 73, 90, and 99 mmHg for diastolic blood pressure (DBP), respectively. The mean ± SD device-observer difference was -1.21 ± 5.87 mmHg for SBP and -1.04 ± 5.28 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 25 for SBP and 28 for DBP. In addition, three participants had no device-observer difference within 5 mmHg for SBP and none of the participants had the same for DBP. According to the validation results on the basis of the ESH-IP revision 2010, the iHealth BP5 wireless upper arm BP monitor can be recommended for self/home measurement in an adult population.

Validation of A&D TM-2430 upper-arm blood pressure monitor for ambulatory blood pressure monitoring in children and adolescents, according to the British Hypertension Society protocol.

PubMed

Yip, Gabriel Wai-Kwok; So, Hung-Kwan; Li, Albert Martin; Tomlinson, Brian; Wong, Sik-Nin; Sung, Rita Yn-Tz

2012-04-01

The A&D TM-2430 ambulatory blood pressure (BP) monitor has been validated in adults but not in a young population. We sought to validate the device monitoring in children and adolescents, according to the British Hypertension Society (BHS) protocol. The A&D TM-2430 is an automated oscillometric upper-arm device for ambulatory BP monitoring. Nine consecutive measurements were taken in 61 children (mean age, 9.8 years; range, 5-15 years) according to the BHS criteria. Overseen by an independent supervisor, measurements were recorded by two observers blinded from each other's readings and from the device readings. The mean difference ± SD between the observers and device measurements was 0.73 ± 1.64 mmHg for systolic blood pressure (SBP) and -1.23 ± 1.65 mmHg for diastolic blood pressure (DBP), respectively, with an interobserver difference of 4 mmHg. The cumulative percentages of differences within 5, 10, and 15 mmHg were 89, 95, and 98% for SBP and 67, 88, and 98% for DBP. The device achieved a grade A rating for SBP and a B grade for DBP. The A&D TM-2430 upper-arm BP monitor has fulfilled the required BHS standards and can be recommended for measuring ambulatory BP in children and adolescent populations.

The Motor Activity Log-28: assessing daily use of the hemiparetic arm after stroke.

PubMed

Uswatte, G; Taub, E; Morris, D; Light, K; Thompson, P A

2006-10-10

Data from monkeys with deafferented forelimbs and humans after stroke indicate that tests of the motor capacity of impaired extremities can overestimate their spontaneous use. Before the Motor Activity Log (MAL) was developed, no instruments assessed spontaneous use of a hemiparetic arm outside the treatment setting. To study the MAL's reliability and validity for assessing real-world quality of movement (QOM scale) and amount of use (AOU scale) of the hemiparetic arm in stroke survivors. Participants in a multisite clinical trial completed a 30-item MAL before and after treatment (n = 106) or an equivalent no-treatment period (n = 116). Participants also completed the Stroke Impact Scale (SIS) and wore accelerometers that monitored arm movement for three consecutive days outside the laboratory. All were 3 to 12 months post-stroke and had mild to moderate paresis of an upper extremity. After an item analysis, two MAL tasks were eliminated. Revised participant MAL QOM scores were reliable (r =0.82). Validity was also supported. During the first observation period, the correlation between QOM and SIS Hand Function scale scores was 0.72. The corresponding correlation for QOM and accelerometry values was 0.52. Participant QOM and AOU scores were highly correlated (r = 0.92). The participant Motor Activity Log is reliable and valid in individuals with subacute stroke. It might be employed to assess the real-world effects of upper extremity neurorehabilitation and detect deficits in spontaneous use of the hemiparetic arm in daily life.

Movement Kinematics of the Ipsilesional Upper Extremity in Persons With Moderate or Mild Stroke.

PubMed

Bustrén, Eva-Lena; Sunnerhagen, Katharina Stibrant; Alt Murphy, Margit

2017-04-01

An increasing number of studies have indicated that the ipsilesional arm may be impaired after stroke. There is, however, a lack of knowledge whether ipsilesional deficits influence movement performance during purposeful daily tasks. The aim of this study was to investigate whether, and to what extent, movement impairments are present while performing an ipsilesional upper extremity task during the first 3 months after stroke. Movement kinematics describing movement time, smoothness, velocity, strategy, and pattern were captured during a standardized drinking task in 40 persons with first-ever stroke and 20 controls. Kinematics were measured early and at 3 months poststroke, and sensorimotor impairment was assessed with Fugl-Meyer Assessment in stroke. Half of the ipsilesional kinematics showed significant deficits early after stroke compared to controls, and the stroke severity had a significant impact on the kinematics. Movements of the ipsilesional arm were slower, less smooth, demonstrated prolonged relative time in deceleration, and increased arm abduction during drinking. Kinematics improved over time and reached a level comparable with controls at 3 months, except for angular velocity of the elbow and deceleration time in reaching for those with more severe motor impairment. This study demonstrates that movements of the ipsilesional arm, during a purposeful daily task, are impaired after stroke. These deficits are more prominent early after stroke and when the motor impairment is more severe. In clinical studies and praxis, the use of less-affected arm as a reference may underestimate the level of impairment and extent of recovery.

[Hand fine motor skills and use of both hand and arm in subjects after a stroke: a systematic review].

PubMed

Ostolaza, M; Abudarham, J; Dilascio, S; Drault-Boedo, E; Gallo, S; Garcete, A; Kramer, M; Maiaru, M; Mendelevich, A; Modica, M; Peralta, F; Sanchez-Correa, C

2017-04-01

In clinical practice it is important to be able to assess the function of the upper limb of the patient who has suffered a stroke. There is currently no systemic review that could identify assessment tools for the 'fine use of the hand' and 'use of both hand and arm'. Primary, to identify observational tools which can assess the fine use of the hand and the use of both hand and arm in patients with stroke sequels. Secondary, to analyze the bias risk in the included articles, describing and categorizing the clinical utility, validity and reliability. A search was carried in Medline, LILACS, SciELO and Open Grey, which included articles published until October 2015. Studies that validate assessing tools of the upper limb in subjects with a stroke sequel which evaluate the fine use of the hand and the use of both hand and arm were included. Eleven tools in evaluate observational haven been selected, which assess the fine use of the hand and the use of hand and arm. In every case both validity and reliability have been reported, but clinical utility has been less considered for assessment. The studies that researched these tools showed a high risk of bias in their development. ARAT-19 showed a lower bias risk, but when it has to do with applicability and the reference trial is taken into account, the level of concern is high.

Relative importance of different surface regions for thermal comfort in humans.

PubMed

Nakamura, Mayumi; Yoda, Tamae; Crawshaw, Larry I; Kasuga, Momoko; Uchida, Yuki; Tokizawa, Ken; Nagashima, Kei; Kanosue, Kazuyuki

2013-01-01

In a previous study, we investigated the contribution of the surface of the face, chest, abdomen, and thigh to thermal comfort by applying local temperature stimulation during whole-body exposure to mild heat or cold. In hot conditions, humans prefer a cool face, and in cold they prefer a warm abdomen. In this study, we extended investigation of regional differences in thermal comfort to the neck, hand, soles, abdomen (Experiment 1), the upper and lower back, upper arm, and abdomen (Experiment 2). The methodology was similar to that used in the previous study. To compare the results of each experiment, we utilized the abdomen as the reference area in these experiments. Thermal comfort feelings were not particularly strong for the limbs and extremities, in spite of the fact that changes in skin temperature induced by local temperature stimulation of the limbs and extremities were always larger than changes that were induced in the more proximal body parts. For the trunk areas, a significant difference in thermal comfort was not observed among the abdomen, and upper and lower back. An exception involved local cooling during whole-body mild cold exposure, wherein the most dominant preference was for a warmer temperature of the abdomen. As for the neck and abdomen, clear differences were observed during local cooling, while no significant difference was observed during local warming. We combined the results for the current and the previous study, and characterized regional differences in thermal comfort and thermal preference for the whole-body surface.

The ARAMIS project: a concept robot and technical design.

PubMed

Colizzi, Lucio; Lidonnici, Antonio; Pignolo, Loris

2009-11-01

To describe the ARAMIS (Automatic Recovery Arm Motility Integrated System) project, a concept robot applicable in the neuro-rehabilitation of the paretic upper limb after stroke. Methods, results and conclusion: The rationale and engineering of a state-of-the-art, hardware/software integrated robot system, its mechanics, ergonomics, electric/electronics features providing control, safety and suitability of use are described. An ARAMIS prototype has been built and is now available for clinical tests. It allows the therapist to design neuro-rehabilitative (synchronous or asynchronous) training protocols in which sample exercises are generated by a single exoskeleton (operated by the patient's unaffected arm or by the therapist's arm) and mirrored in real-time or offline by the exoskeleton supporting the paretic arm.

The Differential Effect of Arm Movements during Gait on the Forward Acceleration of the Centre of Mass in Children with Cerebral Palsy and Typically Developing Children.

PubMed

Meyns, Pieter; Molenaers, Guy; Duysens, Jacques; Jonkers, Ilse

2017-01-01

Background: We aimed to study the contribution of upper limb movements to propulsion during walking in typically developing (TD) children ( n = 5) and children with hemiplegic and diplegic cerebral palsy (CP; n = 5 and n = 4, respectively). Methods: Using integrated three-dimensional motion capture data and a scaled generic musculoskeletal model that included upper limbs, we generated torque driven simulations of gait in OpenSim. Induced acceleration analyses were then used to determine the contributions of the individual actuators located at the relevant degrees of freedoms of the upper and lower limb joints to the forward acceleration of the COM at each time point of the gait simulation. The mean values of the contribution of the actuators of upper limbs, lower limbs, and gravity in different phases of the gait cycle were compared between the three groups. Findings: The results indicated a limited contribution of the upper limb actuators to COM forward acceleration compared to the contribution of lower limbs and gravity, in the three groups. In diplegic CP, the contribution of the upper limbs seemed larger compared to TD during the preswing and swing phases of gait. In hemiplegic CP, the unaffected arm seemed to contribute more to COM deceleration during (pre)swing, while the affected side contributed to COM acceleration. Interpretation: These findings suggest that in the presence of lower limb dysfunction, the contribution of the upper limbs to forward propulsion is altered, although they remain negligible compared to the lower limbs and gravity.

Planar covariance of upper and lower limb elevation angles during hand-foot crawling in healthy young adults.

PubMed

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

2017-11-01

Habitual quadrupeds have been shown to display a planar covariance of segment elevation angle waveforms in the fore and hind limbs during many forms of locomotion. The purpose of the current study was to determine if humans generate similar patterns in the upper and lower limbs during hand-foot crawling. Nine healthy young adults performed hand-foot crawling on a treadmill at speeds of 1, 2, and 3 km/h. A principal component analysis (PCA) was applied to the segment elevation angle waveforms for the upper (upper arm, lower arm, and hand) and lower (thigh, shank, and foot) limbs separately. The planarity of the elevation angle waveforms was determined using the sum of the variance explained by the first two PCs and the orientation of the covariance plane was quantified using the direction cosines of the eigenvector orthogonal to the plane, projected upon each of the segmental semi-axes. Results showed that planarity of segment elevation angles was maintained in the upper and lower limbs (explained variance >97%), although a slight decrease was present in the upper limb when crawling at 3 km/h. The orientation of the covariance plane was highly limb-specific, consistent with animal studies and possibly related to the functional neural control differences between the upper and lower limbs. These results may suggest that the motor patterns stored in the central nervous system for quadrupedal locomotion may be retained through evolution and may still be exploited when humans perform such tasks.

Congenital Becker's nevus with a familial association.

PubMed

Book, S E; Glass, A T; Laude, T A

1997-01-01

Becker's nevus is a unilateral, hyperpigmented cutaneous hamartoma usually with hypertrichosis. It occurs predominantly in boys, becoming apparent during adolescence, although several cases of congenital Becker's nevus have been reported. Rarely it may be familial and as such is transmitted in an autosomal dominant pattern. We report a 16-month-old black boy with a hyperpigmented patch on his right shoulder and upper pectoral area that extended down his arm. The patient's father has a similar lesion with hair on his left shoulder which has been present since childhood. Histology of the child's lesion was consistent with Becker's nevus. We believe this to be the first reported case of a congenital Becker's nevus with a familial association.

Dislocated Shoulder

MedlinePlus

... up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of ... fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens ...

Arm and Intensity-Matched Leg Exercise Induce Similar Inflammatory Responses.

PubMed

Leicht, Christof A; Paulson, Thomas A W; Goosey-Tolfrey, Victoria L; Bishop, Nicolette C

2016-06-01

The amount of active muscle mass can influence the acute inflammatory response to exercise, associated with reduced risk for chronic disease. This may affect those restricted to upper body exercise, for example, due to injury or disability. The purpose of this study was to compare the inflammatory responses for arm exercise and intensity-matched leg exercise. Twelve male individuals performed three 45-min constant load exercise trials after determination of peak oxygen uptake for arm exercise (V˙O2peak A) and cycling (V˙O2peak C): 1) arm cranking exercise at 60% V˙O2peak A, 2) moderate cycling at 60% V˙O2peak C, and 3) easy cycling at 60% V˙O2peak A. Cytokine, adrenaline, and flow cytometric analysis of monocyte subsets were performed before and up to 4 h postexercise. Plasma IL-6 increased from resting concentrations in all trials; however, postexercise concentrations were higher for arm exercise (1.73 ± 1.04 pg·mL) and moderate cycling (1.73 ± 0.95 pg·mL) compared with easy cycling (0.87 ± 0.41 pg·mL; P < 0.04). Similarly, the plasma IL-1ra concentration in the recovery period was higher for arm exercise (325 ± 139 pg·mL) and moderate cycling (316 ± 128 pg·mL) when compared with easy cycling (245 ± 77 pg·mL, P < 0.04). Arm exercise and moderate cycling induced larger increases in monocyte numbers and larger increases of the classical monocyte subset in the recovery period than easy cycling (P < 0.05). The postexercise adrenaline concentration was lowest for easy cycling (P = 0.04). Arm exercise and cycling at the same relative exercise intensity induces a comparable acute inflammatory response; however, cycling at the same absolute oxygen uptake as arm exercise results in a blunted cytokine, monocyte, and adrenaline response. Relative exercise intensity appears to be more important to the acute inflammatory response than modality, which is of major relevance for populations restricted to upper body exercise.

Quantitative measures with WREX usage.

PubMed

Shank, Tracy M; Wee, Jinyong; Ty, Jennifer; Rahman, Tariq

2017-07-01

This paper presents the results of two surveys conducted with users of a functional upper extremity orthosis called the Wilmington Robotic EXoskeleton (WREX). The WREX is a passive anti-gravity arm orthosis that allows people with neuromuscular disabilities to move their arms in three dimensions. An online user survey with 55 patients was conducted to determine the benefits of the WREX. The survey asked 10 questions related to upper extremity function with and without the WREX as well as subjective impressions of the device. A second survey used a phone interview based on the Canadian Occupational Performance Measure (COPM). Parents rated their child's performance and satisfaction while partaking in important activities both with and without the exoskeleton device. Scores were assessed for change between the two conditions. Twenty-five families responded to this survey. Twenty-four out of 25 subjects reported greater levels of performance and satisfaction when they were wearing the WREX. The mean change in performance score was 3.61 points, and the mean change in satisfaction score was 4.44 points. Results show a statistically significant improvement in arm function for everyday tasks with the WREX.

Obesity, hypertension and home sphygmomanometer cuffs.

PubMed

Akpolat, Tekin

2010-08-01

Since the increasing prevalence of obesity leads to a larger mean arm circumferences in the hypertensive population and appropriate cuff size is essential for accurate measurement of blood pressure, overweight and obese patients often require automated home sphygmomanometers with large- or extra large-sized cuffs. The aims of this study were to evaluate the information about cuff size on automated upper arm home sphygmomanometer packing boxes and compare the findings with wrist device boxes. One hundred twelve different device boxes (49 automated upper arm, 5 semi-automatic, and 58 wrist) produced by 40 manufacturers were investigated. Three different types of information were observed (written, graphical, or a combination of both). There was not any information about cuff size on 49 (44%) device boxes. Most of the information expressed on the boxes was not attractive or informative for the patients. This study showed that the information regarding cuff size on most of the device boxes was obtuse and the patients are not warned sufficiently about appropriate cuff size. Physicians and health care providers should inform and train their patients about appropriate cuff size.

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

NASA Astrophysics Data System (ADS)

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

2007-11-01

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

Bilateral differences in the upper quarter function of high school aged baseball and softball players.

PubMed

Butler, Robert J; Myers, Heather S; Black, Douglass; Kiesel, Kyle B; Plisky, Phillip J; Moorman, Claude T; Queen, Robin M

2014-08-01

The Upper Quarter Y Balance Test (YBT-UQ) was developed as a way to identify upper extremity and trunk mobility in the open kinetic chain in the reaching limb as well as midrange limitations and asymmetries of upper extremity and core stability in the closed kinetic chain on the stabilizing limb. Performance on the YBT-UQ is similar between genders and between limbs; however, this has not been examined in athletes who participate in sports that result in upper extremity asymmetries. The primary purpose of this study is to determine if differences exist between the throwing vs. non-throwing sides in high-school baseball and softball athletes on the YBT-UQ. In order to complete this forty-eight male high school baseball players and seventeen female high school softball players were tested on the YBT-UQ. Reach distances were normalized to arm length (% AL). Comparisons were made between the throwing (T) and non-throwing (NT) arm for each direction as well as the composite score. No significant differences were observed between the T and NT arm for the medial (NT: 98.4 ± 8.6 %AL, T: 99.1 ± 8.6 %AL, p=0.42), inferolateral (NT: 90.8 ± 11.8 %AL, T: 90.3 ± 11.5 %AL, p =0.61), superolateral (NT: 70.6 ± 10.9 %AL, T: 70.4 ± 11.1 % AL, p=0.91) reaches, or the composite score (NT: 87.2 ± 8.9 % AL, T: 86.6 ± 8.1 %AL, p=0.72). Similarly, no differences were observed between the male baseball and female softball players (p=0.30-0.90). Based on these findings, it was concluded that there was no difference in performance on the YBT-UQ between throwing and non-throwing limbs in high school baseball and softball players. 3.

Differences in physical workload, psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models.

PubMed

Unge, Jeannette; Ohlsson, Kerstina; Nordander, Catarina; Hansson, Gert-Ake; Skerfving, Staffan; Balogh, Istvan

2007-11-01

To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors. The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination. The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P<0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35 degrees/s vs 71 degrees/s; P<0.001) and wrist movements (20 degrees/s vs 27 degrees/s; P=0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P=0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P<0.001). Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.

The nature of arm movement in children with cerebral palsy when using computer-generated exercise games.

PubMed

Weightman, Andrew; Preston, Nick; Levesley, Martin; Bhakta, Bipin; Holt, Raymond; Mon-Williams, Mark

2014-05-01

To compare upper limb kinematics of children with spastic cerebral palsy (CP) using a passive rehabilitation joystick with those of adults and able-bodied children, to better understand the design requirements of computer-based rehabilitation devices. A blocked comparative study involving seven children with spastic CP, nine able-bodied adults and nine able-bodied children, using a joystick system to play a computer game whilst the kinematics of their upper limb were recorded. The translational kinematics of the joystick's end point and the participant's shoulder movement (protraction/retraction) and elbow rotational kinematics (flexion/extension) were analysed for each group. Children with spastic CP matched their able-bodied peers in the time taken to complete the computer task, but this was due to a failure to adhere to the task instructions of travelling along a prescribed straight line when moving between targets. The spastic CP group took longer to initiate the first movement, which showed jerkier trajectories and demonstrated qualitatively different movement patterns when using the joystick, with shoulder movements that were significantly of greater magnitude than the able-bodied participants. Children with spastic CP generate large shoulder and hence trunk movements when using a joystick to undertake computer-generated arm exercises. This finding has implications for the development and use of assistive technologies to encourage exercise and the instructions given to users of such systems. A kinematic analysis of upper limb function of children with CP when using joystick devices is presented. Children with CP may use upper body movements to compensate for limitations in voluntary shoulder and elbow movements when undertaking computer games designed to encourage the practice of arm movement. The design of rehabilitative computer exercise systems should consider movement of the torso/shoulder as it may have implications for the quality of therapy in the rehabilitation of the upper limb in children with CP.

The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point.

PubMed

Yassin, Marzieh; Talebian, Saeed; Ebrahimi Takamjani, Ismail; Maroufi, Nader; Ahmadi, Amir; Sarrafzadeh, Javad; Emrani, Anita

2015-01-01

Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. There was significant differences in motor time and reaction time between active and control groups (p< 0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p< 0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG).

Time course of upper limb function and return-to-work post-radiotherapy in young adults with breast cancer: a pilot randomized control trial on effects of targeted exercise program.

PubMed

Ibrahim, Marize; Muanza, Thierry; Smirnow, Nadia; Sateren, Warren; Fournier, Beatrice; Kavan, Petr; Palumbo, Michael; Dalfen, Richard; Dalzell, Mary-Ann

2017-12-01

Breast cancer (BC) diagnosis in young adults (YA) is rising, and both disease and treatments are aggressive in this population. Evidence supports the use of physical activity in reducing shoulder dysfunction, which is common among BC survivors. A pilot randomized clinical trial was performed to determine the effectiveness of a 12-week post-radiation exercise program in minimizing upper extremity dysfunction in YA with BC. Participants were randomized to either an exercise arm or a control arm receiving standard care. Data was collected over six time points using: the Disability of Arm, Shoulder, and Hand (DASH); the Metabolic Equivalent of Task-hours per week (MET-hours/week), and a post hoc questionnaire on return to work. In total, 59 young women participated in the study (n = 29 exercise; n = 30 control). No statistically significant differences were found in overall DASH results between groups; however, those who underwent total mastectomy had residual upper limb dysfunction (p < 0.05). Both groups returned to pre-diagnosis activity levels by 18 months. Final evaluation showed that 86% of the women returned to work, and 89% resumed prior work activities with a decrease of 8.5 h/week. Although the short-term targeted exercise program had no effect on long-term upper limb function post-radiation, timing and program specificity may require consideration of tissue healing post-radiation and surgery type. The majority of participants returned to work, however not returning to pre-diagnosis work hours. Exercise interventions alone may not reverse the long-term sequelae of breast cancer treatment and allow young adult patients to return to work.

A Neuromuscular Electrical Stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke.

PubMed

Rong, Wei; Li, Waiming; Pang, Mankit; Hu, Junyan; Wei, Xijun; Yang, Bibo; Wai, Honwah; Zheng, Xiaoxiang; Hu, Xiaoling

2017-04-26

It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P < 0.05). The intra-joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers. ClinicalTrials.gov. NCT02117089 ; date of registration: April 10, 2014.

Functional electrical stimulation mediated by iterative learning control and 3D robotics reduces motor impairment in chronic stroke

PubMed Central

2012-01-01

Background Novel stroke rehabilitation techniques that employ electrical stimulation (ES) and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients’ voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL), a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. Methods Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants’ arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC) algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test) at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. Results From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. Conclusions The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this. PMID:22676920

Functional electrical stimulation mediated by iterative learning control and 3D robotics reduces motor impairment in chronic stroke.

PubMed

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

2012-06-07

Novel stroke rehabilitation techniques that employ electrical stimulation (ES) and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients' voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL), a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants' arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC) algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test) at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this.

Effects of acute upper-body vibration on strength and power variables in climbers.

PubMed

Cochrane, Darryl J; Hawke, Emma J

2007-05-01

Whole-body vibration training has recently received a lot of attention with reported enhancements of strength and power qualities in athletes. This study investigated whether upper-body vibration would be able to augment muscular attributes for climbing performance. Twelve healthy active climbers volunteered for the study. All participants underwent 3 treatments--arm cranking (AC), upper-body vibration (UBV), and non-UBV (NUBV)--in a balanced random order, conducted on separate days. Upper-body vibration was generated via a commercialized electric-powered dumbbell with a rotating axis that delivered oscillatory movements to the shoulders and arms. The UBV treatment consisted of performing 5 upper-body exercises for a total duration of 5 minutes. The UBV frequency was set at 26 Hz, amplitude 3 mm. For the NUBV treatment, the participants performed the exact exercises and time constraints as UBV; however, the vibration dumbbell was set at 0 Hz and 0 mm amplitude. The third treatment consisted of AC, which was performed at 75 k.min(-1) for 5 minutes. Pre- and postmuscular performance measures of medicine ball throw, hand grip strength, and a specific climbing maneuver were performed after each treatment. There were no significant treatment differences on medicine ball throw, hand grip strength, and the specific climbing maneuver. Acute UBV exposure did not demonstrate the expected potential neuromuscular enhancements on the climbing performance tests selected for this study.

Upper limb movement analysis during gait in multiple sclerosis patients.

PubMed

Elsworth-Edelsten, Charlotte; Bonnefoy-Mazure, Alice; Laidet, Magali; Armand, Stephane; Assal, Frederic; Lalive, Patrice; Allali, Gilles

2017-08-01

Gait disorders in multiple sclerosis (MS) are well studied; however, no previous study has described upper limb movements during gait. However, upper limb movements have an important role during locomotion and can be altered in MS patients due to direct MS lesions or mechanisms of compensation. The aim of this study was to describe the arm movements during gait in a population of MS patients with low disability compared with a healthy control group. In this observational study we analyzed the arm movements during gait in 52 outpatients (mean age: 39.7±9.6years, female: 40%) with relapsing-remitting MS with low disability (mean EDSS: 2±1) and 25 healthy age-matched controls using a 3-dimension gait analysis. MS patients walked slower, with increased mean elbow flexion and decreased amplitude of elbow flexion (ROM) compared to the control group, whereas shoulder and hand movements were similar to controls. These differences were not explained by age or disability. Upper limb alterations in movement during gait in MS patients with low disability can be characterized by an increase in mean elbow flexion and a decrease in amplitude (ROM) for elbow flexion/extension. This upper limb movement pattern should be considered as a new component of gait disorders in MS and may reflect subtle motor deficits or the use of compensatory mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

Health Status of Women in the Armed Forces

DTIC Science & Technology

1991-12-01

1984, howeper, women’s rates for acute upper respiratory infection, diarrheal disease, ribella, and infectious mononucleosis had declined to such an...were observed for induced abortions and acute upper respiratory infection for the 1973-77 cohort; alcohol abuse and complications of pregnancy for the...1978-82 cohort; and complications of pregnancy and transient situational disturbances for the 1983-87 cohort. The most vulnerable time for the

33 CFR 334.1275 - West Arm Behm Canal, Ketchikan, Alaska, restricted areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false West Arm Behm Canal, Ketchikan, Alaska, restricted areas. 334.1275 Section 334.1275 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.1275 West Arm...

33 CFR 334.1275 - West Arm Behm Canal, Ketchikan, Alaska, restricted areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false West Arm Behm Canal, Ketchikan, Alaska, restricted areas. 334.1275 Section 334.1275 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.1275 West Arm...

33 CFR 334.1275 - West Arm Behm Canal, Ketchikan, Alaska, restricted areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false West Arm Behm Canal, Ketchikan, Alaska, restricted areas. 334.1275 Section 334.1275 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.1275 West Arm...

33 CFR 334.1275 - West Arm Behm Canal, Ketchikan, Alaska, restricted areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false West Arm Behm Canal, Ketchikan, Alaska, restricted areas. 334.1275 Section 334.1275 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.1275 West Arm...

Use of the Coastal and Marine Ecological Classification Standard (CMECS) for Geological Studies in Glacier Bay, Alaska

NASA Astrophysics Data System (ADS)

Cochrane, G. R.; Hodson, T. O.; Allee, R.; Cicchetti, G.; Finkbeiner, M.; Goodin, K.; Handley, L.; Madden, C.; Mayer, G.; Shumchenia, E.

2012-12-01

The U S Geological Survey (USGS) is one of four primary organizations (along with the National Oceanographic and Atmospheric Administration, the Evironmental Protection Agency, and NatureServe) responsible for the development of the Coastal and Marine Ecological Classification Standard (CMECS) over the past decade. In June 2012 the Federal Geographic Data Committee approved CMECS as the first-ever comprehensive federal standard for classifying and describing coastal and marine ecosystems. The USGS has pioneered the application of CMECS in Glacier Bay, Alaska as part of its Seafloor Mapping and Benthic Habitat Studies Project. This presentation briefly describes the standard and its application as part of geological survey studies in the Western Arm of Glacier Bay. CMECS offers a simple, standard framework and common terminology for describing natural and human influenced ecosystems from the upper tidal reaches of estuaries to the deepest portions of the ocean. The framework is organized into two settings, biogeographic and aquatic, and four components, water column, geoform, substrate, and biotic. Each describes a separate aspect of the environment and biota. Settings and components can be used in combination or independently to describe ecosystem features. The hierarchical arrangement of units of the settings and components allows users to apply CMECS to the scale and specificity that best suits their needs. Modifiers allow users to customize the classification to meet specific needs. Biotopes can be described when there is a need for more detailed information on the biota and their environment. USGS efforts focused primarily on the substrate and geoform components. Previous research has demonstrated three classes of bottom type that can be derived from multibeam data that in part determine the distribution of benthic organisms: soft, flat bottom, mixed bottom including coarse sediment and low-relief rock with low to moderate rugosity, and rugose, hard bottom. The West Arm of Glacier Bay has all of these habitats, with the greatest abundance being soft, flat bottom. In Glacier Bay, species associated with soft, flat bottom habitats include gastropods, algae, flatfish, Tanner crabs, shrimp, sea pen, and other crustaceans; soft corals and sponge dominate areas of boulder and rock substrate. Video observations in the West Arm suggest that geological-biological associations found in central Glacier Bay to be at least partially analogous to associations in the West Arm. Given that soft, mud substrate is the most prevalent habitat in the West Arm, it is expected that the species associated with a soft bottom in the bay proper are the most abundant types of species within the West Arm. While mud is the dominant substrate throughout the fjord, the upper and lower West Arm are potentially very different environments due to the spatially and temporally heterogeneous influence of glaciation and associated effects on fjord hydrologic and oceanographic conditions. Therefore, we expect variations in the distribution of species and the development of biotopes for Glacier Bay will require data applicable to the full spectrum of CMECS components.

Embodied prosthetic arm stabilizes body posture, while unembodied one perturbs it.

PubMed

Imaizumi, Shu; Asai, Tomohisa; Koyama, Shinichi

2016-10-01

Senses of ownership (this arm belongs to me) and agency (I am controlling this arm) originate from sensorimotor system. External objects can be integrated into the sensorimotor system following long-term use, and recognized as one's own body. We examined how an (un)embodied prosthetic arm modulates whole-body control, and assessed the components of prosthetic embodiment. Nine unilateral upper-limb amputees participated. Four frequently used their prosthetic arm, while the others rarely did. Their postural sway was measured during quiet standing with or without their prosthesis. The frequent users showed greater sway when they removed the prosthesis, while the rare users showed greater sway when they fitted the prosthesis. Frequent users reported greater everyday feelings of postural stabilization by prosthesis and a larger sense of agency over the prosthesis. We suggest that a prosthetic arm maintains or perturbs postural control, depending on the prosthetic embodiment, which involves sense of agency rather than ownership. Copyright © 2016 Elsevier Inc. All rights reserved.

Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis.

PubMed

El Mendili, Mohamed-Mounir; Cohen-Adad, Julien; Pelegrini-Issac, Mélanie; Rossignol, Serge; Morizot-Koutlidis, Régine; Marchand-Pauvert, Véronique; Iglesias, Caroline; Sangari, Sina; Katz, Rose; Lehericy, Stéphane; Benali, Habib; Pradat, Pierre-François

2014-01-01

To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS) patients. After a first MRI (MRI1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 11±3 months. Cross-sectional area (CSA) that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA), axial/radial/mean diffusivities (λ⊥, λ//, MD) and magnetization transfer ratio (MTR) were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R) and manual muscle testing (MMT) score. At MRI1, CSA correlated significantly (P<0.05) with MMT and arm ALSFRS-R scores. FA correlated significantly with leg ALFSRS-R scores. One year after MRI1, CSA predicted (P<0.01) arm ALSFSR-R subscore and FA predicted (P<0.01) leg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (P<0.01) were detected for CSA and MTR. CSA rate of change (i.e. atrophy) highly correlated (P<0.01) with arm ALSFRS-R and arm MMT subscores rate of change. Atrophy and DTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs.

Quantitative assessment of ischemia and reactive hyperemia of the dermal layers using multi - spectral imaging on the human arm

NASA Astrophysics Data System (ADS)

Kainerstorfer, Jana M.; Amyot, Franck; Demos, Stavros G.; Hassan, Moinuddin; Chernomordik, Victor; Hitzenberger, Christoph K.; Gandjbakhche, Amir H.; Riley, Jason D.

2009-07-01

Quantitative assessment of skin chromophores in a non-invasive fashion is often desirable. Especially pixel wise assessment of blood volume and blood oxygenation is beneficial for improved diagnostics. We utilized a multi-spectral imaging system for acquiring diffuse reflectance images of healthy volunteers' lower forearm. Ischemia and reactive hyperemia was introduced by occluding the upper arm with a pressure cuff for 5min with 180mmHg. Multi-spectral images were taken every 30s, before, during and after occlusion. Image reconstruction for blood volume and blood oxygenation was performed, using a two layered skin model. As the images were taken in a non-contact way, strong artifacts related to the shape (curvature) of the arms were observed, making reconstruction of optical / physiological parameters highly inaccurate. We developed a curvature correction method, which is based on extracting the curvature directly from the intensity images acquired and does not require any additional measures on the object imaged. The effectiveness of the algorithm was demonstrated, on reconstruction results of blood volume and blood oxygenation for in vivo data during occlusion of the arm. Pixel wise assessment of blood volume and blood oxygenation was made possible over the entire image area and comparison of occlusion effects between veins and surrounding skin was performed. Induced ischemia during occlusion and reactive hyperemia afterwards was observed and quantitatively assessed. Furthermore, the influence of epidermal thickness on reconstruction results was evaluated and the exact knowledge of this parameter for fully quantitative assessment was pointed out.

Training the Unimpaired Arm Improves the Motion of the Impaired Arm and the Sitting Balance in Chronic Stroke Survivors.

PubMed

De Luca, Alice; Giannoni, Psiche; Vernetti, Honore; Capra, Cristina; Lentino, Carmelo; Checchia, Giovanni Antonio; Casadio, Maura

2017-07-01

Robot-assisted rehabilitation of stroke survivors mainly focuses on the impaired side of the body while the role of the unimpaired side in the recovery after stroke is still controversial. The goal of this study is to investigate the influence on sitting balance and paretic arm functions of a training protocol based on movements of the unimpaired arm. Sixteen chronic stroke survivors underwent nineteen training sessions, in which they performed active movements with the unimpaired arm supported by a passive exoskeleton. Performance of the trunk and upper limbs was evaluated before treatment, after treatment and at six months follow up with clinical scales and an instrumented evaluation. A reaching test executed with the exoskeleton was used to assess changes in performance of both arms. The treatment based on the unimpaired arm's movements executed with a correct body posture led to benefits in control of the trunk and of both the trained and the untrained arm. The amount of impaired arm improvement in the Fugl-Meyer score was comparable to the outcome of robotic treatments focused directly on this arm. Our results highlight the importance of taking into account all body schema in the rehabilitation robotic program, instead of focusing only on the impaired side of the body.

Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction.

PubMed

Celli, B R; Rassulo, J; Make, B J

1986-06-05

Some patients with chronic airflow obstruction experience dyspnea with mild arm exercise but not with more-intense leg exercise. To investigate why these patients have limited endurance during arm exertion, we studied ventilatory responses to exercise with unsupported arms in 12 patients with chronic airflow obstruction (mean [+/- SD] forced expiratory volume in one second, 0.68 +/- 0.28 liters). Unloaded leg cycling was also studied for comparison. In the five patients who had the most severe airflow obstruction, arm exercise was limited by dyspnea after 3.3 +/- 0.7 minutes, and dyssynchronous thoracoabdominal breathing developed. In the other seven patients, arm exercise was limited by the sensation of muscle fatigue after 6.1 +/- 2.0 minutes (P less than 0.05), and dyssynchronous breathing did not occur. None of the 12 patients had dyssynchronous breathing during unloaded leg cycling. Maximal transdiaphragmatic pressure, a measure of diaphragmatic fatigue, declined similarly after arm and leg exercise in both groups. During unsupported arm work, the accessory muscles of inspiration help position the torso and arms. We hypothesize that the extra demand placed on these muscles during arm exertion leads to early fatigue, an increased load on the diaphragm, and dyssynchronous thoracoabdominal inspirations. This sequence may contribute to dyspnea and limited endurance during upper-extremity exercise.

6A.03: THE RELATIONSHIP BETWEEN INTER-ARM SYSTOLIC BLOOD PRESSURE AND CARDIOVASCULAR RISK FACTORS.

PubMed

Ma, W; Zhang, B; Yang, Y; Qi, L; Meng, L; Zhang, Y; Huo, Y

2015-06-01

To analyze the relationship between the inter arm blood pressure difference (IASBPD) and other cardiovascular risk factors. To identify what factors are associated with this difference in a general population. The study subjects were 1426 individuals. The BP was measured simultaneously in both arms by VP1000 vascular profiler (Omron Colin, Japan). The inter-arm BP difference was expressed as the absolute difference (|R - L|). The various risk factors, ba-PWV, carotid IMT and plaque were compared between IASBPD more than 10mmHg group and IASBPD less than 10mmHg group. The relationship between IASBPD more than 10mmHg and various cardiovascular risk factors were analyzed by multivariate logistic analysis. Left upper limb systolic blood pressure was higher than the right upper limb, while right upper limb diastolic pressure was higher than the left upper limb. The prevalence of hypertension was higher in IASBPD increasing group than normal group (40.5% vs 22.6%, p < 0.05). The weight, BMI, systolic and diastolic blood pressure were also higher in IASBPD increasing group(p < 0.05). The mean IMT and max IMT in any segment carotid artery except for mean IMT of internal carotid artery were thicker in IASBPD increasing group than normal group(p < 0.05). Ba-PWV was higher, while ABI was lower in IASBPD increasing group(1.04 ± 0.16 vs 1.09 ± 0.16, p < 0.05). By multivariate logistic regression analysis, after adjusting for age, sex, BMI, hypertension, diabetes, smoking, SBP, TC, TG, LDL-C,HDL-C,ABI, PWV, mean IMT and plaque, IASBPD more than 10mmHg was positive associated with BMI(OR 1.081 95%CI: 1.030,1.134,p = 0.002), SBP (OR 1.032 95%CI: 1.023,1.041,p < 0.001), and negative associated with ABI(OR 0.051 95%CI: 0.009,0.273,p = 0.001). The increasing IASBPD was associated with systolic blood pressure, BMI and ABI independently, which may partly explain the mechanism that increasing IASBPD is associated with cardiovascular disease.

Arm Activity During Daily Life in Individuals With Chronic Obstructive Pulmonary Disease.

PubMed

Janaudis-Ferreira, Tania; Mathur, Sunita; Romano, Julia Marie; Goldstein, Roger Samuel; Brooks, Dina

2016-01-01

To determine whether individuals with chronic obstructive pulmonary disease (COPD) have decreased arm activity during daily life compared with healthy controls and explore the relationships between arm activity during daily life and arm functional measures in individuals with COPD. This was a prospective cross-sectional study that included 30 people with COPD and 14 healthy controls. Subjects attended a single assessment session in which measurements of arm exercise capacity, arm functional performance, self-perception of performance during activities of daily living (ADL), shoulder and elbow flexion force and biceps and triceps thickness were performed. On completion of this session, participants were issued a wrist actigraph and asked to wear the device on the dominant arm for 24 hours for 7 consecutive days. Compared with healthy controls, patients with COPD presented decreased total activity level in daily life (P = .001). When corrected for walking, the level of arm activity did not differ between individuals with COPD and healthy controls (P = .62). No correlations were found between arm activity and arm exercise capacity, arm functional performance, upper limb muscle strength, and self-perception of performance during ADL (r =-0.20 to 0.14; all P ≥ .10). Arm activity intensity in individuals with COPD did not differ from that of healthy controls when measured by a wrist actigraph. Moreover, arm activity was not associated with other clinical outcomes of arm function. Disability during ADL is multifactorial, and only limited inferences of function can be made from accelerometer data.

Subcutaneous Fascial Bands—A Qualitative and Morphometric Analysis

PubMed Central

Li, Weihui; Ahn, Andrew C.

2011-01-01

Background Although fascial bands within the subcutaneous (SQ) layer are commonly seen in ultrasound images, little is known about their functional role, much less their structural characteristics. This study's objective is to describe the morphological features of SQ fascial bands and to systematically evaluate the bands using image analyses tools and morphometric measures. Methods In 28 healthy volunteers, ultrasound images were obtained at three body locations: the lateral aspect of the upper arm, medial aspect of the thigh and posterior aspect of lower leg. Using image analytical techniques, the total SQ band area, fascial band number, fascial band thickness, and SQ zone (layer) thickness were determined. In addition, the SQ spatial coherence was calculated based on the eigenvalues associated with the largest and smallest eigenvectors of the images. Results Fascial bands at these sites were contiguous with the dermis and the epimysium forming an interconnected network within the subcutaneous tissue. Subcutaneous blood vessels were also frequently encased by these fascial bands. The total SQ fascial band area was greater at the thigh and calf compared to the arm and was unrelated to SQ layer (zone) thickness. The thigh was associated with highest average number of fascial bands while calf was associated with the greatest average fascial band thickness. Across body regions, greater SQ zone thickness was associated with thinner fascial bands. SQ coherence was significantly associated with SQ zone thickness and body location (calf with statistically greater coherence compared to arm). Conclusion Fascial bands are structural bridges that mechanically link the skin, subcutaneous layer, and deeper muscle layers. This cohesive network also encases subcutaneous vessels and may indirectly mediate blood flow. The quantity and morphological characteristics of the SQ fascial band may reflect the composite mechanical forces experienced by the body part. PMID:21931632

Cosmic-Ray Moisture Probe on North Slope of Alaska Field Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Desilets, Darin

2016-06-15

In September of 2014 a wide-area snow monitoring device was installed at the U.S. Department of Energy (DOE)’s Barrow, Alaska Atmospheric Radiation Measurement (ARM) Climate Research Facility site. The device is special in that it uses measurements of cosmic-ray neutrons as a proxy for snow water equivalent (SWE) depth. A unique characteristic of the technology is that it integrates over a wide area (as much as 40 ha), in contrast to conventional ground-based technologies, which essentially give point samples. Conventional point-scale technologies are problematic in the Arctic, both because extreme weather conditions are taxing on equipment, and because point measurementsmore » can fail to accurately characterize the average SWE over a larger area, even when excellent precision is obtained. The sensor installed in Barrow is, by far, the northernmost of a constellation of sites that makeup the U.S. COsmic ray Soil Moisture Observing System (COSMOS). The sensor is used for SWE measurements in winter and soil moisture measurements in summer. The ability of this type of sensor to operate in the Arctic had not been verified until now. The cosmic-ray sensor was installed on a tripod located approximately 150 m south of the ARM User Facility (Figure 1), and within boundaries of land managed by the ARM Facility. The sensor consists of both “bare” and “moderated” channels, where the moderated channel is the primary output used to calculate SWE. A QDL2100 data logger with pressure sensor was located inside of the User Facility, and a Campbell CS215 temperature and humidity sensor was attached to a rail on the upper deck of the User Facility, to enable near-real-time absolute humidity corrections to the data. The cosmic-ray sensors are connected to the data logger using an armored Cat5e cable that lies on top of the tundra. Data are retrieved hourly via Iridium satellite link.« less

Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire.

PubMed

Eltayeb, Shahla; Staal, J Bart; Kennes, Janneke; Lamberts, Petra H G; de Bie, Rob A

2007-07-14

Complaints of Arm Neck and Shoulder (CANS) represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints. To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability). The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%). The psychometric properties of the MUEQ were assessed using exploratory factor analysis which resulted in the identification of 12 factors. The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document CANS among computer workers in the Netherlands.

Comparison of muscle cross-sectional areas between weight lifters and wrestlers.

PubMed

Kanehisa, H; Ikegawa, S; Fukunaga, T

1998-05-01

The purpose of this study was to investigate the difference in the magnitude of muscular development between Olympic weight lifters and wrestlers through the measurements of fat-free mass (FFM) and limb muscle cross-sectional area (CSA). Subjects were college Olympic weight lifters (N = 34, age = 20.0 +/- 1.3 years, stature = 1.67 +/- 0.07 m, body mass = 70.1 +/- 10.2 kg, X +/- SD) and wrestlers (N = 33,20.3 +/- 1.2 years, 1.69 +/- 0.06 m, 71.0 +/- 1.8 kg) who had identical range of body mass. Body density and the CSAs of reciprocal muscle groups in the forearm, upper arm, lower leg and thigh were measured by underwater weighing and B-mode ultrasound methods, respectively. No significant difference was found in body density between the weight lifters (1.077 +/- 0.007 g x ml(-3)) and wrestlers (1.076 +/- 0.008 g x ml(-3)). Moreover, FFM and the CSA values of all muscle groups tested were similar in the two groups of weight-classified athletes, with an exception that the wrist flexor CSA was significantly larger in wrestlers than in weight lifters, and the knee extensor and thigh (extensors + flexors) CSAs were larger in weight lifters than in wrestlers. The total muscle CSA of every site was significantly correlated to FFM2/3 in the separate groups; r = 0.714 to 0.815 (p < 0.05) in weight lifters and r = 0.769 to 0.919 (p < 0.05) in wrestlers. While the CSA-to-FFM2/3 ratios of the upper arm and wrist flexor muscles were significantly higher in wrestlers than in weight lifters, those of the thigh and knee extensor muscles were higher in weight lifters than in wrestlers. Thus, the present results suggest that an event-related difference exists in the magnitude of limb muscle CSA between competitive weight lifters and wrestlers of similar FFM.

Remapping cortical modulation for electrocorticographic brain-computer interfaces: a somatotopy-based approach in individuals with upper-limb paralysis

NASA Astrophysics Data System (ADS)

Degenhart, Alan D.; Hiremath, Shivayogi V.; Yang, Ying; Foldes, Stephen; Collinger, Jennifer L.; Boninger, Michael; Tyler-Kabara, Elizabeth C.; Wang, Wei

2018-04-01

Objective. Brain-computer interface (BCI) technology aims to provide individuals with paralysis a means to restore function. Electrocorticography (ECoG) uses disc electrodes placed on either the surface of the dura or the cortex to record field potential activity. ECoG has been proposed as a viable neural recording modality for BCI systems, potentially providing stable, long-term recordings of cortical activity with high spatial and temporal resolution. Previously we have demonstrated that a subject with spinal cord injury (SCI) could control an ECoG-based BCI system with up to three degrees of freedom (Wang et al 2013 PLoS One). Here, we expand upon these findings by including brain-control results from two additional subjects with upper-limb paralysis due to amyotrophic lateral sclerosis and brachial plexus injury, and investigate the potential of motor and somatosensory cortical areas to enable BCI control. Approach. Individuals were implanted with high-density ECoG electrode grids over sensorimotor cortical areas for less than 30 d. Subjects were trained to control a BCI by employing a somatotopic control strategy where high-gamma activity from attempted arm and hand movements drove the velocity of a cursor. Main results. Participants were capable of generating robust cortical modulation that was differentiable across attempted arm and hand movements of their paralyzed limb. Furthermore, all subjects were capable of voluntarily modulating this activity to control movement of a computer cursor with up to three degrees of freedom using the somatotopic control strategy. Additionally, for those subjects with electrode coverage of somatosensory cortex, we found that somatosensory cortex was capable of supporting ECoG-based BCI control. Significance. These results demonstrate the feasibility of ECoG-based BCI systems for individuals with paralysis as well as highlight some of the key challenges that must be overcome before such systems are translated to the clinical realm. ClinicalTrials.gov Identifier: NCT01393444.

Influence of Rostral Fluid Shift on Upper Airway Size and Mucosal Water Content

PubMed Central

Kasai, Takatoshi; Motwani, Shveta S.; Elias, Rosilene M.; Gabriel, Joseph M.; Taranto Montemurro, Luigi; Yanagisawa, Naotake; Spiller, Neil; Paul, Narinder; Bradley, T. Douglas

2014-01-01

Study Objective: Fluid displacement from the legs during recumbency while in bed might narrow the upper airway (UA) in association with nuchal fluid accumulation that may contribute to the pathogenesis of obstructive sleep apnea (OSA). The aim of this study was to test the hypothesis that rostral fluid displacement from the legs causes a greater decrease in UA cross-sectional area (UA-XSA) and a greater increase in UA mucosal water content (UA-MWC) and internal jugular venous volume (IJVVol) in subjects with OSA than in those without OSA. Methods: Subjects underwent baseline assessment of leg fluid volume (LFV) measured by bio-electrical impedance, as well as UA-XSA and UA-MWC by magnetic resonance imaging. They were then randomly assigned to a 20-min period either with or without application of lower body positive pressure (LBPP) of 40 mm Hg, followed by a 15-min washout period, after which they crossed over to the other arm of the study. Measurements of LFV, UA-MWC, and UA-XSA were repeated after each arm of the study. Results: In 12 subjects without sleep apnea, UA-XSA increased and UA-MWC decreased significantly, whereas in 12 subjects with OSA, UA-XSA decreased and UA-MWC increased significantly in response to LBPP. The changes in UA-XSA and UA-MWC in response to LBPP differed significantly between the 2 groups (p = 0.006 and p < 0.001, respectively), despite similar changes in LFV and IJVVol. Conclusions: Our results suggest that rostral fluid shift may contribute to the pathogenesis of OSA at least partly through narrowing of the UA due to transudation of fluid into the UA mucosa. Citation: Kasai T, Motwani SS, Elias RM, Gabriel JM, Taranto Montemurro L, Yanagisawa N, Spiller N, Paul N, Bradley TD. Influence of rostral fluid shift on upper airway size and mucosal water content. J Clin Sleep Med 2014;10(10):1069-1074. PMID:25317087

Spatial Map of Synthesized Criteria for the Redundancy Resolution of Human Arm Movements.

PubMed

Li, Zhi; Milutinovic, Dejan; Rosen, Jacob

2015-11-01

The kinematic redundancy of the human arm enables the elbow position to rotate about the axis going through the shoulder and wrist, which results in infinite possible arm postures when the arm reaches to a target in a 3-D workspace. To infer the control strategy the human motor system uses to resolve redundancy in reaching movements, this paper compares five redundancy resolution criteria and evaluates their arm posture prediction performance using data on healthy human motion. Two synthesized criteria are developed to provide better real-time arm posture prediction than the five individual criteria. Of these two, the criterion synthesized using an exponential method predicts the arm posture more accurately than that using a least squares approach, and therefore is preferable for inferring the contributions of the individual criteria to motor control during reaching movements. As a methodology contribution, this paper proposes a framework to compare and evaluate redundancy resolution criteria for arm motion control. A cluster analysis which associates criterion contributions with regions of the workspace provides a guideline for designing a real-time motion control system applicable to upper-limb exoskeletons for stroke rehabilitation.

Measuring skin aging using optical coherence tomography in vivo: a validation study

NASA Astrophysics Data System (ADS)

Trojahn, Carina; Dobos, Gabor; Richter, Claudia; Blume-Peytavi, Ulrike; Kottner, Jan

2015-04-01

Dermal and epidermal structures in human skin change during intrinsic and extrinsic aging. Epidermal thickness is one of the most often reported parameters for the assessment of skin aging in cross-sectional images captured by optical coherence tomography (OCT). We aimed to identify further parameters for the noninvasive measurement of skin aging of sun-exposed and sun-protected areas utilizing OCT. Based on a literature review, seven parameters were inductively developed. Three independent raters assessed these parameters using four-point scales on images of female subjects of two age groups. All items could be detected and quantified in our sample. Interrater agreement ranged between 25.0% and 83.3%. The item scores "stratum corneum reflectivity," "upper dermal reflectivity," and "dermoepidermal contrast" showed significant differences between age groups on the volar and dorsal forearm indicating that they were best able to measure changes during skin aging. "Surface unevenness" was associated with the skin roughness parameters, Rz and Rmax, on the inner upper arm and volar forearm supporting the criterion validity of this parameter on sun-protected skin areas. Based on the interrater agreement and the ability to differentiate between age groups, these four parameters are being considered as the best candidates for measuring skin aging in OCT images.

Measuring skin aging using optical coherence tomography in vivo: a validation study.

PubMed

Trojahn, Carina; Dobos, Gabor; Richter, Claudia; Blume-Peytavi, Ulrike; Kottner, Jan

2015-04-01

Dermal and epidermal structures in human skin change during intrinsic and extrinsic aging. Epidermal thickness is one of the most often reported parameters for the assessment of skin aging in cross-sectional images captured by optical coherence tomography (OCT). We aimed to identify further parameters for the noninvasive measurement of skin aging of sun-exposed and sun-protected areas utilizing OCT. Based on a literature review, seven parameters were inductively developed. Three independent raters assessed these parameters using four-point scales on images of female subjects of two age groups. All items could be detected and quantified in our sample. Interrater agreement ranged between 25.0% and 83.3%. The item scores “stratum corneum reflectivity,” “upper dermal reflectivity,” and “dermoepidermal contrast” showed significant differences between age groups on the volar and dorsal forearm indicating that they were best able to measure changes during skin aging. “Surface unevenness” was associated with the skin roughness parameters, Rz and Rmax, on the inner upper arm and volar forearm supporting the criterion validity of this parameter on sun-protected skin areas. Based on the interrater agreement and the ability to differentiate between age groups, these four parameters are being considered as the best candidates for measuring skin aging in OCT images.

Arm lymphoedema and upper limb impairments in sentinel node-negative breast cancer patients: A one year follow-up study.

PubMed

De Groef, An; Van Kampen, Marijke; Tieto, Elena; Schönweger, Petra; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Gebruers, Nick; Devoogdt, Nele

2016-10-01

The aim of this study is (1) to investigate the prevalence rate of arm lymphedema, pain, impaired shoulder range of motion, strength and shoulder function one year after a sentinel lymph node biopsy (SLNB) for breast cancer and (2) to determine predictive factors for these complications. A longitudinal study was performed. One hundred patients with a sentinel-lymph node negative breast cancer were included. All patients were measured before surgery and one year after. Arm lymphedema was measured with the perimeter, pain with the Visual Analogue Scale, shoulder range of motion with an inclinometer, strength with a handheld dynamometer and shoulder function with the Disability of Arm, Shoulder and Hand questionnaire. Patient-, breast cancer- and treatment-related variables were recorded. One year after surgery 8% of sentinel node-negative breast cancer patients had developed arm lymphedema. Fifty percent of patients had pain, 30% had an impaired shoulder range of motion, 8% had a decreased handgrip strength and 49% had an impaired shoulder function. Pain, shoulder range of motion, strength and shoulder dysfunctions changed significantly over one year (p < 0.001). Higher Body Mass Index is a predictive variable for shoulder dysfunctions one year post-SLNB. Prevalence rate of lymphedema and other upper limb impairments may not be underestimated after SLNB. Pain, shoulder range of motion, handgrip strength and shoulder function change significantly up to one year compared to preoperative values in sentinel node-negative breast cancer patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Acquired bilateral telangiectatic macules: a distinct clinical entity.

PubMed

Park, Ji-Hye; Lee, Dong Jun; Lee, Yoo-Jung; Jang, Yong Hyun; Kang, Hee Young; Kim, You Chan

2014-09-01

We evaluated 13 distinct patients with multiple telangiectatic pigmented macules confined mostly to the upper arms to determine if the clinical and histopathological features of these cases might represent a specific clinical entity. We retrospectively investigated the clinical, histopathologic, and immunohistochemical features of 13 patients with multiple telangiectatic pigmented macules on the upper arms who presented between January 2003 and December 2012. Epidermal pigmentation, melanogenic activity, melanocyte number, vascularity, epidermal thickness, and perivascular mast cell number of the specimens were evaluated. Clinically, the condition favored middle-aged men. On histopathologic examination, the lesional skin showed capillary proliferation and telangiectasia in the upper dermis. Histochemical and immunohistochemical analysis revealed basal hyperpigmentation and increased melanogenic activity in the lesional skin (P < .05). No significant difference in epidermal thickness or mast cell number was observed between the normal perilesional skin and the lesional skin. The clinical and histopathologic features of these lesions were relatively consistent in all patients. In addition, the features are quite distinct from other diseases. Based on clinical and histologic features, we suggest the name acquired bilateral telangiectatic macules for this new entity.

Design and kinematic analysis of a novel upper limb exoskeleton for rehabilitation of stroke patients.

PubMed

Zeiaee, Amin; Soltani-Zarrin, Rana; Langari, Reza; Tafreshi, Reza

2017-07-01

This paper details the design process and features of a novel upper limb rehabilitation exoskeleton named CLEVER (Compact, Low-weight, Ergonomic, Virtual/Augmented Reality Enhanced Rehabilitation) ARM. The research effort is focused on designing a lightweight and ergonomic upper-limb rehabilitation exoskeleton capable of producing diverse and perceptually rich training scenarios. To this end, the knowledge available in the literature of rehabilitation robotics is used along with formal conceptual design techniques. This paper briefly reviews the systematic approach used for design of the exoskeleton, and elaborates on the specific details of the proposed design concept and its advantages over other design possibilities. The kinematic structure of CLEVER ARM has eight degrees of freedom supporting the motion of shoulder girdle, glenohumeral joint, elbow and wrist. Six degrees of freedom of the exoskeleton are active, and the two degrees of freedom supporting the wrist motion are passive. Kinematics of the proposed design is studied analytically and experimentally with the aid of a 3D printed prototype. The paper is concluded by some remarks on the optimization of the design, motorization of device, and the fabrication challenges.

A Multi-Armed Bandit Approach to Following a Markov Chain

DTIC Science & Technology

2017-06-01

focus on the House to Café transition (p1,4). We develop a Multi-Armed Bandit approach for efficiently following this target, where each state takes the...and longitude (each state corresponding to a physical location and a small set of activities). The searcher would then apply our approach on this...the target’s transition probability and the true probability over time. Further, we seek to provide upper bounds (i.e., worst case bounds) on the

The association of dementia with upper arm and waist circumference in seven low- and middle-income countries: the 10/66 cross-sectional surveys.

PubMed

Taylor, Clare L; Albanese, Emiliano; Stewart, Robert

2012-08-01

Weight loss in dementia contributes to morbidity and mortality but the distribution of anthropometric change and its consistency between populations are less clear. Our aim was to investigate and compare the associations of dementia with waist and upper arm circumference in elders from seven low- and middle-income nations. Cross-sectional surveys were conducted of 15,022 residents aged 65 years and older in Cuba, Mexico, Venezuela, Peru, Dominican Republic, China, and India. Dementia was assessed using a cross-culturally validated algorithm, and anthropometric measurements were taken. Associations with dementia and dementia severity (clinical dementia rating scale) were investigated in linear regression models, with fixed-effects meta-analyses used to investigate between-country heterogeneity. Dementia and increased dementia severity were both associated with smaller arm and waist circumferences with little evidence of confounding by sociodemographic and health status. Associations between dementia/clinical dementia rating and arm circumference were homogeneous between countries (Higgins I(2) 0% and 7%, respectively), whereas those with waist circumference were more heterogeneous (Higgins I(2) 67% and 62%, respectively). Although cross-sectional, our findings are consistent with prospective observations of weight loss in dementia and suggest loss of both muscle and fat-the former being consistent across different settings and the latter being more context dependent.

Overview: Mechanism and Control of a Prosthetic Arm.

PubMed

Kulkarni, Tushar; Uddanwadiker, Rashmi

2015-09-01

Continuous growth in industrialization and lack of awareness in safety parameters the cases of amputations are growing. The search of safer, simpler and automated prosthetic arms for managing upper limbs is expected. Continuous efforts have been made to design and develop prosthetic arms ranging from simple harness actuated to automated mechanisms with various control options. However due the cost constraints, the automated prosthetic arms are still out of the reach of needy people. Recent data have shown that there is a wide scope to develop a low cost and light weight upper limb prosthesis. This review summarizes the various designs methodologies, mechanisms and control system developed by the researchers and the advances therein. Educating the patient to develop acceptability to prosthesis and using the same for the most basic desired functions of human hand, post amputation care and to improve patient's independent life is equally important. In conclusion it can be interpreted that there is a wide scope in design in an adaptive mechanism for opening and closing of the fingers using other methods of path and position synthesis. Simple mechanisms and less parts may optimize the cost factor. Reduction in the weight of the prosthesis may be achieved using polymers used for engineering applications. Control system will remain never ending challenge for the researchers, but it is essential to maintain the simplicity from the patients perspective.

New approach to evaluate late arm impairment and effects of dragon boat activity in breast cancer survivors.

PubMed

Melchiorri, Giovanni; Viero, Valerio; Triossi, Tamara; Sorge, Roberto; Tancredi, Virginia; Cafaro, Domenico; Andreis, Caterina; Vulpiani, Maria Chiara; Saraceni, Vincenzo Maria

2017-11-01

To verify the applicability of a new approach based on the strength curves (SCs) methodology in late arm impairment in breast cancer (BC) survivors and to evaluate the effects of dragon boat (DB) activity on the late regaining of the muscle strength, upper limb impairment, and quality of life in patients undergoing surgery for BC.Retrospective observational study on 64 subjects (54.5 ± 9.7 years), 47 of them had undergone unilateral mastectomy surgery and were evaluated for late arm impairment. A clinical evaluation of the shoulder and compilation of functional assessment (DASH, Rowe, Constant-Murley) and quality of life (SF-36) scales were carried out. Assessment of muscle strength with SC obtained with isometric assessments and serratus anterior muscle test were performed.Differences between the SC are evident between healthy and operated subjects. Among the 3 groups of operated subjects the difference in strength is maximum at 0°. Statistically significant difference was found between operated and nonoperated only in SF-36 scale. No significant difference was found between groups for shoulder instability and winged scapula.The SC can be used in the study of upper limb impairment after surgery for BC: measurements carried out at 1st degrees of the range of motion are more useful for clinicians. DB activity is useful to reduce the late arm impairment.

The effects of electromyography-controlled functional electrical stimulation on upper extremity function and cortical perfusion in stroke patients.

PubMed

Hara, Yukihiro; Obayashi, Shigeru; Tsujiuchi, Kazuhito; Muraoka, Yoshihiro

2013-10-01

The relation was investigated between hemiparetic arm function improvement and brain cortical perfusion (BCP) change during voluntary muscle contraction (VOL), EMG-controlled FES (EMG-FES) and simple electrical muscle stimulation (ES) before and after EMG-FES therapy in chronic stroke patients. Sixteen chronic stroke patients with moderate residual hemiparesis underwent 5 months of task-orientated EMG-FES therapy of the paretic arm once or twice a week. Before and after treatment, arm function was clinically evaluated and BCP during VOL, ES and EMG-FES were assessed using multi-channel near-infrared spectroscopy. BCP in the ipsilesional sensory-motor cortex (SMC) was greater during EMG-FES than during VOL or ES; therefore, EMG-FES caused a shift in the dominant BCP from the contralesional to ipsilesional SMC. After EMG-FES therapy, arm function improved in most patients, with some individual variability, and there was significant improvement in Fugl-Meyer (FM) score and maximal grip strength (GS). Clinical improvement was accompanied by an increase in ipsilesional SMC activation during VOL and EMG-FES condition. The EMG-FES may have more influence on ipsilesional BCP than VOL or ES alone. The sensory motor integration during EMG-FES therapy might facilitate BCP of the ipsilesional SMC and result in functional improvement of hemiparetic upper extremity. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Neck Injuries and Disorders

MedlinePlus

... tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from ... upper arms. Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from ...

Genetics Home Reference: facioscapulohumeral muscular dystrophy

MedlinePlus

... those of the face (facio-), around the shoulder blades (scapulo-), and in the upper arms (humeral). The ... Weak shoulder muscles tend to make the shoulder blades (scapulae) protrude from the back, a common sign ...

Complex upper arm reconstruction using an antero-lateral thigh free flap after an extravasation of Yttrium-90-ibritumomab Tiuxetan: A case report and literature review.

PubMed

Baus, A; Keilani, C; Bich, C-S; Entine, F; Brachet, M; Duhamel, P; Amabile, J-C; Malfuson, J V; Bey, E

2018-04-01

Yttrium-90-Ibritumomab Tiuxetan (Zevalin ® ) is used in the treatment of non- Hodgkin's lymphoma. Extravasation is an iatrogenic complication that is fortunately rare. However, the treatment of this complication is often complex due to the risk of extensive skin necrosis and unpredictable evolution of localized irradiation. This vesicant drug requires emergency management when extravasation occured. Radiations burns have specificities. Therefore, wound coverage involves specific plastic surgical techniques. Here, we report the case of a man presenting a chronic and extensive skin necrosis of upper arm treated with an antero-lateral thigh free flap. Moreover, we compare our experience of Zevalin ® extravasation management to other past publications and propose recommendations to prevent this unacceptable complication. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Reliability and validity of the upper-extremity Motor Activity Log-14 for measuring real-world arm use.

PubMed

Uswatte, Gitendra; Taub, Edward; Morris, David; Vignolo, Mary; McCulloch, Karen

2005-11-01

In research on Constraint-Induced Movement (CI) therapy, a structured interview, the Motor Activity Log (MAL), is used to assess how stroke survivors use their more-impaired arm outside the laboratory. This article examines the psychometrics of the 14-item version of this instrument in 2 chronic stroke samples with mild-to-moderate upper-extremity hemiparesis. Participants (n=41) in the first study completed MALs before and after CI therapy or a placebo control procedure. In addition, caregivers independently completed a MAL on the participants. Participants (n=27) in the second study completed MALs and wore accelerometers that monitored their arm movements for 3 days outside the laboratory before and after an automated form of CI therapy. Validity of the participant MAL Quality of Movement (QOM) scale was supported. Correlations between pretreatment-to-posttreatment change scores on the participant QOM scale and caregiver MAL QOM scale, caregiver MAL amount of use (AOU) scale, and accelerometer recordings were 0.70, 0.73, and 0.91 (P<0.01), respectively. Internal consistency (alpha>0.81), test-retest reliability (r>0.91), stability, and responsiveness (ratio>3) of the participant QOM scale were also supported. The participant AOU and caregiver QOM and AOU scales were internally consistent, stable, and sensitive, but were not reliable. The participant MAL QOM scale can be used exclusively to reliably and validly measure real-world, upper-extremity rehabilitation outcome and functional status in chronic stroke patients with mild-to-moderate hemiparesis.

Validation of the AVITA BPM64 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Kang, Yuan-Yuan; Chen, Qi; Liu, Chang-Yuan; Li, Yan; Wang, Ji-Guang

2018-02-01

The aim of this study was to evaluate the accuracy of the automated oscillometric upper arm blood pressure (BP) monitor AVITA BPM64 for home BP monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic BPs were measured sequentially in 33 adult Chinese (14 women, mean age 47.0 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM64 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM64 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 91/99, 98/99, and 98/99, respectively, for systolic BP and 92/99, 99/99, and 99/99, respectively, for diastolic BP. The device also fulfilled the criteria in part 2 of the validation study. Thirty-two participants for both systolic and diastolic BP had at least two of the three device-observer differences within 5 mmHg (required ≥24). Only one participant for systolic BP had all three device-observer comparisons greater than 5 mmHg. The AVITA upper arm BP monitor BPM64 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

Validation of the Beurer BM 44 upper arm blood pressure monitor for home measurement, according to the European Society of Hypertension International Protocol 2002.

PubMed

Lüders, Stephan; Krüger, Ralf; Zemmrich, Claudia; Forstner, Klaus; Sturm, Claus-Dieter; Bramlage, Peter

2012-12-01

The present study aimed to validate the automated upper arm blood pressure (BP) measuring device BM 44 for home BP monitoring according to the 2002 Protocol of the European Society of Hypertension. The most important new feature of the new device was an integrated 'WHO indicator', which categorizes the patient's individual result within the WHO recommendations for target BP by a coloured scale. Systolic and diastolic BPs were measured sequentially in 35 adult participants (16 men, 19 women) using a standard mercury y-tubed reference sphygmomanometer (two observers) and the BM 44 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. The BM 44 device passed phase 1 of the validation study successfully with a number of absolute differences between device and observers of 5, 10 and 15 mmHg for at least 28 out of 25, 35 out of 35 and 40 out of 40 measurements, respectively. The device also achieved the targets for phases 2.1 and 2.2, with 23 and 26 participants having had at least two of three device-observers differences within 5 mmHg for systolic and diastolic BP, respectively. The Beurer BM 44 upper arm BP monitor has passed the International Protocol requirements, and hence can be recommended for home use in adults. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Goal setting, using goal attainment scaling, as a method to identify patient selected items for measuring arm function.

PubMed

Ashford, Stephen; Jackson, Diana; Turner-Stokes, Lynne

2015-03-01

Following stroke or brain injury, goals for rehabilitation of the hemiparetic upper limb include restoring active function if there is return of motor control or, if none is possible, improving passive function, and facilitating care for the limb. To inform development of a new patient reported outcome measure (PROM) of active and passive function in the hemiparetic upper limb, the Arm Activity measure, we examined functional goals for the upper limb, identified during goal setting for spasticity intervention (physical therapy and concomitant botulinum toxin A interventions). Using secondary analysis of a prospective observational cohort study, functional goals determined between patients, their carers and the clinical team were assigned into categories by two raters. Goal category identification, followed by assignment of goals to a category, was undertaken and then confirmed by a second reviewer. Participants comprised nine males and seven females of mean (SD) age 54.5 (15.7) years and their carers. Fifteen had sustained a stroke and one a traumatic brain injury. Goals were used to identify five categories: passive function, active function, symptoms, cosmesis and impairment. Two passive function items not previously identified by a previous systematic review were identified. Analysis of goals important to patients and carers revealed items for inclusion in a new measure of arm function and provide a useful alternative method to involve patients and carers in standardised measure development. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Influence of exercise modality on cardiac parasympathetic and sympathetic indices during post-exercise recovery.

PubMed

Michael, Scott; Jay, Ollie; Graham, Kenneth S; Davis, Glen M

2018-02-12

This study investigated indirect measures of post-exercise parasympathetic reactivation (using heart-rate-variability, HRV) and sympathetic withdrawal (using systolic-time-intervals, STI) following upper- and lower-body exercise. Randomized, counter-balanced, crossover. 13 males (age 26.4±4.7years) performed maximal arm-cranking (MAX-ARM) and leg-cycling (MAX-LEG). Subsequently, participants undertook separate 8-min bouts of submaximal HR-matched exercise of each mode (ARM and LEG). HRV (including natural-logarithm of root-mean-square-of-successive-differences, Ln-RMSSD) and STI (including pre-ejection-period, PEP) were assessed throughout 10-min seated recovery. Peak-HR was higher (p=0.001) during MAX-LEG (182±7beatsmin -1 ) compared with MAX-ARM (171±12beatsmin -1 ), while HR (p<0.001) and Ln-RMSSD (p=0.010) recovered more rapidly following MAX-ARM. PEP recovery was similar between maximal bouts (p=0.106). HR during submaximal exercise was 146±7 (LEG) and 144±8beatsmin -1 (LEG) (p=0.139). Recovery of HR and Ln-RMSSD was also similar between submaximal modalities, remaining below baseline throughout recovery (p<0.001). PEP was similar during submaximal exercise (LEG 70±6ms; ARM 72±9ms; p=0.471) although recovery was slower following ARM (p=0.021), with differences apparent from 1- to 10-min recovery (p≤0.036). By 10-min post-exercise, PEP recovered to baseline (132±21ms) following LEG (130±21ms; p=0.143), but not ARM (121±17ms; p=0.001). Compared with submaximal lower-body exercise, HR-matched upper-body exercise elicited a similar recovery of HR and HRV indices of parasympathetic reactivation, but delayed recovery of PEP (reflecting sympathetic withdrawal). Exercise modality appears to influence post-exercise parasympathetic reactivation and sympathetic withdrawal in an intensity-dependent manner. These results highlight the need for test standardization and may be relevant to multi-discipline athletes and in clinical applications with varying modes of exercise testing. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients.

PubMed

Charmoy, Alexia; Würzner, Grégoire; Ruffieux, Christiane; Hasler, Christopher; Cachat, François; Waeber, Bernard; Burnier, Michel

2007-10-01

Cuff inflation at the arm is known to cause an instantaneous rise in blood pressure, which might be due to the discomfort of the procedure and might interfere with the precision of the blood pressure measurement. In this study, we compared the reactive rise in blood pressure induced by cuff inflation when the cuff was placed at the upper arm level and at the wrist. The reactive rise in systolic and diastolic blood pressure to cuff inflation was measured in 34 normotensive participants and 34 hypertensive patients. Each participant was equipped with two cuffs, one around the right upper arm (OMRON HEM-CR19, 22-32 cm) and one around the right wrist (OMRON HEM-CS 19, 17-22 cm; Omron Health Care Europe BV, Hoofddorp, The Netherlands). The cuffs were inflated in a double random order (maximal cuff pressure and position of the cuff) with two maximal cuff pressures: 180 and 240 mmHg. The cuffs were linked to an oscillometric device (OMRON HEM 907; Omron Health Care). Simultaneously, blood pressure was measured continuously at the middle finger of the left hand using photoplethysmography. Three measurements were made at each level of blood pressure at the arm and at the wrist, and the sequence of measurements was randomized. In normotensive participants, no significant difference was observed in the reactive rise in blood pressure when the cuff was inflated either at the arm or at the wrist irrespective of the level of cuff inflation. Inflating a cuff at the arm, however, induced a significantly greater rise in blood pressure than inflating it at the wrist in hypertensive participants for both systolic and diastolic pressures (P<0.01), and at both levels of cuff inflation. The blood pressure response to cuff inflation was independent of baseline blood pressure. The results show that in hypertensive patients, cuff inflation at the wrist produces a smaller reactive rise in blood pressure. The difference between the arm and the wrist is independent of the patient's level of blood pressure.

Visual search strategies of experienced and nonexperienced swimming coaches.

PubMed

Moreno, Francisco J; Saavedra, José M; Sabido, Rafael; Luis, Vicente; Reina, Raúl

2006-12-01

The aim of this study consists of the application of an experimental protocol that allows information to be obtained about the visual search strategies elaborated by swimming coaches. 16 swimming coaches participated. The Experienced group (n=8) had 16.1 yr. (SD=8.2) of coaching experience and at least five years of experience in underwater vision. The Nonexperienced group in underwater vision (n= 8) had 4.2 yr. (SD= 4.0) of coaching experience. Participants were tested in a laboratory environment using a video-projected sample of the crawl stroke of an elite swimmer. This work discusses the main areas of the swimmer's body used by coaches to identify and analyse errors in technique from overhead and underwater perspectives. In front-underwater videos, body roll and mid-water were the locations of the display with higher percentages of fixation time. In the side-underwater slow videos, the upper body was the location with higher percentages of visual fixation time and was used to detect the low elbow fault. Side-overhead takes were not the best perspectives to pick up information directly about performance of the arms; coaches attended to the head as a reference for their visual search. The observation and technical analysis of the hands and arms were facilitated by an underwater perspective. Visual fixation on the elbow served as a reference to identify errors in the upper body. The side-underwater perspective may be an adequate way to identify correct knee angles in leg kicking and the alignment of a swimmer's body and leg actions.

[Clinical features of the hand-arm vibration syndrome in miners].

PubMed

Kákosy, Tibor; Németh, László; Kiss, Gábor; Lászlóffy, Marianna; Kardos, Kálmán

2006-05-07

It is well known that the vibrating tools used by the miners can cause hand-arm vibration syndrome. However no detailed reports on this field could be found in the Hungarian literature. The aim of this study was to clarify the clinical features of the hand-arm vibration syndrome of the miners. The circulation, the peripheral nerves and the osteoarticular system of the upper extremities of 152 miners were examined by means of cold provocation test, Allen-test, measurement of systolic blood pressure performed by Doppler flowmeter, clinical neurological and neurographic examination and X-ray investigation of the bones and joints. Hand-arm vibration syndrome was diagnosed in 87 patients (57.2%). The most common symptom was the lesion of the circulation which occurred in 78 patients (89.6%). The peripheral nerves were affected in 44 cases (50.5%). Radiological alteration of the bones and joints of the upper extremities was observed in 32 patients (36.8%). Out of 78 damaged cases the frequency of the vascular diseases was as follows: angiopathy (diminished systolic blood pressure in the fingers): 66 patient (84.6%), occlusion of the hand arteries (positive Allen-test) and arterial form of the thoracic outlet syndrome (positive elevation-test) respectively: 28 and 28 cases (35.9%), Raynaud phenomenon (positive cold-provocation test): 26 cases (33.3%). The peripheral nerves were examined in detail in 141 cases. Pathological alterations were observed in 78 patients (55.3%) in the following forms: carpal tunnel syndrome: 66 cases (84.6%), peripheral neuropathy of the upper limbs: 20 patients (25.6%), lesion of the ulnar nerve: 3 cases (3.8%), brachial plexus lesion: one patient (1.3%). Radiological alteration was most common in the carpal region (87 cases, 57.2%). The frequency of the lesion of cubital (40.4%) and shoulder region (40.7%) was practically the same. In the carpal region the most common alterations were the degenerative processes (23 cases, 15.1%) followed by the aseptic osteonecroses (22 patients, 14.5%). In the cubital region the periarticular changes (31 patients, 23.9%) were most common followed by degenerative changes (21 cases, 16.2%) and the osteochondrosis dissecans (13 cases, 10.1%). In the shoulder region the degenerative processes were the most common changes (41 patients, 34.7%), first of all in the acromioclavicular joint (21 cases, 17.8%). Aseptic necrosis was observed in two patients. The miners are professionally exposed not only to hand-arm vibration, but also to increased physical stress. The symptoms on the upper limbs can develop as the result of both exposures.

Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

PubMed

Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

2012-07-01

To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (P<0.001) were found; pectoralis major, infraspinatus, upper trapezius, and scalene muscles showed the largest referred pain areas (P<0.01), whereas the temporalis, masseter, and splenius capitis muscles showed the smallest (P<0.05). The combination of the referred pain from TrPs reproduced the overall clinical pain area in all participants. Blue-collar and white-collar workers exhibited a similar number of TrPs in the upper quadrant musculature. The referred pain elicited by active TrPs reproduced the overall pain pattern. The distribution of TrPs was not significantly different between groups. Clinicians should examine for the presence of muscle TrPs in blue-collar and white-collar workers.

Does intervention using virtual reality improve upper limb function in children with neurological impairment: a systematic review of the evidence.

PubMed

Galvin, Jane; McDonald, Rachael; Catroppa, Cathy; Anderson, Vicki

2011-01-01

Virtual reality (VR) is an emerging area of paediatric clinical and research practice, however the majority of research to date has focused on outcomes for adults following stroke. This paper appraises and describes current evidence for use of virtual reality interventions to improve upper limb function of children with neurological impairment. A comprehensive database search was undertaken to explore literature on the use of VR systems for rehabilitation of upper limb skills of children with neurological impairment. Studies investigating the use of robotics or other mechanical devices were excluded. Five studies were found and were critiqued using the Downs and Black scale for measuring study quality. One randomized control trial and four case studies were found. No study scored over 50% on the Downs and Black scale, indicating methodological limitations that limit generalizability. Current evidence for the use of VR to improve hand and arm skills is at an emerging stage. Small sample sizes and inconsistencies in outcome measurement limit the ability to generalize findings. Further studies are required to investigate the ability to maintain gains made in VR over time and to determine whether gains transfer from the VR to real life tasks and activities.

105KE Basin Area Radiation Monitor System (ARMS) Acceptance Test Procedure

DOE Office of Scientific and Technical Information (OSTI.GOV)

KINKEL, C.C.

1999-12-14

This procedure is intended for the Area Radiation Monitoring System, ARMS, that is replacing the existing Programmable Input-Output Processing System, PIOPS, radiation monitoring system in the 105KE basin. The new system will be referred to as the 105KE ARMS, 105KE Area Radiation Monitoring System. This ATP will ensure calibration integrity of the 105KE radiation detector loops. Also, this ATP will test and document the display, printing, alarm output, alarm acknowledgement, upscale check, and security functions. This ATP test is to be performed after completion of the 105KE ARMS installation. The alarm outputs of the 105KE ARMS will be connected tomore » the basin detector alarms, basin annunciator system, and security Alarm Monitoring System, AMS, located in the 200 area Central Alarm Station (CAS).« less

Go4Life:Flexibility | NIH MedlinePlus the Magazine

MedlinePlus

... Upper Arm How Much, How Often Do each stretching exercise 3 to 5 times at each session. ... lower-back flexibility exercises. Always warm up before stretching exercises. Stretching your muscles before they are warmed ...

PCOS: What Teens Need to Know

MedlinePlus

... that are very heavy or very light Unwanted hair growth on your face, chest, back, hands, upper arms ... your weight. Your doctor will also look at hair growth on your body and will check for patches ...

Exercise and age

MedlinePlus

... down the stairs STRETCHING Stretching can help your body stay flexible. To stay limber: Learn shoulder, upper arm, and calf stretches Take yoga classes Do everyday activities, such as making your bed or bending over to tie your shoes

33 CFR 334.740 - Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area. 334.740 Section 334.740 Navigation and Navigable... REGULATIONS § 334.740 Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area. (a...

33 CFR 334.740 - Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area. 334.740 Section 334.740 Navigation and Navigable... REGULATIONS § 334.740 Weekley Bayou, an arm of Boggy Bayou, Fla., at Eglin Air Force Base; restricted area. (a...

Survey of Hand and Upper Extremity Injuries Among Rock Climbers.

PubMed

Nelson, Clayton E; Rayan, Ghazi M; Judd, Dustin I; Ding, Kai; Stoner, Julie A

2017-07-01

Rock climbing first evolved as a sport in the late 18th century. With its growing popularity, the number of rock climbing-related injuries has potential to increase, spurring a rise in the number of articles associated with it. Despite the available literature, there remains a paucity of information about upper extremity injuries sustained by rock climbers, and no studies to date have focused on gender-specific injuries. A 24-question online survey was distributed to rock climbers about upper extremity injuries sustained during rock climbing. Statistical analysis was used to study association between participants' demographics and injuries. A total of 397 participants responded to the survey. Mean age was 32.5 years with males comprising 85%. No significant differences in demographics or climbing behaviors were found between males and females. Ninety percent of participants reported sustaining an upper extremity injury. Fingers were the most common injury followed by shoulder/arm and elbow/forearm. Our study found females to be more likely to report a rock climbing-related injury, and more likely to undergo surgery for it. Female rock climbers were significantly more likely to report a shoulder/upper arm injury and were also more likely to report undergoing surgery compared with males, where these differences were not due to age or climbing behaviors. Further investigation is warranted into the association between shoulder injuries and female athletes to determine how the gender differences relate to extent of injury as well as health service utilization behaviors.

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

PubMed Central

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

2014-01-01

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

Stochastic Estimation of Arm Mechanical Impedance During Robotic Stroke Rehabilitation

PubMed Central

Palazzolo, Jerome J.; Ferraro, Mark; Krebs, Hermano Igo; Lynch, Daniel; Volpe, Bruce T.; Hogan, Neville

2009-01-01

This paper presents a stochastic method to estimate the multijoint mechanical impedance of the human arm suitable for use in a clinical setting, e.g., with persons with stroke undergoing robotic rehabilitation for a paralyzed arm. In this context, special circumstances such as hypertonicity and tissue atrophy due to disuse of the hemiplegic limb must be considered. A low-impedance robot was used to bring the upper limb of a stroke patient to a test location, generate force perturbations, and measure the resulting motion. Methods were developed to compensate for input signal coupling at low frequencies apparently due to human–machine interaction dynamics. Data was analyzed by spectral procedures that make no assumption about model structure. The method was validated by measuring simple mechanical hardware and results from a patient's hemiplegic arm are presented. PMID:17436881

System integration of pattern recognition, adaptive aided, upper limb prostheses

NASA Technical Reports Server (NTRS)

Lyman, J.; Freedy, A.; Solomonow, M.

1975-01-01

The requirements for successful integration of a computer aided control system for multi degree of freedom artificial arms are discussed. Specifications are established for a system which shares control between a human amputee and an automatic control subsystem. The approach integrates the following subsystems: (1) myoelectric pattern recognition, (2) adaptive computer aiding; (3) local reflex control; (4) prosthetic sensory feedback; and (5) externally energized arm with the functions of prehension, wrist rotation, elbow extension and flexion and humeral rotation.

Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroesophageal Junction Cancer

PubMed Central

Homann, Nils; Pauligk, Claudia; Illerhaus, Gerald; Martens, Uwe M.; Stoehlmacher, Jan; Schmalenberg, Harald; Luley, Kim B.; Prasnikar, Nicole; Egger, Matthias; Probst, Stephan; Messmann, Helmut; Moehler, Markus; Fischbach, Wolfgang; Hartmann, Jörg T.; Mayer, Frank; Höffkes, Heinz-Gert; Koenigsmann, Michael; Arnold, Dirk; Kraus, Thomas W.; Grimm, Kersten; Berkhoff, Stefan; Post, Stefan; Jäger, Elke; Bechstein, Wolf; Ronellenfitsch, Ulrich; Mönig, Stefan; Hofheinz, Ralf D.

2017-01-01

Importance Surgical resection has a potential benefit for patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. Objective To evaluate outcome in patients with limited metastatic disease who receive chemotherapy first and proceed to surgical resection. Design, Setting, and Participants The AIO-FLOT3 (Arbeitsgemeinschaft Internistische Onkologie–fluorouracil, leucovorin, oxaliplatin, and docetaxel) trial is a prospective, phase 2 trial of 252 patients with resectable or metastatic gastric or gastroesophageal junction adenocarcinoma. Patients were enrolled from 52 cancer care centers in Germany between February 1, 2009, and January 31, 2010, and stratified to 1 of 3 groups: resectable (arm A), limited metastatic (arm B), or extensive metastatic (arm C). Data cutoff was January 2012, and the analysis was performed in March 2013. Interventions Patients in arm A received 4 preoperative cycles of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) followed by surgery and 4 postoperative cycles. Patients in arm B received at least 4 cycles of neoadjuvant FLOT and proceeded to surgical resection if restaging (using computed tomography and magnetic resonance imaging) showed a chance of margin-free (R0) resection of the primary tumor and at least a macroscopic complete resection of the metastatic lesions. Patients in arm C were offered FLOT chemotherapy and surgery only if required for palliation. Patients received a median (range) of 8 (1-15) cycles of FLOT. Main Outcomes and Measures The primary end point was overall survival. Results In total, 238 of 252 patients (94.4%) were eligible to participate. The median (range) age of participants was 66 (36-79) years in arm A (n = 51), 63 (28-79) years in arm B (n = 60), and 65 (23-83) years in arm C (n = 127). Patients in arm B (n = 60) had only retroperitoneal lymph node involvement (27 patients [45%]), liver involvement (11 [18.3%]), lung involvement (10 [16.7%]), localized peritoneal involvement (4 [6.7%]), or other (8 [13.3%]) incurable sites. Median overall survival was 22.9 months (95% CI, 16.5 to upper level not achieved) for arm B, compared with 10.7 months (95% CI, 9.1-12.8) for arm C (hazard ratio, 0.37; 95% CI, 0.25-0.55) (P < .001). The response rate for arm B was 60% (complete, 10%; partial, 50%), which is higher than the 43.3% for arm C. In arm B, 36 of 60 patients (60%) proceeded to surgery. The median overall survival was 31.3 months (95% CI, 18.9-upper level not achieved) for patients who proceeded to surgery and 15.9 months (95% CI, 7.1-22.9) for the other patients. Conclusions and Relevance Patients with limited metastatic disease who received neoadjuvant chemotherapy and proceeded to surgery showed a favorable survival. The AIO-FLOT3 trial provides a rationale for further randomized clinical trials. Trial Registration clinicaltrials.gov identifier: NCT00849615 PMID:28448662

Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroesophageal Junction Cancer: The AIO-FLOT3 Trial.

PubMed

Al-Batran, Salah-Eddin; Homann, Nils; Pauligk, Claudia; Illerhaus, Gerald; Martens, Uwe M; Stoehlmacher, Jan; Schmalenberg, Harald; Luley, Kim B; Prasnikar, Nicole; Egger, Matthias; Probst, Stephan; Messmann, Helmut; Moehler, Markus; Fischbach, Wolfgang; Hartmann, Jörg T; Mayer, Frank; Höffkes, Heinz-Gert; Koenigsmann, Michael; Arnold, Dirk; Kraus, Thomas W; Grimm, Kersten; Berkhoff, Stefan; Post, Stefan; Jäger, Elke; Bechstein, Wolf; Ronellenfitsch, Ulrich; Mönig, Stefan; Hofheinz, Ralf D

2017-09-01

Surgical resection has a potential benefit for patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. To evaluate outcome in patients with limited metastatic disease who receive chemotherapy first and proceed to surgical resection. The AIO-FLOT3 (Arbeitsgemeinschaft Internistische Onkologie-fluorouracil, leucovorin, oxaliplatin, and docetaxel) trial is a prospective, phase 2 trial of 252 patients with resectable or metastatic gastric or gastroesophageal junction adenocarcinoma. Patients were enrolled from 52 cancer care centers in Germany between February 1, 2009, and January 31, 2010, and stratified to 1 of 3 groups: resectable (arm A), limited metastatic (arm B), or extensive metastatic (arm C). Data cutoff was January 2012, and the analysis was performed in March 2013. Patients in arm A received 4 preoperative cycles of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) followed by surgery and 4 postoperative cycles. Patients in arm B received at least 4 cycles of neoadjuvant FLOT and proceeded to surgical resection if restaging (using computed tomography and magnetic resonance imaging) showed a chance of margin-free (R0) resection of the primary tumor and at least a macroscopic complete resection of the metastatic lesions. Patients in arm C were offered FLOT chemotherapy and surgery only if required for palliation. Patients received a median (range) of 8 (1-15) cycles of FLOT. The primary end point was overall survival. In total, 238 of 252 patients (94.4%) were eligible to participate. The median (range) age of participants was 66 (36-79) years in arm A (n = 51), 63 (28-79) years in arm B (n = 60), and 65 (23-83) years in arm C (n = 127). Patients in arm B (n = 60) had only retroperitoneal lymph node involvement (27 patients [45%]), liver involvement (11 [18.3%]), lung involvement (10 [16.7%]), localized peritoneal involvement (4 [6.7%]), or other (8 [13.3%]) incurable sites. Median overall survival was 22.9 months (95% CI, 16.5 to upper level not achieved) for arm B, compared with 10.7 months (95% CI, 9.1-12.8) for arm C (hazard ratio, 0.37; 95% CI, 0.25-0.55) (P < .001). The response rate for arm B was 60% (complete, 10%; partial, 50%), which is higher than the 43.3% for arm C. In arm B, 36 of 60 patients (60%) proceeded to surgery. The median overall survival was 31.3 months (95% CI, 18.9-upper level not achieved) for patients who proceeded to surgery and 15.9 months (95% CI, 7.1-22.9) for the other patients. Patients with limited metastatic disease who received neoadjuvant chemotherapy and proceeded to surgery showed a favorable survival. The AIO-FLOT3 trial provides a rationale for further randomized clinical trials. clinicaltrials.gov identifier: NCT00849615.

The biomechanical effect of arm mass on long jump performance: A case study of a paralympic upper limb amputee.

PubMed

Pradon, Didier; Mazure-Bonnefoy, Alice; Rabita, Giuseppe; Hutin, Emilie; Zory, Raphael; Slawinski, Jean

2014-06-01

The role of arm motion during the long jump has been well studied. The aim of this study was to quantify the effect of forearm mass on impulse and the kinematics of the flight phase in an upper limb amputee. A world-record paralympic long jumper carried out jumps in three conditions: wearing his usual forearm prosthesis and with 0.3 and 0.4 kg added mass. A motion capture system including force plates was used to record the jump. At take-off, the addition of 0.4 kg to the prosthesis decreased the vertical velocity of the centre of mass but increased horizontal velocity. These modifications were associated with an increase in landing distance and an improvement of the synchronization between arms. Increasing forearm mass appears to improve long jump performance. Further studies need to evaluate the optimal prosthetic mass for both training and competition. This biomechanical analysis of the long jump highlighted the effects of changing prosthesis mass on performance. This methodological approach may be useful in the context of sport and performance research. © The International Society for Prosthetics and Orthotics 2013.

Optimism in the face of uncertainty supported by a statistically-designed multi-armed bandit algorithm.

PubMed

Kamiura, Moto; Sano, Kohei

2017-10-01

The principle of optimism in the face of uncertainty is known as a heuristic in sequential decision-making problems. Overtaking method based on this principle is an effective algorithm to solve multi-armed bandit problems. It was defined by a set of some heuristic patterns of the formulation in the previous study. The objective of the present paper is to redefine the value functions of Overtaking method and to unify the formulation of them. The unified Overtaking method is associated with upper bounds of confidence intervals of expected rewards on statistics. The unification of the formulation enhances the universality of Overtaking method. Consequently we newly obtain Overtaking method for the exponentially distributed rewards, numerically analyze it, and show that it outperforms UCB algorithm on average. The present study suggests that the principle of optimism in the face of uncertainty should be regarded as the statistics-based consequence of the law of large numbers for the sample mean of rewards and estimation of upper bounds of expected rewards, rather than as a heuristic, in the context of multi-armed bandit problems. Copyright © 2017 Elsevier B.V. All rights reserved.

The Influences of Arm Resist Motion on a CAR Crash Test Using Hybrid III Dummy with Human-Like Arm

NASA Astrophysics Data System (ADS)

Kim, Yongchul; Youm, Youngil; Bae, Hanil; Choi, Hyeonki

Safety of the occupant during the crash is very essential design element. Many researches have been investigated in reducing the fatal injury of occupant. They are focusing on the development of a dummy in order to obtain the real human-like motion. However, they have not considered the arm resist motion during the car accident. In this study, we would like to suggest the importance of the reactive force of the arm in a car crash. The influences of reactive force acting on the human upper extremity were investigated using the impedance experimental method with lumped mass model of hand system and a Hybrid III dummy with human-like arm. Impedance parameters (e.g. inertia, spring constant and damping coefficient) of the elbow joint in maximum activation level were measured by free oscillation test using single axis robot. The results showed that without seat belt, the reactive force of human arm reduced the head, chest, and femur injury, and the flexion moment of the neck is higher than that of the conventional dummy.

Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease.

PubMed

Lewek, Michael D; Poole, Roxanne; Johnson, Julia; Halawa, Omar; Huang, Xuemei

2010-02-01

The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in "off" state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p = 0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p = 0.907) or less (p = 0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9 + or - 7.9%) compared to the control group (asymmetry angle: 5.1 + or - 4.0%; p = 0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD. Copyright 2009 Elsevier B.V. All rights reserved.

Arm Swing Magnitude and Asymmetry During Gait in the Early Stages of Parkinson's Disease

PubMed Central

Lewek, Michael D.; Poole, Roxanne; Johnson, Julia; Halawa, Omar; Huang, Xuemei

2009-01-01

The later stages of Parkinson's disease (PD) are characterized by altered gait patterns. Although decreased arm swing during gait is the most frequently reported motor dysfunction in individuals with PD, quantitative descriptions of gait in early PD have largely ignored upper extremity movements. This study was designed to perform a quantitative analysis of arm swing magnitude and asymmetry that might be useful in the assessment of early PD. Twelve individuals with early PD (in “off” state) and eight controls underwent gait analysis using an optically-based motion capture system. Participants were instructed to walk at normal and fast velocities, and then on heels (to minimize push-off). Arm swing was measured as the excursion of the wrist with respect to the pelvis. Arm swing magnitude for each arm, and inter-arm asymmetry, were compared between groups. Both groups had comparable gait velocities (p=0.61), and there was no significant difference between the groups in the magnitude of arm swing in all walking conditions for the arm that swung more (p=0.907) or less (p=0.080). Strikingly, the PD group showed significantly greater arm swing asymmetry (asymmetry angle: 13.9±7.9%) compared to the control group (asymmetry angle: 5.1±4.0%; p=0.003). Unlike arm swing magnitude, arm swing asymmetry unequivocally differs between people with early PD and controls. Such quantitative evaluation of arm swing, especially its asymmetry, may have utility for early and differential diagnosis, and for tracking disease progression in patients with later PD. PMID:19945285

Exposure-response relationships for work-related neck and shoulder musculoskeletal disorders--Analyses of pooled uniform data sets.

PubMed

Nordander, Catarina; Hansson, Gert-Åke; Ohlsson, Kerstina; Arvidsson, Inger; Balogh, Istvan; Strömberg, Ulf; Rittner, Ralf; Skerfving, Staffan

2016-07-01

There is a lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal disorders in the neck and shoulders. We explored such relationships in pooled data from a series of our cross-sectional studies. We recorded the prevalence of complaints/discomfort (Nordic Questionnaire) and diagnoses (physical examination) in 33 groups (24 female and 9 male) within which the workers had similar work tasks (3141 workers, of which 817 were males). In representative sub-groups, we recorded postures and velocities of the head (N = 299) and right upper arm (inclinometry; N = 306), right wrist postures and velocities (electrogoniometry; N = 499), and muscular activity (electromyography) in the right trapezius muscle (N = 431) and forearm extensors (N = 206). We also assessed the psychosocial work environment (Job Content Questionnaire). Uni- and multivariate linear meta-regression analysis revealed several statistically significant group-wise associations. Neck disorders were associated with head inclination, upper arm elevation, muscle activity of the trapezius and forearm extensors and wrist posture and angular velocity. Right-side shoulder disorders were associated with head and upper arm velocity, activity in the trapezius and forearm extensor muscles and wrist posture and angular velocity. The psychosocial work environment (low job control, job strain and isostrain) was also associated with disorders. Women exhibited a higher prevalence of neck and shoulder complaints and tension neck syndrome than men, when adjusting for postures, velocities, muscular activity or psychosocial exposure. In conclusion, the analyses established quantitative exposure-response relationships between neck and shoulder disorders and objective measures of the physical workload on the arm. Such information can be used for risk assessment in different occupations/work tasks, to establish quantitative exposure limits, and for the evaluation of preventive measures. Copyright © 2016 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Dopaminergic modulation of arm swing during gait among Parkinson’s disease patients

PubMed Central

Sterling, Nicholas W.; Cusumano, Joseph P.; Shaham, Noam; Piazza, Stephen J.; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M.; Huang, Xuemei

2015-01-01

Background Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson’s disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. This study investigated the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Methods Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Results Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p=0.0018), but not faster- (p=0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p=0.0046) and lower maximum cross-correlation (p=0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p=0.0182), but not faster- (p=0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p=0.0386), whereas maximum cross-correlation showed no change (p=0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R=−0.73824, p=0.0011). Conclusions This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression. PMID:25502948

Dopaminergic modulation of arm swing during gait among Parkinson's disease patients.

PubMed

Sterling, Nicholas W; Cusumano, Joseph P; Shaham, Noam; Piazza, Stephen J; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M; Huang, Xuemei

2015-01-01

Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson's disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. We aimed to investigate the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p = 0.0018), but not faster- (p = 0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p = 0.0046) and lower maximum cross-correlation (p = 0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p = 0.0182), but not faster- (p = 0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p = 0.0386), whereas maximum cross-correlation showed no change (p = 0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R = -0.73824, p = 0.0011). This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression.

Rotationally Actuated Prosthetic Hand

NASA Technical Reports Server (NTRS)

Norton, William E.; Belcher, Jewell G., Jr.; Carden, James R.; Vest, Thomas W.

1991-01-01

Prosthetic hand attached to end of remaining part of forearm and to upper arm just above elbow. Pincerlike fingers pushed apart to degree depending on rotation of forearm. Simpler in design, simpler to operate, weighs less, and takes up less space.