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Sample records for upper limb muscle

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

    PubMed Central

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

    2015-01-01

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

  2. Characteristics of lower limb muscle activity during upper limb elevation in badminton players

    PubMed Central

    Masu, Yujiro; Nagai, Masanori

    2016-01-01

    [Purpose] To clarify the characteristics of postural control in badminton players by examining their lower-limb muscle activity during upper-limb elevation. [Subjects and Methods] Fourteen badminton players and 14 non-players were studied. The subjects were instructed to perform an upper-limb elevation task in order to measure the activities of the biceps femoris and biceps brachii. [Results] When elevating the dominant hand, the mean biceps femoris integrated electromyogram showed markedly higher values in the player group, for the contralateral compared with the ipsilateral leg. Similarly, when elevating the dominant hand, the difference in the maximum integrated electromyogram response time between the ipsilateral and contralateral legs was significantly smaller in the players compared with non-players. [Conclusion] It may be possible to reduce the time needed to elevate the dominant hand by shifting lower-limb activity from the ipsilateral to the contralateral leg more quickly, while increasing the rate of rise in contralateral leg muscle activity. PMID:27799681

  3. Differences in muscle power between the dominant and nondominant upper limbs of baseball players.

    PubMed

    Noguchi, Takanori; Demura, Shinichi; Takahashi, Kenji; Demura, Gou; Mori, Yasunori

    2014-01-01

    We examined the differences in muscle power between the dominant and nondominant upper limbs of 33 healthy, right-handed, university baseball players (mean age, 20.4 ± 1.1 years) with an average baseball experience >11 years. After measuring maximal voluntary contraction (MVC) of hand grip, elbow flexion, and shoulder internal rotation in both upper limbs, the muscle power of each joint was measured at 40%, 50%, and 60% MVC. No significant differences were observed in the main factors affecting MVC and elbow flexion power loads between dominant and nondominant upper limbs. For handgrip power, load factors at 40% MVC in the dominant hand were lower than those at 60% MVC in the same hand and those at 50% and 60% MVC in the nondominant hand. Significant differences were observed in shoulder internal rotation power between dominant and nondominant upper limbs, with the dominant limb having greater power at all loads. Correlations between muscle power of both upper limbs for handgrip and elbow flexion were significant and moderately high at all loads. For shoulder internal rotation power, the degree of correlation was significant and moderately high at 40% MVC but low to moderate at 50% and 60% MVC. Therefore, baseball players have marked lateral dominance in shoulder internal rotation power unlike handgrip and elbow flexion power, although the relationship between shoulder internal rotation muscle powers of both upper limbs becomes lower with increasing load. The dominance of muscle power of each joint varied even in the same upper limb. It is thus beneficial for baseball players to train with even loads on both arms or adopt simultaneous workout of both arms after adjusting for strength differences.

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

    PubMed

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

    2015-04-01

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

  5. Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels

    NASA Astrophysics Data System (ADS)

    Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

    2010-10-01

    A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

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

    NASA Astrophysics Data System (ADS)

    Zu, Xiaoqi; Zhou, Qianxiang; Li, Yun

    2012-07-01

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

  7. Decoding upper limb residual muscle activity in severe chronic stroke

    PubMed Central

    Ramos-Murguialday, Ander; García-Cossio, Eliana; Walter, Armin; Cho, Woosang; Broetz, Doris; Bogdan, Martin; Cohen, Leonardo G; Birbaumer, Niels

    2015-01-01

    Objective Stroke is a leading cause of long-term motor disability. Stroke patients with severe hand weakness do not profit from rehabilitative treatments. Recently, brain-controlled robotics and sequential functional electrical stimulation allowed some improvement. However, for such therapies to succeed, it is required to decode patients' intentions for different arm movements. Here, we evaluated whether residual muscle activity could be used to predict movements from paralyzed joints in severely impaired chronic stroke patients. Methods Muscle activity was recorded with surface-electromyography (EMG) in 41 patients, with severe hand weakness (Fugl-Meyer Assessment [FMA] hand subscores of 2.93 ± 2.7), in order to decode their intention to perform six different motions of the affected arm, required for voluntary muscle activity and to control neuroprostheses. Decoding of paretic and nonparetic muscle activity was performed using a feed-forward neural network classifier. The contribution of each muscle to the intended movement was determined. Results Decoding of up to six arm movements was accurate (>65%) in more than 97% of nonparetic and 46% of paretic muscles. Interpretation These results demonstrate that some level of neuronal innervation to the paretic muscle remains preserved and can be used to implement neurorehabilitative treatments in 46% of patients with severe paralysis and extensive cortical and/or subcortical lesions. Such decoding may allow these patients for the first time after stroke to control different motions of arm prostheses through muscle-triggered rehabilitative treatments. PMID:25642429

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

    PubMed

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

    2012-01-10

    Aging is associated with the loss of muscle volume (MV) and force leading to difficulties with activities of daily living. However, the relationship between upper limb MV and joint strength has not been characterized for older adults. Quantifying this relationship may help our understanding of the functional declines of the upper limb that older adults experience. Our objective was to assess the relationship between upper limb MV and maximal isometric joint moment-generating capacity (IJM) in a single cohort of healthy older adults (age ≥ 65 years) for 6 major functional groups (32 muscles). MV was determined from MRI for 18 participants (75.1±4.3 years). IJM at the shoulder (abduction/adduction), elbow (flexion/extension), and wrist (flexion/extension) was measured. MV and IJM measurements were compared to previous reports for young adults (28.6±4.5 years). On average older adults had 16.5% less total upper limb MV compared to young adults. Additionally, older adult wrist extensors composed a significantly increased percentage of upper limb MV. Older adult IJM was reduced across all joints, with significant differences for shoulder abductors (p<0.0001), adductors (p=0.01), and wrist flexors (p<0.0001). Young adults were strongest at the shoulder, which was not the case for older adults. In older adults, 40.6% of the variation in IJM was accounted for by MV changes (p≤0.027), compared to 81.0% in young adults. We conclude that for older adults, MV and IJM are, on average, reduced but the significant linear relationship between MV and IJM is maintained. These results suggest that older adult MV and IJM cannot be simply scaled from young adults.

  9. Long-Latency Feedback Coordinates Upper-Limb and Hand Muscles during Object Manipulation Tasks123

    PubMed Central

    Thonnard, Jean-Louis; Scott, Stephen H.

    2016-01-01

    Suppose that someone bumps into your arm at a party while you are holding a glass of wine. Motion of the disturbed arm will engage rapid and goal-directed feedback responses in the upper-limb. Although such responses can rapidly counter the perturbation, it is also clearly desirable not to destabilize your grasp and/or spill the wine. Here we investigated how healthy humans maintain a stable grasp following perturbations by using a paradigm that requires spatial tuning of the motor response dependent on the location of a virtual target. Our results highlight a synchronized expression of target-directed feedback in shoulder and hand muscles occurring at ∼60 ms. Considering that conduction delays are longer for the more distal hand muscles, these results suggest that target-directed responses in hand muscles were initiated before those for the shoulder muscles. These results show that long-latency feedback can coordinate upper limb and hand muscles during object manipulation tasks. PMID:27022624

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

    PubMed Central

    2014-01-01

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

  11. Trunk and upper limb muscle activation during flat and topspin forehand drives in young tennis players.

    PubMed

    Rogowski, Isabelle; Rouffet, David; Lambalot, Frederic; Brosseau, Olivier; Hautier, Christophe

    2011-02-01

    This study compared EMG activity of young tennis players' muscles during forehand drives in two groups, GD-those able to raise by more than 150% the vertical velocity of racket-face at impact from flat to topspin forehand drives, and GND, those not able to increase their vertical velocity to the same extent. Upper limb joint angles, racket-face velocities, and average EMGrms values, were studied. At similar joint angles, a fall in horizontal velocity and a rise in racket-face vertical velocity from flat to topspin forehand drives were observed. Shoulder muscle activity rose from flat to topspin forehand drives in GND, but not for drives in GD. Forearm muscle activity reduced from flat to topspin forehand drives in GD, but muscle activation was similar in GND. The results show that radial deviation increased racket-face vertical velocity more at impact from the flat to topspin forehand drives than shoulder abduction.

  12. Effect of the upper limbs muscles activity on the mechanical energy gain in pole vaulting.

    PubMed

    Frère, Julien; Göpfert, Beat; Slawinski, Jean; Tourny-chollet, Claire

    2012-04-01

    The shoulder muscles are highly solicited in pole vaulting and may afford energy gain. The objective of this study was to determine the bilateral muscle activity of the upper-limbs to explain the actions performed by the vaulter to bend the pole and store elastic energy. Seven experienced athletes performed 5-10 vaults which were recorded using two video cameras (50Hz). The mechanical energy of the centre of gravity (CG) was computed, while surface electromyographic (EMG) profiles were recorded from 5 muscles bilateral: deltoideus, infraspinatus, biceps brachii, triceps, and latissimus dorsi muscles. The level of intensity from EMG profile was retained in four sub phases between take-off (TO1) and complete pole straightening (PS). The athletes had a mean mechanical energy gain of 22% throughout the pole vault, while the intensities of deltoideus, biceps brachii, and latissimus dorsi muscles were sub phases-dependent (p<0.05). Stabilizing the glenohumeral joint (increase of deltoideus and biceps brachii activity) and applying a pole bending torque (increase of latissimus dorsi activity) required specific muscle activation. The gain in mechanical energy of the vaulter could be linked to an increase in muscle activation, especially from latissimusdorsi muscles.

  13. Upper Limb Strength and Muscle Volume in Healthy Middle-Aged Adults.

    PubMed

    Saul, Katherine R; Vidt, Meghan E; Gold, Garry E; Murray, Wendy M

    2015-12-01

    Our purpose was to characterize shoulder muscle volume and isometric moment, as well as their relationship, for healthy middle- aged adults. Muscle volume and maximum isometric joint moment were assessed for 6 functional muscle groups of the shoulder, elbow, and wrist in 10 middle-aged adults (46–60 y, 5M, 5F). Compared with young adults, shoulder abductors composed a smaller percentage of total muscle volume (P = .0009) and there was a reduction in shoulder adductor strength relative to elbow flexors (P = .012). We observed a consistent ordering of moment-generating capacity among functional groups across subjects. Although total muscle volume spanned a 2.3-fold range, muscle volume was distributed among functional groups in a consistent manner across subjects. On average, 72% of the variation in joint moment could be explained by the corresponding functional group muscle volume. These data are useful for improved modeling of upper limb musculoskeletal performance in middle-aged subjects, and may improve computational predictions of function for this group. PMID:26155870

  14. Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction

    PubMed Central

    Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

    2013-01-01

    [Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises. PMID:24396194

  15. Effect of handedness on muscle synergies during upper limb planar movements.

    PubMed

    Duthilleul, N; Pirondini, E; Coscia, M; Micera, S

    2015-08-01

    Handedness is a prominent but poorly understood aspect of human motor performances. Despite it is generally accepted that it results from differences in the neural control of the arm, the mechanisms at the origin of the side-difference in motor performances are still unknown. In this work, we propose to deepen this aspect by investigating muscle synergies organization. We obtained muscle synergies through the factorization of the superficial electromyographical (EMG) activity related to fifteen upper limb muscles in the dominant and non-dominant side of 5 healthy young right and left dominant subjects, while executing planar wide and tight circular trajectories. Our preliminary results showed that right and left handed subjects performed the circular trajectories with a different muscle organization. Moreover, a task-related side-difference in muscle synergies was observed. Further investigations in a larger cohort of individuals are necessary to determine the neural mechanisms generating the differences in number and organization of muscle synergies between left and right handed individuals. PMID:26737035

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

    PubMed

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

    2010-06-01

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

  17. Simulation of Upper Limb Movements

    NASA Astrophysics Data System (ADS)

    Uherčík, Filip; Hučko, Branislav

    2011-12-01

    The paper deals with controlling an upper limb prosthesis based on the measurement of myoelectric signals (MES) while drinking. MES signals have been measured on healthy limbs to obtain the same response for the prosthesis. To simulate the drinking motion of a healthy upper limb, the program ADAMS was used, with all degrees of freedom and a hand after trans-radial amputation with an existing hand prosthesis. Modification of the simulation has the exact same logic of control, where the muscle does not have to be strenuous all the time, but it is the impulse of the muscle which drives the motor even though the impulse disappears and passed away.

  18. Reproducibility of transcranial magnetic stimulation metrics in the study of proximal upper limb muscles

    PubMed Central

    Sankarasubramanian, Vishwanath; Roelle, Sarah; Bonnett, Corin E; Janini, Daniel; Varnerin, Nicole; Cunningham, David A; Sharma, Jennifer S; Potter-Baker, Kelsey A; Wang, Xiaofeng; Yue, Guang H; Plow, Ela B

    2015-01-01

    Objective Reproducibility of transcranial magnetic stimulation (TMS) metrics is essential in accurately tracking recovery and disease. However, majority of evidence pertains to reproducibility of metrics for distal upper limb muscles. We investigate for the first time, reliability of corticospinal physiology for a large proximal muscle-the biceps brachii and relate how varying statistical analyses can influence interpretations. Methods 14 young right-handed healthy participants completed two sessions assessing resting motor threshold (RMT), motor evoked potentials (MEPs), motor map and intra-cortical inhibition (ICI) from the left biceps brachii. Analyses included paired t-tests, Pearson's, intra-class (ICC) and concordance correlation coefficients (CCC) and Bland-Altman plots. Results Unlike paired t-tests, ICC, CCC and Pearson's were >0.6 indicating good reliability for RMTs, MEP intensities and locations of map; however values were <0.3 for MEP responses and ICI. Conclusions Corticospinal physiology, defining excitability and output in terms of intensity of the TMS device, and spatial loci are the most reliable metrics for the biceps. MEPs and variables based on MEPs are less reliable since biceps receives fewer cortico-motor-neuronal projections. Statistical tests of agreement and associations are more powerful reliability indices than inferential tests. Significance Reliable metrics of proximal muscles when translated to a larger number of participants would serve to sensitively track and prognosticate function in neurological disorders such as stroke where proximal recovery precedes distal. PMID:26111434

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

    NASA Astrophysics Data System (ADS)

    Sharpe, Abigail N.; Jackson, Andrew

    2014-02-01

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

  20. Remote effect of lower limb acupuncture on latent myofascial trigger point of upper trapezius muscle: a pilot study.

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

    Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs) of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40) and Yanglingquan (GB34) points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side) versus sham needling on the contralateral lower limb (control side) in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM) upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P = 0.03) in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P = 0.036). Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle. PMID:23710218

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

    PubMed Central

    Sharpe, Abigail N; Jackson, Andrew

    2014-01-01

    Objective Electrical stimulation of the spinal cord has potential applications following spinal cord injury for reanimating paralysed limbs and promoting neuroplastic changes that may facilitate motor rehabilitation. Here we systematically compare the efficacy, selectivity and frequency-dependence of different stimulation methods in the cervical enlargement of anaesthetized monkeys. Approach Stimulating electrodes were positioned at multiple epidural and subdural sites on both dorsal and ventral surfaces, as well as at different depths within the spinal cord. Motor responses were recorded from arm, forearm and hand muscles. Main results Stimulation efficacy increased from dorsal to ventral stimulation sites, with the exception of ventral epidural electrodes which had the highest recruitment thresholds. Compared to epidural and intraspinal methods, responses to subdural stimulation were more selective but also more similar between adjacent sites. Trains of stimuli delivered to ventral sites elicited consistent responses at all frequencies whereas from dorsal sites we observed a mixture of short-latency facilitation and long-latency suppression. Finally, paired stimuli delivered to dorsal surface and intraspinal sites exhibited symmetric facilitatory interactions at interstimulus intervals between 2–5 ms whereas on the ventral side interactions tended to be suppressive for near-simultaneous stimuli. Significance We interpret these results in the context of differential activation of afferent and efferent roots and intraspinal circuit elements. In particular, we propose that distinct direct and indirect actions of spinal cord stimulation on motoneurons may be advantageous for different applications, and this should be taken into consideration when designing neuroprostheses for upper-limb function. PMID:24654267

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

    PubMed

    Bent, Leah R; Lowrey, Catherine R

    2013-03-01

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

  4. Upper limb prostheses.

    PubMed

    Bogucki, A

    2001-04-30

    This article discusses the technical and medical difficulties involved in managing prostheses of the upper limb. The level of amputation governs the type of prosthesis construction chosen, but does not affect emotional acceptance. The factors determining therapeutic success include the quality of the stump, the skill involved in prosthetic socket fabrication, and the proper selection of modular components, as well as good rehabilitation and professional care for the patient with amputated upper limb. PMID:17987000

  5. 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. PMID:25881663

  6. 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.

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

    PubMed

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

    2014-02-01

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

  8. Reliability of electromyographic amplitude values of the upper limb muscles during closed kinetic chain exercises with stable and unstable surfaces.

    PubMed

    de Araújo, Rodrigo Cappato; Tucci, Helga Tatiana; de Andrade, Rodrigo; Martins, Jaqueline; Bevilaqua-Grossi, Débora; de Oliveira, Anamaria Siriani

    2009-08-01

    The purpose of the present study was to evaluate the intra and interday reliability of surface electromyographic amplitude values of the scapular girdle muscles and upper limbs during 3 isometric closed kinetic chain exercises, involving upper limbs with the fixed distal segment extremity on stable base of support and on a Swiss ball (relatively unstable). Twenty healthy adults performed the exercises push-up, bench-press and wall-press with different effort levels (80% and 100% maximal load). Subjects performed three maximal voluntary contractions (MVC) in muscular testing position of each muscle to obtain a reference value for root mean square (RMS) normalization. Individuals were instructed to randomly perform three isometric contraction series, in which each exercise lasted 6 s with a 2-min resting-period between series and exercises. Intra and interday reliabilities were calculated through the intraclass correlation coefficient (ICC 2.1), standard error of the measurement (SEM). Results indicated an excellent intraday reliability of electromyographic amplitude values (ICC > or = 0.75). The interday reliability of normalized RMS values ranged between good and excellent (ICC 0.52-0.98). Finally, it is suggested that the reliability of normalized electromyographic amplitude values of the analyzed muscles present better values during exercises on a stable surface. However, load levels used during the exercises do not seem to have any influence on variability levels, possibly because the loads were quite similar.

  9. Comparison of neck and upper-limb muscle activities between able-bodied and paraplegic individuals during wheelchair propulsion on the ground.

    PubMed

    Kim, Sang Jin; Park, So Hyun; Lee, Chang-Ryeol

    2015-05-01

    [Purpose] This study compared the muscle activities of the neck and upper-limb muscles between able-bodied individuals and persons with paraplegia during wheelchair propulsion on the ground. [Subjects and Methods] The muscle activities of the neck and upper-limb muscles of 8 normal individuals and 8 individuals with paraplegia were analyzed during wheelchair propulsion. The activities of the latissimus dorsi, pectoralis major, anterior/posterior deltoids, triceps brachii, extensor carpi radialis, and sternocleidomastoid muscles were assessed. [Results] The paraplegic group showed significantly higher sternocleidomastoid activity than the normal group. Latissimus dorsi activity was also higher in the paraplegia group than in the normal group, but the difference was not significant. There were no significant differences in the other muscle activities between groups. [Conclusion] Paraplegic patients tend to use the sternocleidomastoid and latissimus dorsi muscles with greater degrees of activity. Therefore, physiotherapists should not overlook the treatment of these muscles for paraplegic patients who are long-term wheelchair users.

  10. Changes in postural and trunk muscles responses in patients with chronic nonspecific low back pain during sudden upper limb loading

    PubMed Central

    Akbari, Mahmood; Sarrafzadeh, Javad; Maroufi, Nader; Haghani, Hamid

    2015-01-01

    Background: Alterations in the neuromuscular control of the spine were found in patients with chronic low back pain (CLBP). Sudden loading of the spine is assumed to be the cause of approximately 12% of lower back injuries. However, some aspects of this problem, such as alterations in the sensory–motor control of the spine, remain questionable. This study investigated postural and neuro– motor changes in trunk muscles during sudden upper limb loading in patients with CLBP. Methods: Electromyography of the erector spinae (ES) and transverses abdominis/internal oblique (TrA/IO) and external oblique (EOA) muscles were recorded in 20 patients with CLBP and 20 asymptomatic individuals with eyes open (EO) and eyes closed (EC) conditions. Moreover, measurements of the center of pressure (COP) and vertical ground reaction force (GRF) or Fz were recorded using a force plate. Data were analyzed using paired t-test and independent t-test at the significance level of 0.05. Results: In patients with CLBP, decreased electrical activity of the ES muscle was observed under both the EO and EC conditions and that of the TrA/IO muscle was observed under the EO condition (p< 0.05). Other findings included a shorter peak latency of the ES muscle in the EO condition and a greater increase in the peak latency of the ES muscle following the EC condition (p< 0.05). No significant differences were observed in COP and GRF measurements between the groups. Conclusion: Electrical muscle activity may indicate less stiffening or preparatory muscle activity in the trunk muscle of patients with CLBP. Altered latency of the muscle may lead to microtrauma of lumbar structures and CLBP. PMID:26793656

  11. Upper limb and trunk muscle activation during an unexpected descent on the outstretched hands in young and older women.

    PubMed

    Lattimer, Lauren J; Lanovaz, Joel L; Farthing, Jonathan P; Madill, Stéphanie; Kim, Soo; Arnold, Cathy

    2016-10-01

    Falling on the outstretched hands (FOOSH), a protective mechanism to arrest the body and avoid injury, requires upper limb and trunk motor control for effective body descent. The purpose of this study was to investigate muscle activity during three phases of an unexpected FOOSH in healthy older and younger women. Twenty young (mean age 22.9yrs, SD±3.7) and 20 older females (mean age 68.1yrs, SD±5.0) performed five trials of unexpected FOOSHs. Surface electromyography (EMG) determined muscle activations for left shoulder girdle, elbow and abdominal muscles during an unexpected FOOSH. Root mean squared EMG data were calculated during three phases: (1) baseline (BL; 500msprior to release), (2) the preparatory phase (PRE; time between release and impact) (mean 257±37ms) and post-impact (POST; 200msafter impact). A mixed MANOVA determined differences between phases and age groups. There was a significant multivariate interaction effect of age and time phase on muscle activity (p=0.001). Younger women had significantly higher internal oblique/transversus abdominus activity during PRE (p=0.006) as well as variations in muscle activity of shoulder girdle and elbow muscles. The age differences observed may lead to poorer preliminary trunk activation and greater arm bracing in older women, potentially increasing risk of fallrelated injury.

  12. Upper limb and trunk muscle activation during an unexpected descent on the outstretched hands in young and older women.

    PubMed

    Lattimer, Lauren J; Lanovaz, Joel L; Farthing, Jonathan P; Madill, Stéphanie; Kim, Soo; Arnold, Cathy

    2016-10-01

    Falling on the outstretched hands (FOOSH), a protective mechanism to arrest the body and avoid injury, requires upper limb and trunk motor control for effective body descent. The purpose of this study was to investigate muscle activity during three phases of an unexpected FOOSH in healthy older and younger women. Twenty young (mean age 22.9yrs, SD±3.7) and 20 older females (mean age 68.1yrs, SD±5.0) performed five trials of unexpected FOOSHs. Surface electromyography (EMG) determined muscle activations for left shoulder girdle, elbow and abdominal muscles during an unexpected FOOSH. Root mean squared EMG data were calculated during three phases: (1) baseline (BL; 500msprior to release), (2) the preparatory phase (PRE; time between release and impact) (mean 257±37ms) and post-impact (POST; 200msafter impact). A mixed MANOVA determined differences between phases and age groups. There was a significant multivariate interaction effect of age and time phase on muscle activity (p=0.001). Younger women had significantly higher internal oblique/transversus abdominus activity during PRE (p=0.006) as well as variations in muscle activity of shoulder girdle and elbow muscles. The age differences observed may lead to poorer preliminary trunk activation and greater arm bracing in older women, potentially increasing risk of fallrelated injury. PMID:27541386

  13. Effect of muscular fatigue on fractal upper limb coordination dynamics and muscle synergies.

    PubMed

    Bueno, Diana R; Lizano, J M; Montano, L

    2015-08-01

    Rehabilitation exercises cause fatigue because tasks are repetitive. Therefore, inevitable human motion performance changes occur during the therapy. Although traditionally fatigue is considered an event that occurs in the musculoskeletal level, this paper studies whether fatigue can be regarded as context that influences lower-dimensional motor control organization and coordination at neural level. Non Negative Factorization Matrix (NNFM) and Detrended Fluctuations Analysis (DFA) are the tools used to analyze the changes in the coordination of motor function when someone is affected by fatigue. The study establishes that synergies remain fairly stable with the onset of fatigue, but the fatigue affects the dynamical coordination understood as a cognitive process. These results have been validated with 9 healthy subjects for three representative exercises for upper limb: biceps, triceps and deltoid. PMID:26737679

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

  15. Pattern recognition control outperforms conventional myoelectric control in upper limb patients with targeted muscle reinnervation.

    PubMed

    Hargrove, Levi J; Lock, Blair A; Simon, Ann M

    2013-01-01

    Pattern recognition myoelectric control shows great promise as an alternative to conventional amplitude based control to control multiple degree of freedom prosthetic limbs. Many studies have reported pattern recognition classification error performances of less than 10% during offline tests; however, it remains unclear how this translates to real-time control performance. In this contribution, we compare the real-time control performances between pattern recognition and direct myoelectric control (a popular form of conventional amplitude control) for participants who had received targeted muscle reinnervation. The real-time performance was evaluated during three tasks; 1) a box and blocks task, 2) a clothespin relocation task, and 3) a block stacking task. Our results found that pattern recognition significantly outperformed direct control for all three performance tasks. Furthermore, it was found that pattern recognition was configured much quicker. The classification error of the pattern recognition systems used by the patients was found to be 16% ±(1.6%) suggesting that systems with this error rate may still provide excellent control. Finally, patients qualitatively preferred using pattern recognition control and reported the resulting control to be smoother and more consistent.

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

    PubMed

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

    2014-02-01

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

  17. Mangling upper limb injuries in industry.

    PubMed

    Ring, D; Jupiter, J B

    1999-01-01

    The salvage of upper limbs mangled by industrial machinery became possible with the development of predictable techniques of vascular and microvascular anastamosis. Unfortunately, many of these salvaged limbs are associated with fair and poor functional outcomes. The quality of the skeletal fixation can have a substantial effect on the functional outcome and should be a major focus of the limb repair process. Internal plate fixation facilitates wound care and limb mobilization without tethering muscle-tendon units and is safe in the majority of severe upper limb injuries provided that all devitalized tissue is debrided and, if necessary, reconstructed using microvascular tissue transfers. Injury patterns, especially those which involve associated injury of the elbow or forearm ligaments, must be identified and treated appropriately. Internal fixation should restore anatomical alignment and provide sufficient stability to allow immediate active mobilization of the limb without contributing to devascularization of the soft tissues or skeleton. PMID:10562855

  18. Comparison of the depression of H-reflexes following previous activation in upper and lower limb muscles in human subjects.

    PubMed

    Rossi-Durand, C; Jones, K E; Adams, S; Bawa, P

    1999-05-01

    When conditioning-testing (C-T) stimuli are applied to Ia afferents to elicit H-reflexes, the test reflex is abolished immediately following the conditioning reflex. As the C-T interval is increased, the test response slowly begins to recover, taking several hundred milliseconds to attain control values. The time course of this recovery is known as the H-reflex recovery curve. H-reflex recovery curves were compared using surface EMG and single motor unit activities in lower limb soleus and upper limb flexor carpi radialis (FCR) muscles in seven healthy human subjects. Under rest conditions, the recovery of H-reflexes and single motor unit activity was slow for soleus; the recovery was not complete even in 1 s. In comparison, the recovery was very fast for FCR motor units, occurring in 200-300 ms. The effects of rate of stimulation (0.1-10.0 imp/s) were also examined on the magnitude of H-reflex responses. The reflex response declined with increasing rate of stimulation, the decline being slightly greater in soleus than in FCR. When these phenomena were examined with voluntary facilitation of the spinal cord, the time of recovery shortened and the effect of stimulus rate also diminished. Changes with background facilitation were greater in FCR than in soleus. The differences between the two muscles are attributed mainly to differences in presynaptic inhibition in the two spinal segments, and/or to the differences in dynamics of the transmitter release in terminals of Ia afferents synapsing with slow soleus motoneurons and those synapsing with the fast FCR motoneurons.

  19. Comparison of the depression of H-reflexes following previous activation in upper and lower limb muscles in human subjects.

    PubMed

    Rossi-Durand, C; Jones, K E; Adams, S; Bawa, P

    1999-05-01

    When conditioning-testing (C-T) stimuli are applied to Ia afferents to elicit H-reflexes, the test reflex is abolished immediately following the conditioning reflex. As the C-T interval is increased, the test response slowly begins to recover, taking several hundred milliseconds to attain control values. The time course of this recovery is known as the H-reflex recovery curve. H-reflex recovery curves were compared using surface EMG and single motor unit activities in lower limb soleus and upper limb flexor carpi radialis (FCR) muscles in seven healthy human subjects. Under rest conditions, the recovery of H-reflexes and single motor unit activity was slow for soleus; the recovery was not complete even in 1 s. In comparison, the recovery was very fast for FCR motor units, occurring in 200-300 ms. The effects of rate of stimulation (0.1-10.0 imp/s) were also examined on the magnitude of H-reflex responses. The reflex response declined with increasing rate of stimulation, the decline being slightly greater in soleus than in FCR. When these phenomena were examined with voluntary facilitation of the spinal cord, the time of recovery shortened and the effect of stimulus rate also diminished. Changes with background facilitation were greater in FCR than in soleus. The differences between the two muscles are attributed mainly to differences in presynaptic inhibition in the two spinal segments, and/or to the differences in dynamics of the transmitter release in terminals of Ia afferents synapsing with slow soleus motoneurons and those synapsing with the fast FCR motoneurons. PMID:10333012

  20. Muscle power output properties using the stretch-shortening cycle of the upper limb and their relationships with a one-repetition maximum bench press.

    PubMed

    Miyaguchi, Kazuyoshi; Demura, Shinichi

    2006-05-01

    The purpose of this study was to examine the output properties of muscle power by the dominant upper limb using SSC, and the relationships between the power output by SSC and a one-repetition maximum bench press (1 RM BP) used as a strength indicator of the upper body. Sixteen male athletes (21.4+/-0.9 yr) participated in this study. They pulled a load of 40% of maximum voluntary contraction (MVC) at a stretch by elbow flexion of the dominant upper limb in the following three preliminary conditions: static relaxed muscle state (SR condition), isometric muscle contraction state (ISO condition), and using SSC (SSC condition). The velocity with a wire load via a pulley during elbow flexion was measured accurately using a power instrument with a rotary encoder, and the muscle power curve was drawn from the product of the velocity and load. Significant differences were found among all evaluation parameters of muscle power exerted from the above three conditions and the parameters regarding early power output during concentric contraction were larger in the SSC condition than the SR and ISO conditions. The parameters on initial muscle contraction velocity when only using SSC significantly correlated with 1 RM BP (r=0.60-0.62). The use of SSC before powerful elbow flexion may contribute largely to early explosive power output during concentric contraction. Bench press capacity relates to a development of the above early power output when using SSC. PMID:16763366

  1. EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing.

    PubMed

    Ntousis, Theodoros; Mandalidis, Dimitris; Chronopoulos, Efstathios; Athanasopoulos, Spyros

    2013-02-01

    Kinematic studies have shown that experimentally-induced overpronation or oversupination of the subtalar joint may alter the position of the legs, hips and pelvis and consequently the trunk and upper limb. The purpose of the present study was to examine whether such foot deformity affects the activity of muscles that act on the trunk and upper limb. Twenty-eight healthy individuals (11 males and 17 females) 21.4±1.9 years of age without skeletal deformity, leg length discrepancy (LLD), overpronated or oversupinated feet or excessive lateral pelvic inclination volunteered for the study. Bilateral EMG recordings of the latissimus dorsi, pectoralis major and rectus abdominis were undertaken for 30-s with each subject in the relaxed standing position and at 5° and 10° bilateral or unilateral overpronation or oversupination of the foot on the dominant side using wooden wedge-shape blocks. The recorded EMG activity was normalised based on the EMG activity produced by the muscles under investigation during maximum isometric voluntary contraction. The findings of the present study revealed that neither bilateral nor unilateral overpronation/oversupination of the feet induced a significant alteration of the EMG activity of the latissimus dorsi, pectoralis major and rectus abdominis on either the dominant or non-dominant side. These findings suggest that in the absence of other major structural deformity bilateral or unilateral foot overpronation or oversupination does not affect the EMG activity of muscles that act on the trunk and upper limb in quiet standing. PMID:22940541

  2. Upper Limb Evaluation in Duchenne Muscular Dystrophy: Fat-Water Quantification by MRI, Muscle Force and Function Define Endpoints for Clinical Trials

    PubMed Central

    Ricotti, Valeria; Evans, Matthew R. B.; Sinclair, Christopher D. J.; Butler, Jordan W.; Ridout, Deborah A.; Hogrel, Jean-Yves; Emira, Ahmed; Morrow, Jasper M.; Reilly, Mary M.; Hanna, Michael G.; Janiczek, Robert L.; Matthews, Paul M.; Yousry, Tarek A.; Muntoni, Francesco; Thornton, John S.

    2016-01-01

    Objective A number of promising experimental therapies for Duchenne muscular dystrophy (DMD) are emerging. Clinical trials currently rely on invasive biopsies or motivation-dependent functional tests to assess outcome. Quantitative muscle magnetic resonance imaging (MRI) could offer a valuable alternative and permit inclusion of non-ambulant DMD subjects. The aims of our study were to explore the responsiveness of upper-limb MRI muscle-fat measurement as a non-invasive objective endpoint for clinical trials in non-ambulant DMD, and to investigate the relationship of these MRI measures to those of muscle force and function. Methods 15 non-ambulant DMD boys (mean age 13.3 y) and 10 age-gender matched healthy controls (mean age 14.6 y) were recruited. 3-Tesla MRI fat-water quantification was used to measure forearm muscle fat transformation in non-ambulant DMD boys compared with healthy controls. DMD boys were assessed at 4 time-points over 12 months, using 3-point Dixon MRI to measure muscle fat-fraction (f.f.). Images from ten forearm muscles were segmented and mean f.f. and cross-sectional area recorded. DMD subjects also underwent comprehensive upper limb function and force evaluation. Results Overall mean baseline forearm f.f. was higher in DMD than in healthy controls (p<0.001). A progressive f.f. increase was observed in DMD over 12 months, reaching significance from 6 months (p<0.001, n = 7), accompanied by a significant loss in pinch strength at 6 months (p<0.001, n = 9) and a loss of upper limb function and grip force observed over 12 months (p<0.001, n = 8). Conclusions These results support the use of MRI muscle f.f. as a biomarker to monitor disease progression in the upper limb in non-ambulant DMD, with sensitivity adequate to detect group-level change over time intervals practical for use in clinical trials. Clinical validity is supported by the association of the progressive fat transformation of muscle with loss of muscle force and function. PMID

  3. Interhemispheric sensorimotor integration; an upper limb phenomenon?

    PubMed

    Ruddy, Kathy L; Jaspers, Ellen; Keller, Martin; Wenderoth, Nicole

    2016-10-01

    Somatosensory information from the limbs reaches the contralateral Primary Sensory Cortex (S1) with a delay of 23ms for finger, and 40ms for leg (somatosensory N20/N40). Upon arrival of this input in the cortex, motor evoked potentials (MEPs) elicited by Transcranial Magnetic Stimulation (TMS) are momentarily inhibited. This phenomenon is called 'short latency afferent inhibition (SAI)' and can be used as a tool for investigating sensorimotor interactions in the brain. We used SAI to investigate the process of sensorimotor integration in the hemisphere ipsilateral to the stimulated limb. We hypothesized that ipsilateral SAI would occur with a delay following the onset of contralateral SAI, to allow for transcallosal conduction of the signal. We electrically stimulated the limb either contralateral or ipsilateral to the hemisphere receiving TMS, using a range of different interstimulus intervals (ISI). We tested the First Dorsal Interosseous (FDI) muscle in the hand, and Tibialis Anterior (TA) in the lower leg, in three separate experiments. Ipsilateral SAI was elicited in the upper limb (FDI) at all ISIs that were greater than N20+18ms (all p<.05) but never at any earlier timepoint. No ipsilateral SAI was detected in the lower limb (TA) at any of the tested ISIs. The delayed onset timing of ipsilateral SAI suggests that transcallosal communication mediates this inhibitory process for the upper limb. The complete absence of ipsilateral SAI in the lower limb warrants consideration of the potential limb-specific differences in demands for bilateral sensorimotor integration. PMID:27425210

  4. Interhemispheric sensorimotor integration; an upper limb phenomenon?

    PubMed

    Ruddy, Kathy L; Jaspers, Ellen; Keller, Martin; Wenderoth, Nicole

    2016-10-01

    Somatosensory information from the limbs reaches the contralateral Primary Sensory Cortex (S1) with a delay of 23ms for finger, and 40ms for leg (somatosensory N20/N40). Upon arrival of this input in the cortex, motor evoked potentials (MEPs) elicited by Transcranial Magnetic Stimulation (TMS) are momentarily inhibited. This phenomenon is called 'short latency afferent inhibition (SAI)' and can be used as a tool for investigating sensorimotor interactions in the brain. We used SAI to investigate the process of sensorimotor integration in the hemisphere ipsilateral to the stimulated limb. We hypothesized that ipsilateral SAI would occur with a delay following the onset of contralateral SAI, to allow for transcallosal conduction of the signal. We electrically stimulated the limb either contralateral or ipsilateral to the hemisphere receiving TMS, using a range of different interstimulus intervals (ISI). We tested the First Dorsal Interosseous (FDI) muscle in the hand, and Tibialis Anterior (TA) in the lower leg, in three separate experiments. Ipsilateral SAI was elicited in the upper limb (FDI) at all ISIs that were greater than N20+18ms (all p<.05) but never at any earlier timepoint. No ipsilateral SAI was detected in the lower limb (TA) at any of the tested ISIs. The delayed onset timing of ipsilateral SAI suggests that transcallosal communication mediates this inhibitory process for the upper limb. The complete absence of ipsilateral SAI in the lower limb warrants consideration of the potential limb-specific differences in demands for bilateral sensorimotor integration.

  5. Influence of mental practice on upper limb muscle activity and activities of daily living in chronic stroke patients

    PubMed Central

    Park, JuHyung

    2016-01-01

    [Purpose] The aim of this study was to determine the effects of mental practice on muscle activity of the upper extremity and performance of daily activities in chronic stroke patients. [Subjects and Methods] In this research, mental practice was conducted by 2 chronic hemiplegic stroke patients. Mental practice was conducted 30 minutes a day, 5 times a week, for 2 weeks. Evaluation was conducted 4 times before and after intervention. Muscle activity was measured using a surface electromyogram test, and the Modified Barthel Index was used to measure changes in the ability to carry out daily activities. [Results] Both the muscle activity of the upper extremity and capability to perform daily activities showed improved outcomes after mental practice was conducted. [Conclusion] Through this research, mental practice was proven to be effective in improving the muscle activity of upper extremity and capability to perform daily activities in chronic hemiplegic stroke patients. PMID:27134412

  6. Neural coupling between upper and lower limbs during recumbent stepping.

    PubMed

    Huang, Helen J; Ferris, Daniel P

    2004-10-01

    During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes (P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity. PMID:15180979

  7. Soft-tissue anatomy of the primates: phylogenetic analyses based on the muscles of the head, neck, pectoral region and upper limb, with notes on the evolution of these muscles.

    PubMed

    Diogo, R; Wood, B

    2011-09-01

    Apart from molecular data, nearly all the evidence used to study primate relationships comes from hard tissues. Here, we provide details of the first parsimony and Bayesian cladistic analyses of the order Primates based exclusively on muscle data. The most parsimonious tree obtained from the cladistic analysis of 166 characters taken from the head, neck, pectoral and upper limb musculature is fully congruent with the most recent evolutionary molecular tree of Primates. That is, this tree recovers not only the relationships among the major groups of primates, i.e. Strepsirrhini {Tarsiiformes [Platyrrhini (Cercopithecidae, Hominoidea)]}, but it also recovers the relationships within each of these inclusive groups. Of the 301 character state changes occurring in this tree, ca. 30% are non-homoplasic evolutionary transitions; within the 220 changes that are unambiguously optimized in the tree, ca. 15% are reversions. The trees obtained by using characters derived from the muscles of the head and neck are more similar to the most recent evolutionary molecular tree than are the trees obtained by using characters derived from the pectoral and upper limb muscles. It was recently argued that since the Pan/Homo split, chimpanzees accumulated more phenotypic adaptations than humans, but our results indicate that modern humans accumulated more muscle character state changes than chimpanzees, and that both these taxa accumulated more changes than gorillas. This overview of the evolution of the primate head, neck, pectoral and upper limb musculature suggests that the only muscle groups for which modern humans have more muscles than most other extant primates are the muscles of the face, larynx and forearm.

  8. Soft-tissue anatomy of the primates: phylogenetic analyses based on the muscles of the head, neck, pectoral region and upper limb, with notes on the evolution of these muscles

    PubMed Central

    Diogo, R; Wood, B

    2011-01-01

    Apart from molecular data, nearly all the evidence used to study primate relationships comes from hard tissues. Here, we provide details of the first parsimony and Bayesian cladistic analyses of the order Primates based exclusively on muscle data. The most parsimonious tree obtained from the cladistic analysis of 166 characters taken from the head, neck, pectoral and upper limb musculature is fully congruent with the most recent evolutionary molecular tree of Primates. That is, this tree recovers not only the relationships among the major groups of primates, i.e. Strepsirrhini {Tarsiiformes [Platyrrhini (Cercopithecidae, Hominoidea)]}, but it also recovers the relationships within each of these inclusive groups. Of the 301 character state changes occurring in this tree, ca. 30% are non-homoplasic evolutionary transitions; within the 220 changes that are unambiguously optimized in the tree, ca. 15% are reversions. The trees obtained by using characters derived from the muscles of the head and neck are more similar to the most recent evolutionary molecular tree than are the trees obtained by using characters derived from the pectoral and upper limb muscles. It was recently argued that since the Pan/Homo split, chimpanzees accumulated more phenotypic adaptations than humans, but our results indicate that modern humans accumulated more muscle character state changes than chimpanzees, and that both these taxa accumulated more changes than gorillas. This overview of the evolution of the primate head, neck, pectoral and upper limb musculature suggests that the only muscle groups for which modern humans have more muscles than most other extant primates are the muscles of the face, larynx and forearm. PMID:21689100

  9. The forearm positioning changes electromyographic activity of upper limb muscles and handgrip strength in the task of pushing a load cart.

    PubMed

    de Ponte, Áurea Maria; Guirro, Elaine Caldeira de Oliveira; Pletsch, Ariane Hidalgo Mansano; Dibai-Filho, Almir Vieira; Brandino, Hugo Evangelista; Guirro, Rinaldo Roberto de Jesus

    2015-10-01

    The aim of the present study was to analyse the electromyographic activity of the upper limb muscles as well as the handgrip strength during the activity of pushing a load cart. Eighteen healthy male right-handed volunteers (21.50 ± 2.77 years old) took part in the study. Electrodes were placed on upper trapezius fibres, brachial biceps, brachial triceps, and extensors and flexors of wrist and fingers. The original handle of the load cart was replaced by two handgrip systems mounted on load cells, thus allowing the handgrip strength to be measured according to the wrist position variation, that is, wrists in neutral position with pronated forearm (WN-PF) or in ulnar deviation with forearm in neutral position (WUD-NF). The signals generated by the load cells during manoeuvre of the load cart and the electromyographic signals were simultaneously captured. Signal processing was performed by using a specific routine developed for analysis of root mean square (RMS) and median frequency (MF). Greater handgrip strength occurred in WN-PF position. In maximal isometric contraction, the RMS of the flexors and extensors showed greater electromyographic activity in WN-PF (intra-muscles) and extensors position (inter-muscles). Decreased handgrip strength in the latter stages of the circuit, with variation of the RMS and MF of all muscles tested. One can conclude that electromyographic activity and handgrip strength are both affected during the phases of an elliptical displacement of the load cart.

  10. Orthoses of the upper limb.

    PubMed

    Bogucki, A

    2001-01-01

    This article presents the medical indications and contemporary technological capabilities in the orthotic treatment of the upper limb. The devices that today constitute an integral part of therapeutic procedures are presented, as well as the potential created by the application of low-temperature thermoplastic materials. Therapeutic success is conditioned by professional cooperation between the physician, the kinesitherapist, the orthotic technician, and the patient. PMID:17984921

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

    PubMed

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

    2014-12-01

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

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

    PubMed

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

    2014-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

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

    PubMed

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

    2013-12-01

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

  15. Stress fractures of the upper limb.

    PubMed

    Brukner, P

    1998-12-01

    Stress fractures are commonly found in the lower limb, but also occur in the upper limb, and are particularly associated with upper limb-dominated sports such as tennis and swimming and those involving throwing activities. Stress fractures of the clavicle and scapula are rare but have been reported, whereas those of the humerus are more frequent and have been described mainly in adolescent baseball pitchers. Olecranon stress fractures occur in throwers and gymnasts. Stress fractures of the ulna and radius have also been reported in a number of different upper limb-dominated sports. In all cases, these fractures heal with conservative management. The physician should consider stress fracture as a possible diagnosis in cases of upper limb pain of bony origin where the pain is associated with overuse.

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

    PubMed

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

    2014-03-01

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

  17. Upper limb prosthetic use in Slovenia.

    PubMed

    Burger, H; Marincek, C

    1994-04-01

    The article deals with the use of different types of upper limb prostheses in Slovenia. Four hundred and fourteen upper limb amputees were sent a questionnaire on the type of their prosthesis, its use and reasons for non-use, respectively. The replies were subject to statistical analysis. Most of the questioned upper limb amputees (70%) wear a prosthesis only for cosmesis. The use of a prosthesis depends on the level of upper limb amputation, loss of the dominant hand, and time from amputation. Prosthetic success appears to be unrelated to age at the time of amputation and the rehabilitation programme. The most frequent reason for not wearing a prosthesis is heat and consequent sweating of the stump. More than a third of amputees are dissatisfied with their prostheses.

  18. CONGENITAL DEFORMITIES OF THE UPPER LIMBS.

    PubMed Central

    Bisneto, Edgard Novaes França

    2015-01-01

    This article, divided into three parts, had the aims of reviewing the most common upper-limb malformations and describing their treatments. In this first part, failure of formation is discussed. The bibliography follows after the first part. PMID:27047864

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

    ERIC Educational Resources Information Center

    Bakheit, Abdel Magid

    2010-01-01

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

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

    PubMed

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

    2014-08-01

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

  1. Upper Limb Motor Impairment Post Stroke

    PubMed Central

    Raghavan, Preeti

    2016-01-01

    Synopsis Understanding upper limb impairment after stroke is essential to planning therapeutic efforts to restore function. However determining which upper limb impairment to treat and how is complex for two reasons: 1) the impairments are not static, i.e. as motor recovery proceeds, the type and nature of the impairments may change; therefore the treatment needs to evolve to target the impairment contributing to dysfunction at a given point in time. 2) multiple impairments may be present simultaneously, i.e., a patient may present with weakness of the arm and hand immediately after a stroke, which may not have resolved when spasticity sets in a few weeks or months later; hence there may be a layering of impairments over time making it difficult to decide what to treat first. The most useful way to understand how impairments contribute to upper limb dysfunction may be to examine them from the perspective of their functional consequences. There are three main functional consequences of impairments on upper limb function are: (1) learned nonuse, (2) learned bad-use, and (3) forgetting as determined by behavioral analysis of tasks. The impairments that contribute to each of these functional limitations are described. PMID:26522900

  2. IncobotulinumtoxinA: A Review in Upper Limb Spasticity.

    PubMed

    Lamb, Yvette N; Scott, Lesley J

    2016-09-01

    Intramuscular incobotulinumtoxinA (Xeomin(®)) is indicated for the treatment or improvement of adult patients with upper limb spasticity (featured indication), cervical dystonia, blepharospasm and glabellar lines. It is a highly purified formulation of botulinum toxin type A that inhibits acetylcholine signalling at neuromuscular junctions, reducing muscle hypertonia. This narrative review discusses the clinical use of incobotulinumtoxinA in adults with upper limb spasticity and summarizes its pharmacological properties. In single-treatment phase 3 trials, compared with placebo, incobotulinumtoxinA treatment improved muscle tone, global spasticity, functional spasticity-related disability and some aspects of carer burden in adults with upper limb spasticity. These beneficial effects of incobotulinumtoxinA on muscle tone were generally maintained in extension studies, in which up to five additional incobotulinumtoxinA treatments were administered. Functional spasticity-related disability and carer burden were also reduced during longer-term incobotulinumtoxinA treatment. IncobotulinumtoxinA was generally well tolerated in clinical trials, with relatively few patients experiencing treatment-related adverse events, most of which were of mild to moderate intensity. No neutralizing antibodies that would potentially cause secondary nonresponse against incobotulinumtoxinA were detected after single and multiple treatments in these trials or in phase 3 and 4 trials of incobotulinumtoxinA in other indications, which may be an advantage of this purified formulation. Further research would help to more fully determine the impact of neurotoxin purification in terms of reducing the potential risk of immunogenic responses during long-term treatment. Hence, incobotulinumtoxinA is a useful treatment option for upper limb spasticity in adult patients. PMID:27530616

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  4. SPORTS INJURIES OF THE UPPER LIMBS

    PubMed Central

    da Silva, Rogerio Teixeira

    2015-01-01

    Sports injuries of the upper limbs are very common in physical activities and therefore, they need to be studied in detail, taking into consideration specific aspects of the types of sports practiced. Special attention should be paid to the dynamics of the shoulder girdle and the entire scapular belt, since the most appropriate treatment for athletes can only be provided in this manner. This can also help to prevent recurrences, which can occur in some cases because athletes always seek to return to their pre-injury level of sports activity. This article will focus primarily on the management of upper-limb tendon injuries, from the physiopathology through to the new methods of injury treatment that are more prevalent in sports practice in Brazil. PMID:27022529

  5. The upper limb of Australopithecus sediba.

    PubMed

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

    2013-04-12

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

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

    PubMed

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

    2015-01-30

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2012-04-01

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

  10. Effect of limb immobilization on skeletal muscle

    NASA Technical Reports Server (NTRS)

    Booth, F. W.

    1982-01-01

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

  11. [Problems and techniques of functional rehabilitation of upper limb stump].

    PubMed

    Martini, G; Vitangeli, L; Assennato, P; Drommi, M

    1990-07-15

    The authors discuss problems and techniques of rehabilitation in subjects who have undergone upper limb amputation, as well as the requirements for good application of a prosthesis. Various types of prostheses are described: passive ones, those moved by the body and externally operated ones. The amputee undergoes three stages of rehabilitation: a general preparatory phase for maintenance of good joint function and muscle efficiency; a phase of specific rehabilitation with the help of electromyometry and an electronic training device for the use of the prosthesis, and finally individual and group exercises in laboratories with special facilities.

  12. Exploring Selective Neural Electrical Stimulation for Upper Limb Function Restoration

    PubMed Central

    Tigra, Wafa; Guiraud, David; Andreu, David; Coulet, Bertrand; Gelis, Anthony; Fattal, Charles; Maciejasz, Pawel; Picq, Chloé; Rossel, Olivier; Teissier, Jacques; Coste, Christine Azevedo

    2016-01-01

    This article introduces a new approach of selective neural electrical stimulation of the upper limb nerves. Median and radial nerves of individuals with tetraplegia are stimulated via a multipolar cuff electrode to elicit movements of wrist and hand in acute conditions during a surgical intervention. Various configurations corresponding to various combinations of a 12-poles cuff electrode contacts are tested. Video recording and electromyographic (EMG) signals recorded via sterile surface electrodes are used to evaluate the selectivity of each stimulation configuration in terms of activated muscles. In this abstract we introduce the protocol and preliminary results will be presented during the conference. PMID:27478571

  13. Dissociated lower limb muscle involvement in amyotrophic lateral sclerosis.

    PubMed

    Simon, Neil G; Lee, Michael; Bae, Jong Seok; Mioshi, Eneida; Lin, Cindy S-Y; Pfluger, Casey M; Henderson, Robert D; Vucic, Steve; Swash, Michael; Burke, David; Kiernan, Matthew C

    2015-06-01

    It has been suggested that corticomotoneuronal drive to ankle dorsiflexors is greater than to ankle plantar flexor muscles, despite the finding that plantar flexors are no less active than TA during walking and standing. The present study was undertaken to determine whether there was differential involvement of distal lower limb muscles in amyotrophic lateral sclerosis (ALS), to elucidate pathophysiological mechanisms of selective muscle involvement. Prospective studies were undertaken in 52 ALS patients, including clinical assessment, disease staging (revised ALS functional rating scale), Medical Research Council sum score, and a scale of upper motor neurone (UMN) dysfunction. Motor unit number estimates (MUNE) and compound muscle action potentials (CMAP) from ankle dorsiflexors and plantar flexors were used to provide objective measures. A novel 'split leg index' was calculated as follows: SLI = CMAPDF ÷ CMAPPF. In ALS, there was significantly greater reduction of MUNE and CMAP amplitude recorded from plantar flexors when compared to dorsiflexors, suggesting preferential involvement of plantar flexor muscles, underpinning a 'split leg' appearance. The SLI correlated with clinical plantar flexor strength (R= -0.56, p < 0.001). In no patient did the SLI suggest preferential dorsiflexor involvement. In subgroup analyses, mean SLI was greatest in lower limb-onset ALS. In conclusion, the present study has established dissociated involvement of muscles acting around the ankle in ALS. We suggest this reflects underlying differences in cortical, descending or local spinal modulation of these muscles. PMID:25845764

  14. Proximal monomelic amyotrophy of the upper limb.

    PubMed

    Amir, D; Magora, A; Vatine, J J

    1987-07-01

    A 30-year-old patient of Central European origin, suffering from monomelic amyotrophy, is presented. The disease was characterized by proximal weakness of one upper limb, mainly of the shoulder girdle, accompanied by atrophy. The electrodiagnostic examination revealed signs of partial denervation in the presence of normal motor and sensory conduction. The disease, which is probably of the anterior horn cells, had a benign course and good prognosis, as evident from repeated examinations during a follow-up of eight years. PMID:3606370

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

    ERIC Educational Resources Information Center

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

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

  16. Effect of upper limb deformities on gross motor and upper limb functions in children with spastic cerebral palsy.

    PubMed

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

    2011-01-01

    The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were admitted to the university hospital for intensive rehabilitation. Upper limb deformities were classified according to the Zancolli classification for finger and wrist extension ability, the Gshwind and Tonkin classification for supination ability, and the House classification for thumb-in-palm deformity. Digital deformity was also classified. Upper limb function was assessed using the Upper Extremity Rating Scale (UERS) and the Upper Limb Physician's Rating Scale (ULPRS). Gross motor function was assessed using the Gross Motor Functional Classification System (GMFCS). Among the 234 children observed, 70.5% had a limitation in forearm supination, and 62.8% had problems with wrist and finger extension in at least one limb. Thumb-in-palm deformity of at least one hand was found in 47.0% of patients. Swan neck deformity was the most common finger deformity. Upper limb functional measures, the ULPRS and the UERS, significantly correlated with the degree of upper limb deformity, as assessed by the Gschwind and Tonkin, Zancolli, and House classifications. Further, the degree of upper limb deformity was significantly related to the GMFCS level in children with bilateral CP, but not in children with unilateral CP. Limitation of forearm supination was the most common upper limb deformity in children with spastic CP. The degree of upper limb deformity significantly affected upper limb function in these children. PMID:21821392

  17. [Arterial surgery of the upper limb].

    PubMed

    Perrault, L; Lassonde, J; Laurendeau, F

    1991-01-01

    Arterial surgery of the upper limb represents 2.5% of peripheral vascular procedures in our center. From 1976 to 1989, 58 procedures were performed in 45 patients. There were 26 men and 19 women with average age of 52 years, ranging from 6 to 92 years. These patients were grouped in three categories according to etiology: 1) trauma; 2) acute non traumatic ischemia and 3) chronic ischemia. Sixteen patients (35.5%) were operated on for arterial trauma including three false aneurysms. Blunt trauma was the cause in 9 patients, penetrating in 6 and iatrogenic in one. Angioplasty and primary end to end anastomosis were used in 6, bypass in 4, simple ligation in 3, thrombectomy in 3. The outcome was excellent in 15/16 (93%). Non traumatic acute ischemia occurred in 16 patients (35.5%) and was due to emboli of cardiac origin in 92%. All patients were treated by thromboembolectomy. This group had a high mortality (5/16, 31%) because of associated medical conditions. The third group of 13 patients (29%) underwent surgery for chronic ischemia of the upper limb localized to the subclavian artery in 92%. They were treated with carotid subclavian bypasses in 9, other types of bypass in 3 and endarterectomy in 1. Excellent results were obtained in 10/13 (78%). Overall, satisfactory results were obtained in 90% of surviving patients. Operative mortality was 11.1% and the amputation rate was 13%.

  18. Capillary-venous malformation in the upper limb.

    PubMed

    Uihlein, Lily Changchien; Liang, Marilyn G; Fishman, Steven J; Alomari, Ahmad I; Mulliken, John B

    2015-01-01

    We present a group of patients with regional capillary malformations of the upper limbs and few additional findings other than prominent veins. We believe that this entity is the upper extremity equivalent of capillary-venous malformation of the lower limb and, likewise, belongs at the minor end of the spectrum of vascular disorders with overgrowth. PMID:25557931

  19. A novel myoelectric training device for upper limb prostheses.

    PubMed

    Clingman, Ryan; Pidcoe, Peter

    2014-07-01

    A training system intended for myoelectric prosthetic hands for upper limb amputees was developed to assist in learning myoelectric control schemes and training muscle isolation. The trainer allowed a user to operate a remote controlled car by use of a control scheme commonly used in myoelectric prosthetic hands. The trainer was designed to be easy for therapists to use and more engaging for the user than current methods of signal training. Preliminary testing of the trainer was conducted with eight nonamputee adult volunteers. The results indicated that the trainer could be a useful tool for myoelectric training in upper limb amputees. All subjects' skill with the myoelectric control scheme improved over the course of testing, with the improvements being greater at the beginning of the training period than at the end. Whereas the individual subjects' performance varied greatly at the beginning of the training, the subjects had achieved a more uniform level of performance by the end of the training, approaching the minimum possible values for the assessments.

  20. Validity of estimating limb muscle volume by bioelectrical impedance.

    PubMed

    Miyatani, M; Kanehisa, H; Masuo, Y; Ito, M; Fukunaga, T

    2001-07-01

    The present study aimed to investigate the validity of estimating muscle volume by bioelectrical impedance analysis. Bioelectrical impedance and series cross-sectional images of the forearm, upper arm, lower leg, and thigh on the right side were determined in 22 healthy young adult men using a specially designed bioelectrical impedance acquisition system and magnetic resonance imaging (MRI) method, respectively. The impedance index (L(2)/Z) for every segment, calculated as the ratio of segment length squared to the impedance, was significantly correlated to the muscle volume measured by MRI, with r = 0.902-0.976 (P < 0.05). In these relationships, the SE of estimation was 38.4 cm(3) for the forearm, 40.9 cm(3) for the upper arm, 107.2 cm(3) for the lower leg, and 362.3 cm(3) for the thigh. Moreover, isometric torque developed in elbow flexion or extension and knee flexion or extension was significantly correlated to the L(2)/Z values of the upper arm and thigh, respectively, with correlation coefficients of 0.770-0.937 (P < 0.05), which differed insignificantly from those (0.799-0.958; P < 0.05) in the corresponding relationships with the muscle volume measured by MRI of elbow flexors or extensors and knee flexors or extensors. Thus the present study indicates that bioelectrical impedance analysis may be useful to predict the muscle volume and to investigate possible relations between muscle size and strength capability in a limited segment of the upper and lower limbs.

  1. 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

  2. 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. PMID:27583121

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

    NASA Technical Reports Server (NTRS)

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

    1984-01-01

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

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

    PubMed

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

    2013-07-01

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

  5. A higher number of TMS-elicited MEP from a combined hotspot improves intra- and inter-session reliability of the upper limb muscles in healthy individuals.

    PubMed

    Bastani, Andisheh; Jaberzadeh, Shapour

    2012-01-01

    We aimed to determine, using transcranial magnetic stimulation (TMS), the number of elicited motor evoked potentials (MEPs) that induces the highest intra- and inter-sessions reliability for the extensor carpi radialis (ECR) and first dorsal interosseus (FDI) muscles. Twelve healthy subjects participated in this study on two separate days. Single pulse magnetic stimuli were triggered with Magstim 200(2) to obtain MEPs from the muscles of interest, with the subjects in a relaxed position. Reliability of MEP responses was investigated in three blocks of 5, 10 and 15 trials. The intra- and inter-session reliability of the MEPs' amplitudes and latencies were assessed using intraclass correlation coefficients (ICCs). Repeated measures ANOVA and paired t-tests revealed no significant time effect in the MEP amplitude and latency measurements (P>0.05). The ICCs indicated high intra-session reliability in the MEPs' amplitudes for the ECR and FDI muscles (0.77 to 0.99, 0.90 to 0.99, respectively) and latency (0.80 to 1.00, 0.75 to 0.97, respectively). The MEPs' amplitudes also had high inter-session reliability (0.84 to 0.97, 0.88 to 0.93, respectively), as did their latency (0.80 to 0.90, 0.75 to 0.97, respectively). Highest intra- and inter-session reliability was achieved for blocks of 10 and 15 trials. Our data suggest that intra- and inter-session comparisons should be performed using at least 10 MEPs in "combined hotspot" stimulation technique to ensure highest reliability.

  6. Fibre operating lengths of human lower limb muscles during walking

    PubMed Central

    Arnold, Edith M.; Delp, Scott L.

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Veer, Karan

    2015-04-01

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

  8. Myogenic capacity of muscle progenitor cells from head and limb muscles.

    PubMed

    Grefte, Sander; Kuijpers, Mette A R; Kuijpers-Jagtman, Anne M; Torensma, Ruurd; Von den Hoff, Johannes W

    2012-02-01

    The restoration of muscles in the soft palate of patients with cleft lip and/or palate is accompanied by fibrosis, which leads to speech and feeding problems. Treatment strategies that improve muscle regeneration have only been tested in limb muscles. Therefore, in the present study the myogenic potential of muscle progenitor cells (MPCs) isolated from head muscles was compared with that of limb muscles. Muscle progenitor cells were isolated from the head muscles and limb muscles of rats and cultured. The proliferation of MPCs was analysed by DNA quantification. The differentiation capacity was analysed by quantifying the numbers of fused cells, and by measuring the mRNA levels of differentiation markers. Muscle progenitor cells were stained to quantify the expression of paired box protein Pax 7 (Pax-7), myoblast determination protein 1 (MyoD), and myogenin. Proliferation was similar in the head MPCs and the limb MPCs. Differentiating head and limb MPCs showed a comparable number of fused cells and mRNA expression levels of myosin-1 (Myh1), myosin-3 (Myh3), and myosin-4 (Myh4). During proliferation and differentiation, the number of Pax-7(+), MyoD(+), and myogenin(+) cells in head and limb MPCs was equal. It was concluded that head and limb MPCs show similar myogenic capacities in vitro. Therefore, in vivo myogenic differences between those muscles might rely on the local microenvironment. Thus, regenerative strategies for limb muscles might also be used for head muscles.

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

    PubMed

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

    2015-01-01

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

  10. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    PubMed Central

    2012-01-01

    Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head) and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius) of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system. PMID:22882763

  11. Ubiquitous human upper-limb motion estimation using wearable sensors.

    PubMed

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

    2011-07-01

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

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

    NASA Astrophysics Data System (ADS)

    Wu, Tzong-Ming; Chen, Dar-Zen

    2012-06-01

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

  13. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    PubMed

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. PMID:25525208

  14. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    PubMed

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents.

  15. Upper limb malformations in DiGeorge syndrome

    SciTech Connect

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

    1995-03-13

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

  16. An assessment of skin preparation in upper limb surgery.

    PubMed

    Sullivan, P J; Healy, C E; Hirpara, K M; Hussey, A J; Potter, S M; Kelly, J L

    2008-08-01

    Postoperative wound infections remain a major source of upper limb morbidity. The effectiveness of peri-operative human upper limb preparation was determined using a clear fluid antiseptic and an iodine-based solution over 60 and 90 seconds. Less area was missed using iodine over both times and increasing clear solution preparation time from 60 to 90 seconds improved coverage. Surgical experience had little outcome relevance and a 90-second preparation time with either solution was insufficient, with fingers being the sites most commonly missed.

  17. The Effect of Lateral Epicondylosis on Upper Limb Mechanical Parameters

    PubMed Central

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

    2011-01-01

    Background Lateral epicondylosis is a prevalent and costly musculoskeletal disorder characterized by degeneration of the common extensor tendon origin at the lateral epicondyle. Grip strength is commonly affected due to lateral epicondylosis. However, less is known about the effect of lateral epicondylosis on other functional parameters such as ability to react to rapid loading. Methods Twenty-nine lateral epicondylosis participants and ten controls participated in a case-control study comparing mechanical parameters (mass, stiffness and damping), magnetic resonance imaging signal intensity and grip strength of injured and uninjured limbs. A mixed effects model was used to assess the effect of dominance and injury on mechanical parameters and grip strength. Findings Significant effect of injury and dominance was observed on stiffness, damping and grip strength. An injured upper limb had, on average, 18% less stiffness (p<0.01, 95% CI [9.8%, 26%]), 21% less damping (p<0.01, 95% CI [11%, 31%]) and 50% less grip strength (p<0.01, 95% CI [37%, 61%]) than an uninjured upper limb. The dominant limb had on average 15% more stiffness (p<0.01, 95% CI [8.0%, 23%], 33% more damping (p<0.01, 95% CI [22%, 45%]), and 24% more grip strength (p<0.01, 95% CI [6.6%, 44%]) than the non-dominant limb. Interpretation Lower mechanical parameters are indicative of a lower capacity to oppose rapidly rising forces and quantify an important aspect of upper limb function. For individuals engaged in manual or repetitive activities involving the upper limb, a reduction in ability to oppose these forces may result in increased risk for injury or recurrence. PMID:21937156

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

    PubMed Central

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

    2015-01-01

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

  19. A short overview of upper limb rehabilitation devices

    NASA Astrophysics Data System (ADS)

    Macovei, S.; Doroftei, I.

    2016-08-01

    As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

  20. Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease.

    PubMed

    Nyberg, André; Saey, Didier; Maltais, François

    2015-09-01

    Impaired limb muscle function is a common occurrence in patients with chronic obstructive pulmonary disease (COPD), and it negatively influences exercise tolerance, quality of life, and even survival. Assessment of limb muscle mass and function in COPD is highly encouraged; it should include the quadriceps muscle, but other lower and upper limb muscles may also be evaluated to provide valuable information. Quantification of muscle mass as well as assessment of muscle strength and endurance are suggested. Bioelectrical impedance and dual-energy X-ray absorption can be realistically used in the clinical environment to monitor body composition. Although sophisticated computerized dynamometers provide the most accurate assessment, simple exercise and testing equipment are valid alternatives and they should help in implementing limb muscle function assessment in clinical settings. Isometric measurements, using strain-gauges or hand-held dynamometers, should be favored for their simplicity, availability, and quality of information provided. This perspective provides a rationale for the evaluation of limb muscle mass and function in COPD in routine clinical practice. In addition, measurement techniques used to assess limb muscle mass, strength, endurance, and fatigue in various clinical settings are discussed. PMID:26208090

  1. Skeletal muscle responses to lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  2. Effects of upper-limb immobilisation on driving safety.

    PubMed

    Gregory, J J; Stephens, A N; Steele, N A; Groeger, J A

    2009-03-01

    Doctors are frequently asked by patients whether it is safe to drive with an upper limb immobilised in a cast. In the literature there are no objective measurements of the effects of upper-limb immobilisation upon driving performance. Eight healthy volunteers performed four 20-min driving circuits in a driving simulator (STISIM 400W), circuits 1 and 4 without immobilisation and circuits 2 and 3 with immobilisation. Immobilisation involved a lightweight below-elbow cast with the thumb left free. Volunteers were randomised to right or left immobilisation for circuit 2, and the contralateral wrist was immobilised for circuit 3. Circuits included urban and rural environments and specific hazards (pedestrians crossing, vehicles emerging from a concealed entrance, traffic lights changing suddenly, avoidance of an oncoming vehicle in the driver's carriageway). Limb immobilisation led to more cautious rural and urban driving, with less adjustment of speed and lateral road position than when unrestricted. However when responding to hazards immobilisation caused less safe driving, with higher speeds, a greater proximity to the hazard before action was taken and less steering adjustment. The effects of restriction upon performance were more prevalent and severe with right-arm immobilisation. Upper-limb immobilisation appears to have little effect on the ability to drive a car unchallenged, but to adversely affect responses to routine hazards. Advice on ability to drive safely should be cautious, as the impact of immobilisation appears to be more subtle and wide ranging than previously thought.

  3. UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES

    PubMed Central

    Corrêa, Mário Chaves; Gomes, Felipe Antônio; Linhares, Daniel Campos; Gonçalves, Lucas Braga Jacques; Vilela, José Carlos Souza; de Andrade, Ronaldo Percopi

    2015-01-01

    Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures. PMID:27022560

  4. UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES.

    PubMed

    Corrêa, Mário Chaves; Gomes, Felipe Antônio; Linhares, Daniel Campos; Gonçalves, Lucas Braga Jacques; Vilela, José Carlos Souza; de Andrade, Ronaldo Percopi

    2010-01-01

    Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures.

  5. Micro movements of the upper limb in fibromyalgia: The relation to proprioceptive accuracy and visual feedback.

    PubMed

    Bardal, Ellen Marie; Roeleveld, Karin; Ihlen, Espen; Mork, Paul Jarle

    2016-02-01

    The purpose of this study was to explore the role of visual and proprioceptive feedback in upper limb posture control in fibromyalgia (FM) and to assess the coherence between acceleration measurements of upper limb micro movements and surface electromyography (sEMG) of shoulder muscle activity (upper trapezius and deltoid). Twenty-five female FM patients and 25 age- and sex-matched healthy controls (HCs) performed three precision motor tasks: (1) maintain a steady shoulder abduction angle of 45° while receiving visual feedback about upper arm position and supporting external loads (0.5, 1, or 2kg), (2) maintain the same shoulder abduction angle without visual feedback (eyes closed) and no external loading, and (3) a joint position sense test (i.e., assessment of proprioceptive accuracy). Patients had more extensive increase in movement variance than HCs when visual feedback was removed (P<0.03). Proprioceptive accuracy was related to movement variance in HCs (R⩾0.59, P⩽0.002), but not in patients (R⩽0.25, P⩾0.24). There was no difference between patients and HCs in coherence between sEMG and acceleration data. These results may indicate that FM patients are more dependent on visual feedback and less reliant on proprioceptive information for upper limb posture control compared to HCs.

  6. Isolated bony metastasis to upper limb from carcinoma of the oesophagus: report of three cases.

    PubMed

    Purkayastha, Joydeep

    2015-03-01

    Carcinoma of the oesophagus metastasizes to distant sites in approximately one third of cases and rarely involves the upper limb bones. We describe three such rare cases of isolated metastasis to upper limb bone from oesophageal cancer. PMID:25762887

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

    PubMed

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

    2013-06-01

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

  8. Coordinated upper limb training assisted with an electromyography (EMG)-driven hand robot after stroke.

    PubMed

    Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

    2013-01-01

    An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training on muscular coordination was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5 times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Improvements were found in the muscle co-ordination between the antagonist muscle pair (flexor digitorum and extensor digitorum) as measured by muscle co-contractions in EMG signals; and also in the reduction of excessive muscle activities in the biceps brachii. Reduced spasticity in the fingers was also observed as measured by the Modified Ashworth Score.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  10. An Experimental Analysis Of The Kinematics Of The Upper Limb.

    NASA Astrophysics Data System (ADS)

    Hennion, P.-Y.; Mollard, R.; Lornet, P.

    1986-07-01

    The purpose of this work is the knowledge of the upper limb kinematics for various final tasks requiring effort or precision. The aim is to integrate these results in a C.A.D. system for human engineering studies. The description of these movements proceeds from the 3-D trajectories of anatomical landmarks delivered by the VICON system. Such a representation using fixed orthogonal reference system x, y, z, does not lead to a simple analysis of the gesture. So from these data we compute a set of angular parameters which are in closer relation with the real kinematics of the upper limb. We obtain this result by the introduction of pertinent intermediate reference systems, related to each rotation degree of freedom. The result exhibit typical patterns of the temporal evolution of the angular parameters related to the task assigned to the subject. The collected data constitute a computerized catalogue of movements included in ERGODATA system.

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

    PubMed Central

    Stinear, James W; Byblow, Winston D

    2002-01-01

    The phasic modulation of wrist flexor corticomotor disinhibition has previously been demonstrated during the flexion phase of rhythmical passive flexion-extension of the human wrist. Here we ask if rhythmical bimanual flexion-extension movements of the wrists of neurologically intact subjects, modulate inhibitory activity in the motor cortex. In the first experiment intracortical inhibition was assessed when one wrist was passively flexed and extended on its own, with the addition of the opposite limb voluntarily moving synchronously in a mirror symmetric pattern, and also in a near-symmetric asynchronous pattern. Two subsequent experiments investigated firstly the modulation of spinal reflex pathway activity during the same three movement conditions, and secondly the effect of contralateral wrist movement alone on the excitability of corticomotoneuronal pathways to a static test limb. When the wrist flexors of both upper limbs were shortening simultaneously (i.e. synchronously), intracortical inhibition associated with flexor representations was suppressed to a greater extent than when the two muscles were shortening asynchronously. The results of the three experiments indicate that modulation of inhibitory activity was taking place at the cortical level. These findings may have further application in the study of rehabilitation procedures where the effects of simultaneous activation of affected and unaffected upper limbs in hemiparetic patients are to be investigated. PMID:12181301

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

    PubMed

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

    2015-05-01

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

  13. Differences in childhood adiposity influence upper limb fracture site

    PubMed Central

    Moon, Rebecca J; Lim, Adelynn; Farmer, Megan; Segaran, Avinash; Clarke, Nicholas MP; Dennison, Elaine M; Harvey, Nicholas C; Cooper, Cyrus; Davies, Justin H

    2015-01-01

    Introduction Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site in children. Methods Height, weight, BMI, triceps and subscapular skinfold thickness (SFT) were measured in children aged 3-18 years with an acute upper limb fracture. Data was compared across three fracture sites (hand, forearm and upper arm/shoulder [UA]), and to published reference data. Results 401 children (67.1% male, median age 11.71 years (range 3.54-17.27 years) participated. 34.2%, 50.6% and 15.2% had fractures of the hand, forearm and UA, respectively. Children with forearm fractures had higher weight, BMI and SFT z-scores than those with UA fractures (p<0.05 for all). SFT z-scores were also higher in children with forearm fractures compared to hand fractures, but children withor hand and UA fractures did not differ. Overweight and obesity prevalence was higher in children with forearm fractures (37.6%) than those with UA fractures (19.0%, p=0.009). This prevalence was also higher than the published United Kingdom population prevalence (27.9%, p=0.003), whereas that of children with either UA (p=0.13) or hand fractures (29.1%, p=0.76) did not differ. The differences in anthropometry and overweight/obesity were similar for boys, but not present in girls. Conclusion Measurements of adiposity and the prevalence of overweight/obesity differ by fracture site in children, and in particular boys, with upper limb fractures. PMID:26027507

  14. Effect of STS space suit on astronaut dominant upper limb EVA work performance

    NASA Technical Reports Server (NTRS)

    Greenisen, Michael C.

    1987-01-01

    The STS Space Suited and unsuited dominant upper limb performance was evaluated in order to quantify future EVA astronaut skeletal muscle upper limb performance expectations. Testing was performed with subjects standing in EVA STS foot restraints. Data was collected with a CYBEX Dynamometer enclosed in a waterproof container. Control data was taken in one g. During one g testing, weight of the Space Suit was relieved from the subject via an overhead crane with a special connection to the PLSS of the suit. Experimental data was acquired during simulated zero g, accomplished by neutral buoyancy in the Weightless Environment Training Facility. Unsuited subjects became neutrally buoyant via SCUBA BC vests. Actual zero g experimental data was collected during parabolic arc flights on board NASA's modified KC-135 aircraft. During all test conditions, subjects performed five EVA work tasks requiring dominant upper limb performance and ten individual joint articulation movements. Dynamometer velocities for each tested movement were 0 deg/sec, 30 or 60 deg/sec and 120 or 180 deg/sec, depending on the test, with three repetitions per test. Performance was measured in foot pounds of torque.

  15. 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. PMID:22275698

  16. Long-duration muscle dedifferentiation during limb regeneration in axolotls.

    PubMed

    Wu, Cheng-Han; Huang, Ting-Yu; Chen, Bo-Sung; Chiou, Ling-Ling; Lee, Hsuan-Shu

    2015-01-01

    Although still debated, limb regeneration in salamanders is thought to depend on the dedifferentiation of remnant tissue occurring early after amputation and generating the progenitor cells that initiate regeneration. This dedifferentiation has been demonstrated previously by showing the fragmentation of muscle fibers into mononucleated cells and by revealing the contribution of mature muscle fibers to the regenerates by using lineage-tracing studies. Here, we provide additional evidence of dedifferentiation by showing that Pax7 (paired-box protein-7) transcripts are expressed at the ends of remnant muscle fibers in axolotls by using in situ hybridization and by demonstrating the presence of Pax7+ muscle-fiber nuclei in the early bud and mid-bud stages by means of immunohistochemical staining. During the course of regeneration, the remnant muscles did not progress; instead, muscle progenitors migrated out from the remnants and proliferated and differentiated in the new tissues at an early stage of differentiation. The regenerating muscles and remnant muscles were largely disconnected, and this left a gap between them until extremely late in the late stage of differentiation, at which point the new and old muscles connected together. Notably, Pax7 transcripts were detected in the regions of muscles that faced these gaps; thus, Pax7 expression might indicate dedifferentiation in the remnant-muscle ends and partial differentiation in the regenerating muscles. The roles of this long-duration dedifferentiation in the remnants remain unknown. However, the results presented here could support the hypothesis that long-duration muscle dedifferentiation facilitates the connection and fusion between the new and old muscles that are both in an immature state; this is because immature Pax7+ myoblasts readily fuse during developmental myogenesis. PMID:25671422

  17. Long-Duration Muscle Dedifferentiation during Limb Regeneration in Axolotls

    PubMed Central

    Wu, Cheng-Han; Huang, Ting-Yu; Chen, Bo-Sung; Chiou, Ling-Ling; Lee, Hsuan-Shu

    2015-01-01

    Although still debated, limb regeneration in salamanders is thought to depend on the dedifferentiation of remnant tissue occurring early after amputation and generating the progenitor cells that initiate regeneration. This dedifferentiation has been demonstrated previously by showing the fragmentation of muscle fibers into mononucleated cells and by revealing the contribution of mature muscle fibers to the regenerates by using lineage-tracing studies. Here, we provide additional evidence of dedifferentiation by showing that Pax7 (paired-box protein-7) transcripts are expressed at the ends of remnant muscle fibers in axolotls by using in situ hybridization and by demonstrating the presence of Pax7+ muscle-fiber nuclei in the early bud and mid-bud stages by means of immunohistochemical staining. During the course of regeneration, the remnant muscles did not progress; instead, muscle progenitors migrated out from the remnants and proliferated and differentiated in the new tissues at an early stage of differentiation. The regenerating muscles and remnant muscles were largely disconnected, and this left a gap between them until extremely late in the late stage of differentiation, at which point the new and old muscles connected together. Notably, Pax7 transcripts were detected in the regions of muscles that faced these gaps; thus, Pax7 expression might indicate dedifferentiation in the remnant-muscle ends and partial differentiation in the regenerating muscles. The roles of this long-duration dedifferentiation in the remnants remain unknown. However, the results presented here could support the hypothesis that long-duration muscle dedifferentiation facilitates the connection and fusion between the new and old muscles that are both in an immature state; this is because immature Pax7+ myoblasts readily fuse during developmental myogenesis. PMID:25671422

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2009-01-01

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

  1. Electromyography-based analysis of human upper limbs during 45-day head-down bed-rest

    NASA Astrophysics Data System (ADS)

    Fu, Anshuang; Wang, Chunhui; Qi, Hongzhi; Li, Fan; Wang, Zheng; He, Feng; Zhou, Peng; Chen, Shanguang; Ming, Dong

    2016-03-01

    Muscle deconditioning occurs in response to simulated or actual microgravity. In spaceflight, astronauts become monkey-like for mainly using their upper limbs to control the operating system and to complete corresponding tasks. The changes of upper limbs' athletic ability will directly affect astronauts' working performance. This study investigated the variation trend of surface electromyography (sEMG) during prolonged simulated microgravity. Eight healthy males participating in this study performed strict 45-day head-down bed-rest (HDBR). On the 5th day of pre-HDBR, and the 15th, the 30th and the 45th days of HDBR, the subjects performed maximum pushing task and maximum pulling task, and sEMG was collected from upper limbs synchronously. Each subject's maximum volunteer contractions of both the tasks during these days were compared, showing no significant change. However, changes were detected by sEMG-based analysis. It was found that integrated EMG, root mean square, mean frequency, fuzzy entropy of deltoid, and fuzzy entropy of triceps brachii changed significantly when comparing pre-HDBR with HDBR. The variation trend showed a recovery tendency after significant decline, which is inconsistent with the monotonic variation of lower limbs that was proved by previous research. These findings suggest that EMG changes in upper limbs during prolonged simulated microgravity, but has different variation trend from lower limbs.

  2. Comparative anatomy and muscle architecture of selected hind limb muscles in the Quarter Horse and Arab.

    PubMed

    Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wakeling, J M; Wilson, A M; Payne, R C

    2008-02-01

    The Quarter Horse (bred for acceleration) and the Arab (bred for endurance) are situated at either end of the equine athletic spectrum. Studies into the form and function of the leg muscles in human sprint and endurance runners have demonstrated that differences exist in their muscle architecture. It is not known whether similar differences exist in the horse. Six Quarter Horse and six Arab fresh hind limb cadavers were dissected to gain information on the muscle mass and architecture of the following muscles: gluteus medius; biceps femoris; semitendinosus; vastus lateralis; gastrocnemius; tibialis cranialis and extensor digitorum longus. Specifically, muscle mass, fascicle length and pennation angle were quantified and physiological cross-sectional area (PCSA) and maximum isometric force were estimated. The hind limb muscles of the Quarter Horse were of a significantly greater mass, but had similar fascicle lengths and pennation angles when compared with those of the Arab; this resulted in the Quarter Horse hind limb muscles having greater PCSAs and hence greater isometric force potential. This study suggests that Quarter Horses as a breed inherently possess large strong hind limb muscles, with the potential to accelerate their body mass more rapidly than those of the Arab.

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

    PubMed Central

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

    2015-01-01

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

  4. A solitary fibrous tumor of the upper limb.

    PubMed

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

    2015-02-01

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

  5. A solitary fibrous tumor of the upper limb.

    PubMed

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

    2015-02-01

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

  6. [The efficacy of botulinum toxin therapy in patients with upper limb spasticity due to traumatic brain injury].

    PubMed

    Akulov, M A; Khat'kova, S E; Mokienko, O A; Orlova, O R; Usachev, D Yu; Zakharov, V O; Orlova, A S; Tomsky, A A

    2016-01-01

    Spasticity is a type of muscle hyperactivity that occurs in patients after focal lesions of the Central nervous system due to various diseases: stroke, traumatic brain injury or spinal cord injury, neurosurgical intervention, as well as multiple sclerosis and other diseases of the Central nervous system and is the most disability manifestation of the syndrome of upper motor neuron (UMNS). Focal spasticity of the upper limb requires a complex treatment. Botulinum toxin therapy is an effective treatment for focal/multifocal spasticity in reducing muscle tone and improving function with the highest level of evidence according to the latest American and European guidelines for treatment of spasticity. There are many publications devoted to BTA use in post-stroke patients. This article provides a review of the BTA use in patients with the upper limb spasticity due to severe traumatic brain injury. Some local data on the BTA efficacy in the cohort of patients with traumatic brain injury are also presented. PMID:27635608

  7. [The efficacy of botulinum toxin therapy in patients with upper limb spasticity due to traumatic brain injury].

    PubMed

    Akulov, M A; Khat'kova, S E; Mokienko, O A; Orlova, O R; Usachev, D Yu; Zakharov, V O; Orlova, A S; Tomsky, A A

    2016-01-01

    Spasticity is a type of muscle hyperactivity that occurs in patients after focal lesions of the Central nervous system due to various diseases: stroke, traumatic brain injury or spinal cord injury, neurosurgical intervention, as well as multiple sclerosis and other diseases of the Central nervous system and is the most disability manifestation of the syndrome of upper motor neuron (UMNS). Focal spasticity of the upper limb requires a complex treatment. Botulinum toxin therapy is an effective treatment for focal/multifocal spasticity in reducing muscle tone and improving function with the highest level of evidence according to the latest American and European guidelines for treatment of spasticity. There are many publications devoted to BTA use in post-stroke patients. This article provides a review of the BTA use in patients with the upper limb spasticity due to severe traumatic brain injury. Some local data on the BTA efficacy in the cohort of patients with traumatic brain injury are also presented.

  8. The Upper Atmosphere Research Satellite microwave limb sounder instrument

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  9. The volume of vascular compartment in rat hind limb muscles

    PubMed Central

    Law, R. O.; Phelps, C. F.

    1966-01-01

    1. A non-recirculatory perfusion system has been developed suitable for the perfusion of the hind limbs of small experimental animals. 2. By means of it a solution of T. 1824-labelled serum albumin has been introduced into the vascular compartment of the hind limbs of female rats under isogravimetric conditions. Excision and analysis of certain muscles has been used to provide information concerning the percentage distribution of the labelled albumin within these muscles. 3. Experiments have been carried out in vivo employing [131I]labelled serum albumin and [51Cr]labelled erythrocytes in order to compare the vascular volumes determined under in vivo conditions and in perfusions, and to estimate the capillary haematocrit in vivo. 4. The physiological validity of the methods used and the results obtained has been discussed. PMID:5972152

  10. A survey on robotic devices for upper limb rehabilitation

    PubMed Central

    2014-01-01

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

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

    PubMed

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

    2010-03-01

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

  12. Literature Review on Needs of Upper Limb Prosthesis Users

    PubMed Central

    Cordella, Francesca; Ciancio, Anna Lisa; Sacchetti, Rinaldo; Davalli, Angelo; Cutti, Andrea Giovanni; Guglielmelli, Eugenio; Zollo, Loredana

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out the main critical aspects of the current prosthetic solutions, in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. The ultimate goal is to provide design inputs in the prosthetic field and, contemporary, increase user satisfaction rates and reduce device abandonment. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. It wants to (i) provide guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) propose a control architecture of PNS-based prosthetic systems able to satisfy the analyzed user wishes; (iii) provide hints for improving the quality of the methods (e.g., questionnaires) adopted for understanding the user satisfaction with their prostheses. PMID:27242413

  13. Literature Review on Needs of Upper Limb Prosthesis Users.

    PubMed

    Cordella, Francesca; Ciancio, Anna Lisa; Sacchetti, Rinaldo; Davalli, Angelo; Cutti, Andrea Giovanni; Guglielmelli, Eugenio; Zollo, Loredana

    2016-01-01

    The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to limitations in the interfaces adopted for controlling the prosthesis and to the lack of force or tactile feedback, thus limiting hand grasp capabilities. This paper presents a literature review on needs analysis of upper limb prosthesis users, and points out the main critical aspects of the current prosthetic solutions, in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. The ultimate goal is to provide design inputs in the prosthetic field and, contemporary, increase user satisfaction rates and reduce device abandonment. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. It wants to (i) provide guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) propose a control architecture of PNS-based prosthetic systems able to satisfy the analyzed user wishes; (iii) provide hints for improving the quality of the methods (e.g., questionnaires) adopted for understanding the user satisfaction with their prostheses. PMID:27242413

  14. Upper-limb power test in rock-climbing.

    PubMed

    Laffaye, G; Collin, J-M; Levernier, G; Padulo, J

    2014-07-01

    The goal of the present study was to validate a new ecological power-test on athletes of different levels and to assess rock climbers' profiles (boulderers vs. route climbers). 34 athletes divided into novice, skilled and elite groups performed the arm-jump board test (AJ). Power, time, velocity, and efficiency index were recorded. Validity was assessed by comparing the distance with the value extracted from the accelerometer (500 Hz) and the reliability of intra- and inter-session scores. Moreover, a principal component analysis (PCA) was used to assess the climbers' profiles. The AJ test was quite valid, showing a low systematic bias of -0.88 cm (-1.25%) and low limits of agreement (< 6%), and reliable ( Intra-class correlation coefficient = 0.98 and CV < 5%), and was able to distinguish between the 3 samples (p < 0.0001). There was a good correlation between relative upper-limb power (r = 0.70; p < 0.01) and the AJ score. Moreover, the PCA revealed an explosive profile for boulderers and either a weak and quick or slow profile for route climbers, revealing a biomechanical signature of the sub-discipline. The AJ test provides excellent absolute and relative reliabilities for climbing, and can effectively distinguish between climbing athletes of different competitive levels. Thus, the AJ may be suitable for field assessment of upper limb strength in climbing practitioners.

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

    PubMed

    Fleming, Neil; Donne, Bernard; Fletcher, David

    2012-01-01

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

  16. The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series.

    PubMed

    Oh, Se-Il; Kim, Jin-Kyung; Park, So-Yeon

    2015-12-01

    [Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks. Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box & Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted before and after intervention. [Results] Subjects' hemineglect decreased and upper limb function on the paretic side improved after intervention, which enhanced activities of daily living. [Conclusion] Prism glass use and paretic upper limb functional training effectively ameliorated stroke patients' hemineglect and improved upper limb function. Future research should focus on prism glasses that provide a wide visual field for use in patients with different conditions. PMID:26834386

  17. The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series

    PubMed Central

    Oh, Se-Il; Kim, Jin-Kyung; Park, So-Yeon

    2015-01-01

    [Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks. Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box & Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted before and after intervention. [Results] Subjects’ hemineglect decreased and upper limb function on the paretic side improved after intervention, which enhanced activities of daily living. [Conclusion] Prism glass use and paretic upper limb functional training effectively ameliorated stroke patients’ hemineglect and improved upper limb function. Future research should focus on prism glasses that provide a wide visual field for use in patients with different conditions. PMID:26834386

  18. Upper airway muscles awake and asleep.

    PubMed

    Sériès, Frédéric

    2002-06-01

    Upper airway (UA) structures are involved in different respiratory and non-respiratory tasks. The coordination of agonist and antagonist UA dilators is responsible for their mechanical function and their ability to maintain UA patency throughout the respiratory cycle. The activity of these muscles is linked with central respiratory activity but also depends on UA pressure changes and is greatly influenced by sleep. UA muscles are involved in determining UA resistance and stability (i.e. closing pressure), and the effect of sleep on these variables may be accounted for by its effect on tonic and phasic skeletal muscle activities. The mechanical effects of UA dilator contraction also depend on their physiological properties (capacity to generate tension in vitro, activity of the anaerobic enzymatic pathway, histo-chemical characteristics that may differ between subjects who may or may not have sleep-related obstructive breathing disorders). These characteristics may represent an adaptive process to an increased resistive loading of these muscles. The apparent discrepancy between the occurrence of UA closure and an increased capacity to generate tension in sleep apnea patients may be due to a reduction in the effectiveness of UA muscle contraction in these patients; such an increase in tissue stiffness could be accounted for by peri-muscular tissue characteristics. Therefore, understanding of UA muscle physiological characteristics should take into account its capacity for force production and its mechanical coupling with other UA tissues. Important research goals for the future will be to integrate these issues with other physiological features of the disease, such as UA size and dimension, histological characteristics of UA tissues and the effect of sleep on muscle function. Such integration will better inform understanding of the role of pharyngeal UA muscles in the pathophysiology of the sleep apnea/hypopnea syndrome. PMID:12531123

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-05-01

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

  1. Rehabilitation After Surgical Reconstruction to Restore Function to the Upper Limb in Tetraplegia: A Changing Landscape

    PubMed Central

    Johanson, M. Elise

    2016-01-01

    Upper limb reconstructive surgical procedures for individuals with tetraplegia are performed in many centers internationally. Most recipients of surgery return to local communities and nonsurgical centers for postoperative rehabilitation and long-term follow-up. This supplement focuses on the clinical significance of upper extremity reconstruction, addressing issues related to the availability and choice for surgery, preoperative assessments, postoperative training paradigms, and appropriate outcome measures. Comprehensive intervention protocols are described in terms of dose, timing, specific activities, modalities, and related outcomes. Shared knowledge of current rehabilitation practice, as it relates to reconstructive surgery, can expand treatment options communicated to patients, increase the availability of postoperative muscle reeducation programs, and motivate long-term follow-up assessments. PMID:27233593

  2. Rehabilitation After Surgical Reconstruction to Restore Function to the Upper Limb in Tetraplegia: A Changing Landscape.

    PubMed

    Johanson, M Elise

    2016-06-01

    Upper limb reconstructive surgical procedures for individuals with tetraplegia are performed in many centers internationally. Most recipients of surgery return to local communities and nonsurgical centers for postoperative rehabilitation and long-term follow-up. This supplement focuses on the clinical significance of upper extremity reconstruction, addressing issues related to the availability and choice for surgery, preoperative assessments, postoperative training paradigms, and appropriate outcome measures. Comprehensive intervention protocols are described in terms of dose, timing, specific activities, modalities, and related outcomes. Shared knowledge of current rehabilitation practice, as it relates to reconstructive surgery, can expand treatment options communicated to patients, increase the availability of postoperative muscle reeducation programs, and motivate long-term follow-up assessments. PMID:27233593

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

    NASA Technical Reports Server (NTRS)

    Gustincic, J. J. (Inventor)

    1981-01-01

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

  4. Expert opinions on success factors for upper-limb prostheses.

    PubMed

    Schultz, Aimee E; Baade, Susan P; Kuiken, Todd A

    2007-01-01

    The goal of this study was to gather the opinions of prosthetics experts on the most important factors for the successful use of upper-limb (UL) prostheses, compare them with those of prosthesis users, and ultimately direct research efforts in this field. UL prosthetics experts were asked to compare the importance of the comfort, function, and cosmesis of a prosthetic device for a transhumeral amputee. Categories were subdivided into weight, socket-interface comfort, power, agility, color, and shape. The majority of those who responded viewed comfort as the most important factor for a unilateral amputee and considered socket-interface comfort to be more important than weight. Function was considered to be the most important factor for a bilateral amputee, with agility considered more important than power. Cosmesis was consistently reported as being less important than comfort and function, and shape was considered more important than color.

  5. Muscle phenotypic variability in limb girdle muscular dystrophy 2 G.

    PubMed

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

    2013-06-01

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

  6. Dupuytren's Contracture Cosegregation with Limb-Girdle Muscle Dystrophy

    PubMed Central

    Lace, Baiba; Inashkina, Inna; Micule, Ieva; Vasiljeva, Inta; Naudina, Maruta Solvita; Jankevics, Eriks

    2013-01-01

    Limb-girdle muscular dystrophies (LGMDs) is a heterogeneous group of muscular dystrophies that mostly affect the pelvic and shoulder girdle muscle groups. We report here a case of neuromuscular disease associated with Dupuytren's contracture, which has never been described before as cosegregating with an autosomal dominant type of inheritance. Dupuytren's contracture is a common disease, especially in Northern Europe. Comorbid conditions associated with Dupuytren's contracture are repetitive trauma to the hands, diabetes, and seizures, but it has never before been associated with neuromuscular disease. We hypothesize that patients may harbor mutations in genes with functions related to neuromuscular disease and Dupuytren's contracture development. PMID:24024053

  7. Modulation of the Cutaneous Silent Period in the Upper-Limb with Whole-Body Instability

    PubMed Central

    Eckert, Nathanial R.; Poston, Brach; Riley, Zachary A.

    2016-01-01

    The silent period induced by cutaneous electrical stimulation of the digits has been shown to be task-dependent, at least in the grasping muscles of the hand. However, it is unknown if the cutaneous silent period is adaptable throughout muscles of the entire upper limb, in particular when the task requirements are substantially altered. The purpose of the present study was to examine the characteristics of the cutaneous silent period in several upper limb muscles when introducing increased whole-body instability. The cutaneous silent period was evoked in 10 healthy individuals with electrical stimulation of digit II of the right hand when the subjects were seated, standing, or standing on a wobble board while maintaining a background elbow extension contraction with the triceps brachii of ~5% of maximal voluntary contraction (MVC) strength. The first excitatory response (E1), first inhibitory response (CSP), and second excitatory response (E2) were quantified as the percent change from baseline and by their individual durations. The results showed that the level of CSP suppression was lessened (47.7 ± 7.7% to 33.8 ± 13.2% of baseline, p = 0.019) and the duration of the CSP inhibition decreased (p = 0.021) in the triceps brachii when comparing the seated and wobble board tasks. For the wobble board task the amount of cutaneous afferent inhibition of EMG activity in the triceps brachii decreased; which is proposed to be due to differential weighting of cutaneous feedback relative to the corticospinal drive, most likely due to presynaptic inhibition, to meet the demands of the unstable task. PMID:26981863

  8. Modulation of the Cutaneous Silent Period in the Upper-Limb with Whole-Body Instability.

    PubMed

    Eckert, Nathanial R; Poston, Brach; Riley, Zachary A

    2016-01-01

    The silent period induced by cutaneous electrical stimulation of the digits has been shown to be task-dependent, at least in the grasping muscles of the hand. However, it is unknown if the cutaneous silent period is adaptable throughout muscles of the entire upper limb, in particular when the task requirements are substantially altered. The purpose of the present study was to examine the characteristics of the cutaneous silent period in several upper limb muscles when introducing increased whole-body instability. The cutaneous silent period was evoked in 10 healthy individuals with electrical stimulation of digit II of the right hand when the subjects were seated, standing, or standing on a wobble board while maintaining a background elbow extension contraction with the triceps brachii of ~5% of maximal voluntary contraction (MVC) strength. The first excitatory response (E1), first inhibitory response (CSP), and second excitatory response (E2) were quantified as the percent change from baseline and by their individual durations. The results showed that the level of CSP suppression was lessened (47.7 ± 7.7% to 33.8 ± 13.2% of baseline, p = 0.019) and the duration of the CSP inhibition decreased (p = 0.021) in the triceps brachii when comparing the seated and wobble board tasks. For the wobble board task the amount of cutaneous afferent inhibition of EMG activity in the triceps brachii decreased; which is proposed to be due to differential weighting of cutaneous feedback relative to the corticospinal drive, most likely due to presynaptic inhibition, to meet the demands of the unstable task. PMID:26981863

  9. Amyoplasia involving only the upper limbs or only involving the lower limbs with review of the relevant differential diagnoses.

    PubMed

    Hall, Judith G

    2014-04-01

    Of individuals with Amyoplasia, 16.8% (94/560) involve only the upper limbs (Upper Limb Amyoplasia-ULA) and 15.2% (85/560) involve only the lower limbs (Lower Limb Amyoplasia-LLA). The accompanying paper deals with other forms of Amyoplasia [Hall et al., 2013] and discusses etiology. An excess of one of monozygotic (MZ) twins is seen in both groups (ULA 4/94 (4.3%), LLA 5/85 (5.9%)), gastrointestinal (GI) abnormalities thought to be of vascular origin (bowel atresia and gastroschisis) (ULA 16/94 (17%), LLA 4/85 (4.7%)), small or partial absence of digits (ULA 6/94 (6.2%), LLA 8/85 (9.4%)), and umbilical cord wrapping around the limbs at birth (ULA 3/94 (3.2%), LLA 7/85 (8.2%)) (severe enough to leave a permanent groove). Pregnancy complications occurred in 42/60 (70%) of ULA and 36/54 (67%) of LLA. Prenatal diagnosis, after ultrasound usage became routine, occurred in only 7/25 (28%) of ULA and 5/12 (12%) of LLA. This series may represent an over estimate of the complications and associations occurring in ULA and LLA. Differential diagnoses separating LLA from the genetic forms of "lower limb only" arthrogryposis and ULA from "upper limb only" genetic forms of arthrogryposis and Erb's palsy is provided.

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

    PubMed Central

    Gupta, Ravi; Lahan, Vivekananda; Goel, Deepak

    2013-01-01

    Restless legs syndrome (RLS) rarely affects the upper limb during the initial course of disease. We present a patient who complained of symptoms suggesting RLS in the right upper limb as the sole manifestation of illness. Bilateral cervical ribs and depression were co-incidental findings. Patient responded well to dopaminergic therapy. PMID:23546363

  11. EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

    NASA Astrophysics Data System (ADS)

    Tan, Hock Guan; Shee, Cheng Yap; Kong, Keng He; Guan, Cuntai; Ang, Wei Tech

    2011-03-01

    This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (<3 months) stroke patients to use electroencephalogram (EEG) to trigger neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the mu-rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their mu-rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Lukban, Marissa Barlaan; Rosales, Raymond L; Dressler, Dirk

    2009-03-01

    Botulinum toxin type A (BoNT-A) therapy has gained wide acceptance in the management of spasticity in cerebral palsy (CP). Clinical experience from numerous case reports and series, retrospective and prospective open label cohort studies, and randomized controlled trials (RCT) has grown over the past 10 years. Several independent systematic reviews on the role of BoNT-A for upper and lower limb spasticity have been written by various authors. The objective of this paper is to summarize past systematic reviews and recent RCT not yet included in the systematic reviews that assess the effectiveness of BoNT-A in upper and lower limb spasticity in children with CP. We reviewed four Class II RCT discussed in five independent systematic reviews and two new Class II trials on the use of BoNT-A alone or with occupational therapy compared to placebo or occupational therapy alone in children with upper limb spasticity. There were 229 children recruited in these six trials and of those, 115 children received BoNT-A in the upper limbs. Five of six RCT showed a time limited decrease in muscle tone most especially at the wrist. Four of six trials showed improvement of hand function on a few specific functional tests. Four systematic reviews concluded that there is insufficient and inconsistent evidence to support or refute the effectiveness of BoNT-A in upper limb spasticity but one recent review recommended that BoNT-A should be considered as a treatment option in upper limb spasticity. For lower limb spasticity, we reviewed 13 RCT discussed in six systematic reviews and two new trials comparing BoNT-A with placebo or other rehabilitation modalities such as physiotherapy, occupational therapy, casting or electrical stimulation. In these studies, 617 children were recruited and of those, 360 children received BoNT-A in the lower limbs. There were six Class I and nine Class II trials. Three Class I trials documented significant improvement in gait pattern in children with

  14. 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.

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

    PubMed

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

    2010-08-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

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

  20. Scale-independent stiffness measurement of upper limbs with lymphedema by a circular compression.

    PubMed

    Tanaka, Nobuyuki; Kataoka, Tsuyoshi; Kaneko, Makoto; Yamato, Masayuki; Okano, Teruo

    2012-01-01

    Lymphedema caused by the dissection of lymphatic node for treating a breast cancer produces serious swelling on the limbs and reduces the quality of life of the patient. For quantitative assessing the disease, this study newly proposed the stiffness measurement method of upper limb with lymphedema. A measurement system, where a roll-up belt was installed to circularly compress the limb by pulling the belt was developed. Both the belt tension and displacement were measured during the compresson of limb. Scale-independent stiffness index was newly derived from the bulk modulus and applied the measured force and displacement. The stiffness index of upper limb with lymphedema was measured. The index of affected limb was larger than that of healthy limb in a patient.

  1. Upper limb malformations in chromosome 22q11 deletions

    SciTech Connect

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

    1996-03-29

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

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

    PubMed

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

    2010-03-01

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

  3. Temporal alignment of electrocorticographic recordings for upper limb movement

    PubMed Central

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

    2015-01-01

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

  4. [The use of occupational therapy in upper limb amputees].

    PubMed

    Moscato, T A; Orlandini, D

    2010-01-01

    Since pre-history until modern times, the ever more refined use of the hand has been fundamental to the progress of mankind. The list of functions of this incredible part of the body would fill several pages and show its fundamental importance in all our actions; in fact, there is very little that humans do that does not involve the use of the hands. The hand offers points for unlimited dissertation and is the executive organ par excellence, carrying out directly or participating in almost all our actions; it is an organ for communication and an instrument of well-being as well as being the main site of one of the five senses: touch. On this background, attention will be focused on the importance that the hand plays in daily life and, particularly, on the difficulties inevitably faced by people who are forced to live without a hand, even if replaced by an orthopaedic prosthesis. This is the sense of occupational therapy in the context of upper limb amputees. PMID:21438258

  5. Benchmarking of dynamic simulation predictions in two software platforms using an upper limb musculoskeletal model.

    PubMed

    Saul, Katherine R; Hu, Xiao; Goehler, Craig M; Vidt, Meghan E; Daly, Melissa; Velisar, Anca; Murray, Wendy M

    2015-01-01

    Several opensource or commercially available software platforms are widely used to develop dynamic simulations of movement. While computational approaches are conceptually similar across platforms, technical differences in implementation may influence output. We present a new upper limb dynamic model as a tool to evaluate potential differences in predictive behavior between platforms. We evaluated to what extent differences in technical implementations in popular simulation software environments result in differences in kinematic predictions for single and multijoint movements using EMG- and optimization-based approaches for deriving control signals. We illustrate the benchmarking comparison using SIMM-Dynamics Pipeline-SD/Fast and OpenSim platforms. The most substantial divergence results from differences in muscle model and actuator paths. This model is a valuable resource and is available for download by other researchers. The model, data, and simulation results presented here can be used by future researchers to benchmark other software platforms and software upgrades for these two platforms.

  6. Benchmarking of dynamic simulation predictions in two software platforms using an upper limb musculoskeletal model

    PubMed Central

    Saul, Katherine R.; Hu, Xiao; Goehler, Craig M.; Vidt, Meghan E.; Daly, Melissa; Velisar, Anca; Murray, Wendy M.

    2014-01-01

    Several opensource or commercially available software platforms are widely used to develop dynamic simulations of movement. While computational approaches are conceptually similar across platforms, technical differences in implementation may influence output. We present a new upper limb dynamic model as a tool to evaluate potential differences in predictive behavior between platforms. We evaluated to what extent differences in technical implementations in popular simulation software environments result in differences in kinematic predictions for single and multijoint movements using EMG- and optimization-based approaches for deriving control signals. We illustrate the benchmarking comparison using SIMM-Dynamics Pipeline-SD/Fast and OpenSim platforms. The most substantial divergence results from differences in muscle model and actuator paths. This model is a valuable resource and is available for download by other researchers. The model, data, and simulation results presented here can be used by future researchers to benchmark other software platforms and software upgrades for these two platforms. PMID:24995410

  7. Electromyographic Analysis of the Lower Limb Muscles in Low- and High-Handicap Golfers

    ERIC Educational Resources Information Center

    Marta, Sérgio; Silva, Luís; Vaz, João R.; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    Purpose: The aim of this study was to compare the electromyographic patterns of the lower limb muscles during a golf swing performed by low- and high-handicap golfers. Method: Ten golfers (5 low- and 5 high-handicap) performed 8 swings using a 7-iron. Surface electromyography (EMG) was recorded for the following lower limb muscles on both sides:…

  8. Frontal plane standing balance with an ambulation aid: Upper limb biomechanics.

    PubMed

    Tung, James Y; Gage, William H; Zabjek, Karl F; Maki, Brian E; McIlroy, William E

    2011-05-17

    Despite widespread acceptance of clinical benefits, empirical evidence to evaluate the advantages and limitations of ambulation aids for balance control is limited. The current study investigates the upper limb biomechanical contributions to the control of frontal plane stability while using a 4-wheeled walker in quiet standing. We hypothesized that: (1) upper limb stabilizing moments would be significant, and (2) would increase under conditions of increased stability demand. Factors influencing upper limb moment generation were also examined. Specifically, the contributions of upper limb center-of-pressure (COP(hands)), vertical and horizontal loads applied to the assistive device were assessed. The results support a significant mechanical role for the upper limbs, generating 27.1% and 58.8% of overall stabilizing moments under baseline and challenged stability demand conditions, respectively. The increased moment was achieved primarily through the preferential use of phasic upper limb control, reflected by increased COP(hands) (baseline vs. challenged conditions: 0.29 vs. 0.72cm). Vertical, but not horizontal, was the primary force direction contributing to stabilizing moments in quiet standing. The key finding that the upper limbs play an important role in effecting frontal plane balance control has important implications for ambulation aid users (e.g., elderly, stroke, and traumatic brain injury).

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

    PubMed Central

    Williams, Ian; Constandinou, Timothy G.

    2014-01-01

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

  10. Muscle endurance and mitochondrial function after chronic normobaric hypoxia: contrast of respiratory and limb muscles.

    PubMed

    Gamboa, Jorge L; Andrade, Francisco H

    2012-02-01

    Skeletal muscle adaptation to chronic hypoxia includes loss of oxidative capacity and decrease in fiber size. However, the diaphragm may adapt differently since its activity increases in response to hypoxia. Thus, we hypothesized that chronic hypoxia would not affect endurance, mitochondrial function, or fiber size in the mouse diaphragm. Adult male mice were kept in normoxia (control) or hypoxia (hypoxia, FIO(2) = 10%) for 4 weeks. After that time, muscles were collected for histological, biochemical, and functional analyses. Hypoxia soleus muscles fatigued faster (fatigue index higher in control, 21.5 ± 2.6% vs. 13.4 ± 2.4%, p < 0.05), but there was no difference between control and hypoxia diaphragm bundles. Mean fiber cross-sectional area was unchanged in hypoxia limb muscles, but it was 25% smaller in diaphragm (p < 0.001). Ratio of capillary length contact to fiber perimeter was significantly higher in hypoxia diaphragm (28.6 ± 1.2 vs. 49.3 ± 1.4, control and hypoxia, p < 0.001). Mitochondrial respiration rates in hypoxia limb muscles were lower: state 2 decreased 19%, state 3 31%, and state 4 18% vs. control, p < 0.05 for all comparisons. There were similar changes in hypoxia diaphragm: state 3 decreased 29% and state 4 17%, p < 0.05. After 4 weeks of hypoxia, limb muscle mitochondria had lower content of complex IV (cytochrome c oxidase), while diaphragm mitochondria had higher content of complexes IV and V (F (1)/F (0) ATP synthase) and less uncoupling protein 3 (UCP-3). These data demonstrate that diaphragm retains its endurance during chronic hypoxia, apparently due to a combination of morphometric changes and optimization of mitochondrial energy production.

  11. Asymmetry in volume between dominant and nondominant upper limbs in young tennis players.

    PubMed

    Rogowski, Isabelle; Ducher, Gaële; Brosseau, Olivier; Hautier, Christophe

    2008-08-01

    This study aimed at demonstrating the asymmetry in volume between the dominant and nondominant upper limbs in tennis players, controlled for maturity status. Upper limb volumes on both sides were calculated in 72 tennis players and 84 control subjects, using the truncated cone method. The participants' maturity status was determined using the predicted age at peak height velocity (PHV). The results showed significant larger side-to-side asymmetry in volume in tennis groups than in control groups. These findings suggested that, even before PHV, specific-sport adaptations occurred in the dominant upper limb in tennis players.

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

    PubMed

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

    2006-02-01

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

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

    PubMed

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

    2015-09-01

    A proficient start is decisive in sprint competitive swimming events and requires swimmers' to exert maximal forces in a short period to complete the task successfully. The aim of this study was to compare the electromyographic (EMG) activity in-between the backstroke start with feet positioned parallel and partially emerged performed with the hands on the highest horizontal and on the vertical handgrip at hands-off, take-off, flight and entry start phases. EMG comparisons between starting variants were supported by upper and lower limb joint angles at starting position and 15 m start time data. Following a four-week start training to familiarize participants with each start variant, 10 male competitive backstroke swimmers performed randomly six 15 m maximal trials, being three of each start variant. Surface EMG of Biceps Brachii, Triceps Brachii, Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior was recorded and processed using the time integral EMG (iEMG). Eight video cameras (four surface and four underwater) were used to determine backstroke start phases and joint angles at starting position. EMG, joint angles and temporal parameters have not evidenced changes due to the different handgrips. Nevertheless, clear differences were observed in both variants for upper and lower limb muscles activity among starting phases (e.g. Biceps Brachii at take-off vs. flight phase, 15.17% ± 2.76% and 22.38% ± 4.25%; 14.24% ± 7.11% and 25.90% ± 8.65%, for variant with hands horizontal and vertically positioned, respectively). It was concluded that different handgrips did not affect EMG, kinematics and temporal profile in backstroke start. Despite coaches might plan similar strength training for both start variants, further attention should be given on the selection of proper exercises to maximize the contribution of relevant muscles at different starting phases. Key pointsAn effective swim start component (from the starting signal until the

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

    PubMed Central

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

    2015-01-01

    A proficient start is decisive in sprint competitive swimming events and requires swimmers’ to exert maximal forces in a short period to complete the task successfully. The aim of this study was to compare the electromyographic (EMG) activity in-between the backstroke start with feet positioned parallel and partially emerged performed with the hands on the highest horizontal and on the vertical handgrip at hands-off, take-off, flight and entry start phases. EMG comparisons between starting variants were supported by upper and lower limb joint angles at starting position and 15 m start time data. Following a four-week start training to familiarize participants with each start variant, 10 male competitive backstroke swimmers performed randomly six 15 m maximal trials, being three of each start variant. Surface EMG of Biceps Brachii, Triceps Brachii, Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior was recorded and processed using the time integral EMG (iEMG). Eight video cameras (four surface and four underwater) were used to determine backstroke start phases and joint angles at starting position. EMG, joint angles and temporal parameters have not evidenced changes due to the different handgrips. Nevertheless, clear differences were observed in both variants for upper and lower limb muscles activity among starting phases (e.g. Biceps Brachii at take-off vs. flight phase, 15.17% ± 2.76% and 22.38% ± 4.25%; 14.24% ± 7.11% and 25.90% ± 8.65%, for variant with hands horizontal and vertically positioned, respectively). It was concluded that different handgrips did not affect EMG, kinematics and temporal profile in backstroke start. Despite coaches might plan similar strength training for both start variants, further attention should be given on the selection of proper exercises to maximize the contribution of relevant muscles at different starting phases. Key points An effective swim start component (from the starting signal until the

  15. Distinct Changes in Synaptic Protein Composition at Neuromuscular Junctions of Extraocular Muscles versus Limb Muscles of ALS Donors

    PubMed Central

    Liu, Jing-Xia; Brännström, Thomas; Andersen, Peter M.; Pedrosa-Domellöf, Fatima

    2013-01-01

    The pathophysiology of amyotrophic lateral sclerosis (ALS) is very complex and still rather elusive but in recent years evidence of early involvement of the neuromuscular junctions (NMJs) has accumulated. We have recently reported that the human extraocular muscles (EOMs) are far less affected than limb muscles at the end-stage of ALS from the same donor. The present study aimed to compare the differences in synaptic protein composition at NMJ and in nerve fibers between EOM and limb muscles from ALS donors and controls. Neurofilament light subunit and synaptophysin decreased significantly at NMJs and in nerve fibers in limb muscles with ALS whereas they were maintained in ALS EOMs. S100B was significantly decreased at NMJs and in nerve fibers in both EOMs and limb muscles of ALS donors, but other markers confirmed the presence of terminal Schwann cells in these NMJs. p75 neurotrophin receptor was present in nerve fibers but absent at NMJs in ALS limb muscles. The EOMs were able to maintain the integrity of their NMJs to a very large extent until the end-stage of ALS, in contrast to the limb muscles. Changes in Ca2+ homeostasis, reflected by altered S100B distribution, might be involved in the breakdown of nerve-muscle contact at NMJs in ALS. PMID:23468993

  16. Muscle co-contraction modulates damping and joint stability in a three-link biomechanical limb.

    PubMed

    Heitmann, Stewart; Ferns, Norm; Breakspear, Michael

    2011-01-01

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

  17. Classification of the pattern of intrauterine amputations of the upper limb in constriction ring syndrome.

    PubMed

    Al-Qattan, M M

    2000-06-01

    Twenty patients with congenital upper limb amputations caused by constriction rings were reviewed to classify the pattern of these amputations. In the 20 patients studied, 31 upper limbs had congenital amputations. The pattern of amputation was classified into three types. Proximal upper limb amputation was considered type I and was only seen in one limb. The most common pattern of amputation was digital amputation associated with "coning" or "superimposition" of the digits (type II) and was seen in 20 hands. Type II amputations were subclassified according to the involvement of all, ulnar, radial, or central digits by the constriction ring. In type III amputations (N = 10 limbs), there was no associated coning or superimposition of the digits. This type of amputation was subclassified into type IIIA (multiple-digit amputations within the same hand) and type III B (single-digit amputation). Associated anomalies are reviewed and the pathogenesis of constriction rings is discussed.

  18. High-density force myography: A possible alternative for upper-limb prosthetic control.

    PubMed

    Radmand, Ashkan; Scheme, Erik; Englehart, Kevin

    2016-01-01

    Several multiple degree-of-freedom upper-limb prostheses that have the promise of highly dexterous control have recently been developed. Inadequate controllability, however, has limited adoption of these devices. Introducing more robust control methods will likely result in higher acceptance rates. This work investigates the suitability of using high-density force myography (HD-FMG) for prosthetic control. HD-FMG uses a high-density array of pressure sensors to detect changes in the pressure patterns between the residual limb and socket caused by the contraction of the forearm muscles. In this work, HD-FMG outperforms the standard electromyography (EMG)-based system in detecting different wrist and hand gestures. With the arm in a fixed, static position, eight hand and wrist motions were classified with 0.33% error using the HD-FMG technique. Comparatively, classification errors in the range of 2.2%-11.3% have been reported in the literature for multichannel EMG-based approaches. As with EMG, position variation in HD-FMG can introduce classification error, but incorporating position variation into the training protocol reduces this effect. Channel reduction was also applied to the HD-FMG technique to decrease the dimensionality of the problem as well as the size of the sensorized area. We found that with informed, symmetric channel reduction, classification error could be decreased to 0.02%. PMID:27532260

  19. Effect of electrically induced muscle contractions on posttraumatic edema formation in frog hind limbs.

    PubMed

    Taylor, K; Fish, D R; Mendel, F C; Burton, H W

    1992-02-01

    We tested the hypothesis that repeated muscle contractions induced by high voltage pulsed current (HVPC) would limit volume increases in traumatized frog hind limbs. Twelve frogs were anesthetized, and both hind limbs of each frog were traumatized by impact. Limb volumes were measured via water displacement over a 24-hour period. Four 30-minute treatments of continuous 1-pulse per second HVPC were applied to one limb selected randomly. Stimulation produced muscle contractions that resulted in minimal joint movements. Volume changes from pretrauma limb volumes (in milliliters per kilogram) were analyzed by an analysis of variance for repeated measures. Our hypothesis was rejected (ie, repeated muscle contractions, as induced in this study, did not limit posttraumatic edema formation in frogs). Further investigation of the relative influences of limb position and varying pulse rates, pulse durations, and intensities of HVPC on edema formation may provide valuable insights on effective treatment of edema in humans.

  20. Assessing upper limb function in nonambulant SMA patients: development of a new module.

    PubMed

    Mazzone, Elena; Bianco, Flaviana; Martinelli, Diego; Glanzman, Allan M; Messina, Sonia; De Sanctis, Roberto; Main, Marion; Eagle, Michelle; Florence, Julaine; Krosschell, Kristin; Vasco, Gessica; Pelliccioni, Marco; Lombardo, Marilena; Pane, Marika; Finkel, Richard; Muntoni, Francesco; Bertini, Enrico; Mercuri, Eugenio

    2011-06-01

    We report the development of a module specifically designed for assessing upper limb function in nonambulant SMA patients, including young children and those with severe contractures. The application of the module to a preschool cohort of 40 children (age 30-48 months) showed that all the items could be completed by 30 months. The module was also used in 45 nonambulant SMA patients (age 30 months to 27 years). Their scores were more variable than in the preschool cohort, ranging from 0 to 18. The magnitude of scores was not related to age (r=-0.19). The upper limb scores had a good correlation with the Hammersmith Functional Motor Scale, r=0.75, but the upper limb function did not always strictly follow the overall gross motor function. These findings suggest that even some of the very weak nonambulant children possess upper limb skills that can be measured.

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

    PubMed Central

    McHardy, Andrew J; Pollard, Henry P

    2005-01-01

    Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury. PMID:15967021

  2. An investigation into the bilateral functional differences of the lower limb muscles in standing and walking.

    PubMed

    Liang, Shengyun; Xu, Jiali; Wang, Lei; Zhao, Guoru

    2016-01-01

    To date, most studies use surface electromyographic (sEMG) signals as the control source on active rehabilitation robots, and unilateral data are collected based on the gait symmetry hypothesis, which has caused much controversy. The purpose of this study is to quantitatively evaluate the sEMG activity asymmetry of bilateral muscles in lower extremities during functional tasks. Nine participants were instructed to perform static and dynamic steady state tests. sEMG signals from the tibialis anterior, soleus, medial gastrocnemius and lateral gastrocnemius muscles of bilateral lower extremities were recorded in the experiments. Muscle activities are quantified in terms of sEMG amplitude. We investigated whether characteristics of left limb and the one of the right limb have the same statistical characteristics during functional tasks using The Wilcoxon rank-sum test, and studied dynamic signal irregularity degree for sEMG activities via sample entropy. The total of muscle activities showed significant differences between left limb and right limb during the static steady state (p = 0.000). For dynamic steady states, there were significant differences for most muscle activities between left limb and right limb at different speeds (p = 0.000). Nevertheless, there was no difference between the lateral gastrocnemius for bilateral limb at 2.0 kilometers per hour (p = 0.060). For medial gastrocnemius, differences were not found between left limb and right limb at 1.0 and 3.0 kilometers per hours (p = 0.390 and p = 0.085, respectively). Similarly, there was no difference for soleus at 3.0 kilometers per hour (p = 0.115). The importance of the differences in muscle activities between left limb and right limb were found. These results can potentially be used for evaluating lower limb extremity function of special populations (elderly people or stroke patients) in an objective and simple method. PMID:27602282

  3. An investigation into the bilateral functional differences of the lower limb muscles in standing and walking

    PubMed Central

    Liang, Shengyun; Xu, Jiali; wang, Lei

    2016-01-01

    To date, most studies use surface electromyographic (sEMG) signals as the control source on active rehabilitation robots, and unilateral data are collected based on the gait symmetry hypothesis, which has caused much controversy. The purpose of this study is to quantitatively evaluate the sEMG activity asymmetry of bilateral muscles in lower extremities during functional tasks. Nine participants were instructed to perform static and dynamic steady state tests. sEMG signals from the tibialis anterior, soleus, medial gastrocnemius and lateral gastrocnemius muscles of bilateral lower extremities were recorded in the experiments. Muscle activities are quantified in terms of sEMG amplitude. We investigated whether characteristics of left limb and the one of the right limb have the same statistical characteristics during functional tasks using The Wilcoxon rank-sum test, and studied dynamic signal irregularity degree for sEMG activities via sample entropy. The total of muscle activities showed significant differences between left limb and right limb during the static steady state (p = 0.000). For dynamic steady states, there were significant differences for most muscle activities between left limb and right limb at different speeds (p = 0.000). Nevertheless, there was no difference between the lateral gastrocnemius for bilateral limb at 2.0 kilometers per hour (p = 0.060). For medial gastrocnemius, differences were not found between left limb and right limb at 1.0 and 3.0 kilometers per hours (p = 0.390 and p = 0.085, respectively). Similarly, there was no difference for soleus at 3.0 kilometers per hour (p = 0.115). The importance of the differences in muscle activities between left limb and right limb were found. These results can potentially be used for evaluating lower limb extremity function of special populations (elderly people or stroke patients) in an objective and simple method.

  4. An investigation into the bilateral functional differences of the lower limb muscles in standing and walking

    PubMed Central

    Liang, Shengyun; Xu, Jiali; wang, Lei

    2016-01-01

    To date, most studies use surface electromyographic (sEMG) signals as the control source on active rehabilitation robots, and unilateral data are collected based on the gait symmetry hypothesis, which has caused much controversy. The purpose of this study is to quantitatively evaluate the sEMG activity asymmetry of bilateral muscles in lower extremities during functional tasks. Nine participants were instructed to perform static and dynamic steady state tests. sEMG signals from the tibialis anterior, soleus, medial gastrocnemius and lateral gastrocnemius muscles of bilateral lower extremities were recorded in the experiments. Muscle activities are quantified in terms of sEMG amplitude. We investigated whether characteristics of left limb and the one of the right limb have the same statistical characteristics during functional tasks using The Wilcoxon rank-sum test, and studied dynamic signal irregularity degree for sEMG activities via sample entropy. The total of muscle activities showed significant differences between left limb and right limb during the static steady state (p = 0.000). For dynamic steady states, there were significant differences for most muscle activities between left limb and right limb at different speeds (p = 0.000). Nevertheless, there was no difference between the lateral gastrocnemius for bilateral limb at 2.0 kilometers per hour (p = 0.060). For medial gastrocnemius, differences were not found between left limb and right limb at 1.0 and 3.0 kilometers per hours (p = 0.390 and p = 0.085, respectively). Similarly, there was no difference for soleus at 3.0 kilometers per hour (p = 0.115). The importance of the differences in muscle activities between left limb and right limb were found. These results can potentially be used for evaluating lower limb extremity function of special populations (elderly people or stroke patients) in an objective and simple method. PMID:27602282

  5. Involvement of vessels and PDGFB in muscle splitting during chick limb development.

    PubMed

    Tozer, Samuel; Bonnin, Marie-Ange; Relaix, Frédéric; Di Savino, Sandrine; García-Villalba, Pilar; Coumailleau, Pascal; Duprez, Delphine

    2007-07-01

    Muscle formation and vascular assembly during embryonic development are usually considered separately. In this paper, we investigate the relationship between the vasculature and muscles during limb bud development. We show that endothelial cells are detected in limb regions before muscle cells and can organize themselves in space in the absence of muscles. In chick limbs, endothelial cells are detected in the future zones of muscle cleavage, delineating the cleavage pattern of muscle masses. We therefore perturbed vascular assembly in chick limbs by overexpressing VEGFA and demonstrated that ectopic blood vessels inhibit muscle formation, while promoting connective tissue. Conversely, local inhibition of vessel formation using a soluble form of VEGFR1 leads to muscle fusion. The endogenous location of endothelial cells in the future muscle cleavage zones and the inverse correlation between blood vessels and muscle suggests that vessels are involved in the muscle splitting process. We also identify the secreted factor PDGFB (expressed in endothelial cells) as a putative molecular candidate mediating the muscle-inhibiting and connective tissue-promoting functions of blood vessels. Finally, we propose that PDGFB promotes the production of extracellular matrix and attracts connective tissue cells to the future splitting site, allowing separation of the muscle masses during the splitting process.

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

    PubMed Central

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

    2014-01-01

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

  7. Analysis of neurotrophic factors in limb and extraocular muscles of mouse model of amyotrophic lateral sclerosis.

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2013-10-01

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

  9. The determination of correlation between stature and upper limb and hand measurements in Iranian adults.

    PubMed

    Mahakizadeh, S; Moghani-Ghoroghi, F; Moshkdanian, Gh; Mokhtari, T; Hassanzadeh, G

    2016-03-01

    Estimation of stature is an important issue, which is significantly considered in forensic anthropology. It will be difficult to predict the identification of an individual when only some parts of dead body are discovered following disasters or criminal events. The aim of this study was to assess the relationship between stature and upper limb and hand length in Iranian adults to generate regression formulae for stature estimation. Three anthropometric measurements; Stature, Upper Limb Length (ULL) and Hand Length (HL) were taken on subjects, comprising 142 male students (18-25 years) using standard measuring instruments. The data were analysed using SPSS 16. Then linear regression models were used to estimate stature. The results indicated a positive correlation between stature and upper limb and hand measurements. The correlation coefficient with upper limb length was r = 0.89 & p = 0.0001 and with hand length was r = 0.78 & p = 0.0001. In conclusion, we found a strong correlation between stature and upper limb and hand length. The regression analysis also showed that the Upper Limb Length give better prediction of stature compared to Hand length measurements. PMID:26795396

  10. Respiratory and limb muscle dysfunction in pulmonary arterial hypertension: a role for exercise training?

    PubMed

    Panagiotou, Marios; Peacock, Andrew J; Johnson, Martin K

    2015-09-01

    Respiratory and limb muscle dysfunction is emerging as an important pathophysiological abnormality in pulmonary arterial hypertension (PAH). Muscle abnormalities appear to occur frequently and promote dyspnea, fatigue, and exercise limitation in patients with PAH. Preliminary data suggest that targeted muscle training may be of benefit, although further evidence is required to consolidate these findings into specific recommendations for exercise training in patients with PAH. This article reviews the current evidence on prevalence, risk factors, and implications of respiratory and limb muscle dysfunction in patients with PAH. It also reviews the impact of exercise rehabilitation on morphologic, metabolic, and functional muscle profile and outcomes in PAH. Future research priorities are highlighted.

  11. Respiratory and limb muscle dysfunction in pulmonary arterial hypertension: a role for exercise training?

    PubMed Central

    2015-01-01

    Abstract Respiratory and limb muscle dysfunction is emerging as an important pathophysiological abnormality in pulmonary arterial hypertension (PAH). Muscle abnormalities appear to occur frequently and promote dyspnea, fatigue, and exercise limitation in patients with PAH. Preliminary data suggest that targeted muscle training may be of benefit, although further evidence is required to consolidate these findings into specific recommendations for exercise training in patients with PAH. This article reviews the current evidence on prevalence, risk factors, and implications of respiratory and limb muscle dysfunction in patients with PAH. It also reviews the impact of exercise rehabilitation on morphologic, metabolic, and functional muscle profile and outcomes in PAH. Future research priorities are highlighted. PMID:26401245

  12. Upper limb static-stretching protocol decreases maximal concentric jump performance.

    PubMed

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

    2014-12-01

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

  13. Upper Limb Static-Stretching Protocol Decreases Maximal Concentric Jump Performance

    PubMed Central

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

    2014-01-01

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

  14. Vascular malformations of the upper limb: a review of 270 patients.

    PubMed

    Upton, J; Coombs, C J; Mulliken, J B; Burrows, P E; Pap, S

    1999-09-01

    Vascular malformations of the upper limb were once thought to be impossible to properly diagnose and treat. We reviewed our experience with these malformations of the upper limb in 270 patients seen over a 28-year period. These anomalies were slightly more common in females than males (ratio, 1.5:1.0). The malformations were categorized as either slow flow (venous, n = 125; lymphatic, n = 47; capillary, n = 32; combined, n = 33) or fast flow (arterial, n = 33). Three categories of fast-flow malformations were identified and designated as types A, B, and C. Over 90% of these lesions could be properly diagnosed by their appearance and growth pattern within the first 2 years of life. Additional radiographic studies were used to confirm this diagnosis and to define specific characteristics. Magnetic resonance imaging with and without contrast best demonstrated site, size, flow characteristics, and involvement of contiguous structures for all types of malformations. Algorithms for treatment of both slow-flow and fast-flow anomalies are presented. Two hundred sixty surgical resections were performed in 141 patients, including 24 of 33 fast-flow anomalies. Preoperative angiographic assessment, with magnified views, was an important preoperative adjunct before any well-planned resection of fast-flow arteriovenous malformations. The surgical strategy in all groups was to thoroughly extirpate the malformation, with preservation of nerves, tendons, joints, and uninvolved muscle, and microvascular revascularization and skin replacement as required. Resections were always restricted to well-defined regions and often completed in stages. Symptomatic slow-flow malformations and types A and B fast-flow anomalies were resected without major sequelae. Type C arterial anomalies, diffuse, pulsating lesions with distal vascular steal, and involvement of all tissues, including bone, progressed clinically and resulted in amputation in 10 of 14 patients. The complication rate was 22% for

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

    PubMed

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

    2011-01-01

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

  16. Quantitative evaluation of spasticity in upper limbs in hemiplegic subject using a mathmatical model.

    PubMed

    Uchiyama, Takanori; Kato, Ryoko; Obata, Shitaro; Uchida, Ryusei

    2005-01-01

    This is a proposal for a new technique for evaluating spasticity in the upper limbs of hemiplegic patients. Each subject sat on a chair or stood up, and his or her forearm was extended or flexed by a physician. The subject was instructed to relax. The elbow joint angle, torque, and electromyograms (EMGs) of the biceps brachii, triceps brachii, and brachioradialis muscles were measured. The relationship between the elbow joint angle and torque was approximated with a mathematical model, which consisted of elastic components depending on both muscle activities and elbow joint angle, by the least squares method. The inertia and visco-elastic coefficients were obtained. The elbow angle response was then estimated with the obtained inertia and visco-elastic coefficients by the Runge-Kutta method, and the estimated elbow angle was compared to the observed one. The relationships between the elbow angle and torque were approximated well with the model. Next, the average elasticity was calculated and compared to the modified Ashworth scale. The average elasticity had a tendency to increase as the Ash- worth scale increased. In addition, the average elasticity varied depending on the posture of the subjects. PMID:17281787

  17. An upper-limb power-assist exoskeleton using proportional myoelectric control.

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2012-07-01

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

  20. Upper Limb Function and Cortical Organization in Youth with Unilateral Cerebral Palsy

    PubMed Central

    Mackey, Anna; Stinear, Cathy; Stott, Susan; Byblow, Winston D.

    2014-01-01

    Aim: To explore the relationship between motor cortical and descending motor pathway reorganization, lesion type, and upper limb function in youth with unilateral cerebral palsy (CP). Methods: Twenty participants with unilateral CP (mean age 15 ± 3 years; 11 males) completed a range of upper limb functional measures. Structural MRI, diffusion-weighted, and functional MRI were conducted to determine type and extent of brain lesion, descending white matter integrity, and whole-brain activity during affected hand use. Single pulse transcranial magnetic stimulation (TMS) (n = 12) was used to examine functional integrity of the corticospinal pathway as well as primary motor cortex intracortical and interhemispheric inhibition from motor-evoked potentials and silent periods. Results: Fractional anisotropy measures within the posterior limb of the internal capsule were a predictor of upper limb function (R2 = 0.41, F = 11.3, p = 0.004). Participants with periventricular lesions tended to have better upper limb function [F(2, 17) = 42.48, p < 0.0001]. Five participants with evidence of cortical reorganization and functional ipsilateral projections to their affected hand had worse upper limb function. Deficits in intracortical and interhemispheric inhibitory mechanisms were found in participants with worse upper limb function (Melbourne Assessment of Unilateral Upper Limb Function: Mann Whitney p = 0.02). Conclusion: Neuroimaging and TMS can provide useful information related to hand function of individuals with unilateral CP and may have potential to assist as a predictive tool and/or guide rehabilitation. PMID:25071705

  1. The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot.

    PubMed

    Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

    2013-10-01

    Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p<0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p<0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p<0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p<0.05) and a significant decrease of ED and FD co-contraction during the training (p<0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p<0.05).

  2. Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation

    PubMed Central

    Lyu, Yuanyuan; Guo, Xiaoli; Bekrater-Bodmann, Robin; Flor, Herta; Tong, Shanbao

    2016-01-01

    A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand mental rotation task by means of behavioral and electrophysiological measures. Compared with healthy controls, significantly prolonged response time for both the intact and missing hand were observed specifically in amputees who perceived a phantom limb during the task but not in amputees without phantom limb perception. Event-related desynchronization of EEG in the beta band (beta-ERD) in central and parietal areas showed an angular disparity specifically in amputees with phantom limb perception, with its source localized in the right inferior parietal lobule. The response time as well as the beta-ERD values were significantly positively correlated with phantom vividness. Our results suggest that phantom limb perception during the task is an important interferential factor for motor imagery after amputation and the interference might be related to a change of the body representation resulting from an unnatural posture of the phantom limb. PMID:26879749

  3. Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation.

    PubMed

    Lyu, Yuanyuan; Guo, Xiaoli; Bekrater-Bodmann, Robin; Flor, Herta; Tong, Shanbao

    2016-01-01

    A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand mental rotation task by means of behavioral and electrophysiological measures. Compared with healthy controls, significantly prolonged response time for both the intact and missing hand were observed specifically in amputees who perceived a phantom limb during the task but not in amputees without phantom limb perception. Event-related desynchronization of EEG in the beta band (beta-ERD) in central and parietal areas showed an angular disparity specifically in amputees with phantom limb perception, with its source localized in the right inferior parietal lobule. The response time as well as the beta-ERD values were significantly positively correlated with phantom vividness. Our results suggest that phantom limb perception during the task is an important interferential factor for motor imagery after amputation and the interference might be related to a change of the body representation resulting from an unnatural posture of the phantom limb. PMID:26879749

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

    PubMed

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

    2015-11-01

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

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

    SciTech Connect

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

    2013-06-07

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

  6. Principles of Tendon Reconstruction Following Complex Trauma of the Upper Limb

    PubMed Central

    Chattopadhyay, Arhana; McGoldrick, Rory; Umansky, Elise; Chang, James

    2015-01-01

    Reconstruction of tendons following complex trauma to the upper limb presents unique clinical and research challenges. In this article, the authors review the principles guiding preoperative assessment, surgical reconstruction, and postoperative rehabilitation and management of the upper extremity. Tissue engineering approaches to address tissue shortages for tendon reconstruction are also discussed. PMID:25685101

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Kowalska, Berta; Sudoł-Szopińska, Iwona

    2012-09-01

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

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

    PubMed Central

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

    2010-01-01

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

  10. A descriptive analysis of the upper limb patterns during gait in individuals with cerebral palsy.

    PubMed

    Bonnefoy-Mazure, A; Sagawa, Y; Lascombes, P; De Coulon, G; Armand, S

    2014-11-01

    Patients with cerebral palsy (CP) are characterized by a large diversity of gait deviations; thus, lower limb movements during gait have been well-analyzed in the literature. However, the question of upper limb movements and, more particularly, arm movements during gait has received less attention for CP patients as a function of the disease type (Hemiplegic, HE or Diplegic, DI). Thus, the aim of this study was to investigate upper limb movements for a large group of CP patients; we used a retrospective search, including upper limb kinematic parameters and 92 CP patients (42 females and 50 males, mean±standard deviation (SD); age: 15.2±6.7 years). The diagnoses consisted of 48 HE and 44 DI. A control group of 15 subjects (7 females and 8 males, age: 18.4±8.4 years) was included in the study to provide normal gait data. For the DI patients and CG, 88 arms and 30 arms were analyzed, respectively. For the HE patients, 48 affected arms and 48 non-affected arms were analyzed. The kinematic parameters selected and analyzed were shoulder elevation angles; elbow flexion angles; thorax tilt and obliquity angles; hand vertical and anterior-posterior movements; and arm angles. Several gait parameters were also analyzed, such as the gait profile score (GPS) and normalized speed. Statistical analyses were performed to compare CG with the affected and non-affected upper limbs of HE patients and with the two upper limbs of DI patients. The results show that HE and DI patients adopt abnormal upper limb movements. However, DI patients have greater shoulder, elbow, thorax and arm angle movements compared with HE patients. However, HE patients adopt different movements between their affected and non-affected arms. Thus, the patients used their upper limbs to optimize their gait more where gait deviations were more important. These observations confirm that the upper limbs must be integrated into rehabilitation programs to improve inter-limb coordination. PMID:25084472

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  13. A systematic review of bilateral upper limb training devices for poststroke rehabilitation.

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  15. A systematic review of bilateral upper limb training devices for poststroke rehabilitation.

    PubMed

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

    2012-01-01

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

  16. 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

  17. Connective tissue cells, but not muscle cells, are involved in establishing the proximo-distal outcome of limb regeneration in the axolotl.

    PubMed

    Nacu, Eugen; Glausch, Mareen; Le, Huy Quang; Damanik, Febriyani Fiain Rochel; Schuez, Maritta; Knapp, Dunja; Khattak, Shahryar; Richter, Tobias; Tanaka, Elly M

    2013-02-01

    During salamander limb regeneration, only the structures distal to the amputation plane are regenerated, a property known as the rule of distal transformation. Multiple cell types are involved in limb regeneration; therefore, determining which cell types participate in distal transformation is important for understanding how the proximo-distal outcome of regeneration is achieved. We show that connective tissue-derived blastema cells obey the rule of distal transformation. They also have nuclear MEIS, which can act as an upper arm identity regulator, only upon upper arm amputation. By contrast, myogenic cells do not obey the rule of distal transformation and display nuclear MEIS upon amputation at any proximo-distal level. These results indicate that connective tissue cells, but not myogenic cells, are involved in establishing the proximo-distal outcome of regeneration and are likely to guide muscle patterning. Moreover, we show that, similarly to limb development, muscle patterning in regeneration is influenced by β-catenin signalling.

  18. High-resolution imaging of upper limb neuropathies.

    PubMed

    Howe, Benjamin Matthew; Spinner, Robert J; Felmlee, Joel P; Amrami, Kimberly K

    2015-04-01

    MRI of the peripheral nerves continues to grow technologically and in clinical use. This article reviews the technological aspects and basic interpretation of high-resolution MR imaging of the upper extremity nerves. These techniques work with 1.5-, or preferably 3-T, scanners regardless of vendors. The article also includes selected pitfalls in the interpretation of upper extremity nerve MRI.

  19. Chiropractic management of work-related upper limb disorder complicated by intraosseous ganglion cysts: a case report

    PubMed Central

    Crafts, Glenn J.; Snow, Gregory J.; Ngoc, Kim Hong

    2011-01-01

    Objective Work-related upper limb disorder (WRULD) encompasses a broad array of occupational upper limb injuries, the most common being carpal tunnel syndrome (CTS). Carpal tunnel syndrome occasionally presents with concomitant ganglion cysts. The purpose of this case report is to describe the chiropractic management of a patient with bilateral WRULD complicated by ganglion cysts. Clinical Features The patient was diagnosed previously with bilateral CTS and presented with common CTS symptoms that were nonresponsive to several previous courses of care. Magnetic resonance imaging revealed bilateral ganglion cysts, and electrodiagnostic studies found left CTS and bilateral radial neuralgia. Right limb findings appeared more consistent with nonspecific arm pain. Intervention and Outcome Chiropractic manipulative therapy, soft-tissue approaches, and physiotherapy modalities were applied to the arms and wrists over a 3-month period. Home care included exercises using elastic tubing and a gyroscopic handheld device. Chiropractic manipulative therapy and other conservative approaches resulted in subjective improvements of decreased hand paresthesias and muscle weakness and objective improvements in range of motion and neurologic deficits. Although the patient's symptoms and function improved, she remained with a level of permanent impairment. Conclusion This case demonstrates successful chiropractic management of a patient with WRULD complicated by ganglion cysts. Further larger-scale studies are recommended to determine if chiropractic management demonstrates positive outcomes for this condition. PMID:22014905

  20. Myocytic androgen receptor controls the strength but not the mass of limb muscles.

    PubMed

    Chambon, Céline; Duteil, Delphine; Vignaud, Alban; Ferry, Arnaud; Messaddeq, Nadia; Malivindi, Rocco; Kato, Shigeaki; Chambon, Pierre; Metzger, Daniel

    2010-08-10

    The anabolic effects of androgens on skeletal muscles are thought to be mediated predominantly through the androgen receptor (AR), a member of the ligand-dependent nuclear receptor superfamily. However, despite numerous studies performed in men and in rodents, these effects remain poorly understood. To characterize androgen signaling in skeletal muscles, we generated mice in which the AR is selectively ablated in myofibers. We show that myocytic AR controls androgen-induced insulin-like growth factor IEa (IGF-IEa) expression in the highly androgen-sensitive perineal muscles and that it mediates androgen-stimulated postnatal hypertrophy of these muscles. In contrast, androgen-dependent postnatal hypertrophy of limb muscle fibers is independent of myocytic AR. Thus, androgens control perineal and limb muscle mass in male mice through myocytic AR-dependent and -independent pathways, respectively. Importantly, we also show that AR deficiency in limb myocytes impairs myofibrillar organization of sarcomeres and decreases muscle strength, thus demonstrating that myocytic AR controls key pathways required for maximum force production. These distinct androgen signaling pathways in perineal and limb muscles may allow the design of screens to identify selective androgen modulators of muscle strength.

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

    PubMed

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

    2013-01-01

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

  2. Age-related structural changes in upper extremity muscle tissue in a non-human primate model

    PubMed Central

    Santago, Anthony C.; Plate, Johannes F.; Shively, Carol A.; Register, Thomas C.; Smith, Thomas L.; Saul, Katherine R.

    2015-01-01

    Background Longitudinal studies of upper extremity aging in humans include logistical concerns that animal models can overcome. The vervet is a promising species with which to study aging related processes. However, age-related changes in upper extremity muscle structure have not been quantified in this species. This study measured age-related changes to muscle structure, examined relationships between muscle structure and measures of physical performance, and evaluated the presence of rotator cuff tears. Methods Muscle structure: volume, optimal fiber length, physiological cross-sectional area (PCSA), of 10 upper extremity muscles was quantified from the right upper limb of 5 middle aged and 6 older adult female vervets. Results Total measured PCSA was smaller (p=0.001) in the older adult vervets than the middle aged vervets. Muscle volume reduction predominate the age-related reductions in PCSA. Total measured PCSA was not correlated to any measures of physical performance. No rotator cuff tears were observed. Supraspinatus volume was relatively larger and deltoid volume relatively smaller in the vervet compared to a human. Conclusion The vervet is an appropriate translational model for age-related upper extremity muscle volume loss. Functional measures were not correlated to PCSA, suggesting the vervets may have enough strength for normal function despite loss of muscle tissue. Reduced relative demand on the supraspinatus may be responsible for the lack of naturally occurring rotator cuff tears. PMID:25963066

  3. A developmentally regulated switch from stem cells to dedifferentiation for limb muscle regeneration in newts.

    PubMed

    Tanaka, Hibiki Vincent; Ng, Nathaniel Chuen Yin; Yang Yu, Zhan; Casco-Robles, Martin Miguel; Maruo, Fumiaki; Tsonis, Panagiotis A; Chiba, Chikafumi

    2016-01-01

    The newt, a urodele amphibian, is able to repeatedly regenerate its limbs throughout its lifespan, whereas other amphibians deteriorate or lose their ability to regenerate limbs after metamorphosis. It remains to be determined whether such an exceptional ability of the newt is either attributed to a strategy, which controls regeneration in larvae, or on a novel one invented by the newt after metamorphosis. Here we report that the newt switches the cellular mechanism for limb regeneration from a stem/progenitor-based mechanism (larval mode) to a dedifferentiation-based one (adult mode) as it transits beyond metamorphosis. We demonstrate that larval newts use stem/progenitor cells such as satellite cells for new muscle in a regenerated limb, whereas metamorphosed newts recruit muscle fibre cells in the stump for the same purpose. We conclude that the newt has evolved novel strategies to secure its regenerative ability of the limbs after metamorphosis. PMID:27026263

  4. A developmentally regulated switch from stem cells to dedifferentiation for limb muscle regeneration in newts.

    PubMed

    Tanaka, Hibiki Vincent; Ng, Nathaniel Chuen Yin; Yang Yu, Zhan; Casco-Robles, Martin Miguel; Maruo, Fumiaki; Tsonis, Panagiotis A; Chiba, Chikafumi

    2016-03-30

    The newt, a urodele amphibian, is able to repeatedly regenerate its limbs throughout its lifespan, whereas other amphibians deteriorate or lose their ability to regenerate limbs after metamorphosis. It remains to be determined whether such an exceptional ability of the newt is either attributed to a strategy, which controls regeneration in larvae, or on a novel one invented by the newt after metamorphosis. Here we report that the newt switches the cellular mechanism for limb regeneration from a stem/progenitor-based mechanism (larval mode) to a dedifferentiation-based one (adult mode) as it transits beyond metamorphosis. We demonstrate that larval newts use stem/progenitor cells such as satellite cells for new muscle in a regenerated limb, whereas metamorphosed newts recruit muscle fibre cells in the stump for the same purpose. We conclude that the newt has evolved novel strategies to secure its regenerative ability of the limbs after metamorphosis.

  5. A developmentally regulated switch from stem cells to dedifferentiation for limb muscle regeneration in newts

    PubMed Central

    Tanaka, Hibiki Vincent; Ng, Nathaniel Chuen Yin; Yang Yu, Zhan; Casco-Robles, Martin Miguel; Maruo, Fumiaki; Tsonis, Panagiotis A.; Chiba, Chikafumi

    2016-01-01

    The newt, a urodele amphibian, is able to repeatedly regenerate its limbs throughout its lifespan, whereas other amphibians deteriorate or lose their ability to regenerate limbs after metamorphosis. It remains to be determined whether such an exceptional ability of the newt is either attributed to a strategy, which controls regeneration in larvae, or on a novel one invented by the newt after metamorphosis. Here we report that the newt switches the cellular mechanism for limb regeneration from a stem/progenitor-based mechanism (larval mode) to a dedifferentiation-based one (adult mode) as it transits beyond metamorphosis. We demonstrate that larval newts use stem/progenitor cells such as satellite cells for new muscle in a regenerated limb, whereas metamorphosed newts recruit muscle fibre cells in the stump for the same purpose. We conclude that the newt has evolved novel strategies to secure its regenerative ability of the limbs after metamorphosis. PMID:27026263

  6. Upper limb kinematical analysis of an elite weight lifter in the squat snatch.

    PubMed

    Tang, Gang; Qian, Liwei; Wang, Dongmei; Wei, Gaofeng; Chang, Daofang; Wang, Chengtao; Mi, Weijian

    2014-01-01

    The kinematical parameters such as translational acceleration and angular acceleration in the upper limb of a weightlifter may change regularly during different phases of squat snatch. This study aims to make this question clear. At first, the joint coordinate system (JCS) of human upper limb based on the anatomical landmarks is defined. Then a novel method for calculating the kinematical parameters was brought forward, which was based on analyzing the relative position of the JCS to world coordinate system during an instantaneous situation and the relationship among each JCS at different times during squat snatch. Motion capture system is used to gather the data of the upper limb in an elite weightlifter during squat snatch (the mass of the barbell is 20 kg) and the method mentioned before is applied to analyze the data. Finally, the law of the change of kinematical parameters in each phase of squat snatch is found.

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

    PubMed Central

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

    2012-01-01

    Muscle progenitor cells migrate from the lateral somites into the developing vertebrate limb, where they undergo patterning and differentiation in response to local signals. Sonic hedgehog (Shh) is a secreted molecule made in the posterior limb bud that affects patterning and development of multiple tissues, including skeletal muscles. However, the cell-autonomous and non-cell-autonomous functions of Shh during limb muscle formation have remained unclear. We found that Shh affects the pattern of limb musculature non-cell-autonomously, acting through adjacent nonmuscle mesenchyme. However, Shh plays a cell-autonomous role in maintaining cell survival in the dermomyotome and initiating early activation of the myogenic program in the ventral limb. At later stages, Shh promotes slow muscle differentiation cell-autonomously. In addition, Shh signaling is required cell-autonomously to regulate directional muscle cell migration in the distal limb. We identify neuroepithelial cell transforming gene 1 (Net1) as a downstream target and effector of Shh signaling in that context. PMID:22987639

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

    PubMed Central

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

    2015-01-01

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

  9. Acute upper limb ischemia, a rare presentation of giant cell arteritis.

    PubMed

    Almeida-Morais, Luís; Galego, Sofia; Marques, Nélia; Pack, Tiago; Rodrigues, Hugo; Abreu, Rodolfo; Vasconcelos, Leonor; Marques, Hugo; Sousa Guerreiro, António

    2016-04-01

    Giant cell arteritis (GCA) is a systemic large vessel vasculitis, with extracranial arterial involvement described in 10-15% of cases, usually affecting the aorta and its branches. Patients with GCA are more likely to develop aortic aneurysms, but these are rarely present at the time of the diagnosis. We report the case of an 80-year-old Caucasian woman, who reported proximal muscle pain in the arms with morning stiffness of the shoulders for eight months. In the previous two months, she had developed worsening bilateral arm claudication, severe pain, cold extremities and digital necrosis. She had no palpable radial pulses and no measurable blood pressure. The patient had normochromic anemia, erythrocyte sedimentation rate of 120 mm/h, and a negative infectious and autoimmune workup. Computed tomography angiography revealed concentric wall thickening of the aorta extending to the aortic arch branches, particularly the subclavian and axillary arteries, which were severely stenotic, with areas of bilateral occlusion and an aneurysm of the ascending aorta (47 mm). Despite corticosteroid therapy there was progression to acute critical ischemia. She accordingly underwent surgical revascularization using a bilateral carotid-humeral bypass. After surgery, corticosteroid therapy was maintained and at six-month follow-up she was clinically stable with reduced inflammatory markers. GCA, usually a chronic benign vasculitis, presented exceptionally in this case as acute critical upper limb ischemia, resulting from a massive inflammatory process of the subclavian and axillary arteries, treated with salvage surgical revascularization. PMID:27006059

  10. Management of upper limb dysfunction in children with cerebral palsy: a systematic review.

    PubMed

    Boyd, R N; Morris, M E; Graham, H K

    2001-11-01

    Effective use of the upper limb can impact on educational outcomes, participation in activities of daily living and vocational options for many children with cerebral palsy (CP). This article presents the results of a systematic review of the literature on the management of upper limb dysfunction in children with CP. The range of management options includes therapies such as physiotherapy, occupational therapy, neurodevelopmental therapy and conductive education; peripheral splinting and casting; focal or generalized pharmacotherapy; and surgery to improve upper limb function or correct deformity. A literature search identified 60 papers, of which four were randomized controlled trials and 44 were prospective studies with objective outcome measures. Principal studies undertaken for each type of treatment and the efficacy of the different types of treatment were critically evaluated. In addition, the current level of evidence for each study was evaluated according to Sackett's (1989) model and ICIDH-2 classification. A close examination of two relatively new treatments for upper limb spasticity, constraint induced movement therapy and botulinum toxin type A (BTX-A) was conducted with reference to more extensive data on the efficacy of BTX-A in the lower limb. PMID:11851744

  11. The Effect of an Upper Limb Rehabilitation Robot on Hemispatial Neglect in Stroke Patients

    PubMed Central

    2016-01-01

    Objective To investigate the effectiveness of an upper limb rehabilitation robot therapy on hemispatial neglect in stroke patients. Methods Patients were randomly divided into an upper limb rehabilitation robot treatment group (robot group) and a control group. The patients in the robot group received left upper limb training using an upper limb rehabilitation robot. The patients sat on the right side of the robot, so that the monitor of the robot was located on the patients' left side. In this position, patients could focus continuously on the left side. The control group received conventional neglect treatment, such as visual scanning training and range of motion exercises, administered by occupational therapists. Both groups received their respective therapies for 30 minutes a day, 5 days a week for 3 weeks. Several tests were used to evaluate treatment effects before and after the 3-week treatment. Results In total, 38 patients (20 in the robot group and 18 in the control group) completed the study. After completion of the treatment sessions, both groups showed significant improvements in the Motor-Free Visual Perception Test 3rd edition (MVPT-3), the line bisection test, the star cancellation test, the Albert's test, the Catherine Bergego scale, the Mini-Mental State Examination and the Korean version of Modified Barthel Index. The changes in all measurements showed no significant differences between the two groups. Conclusion This present study showed that the upper limb robot treatment had benefits for hemispatial neglect in stroke patients that were similar to conventional neglect treatment. The upper limb robot treatment could be a therapeutic option in the treatment of hemispatial neglect after stroke.

  12. The Effect of an Upper Limb Rehabilitation Robot on Hemispatial Neglect in Stroke Patients

    PubMed Central

    2016-01-01

    Objective To investigate the effectiveness of an upper limb rehabilitation robot therapy on hemispatial neglect in stroke patients. Methods Patients were randomly divided into an upper limb rehabilitation robot treatment group (robot group) and a control group. The patients in the robot group received left upper limb training using an upper limb rehabilitation robot. The patients sat on the right side of the robot, so that the monitor of the robot was located on the patients' left side. In this position, patients could focus continuously on the left side. The control group received conventional neglect treatment, such as visual scanning training and range of motion exercises, administered by occupational therapists. Both groups received their respective therapies for 30 minutes a day, 5 days a week for 3 weeks. Several tests were used to evaluate treatment effects before and after the 3-week treatment. Results In total, 38 patients (20 in the robot group and 18 in the control group) completed the study. After completion of the treatment sessions, both groups showed significant improvements in the Motor-Free Visual Perception Test 3rd edition (MVPT-3), the line bisection test, the star cancellation test, the Albert's test, the Catherine Bergego scale, the Mini-Mental State Examination and the Korean version of Modified Barthel Index. The changes in all measurements showed no significant differences between the two groups. Conclusion This present study showed that the upper limb robot treatment had benefits for hemispatial neglect in stroke patients that were similar to conventional neglect treatment. The upper limb robot treatment could be a therapeutic option in the treatment of hemispatial neglect after stroke. PMID:27606267

  13. Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy.

    PubMed

    Jaspers, Ellen; Desloovere, Kaat; Bruyninckx, Herman; Molenaers, Guy; Klingels, Katrijn; Feys, Hilde

    2009-11-01

    This review provides an overview of results found in literature on objective measurements of upper limb movements in children with hemiplegic cerebral palsy (HCP). Seventeen articles were selected following a systematic search. Analysed tasks varied from simple reaching and gross motor functions to complex, fine motor tasks. Spatiotemporal characteristics have been extensively studied and longer movement durations, slower movement speed and reduced trajectory straightness at the affected upper limb, compared to the non-affected side or healthy children, were most frequently reported. Joint kinematics has been far less studied. The limited data confirm the clinical impression of children with HCP using less elbow extension and supination to reach for an object, which is compensated by increased trunk flexion. Increased trunk involvement was also reported during gross motor functions. Although three-dimensional (3D) movement analysis seems promising to provide additional insights in the pathological upper limb movements observed in HCP, future standardisation of the entire protocol is crucial. No consensus exists on the procedures for data collection, processing, analysing and reporting of results, or what upper limb tasks should be assessed. The International Society of Biomechanics recently proposed recommendations on the definition of upper limb joint coordinate systems and rotation sequences. These guidelines were not yet applied in these studies. Although the diverse methodological approaches used in the studies complicate the comparison of published results, some general conclusions could be drawn. A further standardisation of the protocol for 3D upper limb movement analysis will provide the foundation for comparable and repeatable results and eventually facilitate the selection and planning of treatment interventions. PMID:19679479

  14. Application of the rubber hand illusion paradigm: comparison between upper and lower limbs.

    PubMed

    Flögel, Mareike; Kalveram, Karl Theodor; Christ, Oliver; Vogt, Joachim

    2016-03-01

    The "rubber hand illusion (RHI)" is a perceptual illusion, which allows the integration of artificial limbs into the body representation of a person by means of combined visual and tactile stimulation. The illusion has been frequently replicated but always concerning the upper limbs. The present study verified an analog illusion that can be called the "rubber foot illusion" (RFI). In a conjoint experiment using both a rubber hand and a rubber foot, brushstrokes were applied to the respective real and rubber limb placed alongside the real one. However, only the artificial limb's handling was visible. The brushstrokes were given either synchronously, with a delay of ±0.5 s, or without tactile stimulation of the real limb. Questionnaire data and the proprioceptive drift towards the rubber limb (determined by calling on the subjects to show where they locate their unseen limb) defined the illusion strength. Results revealed that the illusion was induced in both limbs with comparable strength, but only in the synchronous condition. PMID:25656162

  15. Application of the rubber hand illusion paradigm: comparison between upper and lower limbs.

    PubMed

    Flögel, Mareike; Kalveram, Karl Theodor; Christ, Oliver; Vogt, Joachim

    2016-03-01

    The "rubber hand illusion (RHI)" is a perceptual illusion, which allows the integration of artificial limbs into the body representation of a person by means of combined visual and tactile stimulation. The illusion has been frequently replicated but always concerning the upper limbs. The present study verified an analog illusion that can be called the "rubber foot illusion" (RFI). In a conjoint experiment using both a rubber hand and a rubber foot, brushstrokes were applied to the respective real and rubber limb placed alongside the real one. However, only the artificial limb's handling was visible. The brushstrokes were given either synchronously, with a delay of ±0.5 s, or without tactile stimulation of the real limb. Questionnaire data and the proprioceptive drift towards the rubber limb (determined by calling on the subjects to show where they locate their unseen limb) defined the illusion strength. Results revealed that the illusion was induced in both limbs with comparable strength, but only in the synchronous condition.

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  17. The sensitivity of a lower limb model to axial rotation offsets and muscle bounds at the knee.

    PubMed

    Southgate, Dominic F L; Cleather, Daniel J; Weinert-Aplin, Robert A; Bull, Anthony M J

    2012-09-01

    Soft tissue artifacts during motion capture can lead to errors in kinematics and incorrect estimation of joint angles and segment motion. The aim of this study was to evaluate the effect of shank segment axial rotation and knee rotator muscle bounds on predicted muscle and joint forces in a musculoskeletal model of the lower limb. A maximal height jump for ten subjects was analysed using the original motion data and then modified for different levels of internal and external rotation, and with the upper force bound doubled for five muscles. Both externally rotating the shank and doubling the muscle bounds increased the ability of the model to find a solution in regions of high loading. Muscle force levels in popliteus and tensor fascia latae showed statistically significant differences, but less so in plantaris, sartorius or gracilis. The shear and patellofemoral joint forces were found to be significantly affected by axial rotation during specific phases of the motion and were dependent on the amount of rotation. Fewer differences were observed when doubling the muscle bounds, except for the patellofemoral force and plantaris and sartorius muscle force, which were significantly increased in many of the jump phases. These results give an insight into the behaviour of the model and give an indication of the importance of accurate kinematics and subject-specific geometry.

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  20. 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…

  1. Bilateral Limb Phase Relationship and Its Potential to Alter Muscle Activity Phasing During Locomotion

    PubMed Central

    López-Ortiz, Citlali; Walter, Charles B.; Brown, David A.

    2009-01-01

    It is well established that the sensorimotor state of one limb can influence another limb and therefore bilateral somatosensory inputs make an important contribution to interlimb coordination patterns. However, the relative contribution of interlimb pathways for modifying muscle activation patterns in terms of phasing is less clear. Here we studied adaptation of muscle activity phasing to the relative angular positions of limbs using a split-crank ergometer, where the cranks could be decoupled to allow different spatial angular position relationships. Twenty neurologically healthy individuals performed the specified pedaling tasks at different relative angular positions while surface electromyographic (EMG) signals were recorded bilaterally from eight lower extremity muscles. During each experiment, the relative angular crank positions were altered by increasing or decreasing their difference by randomly ordered increments of 30° over the complete cycle [0° (in phase pedaling); 30, 60, 90, 120, 150, and 180° (standard pedaling); and 210, 240, 270, 300, and 330° out of phase pedaling]. We found that manipulating the relative angular positions of limbs in a pedaling task caused muscle activity phasing changes that were either delayed or advanced, dependent on the relative spatial position of the two cranks and this relationship is well-explained by a sine curve. Further, we observed that the magnitude of phasing changes in biarticular muscles (like rectus femoris) was significantly greater than those of uniarticular muscles (like vastus medialis). These results are important because they provide new evidence that muscle phasing can be systematically influenced by interlimb pathways. PMID:19741107

  2. The muscle activation patterns of lower limb during stair climbing at different backpack load.

    PubMed

    Yali, Han; Aiguo, Song; Haitao, Gao; Songqing, Zhu

    2015-01-01

    Stair climbing under backpack load condition is a challenging task. Understanding muscle activation patterns of lower limb during stair climbing with load furthers our understanding of the factors involved in joint pathology and the effects of treatment. At the same time, stair climbing under backpack load requires adjustments of muscle activations and increases joint moment compared to level walking, which with muscle activation patterns are altered as a result of using an assistive technology, such as a wearable exoskeleton leg for human walking power augmentation. Therefore, the aim of this study was to analyze lower limb muscles during stair climbing under different backpack load. Nine healthy volunteers ascended a four-step staircase at different backpack load (0 kg, 10 kg, 20 kg, 30 kg). Electromyographic (EMG) signals were recorded from four lower limb muscles (gastrocnemius, tibialis anterior, hamstring, rectus femoris). The results showed that muscle activation amplitudes of lower limb increase with increasing load during stair climbing, the maximum RMS of gastrocnemius are greater than tibialis anterior, hamstring and rectus femoris whether stair climbing or level walking under the same load condition. However, the maximum RMS of hamstring are smaller than gastrocnemius, tibialis anterior and rectus femoris. The study of muscle activation under different backpack load during stair climbing can be used to design biomechanism and explore intelligent control based on EMG for a wearable exoskeleton leg for human walking power augmentation. PMID:26899302

  3. Successful Salvage of the Upper Limb After Crush Injury Requiring Nine Operations: A Case Report

    PubMed Central

    Zeng, Qingmin; Cai, Guoping; Liu, Dechang; Wang, Kun; Zhang, Xinchao

    2015-01-01

    Emergency treatment of amputation is one of the most frequently used therapeutic methods for patients with severe upper limb crush injury with a mangled extremity severity score (MESS) of more than 7. With the development of advanced surgical repair techniques and reconstructive technology, cases that once required amputation can now be salvaged with appropriate management, and some limb functions may also be reserved. A patient with a severe upper limb crush injury with a MESS score of 10 was treated in our hospital. The limb was salvaged after 9 surgeries over 10 months. The follow-up visits over the next 18 months post-injury showed that the shoulder joint functions were rated as “excellent” (90) according to the Neer score, the Harris hip evaluation (HHS) for elbow joint functions was “good” (80), and the patient was very satisfied with the overall therapeutic outcome. We conclude from the successful outcome of this extreme injury that salvage attempts should be the first management choice for upper limbs with complex injuries to save as much function as possible. Amputation should only be adopted when the injury is life-threatening or no more function can be saved. The level of evidence was V. PMID:25785341

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

    NASA Technical Reports Server (NTRS)

    Hu, Hua; Liu, W. Timothy

    1998-01-01

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

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

    PubMed Central

    Ache, Jan M.

    2012-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

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

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

    PubMed

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

    2016-01-15

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

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

    PubMed Central

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

    2012-01-01

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

  9. Total Ankylosis of the Upper Left Limb: A Case of Progressive Osseous Heteroplasia

    PubMed Central

    Birjandinejad, Ali; Taraz-Jamshidi, Mohammad-Hossein; Hosseinian, Sayyed Hadi Sayyed

    2016-01-01

    Progressive osseous heteroplasia is a rare inherited disease that begins with skin ossification and proceeds into the deeper connective tissues. The disease should be distinguished from other genetic disorders of heterotopic ossification including fibrodysplasia ossificans progressiva (FOP) and Albright hereditary osteodystrophy (AHO). We report a case of progressive osseous heteroplasia in a twenty four years old male with a complaint of ankylosis of the entire upper left limb and digital cutaneous lesions and sparing of the other limbs and the axial skeleton. Absence of great toe malformation, presence of cutaneous ossification, dermal bone spicules extruding in fingers, and involvement of just left upper limb were unique findings in contrast with FOP diagnosis in this case. There is no effective treatment or prevention for POH. Awareness of diagnostic features is necessary in early diagnosis of POH. PMID:27517079

  10. Total Ankylosis of the Upper Left Limb: A Case of Progressive Osseous Heteroplasia.

    PubMed

    Birjandinejad, Ali; Taraz-Jamshidi, Mohammad-Hossein; Hosseinian, Sayyed Hadi Sayyed

    2016-06-01

    Progressive osseous heteroplasia is a rare inherited disease that begins with skin ossification and proceeds into the deeper connective tissues. The disease should be distinguished from other genetic disorders of heterotopic ossification including fibrodysplasia ossificans progressiva (FOP) and Albright hereditary osteodystrophy (AHO). We report a case of progressive osseous heteroplasia in a twenty four years old male with a complaint of ankylosis of the entire upper left limb and digital cutaneous lesions and sparing of the other limbs and the axial skeleton. Absence of great toe malformation, presence of cutaneous ossification, dermal bone spicules extruding in fingers, and involvement of just left upper limb were unique findings in contrast with FOP diagnosis in this case. There is no effective treatment or prevention for POH. Awareness of diagnostic features is necessary in early diagnosis of POH. PMID:27517079

  11. Upper limb module in non-ambulant patients with spinal muscular atrophy: 12 month changes.

    PubMed

    Sivo, Serena; Mazzone, Elena; Antonaci, Laura; De Sanctis, Roberto; Fanelli, Lavinia; Palermo, Concetta; Montes, Jacqueline; Pane, Marika; Mercuri, Eugenio

    2015-03-01

    Recent studies have suggested that in non-ambulant patients affected by spinal muscular atrophy the Upper Limb Module can increase the range of activities assessed by the Hammersmith Functional Motor Scale Expanded. The aim of this study was to establish 12-month changes in the Upper Limb Module in a cohort of non-ambulant spinal muscular atrophy patients and their correlation with changes on the Hammersmith Functional Motor Scale Expanded. The Upper Limb Module scores ranged between 0 and 17 (mean 10.23, SD 4.81) at baseline and between 1 and 17 at 12 months (mean 10.27, SD 4.74). The Hammersmith Functional Motor Scale Expanded scores ranged between 0 and 34 (mean 12.43, SD 9.13) at baseline and between 0 and 34 at 12 months (mean 12.08, SD 9.21). The correlation betweeen the two scales was 0.65 at baseline and 0.72 on the 12 month changes. Our results confirm that the Upper Limb Module can capture functional changes in non-ambulant spinal muscular atrophy patients not otherwise captured by the other scale and that the combination of the two measures allows to capture changes in different subgroups of patients in whom baseline scores and functional changes may be influenced by several variables such as age.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  13. Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation

    PubMed Central

    Furlan, Leonardo; Conforto, Adriana Bastos; Cohen, Leonardo G.; Sterr, Annette

    2016-01-01

    Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well. PMID:26843992

  14. Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation.

    PubMed

    Furlan, Leonardo; Conforto, Adriana Bastos; Cohen, Leonardo G; Sterr, Annette

    2016-01-01

    Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well. PMID:26843992

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

    PubMed

    Ahmed, Altayeb Abdalla

    2013-11-01

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

  16. The Corticospinal Tract: A Biomarker to Categorize Upper Limb Functional Potential in Unilateral Cerebral Palsy

    PubMed Central

    Jaspers, Ellen; Byblow, Winston D.; Feys, Hilde; Wenderoth, Nicole

    2016-01-01

    Children with unilateral cerebral palsy (CP) typically present with largely divergent upper limb sensorimotor deficits and individual differences in response to upper limb rehabilitation. This review summarizes how early brain damage can cause dramatic deviations from the normal anatomy of sensory and motor tracts, resulting in unique “wiring patterns” of the sensorimotor system in CP. Based on the existing literature, we suggest that corticospinal tract (CST) anatomy and integrity constrains sensorimotor function of the upper limb and potentially also the response to treatment. However, it is not possible to infer CST (re)organization from clinical presentation alone and conventional biomarkers, such as time of insult, location, and lesion extent seem to have limited clinical utility. Here, we propose a theoretical framework based on a detailed examination of the motor system using behavioral, neurophysiological, and magnetic resonance imaging measures, akin to those used to predict potential for upper limb recovery of adults after stroke. This theoretical framework might prove useful because it provides testable hypotheses for future research with the goal to develop and validate a clinical assessment flowchart to categorize children with unilateral CP. PMID:26779464

  17. The Corticospinal Tract: A Biomarker to Categorize Upper Limb Functional Potential in Unilateral Cerebral Palsy.

    PubMed

    Jaspers, Ellen; Byblow, Winston D; Feys, Hilde; Wenderoth, Nicole

    2015-01-01

    Children with unilateral cerebral palsy (CP) typically present with largely divergent upper limb sensorimotor deficits and individual differences in response to upper limb rehabilitation. This review summarizes how early brain damage can cause dramatic deviations from the normal anatomy of sensory and motor tracts, resulting in unique "wiring patterns" of the sensorimotor system in CP. Based on the existing literature, we suggest that corticospinal tract (CST) anatomy and integrity constrains sensorimotor function of the upper limb and potentially also the response to treatment. However, it is not possible to infer CST (re)organization from clinical presentation alone and conventional biomarkers, such as time of insult, location, and lesion extent seem to have limited clinical utility. Here, we propose a theoretical framework based on a detailed examination of the motor system using behavioral, neurophysiological, and magnetic resonance imaging measures, akin to those used to predict potential for upper limb recovery of adults after stroke. This theoretical framework might prove useful because it provides testable hypotheses for future research with the goal to develop and validate a clinical assessment flowchart to categorize children with unilateral CP.

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2015-11-01

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

  20. Evaluation of suitability of a micro-processing unit of motion analysis for upper limb tracking.

    PubMed

    Barraza Madrigal, José Antonio; Cardiel, Eladio; Rogeli, Pablo; Leija Salas, Lorenzo; Muñoz Guerrero, Roberto

    2016-08-01

    The aim of this study is to assess the suitability of a micro-processing unit of motion analysis (MPUMA), for monitoring, reproducing, and tracking upper limb movements. The MPUMA is based on an inertial measurement unit, a 16-bit digital signal controller and a customized algorithm. To validate the performance of the system, simultaneous recordings of the angular trajectory were performed with a video-based motion analysis system. A test of the flexo-extension of the shoulder joint during the active elevation in a complete range of 120º of the upper limb was carried out in 10 healthy volunteers. Additional tests were carried out to assess MPUMA performance during upper limb tracking. The first, a 3D motion reconstruction of three movements of the shoulder joint (flexo-extension, abduction-adduction, horizontal internal-external rotation), and the second, an upper limb tracking online during the execution of three movements of the shoulder joint followed by a continuous random movement without any restrictions by using a virtual model and a mechatronic device of the shoulder joint. Experimental results demonstrated that the MPUMA measured joint angles that are close to those from a motion-capture system with orientation RMS errors less than 3º. PMID:27185034

  1. Lower limb muscle impairment in myotonic dystrophy type 1: the need for better guidelines.

    PubMed

    Petitclerc, Émilie; Hébert, Luc J; Desrosiers, Johanne; Gagnon, Cynthia

    2015-04-01

    In myotonic dystrophy type 1 (DM1), leg muscle weakness is a major impairment. There are challenges to obtaining a clear portrait of muscle strength impairment. A systematic literature review was conducted on lower limb strength impairment in late-onset and adult phenotypes to document variables which affect strength measurement. Thirty-two articles were reviewed using the COSMIN guidelines. Only a third of the studies described a reproducible protocol. Only 2 muscle groups have documented reliability for quantitative muscle testing and only 1 total score for manual muscle testing. Variables affecting muscle strength impairment are not described in most studies. This review illustrates the variability in muscle strength assessment in relation to DM1 characteristics and the questionable validity of the results with regard to undocumented methodological properties. There is therefore a clear need to adopt a consensus on the use of a standardized muscle strength assessment protocol.

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

    SciTech Connect

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

    2013-04-15

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

  3. Coactivation of Lower Limb Muscles during Gait in Patients with Multiple Sclerosis

    PubMed Central

    Boudarham, Julien; Hameau, Sophie; Zory, Raphael; Hardy, Alexandre; Bensmail, Djamel; Roche, Nicolas

    2016-01-01

    Background Coactivation of agonist and antagonist lower limb muscles during gait stiffens joints and ensures stability. In patients with multiple sclerosis, coactivation of lower limb muscles might be a compensatory mechanism to cope with impairments of balance and gait. Objective The aim of this study was to assess coactivation of agonist and antagonist muscles at the knee and ankle joints during gait in patients with multiple sclerosis, and to evaluate the relationship between muscle coactivation and disability, gait performance, dynamic ankle strength measured during gait, and postural stability. Methods The magnitude and duration of coactivation of agonist-antagonist muscle pairs at the knee and ankle were determined for both lower limbs (more and less-affected) in 14 patients with multiple sclerosis and 11 healthy subjects walking at a spontaneous speed, using 3D-gait analysis. Results In the patient group, coactivation was increased in the knee muscles during single support (proximal strategy) and in the ankle muscles during double support (distal strategy). The magnitude of coactivation was highest in the patients with the slowest gait, the greatest motor impairment and the most instability. Conclusion Increased muscle coactivation is likely a compensatory mechanism to limit the number of degrees of freedom during gait in patients with multiple sclerosis, particularly when postural stability is impaired. PMID:27336442

  4. Modeling the Step-like Response in the Upper Limbs of Hemiplegic Subjects for Evaluation of Spasticity

    NASA Astrophysics Data System (ADS)

    Uchiyama, Takanori; Uchida, Ryusei

    The purpose of this study is to develop a new modeling technique for quantitative evaluation of spasticity in the upper limbs of hemiplegic patients. Each subject lay on a bed, and his forearm was supported with a jig to measure the elbow joint angle. The subject was instructed to relax and not to resist the step-like load which was applied to extend the elbow joint. The elbow joint angle and electromyogram (EMG) of the biceps muscle, triceps muscle and brachioradialis muscle were measured. First, the step-like response was approximated with a proposed mathematical model based on musculoskeletal and physiological characteristics by the least square method. The proposed model involved an elastic component depending on both muscle activities and elbow joint angle. The responses were approximated well with the proposed model. Next, the torque generated by the elastic component was estimated. The normalized elastic torque was approximated with a dumped sinusoid by the least square method. The reciprocal of the time constant and the natural frequency of the normalized elastic torque were calculated and they varied depending on the grades of the modified Ashworth scale of the subjects. It was suggested that the proposed modeling technique would provide a good quantitative index of spasticity as shown in the relationship between the reciprocal of the time constant and the natural frequency.

  5. A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women.

    PubMed

    Capozza, R F; Cointry, G R; Cure-Ramírez, P; Ferretti, J L; Cure-Cure, C

    2004-07-01

    A whole-body DXA study of 1450 healthy Caucasian individuals [Bone 22 (1998) 683] found that mineral mass, either crude (BMC) or statistically adjusted to fat mass (FM-adjusted BMC), correlated linearly with lean mass (LM, proportional to muscle mass). The results showed similar slopes but decreasing intercepts (ordinate values) in the order: pre-MP women > men > post-MP women > children. This supports the hypothesis that sex hormones influence the control of bone status by muscle strength in all species. Now we further study those relationships in 2512 healthy Hispanic adults (307 men, 753 pre-MP women, 1452 post-MP women), including separate determinations in their upper and lower limbs. The slopes of the BMC or FM-adjusted BMC vs. LM relationships were parallel in all the studied regions. However, region-related differences were found between the ordinates of the curves. In the whole body, the crude-BMC/LM relationships showed the same ordinate differences as previously observed. In the lower limbs, those differences were smaller in magnitude but highly significant, showing the order: pre-MP women > men = post-MP women. In the upper limbs, the decreasing ordinate order was: men > pre-MP women > post-MP women. After fat adjustment of the BMC, order in both limbs was: men > pre-MP women > post-MP women. Parallelism of the curves was maintained in all cases. LM had a larger independent influence on these results than FM, body weight, or age. The parallelism of the curves supports the idea that a common biomechanical control of bones by muscles occurs in humans. Results suggest that sex-hormone-associated differences in DXA-assessed muscle-bone proportionality in humans could vary according to the region studied. This could be related to the different weight-bearing nature of the musculoskeletal structures studied. Besides the obvious anthropometric associations, FM would exert a mechanical effect as a component of body weight, evident in the lower limbs, while

  6. Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial.

    PubMed

    Dimbwadyo-Terrer, I; Gil-Agudo, A; Segura-Fragoso, A; de los Reyes-Guzmán, A; Trincado-Alonso, F; Piazza, S; Polonio-López, B

    2016-01-01

    The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients' satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra(®) virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p = 0,043, partial η (2) = 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number 2015-002157-35.

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

    NASA Astrophysics Data System (ADS)

    Neri, Gianluca; Zolesi, Valfredo

    2000-01-01

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

  8. Robotic Assessment of Upper Limb Function after Proximal Humeral Fracture: Personal Experience as A Patient and Occupational Therapist.

    PubMed

    Nishimoto, Atsuko; Otaka, Yohei; Kasuga, Shoko; Otaka, Eri; Yamazaki, Kotaro; Ushiba, Junichi; Liu, Meigen

    2016-01-01

    Robotics is an emerging field in rehabilitation medicine. Robots have the potential to complement traditional clinical assessments because they can measure functions more precisely and quantitatively than current clinical assessments. We present a patient with a proximal humeral fracture whose recovery process was evaluated with an exoskeleton robotic device. The patient, a 34-year-old woman, suffered a left proximal humeral fracture while snowboarding. She is an occupational therapist and is the first author of this study. With conservative therapy, fracture union was seen on X-ray at 6 weeks post-injury. At that time, the patient was permitted to move her left upper limb actively within the tolerance of pain. We assessed the function of the injured upper limb at 6, 7, and 12 weeks post-injury with the KINARM exoskeleton robotic device and with conventional clinical measures. The active range of motion and the muscle strength of the left shoulder improved over time. Using robotic assessment, the precise movement profiles, position sense, and functional ability of both arms were quantified and also showed progressive improvement over time. Assessment with a robotic device of the recovery process after proximal humeral fracture allowed quantification of functional impairments that could not be felt subjectively nor identified with conventional clinical assessments. PMID:27665866

  9. Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial

    PubMed Central

    Dimbwadyo-Terrer, I.; Gil-Agudo, A.; Segura-Fragoso, A.; de los Reyes-Guzmán, A.; Trincado-Alonso, F.; Piazza, S.; Polonio-López, B.

    2016-01-01

    The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients' satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra® virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p = 0,043, partial η2 = 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number 2015-002157-35. PMID:26885511

  10. Upper Limb Biomechanics During the Volleyball Serve and Spike

    PubMed Central

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

    2010-01-01

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

  11. Age-dependent motor unit remodelling in human limb muscles.

    PubMed

    Piasecki, Mathew; Ireland, Alex; Jones, David A; McPhee, Jamie S

    2016-06-01

    Voluntary control of skeletal muscle enables humans to interact with and manipulate the environment. Lower muscle mass, weakness and poor coordination are common complaints in older age and reduce physical capabilities. Attention has focused on ways of maintaining muscle size and strength by exercise, diet or hormone replacement. Without appropriate neural innervation, however, muscle cannot function. Emerging evidence points to a neural basis of muscle loss. Motor unit number estimates indicate that by age around 71 years, healthy older people have around 40 % fewer motor units. The surviving low- and moderate-threshold motor units recruited for moderate intensity contractions are enlarged by around 50 % and show increased fibre density, presumably due to collateral reinnervation of denervated fibres. Motor unit potentials show increased complexity and the stability of neuromuscular junction transmissions is decreased. The available evidence is limited by a lack of longitudinal studies, relatively small sample sizes, a tendency to examine the small peripheral muscles and relatively few investigations into the consequences of motor unit remodelling for muscle size and control of movements in older age. Loss of motor neurons and remodelling of surviving motor units constitutes the major change in ageing muscles and probably contributes to muscle loss and functional impairments. The deterioration and remodelling of motor units likely imposes constraints on the way in which the central nervous system controls movements. PMID:26667009

  12. Major ozonated autohemotherapy promotes the recovery of upper limb motor function in patients with acute cerebral infarction★

    PubMed Central

    Wu, Xiaona; Li, Zhensheng; Liu, Xiaoyan; Peng, Haiyan; Huang, Yongjun; Luo, Gaoquan; Peng, Kairun

    2013-01-01

    Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs. In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction. PMID:25206688

  13. Free Functional Muscle Transfers to Restore Upper Extremity Function.

    PubMed

    Krauss, Emily M; Tung, Thomas H; Moore, Amy M

    2016-05-01

    Free functional muscle transfer provides an option for functional restoration when nerve reconstruction and tendon transfers are not feasible. To ensure a successful outcome, many factors need to be optimized, including proper patient selection, timing of intervention, donor muscle and motor nerve selection, optimal microneurovascular technique and tension setting, proper postoperative management, and appropriate rehabilitation. Functional outcomes of various applications to the upper extremity and the authors' algorithm for the use of free functional muscle transfer are also included in this article. PMID:27094895

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2003-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  18. Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC).

    PubMed

    Abdullah, B J J; Mohammad, N; Sangkar, J V; Abd Aziz, Y F; Gan, G G; Goh, K Y; Benedict, I

    2005-07-01

    The objective of this study was to prospectively determine the incidence of venous thrombosis (VT) in the upper limbs in patients with peripherally inserted central catheters (PICC). We prospectively investigated the incidence of VT in the upper limbs of 26 patients who had PICC inserted. The inclusion criteria were all patients who had a PICC inserted, whilst the exclusion criterion was the inability to perform a venogram (allergies, previous contrast medium reaction and inability of gaining venous access). Both valved and non-valved catheters were evaluated. Prior to removal of the PICC, an upper limb venogram was performed. The number of segments involved with VT were determined. The duration of central venous catheterization was classified as; less than 6 days, between 6 days and 14 days and more than 14 days. VT was confirmed in 38.5% (10/26) of the patients. The majority 85.7% (12/14) were complete occlusive thrombi and the majority of VT only involved one segment. There was no statistical correlation between the site of insertion of the PICC and the location of VT. Neither was there any observed correlation between the occurrence of VT with the patient's history of hypertension, hypercholesterolaemia, coronary artery disease, diabetes mellitus, cardiac insufficiency, smoking or cancer. There was also no statistical correlation with the size of the catheter. In conclusion, PICCs are associated with a significant risk of upper extremity deep vein thrombosis (UEVT).

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

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

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

  20. The influence of footwear on the electromyographic activity of selected lower limb muscles during walking.

    PubMed

    Scott, Lisa A; Murley, George S; Wickham, James B

    2012-12-01

    The purpose of this study was to compare the effects of a standard flexible shoe and a stability running shoe on lower limb muscle activity during walking. Twenty-eight young asymptomatic adults with flat-arched feet were recruited. While walking, electromyographic (EMG) activity was recorded from tibialis posterior and peroneus longus via intramuscular electrodes; and from tibialis anterior and medial gastrocnemius via surface electrodes. Three experimental conditions were assessed: (i) barefoot, (ii) a standard flexible shoe, (iii) a stability running shoe. Results showed significant differences for the peak amplitude and the time of peak amplitude for tibialis anterior, peroneus longus and medial gastrocnemius when comparing the three experimental conditions (p < 0.05). Significant differences were detected primarily between the barefoot and shoe conditions and with relatively small effect sizes for peroneus longus, tibialis anterior and medial gastrocnemius. Few significant differences were found between the two shoe styles. We discuss how these changes are most likely associated with the shoe upper bracing the foot, the shape of the shoe outer-sole and weight of the shoes. Further research is needed to investigate differences between these shoe styles when participants walk for longer distances (i.e. over 1000 m) and following fatigue.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Higham, Timothy E.; Biewener, Andrew A.

    2008-01-01

    Muscle fatigue, a reduction in force as a consequence of exercise, is an important factor for any animal that moves, and can result from both peripheral and/or central mechanisms. Although much is known about whole-limb force generation and activation patterns in fatigued muscles under sustained isometric contractions, little is known about the in vivo dynamics of limb muscle function in relation to whole-body fatigue. Here we show that limb kinematics and contractile function in the lateral (LG) and medial (MG) gastrocnemius of helmeted guineafowl (Numida meleagris) are significantly altered following fatiguing exercise at 2 m s−1 on an inclined treadmill. The two most significant findings were that the variation in muscle force generation, measured directly from the muscles' tendons, increased significantly with fatigue, and fascicle shortening in the proximal MG, but not the distal MG, decreased significantly with fatigue. We suggest that the former is a potential mechanism for decreased stability associated with fatigue. The region-specific alteration of fascicle behaviour within the MG as a result of fatigue suggests a complex response to fatigue that probably depends on muscle–aponeurosis and tendon architecture not previously explored. These findings highlight the importance of studying the integrative in vivo dynamics of muscle function in response to fatigue. PMID:19129096

  3. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club.

  4. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club. PMID:26197882

  5. Audio-Visual Stimulation in Conjunction with Functional Electrical Stimulation to Address Upper Limb and Lower Limb Movement Disorder.

    PubMed

    Kumar, Deepesh; Verma, Sunny; Bhattacharya, Sutapa; Lahiri, Uttama

    2016-06-13

    Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder. PMID:27478568

  6. Audio-Visual Stimulation in Conjunction with Functional Electrical Stimulation to Address Upper Limb and Lower Limb Movement Disorder

    PubMed Central

    Kumar, Deepesh; Verma, Sunny; Bhattacharya, Sutapa; Lahiri, Uttama

    2016-01-01

    Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder. PMID:27478568

  7. Haptic Neurorehabilitation and Virtual Reality for Upper Limb Paralysis: A Review.

    PubMed

    Piggott, Leah; Wagner, Samantha; Ziat, Mounia

    2016-01-01

    Motor and sensory loss or dysfunction affects the quality of life for thousands of individuals daily. The upper limb, and especially the hand, are important for a person's ability to complete activities of daily living. Traditional therapy methods focus on motor recovery, but future methods should include sensory recovery and should promote the use of the affected limb(s) at home. In this review, we highlight the current state-of-art robotic devices for the upper limb, and we discuss benefits of including haptic feedback and virtual reality environments during neurorehabilitation. Robotic devices, such as end-effector devices, grounded and ungrounded exoskeletons, have been developed to assist with various functions including individual finger, whole hand, and shoulder movements. Many robots highlighted in this paper are inexpensive and are small enough to be in a patient's home, or allow for telerehabilitation. Virtual reality creates safe environments for patients to practice motor movements and interactive games improve enjoyment of therapy. Haptic feedback creates more immersive virtual reality, and contributes to the recovery of sensory function. Physiological studies conducted after brain trauma and with robotic devices contribute to the understanding of brain plasticity, and illustrate the efficacy of these technologies. We conclude by addressing the future direction of neurorehabilitation research. PMID:27652449

  8. Haptic Neurorehabilitation and Virtual Reality for Upper Limb Paralysis: A Review.

    PubMed

    Piggott, Leah; Wagner, Samantha; Ziat, Mounia

    2016-01-01

    Motor and sensory loss or dysfunction affects the quality of life for thousands of individuals daily. The upper limb, and especially the hand, are important for a person's ability to complete activities of daily living. Traditional therapy methods focus on motor recovery, but future methods should include sensory recovery and should promote the use of the affected limb(s) at home. In this review, we highlight the current state-of-art robotic devices for the upper limb, and we discuss benefits of including haptic feedback and virtual reality environments during neurorehabilitation. Robotic devices, such as end-effector devices, grounded and ungrounded exoskeletons, have been developed to assist with various functions including individual finger, whole hand, and shoulder movements. Many robots highlighted in this paper are inexpensive and are small enough to be in a patient's home, or allow for telerehabilitation. Virtual reality creates safe environments for patients to practice motor movements and interactive games improve enjoyment of therapy. Haptic feedback creates more immersive virtual reality, and contributes to the recovery of sensory function. Physiological studies conducted after brain trauma and with robotic devices contribute to the understanding of brain plasticity, and illustrate the efficacy of these technologies. We conclude by addressing the future direction of neurorehabilitation research.

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

    PubMed

    Siriphorn, Akkradate; Chamonchant, Dannaovarat

    2015-01-01

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

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

    PubMed

    Siriphorn, Akkradate; Chamonchant, Dannaovarat

    2015-01-01

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

  11. Music Upper Limb Therapy—Integrated: An Enriched Collaborative Approach for Stroke Rehabilitation

    PubMed Central

    Raghavan, Preeti; Geller, Daniel; Guerrero, Nina; Aluru, Viswanath; Eimicke, Joseph P.; Teresi, Jeanne A.; Ogedegbe, Gbenga; Palumbo, Anna; Turry, Alan

    2016-01-01

    Stroke is a leading cause of disability worldwide. It leads to a sudden and overwhelming disruption in one’s physical body, and alters the stroke survivors’ sense of self. Long-term recovery requires that bodily perception, social participation and sense of self are restored; this is challenging to achieve, particularly with a single intervention. However, rhythmic synchronization of movement to external stimuli facilitates sensorimotor coupling for movement recovery, enhances emotional engagement and has positive effects on interpersonal relationships. In this proof-of-concept study, we designed a group music-making intervention, Music Upper Limb Therapy-Integrated (MULT-I), to address the physical, psychological and social domains of rehabilitation simultaneously, and investigated its effects on long-term post-stroke upper limb recovery. The study used a mixed-method pre-post design with 1-year follow up. Thirteen subjects completed the 45-min intervention twice a week for 6 weeks. The primary outcome was reduced upper limb motor impairment on the Fugl-Meyer Scale (FMS). Secondary outcomes included sensory impairment (two-point discrimination test), activity limitation (Modified Rankin Scale, MRS), well-being (WHO well-being index), and participation (Stroke Impact Scale, SIS). Repeated measures analysis of variance (ANOVA) was used to test for differences between pre- and post-intervention, and 1-year follow up scores. Significant improvement was found in upper limb motor impairment, sensory impairment, activity limitation and well-being immediately post-intervention that persisted at 1 year. Activities of daily living and social participation improved only from post-intervention to 1-year follow up. The improvement in upper limb motor impairment was more pronounced in a subset of lower functioning individuals as determined by their pre-intervention wrist range of motion. Qualitatively, subjects reported new feelings of ownership of their impaired limb, more

  12. Contribution of oxidative stress to pathology in diaphragm and limb muscles with Duchenne muscular dystrophy.

    PubMed

    Kim, Jong-Hee; Kwak, Hyo-Bum; Thompson, LaDora V; Lawler, John M

    2013-02-01

    Duchenne muscular dystrophy (DMD) is a degenerative skeletal muscle disease that makes walking and breathing difficult. DMD is caused by an X-linked (Xp21) mutation in the dystrophin gene. Dystrophin is a scaffolding protein located in the sarcolemmal cytoskeleton, important in maintaining structural integrity and regulating muscle cell (muscle fiber) growth and repair. Dystrophin deficiency in mouse models (e.g., mdx mouse) destabilizes the interface between muscle fibers and the extracellular matrix, resulting in profound damage, inflammation, and weakness in diaphragm and limb muscles. While the link between dystrophin deficiency with inflammation and pathology is multi-factorial, elevated oxidative stress has been proposed as a central mediator. Unfortunately, the use of non-specific antioxidant scavengers in mouse and human studies has led to inconsistent results, obscuring our understanding of the importance of redox signaling in pathology of muscular dystrophy. However, recent studies with more mechanistic approaches in mdx mice suggest that NAD(P)H oxidase and nuclear factor-kappaB are important in amplifying dystrophin-deficient muscle pathology. Therefore, more targeted antioxidant therapeutics may ameliorate damage and weakness in human population, thus promoting better muscle function and quality of life. This review will focus upon the pathobiology of dystrophin deficiency in diaphragm and limb muscle primarily in mouse models, with a rationale for development of targeted therapeutic antioxidants in DMD patients.

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

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

  14. Proprioceptive rehabilitation of upper limb dysfunction in movement disorders: a clinical perspective.

    PubMed

    Abbruzzese, Giovanni; Trompetto, Carlo; Mori, Laura; Pelosin, Elisa

    2014-01-01

    Movement disorders (MDs) are frequently associated with sensory abnormalities. In particular, proprioceptive deficits have been largely documented in both hypokinetic (Parkinson's disease) and hyperkinetic conditions (dystonia), suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilitation has become an essential element in the management of patients with MDs, and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using "task-intrinsic" or "augmented feedback." This perspective article reviews the available evidence on the effects of proprioceptive stimulation in improving upper limb mobility in patients with MDs and highlights the emerging innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception.

  15. [Kinematics Modeling and Analysis of Central-driven Robot for Upper Limb Rehabilitation after Stroke].

    PubMed

    Yi, Jinhua; Yu, Hongliu; Zhang, Ying; Hu, Xin; Shi, Ping

    2015-12-01

    The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation. PMID:27079086

  16. Proprioceptive Rehabilitation of Upper Limb Dysfunction in Movement Disorders: A Clinical Perspective

    PubMed Central

    Abbruzzese, Giovanni; Trompetto, Carlo; Mori, Laura; Pelosin, Elisa

    2014-01-01

    Movement disorders (MDs) are frequently associated with sensory abnormalities. In particular, proprioceptive deficits have been largely documented in both hypokinetic (Parkinson’s disease) and hyperkinetic conditions (dystonia), suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilitation has become an essential element in the management of patients with MDs, and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using “task-intrinsic” or “augmented feedback.” This perspective article reviews the available evidence on the effects of proprioceptive stimulation in improving upper limb mobility in patients with MDs and highlights the emerging innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception. PMID:25505402

  17. 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

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

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

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

  19. A mass-length scaling law for modeling muscle strength in the lower limb.

    PubMed

    Correa, Tomas A; Pandy, Marcus G

    2011-11-10

    Musculoskeletal computer models are often used to study muscle function in children with and without impaired mobility. Calculations of muscle forces depend in part on the assumed strength of each muscle, represented by the peak isometric force parameter, which is usually based on measurements obtained from cadavers of adult donors. The aim of the present study was twofold: first, to develop a method for scaling lower-limb peak isometric muscle forces in typically-developing children; and second, to determine the effect of this scaling method on model calculations of muscle forces obtained for normal gait. Muscle volumes were determined from magnetic resonance (MR) images obtained from ten children aged from 7 to 13yr. A new mass-length scaling law was developed based on the assumption that muscle volume and body mass are linearly related, which was confirmed by the obtained volume and body mass data. Two musculoskeletal models were developed for each subject: one in which peak isometric muscle forces were estimated using the mass-length scaling law; and another in which these parameters were determined directly from the MR-derived muscle volumes. Musculoskeletal modeling and quantitative gait analysis were then used to calculate lower-limb muscle forces in normal walking. The patterns of muscle forces predicted by the model with scaled peak isometric force values were similar to those predicted by the MR-based model, implying that assessments of muscle function obtained from these two methods are practically equivalent. These results support the use of mass-length scaling in the development of subject-specific musculoskeletal models of children.

  20. Development and testing of new upper-limb prosthetic devices: research designs for usability testing.

    PubMed

    Resnik, Linda

    2011-01-01

    The purposes of this article are to describe usability testing and introduce designs and methods of usability testing research as it relates to upper-limb prosthetics. This article defines usability, describes usability research, discusses research approaches to and designs for usability testing, and highlights a variety of methodological considerations, including sampling, sample size requirements, and usability metrics. Usability testing is compared with other types of study designs used in prosthetic research.

  1. Customized Monitoring and Interaction Devices in Virtual Environments for Upper Limb Rehabilitation After Brain Injury.

    PubMed

    Ontiveros-Ravell, Julio; Molina, Fernando; Almenara-Masbernat, Maria; Soriano, Ignasi; Opisso, Eloy; Hernando, M Elena; Tormos, Josep Maria; Medina, Josep; Gómez, Enrique J

    2016-01-01

    This paper introduces a new approach for upper limb neurorehabilitation based on customized devices for monitoring and interacting with virtual environments. A proof-of-concept test involving eight patients at the Guttmann Neurorehabilitation Hospital shows patient's good acceptance and usability scores and demonstrates the technically feasibility of the devices. The final goal is to achieve a more personalized, monitored, intensive and ecological rehabilitation procedures for ABI patients. PMID:27350460

  2. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    PubMed Central

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-08-01

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

  5. Traumatic upper limb injuries during the Men's Field Hockey Junior World Cup 2009.

    PubMed

    Mukherjee, Swarup

    2013-01-01

    This study was a prospective epidemiological investigation of upper limb injuries during the Men's Field Hockey Junior World Cup 2009. Three hundred twenty-four players were observed in 58 matches of the tournament. Twenty-eight upper limb-related injuries were documented. The injury incidence was 0.48 per match and 19 per 1,000 match hours. Most injuries were due to contact with the ball, and the left hand was the most commonly injured part. Contusion was the most common type of injury. The odds ratio for hand and wrist injuries in players not wearing gloves was 4.01 (95% CI, 0.52-30.62), and the relative risk of hand and wrist injuries in players wearing gloves was 0.26 (95% CI, 0.03-1.92). Male youth hockey players are at a high risk of upper limb, especially hand and wrist, injuries during major international tournaments and that use of protective gloves can provide significant protection against hand and wrist injuries in the sport. PMID:24067118

  6. Reorganizing therapy: changing the clinical approach to upper limb recovery post-stroke.

    PubMed

    Hubbard, Isobel J; Carey, Leeanne M; Budd, Timothy W; Parsons, Mark W

    2015-03-01

    Stroke is the leading cause of adult disability, and as a consequence, most therapists will provide health care to patients with stroke during their professional careers. An increasing number of studies are investigating the association between upper limb recovery and changes in brain activation patterns following stroke. In this review, we explore the translational implications of this research for health professionals working in stroke recovery. We argue that in light of the most recent evidence, therapists should consider how best to take full advantage of the brain's natural ability to reorganize, when prescribing and applying interventions to those with a stroke-affected upper limb. The authors propose that stroke is a brain-based problem that needs a brain-based solution. This review addresses two topics, anticipating recovery and maximizing recovery. It proposes five practice-ready recommendations that are based on the evidence reviewed. The over-riding aim of this review and discussion is to challenge therapists to reconsider the health care they prescribe and apply to people with a stroke-affected upper limb.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Mészáros, Gabriella; Vén, Ildikó

    2015-01-01

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

  9. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke. PMID:27630418

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

    PubMed

    Dermitzakis, Konstantinos; Arieta, Alejandro Hernandez; Pfeifer, Rolf

    2011-01-01

    One of the significant challenges in the upper-limb-prosthetics research field is to identify appropriate interfaces that utilize the full potential of current state-of-the-art neuroprostheses. As the new generation of such prostheses paces towards approximating the human physiological performance in terms of movement dexterity and sensory feedback, it is clear that current non-invasive interfaces are still severely limited. Surface electromyography, the interface ubiquitously used in the field, is riddled with several shortcomings. Gesture recognition, an interface pervasively used in wearables and mobile devices, shows a strong potential as a non-invasive upper-limb prosthetic interface. This study aims at showcasing its potential in the field by using gyroscope sensors. To this end, we (1) explore the viability of Dynamic Time Warping as a classification method for upper-limb prosthetics and (2) look for appropriate sensor locations on the body. Results indicate an optimal classification rate of 97.53%, σ = 8.74 using a sensor located proximal to the endpoint performing a gesture.

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

    PubMed Central

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

    2015-01-01

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

  12. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke.

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Waidhofer, M; Kirchengast, S

    2015-12-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2013-06-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1987-01-01

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

  19. Role of Brain-Derived Neurotrophic Factor in Beneficial Effects of Repetitive Transcranial Magnetic Stimulation for Upper Limb Hemiparesis after Stroke

    PubMed Central

    Kakuda, Wataru; Miyano, Satoshi; Momosaki, Ryo; Abo, Masahiro

    2016-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) can improve upper limb hemiparesis after stroke but the mechanism underlying its efficacy remains elusive. rTMS seems to alter brain-derived neurotrophic factor (BDNF) and such effect is influenced by BDNF gene polymorphism. Objectives To investigate the molecular effects of rTMS on serum levels of BDNF, its precursor proBDNF and matrix metalloproteinase-9 (MMP-9) in poststroke patients with upper limb hemiparesis. Methods Poststroke patients with upper limb hemiparesis were studied. Sixty-two patients underwent rehabilitation plus rTMS combination therapy and 33 patients underwent rehabilitation monotherapy without rTMS for 14 days at our hospital. One Hz rTMS was applied over the motor representation of the first dorsal interosseous muscle on the non-lesional hemisphere. Fugl-Meyer Assessment and Wolf Motor Function (WMFT) were used to evaluate motor function on the affected upper limb before and after intervention. Blood samples were collected for analysis of BDNF polymorphism and measurement of BDNF, proBDNF and MMP-9 levels. Results Two-week combination therapy increased BDNF and MMP-9 serum levels, but not serum proBDNF. Serum BDNF and MMP-9 levels did not correlate with motor function improvement, though baseline serum proBDNF levels correlated negatively and significantly with improvement in WMFT (ρ = -0.422, p = 0.002). The outcome of rTMS therapy was not altered by BDNF gene polymorphism. Conclusions The combination therapy of rehabilitation plus low-frequency rTMS seems to improve motor function in the affected limb, by activating BDNF processing. BDNF and its precursor proBDNF could be potentially suitable biomarkers for poststroke motor recovery. PMID:27007747

  20. Upper body muscle strength and batting performance in cricket batsmen.

    PubMed

    Taliep, Mogammad S; Prim, Sebastian K; Gray, Janine

    2010-12-01

    The aim of this study was to determine if upper body muscle strength (as measured by the 1 repetition maximum bench press) was associated with cricket batting performance. Cricket batting performance was defined by the maximum hitting distance during a batting task and batting average and strike rate during 1-Day and Twenty/20 (T/20) matches. Eighteen, provincial level, elite cricket batsmen participated in the study. Upper body muscle strength was found to be positively correlated with maximum hitting distance (p = 0.0052). There were no significant correlations between upper body strength, batting average, and strike rate for both the 1-Day and T/20 matches. The results of this study have implications for coaches choosing a particular batting line-up. Batsmen who have stronger upper bodies could be favored to bat when a match situation requires them to hit powerful strokes resulting in boundaries. However, coaches cannot use upper body strength as a predictor of overall batting performance in 1-Day or T/20 matches.

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

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

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

  2. Kinematic upper limb evaluation of children and adolescents with cerebral palsy: a systematic review of the literature

    PubMed Central

    Franco de Moura, Renata Calhes; Almeida, Cibele Santos; Dumont, Arislander Jonatan Lopes; Lazzari, Roberta Delasta; Lopes, Jamile Benite Palma; Duarte, Natalia Almeida de Carvalho; Braun, Luiz Ferreira; Oliveira, Claudia Santos

    2016-01-01

    [Purpose] The aim of the present study was to perform a review of the literature on objective measures of upper limb movements in children and adolescents with cerebral palsy and describe the methods used to investigate upper limb kinematics in this population. [Materials and Methods] An extensive database search was performed using the keywords kinematics, upper limb, and cerebral palsy. A total of 146 papers were identified, but only five met the inclusion criteria. [Results] No consensus was found regarding the data collection, processing, and analysis procedures or reporting of the results. [Conclusion] Standardization of the protocol for 3D upper limb movement analysis will provide the foundation for comparable, reproducible results and eventually facilitate the planning of treatment interventions. PMID:27065566

  3. P300-amplitudes in upper limb amputees with and without phantom limb pain in a visual oddball paradigm.

    PubMed

    Karl, Anke; Diers, Martin; Flor, Herta

    2004-07-01

    The aim of the study was to investigate to what extent cortical hyper-reactivity to visual stimuli is present in upper limb amputees. Five amputees with phantom limb pain (PLP), five amputees without PLP (Non-PLP) and 10 healthy controls (HC) were investigated using a visual oddball paradigm. Two hundred visual stimuli were presented with target stimuli occurring at a probability of 25% and standard stimuli at a probability of 75%. Event-related potentials were recorded from nine scalp positions (F3, F4, Fz, C3, C4, Cz, P3, P4, Pz). The PLP-patients had significantly higher P300-amplitudes to both types of stimuli compared to the non-PLP-patients. The HC were not significantly different from both amputee groups. P300-amplitude to targets at frontal sites in the hemisphere contralateral to the amputation was higher in the PLP patients. P300-latencies to target stimuli differed only at frontal sites with PLP-patients showing significantly longer latencies than non-PLP-patients. To standard stimuli, however, they showed significantly shorter latencies at central and parietal scalp positions. The HC had significantly shorter latencies than both amputee groups. The size of the P300-amplitude was positively correlated with the intensity of PLP. These findings suggest a higher magnitude of non-specific cortical excitability in amputees with PLP and a reduced excitability in amputees without PLP. This extends previous findings of differences in cortical excitability in PLP and non-PLP patients in the sensorimotor domain.

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

    PubMed Central

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

    2014-01-01

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

  5. Impact of obstructive apnea syndrome on upper airway respiratory muscles.

    PubMed

    Svanborg, Eva

    2005-07-28

    This article reviews studies of upper airway muscles in humans, with emphasis on muscle fiber structural and electrophysiological changes observed in patients with obstructive sleep apnea syndrome (OSAS). The concept of OSAS as a progressive disease is discussed and also possible causes. These include local nervous lesions in the upper airway, both motor and sensory. Previous muscle biopsy studies have given evidence for motor neuron lesions such as, e.g., the phenomenon of type grouping in histological sections. New data obtained with concentric needle EMG recordings from the palatopharyngeus muscles are also presented. In 10/12 OSAS patients there were typical findings indicating motor neuropathy (reduced EMG activity at maximal voluntary effort, long and polyphasic motor-unit potentials and, in two cases, spontaneous denervation activity), whereas such findings were only present in 3/15 patients with habitual snoring. This supports the hypothesis that progression from habitual snoring to the clinical disease of OSAS could be attributed to peripheral neurogenic lesions. PMID:16054444

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  7. Viscoelastic model for redundancy resolution of the human arm via the swivel angle: applications for upper limb exoskeleton control.

    PubMed

    Kim, Hyunchul; Roldan, Jay Ryan; Li, Zhi; Rosen, Jacob

    2012-01-01

    One of the key research efforts associated with a redundant seven degree of freedom (7-DOF) upper limb exoskeleton robot that is mechanically coupled to the human body is to develop high and low level control algorithms that enable the system to become a natural extension of the human body. Improving the synergistic relationship between the exoskeleton and the operator is manifested in part by decreasing the force exchange between the two entities. Such a reduction is accomplished in part by developing criteria for resolving the human arm redundancy. The redundancy may be represented by a swivel angle which is defined as the angular rotation of the elbow around an axis that passes through the shoulder and wrist joints. The proposed criteria for defining the swivel angle takes into account the dynamics of the human arm along with a viscoelastic muscle-like model with variable damping. The swivel angle is estimated using the pseudo-inverse of the Jacobian with a secondary objective function that estimates the desired joint angles during human arm movement. The result is then fed to the muscle model to create a more realistic human motion. The estimated swivel angle is then compared with the actual swivel angle measured experimentally by a motion capture system. Results indicate that the average error between the estimated and measured swivel joint angle is 4.4 degrees (in the range [3.7-6] degrees), which are lower than the kinematically based redundant resolution criterion. PMID:23367411

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

    PubMed Central

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

    2015-01-01

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

  9. A comparison of the moment arms of pelvic limb muscles in horses bred for acceleration (Quarter Horse) and endurance (Arab)

    PubMed Central

    Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wilson, A M; Hodson-Tole, E; Payne, R C

    2010-01-01

    Selective breeding for performance has resulted in distinct breeds of horse, such as the Quarter Horse (bred for acceleration) and the Arab (bred for endurance). Rapid acceleration, seen during Quarter Horse racing, requires fast powerful muscular contraction and the generation of large joint torques, particularly by the hind limb muscles. This study compared hind limb moment arm lengths in the Quarter Horse and Arab. We hypothesized that Quarter Horse hind limb extensor muscles would have longer moment arms when compared to the Arab, conferring a greater potential for torque generation at the hip, stifle and tarsus during limb extension. Six Quarter Horse and six Arab hind limbs were dissected to determine muscle moment arm lengths for the following muscles: gluteus medius, biceps femoris, semitendinosus, vastus lateralis, gastrocnemius (medialis and lateralis) and tibialis cranialis. The moment arms of biceps femoris (acting at the hip) and gastrocnemius lateralis (acting at the stifle) were significantly longer in the Quarter Horse, although the length of the remaining muscle moment arms were similar in both breeds of horse. All the Quarter Horse muscles were capable of generating greater muscle moments owing to their greater physiological cross-sectional area (PCSA) and therefore greater isometric force potential, which suggests that PCSA is a better determinant of muscle torque than moment arm length in these two breeds of horse. With the exception of gastrocnemius and tibialis cranialis, the observed muscle fascicle length to moment arm ratio (MFL : MA ratio) was greater for the Arab horse muscles. It appears that the Arab muscles have the potential to operate at slower velocities of contraction and hence generate greater force outputs when compared to the Quarter Horse muscles working over a similar range of joint motion; this would indicate that Arab hind limb muscles are optimized to function at maximum economy rather than maximum power output. PMID

  10. A comparison of the moment arms of pelvic limb muscles in horses bred for acceleration (Quarter Horse) and endurance (Arab).

    PubMed

    Crook, T C; Cruickshank, S E; McGowan, C M; Stubbs, N; Wilson, A M; Hodson-Tole, E; Payne, R C

    2010-07-01

    Selective breeding for performance has resulted in distinct breeds of horse, such as the Quarter Horse (bred for acceleration) and the Arab (bred for endurance). Rapid acceleration, seen during Quarter Horse racing, requires fast powerful muscular contraction and the generation of large joint torques, particularly by the hind limb muscles. This study compared hind limb moment arm lengths in the Quarter Horse and Arab. We hypothesized that Quarter Horse hind limb extensor muscles would have longer moment arms when compared to the Arab, conferring a greater potential for torque generation at the hip, stifle and tarsus during limb extension. Six Quarter Horse and six Arab hind limbs were dissected to determine muscle moment arm lengths for the following muscles: gluteus medius, biceps femoris, semitendinosus, vastus lateralis, gastrocnemius (medialis and lateralis) and tibialis cranialis. The moment arms of biceps femoris (acting at the hip) and gastrocnemius lateralis (acting at the stifle) were significantly longer in the Quarter Horse, although the length of the remaining muscle moment arms were similar in both breeds of horse. All the Quarter Horse muscles were capable of generating greater muscle moments owing to their greater physiological cross-sectional area (PCSA) and therefore greater isometric force potential, which suggests that PCSA is a better determinant of muscle torque than moment arm length in these two breeds of horse. With the exception of gastrocnemius and tibialis cranialis, the observed muscle fascicle length to moment arm ratio (MFL : MA ratio) was greater for the Arab horse muscles. It appears that the Arab muscles have the potential to operate at slower velocities of contraction and hence generate greater force outputs when compared to the Quarter Horse muscles working over a similar range of joint motion; this would indicate that Arab hind limb muscles are optimized to function at maximum economy rather than maximum power output.

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

    PubMed

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

    2014-02-15

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

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

    PubMed

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

    2014-02-15

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

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

    PubMed

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

    2015-10-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  15. Muscle coordination limits efficiency and power output of human limb movement under a wide range of mechanical demands.

    PubMed

    Blake, Ollie M; Wakeling, James M

    2015-12-01

    This study investigated the influence of cycle frequency and workload on muscle coordination and the ensuing relationship with mechanical efficiency and power output of human limb movement. Eleven trained cyclists completed an array of cycle frequency (cadence)-power output conditions while excitation from 10 leg muscles and power output were recorded. Mechanical efficiency was maximized at increasing cadences for increasing power outputs and corresponded to muscle coordination and muscle fiber type recruitment that minimized both the total muscle excitation across all muscles and the ineffective pedal forces. Also, maximum efficiency was characterized by muscle coordination at the top and bottom of the pedal cycle and progressive excitation through the uniarticulate knee, hip, and ankle muscles. Inefficiencies were characterized by excessive excitation of biarticulate muscles and larger duty cycles. Power output and efficiency were limited by the duration of muscle excitation beyond a critical cadence (120-140 rpm), with larger duty cycles and disproportionate increases in muscle excitation suggesting deteriorating muscle coordination and limitations of the activation-deactivation capabilities. Most muscles displayed systematic phase shifts of the muscle excitation relative to the pedal cycle that were dependent on cadence and, to a lesser extent, power output. Phase shifts were different for each muscle, thereby altering their mechanical contribution to the pedaling action. This study shows that muscle coordination is a key determinant of mechanical efficiency and power output of limb movement across a wide range of mechanical demands and that the excitation and coordination of the muscles is limited at very high cycle frequencies.

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

    NASA Astrophysics Data System (ADS)

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

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

  17. Two anatomic resources of canine pelvic limb muscles based on CT and MRI.

    PubMed

    Sunico, Sarena K; Hamel, Corentin; Styner, Martin; Robertson, Ian D; Kornegay, Joe N; Bettini, Chris; Parks, Jerry; Wilber, Kathy; Smallwood, J Edgar; Thrall, Donald E

    2012-01-01

    Advances in magnetic resonance (MR) imaging and three-dimensional (3D) modeling software provide the tools necessary to create sophisticated, interactive anatomic resources that can assist in the interpretation of MR images of extremities, and learning the structure and function of limb musculature. Modeling provides advantages over dissection or consultation of print atlases because of the associated speed, flexibility, 3D nature, and elimination of superimposed arrows and labels. Our goals were to create a diagnostic atlas of pelvic limb muscles that will facilitate interpretation of MR images of patients with muscle injury and to create a 3D model of the canine pelvic limb musculature to facilitate anatomic learning. To create these resources, we used structural segmentation of MR images, a process that groups image pixels into anatomically meaningful regions. The Diagnostic Atlas is an interactive, multiplanar, web-based MR atlas of the canine pelvic limb musculature that was created by manually segmenting clinically analogous MR sequences. Higher resolution volumetric MR and computed tomography (CT) data were segmented into separately labeled volumes of data and then transformed into a multilayered 3D computer model. The 3D Model serves as a resource for students of gross anatomy, encouraging integrative learning with its highly interactive and selective display capabilities. For clinicians, the 3D Model also serves to bridge the gap between topographic and tomographic anatomy, displaying both formats alongside, or even superimposed over each other. Both projects are hosted on an open-access website, http://3dvetanatomy.ncsu.edu/

  18. Inferring muscle functional roles of the ostrich pelvic limb during walking and running using computer optimization

    PubMed Central

    Rubenson, Jonas

    2016-01-01

    Owing to their cursorial background, ostriches (Struthio camelus) walk and run with high metabolic economy, can reach very fast running speeds and quickly execute cutting manoeuvres. These capabilities are believed to be a result of their ability to coordinate muscles to take advantage of specialized passive limb structures. This study aimed to infer the functional roles of ostrich pelvic limb muscles during gait. Existing gait data were combined with a newly developed musculoskeletal model to generate simulations of ostrich walking and running that predict muscle excitations, force and mechanical work. Consistent with previous avian electromyography studies, predicted excitation patterns showed that individual muscles tended to be excited primarily during only stance or swing. Work and force estimates show that ostrich gaits are partially hip-driven with the bi-articular hip–knee muscles driving stance mechanics. Conversely, the knee extensors acted as brakes, absorbing energy. The digital extensors generated large amounts of both negative and positive mechanical work, with increased magnitudes during running, providing further evidence that ostriches make extensive use of tendinous elastic energy storage to improve economy. The simulations also highlight the need to carefully consider non-muscular soft tissues that may play a role in ostrich gait. PMID:27146688

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

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  20. Characterization of multi-joint upper limb movements in a single task to assess bradykinesia.

    PubMed

    Delrobaei, Mehdi; Tran, Stephanie; Gilmore, Greydon; McIsaac, Kenneth; Jog, Mandar

    2016-09-15

    Bradykinesia is a disabling symptom of Parkinson's disease (PD) which presents with slowness of movement. Visual assessment using clinical rating scales is currently the gold standard to assess bradykinesia. Such assessments require multiple separate movements, are subjective, and rely on the ability of the rater to determine frequency and amplitude features of excursion of multiple joints simultaneously. The current study introduces the use of wearable inertial measurement units (IMUs) to characterize full-arm repetitive movements and provide a new index score for bradykinesia severity (BKI) in the upper limbs. The BKI provides an approach to measuring bradykinesia reliably and objectively. Importantly, this index is needed to demonstrate separability between healthy individuals and PD participants, and also between bradykinetic and non-bradykinetic PD participants. Thirteen PD participants and ten age-matched healthy control participants were studied. Using a single upper limb task that activated multiple joints and recordings from angular displacements from all joints, features relevant to demonstrating bradykinesia were extracted and systematically combined to create the total BKI. A strong correlation coefficient was obtained comparing BKI to upper limb UPDRS bradykinesia scores (rs=-0.626, p=0.001). The BKI successfully identified differences between control and PD participants (p=0.018). The BKI was also sensitive enough to identify differences within the PD population, separating PD participants with and without bradykinesia (p<0.001). This study demonstrates the feasibility of using IMU-based motion capture systems and employing the new BKI for quantitative assessment of bradykinesia. This approach when generalized to lower extremity and truncal movements would be able to provide an objective and reproducible whole body bradykinesia index. PMID:27538660

  1. Upper limb prosthesis use and abandonment: a survey of the last 25 years.

    PubMed

    Biddiss, Elaine A; Chau, Tom T

    2007-09-01

    This review presents an analytical and comparative survey of upper limb prosthesis acceptance and abandonment as documented over the past 25 years, detailing areas of consumer dissatisfaction and ongoing technological advancements. English-language articles were identified in a search of Ovid, PubMed, and ISI Web of Science (1980 until February 2006) for key words upper limb and prosthesis. Articles focused on upper limb prostheses and addressing: (i) Factors associated with abandonment; (ii) Rejection rates; (iii) Functional analyses and patterns of wear; and (iv) Consumer satisfaction, were extracted with the exclusion of those detailing tools for outcome measurement, case studies, and medical procedures. Approximately 200 articles were included in the review process with 40 providing rates of prosthesis rejection. Quantitative measures of population characteristics, study methodology, and prostheses in use were extracted from each article. Mean rejection rates of 45% and 35% were observed in the literature for body-powered and electric prostheses respectively in pediatric populations. Significantly lower rates of rejection for both body-powered (26%) and electric (23%) devices were observed in adult populations while the average incidence of non-wear was similar for pediatric (16%) and adult (20%) populations. Documented rates of rejection exhibit a wide range of variance, possibly due to the heterogeneous samples involved and methodological differences between studies. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures in order to promote comprehensive understanding of the factors affecting prosthesis use and abandonment. An enhanced understanding of these factors is needed to optimize prescription practices, guide design efforts, and satiate demand for evidence-based measures of intervention.

  2. Effects of acute and chronic interval sprint exercise performed on a manually propelled treadmill on upper limb vascular mechanics in healthy young men.

    PubMed

    Olver, T Dylan; Reid, Steph M; Smith, Alan R; Zamir, Mair; Lemon, Peter W R; Laughlin, M Harold; Shoemaker, J Kevin

    2016-07-01

    Interval sprint exercise performed on a manually propelled treadmill, where the hands grip the handle bars, engages lower and upper limb skeletal muscle, but little is known regarding the effects of this exercise modality on the upper limb vasculature. We tested the hypotheses that an acute bout of sprint exercise and 6 weeks of training induces brachial artery (BA) and forearm vascular remodeling, favoring a more compliant system. Before and following a single bout of exercise as well as 6 weeks of training three types of vascular properties/methodologies were examined in healthy men: (1) stiffness of the entire upper limb vascular system (pulse wave velocity (PWV); (2) local stiffness of the BA; and (3) properties of the entire forearm vascular bed (determined by a modified lumped parameter Windkessel model). Following sprint exercise, PWV declined (P < 0.01), indices of BA stiffness did not change (P ≥ 0.10), and forearm vascular bed compliance increased and inertance and viscoelasticity decreased (P ≤ 0.03). Following manually propelled treadmill training, PWV remained unchanged (P = 0.31), indices of BA stiffness increased (P ≤ 0.05) and forearm vascular bed viscoelasticity declined (P = 0.02), but resistance, compliance, and inertance remained unchanged (P ≥ 0.10) compared with pretraining values. Sprint exercise induced a more compliant forearm vascular bed, without altering indices of BA stiffness. These effects were transient, as following training the forearm vascular bed was not more compliant and indices of BA stiffness increased. On the basis of these data, we conclude that adaptations to acute and chronic sprint exercise on a manually propelled treadmill are not uniform along the arterial tree in upper limb. PMID:27405970

  3. Effects of acute and chronic interval sprint exercise performed on a manually propelled treadmill on upper limb vascular mechanics in healthy young men.

    PubMed

    Olver, T Dylan; Reid, Steph M; Smith, Alan R; Zamir, Mair; Lemon, Peter W R; Laughlin, M Harold; Shoemaker, J Kevin

    2016-07-01

    Interval sprint exercise performed on a manually propelled treadmill, where the hands grip the handle bars, engages lower and upper limb skeletal muscle, but little is known regarding the effects of this exercise modality on the upper limb vasculature. We tested the hypotheses that an acute bout of sprint exercise and 6 weeks of training induces brachial artery (BA) and forearm vascular remodeling, favoring a more compliant system. Before and following a single bout of exercise as well as 6 weeks of training three types of vascular properties/methodologies were examined in healthy men: (1) stiffness of the entire upper limb vascular system (pulse wave velocity (PWV); (2) local stiffness of the BA; and (3) properties of the entire forearm vascular bed (determined by a modified lumped parameter Windkessel model). Following sprint exercise, PWV declined (P < 0.01), indices of BA stiffness did not change (P ≥ 0.10), and forearm vascular bed compliance increased and inertance and viscoelasticity decreased (P ≤ 0.03). Following manually propelled treadmill training, PWV remained unchanged (P = 0.31), indices of BA stiffness increased (P ≤ 0.05) and forearm vascular bed viscoelasticity declined (P = 0.02), but resistance, compliance, and inertance remained unchanged (P ≥ 0.10) compared with pretraining values. Sprint exercise induced a more compliant forearm vascular bed, without altering indices of BA stiffness. These effects were transient, as following training the forearm vascular bed was not more compliant and indices of BA stiffness increased. On the basis of these data, we conclude that adaptations to acute and chronic sprint exercise on a manually propelled treadmill are not uniform along the arterial tree in upper limb.

  4. Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform.

    PubMed

    Sucar, Luis Enrique; Orihuela-Espina, Felipe; Velazquez, Roger Luis; Reinkensmeyer, David J; Leder, Ronald; Hernández-Franco, Jorge

    2014-05-01

    Virtual reality platforms capable of assisting rehabilitation must provide support for rehabilitation principles: promote repetition, task oriented training, appropriate feedback, and a motivating environment. As such, development of these platforms is a complex process which has not yet reached maturity. This paper presents our efforts to contribute to this field, presenting Gesture Therapy, a virtual reality-based platform for rehabilitation of the upper limb. We describe the system architecture and main features of the platform and provide preliminary evidence of the feasibility of the platform in its current status. PMID:24760913

  5. Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform.

    PubMed

    Sucar, Luis Enrique; Orihuela-Espina, Felipe; Velazquez, Roger Luis; Reinkensmeyer, David J; Leder, Ronald; Hernández-Franco, Jorge

    2014-05-01

    Virtual reality platforms capable of assisting rehabilitation must provide support for rehabilitation principles: promote repetition, task oriented training, appropriate feedback, and a motivating environment. As such, development of these platforms is a complex process which has not yet reached maturity. This paper presents our efforts to contribute to this field, presenting Gesture Therapy, a virtual reality-based platform for rehabilitation of the upper limb. We describe the system architecture and main features of the platform and provide preliminary evidence of the feasibility of the platform in its current status.

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

    PubMed

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

    2013-11-01

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

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

    PubMed

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

    2011-01-01

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

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

    PubMed

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

    1995-05-01

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

  9. Permanent pacing in patients without upper limb venous access: a review of current techniques

    PubMed Central

    Seow, Swee-Chong; Lim, Toon-Wei; Singh, Devinder; Yeo, Wee-Tiong; Kojodjojo, Pipin

    2014-01-01

    Permanent transvenous cardiac pacing is usually accomplished through the upper limb veins. When these are occluded, several other vascular access options exist which include the internal jugular, external jugular, femoral and iliac veins as well as more proximal access of the subclavian veins. Anterograde and retrograde techniques to restore subclavian venous patency has been described. A review of these approaches is undertaken, with a discussion of their pros and cons. Familiarity with these techniques will enable the implanter to perform transvenous pacing when faced with limited vascular access. PMID:27326197

  10. Complex muscle vibration patterns to induce gait-like lower-limb movements: proof of concept.

    PubMed

    Duclos, Cyril; Kemlin, Claire; Lazert, David; Gagnon, Dany; Dyer, Joseph-Omer; Forget, Robert

    2014-01-01

    Muscle vibrations can induce motor responses and illusions of complex movements. However, inducing gait-like cyclical movements and illusions requires the application of multiple fast alternating vibrations to lower-limb muscles. The objectives were (1) to test the feasibility of delivering complex vibrations in a time-organized manner and (2) to illustrate the possibility of inducing alternate gait-in-place-like movements using these vibrations. Patterns of vibration, produced by 12 vibrators applied bilaterally on the flexor and extensor muscle groups of the lower limbs, were based on normal gait kinematics. We tested 1 s and 2 s cycle patterns of vibration. Vibrator responses were assessed using auto- and crosscorrelations and frequency analyses based on accelerometry measurements, and compared between patterns. High auto- (>0.8) and crosscorrelation (>0.6) coefficients demonstrated a good response by the vibrators to the control signal. Vibrations induced cyclical, low-amplitude stepping-in-place movements that mimicked alternate walking movements with both legs, with 1 s and 2 s cycle durations, in one nondisabled participant and one participant with American Spinal Injury Association Impairment Scale B spinal cord injury standing, relaxed, with body-weight support. Electromechanical vibrators can deliver complex cyclical vibrations and trigger gait-like lower-limb movements. These results warrant the application of these vibration patterns on individuals with sensorimotor impairments to test their potential in gait rehabilitation.

  11. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton.

    PubMed

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    and antigravity assistance augments upper limb function and brain activity during rehabilitation exercises and may thus provide a novel restorative framework for severely affected stroke patients. PMID:27555805

  12. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton

    PubMed Central

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    and antigravity assistance augments upper limb function and brain activity during rehabilitation exercises and may thus provide a novel restorative framework for severely affected stroke patients. PMID:27555805

  13. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton.

    PubMed

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    and antigravity assistance augments upper limb function and brain activity during rehabilitation exercises and may thus provide a novel restorative framework for severely affected stroke patients.

  14. Bilateral force transients in the upper limbs evoked by single-pulse microstimulation in the pontomedullary reticular formation.

    PubMed

    Hirschauer, Thomas J; Buford, John A

    2015-04-01

    Neurons in the pontomedullary reticular formation (PMRF) give rise to the reticulospinal tract. The motor output of the PMRF was investigated using stimulus-triggered averaging of electromyography (EMG) and force recordings in two monkeys (M. fascicularis). EMG was recorded from 12 pairs of upper limb muscles, and forces were detected using two isometric force-sensitive handles. Of 150 stimulation sites, 105 (70.0%) produced significant force responses, and 139 (92.5%) produced significant EMG responses. Based on the average flexor EMG onset latency of 8.3 ms and average force onset latency of 15.9 ms poststimulation, an electromechanical delay of ∼7.6 ms was calculated. The magnitude of force responses (∼10 mN) was correlated with the average change in EMG activity (P < 0.001). A multivariate linear regression analysis was used to estimate the contribution of each muscle to force generation, with flexors and extensors exhibiting antagonistic effects. A predominant force output pattern of ipsilateral flexion and contralateral extension was observed in response to PMRF stimulation, with 65.3% of significant ipsilateral force responses directed medially and posteriorly (P < 0.001) and 78.6% of contralateral responses directed laterally and anteriorly (P < 0.001). This novel approach permits direct measurement of force outputs evoked by central nervous system microstimulation. Despite the small magnitude of poststimulus EMG effects, low-intensity single-pulse microstimulation of the PMRF evoked detectable forces. The forces, showing the combined effect of all muscle activity in the arms, are consistent with reciprocal pattern of force outputs from the PMRF detectable with stimulus-triggered averaging of EMG. PMID:25652926

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

    PubMed Central

    Sudoł-Szopińska, Iwona

    2012-01-01

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

  16. Upper limb automatisms differ quantitatively in temporal and frontal lobe epilepsies.

    PubMed

    Silva Cunha, João P; Rémi, Jan; Vollmar, Christian; Fernandes, José M; Gonzalez-Victores, Jose A; Noachtar, Soheyl

    2013-05-01

    We quantitatively evaluated the localizing and lateralizing characteristics of ictal upper limb automatisms (ULAs) in patients with temporal lobe epilepsy (TLE; n=38) and frontal lobe epilepsy (FLE; n=20). Movement speed, extent, length, and duration of ULAs were quantitatively analyzed with motion capturing techniques. Upper limb automatisms had a larger extent (p<0.001), covered more distance (p<0.05), and were faster (p<0.001) in FLE than in TLE. In TLE, the maximum speed of ULAs was higher ipsilaterally than contralaterally (173 vs. 84pixels/s; p=0.02), with no significant difference in FLE (511 vs. 428). The duration of ictal automatisms in relation to the total seizure duration was shorter in TLE than in FLE (median 36% vs. 63%; p<0.001), with no difference in the absolute duration (26s vs. 27s). These results demonstrate that quantitative movement analysis of ULAs differentiates FLE from TLE, which may aid in the localization of the epileptogenic zone. PMID:23545438

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

    Arya, Kamal Narayan; Pandian, Shanta

    2014-10-01

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

  20. Bilateral robots for upper-limb stroke rehabilitation: State of the art and future prospects.

    PubMed

    Sheng, Bo; Zhang, Yanxin; Meng, Wei; Deng, Chao; Xie, Shengquan

    2016-07-01

    Robot-assisted bilateral upper-limb training grows abundantly for stroke rehabilitation in recent years and an increasing number of devices and robots have been developed. This paper aims to provide a systematic overview and evaluation of existing bilateral upper-limb rehabilitation devices and robots based on their mechanisms and clinical-outcomes. Most of the articles studied here were searched from nine online databases and the China National Knowledge Infrastructure (CNKI) from year 1993 to 2015. Devices and robots were categorized as end-effectors, exoskeletons and industrial robots. Totally ten end-effectors, one exoskeleton and one industrial robot were evaluated in terms of their mechanical characteristics, degrees of freedom (DOF), supported control modes, clinical applicability and outcomes. Preliminary clinical results of these studies showed that all participants could gain certain improvements in terms of range of motion, strength or physical function after training. Only four studies supported that bilateral training was better than unilateral training. However, most of clinical results cannot definitely verify the effectiveness of mechanisms and clinical protocols used in robotic therapies. To explore the actual value of these robots and devices, further research on ingenious mechanisms, dose-matched clinical protocols and universal evaluation criteria should be conducted in the future.

  1. Bilateral robots for upper-limb stroke rehabilitation: State of the art and future prospects.

    PubMed

    Sheng, Bo; Zhang, Yanxin; Meng, Wei; Deng, Chao; Xie, Shengquan

    2016-07-01

    Robot-assisted bilateral upper-limb training grows abundantly for stroke rehabilitation in recent years and an increasing number of devices and robots have been developed. This paper aims to provide a systematic overview and evaluation of existing bilateral upper-limb rehabilitation devices and robots based on their mechanisms and clinical-outcomes. Most of the articles studied here were searched from nine online databases and the China National Knowledge Infrastructure (CNKI) from year 1993 to 2015. Devices and robots were categorized as end-effectors, exoskeletons and industrial robots. Totally ten end-effectors, one exoskeleton and one industrial robot were evaluated in terms of their mechanical characteristics, degrees of freedom (DOF), supported control modes, clinical applicability and outcomes. Preliminary clinical results of these studies showed that all participants could gain certain improvements in terms of range of motion, strength or physical function after training. Only four studies supported that bilateral training was better than unilateral training. However, most of clinical results cannot definitely verify the effectiveness of mechanisms and clinical protocols used in robotic therapies. To explore the actual value of these robots and devices, further research on ingenious mechanisms, dose-matched clinical protocols and universal evaluation criteria should be conducted in the future. PMID:27117423

  2. A Pre-Clinical Framework for Neural Control of a Therapeutic Upper-Limb Exoskeleton.

    PubMed

    Blank, Amy; O'Malley, Marcia K; Francisco, Gerard E; Contreras-Vidal, Jose L

    2013-01-01

    In this paper, we summarize a novel approach to robotic rehabilitation that capitalizes on the benefits of patient intent and real-time assessment of impairment. Specifically, an upper-limb, physical human-robot interface (the MAHI EXO-II robotic exoskeleton) is augmented with a non-invasive brain-machine interface (BMI) to include the patient in the control loop, thereby making the therapy 'active' and engaging patients across a broad spectrum of impairment severity in the rehabilitation tasks. Robotic measures of motor impairment are derived from real-time sensor data from the MAHI EXO-II and the BMI. These measures can be validated through correlation with widely used clinical measures and used to drive patient-specific therapy sessions adapted to the capabilities of the individual, with the MAHI EXO-II providing assistance or challenging the participant as appropriate to maximize rehabilitation outcomes. This approach to robotic rehabilitation takes a step towards the seamless integration of BMIs and intelligent exoskeletons to create systems that can monitor and interface with brain activity and movement. Such systems will enable more focused study of various issues in development of devices and rehabilitation strategies, including interpretation of measurement data from a variety of sources, exploration of hypotheses regarding large scale brain function during robotic rehabilitation, and optimization of device design and training programs for restoring upper limb function after stroke.

  3. Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphadenectomy

    PubMed Central

    Haddad, Cinira Assad Simão; Saad, Marcelo; Perez, Maria del Carmen Janeiro; Miranda, Fausto

    2013-01-01

    ABSTRACT Objective: To evaluate alterations in posture and range of motion of the upper limbs in women after mastectomy and lymphadenectomy, submitted to radiotherapy as adjuvant treatment. Methods: Two groups were evaluated: 16 post-mastectomy women with lymphedema of the upper limb and 14 post-mastectomy women without lymphedema. Patients were submitted to analysis made by software, one for posture and the other to measure ranges of movement of the shoulder, elbow, and wrists. The results obtained were compared between the right and left sides, and operated and non-operated sides, and then were submitted to statistical tests. Results: Both groups presented with anteriorization of the trunk. The women with lymphedema had head rotation to the right, protrusion of the left shoulder, and trunk inclination angle smaller on the operated side, besides bilateral elevation of the scapula when compared to the group with no lymphedema. Changes in range of motion were also smaller on the operated side in terms of flexion, abduction, and external rotation of the shoulder for all women, and for those with lymphedema, elbow extension and wrist flexion had a smaller range of motion. Conclusion: Women submitted to mastectomy presented with asymmetries and modifications in posture, and lymphedema seemed to worsen this condition. Additionally, they had deficits in range of motion in the shoulders on the operated side. Women with lymphedema also showed deficits in the elbows and wrist. PMID:24488379

  4. Validation of the transfer function technique for generating central from peripheral upper limb pressure waveform.

    PubMed

    Gallagher, David; Adji, Audrey; O'Rourke, Michael F

    2004-11-01

    Central aortic pressure waveforms can be calculated from the radial artery pressure waveform using a generalized transfer function to correct for pressure wave distortion in the upper limb. Although validated to standards conventionally applied, reservations are still expressed on use of this process, because of the relatively small number of patients from whom appropriate invasive data were obtained. The study described here supplemented such data with noninvasive data obtained from carotid and radial artery tonometry in 439 patients and normal subjects. The carotid-radial artery transfer function was similar to the aortic-radial when allowance was made for wave travel from aorta to carotid artery. The carotid-radial transfer function was identical in male and female individuals, was similar at different arterial pressures and in mature adults. Differences are relatively small, are seen at frequencies where central pressure wave components are small and are similar to those seen with vasodilator agents in invasive studies. Findings provide further support for use of a generalized transfer function to calculate aortic from upper limb pressure and conform with previously established views on vascular impedance. PMID:15533735

  5. Design of a rotational hydroelastic actuator for a powered exoskeleton for upper limb rehabilitation.

    PubMed

    Stienenw, Arno H A; Hekman, Edsko E G; ter Braak, Huub; Aalsma, Arthur M M; van der Helm, Frans C T; van der Kooij, Herman

    2010-03-01

    The goal of this study was to validate the suitability of a novel rotational hydroelastic actuator (rHEA) for use in our new rehabilitation exoskeleton for the upper limbs, the Limpact. The rHEA consists of a rotational hydraulic actuator and a custom-designed symmetric torsion spring in a series-elastic configuration. For rehabilitation therapy and impairment quantification, both compliant impedance control and stiff admittance control modes are possible. In the validation experiments, the torque bandwidth of the rHEA was limited to 18 Hz for a desired 20 N m reference signal (multisine, constant spectrum) due the transport delays in the long flexible tubes between the valve and cylinder. These transport delays also required changes to existing theoretical models to better fit the models on the measured frequency response functions. The (theoretical) measurable torque resolution was better than 0.01 N m and the (validated) delivered torque resolution below 1 N m. After the validation experiments, further iterative improvements resulted in a spring design capable of a maximum output torque of 50 N m with an intrinsic stiffness of 150 N . m/rad and a slightly higher bandwidth. With the design locked, the maximum measurable isometric torque is 100 N m. In conclusion, the rHEA is suitable for upper limb rehabilitation therapy as it matches the desired performance. PMID:19362903

  6. Longitudinal functional and NMR assessment of upper limbs in Duchenne muscular dystrophy

    PubMed Central

    Wary, Claire; Moraux, Amélie; Azzabou, Noura; Decostre, Valérie; Ollivier, Gwenn; Canal, Aurélie; Lilien, Charlotte; Ledoux, Isabelle; Annoussamy, Mélanie; Reguiba, Nacera; Gidaro, Teresa; Le Moing, Anne Gaelle; Cardas, Ruxandra; Voit, Thomas; Carlier, Pierre G.; Servais, Laurent

    2016-01-01

    Objective: To explore the value of nuclear magnetic resonance (NMR) and functional assessments for follow-up of ambulatory and nonambulatory patients with Duchenne muscular dystrophy (DMD). Methods: Twenty-five 53-skippable patients with DMD were included in this study; 15 were nonambulatory at baseline. All patients underwent clinical and functional assessments every 6 months using the Motor Function Measure (MFM), hand grip and key pinch strength, MoviPlate, and NMR spectroscopy and imaging studies. Results: Upper limb distal strength decreased in nonambulatory patients over the period of 1 year; ambulatory patients showed improvement during the same period. The same applied for several NMRS indices, such as phosphocreatine/adenosine triphosphate, which decreased in older patients but increased in younger ambulatory patients. Fat infiltration in the upper limbs increased linearly with age. Almost all NMR and functional assessment results correlated. Conclusions: Our results underscore complementarity of functional and NMR assessments in patients with DMD. Sensitivity to change of various indices may differ according to disease stage. PMID:26888987

  7. A Pre-Clinical Framework for Neural Control of a Therapeutic Upper-Limb Exoskeleton.

    PubMed

    Blank, Amy; O'Malley, Marcia K; Francisco, Gerard E; Contreras-Vidal, Jose L

    2013-01-01

    In this paper, we summarize a novel approach to robotic rehabilitation that capitalizes on the benefits of patient intent and real-time assessment of impairment. Specifically, an upper-limb, physical human-robot interface (the MAHI EXO-II robotic exoskeleton) is augmented with a non-invasive brain-machine interface (BMI) to include the patient in the control loop, thereby making the therapy 'active' and engaging patients across a broad spectrum of impairment severity in the rehabilitation tasks. Robotic measures of motor impairment are derived from real-time sensor data from the MAHI EXO-II and the BMI. These measures can be validated through correlation with widely used clinical measures and used to drive patient-specific therapy sessions adapted to the capabilities of the individual, with the MAHI EXO-II providing assistance or challenging the participant as appropriate to maximize rehabilitation outcomes. This approach to robotic rehabilitation takes a step towards the seamless integration of BMIs and intelligent exoskeletons to create systems that can monitor and interface with brain activity and movement. Such systems will enable more focused study of various issues in development of devices and rehabilitation strategies, including interpretation of measurement data from a variety of sources, exploration of hypotheses regarding large scale brain function during robotic rehabilitation, and optimization of device design and training programs for restoring upper limb function after stroke. PMID:24887296

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

    PubMed Central

    Yoo, Doo Han; Kim, Se Yun

    2015-01-01

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

  9. [Coordination patterns assessed by a continuous measure of joints coupling during upper limb repetitive movements].

    PubMed

    Draicchio, F; Silvetti, A; Ranavolo, A; Iavicoli, S

    2008-01-01

    We analyzed the coordination patterns between elbow, shoulder and trunk in a motor task consisting of reaching out, picking up a cylinder, and transporting it back by using the Dynamical Systems Theory and calculating the continuous relative phase (CRP), a continuous measure of the coupling between two interacting joints. We used an optoelectronic motion analysis system consisting of eight infra-red ray cameras to detect the movements of nine skin-mounted markers. We calculated the root square of the adjusted coefficient of determination, the coefficient of multiple correlation (CMC), in order to investigate the repeatability of the joints coordination. The data confirm that the CNS establishes both synergic (i.e. coupling between shoulder and trunk on the frontal plane) and hierarchical (i.e. coupling between elbow-shoulder-trunk on the horizontal plane) relationships among the available degrees of freedom to overcome the complexity due to motor redundancy. The present study describes a method to investigate the organization of the kinematic degrees of freedom during upper limb multi-joint motor tasks that can be useful to assess upper limb repetitive movements.

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

    PubMed Central

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

    2005-01-01

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

  11. Muscular activity of lower limb muscles associated with working on inclined surfaces.

    PubMed

    Lu, Ming-Lun; Kincl, Laurel; Lowe, Brian; Succop, Paul; Bhattacharya, Amit

    2015-01-01

    This study investigated the effects of visual cues, muscular fatigue, task performance and experience of working on inclined surfaces on activity of postural muscles in the lower limbs associated with maintaining balance on three inclined surfaces - 0°, 14° and 26°. Normalised electromyographic (NEMG) data were collected in 44 professional roofers bilaterally from the rectus femoris, biceps femoris, tibialii anterior and gastrocnemii medial muscle groups. The 50th and 95th percentile NEMG amplitudes were used as EMG variables. Results showed that inclination angle and task performance caused a significant increase in the NEMG amplitudes of all postural muscles. Visual cues were significantly associated with a decrease in the 95th percentile EMG amplitude for the right gastrocnemius medial and tibialis anterior. Fatigue was related to a significant decrease in the NEMG amplitude for the rectus femoris. Experience of working on inclined surfaces did not have a significant effect on the NEMG amplitude.

  12. Kinetics of the upper limb during table tennis topspin forehands in advanced and intermediate players.

    PubMed

    Iino, Yoichi; Kojima, Takeji

    2011-11-01

    The purpose of this study was to determine the significance of mechanical energy generation and transfer in the upper limb in generating the racket speed during table tennis topspin forehands. Nine advanced and eight intermediate table tennis players performed the forehand stroke at maximum effort against light and heavy backspin balls. Five high-speed video cameras operating at 200 fps were used to record the motions of the upper body of the players. The joint forces and torques of the racket arm were determined with inverse dynamics, and the amount of mechanical energy generated and transferred in the arm was determined. The shoulder internal rotation torque exerted by advanced players was significantly larger than that exerted by the intermediate players. Owing to a larger shoulder internal rotation torque, the advanced players transferred mechanical energy from the trunk of the body to the upper arm at a higher rate than the intermediate players could. Regression of the racket speed at ball impact on the energy transfer to the upper arm suggests that increase in the energy transfer may be an important factor for enabling intermediate players to generate a higher racket speed at impact in topspin forehands. PMID:22303787

  13. Kinetics of the upper limb during table tennis topspin forehands in advanced and intermediate players.

    PubMed

    Iino, Yoichi; Kojima, Takeji

    2011-11-01

    The purpose of this study was to determine the significance of mechanical energy generation and transfer in the upper limb in generating the racket speed during table tennis topspin forehands. Nine advanced and eight intermediate table tennis players performed the forehand stroke at maximum effort against light and heavy backspin balls. Five high-speed video cameras operating at 200 fps were used to record the motions of the upper body of the players. The joint forces and torques of the racket arm were determined with inverse dynamics, and the amount of mechanical energy generated and transferred in the arm was determined. The shoulder internal rotation torque exerted by advanced players was significantly larger than that exerted by the intermediate players. Owing to a larger shoulder internal rotation torque, the advanced players transferred mechanical energy from the trunk of the body to the upper arm at a higher rate than the intermediate players could. Regression of the racket speed at ball impact on the energy transfer to the upper arm suggests that increase in the energy transfer may be an important factor for enabling intermediate players to generate a higher racket speed at impact in topspin forehands.

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

    PubMed

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

    2011-01-01

    This case study demonstrates the ability of sensory cortical representations to remap following arm amputation and subsequent targeted reinnervation (TR). Previous human studies have demonstrated functional plasticity in the primary sensory cortex months or years after amputation of the upper arm, forearm, the hand or a single finger, or after subsequent replantation. Targeted reinnervation, a surgical procedure that re-routes inactive, residual sensorimotor nerves previously responsible for innervating the missing limb to alternative muscle groups and skin areas [1-3], has shown the ability to restore a subject's sensation in the reinnervated skin areas. Whether this new technique causes analogous cortical remapping in a similar timeframe as following hand replantation is still unknown. In order to answer this question, high-density electroencephalography was used to study whether the original sensory cortical territory was regained after TR. Before TR, we found that the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain, Two years after TR, the sensory map of the reinnervated median nerve shifted back to a close-to-normal, predominantly contralateral pattern. The overall trend of TR-induced sensory remapping is similar to previous reports related to hand replantation but occurs over a slower timeframe. This relatively slower progress after TR as compared to after hand replantation could be because TR is performed months or even years after amputation, while hand replantation was performed immediately after the injury. This work provides new evidence for long term plasticity in the human brain.

  15. Apparent and Actual Trajectory Control Depend on the Behavioral Context in Upper Limb Motor Tasks.

    PubMed

    Cluff, Tyler; Scott, Stephen H

    2015-09-01

    A central problem in motor neuroscience is to understand how we select, plan, and control motor actions. An influential idea is that the motor system computes and implements a desired limb trajectory, an intermediary control process between the behavioral goal (reach a spatial goal) and motor commands to move the limb. The most compelling evidence for trajectory control is that corrective responses are directed back toward the unperturbed trajectory when the limb is disturbed during movement. However, the idea of trajectory control conflicts with optimal control theories that emphasize goal-directed motor corrections. Here we show that corrective responses in human subjects can deviate back toward the unperturbed trajectory, but these reversals were only present when there were explicit limits on movement time. Our second experiment asked whether trajectory control could be generated if the trajectory was made an explicit goal of the task. Participants countered unexpected loads while reaching to a static goal, tracking a moving target, or maintaining their hand within a visually constrained path to a static goal. Corrective responses were directed back toward the constrained path or to intercept the moving target. However, corrections back to the unperturbed path disappeared when reaching to the static target. Long-latency muscle responses paralleled changes in the behavioral goal in both sets of experiments, but goal-directed responses were delayed by 15-25 ms when tracking the moving goal. Our results show the motor system can behave like a trajectory controller but only if a "desired trajectory" is the goal of the task. Significance statement: One of the most influential ideas in motor control is that the motor system computes a "desired trajectory" when reaching to a spatial goal. Here we revisit the experimental paradigm from seminal papers supporting trajectory control to illustrate that corrective responses appear to return to the original trajectory of the

  16. Influence of mechanical ventilation and sepsis on redox balance in diaphragm, myocardium, limb muscles, and lungs.

    PubMed

    Chacon-Cabrera, Alba; Rojas, Yeny; Martínez-Caro, Leticia; Vila-Ubach, Monica; Nin, Nicolas; Ferruelo, Antonio; Esteban, Andrés; Lorente, José A; Barreiro, Esther

    2014-12-01

    Mechanical ventilation (MV), using high tidal volumes (V(T)), causes lung (ventilator-induced lung injury [VILI]) and distant organ injury. Additionally, sepsis is characterized by increased oxidative stress. We tested whether MV is associated with enhanced oxidative stress in sepsis, the commonest underlying condition in clinical acute lung injury. Protein carbonylation and nitration, antioxidants, and inflammation (immunoblotting) were evaluated in diaphragm, gastrocnemius, soleus, myocardium, and lungs of nonseptic and septic (cecal ligation and puncture 24 hours before MV) rats undergoing MV (n = 7 per group) for 150 minutes using 3 different strategies (low V(T) [V(T) = 9 mL/kg], moderate V(T) [V(T) = 15 mL/kg], and high V(T) [V(T) = 25 mL/kg]) and in nonventilated control animals. Compared with nonventilated control animals, in septic and nonseptic rodents (1) diaphragms, limb muscles, and myocardium of high-V(T) rats exhibited a decrease in protein oxidation and nitration levels, (2) antioxidant levels followed a specific fiber-type distribution in slow- and fast-twitch muscles, (3) tumor necrosis factor α (TNF-α) levels were higher in respiratory and limb muscles, whereas no differences were observed in myocardium, and (4) in lungs, protein oxidation was increased, antioxidants were rather decreased, and TNF-α remained unmodified. In this model of VILI, oxidative stress does not occur in distant organs or skeletal muscles of rodents after several hours of MV with moderate-to-high V(T), whereas protein oxidation levels were increased in the lungs of the animals. Inflammatory events were moderately expressed in skeletal muscles and lungs of the MV rats. Concomitant sepsis did not strongly affect the MV-induced effects on muscles, myocardium, or lungs in the rodents.

  17. Limb and back muscle activity adaptations to tripedal locomotion in dogs.

    PubMed

    Fuchs, Aniela; Anders, Alexandra; Nolte, Ingo; Schilling, Nadja

    2015-10-01

    Alterations in muscle recruitment are key to the functional plasticity of the mammalian locomotor system. One particularly challenging situation quadrupeds may face is when the functionality of a limb is reduced or lost. To better understand how mammals manage in such situations and which muscular adaptations they exhibit when locomoting on three legs, we recorded the activity patterns of two limb and one back extensor muscle in nine dogs using surface electromyography. We compared the timing and the level of recruitment before and after the loss of a hindlimb was simulated. Both the intensity and the timing of the activity changed significantly in the m. vastus lateralis of the remaining hindlimb, consistent with this limb bearing a greater proportion of the body weight as well as with previously reported kinematic changes. In accordance with the greater body weight supported by the forelimbs, the m. triceps brachii showed first and foremost an increased level of excitation. The very asymmetrical changes in the timing and the level of activity in the m. longissimus dorsi reflects the highly asymmetrical functional requirements imposed on the trunk and the pelvis when one hindlimb is no longer involved in the production of locomotor work while the other hindlimb partially compensates the loss. Integration of our electromyographical findings with kinetic and kinematic results illustrates that dogs exhibited a well-coordinated response to the functional requirements of tripedalism and underlines the importance of moment-to-moment modulation in muscular recruitment for the functional plasticity of the mammalian locomotor system.

  18. Muscle involvement in limb-girdle muscular dystrophy with GMPPB deficiency (LGMD2T)

    PubMed Central

    Stojkovic, T.; Dahlqvist, J.R.; Bouchet-Seraphin, C.; Nectoux, J.; Leturcq, F.; Cossée, M.; Solé, G.; Thomsen, C.; Krag, T.O.; Vissing, J.

    2016-01-01

    Objective: In this study, muscle involvement assessed by MRI and levels of GMPPB and glycosylation of α-dystroglycan expression in muscle were examined in patients with limb-girdle muscular dystrophy (LGMD) type 2T. Methods: Six new patients with genetically verified mutations in GMPPB were studied. T1-weighted magnetic resonance images were obtained in 4 participants. Muscle strength and potential involvement of extramuscular organs were examined. Glycosylation of α-dystroglycan in muscle was studied, and GMPPB and α-dystroglycan expression was analyzed by Western blotting. Prevalence of LGMD2T was calculated from the total LGMD population in Denmark. GMPPB was sequenced in all unclassified cases. Results: Two patients carried 3 new mutations in GMPPB. The other 4 patients carried previously described pathogenic mutations in GMPPB. MRI showed that the paraspinal muscles were the most affected, followed by involvement of hamstrings. Our results showed a loss of glycosylation of α-dystroglycan as well as secondary loss of merosin expression on Western blotting. The prevalence of LGMD2T in the Danish cohort of patients with LGMD is 1.5%. Conclusions: The new findings of this study are (1) the consistent finding of a preferential affection of paraspinal and hamstring muscles in LGMD2T, (2) 3 new mutations in GMPPB, (3) variable loss of glycosylation tested with IIH6 and VIA4 antibodies, and (4) a prevalence of LGMD2T of 1.5% in a well-characterized Danish LGMD cohort. PMID:27766311

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

    NASA Astrophysics Data System (ADS)

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

    2013-02-01

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

  20. Detecting Elementary Arm Movements by Tracking Upper Limb Joint Angles With MARG Sensors.

    PubMed

    Mazomenos, Evangelos B; Biswas, Dwaipayan; Cranny, Andy; Rajan, Amal; Maharatna, Koushik; Achner, Josy; Klemke, Jasmin; Jobges, Michael; Ortmann, Steffen; Langendorfer, Peter

    2016-07-01

    This paper reports an algorithm for the detection of three elementary upper limb movements, i.e., reach and retrieve, bend the arm at the elbow and rotation of the arm about the long axis. We employ two MARG sensors, attached at the elbow and wrist, from which the kinematic properties (joint angles, position) of the upper arm and forearm are calculated through data fusion using a quaternion-based gradient-descent method and a two-link model of the upper limb. By studying the kinematic patterns of the three movements on a small dataset, we derive discriminative features that are indicative of each movement; these are then used to formulate the proposed detection algorithm. Our novel approach of employing the joint angles and position to discriminate the three fundamental movements was evaluated in a series of experiments with 22 volunteers who participated in the study: 18 healthy subjects and four stroke survivors. In a controlled experiment, each volunteer was instructed to perform each movement a number of times. This was complimented by a seminaturalistic experiment where the volunteers performed the same movements as subtasks of an activity that emulated the preparation of a cup of tea. In the stroke survivors group, the overall detection accuracy for all three movements was 93.75% and 83.00%, for the controlled and seminaturalistic experiment, respectively. The performance was higher in the healthy group where 96.85% of the tasks in the controlled experiment and 89.69% in the seminaturalistic were detected correctly. Finally, the detection ratio remains close ( ±6%) to the average value, for different task durations further attesting to the algorithms robustness. PMID:25966489

  1. A neural tracking and motor control approach to improve rehabilitation of upper limb movements

    PubMed Central

    Goffredo, Michela; Bernabucci, Ivan; Schmid, Maurizio; Conforto, Silvia

    2008-01-01

    Background Restoration of upper limb movements in subjects recovering from stroke is an essential keystone in rehabilitative practices. Rehabilitation of arm movements, in fact, is usually a far more difficult one as compared to that of lower extremities. For these reasons, researchers are developing new methods and technologies so that the rehabilitative process could be more accurate, rapid and easily accepted by the patient. This paper introduces the proof of concept for a new non-invasive FES-assisted rehabilitation system for the upper limb, called smartFES (sFES), where the electrical stimulation is controlled by a biologically inspired neural inverse dynamics model, fed by the kinematic information associated with the execution of a planar goal-oriented movement. More specifically, this work details two steps of the proposed system: an ad hoc markerless motion analysis algorithm for the estimation of kinematics, and a neural controller that drives a synthetic arm. The vision of the entire system is to acquire kinematics from the analysis of video sequences during planar arm movements and to use it together with a neural inverse dynamics model able to provide the patient with the electrical stimulation patterns needed to perform the movement with the assisted limb. Methods The markerless motion tracking system aims at localizing and monitoring the arm movement by tracking its silhouette. It uses a specifically designed motion estimation method, that we named Neural Snakes, which predicts the arm contour deformation as a first step for a silhouette extraction algorithm. The starting and ending points of the arm movement feed an Artificial Neural Controller, enclosing the muscular Hill's model, which solves the inverse dynamics to obtain the FES patterns needed to move a simulated arm from the starting point to the desired point. Both position error with respect to the requested arm trajectory and comparison between curvature factors have been calculated in

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

    PubMed

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

    2004-09-01

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

  3. Botulinum toxin assessment, intervention and after-care for upper limb hypertonicity in adults: international consensus statement.

    PubMed

    Sheean, G; Lannin, N A; Turner-Stokes, L; Rawicki, B; Snow, B J

    2010-08-01

    Upper limb spasticity affecting elbow, wrist, and finger flexors can be safely and effectively reduced with injections of botulinum toxin type-A (BoNT-A). It has been best studied in adults in the context of post-stroke spasticity. The clinical benefits include reduction in pain and deformity, improvement in washing and dressing the upper limb, and a reduction in caregiver burden (Class I evidence, recommendation level A). Some patients show improvement in function performed by active movement of the affected upper limb (Class III evidence, recommendation C), but predicting and measuring this is difficult, and further research is needed. An individually based approach to treatment and outcome measurement is preferred (Class IV, recommendation U). More research is needed to resolve many unknown issues of assessment and treatment, using research methods appropriate to the question. PMID:20633180

  4. Upper-limb stroke rehabilitation using electrode-array based functional electrical stimulation with sensing and control innovations.

    PubMed

    Kutlu, M; Freeman, C T; Hallewell, E; Hughes, A-M; Laila, D S

    2016-04-01

    Functional electrical stimulation (FES) has shown effectiveness in restoring upper-limb movement post-stroke when applied to assist participants' voluntary intention during repeated, motivating tasks. Recent clinical trials have used advanced controllers that precisely adjust FES to assist functional reach and grasp tasks with FES applied to three muscle groups, showing significant reduction in impairment. The system reported in this paper advances the state-of-the-art by: (1) integrating an FES electrode array on the forearm to assist complex hand and wrist gestures; (2) utilising non-contact depth cameras to accurately record the arm, hand and wrist position in 3D; and (3) employing an interactive touch table to present motivating virtual reality (VR) tasks. The system also uses iterative learning control (ILC), a model-based control strategy which adjusts the applied FES based on the tracking error recorded on previous task attempts. Feasibility of the system has been evaluated in experimental trials with 2 unimpaired participants and clinical trials with 4 hemiparetic, chronic stroke participants. The stroke participants attended 17, 1 hour training sessions in which they performed functional tasks, such as button pressing using the touch table and closing a drawer. Stroke participant results show that the joint angle error norm reduced by an average of 50.3% over 6 attempts at each task when assisted by FES. PMID:26947097

  5. Upper-limb stroke rehabilitation using electrode-array based functional electrical stimulation with sensing and control innovations.

    PubMed

    Kutlu, M; Freeman, C T; Hallewell, E; Hughes, A-M; Laila, D S

    2016-04-01

    Functional electrical stimulation (FES) has shown effectiveness in restoring upper-limb movement post-stroke when applied to assist participants' voluntary intention during repeated, motivating tasks. Recent clinical trials have used advanced controllers that precisely adjust FES to assist functional reach and grasp tasks with FES applied to three muscle groups, showing significant reduction in impairment. The system reported in this paper advances the state-of-the-art by: (1) integrating an FES electrode array on the forearm to assist complex hand and wrist gestures; (2) utilising non-contact depth cameras to accurately record the arm, hand and wrist position in 3D; and (3) employing an interactive touch table to present motivating virtual reality (VR) tasks. The system also uses iterative learning control (ILC), a model-based control strategy which adjusts the applied FES based on the tracking error recorded on previous task attempts. Feasibility of the system has been evaluated in experimental trials with 2 unimpaired participants and clinical trials with 4 hemiparetic, chronic stroke participants. The stroke participants attended 17, 1 hour training sessions in which they performed functional tasks, such as button pressing using the touch table and closing a drawer. Stroke participant results show that the joint angle error norm reduced by an average of 50.3% over 6 attempts at each task when assisted by FES.

  6. Deviation in the recovery of the lower limb and respiratory muscles of patients with polymyositis: a preliminary clinical study

    PubMed Central

    Nishikawa, Yuichi; Hosomi, Naohisa; Ueno, Hiroki; Kurashige, Takashi; Ochi, Kazuhide; Takahashi, Tetsuya; Orita, Naoya; Ueda,, Kazuyuki; Maruyama, Hirofumi; Kimura, Hiroaki; Matsumoto, Masayasu

    2016-01-01

    [Purpose] The purposes of this study were to quantify the serial changes in lower limb and respiratory muscle strengths and to evaluate the acute effects of physiotherapy in polymyositis patients. [Subjects and Methods] Five patients (57.6 ± 9.0 years, 50 to 72; four females) received physiotherapy five days a week for four weeks. The lower limb and respiratory muscle strength, the % vital capacity, and the Barthel index were evaluated at baseline and after the intervention. [Results] The patient’s symptoms and creatine kinase values did not change, and after four weeks, all of the patients exhibited significantly increased outcomes compared with the baseline. However, the inspiratory muscle strength of the patients presented smaller improvements than the expiratory muscle strength. [Conclusion] Differential changes in inspiratory and expiratory muscle strength were observed following physiotherapy, and an unbalanced muscle distribution may explain the pathological and therapeutic effects. PMID:27799713

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

    PubMed

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

    2015-04-01

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

  8. Estimation of upper-limb orientation based on accelerometer and gyroscope measurements.

    PubMed

    Hyde, Rick A; Ketteringham, Laurence P; Neild, Simon A; Jones, Rosie S

    2008-02-01

    A solution is proposed to the estimation of upper-limb orientation using miniature accelerometers and gyroscopes. This type of measurement device has many different possible applications, ranging from clinical use with patients presenting a number of conditions such as upper motor neuron syndrome and pathologies that give rise to loss of dexterity, to competitive sports training and virtual reality. Here we focus on a design that minimizes the number of sensors whilst delivering estimates of known accuracy over a defined frequency range. Minimizing the sensor count can make the measurement system less obtrusive, as well as minimising cost and reducing the required bandwidth if using a wireless solution. Accurate measurement of movement amplitude up to 15 Hz is required in our immediate application, namely to quantify tremor in multiple sclerosis patients. The drive for low numbers of sensors and good accuracy at higher frequencies leads to a novel design based on composite filters. The simple estimator structure also gives good insight into the fundamental accuracy limitations based on the sensors chosen. This paper defines the underlying mathematics, and quantifies performance for an estimator for shoulder, upper arm, lower arm and hand orientations. Good estimation accuracy up to 15 Hz is indicated, and this with a reduced total sensor count of 18 compared to 24 that would be required for more conventional estimator architectures. PMID:18270013

  9. 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

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

    PubMed Central

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Detecting the Intention to Move Upper Limbs from Electroencephalographic Brain Signals.

    PubMed

    Gudiño-Mendoza, Berenice; Sanchez-Ante, Gildardo; Antelis, Javier M

    2016-01-01

    Early decoding of motor states directly from the brain activity is essential to develop brain-machine interfaces (BMI) for natural motor control of neuroprosthetic devices. Hence, this study aimed to investigate the detection of movement information before the actual movement occurs. This information piece could be useful to provide early control signals to drive BMI-based rehabilitation and motor assisted devices, thus providing a natural and active rehabilitation therapy. In this work, electroencephalographic (EEG) brain signals from six healthy right-handed participants were recorded during self-initiated reaching movements of the upper limbs. The analysis of these EEG traces showed that significant event-related desynchronization is present before and during the execution of the movements, predominantly in the motor-related α and β frequency bands and in electrodes placed above the motor cortex. This oscillatory brain activity was used to continuously detect the intention to move the limbs, that is, to identify the motor phase prior to the actual execution of the reaching movement. The results showed, first, significant classification between relax and movement intention and, second, significant detection of movement intention prior to the onset of the executed movement. On the basis of these results, detection of movement intention could be used in BMI settings to reduce the gap between mental motor processes and the actual movement performed by an assisted or rehabilitation robotic device. PMID:27217826

  13. Detecting the Intention to Move Upper Limbs from Electroencephalographic Brain Signals

    PubMed Central

    Gudiño-Mendoza, Berenice; Sanchez-Ante, Gildardo; Antelis, Javier M.

    2016-01-01

    Early decoding of motor states directly from the brain activity is essential to develop brain-machine interfaces (BMI) for natural motor control of neuroprosthetic devices. Hence, this study aimed to investigate the detection of movement information before the actual movement occurs. This information piece could be useful to provide early control signals to drive BMI-based rehabilitation and motor assisted devices, thus providing a natural and active rehabilitation therapy. In this work, electroencephalographic (EEG) brain signals from six healthy right-handed participants were recorded during self-initiated reaching movements of the upper limbs. The analysis of these EEG traces showed that significant event-related desynchronization is present before and during the execution of the movements, predominantly in the motor-related α and β frequency bands and in electrodes placed above the motor cortex. This oscillatory brain activity was used to continuously detect the intention to move the limbs, that is, to identify the motor phase prior to the actual execution of the reaching movement. The results showed, first, significant classification between relax and movement intention and, second, significant detection of movement intention prior to the onset of the executed movement. On the basis of these results, detection of movement intention could be used in BMI settings to reduce the gap between mental motor processes and the actual movement performed by an assisted or rehabilitation robotic device. PMID:27217826

  14. Upper-Limb Robotic Exoskeletons for Neurorehabilitation: A Review on Control Strategies.

    PubMed

    Proietti, Tommaso; Crocher, Vincent; Roby-Brami, Agnes; Jarrasse, Nathanael

    2016-01-01

    Since the late 1990s, there has been a burst of research on robotic devices for poststroke rehabilitation. Robot-mediated therapy produced improvements on recovery of motor capacity; however, so far, the use of robots has not shown qualitative benefit over classical therapist-led training sessions, performed on the same quantity of movements. Multidegree-of-freedom robots, like the modern upper-limb exoskeletons, enable a distributed interaction on the whole assisted limb and can exploit a large amount of sensory feedback data, potentially providing new capabilities within standard rehabilitation sessions. Surprisingly, most publications in the field of exoskeletons focused only on mechatronic design of the devices, while little details were given to the control aspects. On the contrary, we believe a paramount aspect for robots potentiality lies on the control side. Therefore, the aim of this review is to provide a taxonomy of currently available control strategies for exoskeletons for neurorehabilitation, in order to formulate appropriate questions toward the development of innovative and improved control strategies. PMID:27071194

  15. Upper limb functional assessment of children with cerebral palsy using a sorting box.

    PubMed

    Quijano-Gonzalez, Y; Melendez-Calderon, A; Burdet, E; Chong-Quero, J E; Villanueva-Ayala, D; Perez-Moreno, J C

    2014-01-01

    We investigated the use of a sorting box to obtain a quantitative assessment of upper limb motor function in children with cerebral palsy. In our study, children with and without cerebral palsy placed and removed geometrical objects of a sorting-box while their wrist position was monitored by a camera-based, motion-tracking system. We analyzed three different smoothness metrics (logarithmic dimensionless jerk, spectral arc-length and number of peaks) together with time to task completion. Our results suggest that smoothness metrics are an effective tool to distinguish between impaired and non-impaired subjects, as well as to quantify differences between the affected and less-affected sides in children with hemiparetic cerebral palsy.

  16. Neural PID Control of Robot Manipulators With Application to an Upper Limb Exoskeleton.

    PubMed

    Yu, Wen; Rosen, Jacob

    2013-04-01

    In order to minimize steady-state error with respect to uncertainties in robot control, proportional-integral-derivative (PID) control needs a big integral gain, or a neural compensator is added to the classical proportional-derivative (PD) control with a large derivative gain. Both of them deteriorate transient performances of the robot control. In this paper, we extend the popular neural PD control into neural PID control. This novel control is a natural combination of industrial linear PID control and neural compensation. The main contributions of this paper are semiglobal asymptotic stability of the neural PID control and local asymptotic stability of the neural PID control with a velocity observer which are proved with standard weight training algorithms. These conditions give explicit selection methods for the gains of the linear PID control. An experimental study on an upper limb exoskeleton with this neural PID control is addressed. PMID:23033432

  17. Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1

    NASA Astrophysics Data System (ADS)

    Kikuchi, T.; Fukushima, K.; Furusho, J.; Ozawa, T.

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  20. Neural PID Control of Robot Manipulators With Application to an Upper Limb Exoskeleton.

    PubMed

    Yu, Wen; Rosen, Jacob

    2013-04-01

    In order to minimize steady-state error with respect to uncertainties in robot control, proportional-integral-derivative (PID) control needs a big integral gain, or a neural compensator is added to the classical proportional-derivative (PD) control with a large derivative gain. Both of them deteriorate transient performances of the robot control. In this paper, we extend the popular neural PD control into neural PID control. This novel control is a natural combination of industrial linear PID control and neural compensation. The main contributions of this paper are semiglobal asymptotic stability of the neural PID control and local asymptotic stability of the neural PID control with a velocity observer which are proved with standard weight training algorithms. These conditions give explicit selection methods for the gains of the linear PID control. An experimental study on an upper limb exoskeleton with this neural PID control is addressed.

  1. Upper limb functional assessment of children with cerebral palsy using a sorting box.

    PubMed

    Quijano-Gonzalez, Y; Melendez-Calderon, A; Burdet, E; Chong-Quero, J E; Villanueva-Ayala, D; Perez-Moreno, J C

    2014-01-01

    We investigated the use of a sorting box to obtain a quantitative assessment of upper limb motor function in children with cerebral palsy. In our study, children with and without cerebral palsy placed and removed geometrical objects of a sorting-box while their wrist position was monitored by a camera-based, motion-tracking system. We analyzed three different smoothness metrics (logarithmic dimensionless jerk, spectral arc-length and number of peaks) together with time to task completion. Our results suggest that smoothness metrics are an effective tool to distinguish between impaired and non-impaired subjects, as well as to quantify differences between the affected and less-affected sides in children with hemiparetic cerebral palsy. PMID:25570455

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

    PubMed Central

    Rhee, Min-Hyung; Kim, Laurentius Jongsoon

    2015-01-01

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

  3. [Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

    PubMed

    Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

    2014-04-01

    In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

  4. Activity-related sexual dimorphism in Alaskan foragers from Point Hope: Evidences from the upper limb.

    PubMed

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

    2015-01-01

    Ipiutak (100BCE-500CE) and Tigara (1200 - 1700CE) are two populations from Point Hope, Alaska. As commonly observed in forager communities, it may be expected males and females to have been involved in markedly different daily activities. Nevertheless, activity-related sexual dimorphism in these populations has been scarcely studied. Using humeral diaphyseal cross-sectional properties and forearm rotational efficiency, which are activity-dependent characteristics, we aim to assess differences between sexes and discuss what activities could have triggered them. Our results suggest that in Ipiutak males and females did not differ meaningfully in their cross-sectional properties. Conversely, in Tigara males had a greater rigidity of the entire humeral diaphysis than females, which suggests the existence of greater relative activity levels and more physically demanding tasks, possibly related to hunting activities. Concerning the differences between sexes in the forearm rotational efficiency, in Tigara females rotational efficiency in elbow flexion is maximal in a more supinated position than in males, which leads to an improvement of efficiency in those stages related to manipulation, and so improves the manipulative capacities of the upper limb. These differences in efficiency are caused by a more proximally oriented humeral medial epicondyle in females, which is thus confirmed to be a good feature to assess differences in labor. Therefore females in Tigara probably performed in a daily basis household activities, such as hide processing and other manipulative labors. In Ipiutak, the analysis of forearm rotational efficiency did not reveal differences between sexes. Overall, the results suggest that division of labor in Ipiutak was not as marked as in Tigara, where upper limb skeletal structure supports the idea that both sexes were involved in different daily activities. Nevertheless, the generalized lack of results in Ipiutak could be due to the small sample

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

    Ferronato, Priscilla A. M.; Domellöf, Erik; Rönnqvist, Louise

    2014-01-01

    Given that the auditory system is rather well developed at the end of the third trimester of pregnancy, it is likely that couplings between acoustics and motor activity can be integrated as early as at the beginning of postnatal life. The aim of the present mini-review was to summarize and discuss studies on early auditory-motor integration, focusing particularly on upper-limb movements (one of the most crucial means to interact with the environment) in association with auditory stimuli, to develop further understanding of their significance with regard to early infant development. Many studies have investigated the relationship between various infant behaviors (e.g., sucking, visual fixation, head turning) and auditory stimuli, and established that human infants can be observed displaying couplings between action and environmental sensory stimulation already from just after birth, clearly indicating a propensity for intentional behavior. Surprisingly few studies, however, have investigated the associations between upper-limb movements and different auditory stimuli in newborns and young infants, infants born at risk for developmental disorders/delays in particular. Findings from studies of early auditory-motor interaction support that the developing integration of sensory and motor systems is a fundamental part of the process guiding the development of goal-directed action in infancy, of great importance for continued motor, perceptual, and cognitive development. At-risk infants (e.g., those born preterm) may display increasing central auditory processing disorders, negatively affecting early sensory-motor integration, and resulting in long-term consequences on gesturing, language development, and social communication. Consequently, there is a need for more studies on such implications. PMID:25278927

  7. A novel robot training system designed to supplement upper limb physiotherapy of patients with spastic hemiparesis.

    PubMed

    Fazekas, Gabor; Horvath, Monika; Toth, Andras

    2006-09-01

    Spasticity is velocity and acceleration dependent, and it is therefore important to execute physiotherapeutic exercises at a relatively low and constant velocity. This can be more accurately managed by a robot than by a person when such exercises are administered continuously for more than 15-20 min. The purpose of this project was to construct a robot-mediated system that could support upper limb physiotherapy of patients with spastic hemiparesis. The system, unlike any known robotic therapeutic system, uses unmodified industrial robots to carry out passive physiotherapy on the upper limb (including the movements of the shoulder and the elbow). An initial trial was executed in order to assess its safety and to gain experience of the robot-mediated therapy. Four healthy subjects and eight patients with spastic hemiparesis were included. Each subject received 30-min-long robotic physiotherapy sessions over 20 consecutive workdays. The 12 participants received, in total, 240 robot-mediated physiotherapeutic sessions. No dangerous situation or considerable technical problem occurred; the robots executed the therapy programme as intended. Investigation of the effectiveness of this kind of therapy was not an aim of this initial trial; however, the patients' clinical status was followed and some favourable changes were found regarding the spasticity of elbow flexors and shoulder abductors. According to the experiences of the first clinical investigation, the programming interface and the mechanical interface device between the patient and the robots had been improved. A controlled clinical study is under way to assess the effectiveness of the REHAROB movement therapy.

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

    PubMed

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

    2007-06-01

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

  9. TMEM5-associated dystroglycanopathy presenting with CMD and mild limb-girdle muscle involvement.

    PubMed

    Astrea, Guja; Pezzini, Ilaria; Picillo, Ester; Pasquariello, Rosa; Moro, Francesca; Ergoli, Manuela; D'Ambrosio, Paola; D'Amico, Adele; Politano, Luisa; Santorelli, Filippo Maria

    2016-07-01

    The dystroglycanopathies, which are caused by reduced glycosylation of alpha-dystroglycan, are a heterogeneous group of neurodegenerative disorders characterized by variable brain and skeletal muscle involvement. Recently, mutations in TMEM5 have been described in severe dystroglycanopathies. We present the clinical, molecular and neuroimaging features of an Italian boy who had delayed developmental milestones with mild limb-girdle muscle involvement, bilateral frontotemporal polymicrogyria, moderate intellectual disability, and no cerebellar involvement. He also presented a cochlear dysplasia and harbored a reported mutation (p.A47Rfs*42) in TMEM5, detected using targeted next-generation sequencing. The relatively milder muscular phenotype and associated structural brain abnormalities distinguish this case from previously reported patients with severe dystroglycanopathies and expand the spectrum of TMEM5-associated disorders. PMID:27212206

  10. Course review: the 4th Bob Huffstadt upper and lower limb flap dissection course.

    PubMed

    Dunne, Jonathan A

    2014-12-01

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

  11. Effect of recovery from muscle strength imbalance in lower limb using four point weight bearing reduction system.

    PubMed

    Yu, Chang Ho; Kang, Seung Rok; Jeong, Ho Choon; Kim, Kyung; Kwon, Tae Kyu

    2014-01-01

    This study was performed to assess the improvement of muscle strength imbalance in the lower limbs using a four point weight bearing reduction system with a two-belt treadmill. Participants, each having differences in muscle function of the left and right legs of over 20%, were divided into two groups of ten. The participants were involved in experiments progressing 40 minutes per day, 3 days per week, during a period of 4 weeks. The maximal peak torque and average power were measured for testing joint torque in the hip, knee and ankle. The results showed the improvement of muscle imbalance as assessed by the maximal muscle strength was the most effective in the hip joint, while the improvement of muscular reaction was the most effective in the knee joint. We suggest that the method of weight bearing reduction could be sufficient to reduce muscle imbalance in the lower limbs.

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

    PubMed

    Harischandra, Nalin; Ekeberg, Orjan

    2008-08-01

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

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

    PubMed

    Harischandra, Nalin; Ekeberg, Orjan

    2008-08-01

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

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

    PubMed

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

    2013-12-28

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-06-01

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

  17. Sports Adaptations for Unilateral and Bilateral Upper-Limb Amputees: Archery/Badminton/Baseball/Softball/Bowling/Golf/Table Tennis.

    ERIC Educational Resources Information Center

    Cowart, Jim

    1979-01-01

    The booklet discusses sports adaptations for unilateral and bilateral upper limb amputees. Designs for adapted equipment are illustrated and information on adaptations are described for archery (including an archery release aid and a stationary bow holder); badminton (serving tray); baseball/softball (adaptations for catching, throwing, and…

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Craje, Celine

    2010-01-01

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

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

    PubMed Central

    Weiss, Patrice L.; Keshner, Emily A.

    2015-01-01

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

  2. Automatic and imperative motor activations in stimulus-response compatibility: magnetoencephalographic analysis of upper and lower limbs.

    PubMed

    Kato, Yuichiro; Endo, Hiroshi; Kizuka, Tomohiro; Asami, Takaaki

    2006-01-01

    The stimulus-response (S-R) compatibility effect refers to the difference in performance due to the spatial S-R relationship in choice reaction time. We investigated the mechanism of neural activities in S-R compatibility at the level of the primary motor cortices for upper and lower limbs responses using magnetoencephalography (MEG). In the S-R compatible task, subjects were required to respond on the same side of the stimulus light using either an upper or lower limb. In the incompatible task, subjects were required to respond in the reverse manner. Premotor times of upper and lower limbs were faster for the compatible response than for the incompatible response. The neuromagnetic brain activities related to response execution were estimated using a multi-dipole model. Stimulus-locked MEG indicated that the current moments of motor dipoles for both effectors occurred bilaterally and reached the first peak at a constant delay irrespective of whether the task was compatible or incompatible. This indicates that the neural activation of the primary motor cortex is automatically synchronized with the stimulus onset. Response-locked MEG showed that the peak current moment of the motor dipole contralateral to the response was stronger for the compatible task than for the incompatible one regardless of whether the responses were made using the upper or lower limbs. The MEG results suggest that automatic motor activation facilitates imperative motor activation for a compatible response, whereas it is not sufficient to prime imperative motor activation for an incompatible response.

  3. Relationship between Isometric Strength of Six Lower Limb Muscle Groups and Motor Skills among Nursing Home Residents.

    PubMed

    Buckinx, F; Croisier, J L; Reginster, J Y; Petermans, J; Goffart, E; Bruyère, O

    2015-01-01

    This research aimed to assess the correlation between isometric muscle strength of the lower limb and motor skills. This is a cross sectional study performed among volunteer nursing home residents included in the SENIOR (Sample of Elderly Nursing home Individuals: an Observational Research) cohort. The present analysis focused on isometric muscle strength of 6 lower limb muscle groups (i.e. knee extensors, knee flexors, hip abductors, hip extensors, ankle flexors and ankle extensors), assessed using a validated hand-held dynamometer (i.e. the MicroFET2 device), and motor skills evaluated using the Tinetti test, the Timed Up and Go test, the Short Physical Performance Battery test (SPPB) and the walking speed. The relationship between all these parameters was tested by means of a multiple correlation, adjusted on age, sex and body mass index. 450 nursing home residents (69.8% of women) with a mean age of 83.1±9.4 years were included in this study. Our results showed a significant inverse correlation between lower limb muscle strength and the time required to perform the TUG test or gait speed, except for ankle flexors and ankle extensors. The relationship between the Tinetti test or the SPPB score, and lower limb muscle strength was significant, except for ankle flexors and ankle extensors. In conclusion, a positive association between lower limb muscle strength of the four main muscle groups and motor skills of the elderly nursing residents was found in this research. Therefore, special attention should be given to these muscle groups during rehabilitation programs.

  4. Chaotic analysis of electromyography signal at low back and lower limb muscles during forward bending posture.

    PubMed

    Swie, Y W; Sakamoto, K; Shimizu, Y

    2005-01-01

    The present study aims to perform further investigation on muscular activity during forward bending posture by applying a nonlinear dynamic (chaotic) analysis method. The objective is to determine the characteristics of the low back and lower limb muscle electromyography (EMG) signal under chaotic analysis while maintaining a certain posture. Twelve subjects were asked to maintain postures of six stages in bending angles from 0 to 180 degrees, and the EMG signals of erector spinae (ES) at L1 and L5 levels, hamstrings, and gastrocnemius were recorded. Two important concepts to characterize deterministic chaos, Correlation Dimension (D2) and Lyapunov Exponents (lambda, LE), were applied to observe the chaotic characteristic of the EMG signals, and the results were also compared to the FFT based total power value. The EMG signals in all observed muscles during bending posture showed results of positive LE and high D2 at 5.5 to 7.5, which led us to classify EMG as a high dimension chaotic signal. The result obtained showed that the correlation dimension could be used as a reliable method to compare the EMG signal in various postures (or muscle contraction conditions). However, Lyapunov exponents did not show a significant difference of comparison result thus leading to the conclusion that LE could not be a reliable measure for high dimension chaotic system, such as an EMG signal. It was also shown that in both light and deep bending, the EMG signal of the low back muscles was of the same complexity level due to the D2 result. It was evident that somehow the low back muscle remained loaded in all bending stages which was contrary to the hypothesis that the low back muscle was less active during the deep bending, as was the case in most of the previous studies. The reason of such phenomenon was elucidated with use of the theory of muscular functional differentiation, including corticalization and spinalization. PMID:16315970

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

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  6. Characteristics of the muscle activities of the elderly for various pressures in the pneumatic actuator of lower limb orthosis

    NASA Astrophysics Data System (ADS)

    Kim, Kyong; Yu, Chang-Ho; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

    2005-12-01

    There developed a lower limb orthosis with a pneumatic rubber actuator, which can assist and improve the muscular activities in the lower limb of the elderly. For this purpose, the characteristics of the lower limbs muscle activities for various pressures in the pneumatic actuator for the lower limb orthosis was investigated. To find out the characteristics of the muscle activities for various pneumatic pressures, it analyzed the flexing and extending movement of the knees, and measured the lower limbs muscular power. The subjects wearing the lower limbs orthosis were instructed to perform flexing and extending movement of the knees. The variation in the air pressure of the pneumatic actuator was varies from one kgf/cm2 to four kgf/cm2. The muscular power was measured by monitoring electromyogram using MP100 (BIOPAC Systems, Inc.) and detailed three-dimensional motions of the lower limbs were collected by APAS 3D Motion Analysis system. Through this study, it expected to find the most suitable air pressure for the improvement of the muscular power of the aged.

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

    PubMed

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

    2013-12-01

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

  8. Surface electromyographic activities of upper body muscles during high-intensity cycle ergometry.

    PubMed

    McCormick, Marie Clare; Watson, Hugh; Simpson, Alan; Kilgore, Lon; Baker, Julien S

    2014-01-01

    The aim of this study was to investigate upper body muscle activity during a 30 s Wingate test. Eighteen physically active participants performed a Wingate test while muscle activity was recorded from the brachioradialis (BR), biceps brachii (BB), triceps brachii (TB) and upper trapezius (UT). Measurements were obtained at rest, during a function maximal contraction (FMC) and during the 30 s Wingate test, whilst participants were positioned in a seated position on the cycle ergometer. All muscles were significantly active for the duration of the test. When normalized as a %FMC no differences in activity were found between muscles. Across the 30 s, power output was found to significantly decrease, whereas no changes were found in upper body muscle activity. All muscles investigated were active during the Wingate test and therefore confirmed previous findings that the upper body significantly contributes to power profiles obtained during high intensity cycle ergometry in addition to its role in stabilizing the body.

  9. Toward the characterization of upper tropospheric clouds using Atmospheric Infrared Sounder and Microwave Limb Sounder observations

    NASA Astrophysics Data System (ADS)

    Kahn, Brian H.; Eldering, Annmarie; Braverman, Amy J.; Fetzer, Eric J.; Jiang, Jonathan H.; Fishbein, Evan; Wu, Dong L.

    2007-03-01

    PCLD are highly dependent on the MLS tangent altitude. For MLS tangent altitudes greater than 146 hPa, the strength of the limb technique, the disagreement becomes statistically significant. This implies that AIRS and MLS "agree" in a statistical sense at lower tangent altitudes and "disagree" at higher tangent altitudes. These results provide important insights on upper tropospheric cloudiness as observed by nadir-viewing AIRS and limb-viewing MLS.

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

    PubMed

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

    2014-07-01

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

  11. Foot posture influences the electromyographic activity of selected lower limb muscles during gait

    PubMed Central

    2009-01-01

    Background Some studies have found that flat-arched foot posture is related to altered lower limb muscle function compared to normal- or high-arched feet. However, the results from these studies were based on highly selected populations such as those with rheumatoid arthritis. Therefore, the objective of this study was to compare lower limb muscle function of normal and flat-arched feet in people without pain or disease. Methods Sixty adults aged 18 to 47 years were recruited to this study. Of these, 30 had normal-arched feet (15 male and 15 female) and 30 had flat-arched feet (15 male and 15 female). Foot posture was classified using two clinical measurements (the arch index and navicular height) and four skeletal alignment measurements from weightbearing foot x-rays. Intramuscular fine-wire electrodes were inserted into tibialis posterior and peroneus longus under ultrasound guidance, and surface EMG activity was recorded from tibialis anterior and medial gastrocnemius while participants walked barefoot at their self-selected comfortable walking speed. Time of peak amplitude, peak and root mean square (RMS) amplitude were assessed from stance phase EMG data. Independent samples t-tests were performed to assess for significant differences between the normal- and flat-arched foot posture groups. Results During contact phase, the flat-arched group exhibited increased activity of tibialis anterior (peak amplitude; 65 versus 46% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (peak amplitude; 24 versus 37% of maximum voluntary isometric contraction). During midstance/propulsion, the flat-arched group exhibited increased activity of tibialis posterior (peak amplitude; 86 versus 60% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (RMS amplitude; 25 versus 39% of maximum voluntary isometric contraction). Effect sizes for these significant findings ranged from 0.48 to 1.3, representing moderate to

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

    PubMed

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

    2012-06-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-06-01

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

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

    PubMed

    Price, R F; Dutia, M B

    1989-01-01

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

  16. Acute forearm compressive myopathy syndrome secondary to upper limb entrapment: an unusual cause of renal failure.

    PubMed

    Tachtsi, Maria D; Kalogirou, Thomas E; Atmatzidis, Stefanos K; Papadimitriou, Dimitrios K; Atmatzidis, Konstantinos S

    2011-05-01

    Compressive myopathy syndrome (SCM) is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents (myoglobin, creatine phosphokinase, potassium, etc.) into the circulatory system, which can cause potentially lethal complications. There are numerous causes that can lead to SCM resulting to acute rhabdomyolysis, and many patients present with multiple causes. The most common potentially lethal complication is acute renal failure. The occurrence of acute rhabdomyolysis should be considered as a possibility in any patient who can remain stationary for long periods, or is in a coma, or is intoxicated in any form. We report the rare case of a 26-year-old patient who developed SCM caused by ischemia reperfusion, with subsequent acute rhabdomyolysis and acute renal failure after prolonged compression of the right upper extremity. PMID:21549937

  17. Acute forearm compressive myopathy syndrome secondary to upper limb entrapment: an unusual cause of renal failure.

    PubMed

    Tachtsi, Maria D; Kalogirou, Thomas E; Atmatzidis, Stefanos K; Papadimitriou, Dimitrios K; Atmatzidis, Konstantinos S

    2011-05-01

    Compressive myopathy syndrome (SCM) is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents (myoglobin, creatine phosphokinase, potassium, etc.) into the circulatory system, which can cause potentially lethal complications. There are numerous causes that can lead to SCM resulting to acute rhabdomyolysis, and many patients present with multiple causes. The most common potentially lethal complication is acute renal failure. The occurrence of acute rhabdomyolysis should be considered as a possibility in any patient who can remain stationary for long periods, or is in a coma, or is intoxicated in any form. We report the rare case of a 26-year-old patient who developed SCM caused by ischemia reperfusion, with subsequent acute rhabdomyolysis and acute renal failure after prolonged compression of the right upper extremity.

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2015-07-31

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

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

    PubMed Central

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

    2015-01-01

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

  2. Context-Dependent Upper Limb Prosthesis Control for Natural and Robust Use.

    PubMed

    Amsuess, Sebastian; Vujaklija, Ivan; Goebel, Peter; Roche, Aidan D; Graimann, Bernhard; Aszmann, Oskar C; Farina, Dario

    2016-07-01

    Pattern recognition and regression methods applied to the surface EMG have been used for estimating the user intended motor tasks across multiple degrees of freedom (DOF), for prosthetic control. While these methods are effective in several conditions, they are still characterized by some shortcomings. In this study we propose a methodology that combines these two approaches for mutually alleviating their limitations. This resulted in a control method capable of context-dependent movement estimation that switched automatically between sequential (one DOF at a time) or simultaneous (multiple DOF) prosthesis control, based on an online estimation of signal dimensionality. The proposed method was evaluated in scenarios close to real-life situations, with the control of a physical prosthesis in applied tasks of varying difficulties. Test prostheses were individually manufactured for both able-bodied and transradial amputee subjects. With these prostheses, two amputees performed the Southampton Hand Assessment Procedure test with scores of 58 and 71 points. The five able-bodied individuals performed standardized tests, such as the box&block and clothes pin test, reducing the completion times by up to 30%, with respect to using a state-of-the-art pure sequential control algorithm. Apart from facilitating fast simultaneous movements, the proposed control scheme was also more intuitive to use, since human movements are predominated by simultaneous activations across joints. The proposed method thus represents a significant step towards intelligent, intuitive and natural control of upper limb prostheses. PMID:26173217

  3. Simplifying the upper limb peripheral motor screen: Proposing the "K" sign.

    PubMed

    Kurmis, A P; Kurmis, T P

    2016-01-01

    The well-recognized erosion of pathoanatomic correlations in basic medical training, combined with the increasing everyday pressures of time-efficacy in patient examination, continue to place strain on junior clinicians. Over the years, many refinements to tried-and-true basic physical examination techniques have been described, allowing improvement in diagnostic yield. A multitude of "screening" techniques are available for physical assessment; however, such approaches are often nonstandardized and inconsistently taught and applied in the clinical realm. Great interexaminer inconsistency in the documentation of many forms of screening techniques also substantively undermines their respective clinical value. The current work presents a novel refinement/combination of previously described examination approaches for the assessment of peripheral upper limb (UL) motor function--the "K" sign. Having been successfully applied in both the acute and ambulatory clinical settings for several years, we feel that the technique has a useful role as a rapid and specific screening technique that is easily taught, learnt, and applied. Arguably, its employment serves to improve time efficacy in the screening examination, and may even improve diagnostic yield through its reliable reproducibility and provision of direct bilateral comparison. Its inherent simplicity also lends itself well to high levels of uptake (and retention) by medical students and junior clinicians alike. On top of presenting the simple screening test itself, we offer a simple means of subsequent notation for the patient's case note record, again in the hope of standardization and endurance of clinical value beyond the time of patient examination.

  4. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    NASA Astrophysics Data System (ADS)

    Kikuchi, T.; Jin, Y.; Fukushima, K.; Akai, H.; Furusho, J.

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named "Hybrid-PLEMO" in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  5. Understanding and Overcoming Barriers to Upper Limb Surgical Reconstruction After Tetraplegia: The Need for Interdisciplinary Collaboration.

    PubMed

    Punj, Vandana; Curtin, Catherine

    2016-06-01

    There are approximately 300,000 persons with spinal cord injury living in the United States, and nearly 60% of these persons have suffered tetraplegia with resultant alterations in body function, activity, and therefore participation. Restoring hand function can improve independence, and various studies have shown that persons with tetraplegia rate restoration of arm and hand function higher than bowel and bladder control, walking, or sexuality. There are conservative options to improve upper limb function in this population (eg, orthoses, neuroprostheses). Surgical interventions are also available, and 70% of surgical patients report satisfaction and improvement in various activities of daily living after surgery to restore arm and hand function. Despite these positive surgical outcomes, <10% of the eligible population of 60% to 70% undergo tendon transfer surgery to restore function. Underutilization of surgical interventions can be explained by population-, provider-, and health care systems-specific barriers. With further education of providers and patients and team building across disciplines these barriers can be overcome, ultimately leading to reduced disability and improved quality of life for persons with tetraplegia. PMID:27233595

  6. Autobiographical memory and psychological distress in a sample of upper-limb amputees.

    PubMed

    Luchetti, Martina; Montebarocci, Ornella; Rossi, Nicolino; Cutti, Andrea G; Sutin, Angelina R

    2014-01-01

    Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a) examines psychological adjustment in a specific trauma-exposed sample, (b) compares the phenomenology (e.g., vividness) of amputation-related memories to more recent memories, and (c) tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories--an amputation-related memory and a recent memory--and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions. PMID:24924483

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

  9. Autobiographical memory and psychological distress in a sample of upper-limb amputees.

    PubMed

    Luchetti, Martina; Montebarocci, Ornella; Rossi, Nicolino; Cutti, Andrea G; Sutin, Angelina R

    2014-01-01

    Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a) examines psychological adjustment in a specific trauma-exposed sample, (b) compares the phenomenology (e.g., vividness) of amputation-related memories to more recent memories, and (c) tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories--an amputation-related memory and a recent memory--and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions.

  10. 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.

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

    PubMed

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

    2015-07-03

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

  12. Contributions of upper limb rotations to racket velocity in table tennis backhands against topspin and backspin.

    PubMed

    Iino, Yoichi; Mori, Teruaki; Kojima, Takeji

    2008-02-01

    The purpose of this study was to assess the contributions of racket arm joint rotations to the racket tip velocity at ball impact in table tennis topspin backhands against topspin and backspin using the method of Sprigings et al. (1994). Two cine cameras were used to determine three-dimensional motions of the racket arm and racket, and the contributions of the rotations for 11 male advanced table tennis players. The racket upward velocity at impact was significantly higher in the backhand against backspin than against topspin, while the forward velocity was not significantly different between the two types of backhands. The negative contribution of elbow extension to the upward velocity was significantly less against backspin than against topspin. The contribution of wrist dorsiflexion to the upward velocity was significantly greater against backspin than against topspin. The magnitudes of the angular velocities of elbow extension and wrist dorsiflexion at impact were both similar between the two types of backhands. Our results suggest that the differences in contributions of elbow extension and wrist dorsiflexion to the upward velocity were associated with the difference in upper limb configuration rather than in magnitudes of their angular velocities.

  13. Generating artificially mastered motions for an upper limb in baseball pitching from several objective functions.

    PubMed

    Mochizuki, Y; Inokuchi, S; Omura, K

    2000-01-01

    It is possible to consider a mastered skill to be an optimal skill under some conditions, especially in the field of sports, We call an ideal skill generated in an artificial environment like a computer, an "artificially mastered skill". There must exist an objective function which represents the objective of the optimization for the skill. The objective function plays the most important role in defining the meaning of the mastered skill. In this paper, we propose a computer simulation method of generating artificially mastered motions for an upper limb during baseball pitching by using a three-dimensional mathematical model and an optimizing method. We report the consequences of simulation experiments for several objective functions that define the mastered skill in the meaning of "nonwasteful" and/or "smooth". From the consequences, we also investigate the property of an "artificially mastered skill motion" generated from each objective function, paying attention to differences among the consequent motions for each objective function from the viewpoints of kinematics and dynamics.

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

    PubMed

    Neely, Kristina A; Morris, Laura J

    2015-09-14

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

  15. 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.

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

    PubMed Central

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

    2015-01-01

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

  17. Characteristics of upper limb muscular strength in male wheelchair tennis players

    PubMed Central

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

    2013-01-01

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

  18. The Effect of Radial Extracorporeal Shock Wave Stimulation on Upper Limb Spasticity in Chronic Stroke Patients: A Single-Blind, Randomized, Placebo-Controlled Study.

    PubMed

    Dymarek, Robert; Taradaj, Jakub; Rosińczuk, Joanna

    2016-08-01

    The main purpose of this study was to determine the clinical, electrophysiological and thermal effects of radial extracorporeal shock wave (rESW) stimulation on upper limb muscles affected by spasticity in patients with chronic stroke. Patients included in the study were randomly assigned into the following two groups: 30 patients stimulated with active rESW (A); and 30 patients stimulated with placebo rESW (B). All patients were analyzed using the Modified Ashworth Scale (MAS) to test the spasticity levels of the elbow (E), radio carpal (RC) and fingers (FF) joints; surface electromyography (sEMG) was performed for the resting bioelectrical activity registration of the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) muscles; and infrared thermal imaging (IRT) was used to assess the temperature distributions of the carpal flexor muscles (CFM). All assessments were performed at baseline (t0), immediately after rESW (t1) as well as 1 and 24 h following its finalization (t2 and t3). Patients treated with active rESW showed a statistically significant reduction in the MAS score for the RC joint at t1 and for the FF joints at t1, t2 and t3 (p < 0.05). A significant decrease in sEMG activity was observed in the FCR and FCU muscles at t1, t2 and t3 (p < 0.05); significant increases in the mean and maximum values of the IRT detection was observed using inter-group comparisons in t2 and t3 (p < 0.05). No significant alterations were observed in patients after placebo rESW stimulation (p > 0.05). Applications of rESW demonstrating positive effects at reducing the level of spastic hypertonia of the upper limb muscles in patients with chronic stroke. ESW treatments should be considered as a potential anti-spastic effect to regulate vasculature. PMID:27126239

  19. Relationship Between Lower Limb Muscle Activity and Platform Acceleration During Whole-Body Vibration Exercise.

    PubMed

    Lienhard, Karin; Vienneau, Jordyn; Nigg, Sandro; Meste, Olivier; Colson, Serge S; Nigg, Benno M

    2015-10-01

    The purpose of this study was to identify the influence of different magnitudes and directions of the vibration platform acceleration on surface electromyography (sEMG) during whole-body vibration (WBV) exercises. Therefore, a WBV platform was used that delivers vertical vibrations by a side-alternating mode, horizontal vibrations by a circular mode, and vibrations in all 3 planes by a dual mode. Surface electromyography signals of selected lower limb muscles were measured in 30 individuals while they performed a static squat on a vibration platform. The WBV trials included 2 side-alternating trials (Side-L: 6 Hz, 2.5 mm; Side-H: 16 Hz, 4 mm), 2 circular trials (Circ-L: 14 Hz, 0.8 mm; Circ-H: 43 Hz, 0.8 mm), and 4 dual-mode trials that were the combinations of the single-mode trials (Side-L/Circ-L, Side-L/Circ-H, Side-H/Circ-L, Side-H/Circ-H). Furthermore, control trials without vibration were assessed, and 3-dimensional platform acceleration was quantified during the vibration. Significant increases in the root mean square of the sEMG (sEMGRMS) compared with the control trial were found in most muscles for Side-L/Circ-H (+17 to +63%, p ≤ 0.05), Side-H/Circ-L (+7 to +227%, p ≤ 0.05), and Side-H/Circ-H (+21 to +207%, p < 0.01) and in the lower leg muscles for Side-H (+35 to +138%, p ≤ 0.05). Furthermore, only the vertical platform acceleration showed a linear relationship (r = 0.970, p < 0.001) with the averaged sEMGRMS of the lower limb muscles. Significant increases in sEMGRMS were found with a vertical acceleration threshold of 18 m·s(-2) and higher. The present results emphasize that WBV exercises should be performed on a platform that induces vertical accelerations of 18 m·s(-2) and higher.

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

    PubMed

    Robertson, Benjamin D; Sawicki, Gregory S

    2015-10-27

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

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

    PubMed

    Robertson, Benjamin D; Sawicki, Gregory S

    2015-10-27

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

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

    PubMed Central

    Robertson, Benjamin D.; Sawicki, Gregory S.

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Pourmahabadian, Mohammad; Akhavan, Mehdi; Azam, Kamal

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

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

    PubMed Central

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

    2016-01-01

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

  5. Amyotrophic lateral sclerosis presenting as upper limb