Subject-Specific Carpal Ligament Elongation in Extreme Positions, Grip, and the Dart Thrower's Motion

PubMed Central

Rainbow, Michael J.; Kamal, Robin N.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

2015-01-01

This study examined whether the radiocarpal and dorsal capsular ligaments limit end-range wrist motion or remain strained during midrange wrist motion. Fibers of these ligaments were modeled in the wrists of 12 subjects over multiple wrist positions that reflect high demand tasks and the dart thrower's motion. We found that many of the volar and dorsal ligaments were within 5% of their maximum length throughout the range of wrist motion. Our finding of wrist ligament recruitment during midrange and end-range wrist motion helps to explain the complex but remarkably similar intersubject patterns of carpal motion. PMID:26367853

Wrist Arthrodesis for Failed Total Wrist Arthroplasty.

PubMed

Adams, Brian D; Kleinhenz, Ben P; Guan, Justin J

2016-06-01

Treatment options for failed total wrist arthroplasty include implant revision, resection arthroplasty, and arthrodesis. Variable results associated with different techniques have been reported for arthrodesis and the procedure has substantial technical challenges, including restoration of wrist height, obtaining stable fixation, and achieving bony fusion. This study evaluates the radiographic results of a surgical technique for conversion of a failed arthroplasty to an arthrodesis. A retrospective chart and radiograph review was performed in 20 wrists in 18 patients in whom conversion to an arthrodesis was performed using a contoured cancellous femoral head structural allograft and a wrist arthrodesis plate. Supplemental demineralized bone matrix combined with corticocancellous allograft chips was also used in 15 wrists. Median age at arthrodesis was 61 years (range, 45-78 years), and median follow-up was 34 months (range, 4-71 months). Nineteen of 20 wrists fused following the index procedure at a median of 4 months (range, 3-7 months). Proximal plate loosening occurred in 1 wrist but the joint still fused at 6 months; a successful osteotomy and revision of screw fixation was done 2 years later to correct the deformity and hardware irritation in this case. Complications were otherwise limited to 1 superficial infection that resolved with intravenous antibiotics. This technique for conversion of a failed total wrist arthroplasty to a wrist arthrodesis is safe, effective, and versatile. Wrist deformity is corrected, wrist height can be restored, stable fixation is obtained, and a high rate of fusion is achieved despite filling large defects using structural cancellous allograft. Therapeutic IV. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Evaluating the Ergonomic Benefit of a Wrist Brace on Wrist Posture, Muscle Activity, Rotational Stiffness, and Peak Shovel-Ground Impact Force During a Simulated Tree-Planting Task.

PubMed

Sheahan, Peter J; Cashaback, Joshua G A; Fischer, Steven L

2017-09-01

Background Tree planters are at a high risk for wrist injury due to awkward postures and high wrist loads experienced during each planting cycle, specifically at shovel-ground impact. Wrist joint stiffness provides a measure that integrates postural and loading information. Objective The purpose of this study was to evaluate wrist joint stiffness requirements at the instant of shovel-ground impact during tree planting and determine if a wrist brace could alter muscular contributions to wrist joint stiffness. Method Planters simulated tree planting with and without wearing a brace on their planting arm. Surface electromyography (sEMG) from six forearm muscles and wrist kinematics were collected and used to calculate muscular contributions to joint rotational stiffness about the wrist. Results Wrist joint stiffness increased with brace use, an unanticipated and negative consequence of wearing a brace. As a potential benefit, planters achieved a more neutrally oriented wrist angle about the flexion/extension axis, although a less neutral wrist angle about the ulnar/radial axis was observed. Muscle activity did not change between conditions. Conclusion The joint stiffness analysis, combining kinematic and sEMG information in a biologically relevant manner, revealed clear limitations with the interface between the brace grip and shovel handle that jeopardized the prophylactic benefits of the current brace design. This limitation was not as evident when considering kinematics and sEMG data independently. Application A neuromechanical model (joint rotational stiffness) enhanced our ability to evaluate the brace design relative to kinematic and sEMG parameter-based metrics alone.

Update on the evaluation of wrist pain.

PubMed

Nichols, Chris M; Cheng, Christine

2006-01-01

Wrist pain is a common presenting complaint in patients both for the hand specialist and the primary care physician. Knowledge of wrist anatomy and a thorough and systematic wrist examination remain the mainstays of evaluation. Radiologic as well as arthroscopic technology and techniques continue to evolve and provide useful adjuncts to wrist evaluation that expand our diagnostic and therapeutic capabilities.

Management of the failed biaxial wrist replacement.

PubMed

Talwalkar, S C; Hayton, M J; Trail, I A; Stanley, J K

2005-06-01

Nine cases of failed biaxial wrist replacement underwent revision surgery and subsequent clinical and radiographic assessment at a mean follow-up of 28 months. Clinical assessment included the hospital for special surgery (HSS) and activities of daily living scoring systems. Five patients had a revision biaxial wrist replacement, three had wrist fusions and two underwent an excision arthroplasty. The mean HSS score was 73 for the revision biaxial replacements, 63 for the wrist fusions and 92 for the excision arthroplasties. The mean activities for daily living score was 16 for the revision biaxial replacements, 14 for the wrist fusion and 20 for the excision arthroplasties. Despite the experience of implant failure, six patients would still choose a primary wrist replacement again. All patients in this small series appear to have had good clinical outcomes. Revision to another wrist replacement appears no worse than a wrist fusion in the short term and patients value the preservation of movement that an implant offers.

A New Wrist Clinical Evaluation Score.

PubMed

Herzberg, Guillaume; Burnier, Marion; Nakamura, Toshiyasu

2018-04-01

Background  The number of available wrist scoring systems is limited; some of them do not include forearm rotation criteria. Purpose  To describe a new electronic wrist clinical score and to present a new patient's generated wrist evaluation criterion, the subjective wrist value (SWV). Materials and Methods  A new electronic wrist clinical score, the Lyon wrist score (LWS) including wrist VAS pain and function, active range of motion and strength was built into an excel file. VAS flexion-extension pain and function were evaluated independently from pronation-supination pain and function. A new patient's generated wrist evaluation criterion, SWV was described. Results  The LWS is available in two versions, standard and full (the latter including forearm rotation strength). Both standard and full LWS are displayed into an automatically generated diamond-shaped graph providing a comprehensive visual display of the clinical status of most osteoarticular wrist disorders. The graph also includes SWV. The LWS, combined with SWV into a graph that may be directly exported to a PowerPoint presentation, provide a new practical and comprehensive tool for following/comparing wrist osteoarticular clinical status/outcomes. Both standard and full LWS charts are available in colored versions on a related website for free download. Conclusion  A comprehensive updated electronic display of osteoarticular wrist clinical status including forearm rotation criteria is provided and displayed into a graph which may be exported as such into a PowerPoint presentation for clinical analysis/comparisons. Level of Evidence  Level II.

Comparability and feasibility of wrist- and hip-worn accelerometers in free-living adolescents.

PubMed

Scott, Joseph J; Rowlands, Alex V; Cliff, Dylan P; Morgan, Philip J; Plotnikoff, Ronald C; Lubans, David R

2017-12-01

To determine the comparability and feasibility of wrist- and hip-worn accelerometers among free-living adolescents. 89 adolescents (age=13-14years old) from eight secondary schools in New South Wales (NSW), Australia wore wrist-worn GENEActiv and hip-worn ActiGraph (GT3X+) accelerometers simultaneously for seven days and completed an accelerometry behavior questionnaire. Bivariate correlations between the wrist- and hip-worn out-put were used to determine concurrent validity. Paired samples t-test were used to compare minutes per day in moderate-to-vigorous physical activity (MVPA). Group means and paired sample t-tests were used to analyze participants' perceptions of the wrist- and hip-worn monitoring protocols to assist with determining the feasibility. Wrist-worn accelerometry compared favorably with the hip-worn in average activity (r=0.88, p<0.001) and MVPA (r=0.84 p<0.001, mean difference=3.54min/day, SD=12.37). The wrist-worn accelerometer had 50% fewer non-valid days (75 days, 12%) than the hip-worn accelerometer (n=152, 24.4%). Participants reported they liked to wear the device on the wrist (p<0.01), and that it was less uncomfortable (p=0.02) and less embarrassing to wear on the wrist (p<0.01). Furthermore, that they would be more willing to wear the device again on the wrist over the hip (p<0.01). Our findings reveal there is a strong linear relationship between wrist- and hip-worn accelerometer out-put among adolescents in free-living conditions. Adolescent compliance was significantly higher with wrist placement, with participants reporting that it was more comfortable and less embarrassing to wear on the wrist. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Wrist osteoarthritis.

PubMed

Laulan, J; Marteau, E; Bacle, G

2015-02-01

Painful wrist osteoarthritis can result in major functional impairment. Most cases are related to posttraumatic sequel, metabolic arthropathies, or inflammatory joint disease, although wrist osteoarthritis occurs as an idiopathic condition in a small minority of cases. Surgery is indicated only when conservative treatment fails. The main objective is to ensure pain relief while restoring strength. Motion-preserving procedures are usually preferred, although residual wrist mobility is not crucial to good function. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, and rib-cartilage graft implantation. Surgical decisions rest on the cause and extent of the degenerative wrist lesions, degree of residual mobility, and patient's wishes and functional demand. Proximal row carpectomy and four-corner fusion with scaphoid bone excision are the most widely used surgical procedures for stage II wrist osteoarthritis secondary to scapho-lunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist. Proximal row carpectomy is not indicated in patients with stage III disease. Total wrist denervation is a satisfactory treatment option in patients of any age who have good range of motion and low functional demands; furthermore, the low morbidity associated with this procedure makes it a good option for elderly patients regardless of their range of motion. Total wrist fusion can be used not only as a revision procedure, but also as the primary surgical treatment in heavy manual labourers with wrist stiffness or generalised wrist-joint involvement. The role for pyrocarbon implants, rib-cartilage graft implantation, and total wrist arthroplasty remains to be determined, given the short follow-ups in available studies. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius.

PubMed

Karnezis, I A; Panagiotopoulos, E; Tyllianakis, M; Megas, P; Lambiris, E

2005-12-01

The present study investigates the correlation between radiological parameters of wrist fractures and the clinical outcome expressed by objective clinical parameters and the level of patient-rated wrist dysfunction. Thirty consecutive cases of unstable distal radial fractures treated with closed reduction and percutaneous fixation were prospectively studied for a period of one year. The outcome parameters included objective clinical and radiological parameters and the previously described and validated patient-rated wrist evaluation (PRWE) score. Analysis showed that for unstable (AO classification types 23-A2, -A3, -C1 and -C2) fractures the fracture type affects the range of wrist palmarflexion (p=0.04) and that the presence of postoperative articular 'step-off' affects the range of wrist dorsiflexion and the patient-rated wrist function at the final time of the study (p<0.01 and p=0.02, respectively). It is also shown that permanent radial shortening and loss of the palmar angle were associated with prolonged wrist pain (p<0.01 and p=0.03, respectively). Our finding that residual articular incongruity correlates with persisting loss of wrist dorsiflexion and wrist dysfunction contradicts the view that loss of articular congruity is associated with late development of articular degeneration but not with early wrist dysfunction. Additionally, this study failed to show any association between the fracture type and the functional outcome as rated by the patients.

[The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma].

PubMed

Walenkamp, Monique M J; Bentohami, Abdelali; Slaar, Annelie; Beerekamp, M S H Suzan; Maas, Mario; Jager, L C Cara; Sosef, Nico L; van Velde, Romuald; Ultee, Jan M; Steyerberg, Ewout W; Goslings, J C Carel; Schep, Niels W L

2016-01-01

Although only 39% of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule. The study was conducted in the EDs of five Dutch hospitals: one academic hospital (derivation cohort) and four regional hospitals (external validation cohort). We included all adult patients with acute wrist trauma. The main outcome was fracture of the wrist (distal radius, distal ulna or carpal bones) diagnosed on conventional X-rays. A total of 882 patients were analyzed; 487 in the derivation cohort and 395 in the validation cohort. We derived a clinical prediction model with eight variables: age; sex, swelling of the wrist; swelling of the anatomical snuffbox, visible deformation; distal radius tender to palpation; pain on radial deviation and painful axial compression of the thumb. The Area Under the Curve at external validation of this model was 0.81 (95% CI: 0.77-0.85). The sensitivity and specificity of the Amsterdam Wrist Rules (AWR) in the external validation cohort were 98% (95% CI: 95-99%) and 21% (95% CI: 15%-28). The negative predictive value was 90% (95% CI: 81-99%). The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs.

3D motion analysis of the wrist splint effect to wrist joint movement.

PubMed

Shin, Joong-Il; Park, Soo-Hee

2017-06-01

[Purpose] This study aimed to investigate the degree of straightness of the wrist joint, depending on the use of a wrist splint while opening a bottle cap. Its results may provide data for later studies on preventing accidents at workplaces and improving efficiency. [Subjects and Methods] Thirty Male and Female in their twenties who did not have hand-related diseases, fractures, or history that included neurological impairments associated with the hand were selected as subjects of the study. Wrist splints were made to fit the hand and lower arm of each subject. Evaluation assignments were carried out without and with the splints after 10 minutes of rest. To analyze the wrist movement in opening the bottle cap, a three-dimensional movement analyzing system by Zebris was used. [Results] Wrist angle decreased while opening caps of four different diameters while wearing splints, but not when splints were not worn. This means that wearing a splint may aid weakened wrist muscles. [Conclusion] Future studies should be conducted among subjects with damaged wrist muscles and evaluate the subjects in actual workplaces to obtain more objective and more valid data.

Ulnar nerve lesion at the wrist and sport: A report of 8 cases compared with 45 non-sport cases.

PubMed

Seror, P

2015-04-01

Reporting clinical and electrodiagnostic characteristics of sport-related ulnar neuropathies at the wrist. Eight sport-related and 45 non-sport-related cases from 53 ulnar neuropathies at the wrist cases over 14 years. Sport-related ulnar neuropathies at the wrist cases were due to cycling (5 cases), kayaking (2 cases), and big-game fishing (1 case). No patient had sensory complaints in ulnar digits, and all had motor impairment. Conduction across the wrist with recording on the first dorsal interosseous muscle was impaired in all cases, with conduction block in 5. Two cyclists showed bilateral ulnar neuropathies at the wrist. All cases recovered within 2 to 6 months with sport discontinuation. Distal lesions of the deep motor branch were more frequent in sport- than non-sport-related cases. The 8 sport-related ulnar neuropathies at the wrist cases involved the deep motor branch. Conduction study to the first dorsal interosseous muscle across the wrist is the key to electrodiagnostics. Bilateral cases in cyclists does not require wrist imaging. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

X-Ray Exam: Wrist

MedlinePlus

... Staying Safe Videos for Educators Search English Español X-Ray Exam: Wrist KidsHealth / For Parents / X-Ray Exam: Wrist What's in this article? What ... Have Questions Print What It Is A wrist X-ray is a safe and painless test that ...

Using walker during walking: a pilot study for health elder.

PubMed

Po-Chan, Yeh; Cherng-Yee, Leung

2012-01-01

Walker operation completely relies on the walker handle, however most marketed walkers possess two horizontal handles. Several researchers have suggested that horizontal handles might lead to wrist injury. Therefore, the purpose of this study is to assess the relevant design aspects of walker for elderly people. 28 elders participated in this study; when the experiment was started, subject walked on the tile for 3 meter distance twice by using walker. Data for analysis were selected at the corresponding wrist deviation and vertical force. The results showed that during walker using, the mean wrist deviation was greater than zero. The largest vertical force is significantly larger than the smallest one, and different wrist deviation occurred at three phases, the largest wrist deviation while raising walker is larger than the smallest one, however, no significant different was found between the largest and smallest wrist deviation while pressing walker. No significant correlation occurred between weight and wrist deviation. The correlation between weight and vertical force was significantly positive. With wrist deviation walker use may cause injury to upper-limb, however wrists remain in a neutral position during hand movement to prevent damage. The findings of this study should improve the design of walker handles to reduce the wrist deviations of users.

Complications of wrist arthroscopy.

PubMed

Ahsan, Zahab S; Yao, Jeffrey

2012-06-01

The purpose of this systematic review was to address the incidence of complications associated with wrist arthroscopy. Given the paucity of information published on this topic, an all-inclusive review of published wrist arthroscopy complications was sought. Two independent reviewers performed a literature search using PubMed, Google Scholar, EBSCO, and Academic Megasearch using the terms "wrist arthroscopy complications," "complications of wrist arthroscopy," "wrist arthroscopy injury," and "wrist arthroscopy." Inclusion criteria were (1) Levels I to V evidence, (2) "complication" defined as an adverse outcome directly related to the operative procedure, and (3) explicit description of operative complications in the study. Eleven multiple-patient studies addressing complications of wrist arthroscopy from 1994 to 2010 were identified, with 42 complications reported from 895 wrist arthroscopy procedures, a 4.7% complication rate. Four case reports were also found, identifying injury to the dorsal sensory branch of the ulnar nerve, injury to the posterior interosseous nerve, and extensor tendon sheath fistula formation. This systematic review suggests that the previously documented rate of wrist arthroscopy complications may be underestimating the true incidence. The report of various complications provides insight to surgeons for improving future surgical techniques. Level IV, systematic review of Levels I-V studies. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The effectiveness of wrist guards for reducing wrist and elbow accelerations resulting from simulated forward falls.

PubMed

Burkhart, Timothy A; Andrews, David M

2010-08-01

The effectiveness of wrist guards and modifying elbow posture for reducing impact-induced accelerations at the wrist and elbow, for the purpose of decreasing upper extremity injury risk during forward fall arrest, has not yet been documented in living people. A seated human pendulum was used to simulate the impact conditions consistent with landing on outstretched arms during a forward fall. Accelerometers measured the wrist and elbow response characteristics of 28 subjects following impacts with and without a wrist guard, and with elbows straight or slightly bent. Overall, the wrist guard was very effective, with significant reductions in peak accelerations at the elbow in the axial and off-axis directions, and in the off-axis direction at the wrist by almost 50%. The effect of elbow posture as an intervention strategy was mixed; a change in magnitude and direction of the acceleration response was documented at the elbow, while there was little effect at the wrist. Unique evidence was presented in support of wrist guard use in activities like in-line skating where impacts to the hands are common. The elbow response clearly shows that more proximal anatomical structures also need to be monitored when assessing the effectiveness of injury prevention strategies.

Patient-Reported Outcome Measures for Hand and Wrist Trauma

PubMed Central

Dacombe, Peter Jonathan; Amirfeyz, Rouin; Davis, Tim

2016-01-01

Background: Patient-reported outcome measures (PROMs) are important tools for assessing outcomes following injuries to the hand and wrist. Many commonly used PROMs have no evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. This systematic review examines the PROMs used in the assessment of hand and wrist trauma patients, and the evidence for reliability, validity, and responsiveness of each measure in this population. Methods: A systematic review of Pubmed, Medline, and CINAHL searching for randomized controlled trials of patients with traumatic injuries to the hand and wrist was carried out to identify the PROMs. For each identified PROM, evidence of reliability, validity, and responsiveness was identified using a further systematic review of the Pubmed, Medline, CINAHL, and reverse citation trail audit procedure. Results: The PROM used most often was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; the Patient-Rated Wrist Evaluation (PRWE), Gartland and Werley score, Michigan Hand Outcomes score, Mayo Wrist Score, and Short Form 36 were also commonly used. Only the DASH and PRWE have evidence of reliability, validity, and responsiveness in patients with traumatic injuries to the hand and wrist; other measures either have incomplete evidence or evidence gathered in a nontraumatic population. Conclusions: The DASH and PRWE both have evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. Other PROMs used to assess hand and wrist trauma patients do not. This should be considered when selecting a PROM for patients with traumatic hand and wrist pathology. PMID:27418884

Trigger wrist caused by avascular necrosis of the capitate: a case report.

PubMed

Matsui, Yuichiro; Kawamura, Daisuke; Kida, Hiroaki; Hatanaka, Kanako C; Iwasaki, Norimasa

2018-03-27

Trigger wrist is a rare condition first described by Marti in 1960, and various causes have been reported. The condition mostly occurs with finger flexion and extension, and rarely with flexion and extension of the wrist itself. Avascular necrosis of the capitate is also a rare condition, first described by Jönsson in 1942. While some reports of this condition have been published, little is known about its etiology. Therefore, no established treatment exists. We report a case of trigger wrist caused by avascular necrosis of the capitate. A 16-year-old right-handed male who was a high school handball player was referred to our department from a nearby hospital 5 months after the onset of pain in the dorsal aspect of the right wrist, with an unknown cause. At the previous hospital, imaging findings led to a diagnosis of avascular necrosis of the capitate, and conservative treatment with a wrist brace did not improve the pain. At the initial visit to our department, the patient was noted to have a painful trigger wrist that was brought on by wrist flexion and extension. Preoperative imaging findings led to a diagnosis of trigger wrist caused by capitolunate instability secondary to avascular necrosis of the capitate. We performed a partial excision of the proximal capitate with tendon ball interposition. Two years after surgery, the patient's clinical outcome was favorable, with no recurrence of wrist pain or triggering. Both trigger wrist and avascular necrosis of the capitate are rare disorders. When a patient presents with painful triggering at the wrist, surgeons must bear in mind that avascular necrosis of the capitate may result in this phenomenon. We recommend partial excision of the proximal capitate with tendon ball interposition for the treatment of this lesion.

The Effect of Supination and Pronation on Wrist Range of Motion

PubMed Central

Kane, Patrick M.; Vopat, Bryan G.; Got, Christopher; Mansuripur, Kaveh; Akelman, Edward

2014-01-01

Wrist range of motion (ROM) is a combination of complex osseous articulations and intricate soft tissue constraints. It has been proposed that forearm rotation contributes significantly to carpal kinematics. However, no studies have investigated whether supination or pronation influence this course of motion. The purpose of this study is to examine whether supination and pronation affect the mechanical axis of the wrist. After being screened for gross anatomic abnormalities, six upper extremity cadaver specimens (three matched pairs) were fixed to a custom-designed jig that allows 24 different directions of wrist motion. Each specimen was tested in three separate forearm positions: neutral, full supination, and full pronation. Moments of ± 2 Nm were applied, and the applied moment versus wrist rotation data were recorded. Forearm position did not significantly (p > 0.31) affect the ROM values of the wrist. In forearm neutral, supination, and pronation positions the envelope of wrist ROM values was ellipsoidal in shape, consistent with prior neutral forearm biomechanical testing. The major axis of the ellipse was oriented in a radial extension to ulnar flexion direction, with the largest ROM in ulnar flexion. We hypothesized that forearm position would influence wrist ROM. However, our biomechanical testing showed no statistically significant difference in the orientation of the mechanical axis nor the passive ROM of the wrist. The primary passive mechanical axis in all three forearm positions tested (neutral, supination, and pronation) was aligned with radial extension and ulnar flexion. Although it has been shown that forearm position affects various radioulnar, radiocarpal, and ulnocarpal ligamentous tensions and lengths, it appears that wrist ROM is independent of forearm position. Consequently we feel our biomechanical testing illustrates that wrist ROM is primarily dependent on the osseous articulations of the carpus. Additionally, given that no change is observed in wrist ROM relative to forearm position, the significance of the contribution of the distal radioulnar joint (DRUJ) to wrist kinematics is debatable. PMID:25097812

Wrist kinetics after luno-triquetral dissociation: the changes in moment arms of the flexor carpi ulnaris tendon.

PubMed

Tang, Jin Bo; Xie, Ren Gou; Yu, Xiao Wei; Chen, Feng

2002-11-01

Wrist biomechanics after luno-triquetral (LT) dissociation is important for understanding the clinical sequelae of the disease and for determining its treatment options. The LT interosseous ligament plays an important role in stabilizing the joint and damage to the ligament would be expected to significantly increase moment arms of tendon of the flexor carpi ulnaris (FCU), the principal ulnar wrist flexor. We investigated the changes in moment arms of FCU tendon after various amounts of sectioning of the ligaments proven to be associated with LT dissociation. In six fresh frozen cadaveric upper extremities, excursions of the FCU tendon were recorded simultaneously with wrist joint angulation during wrist flexion-extension and radioulnar deviation. Tendon excursions were measured in intact wrists, in wrists with sectioning of the dorsal portion of the LT interosseous ligament, in wrists with sectioning of the entire LT interosseous ligament, and finally in wrists with further sectioning of the dorsal radiotriquetral and intercarpal ligaments. Moment arms of the tendon were calculated from tendon excursions and joint motion angulations and expressed as percentage changes from those in the intact wrist. During wrist flexion-extension, moment arms of the FCU tendon after sectioning of the entire LT interosseous ligament and after sectioning of the two capsular ligaments were 112 +/- 7% and 114 +/- 8%, respectively; these values were significantly greater than those in the intact wrist. During radioulnar deviation, the moment arms were 114 +/- 11% after sectioning of the dorsal portion of the LT interosseous ligament, 134 +/- 15% after sectioning of the entire ligament, and 153 +/- 18% after sectioning of the capsular ligaments, again being significantly greater than the normal wrist. Increase in moment arms of the FCU tendon after loss of integrity of the LT interosseous ligament and dorsal capsular ligaments may contribute to clinical sequelae of LT dissociation and difficulty in treating this disorder.

Ergonomic study on wrist posture when using laparoscopic tools in four different techniques regarding minimally invasive surgery.

PubMed

Bartnicka, Joanna; Zietkiewicz, Agnieszka A; Kowalski, Grzegorz J

2018-03-19

With reference to four different minimally invasive surgery (MIS) cholecystectomy the aims were: to recognize the factors influencing dominant wrist postures manifested by the surgeon; to detect risk factors involved in maintaining deviated wrist postures; to compare the wrist postures of surgeons while using laparoscopic tools. Video films were recorded during live surgeries. The films were synchronized with wrist joint angles obtained from wireless electrogoniometers placed on the surgeon's hand. The analysis was conducted for five different laparoscopic tools used during all surgical techniques. The most common wrist posture was extension. In the case of one laparoscopic tool, the mean values defining extended wrist posture were distinct in all four surgical techniques. For one type of surgical technique, considered to be the most beneficial for patients, more extreme postures were noticed regarding all laparoscopic tools. We recognized a new factor, apart from the tool's handle design, that influences extreme and deviated wrist postures. It involves three areas of task specification including the type of action, type of motion patterns and motion dynamism. The outcomes proved that the surgical technique which is most beneficial for the patient imposes the greatest strain on the surgeon's wrist.

3D motion analysis of the wrist splint effect to wrist joint movement

PubMed Central

Shin, Joong-il; Park, Soo-hee

2017-01-01

[Purpose] This study aimed to investigate the degree of straightness of the wrist joint, depending on the use of a wrist splint while opening a bottle cap. Its results may provide data for later studies on preventing accidents at workplaces and improving efficiency. [Subjects and Methods] Thirty Male and Female in their twenties who did not have hand-related diseases, fractures, or history that included neurological impairments associated with the hand were selected as subjects of the study. Wrist splints were made to fit the hand and lower arm of each subject. Evaluation assignments were carried out without and with the splints after 10 minutes of rest. To analyze the wrist movement in opening the bottle cap, a three-dimensional movement analyzing system by Zebris was used. [Results] Wrist angle decreased while opening caps of four different diameters while wearing splints, but not when splints were not worn. This means that wearing a splint may aid weakened wrist muscles. [Conclusion] Future studies should be conducted among subjects with damaged wrist muscles and evaluate the subjects in actual workplaces to obtain more objective and more valid data. PMID:28626332

Can validated wrist devices with position sensors replace arm devices for self-home blood pressure monitoring? A randomized crossover trial using ambulatory monitoring as reference.

PubMed

Stergiou, George S; Christodoulakis, George R; Nasothimiou, Efthimia G; Giovas, Periklis P; Kalogeropoulos, Petros G

2008-07-01

Electronic devices that measure blood pressure (BP) at the arm level are regarded as more accurate than wrist devices and are preferred for home BP (HBP) monitoring. Recently, wrist devices with position sensors have been successfully validated using established protocols. This study assessed whether HBP values measured with validated wrist devices are sufficiently reliable to be used for making patient-related decisions in clinical practice. This randomized crossover study compared HBP measurements taken using validated wrist devices (wrist-HBP, Omron R7 with position sensor) with those taken using arm devices (arm-HBP, Omron 705IT), and also with measurements of awake ambulatory BP (ABP, SpaceLabs), in 79 subjects (36 men and 43 women) with hypertension. The mean age of the study population was 56.7 +/- 11.8 years, and 33 of the subjects were not under treatment for hypertension. The average arm-HBP was higher than the average wrist-HBP (mean difference, systolic 5.2 +/- 9.1 mm Hg, P < 0.001, and diastolic 2.2 +/- 6.7, P < 0.01). Twenty-seven subjects (34%) had a > or =10 mm Hg difference between systolic wrist-HBP and arm-HBP and twelve subjects (15%) showed similar levels of disparity in diastolic HBP readings. Strong correlations were found between arm-HBP and wrist-HBP (r 0.74/0.74, systolic/diastolic, P < 0.0001). However, ABP was more strongly correlated with arm-HBP (r 0.73/0.76) than with wrist-HBP (0.55/0.69). The wrist-arm HBP difference was associated with systolic ABP (r 0.34) and pulse pressure (r 0.29), but not with diastolic ABP, sex, age, arm circumference, and wrist circumference. There might be important differences in HBP measured using validated wrist devices with position sensor vs. arm devices, and these could impact decisions relating to the patient in clinical practice. Measurements taken using arm devices are more closely related to ABP values than those recorded by wrist devices. More research is needed before recommending the widespread use of wrist monitors in clinical practice. American Journal of Hypertension doi:10.1038/ajh.2008.176American Journal of Hypertension (2008); 21, 7, 753-758. doi:10.1038/ajh.2008.176.

The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma.

PubMed

Walenkamp, Monique M J; Bentohami, Abdelali; Slaar, Annelie; Beerekamp, M Suzan H; Maas, Mario; Jager, L Cara; Sosef, Nico L; van Velde, Romuald; Ultee, Jan M; Steyerberg, Ewout W; Goslings, J Carel; Schep, Niels W L

2015-12-18

Although only 39 % of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule. The study was conducted in the EDs of five Dutch hospitals: one academic hospital (derivation cohort) and four regional hospitals (external validation cohort). We included all adult patients with acute wrist trauma. The main outcome was fracture of the wrist (distal radius, distal ulna or carpal bones) diagnosed on conventional X-rays. A total of 882 patients were analyzed; 487 in the derivation cohort and 395 in the validation cohort. We derived a clinical prediction model with eight variables: age; sex, swelling of the wrist; swelling of the anatomical snuffbox, visible deformation; distal radius tender to palpation; pain on radial deviation and painful axial compression of the thumb. The Area Under the Curve at external validation of this model was 0.81 (95 % CI: 0.77-0.85). The sensitivity and specificity of the Amsterdam Wrist Rules (AWR) in the external validation cohort were 98 % (95 % CI: 95-99 %) and 21 % (95 % CI: 15 %-28). The negative predictive value was 90 % (95 % CI: 81-99 %). The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs. This study was registered in the Dutch Trial Registry, reference number NTR2544 on October 1(st), 2010.

Sports-Related Wrist Injuries in Adults

PubMed Central

Chen, Neal C.; Jupiter, Jesse B.; Jebson, Peter J. L.

2009-01-01

Background: Wrist injuries are common in sports. Those who are involved in the care of athletes should be familiar with hand and wrist anatomy, common wrist injuries, and clinical examination; they should also know how to recognize emergent problems. Level of Evidence: Level V, expert opinion. PMID:23015908

Comparison of Compliance and Intervention Outcomes Between Hip- and Wrist-Worn Accelerometers During a Randomized Crossover Trial of an Active Video Games Intervention in Children.

PubMed

Howie, Erin K; McVeigh, Joanne A; Straker, Leon M

2016-09-01

There are several practical issues when considering the use of hip-worn or wrist-worn accelerometers. This study compared compliance and outcomes between hip- and wrist-worn accelerometers worn simultaneously by children during an active video games intervention. As part of a larger randomized crossover trial, participants (n = 73, age 10 to 12 years) wore 2 Actical accelerometers simultaneously during waking hours for 7 days, on the hip and wrist. Measurements were repeated at 4 timepoints: 1) at baseline, 2) during traditional video games condition, 3) during active video games condition, 4) during no video games condition. Compliance and intervention effects were compared between hip and wrist. There were no statistically significant differences at any timepoint in percentage compliance between hip (77% to 87%) and wrist (79% to 89%). Wrist-measured counts (difference of 64.3 counts per minute, 95% CI 4.4-124.3) and moderate-to-vigorous physical activity (MVPA) (12 min/day, 95% CI 0.3-23.7) were higher during the no video games condition compared with the traditional video games condition. There were no differences in hip-measured counts per minute or MVPA between conditions or sedentary time for hip or wrist. There were no differences in compliance between hip- and wrist-worn accelerometers during an intervention trial, however, intervention findings differed between hip and wrist.

[Theoretical origin and clinical application of wrist-ankle acupuncture therapy].

PubMed

Wang, Qiong; Zhou, Qinghui

2017-05-12

The theory of wrist-ankle acupuncture is consistent with traditional meridian-collateral theory. For example, the body divisions of wrist-ankle acupuncture are corresponding to the distribution of 12 cutaneous regions of meridians, the needling sites of it are to the running courses of 12 meridians; the indications of it are to those of 12 meridians. The needling sites of wrist-ankle acupuncture are relevant with some special acupoints of acupuncture theory. For example, the 12-needling sites of wrist-ankle acupuncture are located similar to those of 12 meridian points and have very similar indications. The needling sites of it are located in the wrist and ankle regions, in which the five- shu points are located nearby, for meridian disorders. Most luo -connecting points are located near to the needling sites of wrist-ankle acupuncture or the needle tip points to. Additionally, the needling method of wrist-ankle acupuncture is consistent with some of the subcutaneous needling methods in traditional acupuncture therapy. On the basis of the aspects mentioned above, it is explained that wrist-ankle acupuncture is the development of traditional acupuncture and cannot be independent from the traditional theories of acupuncture and meridians. It is necessary to seek for the evidence from the traditional theories of TCM. The traditional theories of TCM are summarized from clinical practice, which can be newly verified from the practice of wrist-ankle acupuncture.

Patient-Reported Outcome Measures for Hand and Wrist Trauma: Is There Sufficient Evidence of Reliability, Validity, and Responsiveness?

PubMed

Dacombe, Peter Jonathan; Amirfeyz, Rouin; Davis, Tim

2016-03-01

Patient-reported outcome measures (PROMs) are important tools for assessing outcomes following injuries to the hand and wrist. Many commonly used PROMs have no evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. This systematic review examines the PROMs used in the assessment of hand and wrist trauma patients, and the evidence for reliability, validity, and responsiveness of each measure in this population. A systematic review of Pubmed, Medline, and CINAHL searching for randomized controlled trials of patients with traumatic injuries to the hand and wrist was carried out to identify the PROMs. For each identified PROM, evidence of reliability, validity, and responsiveness was identified using a further systematic review of the Pubmed, Medline, CINAHL, and reverse citation trail audit procedure. The PROM used most often was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; the Patient-Rated Wrist Evaluation (PRWE), Gartland and Werley score, Michigan Hand Outcomes score, Mayo Wrist Score, and Short Form 36 were also commonly used. Only the DASH and PRWE have evidence of reliability, validity, and responsiveness in patients with traumatic injuries to the hand and wrist; other measures either have incomplete evidence or evidence gathered in a nontraumatic population. The DASH and PRWE both have evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. Other PROMs used to assess hand and wrist trauma patients do not. This should be considered when selecting a PROM for patients with traumatic hand and wrist pathology.

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint metal constrained cemented prosthesis... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3790 Wrist joint metal constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a...

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint metal constrained cemented prosthesis... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3790 Wrist joint metal constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a...

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

21 CFR 888.3780 - Wrist joint polymer constrained prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint polymer constrained prosthesis. 888... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3780 Wrist joint polymer constrained prosthesis. (a) Identification. A wrist joint polymer constrained prosthesis is a device made of...

Current role of multidetector computed tomography in imaging of wrist injuries.

PubMed

Syed, Mohd Arif; Raj, Vimal; Jeyapalan, Kanagaratnam

2013-01-01

Imaging of the wrist is challenging to both radiologists and orthopedic surgeons. This is primarily because of the complex anatomy/functionality of the wrist and also the fact that many frequent injuries are sustained to the hands. On going developments in multidetector computed tomography (MDCT) technology with its "state of the art" postprocessing capabilities have revolutionized this field. Apart from routine imaging of wrist trauma, it is now possible to assess intrinsic ligaments with MDCT arthrography, thereby avoiding invasive diagnostic arthroscopies. Postoperative wrist imaging can be a diagnostic challenge, and MDCT can be helpful in assessment of these cases because volume acquisition and excellent postprocessing abilities help to evaluate these wrists in any desired plane and thinner slices. This article pictorially reviews the current clinical role of MDCT imaging of wrist in our practice. It also describes arthrography technique and scanning parameters used at our center. Copyright © 2013 Mosby, Inc. All rights reserved.

Estimation of Thermal Sensation Based on Wrist Skin Temperatures.

PubMed

Sim, Soo Young; Koh, Myung Jun; Joo, Kwang Min; Noh, Seungwoo; Park, Sangyun; Kim, Youn Ho; Park, Kwang Suk

2016-03-23

Thermal comfort is an essential environmental factor related to quality of life and work effectiveness. We assessed the feasibility of wrist skin temperature monitoring for estimating subjective thermal sensation. We invented a wrist band that simultaneously monitors skin temperatures from the wrist (i.e., the radial artery and ulnar artery regions, and upper wrist) and the fingertip. Skin temperatures from eight healthy subjects were acquired while thermal sensation varied. To develop a thermal sensation estimation model, the mean skin temperature, temperature gradient, time differential of the temperatures, and average power of frequency band were calculated. A thermal sensation estimation model using temperatures of the fingertip and wrist showed the highest accuracy (mean root mean square error [RMSE]: 1.26 ± 0.31). An estimation model based on the three wrist skin temperatures showed a slightly better result to the model that used a single fingertip skin temperature (mean RMSE: 1.39 ± 0.18). When a personalized thermal sensation estimation model based on three wrist skin temperatures was used, the mean RMSE was 1.06 ± 0.29, and the correlation coefficient was 0.89. Thermal sensation estimation technology based on wrist skin temperatures, and combined with wearable devices may facilitate intelligent control of one's thermal environment.

Estimation of Thermal Sensation Based on Wrist Skin Temperatures

PubMed Central

Sim, Soo Young; Koh, Myung Jun; Joo, Kwang Min; Noh, Seungwoo; Park, Sangyun; Kim, Youn Ho; Park, Kwang Suk

2016-01-01

Thermal comfort is an essential environmental factor related to quality of life and work effectiveness. We assessed the feasibility of wrist skin temperature monitoring for estimating subjective thermal sensation. We invented a wrist band that simultaneously monitors skin temperatures from the wrist (i.e., the radial artery and ulnar artery regions, and upper wrist) and the fingertip. Skin temperatures from eight healthy subjects were acquired while thermal sensation varied. To develop a thermal sensation estimation model, the mean skin temperature, temperature gradient, time differential of the temperatures, and average power of frequency band were calculated. A thermal sensation estimation model using temperatures of the fingertip and wrist showed the highest accuracy (mean root mean square error [RMSE]: 1.26 ± 0.31). An estimation model based on the three wrist skin temperatures showed a slightly better result to the model that used a single fingertip skin temperature (mean RMSE: 1.39 ± 0.18). When a personalized thermal sensation estimation model based on three wrist skin temperatures was used, the mean RMSE was 1.06 ± 0.29, and the correlation coefficient was 0.89. Thermal sensation estimation technology based on wrist skin temperatures, and combined with wearable devices may facilitate intelligent control of one’s thermal environment. PMID:27023538

Overuse wrist injuries in young athletes: What do sports physicians consider important signals and functional limitations?

PubMed

Kox, Laura S; Kuijer, P Paul F M; Opperman, Jip; Kerkhoffs, Gino M M J; Maas, Mario; Frings-Dresen, Monique H W

2018-01-01

This study's objective was to collect items from experienced sports physicians, relating to the presence and severity of overuse wrist injuries in young athletes, for developing a measurement instrument for signals of overuse wrist injury. Seven Dutch elite sports physicians involved in guidance and treatment of young athletes in wrist-loading sports (gymnastics, tennis, judo, field hockey, volleyball and rowing) participated in a focus group. They discussed signals and limitations related to overuse wrist injuries in young athletes. Data were coded and categorised into signals and limitations with subcategories, using an inductive approach. Of the resulting 61 signals and limitations in nineteen (sub)categories, 20 were considered important, forming a comprehensive item set for identifying overuse wrist injury in young athletes. Signals such as pain, "click", crepitations, swelling and limited range of motion were marked useful for early identification of overuse wrist injury. Limitations in movement and performance were considered indicative of severe overuse injury but less relevant for initial injury identification. The focus group provided 17 important signals and 3 important limitations indicative of overuse wrist injury. These provide the basis for a valid measurement instrument for identifying overuse wrist injury in young athletes, with equal emphasis on pain and on other symptoms.

Effects of the forearm support band on wrist extensor muscle fatigue.

PubMed

Knebel, P T; Avery, D W; Gebhardt, T L; Koppenhaver, S L; Allison, S C; Bryan, J M; Kelly, A

1999-11-01

A crossover experimental design with repeated measures. To determine whether the forearm support band alters wrist extensor muscle fatigue. Fatigue of the wrist extensor muscles is thought to be a contributing factor in the development of lateral epicondylitis. The forearm support band is purported to reduce or prevent symptoms of lateral epicondylitis but the mechanism of action is unknown. Fifty unimpaired subjects (36 men, 14 women; mean age = 29 +/- 6 years) were tested with and without a forearm support band before and after a fatiguing bout of exercise. Peak wrist extension isometric force, peak isometric grip force, and median power spectral frequency for wrist extensor electromyographic activity were measured before and after exercise and with and without the forearm support band. A 2 x 2 repeated measures multivariate analysis of variance was used to analyze the data, followed by univariate analysis of variance and Tukey's multiple comparison tests. Peak wrist extension isometric force, peak grip isometric force, and median power spectral frequency were all reduced after exercise. However, there was a significant reduction in peak grip isometric force and peak wrist extension isometric force values for the with-forearm support band condition (grip force 28%, wrist extension force 26%) compared to the without-forearm support band condition (grip force 18%, wrist extension force 15%). Wearing the forearm support band increased the rate of fatigue in unimpaired individuals. Our findings do not support the premise that wearing the forearm support band reduces muscle fatigue in the wrist extensors.

[The reconstruction of the human body length from the wrist size].

PubMed

Grigor'eva, M A; Anushkina, E S

2015-01-01

The objective of the present study was to develop the regression models for the reconstruction of the human body length from the wrist size taking into consideration the availability of the results of the measurements of the palm fragments or the wrist undergoing muscular contracture. The study included 106 Caucasoid subjects (41 men and 65 women) at the age varying from 18 to 76 years. The following parameters were measured: body length, wrist length, the length of the fingers and phalanges on the back of the hand, palmar length and width, ulnar edge size of the palm. It was shown that the selected longitudinal dimensions of the palm and fingers can be used to estimate the body length as accurately as from the wrist length. The high prognostic value of ulnar edge size of the palm was documented which allows this characteristic to be used in the cases of partial palm destruction or in the wrist with pronounced flexion contracture of the fingers. The most exact equations are those derived from the combination of the results of the measurement of the fingers and the ulnar edge size of the palm. Less accurate equations are based on the palmar dimensions alone and on the total wrist size with the exception of the equation for the wrist length with regard to the subject's sex. The gender information needs to be taken into account if the wrist is preserved to the extent that only the length of the palm and of the IV and V fingers can be measured or if the wrist is sufficiently long and wide (short and wide) and the gender is supposed to be masculine. In contrast, this information should be disregarded if the wrist is long and narrow (short and narrow) and the gender is supposedly feminine.

Reference centile curves for wrist circumference for Indian children aged 3-18 years.

PubMed

Khadilkar, Vaman; Chiplonkar, Shashi; Ekbote, Veena; Kajale, Neha; Mandlik, Rubina; Khadilkar, Anuradha

2018-01-26

Childhood obesity and its consequences have reached alarming proportions worldwide and in India. Wrist circumference is emerging as an easily measurable reproducible parameter for screening children at risk of obesity-related morbidities such as hypertension and insulin resistance. The objectives of this study were: (1) to compute age and gender-specific wrist circumference percentiles for 3-18-year-old apparently healthy Indian children and adolescents; (2) to assess the relationship of wrist circumference with measures of obesity and adiposity such as body mass index (BMI), fat percentage and blood pressure (BP) and (3) to suggest age and gender-specific cut-offs for wrist circumference percentile for the risk of hypertension in Indian children and adolescents. This was a cross-sectional study on samples of 10,199 3-18-year-old children (5703 boys) from randomly selected schools from five major cities in India. Height, weight, waist and wrist circumference and BP were recorded. Body composition was measured using bioelectrical impedance analysis (BIA). Wrist circumference percentiles were computed using the LMS method. The average wrist circumference of boys and girls was 10.4 cm and 10.0 cm at 3 years and increased to 15.1 cm and 13.9 cm, respectively, at 18 years. Compared to their Caucasian counterparts, Indian children's wrists were smaller. Receiver operating characteristic (ROC) curve analysis derived the 70th percentile of wrist circumference as the cut-off for identifying the risk of hypertension. Contemporary cross-sectional reference percentile curves for wrist circumference for 3-18-year-old Indian children are presented. The 70th percentile of the current study is proposed as the cut-off to screen children for cardiometabolic risk factors such as hypertension.

Effect of wrist cooling on aerobic and anaerobic performance in elite sportsmen.

PubMed

Krishnan, Anup; Singh, Krishan; Sharma, Deep; Upadhyay, Vivekanand; Singh, Amit

2018-01-01

Body cooling has been used to increase sporting performance and enhance recovery. Several studies have reported improvement in exercise capacities using forearm and hand cooling or only hand cooling. Wrist cooling has emerged as a portable light weight solution for precooling prior to sporting activity. The Astrand test for aerobic performance and the Wingate test for anaerobic performance are reliable and accurate tests for performance assessment. This study conducted on elite Indian athletes analyses the effects of wrist precooling on aerobic and anaerobic performance as tested by the Astrand test and the Wingate test before and after wrist precooling. 67 elite sportsmen were administered Wingate and Astrand test under standardised conditions with and without wrist precooling using a wrist cooling device (dhamaSPORT). Paired t -test was applied to study effect on aerobic [VO 2 (ml/min/kg)] and anaerobic performance [peak power (W/kg) and average power (W/kg)] and Cohen's d was used to calculate effect size of wrist precooling. After wrist precooling, significant increase of 0.22 ( p  = 0.014, 95% CI: 0.047, 0.398) in peak power (W/kg) and 0.22 ( p  < 0.0001, 95% CI: 0.142, 0.291) was observed in average power (W/kg). Although, an increase of 1.38 ( p  = 0.097, 95% CI: -0.225, 3.012) was observed in VO 2 (ml/min/kg), wrist precooling was not significantly effective in aerobic performance. Wrist cooling effect size was smaller in VO 2 (Cohen's d  = 0.21), peak power (Cohen's d  = 0.31) and it was larger in average power (Cohen's d  = 0.71). Results show wrist precooling significantly improves anaerobic than aerobic performance of elite sportsmen.

Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

PubMed Central

2014-01-01

Background Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arthroscopy. PubMed and Cochrane Library databases were searched up to December 2012. Two researchers reviewed each article and recorded the condition treated, randomization method, number of randomized participants, time of randomization, outcomes measures, blinding, and description of dropouts and withdrawals. We used the modified Jadad scale that considers the randomization method, blinding, and dropouts/withdrawals; score 0 (lowest quality) to 5 (highest quality). The scores for the wrist and shoulder RCTs were compared with the Mann–Whitney test. Results The first references to both wrist and shoulder arthroscopy appeared in the late 1970s. The search found 4 wrist arthroscopy intervention RCTs (Kienböck’s disease, dorsal wrist ganglia, volar wrist ganglia, and distal radius fracture; first 3 compared arthroscopic with open surgery). The median number of participants was 45. The search found 50 shoulder arthroscopy intervention RCTs (rotator cuff tears 22, instability 14, impingement 9, and other conditions 5). Of these, 31 compared different arthroscopic treatments, 12 compared arthroscopic with open treatment, and 7 compared arthroscopic with nonoperative treatment. The median number of participants was 60. The median modified Jadad score for the wrist RCTs was 0.5 (range 0–1) and for the shoulder RCTs 3.0 (range 0–5) (p = 0.012). Conclusion Despite the increasing use of wrist arthroscopy in the treatment of various wrist disorders the efficacy of arthroscopically performed wrist interventions has been studied in only 4 randomized studies compared to 50 randomized studies of significantly higher quality assessing interventions performed through shoulder arthroscopy. PMID:25059881

Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders.

PubMed

Dahlqvist, Camilla; Nordander, Catarina; Granqvist, Lothy; Forsman, Mikael; Hansson, Gert-Åke

2018-01-01

Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable. To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning. Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions. The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip. The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

Evaluation of effects of different treatments for the wrist joints of subdominant hands using joint proprioception and writing time.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Hu, Yue; Rongming, Xia; Li, Zhou; Xiaojiao, Fu; Gu, Rui; Cui, Yao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-05-01

[Purpose] The purpose of this study was to examine immediate effects of strength training and NJF distal resistance training in wrist joints by using writing time and evaluation of proprioception using the JPE test. [Subjects and Methods] The subjects were 12 young healthy people (24.2 ± 3.1 y, 169.7 ± 6.5 cm, 65.3 ± 12.6 kg). Two isotonic contraction techniques were applied on the wrist joint: wrist joint extension muscle strength training (MST) and the wrist joint extension pattern of NJF. The uppercase English alphabet writing time and joint position errors of the left upper limb were measured before and after one intervention session of MST and NJF. [Results] The decrease in errors in wrist extension angle repetition and the writing time represented the improvement resulting from NJF. [Conclusion] This result suggests that the subdominant hands wrist joint proprioception and writing function can be improved by NJF together with proximal resistance training.

A structurally decoupled mechanism for measuring wrist torque in three degrees of freedom

NASA Astrophysics Data System (ADS)

Pan, Lizhi; Yang, Zhen; Zhang, Dingguo

2015-10-01

The wrist joint is a critical part of the human body for movement. Measuring the torque of the wrist with three degrees of freedom (DOFs) is important in some fields, including rehabilitation, biomechanics, ergonomics, and human-machine interfacing. However, the particular structure of the wrist joint makes it difficult to measure the torque in all three directions simultaneously. This work develops a structurally decoupled instrument for measuring and improving the measurement accuracy of 3-DOF wrist torque during isometric contraction. Three single-axis torque sensors were embedded in a customized mechanical structure. The dimensions and components of the instrument were designed based on requirement of manufacturability. A prototype of the instrument was machined, assembled, integrated, and tested. The results show that the structurally decoupled mechanism is feasible for acquiring wrist torque data in three directions either independently or simultaneously. As a case study, we use the device to measure wrist torques concurrently with electromyography signal acquisition in preparation for simultaneous and proportional myoelectric control of prostheses.

A structurally decoupled mechanism for measuring wrist torque in three degrees of freedom.

PubMed

Pan, Lizhi; Yang, Zhen; Zhang, Dingguo

2015-10-01

The wrist joint is a critical part of the human body for movement. Measuring the torque of the wrist with three degrees of freedom (DOFs) is important in some fields, including rehabilitation, biomechanics, ergonomics, and human-machine interfacing. However, the particular structure of the wrist joint makes it difficult to measure the torque in all three directions simultaneously. This work develops a structurally decoupled instrument for measuring and improving the measurement accuracy of 3-DOF wrist torque during isometric contraction. Three single-axis torque sensors were embedded in a customized mechanical structure. The dimensions and components of the instrument were designed based on requirement of manufacturability. A prototype of the instrument was machined, assembled, integrated, and tested. The results show that the structurally decoupled mechanism is feasible for acquiring wrist torque data in three directions either independently or simultaneously. As a case study, we use the device to measure wrist torques concurrently with electromyography signal acquisition in preparation for simultaneous and proportional myoelectric control of prostheses.

Wrist Pain

MedlinePlus

... repetitive stress on the wrist. These can include football, bowling, golf, gymnastics, snowboarding and tennis. Repetitive work. ... wrist guards for high-risk activities, such as football, snowboarding and rollerblading. Pay attention to ergonomics. If ...

Wrist sprain - aftercare

MedlinePlus

... begins to heal. This can improve with light stretching. Severe (grade 3) wrist sprains may need to ... times. Bend your wrist in the opposite direction, stretching downward and holding for 30 seconds. Relax your ...

Bone Mineral Density as a Predictor of Subsequent Wrist Fractures: Findings From the Women's Health Initiative Study

PubMed Central

Hovey, Kathleen M.; Andrews, Christopher A.; Cauley, Jane A.; Manson, JoAnn E.; Wactawski-Wende, Jean; Wright, Nicole C.; Li, Wenjun; Beavers, Kristen; Curtis, Jeffrey R.; LeBoff, Meryl S.

2015-01-01

Context: Wrist fractures are common among postmenopausal women. Associations of bone mineral density (BMD) and 10-year predicted risk of major osteoporotic fracture (MOF) with wrist fractures are poorly characterized. Objective: The objective was to examine associations between the Fracture Risk Assessment Tool (FRAX)-predicted risk of MOF, BMD, BMD change, and wrist fracture. Design: This was a prospective observational study with a mean follow-up of 8.5 years. Setting: This study included 40 US centers. Participants: A total of 11 392 participants from the Women's Health Initiative BMD Cohort aged 50–79 years at baseline were included in this study. Interventions: None. Main Outcome: The goal was to measure incident wrist fracture. Results: A FRAX-predicted MOF risk ≥9.3% identified 17% of the women aged <65 years who subsequently experienced wrist fracture. Each one standard deviation lower BMD was associated with higher wrist fracture risk, with adjusted hazard ratio (95% confidence interval) of 1.66 (1.42–1.93) for femoral neck (FN) BMD and 1.45 (1.28–1.64) for lumbar spine BMD. Compared with FN BMD T score ≥ −1.0, wrist fracture adjusted hazard ratios (95% confidence interval) were: 1.51 (1.06–2.16) for a T score between −1.01 and −1.49; 1.93 (1.36–2.72) for T score between −1.50 and −1.99; 2.52 (1.77–3.60) for a T score between −2.00 and −2.49; and 2.65 (1.78–3.95) for a T score ≤ −2.5. Decrease in FN BMD between baseline and year 3 was associated with increased risk of subsequent wrist fracture; however, change in lumbar spine BMD was not. Conclusions: Lumbar spine and femoral neck BMDs were associated with incident wrist fracture, but the FRAX threshold recommended to identify screening candidates did not identify the majority of women who subsequently experienced wrist fracture. Improved understanding of determinants of wrist fractures is warranted. PMID:26367200

Different evolutionary pathways underlie the morphology of wrist bones in hominoids

PubMed Central

2013-01-01

Background The hominoid wrist has been a focus of numerous morphological analyses that aim to better understand long-standing questions about the evolution of human and hominoid hand use. However, these same analyses also suggest various scenarios of complex and mosaic patterns of morphological evolution within the wrist and potentially multiple instances of homoplasy that would benefit from require formal analysis within a phylogenetic context. We identify morphological features that principally characterize primate – and, in particular, hominoid (apes, including humans) - wrist evolution and reveal the rate, process and evolutionary timing of patterns of morphological change on individual branches of the primate tree of life. Linear morphological variables of five wrist bones – the scaphoid, lunate, triquetrum, capitate and hamate – are analyzed in a diverse sample of extant hominoids (12 species, 332 specimens), Old World (8 species, 43 specimens) and New World (4 species, 26 specimens) monkeys, fossil Miocene apes (8 species, 20 specimens) and Plio-Pleistocene hominins (8 species, 18 specimens). Result Results reveal a combination of parallel and synapomorphic morphology within haplorrhines, and especially within hominoids, across individual wrist bones. Similar morphology of some wrist bones reflects locomotor behaviour shared between clades (scaphoid, triquetrum and capitate) while others (lunate and hamate) indicate clade-specific synapomorphic morphology. Overall, hominoids show increased variation in wrist bone morphology compared with other primate clades, supporting previous analyses, and demonstrate several occurrences of parallel evolution, particularly between orangutans and hylobatids, and among hominines (extant African apes, humans and fossil hominins). Conclusions Our analyses indicate that different evolutionary processes can underlie the evolution of a single anatomical unit (the wrist) to produce diversity in functional and morphological adaptations across individual wrist bones. These results exemplify a degree of evolutionary and functional independence across different wrist bones, the potential evolvability of skeletal morphology, and help to contextualize the postcranial mosaicism observed in the hominin fossil record. PMID:24148262

Effects of Volar Tilt, Wrist Extension, and Plate Position on Contact Between Flexor Pollicis Longus Tendon and Volar Plate.

PubMed

Wurtzel, Caroline N Wolfe; Burns, Geoffrey T; Zhu, Andy F; Ozer, Kagan

2017-12-01

Volar plates positioned at, or distal to, the watershed line have been shown to have a higher incidence of attritional rupture of the flexor pollicis longus (FPL). In this study, we aimed to evaluate the effect of wrist extension and volar tilt on the contact between the plate and the FPL tendon in a cadaver model. We hypothesized that, following volar plate application, loss of native volar tilt increases the contact between the FPL and the plate at lower degrees of wrist extension. A volar locking plate was applied on 6 fresh-frozen cadavers. To determine the contact between the plate and the FPL tendon, both structures were wrapped with copper wire and circuit conductivity was monitored throughout wrist motion. A lateral wrist radiograph was obtained at each circuit closure, indicating tendon-plate contact. Baseline measurements were obtained with plate positioned at Soong grades 0, 1, and 2. An extra-articular osteotomy was made and contact was recorded at various volar tilt angles (+5°, 0°, -5°, -10°, -15°, and -20°) in 3 different plate positions. A blinded observer measured the degree of wrist extension on all lateral radiographs. Data were analyzed using linear mixed-effects regression model. Plates placed distal to the watershed line had the most contact throughout wrist range of motion. Significantly, less wrist extension was required for contact in wrists with neutral or dorsal tilt and in distally placed volar plates. Volar tilt, wrist extension, and plate position were 3 independent risk factors determining contact between plate and tendon. Loss of volar tilt, increased wrist extension, and higher Soong grade plate position result in greater contact between wire-wrapped FPL tendon and plate. The FPL/plate contact chart generated in this study may be used to assess the risk of rupture in the clinical setting. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Poor Reliability of Wrist Blood Pressure Self-Measurement at Home: A Population-Based Study.

PubMed

Casiglia, Edoardo; Tikhonoff, Valérie; Albertini, Federica; Palatini, Paolo

2016-10-01

The reliability of blood pressure measurement with wrist devices, which has not previously been assessed under real-life circumstances in general population, is dependent on correct positioning of the wrist device at heart level. We determined whether an error was present when blood pressure was self-measured at the wrist in 721 unselected subjects from the general population. After training, blood pressure was measured in the office and self-measured at home with an upper-arm device (the UA-767 Plus) and a wrist device (the UB-542, not provided with a position sensor). The upper-arm-wrist blood pressure difference detected in the office was used as the reference measurement. The discrepancy between office and home differences was the home measurement error. In the office, systolic blood pressure was 2.5% lower at wrist than at arm (P=0.002), whereas at home, systolic and diastolic blood pressures were higher at wrist than at arm (+5.6% and +5.4%, respectively; P<0.0001 for both); 621 subjects had home measurement error of at least ±5 mm Hg and 455 of at least ±10 mm Hg (bad measurers). In multivariable linear regression, a lower cognitive pattern independently determined both the systolic and the diastolic home measurement error and a longer forearm the systolic error only. This was confirmed by logistic regression having bad measurers as dependent variable. The use of wrist devices for home self-measurement, therefore, leads to frequent detection of falsely elevated blood pressure values likely because of a poor memory and rendition of the instructions, leading to the wrong position of the wrist. © 2016 American Heart Association, Inc.

Dissection of a single rat muscle-tendon complex changes joint moments exerted by neighboring muscles: implications for invasive surgical interventions.

PubMed

Maas, Huub; Baan, Guus C; Huijing, Peter A

2013-01-01

The aim of this paper is to investigate mechanical functioning of a single skeletal muscle, active within a group of (previously) synergistic muscles. For this purpose, we assessed wrist angle-active moment characteristics exerted by a group of wrist flexion muscles in the rat for three conditions: (i) after resection of the upper arm skin; (ii) after subsequent distal tenotomy of flexor carpi ulnaris muscle (FCU); and (iii) after subsequent freeing of FCU distal tendon and muscle belly from surrounding tissues (MT dissection). Measurements were performed for a control group and for an experimental group after recovery (5 weeks) from tendon transfer of FCU to extensor carpi radialis (ECR) insertion. To assess if FCU tenotomy and MT dissection affects FCU contributions to wrist moments exclusively or also those of neighboring wrist flexion muscles, these data were compared to wrist angle-moment characteristics of selectively activated FCU. FCU tenotomy and MT dissection decreased wrist moments of the control group at all wrist angles tested, including also angles for which no or minimal wrist moments were measured when activating FCU exclusively. For the tendon transfer group, wrist flexion moment increased after FCU tenotomy, but to a greater extent than can be expected based on wrist extension moments exerted by selectively excited transferred FCU. We conclude that dissection of a single muscle in any surgical treatment does not only affect mechanical characteristics of the target muscle, but also those of other muscles within the same compartment. Our results demonstrate also that even after agonistic-to-antagonistic tendon transfer, mechanical interactions with previously synergistic muscles do remain present.

A feasibility study on age-related factors of wrist pulse using principal component analysis.

PubMed

Jang-Han Bae; Young Ju Jeon; Sanghun Lee; Jaeuk U Kim

2016-08-01

Various analysis methods for examining wrist pulse characteristics are needed for accurate pulse diagnosis. In this feasibility study, principal component analysis (PCA) was performed to observe age-related factors of wrist pulse from various analysis parameters. Forty subjects in the age group of 20s and 40s were participated, and their wrist pulse signal and respiration signal were acquired with the pulse tonometric device. After pre-processing of the signals, twenty analysis parameters which have been regarded as values reflecting pulse characteristics were calculated and PCA was performed. As a results, we could reduce complex parameters to lower dimension and age-related factors of wrist pulse were observed by combining-new analysis parameter derived from PCA. These results demonstrate that PCA can be useful tool for analyzing wrist pulse signal.

Arthroscopic Synovectomy of Wrist in Rheumatoid Arthritis.

PubMed

Shim, Jae Woo; Park, Min Jong

2017-11-01

Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting multiple joints. Wrist involvement is common. Patients with persistent symptoms despite medical management are candidates for surgery. Synovectomy can provide pain relief and functional improvement for rheumatoid wrist. Arthroscopic synovectomy is a safe and reliable method, with minimal postoperative morbidity. This article reviews the role, technique, and results of arthroscopic synovectomy in the rheumatoid wrist. Copyright © 2017 Elsevier Inc. All rights reserved.

A comparative analysis of speed profile models for wrist pointing movements.

PubMed

Vaisman, Lev; Dipietro, Laura; Krebs, Hermano Igo

2013-09-01

Following two decades of design and clinical research on robot-mediated therapy for the shoulder and elbow, therapeutic robotic devices for other joints are being proposed: several research groups including ours have designed robots for the wrist, either to be used as stand-alone devices or in conjunction with shoulder and elbow devices. However, in contrast with robots for the shoulder and elbow which were able to take advantage of descriptive kinematic models developed in neuroscience for the past 30 years, design of wrist robots controllers cannot rely on similar prior art: wrist movement kinematics has been largely unexplored. This study aimed at examining speed profiles of fast, visually evoked, visually guided, target-directed human wrist pointing movements. One thousand three-hundred ninety-eight (1398) trials were recorded from seven unimpaired subjects who performed center-out flexion/extension and abduction/adduction wrist movements and fitted with 19 models previously proposed for describing reaching speed profiles. A nonlinear, least squares optimization procedure extracted parameters' sets that minimized error between experimental and reconstructed data. Models' performances were compared based on their ability to reconstruct experimental data. Results suggest that the support-bounded lognormal is the best model for speed profiles of fast, wrist pointing movements. Applications include design of control algorithms for therapeutic wrist robots and quantitative metrics of motor recovery.

Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship?

PubMed

Uysal, Tancan; Ramoglu, Sabri Ilhan; Basciftci, Faruk Ayhan; Sari, Zafer

2006-11-01

The aims of this study were (1) to investigate the relationship between chronologic age and maturation of cervical vertebrae, (2) to identify the relationship between chronologic age and maturation stage evaluated by hand-wrist radiographs, and (3) to determine whether the maturation of cervical vertebrae correlates with maturation indicated by hand-wrist radiographs in a Turkish population. The samples were derived from lateral cephalometric and hand-wrist radiographs of 503 subjects (213 male, 290 female; ages, 5.3-24.1 years). Cervical vertebral development was evaluated by the method of Hassel and Farman. Skeletal maturation of each hand-wrist radiograph was determined according to the method described by Björk and Grave, and Brown's system. The Spearman rank-order correlation coefficients were estimated separately for males and females to measure the relationships among chronologic age, cervical vertebral maturation, and the skeletal maturation measured at the hand-wrist. The Spearman correlation coefficients were 0.72 (P <.001) between chronologic age and cervical vertebrae skeletal maturation, and 0.79 (P < .001) between chronologic age and maturation via hand-wrist radiographs. The correlation coefficient between hand-wrist and cervical-vertebrae maturation was 0.86 (P <.001). The cervical-vertebrae maturation stages are clinically useful maturity indicators of the pubertal growth period Turkish subjects.

Is it Finger or Wrist Dexterity That is Missing in Current Hand Prostheses?

PubMed

Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

2015-07-01

Building prostheses with dexterous motor function equivalent to that of the human hand is one of the ambitious goals of bioengineers. State of art prostheses lack several degrees of freedom (DoF) and force the individuals to compensate for them by changing the motions of their arms and body. However, such compensatory movements often result in residual limb pain and overuse syndromes. Significant efforts were spent in designing artificial hands with multiple allowed grasps but little work has been done with regards to wrist design, regardless the fact that the wrist contributes significantly to the execution of upper limb motor tasks. We hypothesized that a single DoF hand with wrist flexion/extension allowed function comparable to a highly performant multi DoF hand without wrist flexion/extension. To assess this we compared four emulated architectures of hand-wrist prostheses using the Southampton Hand Assessment Procedure and evaluating the extent of compensatory movements with unimpaired subjects wearing ortheses. Our findings show indeed that shifting the dexterity from the hand to the wrist could preserve the ability of transradial amputees in performing common tasks with limited effect on the compensatory movements. Hence, this study invites rehabilitation engineers to focus on novel artificial wrist architectures.

Functional decline after incident wrist fractures—Study of Osteoporotic Fractures: prospective cohort study

PubMed Central

Song, Jing; Dunlop, Dorothy D; Fink, Howard A; Cauley, Jane A

2010-01-01

Objective To study the effect of an incident wrist fracture on functional status in women enrolled in the Study of Osteoporotic Fractures. Design Prospective cohort study. Setting Baltimore, Minneapolis, Portland, and the Monongahela valley in Pennsylvania, USA Participants 6107 women aged 65 years and older without previous wrist or hip fracture recruited from the community between September 1986 and October 1988. Main outcome measure Clinically important functional decline, defined as a functional deterioration of 5 points in five activities of daily living each scored from 0 to 3 (equivalent to one standard deviation decrease in functional ability). Results Over a mean follow-up of 7.6 years, 268 women had an incident wrist fracture and 41 (15%) of these developed clinically important functional decline. Compared with women without wrist fractures, those with incident wrist fractures had greater annual functional decline after adjustment for age, body mass index, and health status. Occurrence of a wrist fracture increased the odds of having a clinically important functional decline by 48% (odds ratio 1.48, 95% confidence interval 1.04 to 2.12), even after adjustment for age, body mass index, health status, baseline functional status, lifestyle factors, comorbidities, and neuromuscular function. Conclusions Wrist fractures contribute to clinically important functional decline in older women. PMID:20616099

Kinematic control of robot with degenerate wrist

NASA Technical Reports Server (NTRS)

Barker, L. K.; Moore, M. C.

1984-01-01

Kinematic resolved rate equations allow an operator with visual feedback to dynamically control a robot hand. When the robot wrist is degenerate, the computed joint angle rates exceed operational limits, and unwanted hand movements can result. The generalized matrix inverse solution can also produce unwanted responses. A method is introduced to control the robot hand in the region of the degenerate robot wrist. The method uses a coordinated movement of the first and third joints of the robot wrist to locate the second wrist joint axis for movement of the robot hand in the commanded direction. The method does not entail infinite joint angle rates.

Application of the Trio-Tri-Star Carpal Wrist for use in a Solar Array Tracking Mechanism for the Momentum-eXchange/Electrodynamic Reboost (MXER) Tether Concept

NASA Technical Reports Server (NTRS)

Robertson, Jeffrey

2006-01-01

This paper describes the application of the Trio-Tri-Star Carpal Wrist to the Momentum Exchange Electro-Dynamic Re-boost (MXER) tether, an advanced space transportation concept being developed by the In-Space Propulsion Technology Office at NASA s Marshall Space Flight Center in Huntsville, Alabama. Dr. Joseph Bonometti and Mr. Kirk Sorensen are the principal engineers. In the paper, a brief overview of the MXER concept is given, with an emphasis on the design problem that this wrist is designed to address. The Trio-Tri-Star Carpal Wrist, a three degree of freedom parallel manipulator, invented by Dr. Stephen J. Canfield of Tennessee Tech University, is described with an overview of wrist geometry, kinematics, and stress analysis. A working model of the wrist was assembled at MSFC using Dr. Canfield s prototype to demonstrate its operation. Finally, a design description and supporting analysis of a MXER flight concept wrist is given, with recommendations for future development work.

Clinical, electrophysiological and magnetic resonance imaging findings in carpal tunnel syndrome.

PubMed

Musluoğlu, L; Celik, M; Tabak, H; Forta, H

2004-01-01

To assess magnetic resonance imaging (MRI) findings in carpal tunnel syndrome (CTS) and to compare them with electrophysiological findings. Routine motor and sensory nerve conduction examinations and needle EMG were performed in 42 hands of 22 patients, who were clinically diagnosed as having CTS in at least one wrist. Of 29 wrists with clinically and electrophysiologically confirmed CTS, MRI could detect abnormality in 18 wrists (62%). Median nerve was found to be abnormal in MRI in 1 of 2 wrists with suspected clinical symptoms and proven CTS by electrophysiological examination. MRI was abnormal in 1 of 4 wrists with normal clinical and electrophysiological examination. MRI was abnormal in 46, 7% of wrists with mild CTS, in 61.6% of moderate CTS and in 100% of severe CTS. Volar bulging of the flexor retinaculum was detected in a single wrist with severe CTS. Enlargement of median nerve was observed in 3 of 5 severe CTS. MRI could be useful in the diagnosis of unproven cases in CTS. It also provides anatomical information that correlate well with electrophysiological findings in regard of the severity of median nerve compression.

Skill Analysis of the Wrist Release in the Golf Swings Utilizing Shaft Elasticity

NASA Astrophysics Data System (ADS)

Suzuki, Soichiro; Hoshino, Yohei; Kobayashi, Yukinori

This study analyzes the skill component of the wrist release in the golf swing by employing a three-dimensional dynamic model considering vibration of the club shaft. It is observed that professional and expert golfers relax their wrists in the swing motion as a "natural" or "late" release. Thus, the relationship between the timing of the wrist release and the shaft vibration is examined in this study. First, it is demonstrated that "natural release" at the zero-crossing point of the bending vibration of the shaft efficiently increases the head speed at impact. In the next step, the "late hitting" condition is imposed upon the model. It is demonstrated that "late hitting" could further improve the efficiency of the swing motion. Finally, the skill component in the wrist release for the long drive is experimentally verified by measuring the movement of the wrist and the dynamic deformation of the shaft during the downswing.

A fabric wrist patch sensor for continuous and comprehensive monitoring of the cardiovascular system.

PubMed

Kwonjoon Lee; Kiseok Song; Taehwan Roh; Hoi-Jun Yoo

2016-08-01

The wrist patch-type ECG/APW sensor system is proposed for continuous and comprehensive monitoring of the patient's cardiovascular system. The wrist patch-type ECG/APW sensor system is consists of ECG/APW sensor, ECG/APW electrodes, and base station for real-time monitoring of the patient's status. The ECG/APW sensor and electrodes are composed of wrist patch, bandage-type ECG electrode and fabric APW electrode, respectively so that the patient's cardiovascular system can be continuously monitored in daily life with free hand-movement. Since the proposed wrist patchtype ECG/APW sensor simultaneously measures ECG/APW, the cardiac indicators, such as HR and PAT, can be extracted for comprehensive and accurate monitoring of the patient's cardiovascular system. The proposed wrist patch-type ECG/APW sensor system is successfully verified using the commercial PPG sensor (RP520) and demonstrated with the customized Android application on the smart phone.

How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder.

PubMed

Hayakawa, Masaya

2009-01-01

The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.

Impact of keyboard typing on the morphological changes of the median nerve

PubMed Central

Yeap Loh, Ping; Liang Yeoh, Wen; Nakashima, Hiroki; Muraki, Satoshi

2017-01-01

Objectives: The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Methods: Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Results: Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (p<0.05). Additionally, the median nerve cross-sectional area (MNCSA) significantly increased in both the typing I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. Conclusions: This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve. PMID:28701627

Impact of keyboard typing on the morphological changes of the median nerve.

PubMed

Yeap Loh, Ping; Liang Yeoh, Wen; Nakashima, Hiroki; Muraki, Satoshi

2017-09-28

The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (p<0.05). Additionally, the median nerve cross-sectional area (MNCSA) significantly increased in both the typing I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve.

Defining occult injuries of the distal forearm and wrist in children.

PubMed

Elvey, Michael; Patel, S; Avisar, Erez; White, W J; Sorene, E

2016-06-01

The nonspecific terms "wrist sprain" and "suspected occult bony injury" are frequently documented as diagnoses in occult paediatric wrist injuries. To date, however, no one has accurately defined their true underlying pathology. The primary objective of this study was to identify the true pathoanatomy of occult acute paediatric wrist injuries. Our secondary objective was to compare our findings with existing adult data in order to determine any population differences that might be clinically relevant. We performed a single-centre retrospective case series evaluating MRI findings in acute paediatric wrist injuries presenting to the hand injury unit between 2011 and 2014. All patients underwent standardised radiographs of the wrist and, where clinically indicated, of the scaphoid. Where no bony anomaly was identified, MRI scanning was offered. Cohen's kappa coefficient was used to calculate the agreement between clinical and MRI diagnosis. 57 patients met the final inclusion criteria. Occult fractures and bony contusions comprised the majority of the pathologies, at 36.5 and 35.0 %, respectively. There were no cases of isolated soft-tissue injury. MRI effected management change in 35.1 % of cases. Paediatric wrists demonstrated differences in injury pattern and distribution when compared to an adult population. This study defines for the first time the true pathology of occult paediatric wrist injuries. The current definition of a wrist sprain was not applicable to a single case and therefore appears to be inappropriate for use in the paediatric population. A precise knowledge of the likely pathology facilitates accurate information delivery whilst reducing parental uncertainty and treatment variation.

How Much Volume of Local Anesthesia and How Long Should You Wait After Injection for an Effective Wrist Median Nerve Block?

PubMed

Lovely, Lyndsay M; Chishti, Yasmin Z; Woodland, Jennifer L; Lalonde, Donald H

2018-05-01

Many surgeons and emergentologists use non-ultrasound-guided wrist nerve blocks. There is little evidence to guide the ideal volume of local anesthesia or how long we should wait after injection before performing pain-free procedures. This pilot study examined time to maximal anesthesia to painful needle stick in 14 volunteer participants receiving bilateral wrist blocks of 6 versus 11 mL of local. One surgeon performed all 14 bilateral wrist median nerve blocks in participants who remained blinded until after bandages were applied to their wrist. No one could see which wrist received the larger 11-mL volume injection versus the 6-mL block. Blinded sensory assessors then measured perceived maximal numbness time and numbness to needle stick pain in the fingertips of the median nerve distribution. Failure to get a complete median nerve block occurred in seven of fourteen 6-mL wrist blocks versus failure in only one of fourteen 11-mL blocks. Perceived maximal numbness occurred at roughly 40 minutes after injection, but actual numbness to painful needle stick took around 100 minutes. Incomplete median nerve numbness occurred with both 6- and 11-mL non-ultrasound-guided blocks at the wrist. In those with complete blocks, it took a surprisingly long time of 100 minutes for maximal anesthesia to occur to painful needle stick stimuli to the fingertips of the median nerve distribution. Non-ultrasound-guided median nerve blocks at the wrist as described in this article lack reliability and take too long to work.

78 FR 68905 - Agency Information Collection (Wrist Conditions Disability Benefits Questionnaire) Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits Administration...- NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER... ``OMB Control No. 2900-NEW (Wrist Conditions Disability Benefits Questionnaire)''. SUPPLEMENTARY...

78 FR 44625 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity: Withdrawal AGENCY: Veterans Benefits Administration... proposed information collection titled ``Wrist Conditions Disability Benefits Questionnaire, VA Form 21...

Shock-Absorbing Effects of Various Padding Conditions in Improving Efficacy of Wrist Guards

PubMed Central

Hwang, Il-Kyu; Kim, Kyu-Jung

2004-01-01

The use of wrist guards has limited efficacy in preventing wrist injuries during falling in many sports activities. The objectives of this study were to measure the ground reaction force of the hand under simulated impact of the forearm and hand complex with different padding conditions of wrist guards and to analyze their impact force attenuation and maximum energy absorption for improved functional efficiency. A total of 15 subjects, wearing a commercial wrist guard, participated in a cable-released hand impact experiment to test four different conditions on the volar aspect of the hand, which include a wrist guard without a volar splint (bare hand), with a volar splint (normal use), with a volar splint and additional viscoelastic polymeric padding, and a volar splint and additional air cell padding. The ground reaction force and acceleration of the hand were measured using a force platform mounted on an anti-vibration table and a miniature accelerometer, respectively. Additional padding on the bare hand could substantially improve the maximum energy absorption by more than 39%, with no differences with each other. However, only the air cell padding could simultaneously improve the impact force attenuation by 32% compared with the bare hand impact without compromising the maximum energy absorption. It is recommended that common wrist guard design should provide more compliant padding in the volar aspect to improve the impact force attenuation through optimal material selection and design. Key Points The controversial efficacy of wrist guards in preventing wrist injuries during falling was tested through investigation of their impact force attenuation and maximum energy absorption from the measured ground reaction force of the hand under simulated impact of the forearm and hand complex with four different padding conditions of wrist guards: a wrist guard without a volar splint (bare hand), with a volar splint (normal use), with a volar splint and additional viscoelastic polymeric padding, and a volar splint and additional air cell padding. In general, padding on the bare hand could improve the maximum energy absorption by more than 39%, while only the air cell padding could simultaneously attenuate the peak impact force by 32% without compromising the maximum energy absorption. Common wrist guard design requires more compliant padding in the volar aspect to improve the impact force attenuation, which should be done through optimal material selection and design. PMID:24497817

Optimizing pattern recognition-based control for partial-hand prosthesis application.

PubMed

Earley, Eric J; Adewuyi, Adenike A; Hargrove, Levi J

2014-01-01

Partial-hand amputees often retain good residual wrist motion, which is essential for functional activities involving use of the hand. Thus, a crucial design criterion for a myoelectric, partial-hand prosthesis control scheme is that it allows the user to retain residual wrist motion. Pattern recognition (PR) of electromyographic (EMG) signals is a well-studied method of controlling myoelectric prostheses. However, wrist motion degrades a PR system's ability to correctly predict hand-grasp patterns. We studied the effects of (1) window length and number of hand-grasps, (2) static and dynamic wrist motion, and (3) EMG muscle source on the ability of a PR-based control scheme to classify functional hand-grasp patterns. Our results show that training PR classifiers with both extrinsic and intrinsic muscle EMG yields a lower error rate than training with either group by itself (p<0.001); and that training in only variable wrist positions, with only dynamic wrist movements, or with both variable wrist positions and movements results in lower error rates than training in only the neutral wrist position (p<0.001). Finally, our results show that both an increase in window length and a decrease in the number of grasps available to the classifier significantly decrease classification error (p<0.001). These results remained consistent whether the classifier selected or maintained a hand-grasp.

Effects of radiofrequency probe application on irrigation fluid temperature in the wrist joint.

PubMed

Sotereanos, Dean G; Darlis, Nickolaos A; Kokkalis, Zinon T; Zanaros, George; Altman, Gregory T; Miller, Mark Carl

2009-12-01

Radiofrequency (RF) probes used in wrist arthroscopy may raise joint fluid temperature, increasing the risk of capsular and ligamentous damage. The purposes of the current study were to measure joint fluid temperature during wrist arthroscopy with the use of RF probes, and to determine whether using an outlet portal will reduce the maximum temperature. We performed wrist arthroscopy on 8 cadaveric arms. Ablation and coagulation cycles using RF probe were performed at documented locations within the joint. This was done for 60-second intervals on both the radial and ulnar side of the wrist, to mimic clinical practice. We used 4 fiberoptic phosphorescent probes to measure temperature (radial, ulnar, inflow-tube, and outflow-tube probes) and measured joint fluid temperature with and without outflow. There was a significant difference between wrists with and without outflow when examining maximum ablation temperatures (p < .002). All specimens showed higher maximum and average ablation temperatures without outflow. Maximum joint temperatures, greater than 60 degrees C, were observed in only no-outflow conditions. In performing RF ablation during wrist arthroscopy, the use of an outlet portal reduces the joint fluid temperature. Without an outlet portal, maximum temperatures can exceed desirable levels when using ablation; such temperatures have the potential to damage adjacent tissues. It is useful to maintain adequate outflow when using the radiofrequency probes during wrist arthroscopy.

Wrist Arthroscopy: Can We Gain Proficiency Through Knee Arthroscopy Simulation?

PubMed

Ode, Gabriella; Loeffler, Bryan; Chadderdon, Robert Christopher; Haines, Nikkole; Scannell, Brian; Patt, Joshua; Gaston, Glenn

2018-05-02

Wrist arthroscopy is a challenging discipline with limited training exposure during residency. The purpose of this study was to evaluate the effectiveness of virtual knee arthroscopy simulation training for gaining proficiency in wrist arthroscopy. Participants were recorded performing a cadaveric wrist arthroscopy simulation. The residents then practiced knee arthroscopy on a virtual reality simulator and repeated the wrist arthroscopy simulation. All videos were blinded prior to assessment. Proficiency was graded using the Arthroscopic Surgery Skill Evaluation Tool global rating scale. In addition, participants were asked to complete a survey assessing the value of the virtual reality knee arthroscopy simulator for wrist arthroscopy. Orthopaedic Surgery Residency Program, Carolinas Medical Center, a large, public, nonprofit hospital located in Charlotte, North Carolina. Orthopaedic residents at our center were asked to participate in the simulation training. Participation was voluntary and nonincentivized. All orthopaedic residents at our institution (N = 27) agreed to participate. In total, there were 10 Intern (PGY-0 and PGY-1), 10 Junior (PGY-2 and PGY-3), and 7 Senior (PGY-4 and PGY-5) residents. In addition, a fellowship-trained hand surgeon was recruited to participate in the study, performing the wrist arthoscopy simulation. Two additional fellowship-trained hand surgeons, for a total of 3, assessed the blinded videos. There was a trend toward better wrist Arthroscopic Surgery Skill Evaluation Tool scores by training level, although the difference was not statistically significant. Interns improved by an average of 1.8 points between baseline and postknee simulation tests. Junior and senior residents decreased by 1.6 and 5.0 points, respectively. Knee arthroscopy simulation training did not objectively improve wrist arthroscopy proficiency among residents. A wrist-specific arthroscopy simulation program is needed if measurable competence through simulation is desired. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Desensitizing the posterior interosseous nerve alters wrist proprioceptive reflexes.

PubMed

Hagert, Elisabet; Persson, Jonas K E

2010-07-01

The presence of wrist proprioceptive reflexes after stimulation of the dorsal scapholunate interosseous ligament has previously been described. Because this ligament is primarily innervated by the posterior interosseous nerve (PIN) we hypothesized altered ligamento-muscular reflex patterns following desensitization of the PIN. Eight volunteers (3 women, 5 men; mean age, 26 y; range 21-28 y) participated in the study. In the first study on wrist proprioceptive reflexes (study 1), the scapholunate interosseous ligament was stimulated through a fine-wire electrode with 4 1-ms bipolar pulses at 200 Hz, 30 times consecutively, while EMG activity was recorded from the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris, with the wrist in extension, flexion, radial deviation, and ulnar deviation. After completion of study 1, the PIN was anesthetized in the radial aspect of the fourth extensor compartment using 2-mL lidocaine (10 mg/mL) infiltration anesthesia. Ten minutes after desensitization, the experiment was repeated as in study 1. The average EMG results from the 30 consecutive stimulations were rectified and analyzed using Student's t-test. Statistically significant changes in EMG amplitude were plotted along time lines so that the results of study 1 and 2 could be compared. Dramatic alterations in reflex patterns were observed in wrist flexion, radial deviation, and ulnar deviation following desensitization of the PIN, with an average of 72% reduction in excitatory reactions. In ulnar deviation, the inhibitory reactions of the extensor carpi ulnaris were entirely eliminated. In wrist extension, no differences in the reflex patterns were observed. Wrist proprioception through the scapholunate ligament in flexion, radial deviation, and ulnar deviation depends on an intact PIN function. The unchanged reflex patterns in wrist extension suggest an alternate proprioceptive pathway for this position. Routine excision of the PIN during wrist surgical procedures should be avoided, as it alters the proprioceptive function of the wrist. Therapeutic IV. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Immediate effects of different treatments for the wrist joints of subdominant hands, using electromechanical reaction time.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Cui, Yao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-08-01

[Purpose] The aim of this study was to examine the immediate effects of muscle strength training and neuromuscular joint facilitation distal resistance training on wrist joints by using electromechanical reaction time. [Subjects and Methods] The subjects were 12 healthy young people (24.2 ± 3.1 years, 169.7 ± 6.5 cm, 65.3 ± 12.6 kg). Two kinds of isotonic contraction techniques were applied on the wrist joint: the wrist joint extension muscle strength training and the wrist joint extension pattern of neuromuscular joint facilitation. The electromechanical reaction time, premotor time, and motor time of the left upper limb were measured before and after each intervention session of muscle strength training and neuromuscular joint facilitation. [Results] The neuromuscular joint facilitation group showed significant shortening of the electromechanical reaction time and motor time after the intervention. [Conclusion] These results suggest that the electromechanical reaction time and motor time of the wrist joint can be improved by neuromuscular joint facilitation together with proximal resistance training, which can be used as a new form of exercise for improving the functions of subdominant hand wrist joints.

A cable-driven wrist robotic rehabilitator using a novel torque-field controller for human motion training.

PubMed

Chen, Weihai; Cui, Xiang; Zhang, Jianbin; Wang, Jianhua

2015-06-01

Rehabilitation technologies have great potentials in assisted motion training for stroke patients. Considering that wrist motion plays an important role in arm dexterous manipulation of activities of daily living, this paper focuses on developing a cable-driven wrist robotic rehabilitator (CDWRR) for motion training or assistance to subjects with motor disabilities. The CDWRR utilizes the wrist skeletal joints and arm segments as the supporting structure and takes advantage of cable-driven parallel design to build the system, which brings the properties of flexibility, low-cost, and low-weight. The controller of the CDWRR is designed typically based on a virtual torque-field, which is to plan "assist-as-needed" torques for the spherical motion of wrist responding to the orientation deviation in wrist motion training. The torque-field controller can be customized to different levels of rehabilitation training requirements by tuning the field parameters. Additionally, a rapidly convergent parameter self-identification algorithm is developed to obtain the uncertain parameters automatically for the floating wearable structure of the CDWRR. Finally, experiments on a healthy subject are carried out to demonstrate the performance of the controller and the feasibility of the CDWRR on wrist motion training or assistance.

The double universal joint wrist on a manipulator: Solution of inverse position kinematics and singularity analysis

NASA Technical Reports Server (NTRS)

Williams, Robert L., III

1992-01-01

This paper presents three methods to solve the inverse position kinematics position problem of the double universal joint attached to a manipulator: (1) an analytical solution for two specific cases; (2) an approximate closed form solution based on ignoring the wrist offset; and (3) an iterative method which repeats closed form position and orientation calculations until the solution is achieved. Several manipulators are used to demonstrate the solution methods: cartesian, cylindrical, spherical, and an anthropomorphic articulated arm, based on the Flight Telerobotic Servicer (FTS) arm. A singularity analysis is presented for the double universal joint wrist attached to the above manipulator arms. While the double universal joint wrist standing alone is singularity-free in orientation, the singularity analysis indicates the presence of coupled position/orientation singularities of the spherical and articulated manipulators with the wrist. The cartesian and cylindrical manipulators with the double universal joint wrist were found to be singularity-free. The methods of this paper can be implemented in a real-time controller for manipulators with the double universal joint wrist. Such mechanically dextrous systems could be used in telerobotic and industrial applications, but further work is required to avoid the singularities.

Design and fuzzy logic control of an active wrist orthosis.

PubMed

Kilic, Ergin; Dogan, Erdi

2017-08-01

People who perform excessive wrist movements throughout the day because of their professions have a higher risk of developing lateral and medial epicondylitis. If proper precautions are not taken against these diseases, serious consequences such as job loss and early retirement can occur. In this study, the design and control of an active wrist orthosis that is mobile, powerful and lightweight is presented as a means to avoid the occurrence and/or for the treatment of repetitive strain injuries in an effective manner. The device has an electromyography-based control strategy so that the user's intention always comes first. In fact, the device-user interaction is mainly activated by the electromyography signals measured from the forearm muscles that are responsible for the extension and flexion wrist movements. Contractions of the muscles are detected using surface electromyography sensors, and the desired quantity of the velocity value of the wrist is extracted from a fuzzy logic controller. Then, the actuator system of the device comes into play by conveying the necessary motion support to the wrist. Experimental studies show that the presented device actually reduces the demand on the muscles involved in repetitive strain injuries while performing challenging daily life activities including extension and flexion wrist motions.

A cable-driven wrist robotic rehabilitator using a novel torque-field controller for human motion training

NASA Astrophysics Data System (ADS)

Chen, Weihai; Cui, Xiang; Zhang, Jianbin; Wang, Jianhua

2015-06-01

Rehabilitation technologies have great potentials in assisted motion training for stroke patients. Considering that wrist motion plays an important role in arm dexterous manipulation of activities of daily living, this paper focuses on developing a cable-driven wrist robotic rehabilitator (CDWRR) for motion training or assistance to subjects with motor disabilities. The CDWRR utilizes the wrist skeletal joints and arm segments as the supporting structure and takes advantage of cable-driven parallel design to build the system, which brings the properties of flexibility, low-cost, and low-weight. The controller of the CDWRR is designed typically based on a virtual torque-field, which is to plan "assist-as-needed" torques for the spherical motion of wrist responding to the orientation deviation in wrist motion training. The torque-field controller can be customized to different levels of rehabilitation training requirements by tuning the field parameters. Additionally, a rapidly convergent parameter self-identification algorithm is developed to obtain the uncertain parameters automatically for the floating wearable structure of the CDWRR. Finally, experiments on a healthy subject are carried out to demonstrate the performance of the controller and the feasibility of the CDWRR on wrist motion training or assistance.

Biomechanical efficiency of wrist guards as a shock isolator.

PubMed

Hwang, Il-Kyu; Kim, Kyu-Jung; Kaufman, Kenton R; Cooney, William P; An, Kai-Nan

2006-04-01

Despite the use of wrist guards during skate- and snowboard activities, fractures still occur at the wrist or at further proximal locations of the forearm. The main objectives of this study were to conduct a human subject testing under simulated falling conditions for measurement of the impact force on the hand, to model wrist guards as a shock isolator, to construct a linear mass-spring-damper model for quantification of the impact force attenuation (Q-ratio) and energy absorption (S-ratio), and to determine whether wrist guards play a role of an efficient shock isolator. While the falling direction (forward and backward) significantly influenced the impact responses, use of wrist guards provided minimal improvements in the Q- and S-ratios. It was suggested based on the results under the submaximal loading conditions that protective functions of the common wrist guard design could be enhanced with substantial increase in the damping ratio so as to maximize the energy absorption. This would bring forth minor deterioration in the impact force attenuation but significant increase in the energy absorption by 19%, which would help better protection against fall-related injuries of the upper extremity.

78 FR 36643 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits... ``OMB Control No. 2900--NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-16. OMB Control Number: 2900-NEW (Wrist...

78 FR 36307 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits... Control No. 2900-NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Disability Benefits Questionnaire, VA Form 21-0960M-16. OMB Control Number: 2900-NEW (Wrist Conditions...

The effect of lunate position on range of motion after a four-corner arthrodesis: a biomechanical simulation study.

PubMed

Dvinskikh, N A; Blankevoort, L; Strackee, S D; Grimbergen, C A; Streekstra, G J

2011-04-29

A four-corner arthrodesis of the wrist is a salvage procedure for the treatment of specific wrist disorders, to achieve a movable, stable and pain free joint. However, a partial arthrodesis limits the postoperative range of motion (ROM). The goal of this study is to understand the mechanism of the reduction of the ROM and to evaluate the effect of the orientation of the lunate in the four-corner arthrodesis on the range of motion by using a biomechanical model, containing articular contacts and ligaments. Multi-body models of a normal wrist and a four-corner arthrodesis wrist with different orientation of the lunate were used for simulations of flexion-extension motion (FEM) and radial-ulnar deviation motion (RUD). The ROM of the postoperative wrist was reduced from 145° to 82° of the total arc of FEM and from 73° to 41.5° of the total arc of RUD. The model simulations show that the range of motion reduction is caused by overtension of the extrinsic wrist ligaments. Different positioning of the lunate changes the balance between the contact forces and ligament forces in the wrist. This explains the effect on the postoperative range of motion. The 20° flexed lunate did not give any gain in the extension motion of the wrist, caused joint luxation in flexion and limitation in RUD. The 30° extended lunate caused overtension of the extrinsic ligaments attached to the lunate. The ROM in this case is dramatically reduced. The model simulations suggest that the neutral position of the lunate seems to be most favorable for mobility of the wrist after a four-corner arthrodesis procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

Blood pressure monitor with a position sensor for wrist placement to eliminate hydrostatic pressure effect on blood pressure measurement.

PubMed

Sato, Hironori; Koshimizu, Hiroshi; Yamashita, Shingo; Ogura, Toshihiko

2013-01-01

Accurate measurement of blood pressure at wrist requires the heart and wrist to be kept at the same level to avoid the effects of hydrostatic pressure. Although a blood pressure monitor with a position sensor that guides appropriate forearm angle without use of a chair and desk has already been proposed, a similar functioning device for measuring upper arm blood pressure with a chair and desk is needed. In this study, a calculation model was first used to explore design of such a system. The findings were then implemented into design of a new blood pressure monitor. Results of various methods were compared. The calculation model of the wrist level from arthrosis angles and interarticulars lengths was developed and considered using published anthropometric dimensions. It is compared with 33 volunteer persons' experimental results. The calculated difference of level was -4.1 to 7.9 (cm) with a fixed chair and desk. The experimental result was -3.0 to 5.5 (cm) at left wrist and -2.1 to 6.3(cm) at right wrist. The absolute difference level equals ±4.8 (mmHg) of blood pressure readings according to the calculated result. This meets the AAMI requirements for a blood pressure monitor. In the conclusion, the calculation model is able to effectively evaluate the difference between the heart and wrist level. Improving the method for maintaining wrist to heart level will improve wrist blood pressure measurement accuracy when also sitting in the chair at a desk. The leading angle of user's forearm using a position sensor is shown to work for this purpose.

Hip and Wrist Accelerometer Algorithms for Free-Living Behavior Classification.

PubMed

Ellis, Katherine; Kerr, Jacqueline; Godbole, Suneeta; Staudenmayer, John; Lanckriet, Gert

2016-05-01

Accelerometers are a valuable tool for objective measurement of physical activity (PA). Wrist-worn devices may improve compliance over standard hip placement, but more research is needed to evaluate their validity for measuring PA in free-living settings. Traditional cut-point methods for accelerometers can be inaccurate and need testing in free living with wrist-worn devices. In this study, we developed and tested the performance of machine learning (ML) algorithms for classifying PA types from both hip and wrist accelerometer data. Forty overweight or obese women (mean age = 55.2 ± 15.3 yr; BMI = 32.0 ± 3.7) wore two ActiGraph GT3X+ accelerometers (right hip, nondominant wrist; ActiGraph, Pensacola, FL) for seven free-living days. Wearable cameras captured ground truth activity labels. A classifier consisting of a random forest and hidden Markov model classified the accelerometer data into four activities (sitting, standing, walking/running, and riding in a vehicle). Free-living wrist and hip ML classifiers were compared with each other, with traditional accelerometer cut points, and with an algorithm developed in a laboratory setting. The ML classifier obtained average values of 89.4% and 84.6% balanced accuracy over the four activities using the hip and wrist accelerometer, respectively. In our data set with average values of 28.4 min of walking or running per day, the ML classifier predicted average values of 28.5 and 24.5 min of walking or running using the hip and wrist accelerometer, respectively. Intensity-based cut points and the laboratory algorithm significantly underestimated walking minutes. Our results demonstrate the superior performance of our PA-type classification algorithm, particularly in comparison with traditional cut points. Although the hip algorithm performed better, additional compliance achieved with wrist devices might justify using a slightly lower performing algorithm.

Tactile information transfer: A comparison of two stimulation sites

NASA Astrophysics Data System (ADS)

Summers, Ian R.; Whybrow, Jon J.; Gratton, Denise A.; Milnes, Peter; Brown, Brian H.; Stevens, John C.

2005-10-01

Two experiments on the discrimination of time-varying tactile stimuli were performed, with comparison of stimulus delivery to the distal pad of the right index finger and to the right wrist (palmar surface). Subjects were required to perceive differences in short sequences of computer-generated stimulus elements (experiment 1) or differences in short tactile stimuli derived from a speech signal (experiment 2). The pulse-train stimuli were distinguished by differences in frequency (i.e., pulse repetition rate) and amplitude, and by the presence/absence of gaps (~100-ms duration). Stimulation levels were 10 dB higher at the wrist than at the fingertip, to compensate for the lower vibration sensitivity at the wrist. Results indicate similar gap detection at wrist and fingertip and similar perception of frequency differences. However, perception of amplitude differences was found to be better at the wrist than at the fingertip. Maximum information transfer rates for the stimuli in experiment 1 were estimated at 7 bits s-1 at the wrist and 5 bits s-1 at the fingertip.

Tactile information transfer: a comparison of two stimulation sites.

PubMed

Summers, lan R; Whybrow, Jon J; Gratton, Denise A; Milnes, Peter; Brown, Brian H; Stevens, John C

2005-10-01

Two experiments on the discrimination of time-varying tactile stimuli were performed, with comparison of stimulus delivery to the distal pad of the right index finger and to the right wrist (palmar surface). Subjects were required to perceive differences in short sequences of computer-generated stimulus elements (experiment 1) or differences in short tactile stimuli derived from a speech signal (experiment 2). The pulse-train stimuli were distinguished by differences in frequency (i.e., pulse repetition rate) and amplitude, and by the presence/absence of gaps (approximately 100-ms duration). Stimulation levels were 10 dB higher at the wrist than at the fingertip, to compensate for the lower vibration sensitivity at the wrist. Results indicate similar gap detection at wrist and fingertip and similar perception of frequency differences. However, perception of amplitude differences was found to be better at the wrist than at the fingertip. Maximum information transfer rates for the stimuli in experiment 1 were estimated at 7 bits s(-1) at the wrist and 5 bits s(-1) at the fingertip.

Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome.

PubMed

Mlakar, Maja; Ramstrand, Nerrolyn; Burger, Helena; Vidmar, Gaj

2014-06-01

Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position. We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses. Experimental. Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20° of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side. Orthosis type did not significantly affect grip strength (p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips (p < 0.050). The grips of the affected side were weaker than those of the nonaffected side (p = 0.002). In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20° wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker. The findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome. © The International Society for Prosthetics and Orthotics 2013.

Physical activity classification using the GENEA wrist-worn accelerometer.

PubMed

Zhang, Shaoyan; Rowlands, Alex V; Murray, Peter; Hurst, Tina L

2012-04-01

Most accelerometer-based activity monitors are worn on the waist or lower back for assessment of habitual physical activity. Output is in arbitrary counts that can be classified by activity intensity according to published thresholds. The purpose of this study was to develop methods to classify physical activities into walking, running, household, or sedentary activities based on raw acceleration data from the GENEA (Gravity Estimator of Normal Everyday Activity) and compare classification accuracy from a wrist-worn GENEA with a waist-worn GENEA. Sixty participants (age = 49.4 ± 6.5 yr, body mass index = 24.6 ± 3.4 kg·m⁻²) completed an ordered series of 10-12 semistructured activities in the laboratory and outdoor environment. Throughout, three GENEA accelerometers were worn: one at the waist, one on the left wrist, and one on the right wrist. Acceleration data were collected at 80 Hz. Features obtained from both fast Fourier transform and wavelet decomposition were extracted, and machine learning algorithms were used to classify four types of daily activities including sedentary, household, walking, and running activities. The computational results demonstrated that the algorithm we developed can accurately classify certain types of daily activities, with high overall classification accuracy for both waist-worn GENEA (0.99) and wrist-worn GENEA (right wrist = 0.97, left wrist = 0.96). We have successfully developed algorithms suitable for use with wrist-worn accelerometers for detecting certain types of physical activities; the performance is comparable to waist-worn accelerometers for assessment of physical activity.

Optimal wrist angulation shortens time needed for radial artery catheterization: a prospective, randomized, and blinded study.

PubMed

Pandey, R; Ashraf, H; Bhalla, A P; Garg, R

2012-01-01

Optimal wrist position is essential for successful catheterization of the radial artery. We planned to study the success rate of radial artery catheterization at various degrees of wrist extension angulations. This prospective, randomized study was performed in 60 consenting patients aged between 18-65 years and undergoing variable surgeries where the anesthetic management required an arterial catheterization. All patients were randomized into three groups of 20 patients each, according to wrist angulation during radial artery catheterization : either 30 degrees (Group 30), 45 degrees (Group 45), or 60 degrees (Group 60). Three metallic angulated wrist boards with angles of 30 degrees, 45 degrees, and 60 degrees (angle measured with calipers) were prepared, on which patient's wrist was kept at the above-mentioned angles of extension. Radial artery catheterization success rate, catheterization time, and numbers of attempts were recorded. The catheterization time was minimal in group 45 (30.50 +/- 16.82 sec) as compared to 36.00 +/- 14.19 sec and 43.50 +/- 13.80 sec in group 30 and 60, respectively. Radial artery was catheterized at first attempt in 60% of Group 45 and Group 60 patients, and in 50% of Group 30 patients. The arterial catheterization was successful in 14/20 patients in Group 30, 19/20 patients in group 45, and 16/20 patients in group 60. We conclude that a wrist extension of 450 appears to be the optimal wrist joint extension for a successful radial artery cannula insertion.

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint metal constrained cemented prosthesis. 888.3790 Section 888.3790 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3790 Wrist joint metal...

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint metal constrained cemented prosthesis. 888.3790 Section 888.3790 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3790 Wrist joint metal...

21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint metal constrained cemented prosthesis. 888.3790 Section 888.3790 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3790 Wrist joint metal...

The compensatory motion of wrist immobilization on thumb and index finger performance--kinematic analysis and clinical implications.

PubMed

Liu, Chien-Hsiou; Chiang, Hsin-Yu; Chen, Kun-Hung

2015-01-01

Based on the high prevalence of people with problems in the wrist and hand simultaneously, it is of its importance to clarify whether hand joints exert extra motion to compensate for wrist motion while immobilized. This study aimed to measure the compensatory movement of the thumb and index finger when people perform daily activities with an immobilized wrist. Thirty healthy volunteers were recruited in this study. A wrist splint, the Jebsen-Taylor Hand Function Test, and the OptoTrak Certus motion tracking system were used. Seven inter-digit mean joint angles of the index finger and thumb were calculated. Paired sample t-test was used. (1) The compensatory motions were noted in the Metacarpophalangeal and Carpometacarpal joints of the thumb, and the proximal interphalangeal joints of the index finger; (2) The manifestation of compensatory motion was related to type of activity performed except when picking up light and heavy cans. The compensatory motions appeared while the wrist was immobilized and were found to be disadvantageous to the progression of disease. In the future, studies need to be done to understand how to select products with correct ergonomic design to enable people to reap greater benefits from wearing wrist splints.

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

PubMed

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

2010-02-01

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

A randomized single blind crossover trial comparing leather and commercial wrist splints for treating chronic wrist pain in adults

PubMed Central

Thiele, Jill; Nimmo, Rachel; Rowell, Wendy; Quinn, Stephen; Jones, Graeme

2009-01-01

Background To compare the effectiveness of a custom-made leather wrist splint (LS) with a commercially available fabric splint (FS) in adults with chronic wrist pain. Methods Participants (N = 25, mean age = 54) were randomly assigned to treatment order in a 2-phase crossover trial. Splints were worn for 2 weeks, separated by a one-week washout period. Outcomes were assessed at baseline and after each splint phase using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Canadian Occupational Performance Measure (COPM) and Jamar dynamometer by an observer blinded to treatment allocation. Results Both styles of wrist splint significantly reduced pain (effect size LS 0.79, FS 0.43), improved hand function and increased grip strength compared to baseline (all p < 0.05) with no increase in wrist stiffness. There was a consistent trend for the LS to be superior to the FS but this was statistically significant only for patient perceived occupational performance (p = 0.008) and satisfaction (p = 0.015). Lastly, 72% of patients preferred the custom-made leather splint compared to the commercially available splint. Conclusion Leather wrist splints were superior to a commercially available fabric splint for the short-term relief of pain and dysfunction. PMID:19843345

Four-corner fusion of the wrist: clinical and radiographic outcome of 31 patients.

PubMed

Mavrogenis, Andreas F; Flevas, Dimitrios A; Raptis, Konstantinos; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios G; Antoniadou, Thekla; Dimopoulos, Leonidas; Antonopoulos, Dimitrios; Spyridonos, Sarantis G

2016-12-01

Four-corner fusion is a rational surgical option for the management of degenerative conditions of the wrist. Most related studies have compared four-corner fusion with scaphoid excision or proximal row carpectomy, with a variety of reported results. To enhance the literature, we performed this study to evaluate a series of patients with degenerative conditions of the wrist treated with four-corner fusion using 3 surgical techniques and to discuss the clinical and radiographic outcome of the patients. We retrospectively studied 31 patients (24 men, 7 women; mean age, 43 years; 9 heavy manual laborers) who underwent four-corner fusion of their wrists for degenerative conditions from 2005 to 2015. Internal fixation was done using multiple Kirschner wires (14 patients), headless compressive screws (8 patients), or a circular plate (9 patients). Mean follow-up was 4 years (1-11 years). We evaluated the clinical outcome with the Patient-Rated Wrist Evaluation (PRWE) score and fusion with radiographs. All patients experienced improvement of their pain, function, range of motion and grip strength (p < 0.05). Twenty-three patients (74 %) reported no pain, and eight patients reported mild, occasional pain. Twenty-one patients (68 %) were able to do usual and specific activities. Mean wrist motion improved to 70 % and mean grip strength improved to 85 % of opposite wrist. Two heavy manual labor patients requested a job modification because of wrist impairment. Radiographs of the wrist showed fusion of all fused joints in 28 (90.3 %) patients and partial fusion in three patients (9.7 %). No patient with partial fusion required a reoperation for symptomatic nonunion until the period of this study. Three patients experienced complications (10 %). Two patients treated with a circular plate experienced complex regional pain syndrome and painful implant impingement; another patient treated with Kirschner wires and headless compression screws experienced radiolunate arthritis from impingement of the lunate screw to the radius. Four-corner fusion is a reliable limited wrist fusion technique that provides pain relief, grip strength and satisfactory range of motion in patients with degenerative conditions of the wrist. Partial union is more common with Kirschner wire fixation and complications are more common with circular plate fixation.

Accuracy and reliability of wrist-cuff devices for self-measurement of blood pressure.

PubMed

Kikuya, Masahiro; Chonan, Kenichi; Imai, Yutaka; Goto, Eiji; Ishii, Masao

2002-04-01

Self-measurement of blood pressure (BP) might offer some advantages in diagnosis and therapeutic evaluation and in patient management of hypertension. Recently, wrist-cuff devices for self-measurement of BP have gained more than one-third of the world market share. In the present study, we validated wrist-cuff devices and compared the results between wrist- and arm-cuff devices. The factors affecting the accuracy of wrist-cuff devices were also studied. The research group to assess the validity of automated blood pressure measuring device consisted of 13 institutes in Japan, which validated two wrist-cuff devices (WC-1 and WC-2) and two arm-cuff devices (AC-1 and AC-2). They used a crossover method, where the comparison was done between auscultation, by two observers by means of a double stethoscope on one arm and the device on the opposite arm or wrist. There was good inter-observer agreement for the auscultation method in each institute (systolic blood pressure (SBP), -0.1 +/- 2.8 mmHg; diastolic blood pressure (DBP), -0.1 +/- 2.6 mmHg, n = 498). The mean difference between auscultation and the device was minimal both in arm-cuff devices (mean difference for AC-1, 2.2/1.9 mmHg, n = 97 and for AC-2, 5.1/2.9 mmHg, n = 136, SBP/DBP) and wrist-cuff devices (mean difference for WC-1, -2.1/1.2 mmHg, n = 173 mmHg and for WC-2, -2.3/-5.6 mmHg, n = 92). The standard deviation of the difference (SDD) in wrist-cuff devices, however (SDD for WC-1, 9.7/7.3 mmHg and for WC-2, 10.2/8.6 mmHg), was larger than that of the arm-cuff devices (SDD for AC-1, 5.6/6.6 mmHg and for AC-2, 6.3/5.1 mmHg). Grading of AC-1 and AC-2 based on criteria of British Hypertension Society was A/A and B/A, respectively, while that of WC-1 and WC-2 was C/B and D/B, respectively. Using the same validation protocol, the results of validation for one device were divergent in each institute. In wrist-cuff devices, the BP value obtained in palmar flexion was significantly higher and that obtained in palmar dorsiflexion was significantly lower than that in palmar extension. In some cases, finger plethysmogram did not disappear during maximum inflation of the wrist-cuff (congruent with 250 mmHg), even in palmar extension and especially in palmar flexion, suggesting incomplete obstruction of radial and/or ulnar arteries during inflation. The results suggest that wrist-cuff devices in the present form are inadequate for self-measurement of blood pressure and, thus, are inadequate for general use or clinical and practical use. However, there is much possibility in wrist-cuff device and the accuracy and reliability of wrist-cuff device are warranted by an improvement of technology.

Effects of extensor synovectomy and excision of the distal ulna in rheumatoid arthritis on long-term function.

PubMed

Jain, Abhilash; Ball, Cathy; Freidin, Andrew J; Nanchahal, Jagdeep

2010-09-01

Objective outcomes data after excision of the distal ulna in rheumatoid arthritis are lacking. The aim of this study was to evaluate the functional results of this surgery in the long term. We prospectively collected data on range of motion (22 wrists), visual analog pain scores (14 wrists), and grip strength measured using a Jamar dynamometer (20 hands) in a group of 23 patients (26 wrists) preoperatively and at 3 months, 12 months, and a minimum of 5 years postoperatively (range, 5.3-10.4 y). The Jebsen-Taylor hand function test was administered to 9 patients at the same time points. A subgroup of patients also underwent extensor carpi radialis longus to extensor carpi ulnaris tendon transfer (11 wrists). At one year, there were improvements in wrist pronation and supination, which were maintained at final follow-up. Active radial deviation decreased significantly at 3 months (p = .01) and one year (p = .02); this remained reduced at final follow-up (not significant). Wrist extension and active ulnar deviation showed slight improvements by one year, but reduced to levels below that measured preoperatively by final follow-up. Wrist flexion was significantly reduced at all time points postoperatively. Grip strength showed improvement from 10.0 kg (standard deviation [SD] 4.1 kg) preoperatively to 12.5 kg (SD 4.6 kg) 1 year after surgery and returned to preoperative levels (9.5 kg, SD 5.6 kg) by final follow-up. Wrist pain was significantly reduced from a mean score of 5 (SD 4) preoperatively to 2 (SD 2) postoperatively (p = .01). The Jebsen-Taylor hand function test showed improvements in writing and card turning. In the long term, excision of the distal ulna in rheumatoid patients results in an improvement in some aspects of hand function. There is a significant (p = .01) reduction in wrist pain but a reduction of wrist flexion. Therapeutic IV. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Kinematic synthesis of bevel-gear-type robotic wrist mechanisms

NASA Astrophysics Data System (ADS)

Lin, Chen-Chou

Bevel-gear-type robotic wrist mechanisms are commonly used in industry. The reasons for their popularity are that they are compact, light-weight, and relatively inexpensive. However, there are singularities in their workspace, which substantially degrade their manipulative performance. The objective of this research is to develop an atlas of three-degree-of-freedom bevel-gear-type wrist mechanisms, and through dimensional synthesis to improve their kinematic performance. The dissertation contains two major parts: the first is structural analysis and synthesis, the other is kinematic analysis and dimensional synthesis. To synthesize the kinematic structures of bevel-gear-type wrist mechanisms, the kinematic structures are separated from their functional considerations. All kinematic structures which satisfy the mobility condition are enumerated in an unbiased, systematic manner. Then the bevel-gear-type wrist mechanisms are identified by applying the functional requirements. Structural analysis shows that a three-degree-of-freedom wrist mechanism usually consists of non-fractionated, two degree-of-freedom epicyclic gear train jointed with the base link. Therefore, the structural synthesis can be simplified into a problem of examining the atlas of non-fractionated, two-degree-of-freedom epicyclic gear trains. The resulting bevel-gear-type wrist mechanism has been categorized and evaluated. It is shown that three-degree-of-freedom, four-jointed wrist mechanisms are promising for further improving the kinematic performance. It is found that a spherical planetary gear train is necessarily imbedded in a three-degree-of-freedom, four-jointed wrist mechanism. Therefore, to study the workspace and singularity problems of three-degree-of-freedom four-jointed spherical wrist mechanisms, we have to study the trajectories of spherical planetary gear trains. The parametric equations of the trajectories and some useful geometric properties for the analysis and synthesis of workplace are derived. The workspace boundary equations can be derived via both geometric consideration and Jacobian analysis. The workspace is divided by inner and outer boundaries into regions of accessibility of zero, two, and four. The design criteria of full workspace and a maximum four-root region are established.

The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.

PubMed

Wright, N C; Hooker, E R; Nielson, C M; Ensrud, K E; Harrison, S L; Orwoll, E S; Barrett-Connor, E

2018-04-01

There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance. To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study. Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks. We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65-69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake. Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney function and the inability to perform the grip strength test.

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

PubMed

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

2015-09-01

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

Kinesthetic Feedback During 2DOF Wrist Movements via a Novel MR-Compatible Robot.

PubMed

Erwin, Andrew; O'Malley, Marcia K; Ress, David; Sergi, Fabrizio

2017-09-01

We demonstrate the interaction control capabilities of the MR-SoftWrist, a novel MR-compatible robot capable of applying accurate kinesthetic feedback to wrist pointing movements executed during fMRI. The MR-SoftWrist, based on a novel design that combines parallel piezoelectric actuation with compliant force feedback, is capable of delivering 1.5 N [Formula: see text] of torque to the wrist of an interacting subject about the flexion/extension and radial/ulnar deviation axes. The robot workspace, defined by admissible wrist rotation angles, fully includes a circle with a 20 deg radius. Via dynamic characterization, we demonstrate capability for transparent operation with low (10% of maximum torque output) backdrivability torques at nominal speeds. Moreover, we demonstrate a 5.5 Hz stiffness control bandwidth for a 14 dB range of virtual stiffness values, corresponding to 25%-125% of the device's physical reflected stiffness in the nominal configuration. We finally validate the possibility of operation during fMRI via a case study involving one healthy subject. Our validation experiment demonstrates the capability of the device to apply kinesthetic feedback to elicit distinguishable kinetic and neural responses without significant degradation of image quality or task-induced head movements. With this study, we demonstrate the feasibility of MR-compatible devices like the MR-SoftWrist to be used in support of motor control experiments investigating wrist pointing under robot-applied force fields. Such future studies may elucidate fundamental neural mechanisms enabling robot-assisted motor skill learning, which is crucial for robot-aided neurorehabilitation.

Is there a need for a clinical decision rule in blunt wrist trauma?

PubMed

van den Brand, Crispijn L; van Leerdam, Roderick H; van Ufford, Jet H M E Quarles; Rhemrev, Steven J

2013-11-01

Blunt wrist trauma is a very common injury in emergency medicine. However, in contrast to other extremity trauma, there is no clinical decision rule for radiography in patients with blunt wrist trauma. The purpose of this study is to describe current practice and to assess the need and feasibility for a clinical decision rule for radiography in patients with blunt wrist trauma. All patients with blunt wrist trauma who presented to our Emergency Department (ED) during a 6-month period were included in this study. Basic demographics were analysed and the radiography ratio was determined. The radiography results were compared for different demographic groups. Current practice and the need and feasibility for a decision rule were evaluated using Stiell's checklist for clinical decision rules. A total of 1019 patients with 1032 blunt wrist injuries presented at our ED in a period of 6 months. In 91.4% of patients, radiographs were taken. In 41.6% of those radiographed, a fracture was visible on plain radiography. Fractures were most common in the paediatric and senior age groups. However, even in the lower-risk groups we observed a fracture incidence of about 20%. There is no need for a clinical decision rule for radiography in patients with blunt wrist trauma because the fracture ratio is high. Neither does it seem feasible to develop a highly sensitive and efficient decision rule. Therefore, the authors recommend radiography in all patients with blunt wrist trauma presenting to the ED. Copyright © 2013 Elsevier Ltd. All rights reserved.

Innervation of the wrist joint and surgical perspectives of denervation.

PubMed

Van de Pol, Gerrit J; Koudstaal, Maarten J; Schuurman, Arnold H; Bleys, Ronald L A W

2006-01-01

Because our experience with the techniques used in denervation surgery of the wrist joint often has proven insufficient in treating chronic pain we conducted an anatomic study to clarify the exact contributions of the nerves supplying the wrist joint. Our goal was to reveal all periosteal and capsular nerve connections and if necessary adjust our technique used in denervation surgery. Innervation of the wrist joint was investigated by microdissection and histologic examination of 18 human wrists. An acetylcholinesterase method was used to identify the nerves, both in whole-mount preparations and in sections. We found that the main innervation to the wrist capsule and periosteal nerve network came from the anterior interosseous nerve, lateral antebrachial cutaneous nerve, and posterior interosseous nerve. The palmar cutaneous branch of the median nerve, the deep branch of the ulnar nerve, the superficial branch of the radial nerve, and the dorsal branch of the ulnar nerve also were found to have connections with the capsule. The periosteal nerve branches did not appear to play a major role in the innervation of the capsule and ligaments; here the specific articular nerve branches proved more important. The posterior and medial antebrachial cutaneous nerves did not connect to the wrist capsule or periosteum but rather terminated in the extensor and flexor retinaculum. Based on our findings we propose to denervate the wrist by making 2 incisions. With one palmar and one dorsal incision it should be possible to disconnect the periosteum from the capsule and interrupt the majority of the capsular nerve branches.

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

Prediction of Energy Expenditure from Wrist Accelerometry in People with and without Down Syndrome

ERIC Educational Resources Information Center

Agiovlasitis, Stamatis; Motl, Robert W.; Foley, John T.; Fernhall, Bo

2012-01-01

This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS…

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

Vertical force and wrist deviation angle in a sample of elderly people using walkers.

PubMed

Leung, Cherng-Yee; Yeh, Po-Chan

2013-02-01

Walkers are frequently used by elderly people with weak lower limbs and limited balance, but the ergonomic relationship between the use of a walker and stress on the upper limbs is relatively unstudied. The current study assessed wrist deviation and vertical force among elderly individuals using a walker for assistance in walking. 60 elderly volunteers (M age = 81.0 yr., SD = 8.8) participated, 30 of whom frequently used a walker, and 30 who had no such prior experience. Data were obtained from four load cells and a twin-axis wrist goniometer during assisted ambulation using the walker. No significant group difference was found in gait cycle. Significant wrist deviation occurred, with ulnar deviation/dorsiflexion of the right hand, which was greater than that of the left. Non-experienced participants had larger dorsiflexion than experienced participants. Experienced participants produced larger vertical force than non-experienced participants. The greaterthe wrist deviation, the greater was the vertical force. The horizontal handles of most marketed walkers cause wrist deviations. This is a concern for users, clinicians, and related industries. Improvements in walker design should be considered.

Physical Examination of the Wrist: Useful Provocative Maneuvers.

PubMed

Kleinman, William B

2015-07-01

Chronic wrist pain resulting from partial interosseous ligament injury remains a diagnostic dilemma for many hand and orthopedic surgeons. Overuse of costly diagnostic studies including magnetic resonance imaging, computed tomography scans, and bone scans can be further frustrating to the clinician because of their inconsistent specificity and reliability in these cases. Physical diagnosis is an effective (and underused) means of establishing a working diagnosis of partial ligament injury to the wrist. Carefully performed provocative maneuvers can be used by the clinician to reproduce the precise character of a patient's problem, reliably establish a working diagnosis, and initiate a plan of treatment. Using precise physical examination techniques, the examiner introduces energy into the wrist in a manner that puts load on specific support ligaments of the carpus, leading to an accurate diagnosis. This article provides a broad spectrum of physical diagnostic tools to help the surgeon develop a working diagnosis of partial wrist ligament injuries in the face of chronic wrist pain and normal x-rays. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Scaphoid tuberosity excursion is minimized during a dart-throwing motion: A biomechanical study.

PubMed

Werner, Frederick W; Sutton, Levi G; Basu, Niladri; Short, Walter H; Moritomo, Hisao; St-Amand, Hugo

2016-01-01

The purpose of this study was to determine whether the excursion of the scaphoid tuberosity and therefore scaphoid motion is minimized during a dart-throwing motion. Scaphoid tuberosity excursion was studied as an indicator of scaphoid motion in 29 cadaver wrists as they were moved through wrist flexion-extension, radioulnar deviation, and a dart-throwing motion. Study results demonstrate that excursion was significantly less during the dart-throwing motion than during either wrist flexion-extension or radioulnar deviation. If the goal of early wrist motion after carpal ligament or distal radius injury and reconstruction is to minimize loading of the healing structures, a wrist motion in which scaphoid motion is minimal should reduce length changes in associated ligamentous structures. Therefore, during rehabilitation, if a patient uses a dart-throwing motion that minimizes his or her scaphoid tuberosity excursion, there should be minimal changes in ligament loading while still allowing wrist motion. Bench research, biomechanics, and cross-sectional. Not applicable. The study was laboratory based. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Wrist display concept demonstration based on 2-in. color AMOLED

NASA Astrophysics Data System (ADS)

Meyer, Frederick M.; Longo, Sam J.; Hopper, Darrel G.

2004-09-01

The wrist watch needs an upgrade. Recent advances in optoelectronics, microelectronics, and communication theory have established a technology base that now make the multimedia Dick Tracy watch attainable during the next decade. As a first step towards stuffing the functionality of an entire personnel computer (PC) and television receiver under a watch face, we have set a goal of providing wrist video capability to warfighters. Commercial sector work on the wrist form factor already includes all the functionality of a personal digital assistant (PDA) and full PC operating system. Our strategy is to leverage these commercial developments. In this paper we describe our use of a 2.2 in. diagonal color active matrix light emitting diode (AMOLED) device as a wrist-mounted display (WMD) to present either full motion video or computer generated graphical image formats.

Market study: Tactile paging system

NASA Technical Reports Server (NTRS)

1977-01-01

A market survey was conducted regarding the commercialization potential and key market factors relevant to a tactile paging system for deaf-blind people. The purpose of the tactile paging system is to communicate to the deaf-blind people in an institutional environment. The system consists of a main console and individual satellite wrist units. The console emits three signals by telemetry to the wrist com (receiving unit) which will measure approximately 2 x 4 x 3/4 inches and will be fastened to the wrist by a strap. The three vibration signals are fire alarm, time period indication, and a third signal which will alert the wearer of the wrist com to the fact that the pin on the top of the wrist is emitting a morse coded message. The Morse code message can be felt and recognized with the finger.

Dexterous Humanoid Robotic Wrist

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Reich, David M. (Inventor); Wampler, II, Charles W. (Inventor); Askew, Scott R. (Inventor); Diftler, Myron A. (Inventor); Nguyen, Vienny (Inventor)

2013-01-01

A humanoid robot includes a torso, a pair of arms, a neck, a head, a wrist joint assembly, and a control system. The arms and the neck movably extend from the torso. Each of the arms includes a lower arm and a hand that is rotatable relative to the lower arm. The wrist joint assembly is operatively defined between the lower arm and the hand. The wrist joint assembly includes a yaw axis and a pitch axis. The pitch axis is disposed in a spaced relationship to the yaw axis such that the axes are generally perpendicular. The pitch axis extends between the yaw axis and the lower arm. The hand is rotatable relative to the lower arm about each of the yaw axis and the pitch axis. The control system is configured for determining a yaw angle and a pitch angle of the wrist joint assembly.

Analysis of Hand and Wrist Postural Synergies in Tolerance Grasping of Various Objects

PubMed Central

Liu, Yuan; Jiang, Li; Yang, Dapeng; Liu, Hong

2016-01-01

Human can successfully grasp various objects in different acceptable relative positions between human hand and objects. This grasp functionality can be described as the grasp tolerance of human hand, which is a significant functionality of human grasp. To understand the motor control of human hand completely, an analysis of hand and wrist postural synergies in tolerance grasping of various objects is needed. Ten healthy right-handed subjects were asked to perform the tolerance grasping with right hand using 6 objects of different shapes, sizes and relative positions between human hand and objects. Subjects were wearing CyberGlove attaching motion tracker on right hand, allowing a measurement of the hand and wrist postures. Correlation analysis of joints and inter-joint/inter-finger modules were carried on to explore the coordination between joints or modules. As the correlation between hand and wrist module is not obvious in tolerance grasping, individual analysis of wrist synergies would be more practical. In this case, postural synergies of hand and wrist were then presented separately through principal component analysis (PCA), expressed through the principal component (PC) information transmitted ratio, PC elements distribution and reconstructed angle error of joints. Results on correlation comparison of different module movements can be well explained by the influence factors of the joint movement correlation. Moreover, correlation analysis of joints and modules showed the wrist module had the lowest correlation among all inter-finger and inter-joint modules. Hand and wrist postures were both sufficient to be described by a few principal components. In terms of the PC elements distribution of hand postures, compared with previous investigations, there was a greater proportion of movement in the thumb joints especially the interphalangeal (IP) and opposition rotation (ROT) joint. The research could serve to a complete understanding of hand grasp, and the design, control of the anthropomorphic hand and wrist. PMID:27580298

Relative Contributions of the Midcarpal and Radiocarpal Joints to Dart-Thrower's Motion at the Wrist.

PubMed

Kane, Patrick M; Vopat, Bryan G; Mansuripur, P Kaveh; Gaspar, Michael P; Wolfe, Scott W; Crisco, Joseph J; Got, Christopher

2018-03-01

To identify the relative contributions of the radiocarpal (RC) and midcarpal (MC) joints to dart-thrower's motion (DTM) of the wrist. Six cadaveric upper extremities were fixed to a custom-designed loading jig allowing for pure moment-rotation analysis in 24 different directions of wrist motion. Each specimen was tested in 3 states: intact, simulated radiocarpal fusion (sRCF) and simulated pancarpal fusion (sPCF). Moments of ± 1.5 Nm were applied at each of 24 directions for each state and the resulting wrist rotation recorded. Data from each specimen were reduced to compute the range of motion (ROM) envelopes and the orientation of the ROM for the 3 different states. The ROM was significantly decreased in the sRCF and sPCF groups compared with the intact group in the directions of the pure extension, radial extension, ulnar flexion, and ulnar deviation. No significant difference in ROM was detected between the sRCF and sPCF groups in any direction. The ROM envelopes for the intact, sRCF, and sPCF groups were all oriented obliquely to the axis of pure wrist flexion-extension near a path of ulnar flexion-radial extension, consistent with prior reports on DTM. Although both simulated fusion types decreased ROM compared with the intact wrist, the principal direction of wrist motion along the path of DTM was not significantly altered by simulated RCF or PCF. These findings suggest that the RC and MC joints can each contribute to a similar mechanical axis of motion located along the path of DTM when the other joint has been eliminated via fusion. Surgical options such as partial wrist fusions may maintain the native wrist's mechanical axis if either the RC or the MC joint is preserved, despite significant reduction in overall ROM. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Effect of Auditory Constraints on Motor Performance Depends on Stage of Recovery Post-Stroke

PubMed Central

Aluru, Viswanath; Lu, Ying; Leung, Alan; Verghese, Joe; Raghavan, Preeti

2014-01-01

In order to develop evidence-based rehabilitation protocols post-stroke, one must first reconcile the vast heterogeneity in the post-stroke population and develop protocols to facilitate motor learning in the various subgroups. The main purpose of this study is to show that auditory constraints interact with the stage of recovery post-stroke to influence motor learning. We characterized the stages of upper limb recovery using task-based kinematic measures in 20 subjects with chronic hemiparesis. We used a bimanual wrist extension task, performed with a custom-made wrist trainer, to facilitate learning of wrist extension in the paretic hand under four auditory conditions: (1) without auditory cueing; (2) to non-musical happy sounds; (3) to self-selected music; and (4) to a metronome beat set at a comfortable tempo. Two bimanual trials (15 s each) were followed by one unimanual trial with the paretic hand over six cycles under each condition. Clinical metrics, wrist and arm kinematics, and electromyographic activity were recorded. Hierarchical cluster analysis with the Mahalanobis metric based on baseline speed and extent of wrist movement stratified subjects into three distinct groups, which reflected their stage of recovery: spastic paresis, spastic co-contraction, and minimal paresis. In spastic paresis, the metronome beat increased wrist extension, but also increased muscle co-activation across the wrist. In contrast, in spastic co-contraction, no auditory stimulation increased wrist extension and reduced co-activation. In minimal paresis, wrist extension did not improve under any condition. The results suggest that auditory task constraints interact with stage of recovery during motor learning after stroke, perhaps due to recruitment of distinct neural substrates over the course of recovery. The findings advance our understanding of the mechanisms of progression of motor recovery and lay the foundation for personalized treatment algorithms post-stroke. PMID:25002859

A comprehensive comparison of simple step counting techniques using wrist- and ankle-mounted accelerometer and gyroscope signals.

PubMed

Rhudy, Matthew B; Mahoney, Joseph M

2018-04-01

The goal of this work is to compare the differences between various step counting algorithms using both accelerometer and gyroscope measurements from wrist and ankle-mounted sensors. Participants completed four different conditions on a treadmill while wearing an accelerometer and gyroscope on the wrist and the ankle. Three different step counting techniques were applied to the data from each sensor type and mounting location. It was determined that using gyroscope measurements allowed for better performance than the typically used accelerometers, and that ankle-mounted sensors provided better performance than those mounted on the wrist.

Pisiform excision for pisotriquetral instability and arthritis.

PubMed

Campion, Heather; Goad, Andrea; Rayan, Ghazi; Porembski, Margaret

2014-07-01

To evaluate wrist strength and kinematics after pisiform excision and preservation of its soft tissue confluence for pisotriquetral instability and arthritis. We evaluated 12 patients, (14 wrists) subjectively and objectively an average of 7.5 years after pisiform excision. Three additional patients were interviewed by phone. Subjective evaluation included inquiry about pain and satisfaction with the treatment. Objective testing included measuring wrist flexion and extension range of motion, grip strength, and static and dynamic flexion and ulnar deviation strengths of the operative hand compared with the nonsurgical normal hand. Four patients had concomitant ulnar nerve decompression at the wrist. All patients were satisfied with the outcome. Wrist flexion averaged 99% and wrist extension averaged 95% of the nonsurgical hand. Mean grip strength of the operative hand was 90% of the nonsurgical hand. Mean static flexion strength of the operative hand was 94% of the nonsurgical hand, whereas mean dynamic flexion strength was 113%. Mean static ulnar deviation strength of the operative hand was 87% of the nonsurgical hand. The mean dynamic ulnar deviation strength of the operative hand was 103% of the nonsurgical hand. Soft tissue confluence-preserving pisiform excision relieved pain and retained wrist motion and static and dynamic strength. Associated ulnar nerve compression was a confounding factor that may have affected outcomes. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

PubMed Central

Wilson, Katherine E.; Tat, Jimmy

2017-01-01

Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS) symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N). Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s) was significantly lower than flexed 30° (3.37 cm/s), flexed 15° (3.27 cm/s), and extended 30° (3.29 cm/s). Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s) than with force (3.56 cm/s). A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression. PMID:28286771

[Operative differential therapy of rheumatic wrists].

PubMed

Dinges, H; Fürst, M; Rüther, H; Schill, S

2007-09-01

The wrists are affected in the long-term in 90% of people with rheumatism and are often (42%) the first manifestation of a destructive disease. The functionality of the wrist and the whole hand is of great importance because in many cases loss of function of the wrists leads to severe limitations. Local and operative treatment of the wrist in rheumatoid arthritis (RA) is one of the main duties in rheuma-orthopaedics. For operative treatment there is a finely tuned differential therapeutic spectrum available. The diagnostic indications take the local and total pattern of affection, the current systemic therapy as well as patient wishes and patient compliance into consideration. In the early stages according to LDE (Larsen, Dale, Eek), soft tissues operations such as articulo-tenosynovectomy (ATS) are most commonly carried out. In further advanced stages osseus stabilisation must often be performed. At this point a smooth transition from partial arthrodesis to complete fixation is possible. After initial euphoria, arthroplasty of the wrist is being increasingly less used for operative treatment due to the unconvincing long-term results and high complication rate. With reference to the good long-term results of all operative procedures, in particular early ATS with respect to pain, function and protection of tendons, after failure of medicinal treatment and persistence of inflammatory activity in the wrist, patients should be transferred to an experienced rheuma-orthopaedic surgeon.

Social humanoid robot SARA: development of the wrist mechanism

NASA Astrophysics Data System (ADS)

Penčić, M.; Rackov, M.; Čavić, M.; Kiss, I.; Cioată, V. G.

2018-01-01

This paper presents the development of a wrist mechanism for humanoid robots. The research was conducted within the project which develops social humanoid robot Sara - a mobile anthropomorphic platform for researching the social behaviour of robots. There are two basic ways for the realization of humanoid wrist. The first one is based on biologically inspired structures that have variable stiffness, and the second one on low backlash mechanisms that have high stiffness. Our solution is low backlash differential mechanism that requires small actuators. Based on the kinematic-dynamic requirements, a dynamic model of the robot wrist is formed. A dynamic simulation for several hand positions was performed and the driving torques of the wrist mechanism were determined. The realized wrist has 2 DOFs and enables movements in the direction of flexion/extension 115°, ulnar/radial deviation ±45° and the combination of these two movements. It consists of a differential mechanism with three spur bevel gears, two of which are driving and identical, while the last one is the driven gear to which the robot hand is attached. Power transmission and motion from the actuator to the input links of the differential mechanism is realized with two parallel placed identical gear mechanisms. The wrist mechanism has high carrying capacity and reliability, high efficiency, a compact design and low backlash that provides high positioning accuracy and repeatability of movements, which is essential for motion control.

Quantitative biomechanical analysis of wrist motion in bone-trimming jobs in the meat packing industry.

PubMed

Marklin, R W; Monroe, J F

1998-02-01

This study was motivated by the serious impact that cumulative trauma disorders (CTDs) of the upper extremities have on the meat packing industry. To date, no quantitative data have been gathered on the kinematics of hand and wrist motion required in bone-trimming jobs in the red-meat packing industry and how these motions are related to the risk of CTDs. The wrist motion of bone-trimming workers from a medium-sized plant was measured, and the kinematic data were compared to manufacturing industry's preliminary wrist motion benchmarks from industrial workers who performed hand-intensive, repetitive work in jobs that were of low and high risk of hand/wrist CTDs. Results of this comparison show that numerous wrist motion variables in both the left and right hands of bone-trimming workers are in the high-risk category. This quantitative analysis provides biomechanical support for the high incidence of CTDs in the meat packing industry. The research reported in this paper established a preliminary database of wrist and hand kinematics required in bone-trimming jobs in the red-meat packing industry. This kinematic database could augment the industry's efforts to reduce the severity and cost of CTDs. Ergonomics practitioners in the industry could use the kinematic methods employed in this research to assess the CTD risk of jobs that require repetitious, hand-intensive work.

Physical activity and sedentary behavior during pregnancy and postpartum, measured using hip and wrist-worn accelerometers.

PubMed

Hesketh, Kathryn R; Evenson, Kelly R; Stroo, Marissa; Clancy, Shayna M; Østbye, Truls; Benjamin-Neelon, Sara E

2018-06-01

Physical activity in pregnancy and postpartum is beneficial to mothers and infants. To advance knowledge of objective physical activity measurement during these periods, this study compares hip to wrist accelerometer compliance; assesses convergent validity (correlation) between hip- and wrist-worn accelerometry; and assesses change in physical activity from pregnancy to postpartum. We recruited women during pregnancy ( n  = 100; 2014-2015), asking them to wear hip and wrist accelerometers for 7 days during Trimester 2 (T2), Trimester 3 (T3), and 3-, 6-, 9- and 12-months postpartum. We assessed average wear-time and correlations (axis-specific counts/minute, vector magnitude counts/day and step counts/day) at T2, T3, and postpartum. Compliance was higher for wrist-worn accelerometers. Hip and wrist accelerometers showed moderate to high correlations (Pearson's r 0.59 to 0.84). Hip-measured sedentary and active time differed little between T2 and T3. Moderate-to-vigorous physical activity decreased at T3 and remained low postpartum. Light physical activity increased and sedentary time decreased throughout the postpartum period. Wrist accelerometers may be preferable during pregnancy and appear comparable to hip accelerometers. As physical activity declines during later pregnancy and may not rebound post birth, support for re-engaging in physical activity earlier in the postpartum period may benefit women.

A Study of Repeated Wrist Temperature of Sixth, Seventh, and Eighth Graders.

ERIC Educational Resources Information Center

Matthews, Doris B.; Quinn, Jimmy L.

While evidence exists that a person's peripheral temperature responds to his state of arousal or stress, it also responds to other environmental factors. Wrist temperature has been found to vary with ambient temperature, and to increase during the school day. Before wrist temperature can be established as a valid measure of anxiety, stress, or…

Effects of Neoprene Wrist/Hand Splints on Handwriting for Students with Joint Hypermobility Syndrome: A Single System Design Study

ERIC Educational Resources Information Center

Frohlich, Lauren; Wesley, Alison; Wallen, Margaret; Bundy, Anita

2012-01-01

Purpose: Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Methods: Multiple baseline, single system design…

Incidence and Risk Factors for Volar Wrist Ganglia in the U.S. Military and Civilian Populations.

PubMed

Balazs, George C; Dworak, Theodora C; Tropf, Jordan; Nanos, George P; Tintle, Scott M

2016-11-01

To identify the incidence and demographic factors associated with volar wrist ganglia in both military and civilian beneficiary populations. The U.S. Department of Defense Management Analysis and Reporting Tool (M2) accesses a comprehensive database of all health care visits by military personnel and their dependents. Because there is no specific code for ganglions of the wrist, the database was searched for all military personnel and civilian beneficiaries with an International Classification of Diseases, 9th Revision, diagnosis of 727.41 (ganglion of a joint) or 727.43 (ganglion, unspecified location) between 2009 and 2014. Two random samples of 1000 patients were selected from both the military and the civilian beneficiary cohorts, and their electronic medical records were examined to identify those with volar wrist ganglia. The proportion of volar wrist ganglia was then applied to the overall population data to estimate the total incidence with a 95% confidence interval and 5% margin of error. Unadjusted incidence rates and adjusted incidence rate ratios were determined using Poisson regression, controlling for age, sex, branch of military service, and military seniority. The unadjusted incidence of volar wrist ganglia is 3.72 per 10,000 person-years (0.04%/y) in female civilian beneficiaries, 1.04 per 10,000 person-years (0.01%/y) in male civilian beneficiaries, 7.98 per 10,000 person-years (0.08%/y) in female military personnel, and 3.73 per 10,000 person-years (0.04%/y) in male military personnel. When controlled for age, military personnel have a 2.5-times increased rate of volar wrist ganglia, and women have a 2.3-times increased rate. In the military cohort, female sex, branch of service, and seniority were significantly associated with the diagnosis of a volar wrist ganglion when controlled for age. In the civilian beneficiary cohort, only female sex was significant. Military service members have higher rates of volar wrist ganglia diagnoses than their age- and sex-matched civilian counterparts. Women are significantly more likely to be diagnosed with a volar wrist ganglion, regardless of age or military status. The epidemiology of volar wrist ganglia is poorly defined, and few studies have firmly defined demographic factors associated with the diagnosis. We provide the overall incidence rate of the diagnosis and report a significant association with female sex even when controlled for age. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists: Correlation with Cross-sectional Anatomy.

PubMed

Zhan, Hui-Li; Li, Wen-Ting; Bai, Rong-Jie; Wang, Nai-Li; Qian, Zhan-Hua; Ye, Wei; Yin, Yu-Ming

2017-04-05

The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study. All cadavers and volunteers had magnetic resonance (MR) examination of the wrist with coronal T1-weighted and proton density-weighted imaging with fat suppression in three planes, respectively. MR arthrography (MRAr) was performed on one of the cadaveric wrists. Subsequently, all 14 cadaveric wrists were sliced into 2 mm thick slab with band saw (six in coronal plane, four in sagittal plane, and four in axial plane). The MRI features of normal TFCC were analyzed in these specimens and forty healthy wrists. Triangular fibrocartilage, the ulnar collateral ligament, and the meniscal homolog could be best observed on images in coronal plane. The palmar and dorsal radioulnar ligaments were best evaluated in transverse plane. The ulnotriquetral and ulnolunate ligaments were best visualized in sagittal plane. The latter two structures and the volar and dorsal capsules were better demonstrated on MRAr. High-resolution 3T MRI is capable to show the detailed complex anatomy of the TFCC and can provide valuable information for the clinical diagnosis in Chinese.

High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists: Correlation with Cross-sectional Anatomy

PubMed Central

Zhan, Hui-Li; Li, Wen-Ting; Bai, Rong-Jie; Wang, Nai-Li; Qian, Zhan-Hua; Ye, Wei; Yin, Yu-Ming

2017-01-01

Background: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. Methods: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study. All cadavers and volunteers had magnetic resonance (MR) examination of the wrist with coronal T1-weighted and proton density-weighted imaging with fat suppression in three planes, respectively. MR arthrography (MRAr) was performed on one of the cadaveric wrists. Subsequently, all 14 cadaveric wrists were sliced into 2 mm thick slab with band saw (six in coronal plane, four in sagittal plane, and four in axial plane). The MRI features of normal TFCC were analyzed in these specimens and forty healthy wrists. Results: Triangular fibrocartilage, the ulnar collateral ligament, and the meniscal homolog could be best observed on images in coronal plane. The palmar and dorsal radioulnar ligaments were best evaluated in transverse plane. The ulnotriquetral and ulnolunate ligaments were best visualized in sagittal plane. The latter two structures and the volar and dorsal capsules were better demonstrated on MRAr. Conclusion: High-resolution 3T MRI is capable to show the detailed complex anatomy of the TFCC and can provide valuable information for the clinical diagnosis in Chinese. PMID:28345546

WRIST: A WRist Image Segmentation Toolkit for carpal bone delineation from MRI.

PubMed

Foster, Brent; Joshi, Anand A; Borgese, Marissa; Abdelhafez, Yasser; Boutin, Robert D; Chaudhari, Abhijit J

2018-01-01

Segmentation of the carpal bones from 3D imaging modalities, such as magnetic resonance imaging (MRI), is commonly performed for in vivo analysis of wrist morphology, kinematics, and biomechanics. This crucial task is typically carried out manually and is labor intensive, time consuming, subject to high inter- and intra-observer variability, and may result in topologically incorrect surfaces. We present a method, WRist Image Segmentation Toolkit (WRIST), for 3D semi-automated, rapid segmentation of the carpal bones of the wrist from MRI. In our method, the boundary of the bones were iteratively found using prior known anatomical constraints and a shape-detection level set. The parameters of the method were optimized using a training dataset of 48 manually segmented carpal bones and evaluated on 112 carpal bones which included both healthy participants without known wrist conditions and participants with thumb basilar osteoarthritis (OA). Manual segmentation by two expert human observers was considered as a reference. On the healthy subject dataset we obtained a Dice overlap of 93.0 ± 3.8, Jaccard Index of 87.3 ± 6.2, and a Hausdorff distance of 2.7 ± 3.4 mm, while on the OA dataset we obtained a Dice overlap of 90.7 ± 8.6, Jaccard Index of 83.0 ± 10.6, and a Hausdorff distance of 4.0 ± 4.4 mm. The short computational time of 20.8 s per bone (or 5.1 s per bone in the parallelized version) and the high agreement with the expert observers gives WRIST the potential to be utilized in musculoskeletal research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Coordination of intrinsic and extrinsic hand muscle activity as a function of wrist joint angle during two-digit grasping.

PubMed

Johnston, Jamie A; Bobich, Lisa R; Santello, Marco

2010-04-26

Fingertip forces result from the activation of muscles that cross the wrist and muscles whose origins and insertions reside within the hand (extrinsic and intrinsic hand muscles, respectively). Thus, tasks that involve changes in wrist angle affect the moment arm and length, hence the force-producing capabilities, of extrinsic muscles only. If a grasping task requires the exertion of constant fingertip forces, the Central Nervous System (CNS) may respond to changes in wrist angle by modulating the neural drive to extrinsic or intrinsic muscles only or by co-activating both sets of muscles. To distinguish between these scenarios, we recorded electromyographic (EMG) activity of intrinsic and extrinsic muscles of the thumb and index finger as a function of wrist angle during a two-digit object hold task. We hypothesized that changes in wrist angle would elicit EMG amplitude modulation of the extrinsic and intrinsic hand muscles. In one experimental condition we asked subjects to exert the same digit forces at each wrist angle, whereas in a second condition subjects could choose digit forces for holding the object. EMG activity was significantly modulated in both extrinsic and intrinsic muscles as a function of wrist angle (both p<0.05) but only for the constant force condition. Furthermore, EMG modulation resulted from uniform scaling of EMG amplitude across all muscles. We conclude that the CNS controlled both extrinsic and intrinsic muscles as a muscle synergy. These findings are discussed within the theoretical frameworks of synergies and common neural input across motor nuclei of hand muscles. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Snowboarding injuries in Australia: investigating risk factors in wrist fractures to enhance injury prevention strategies.

PubMed

Dickson, Tracey J; Terwiel, F Anne

2011-09-01

To investigate risk factors associated with wrist fractures in snowboarders to inform future snowsport safety strategies. A prospective case-control study using a nonprobability convenience sample was conducted with data collected via a respondent-completed questionnaire. Subjects consisted of snowboarders with a snowboard-related injury who presented to one of 10 medical centers and physiotherapy clinics in resort medical centers and gateway communities across the Australian snowsport season in 2007. Those presenting with injuries other than wrist fractures acted as the control. The 611 respondents reported 802 injuries (61.3% were males and 51.5% were aged 16-25 years). Protective equipment was worn by 57.0% of respondents. The main reason for not wearing a wrist guard was that they did not see the need; of these, 12.9% experienced a wrist fracture. Most injuries occurred on-piste, in a terrain park, or in a lesson. The main mechanism of injury was falling. The major risk factors for wrist fractures were being less than 16 years of age (OR 3.97, CI 2.54-6.22), being in the alpine area for a holiday (OR 2.77, CI 1.47-5.21), and being a first-day snowboard participant (OR 2.02, CI 1.15-3.64). A direct logistic regression indicated that 3 variables had a statistically significant contribution to the model (being less than 16 years old, being on holidays in the region, and not wearing a wrist guard). The key risk factors in this Australian study reflect other international studies, providing a clear market segment for targeted snowsport safety messages: those less than 16 years old, visitors to the alpine regions, and those not wearing wrist guards. Copyright © 2011. Published by Elsevier Inc.

Effect of traction on wrist joint space and cartilage visibility with and without MR arthrography

PubMed Central

Griffith, James F; Tang, W K; Ng, Alex W H; Yeung, David K W

2017-01-01

Objective: To compare the effect of traction during non-arthrographic and arthrographic MR examination of the wrist with regard to joint space width, joint fluid dispersion and cartilage surface visibility. Methods: Prospective 3-T MRI study of 100 wrists in 96 patients. The first 50 wrists underwent MR arthrography first without traction and then with traction. The following 50 wrists underwent standard MR first without traction and then with traction. On these examinations, two radiologists independently measured (i) joint space width, semi-quantitatively graded (ii) joint fluid dispersion between opposing cartilage surfaces and (iii) articular cartilage surface visibility. The three parameters were compared between the two groups. Results: Traction led to an increase in joint space width at nearly all joints in all patients (p < 0.05), although more so in the arthrography (∆ = 0.08–0.79 mm, all p < 0.05) than in the non-arthrography (∆ = 0.001–0.61 mm, all p < 0.05) group. Joint fluid dispersion and cartilage surface visibility improved after traction in nearly all joints (p < 0.05) in all patients and more so in the arthographic than in the non-arthrography group. Conclusion: Traction did significantly improve cartilage surface visibility for standard MRI of the wrist although the effect was not as great as that seen with MR arthography or MR arthrography with traction. Advances in knowledge: This is the first study to show the beneficial effect of traction during standard non-arthrography MRI of the wrist and compare the effect of traction between non-arthrographic and arthrographic MRI of the wrist. PMID:28181830

Incidence of Posterior Interosseous Nerve Trauma During Creation of the 3-4 Wrist Arthroscopy Portal in Cadavers.

PubMed

Cheah, Andre Eu-Jin; Le, Wei; Yao, Jeffrey

2017-04-01

To describe histologic evidence of nerve trauma during the creation and use of the 3-4 portal. Fourteen fresh-frozen cadaveric wrists were mounted on a custom-built frame that simulated a wrist arthroscopy traction tower. After the 3-4 portal was created in the usual manner, the skin was dissected off to identify possible trauma to the posterior interosseous nerve (PIN). Specimens were categorized into those where there was clearly no trauma to the PIN and those where trauma was possible. In the cases where trauma was possible, we harvested the PIN with a cuff of the proximal edge of the portal and examined the cross-sectional histology of the most distal sections for the presence of neural tissue. There was clearly no trauma to the PIN in 3 of the wrists during the creation of the 3-4 portal. In the remaining 11 wrists with possible trauma to the PIN, we identified axonal tissue on histologic examination at the proximal edge of the 3-4 portal in 7 of these specimens. In summary, 50% (7 of 14) of our specimens had visual and histologic evidence of trauma to the PIN. Based on the findings of this study, there may be more instances of trauma to the PIN during routine wrist arthroscopy than have been previously reported. Findings suggest that transection or injury to this nerve may not lead to any clinical sequelae. However, if there is an instance where a patient has persistent, otherwise unexplained, dorsal wrist pain after a wrist arthroscopy procedure, iatrogenic neuroma of the PIN may be responsible and should be considered. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Wrist circumference as a novel predictor of hypertension and cardiovascular disease: results of a decade follow up in a West Asian cohort.

PubMed

Mohebi, Reza; Mohebi, Ahmad; Sheikholeslami, Farhad; Azizi, Fereidoun; Hadaegh, Farzad

2014-11-01

No study has yet evaluated the effect of wrist circumference on risk of incident hypertension and cardiovascular disease (CVD) in an adult population. The present study included 3642 women, aged ≥30 years, free of CVD at baseline, who had undergone health examinations between January 1999 and 2001 and were followed up until March 2010. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of wrist circumference for CVD and hypertension events. During 10 years of follow-up, 284 cases of first CVD and 615 cases of incident hypertension occurred. In a model adjusted for conventional CVD risk factors, the HR of 1 cm increase in wrist circumference was 1.15 (1.06-1.25) for hypertension and was marginally significant for CVD (HR, 1.12 [1.00-1.25]; P-value 0.052). After considering body mass index and waist circumference in the model, we found significant interaction between waist circumference and wrist circumference in risk prediction of hypertension and CVD (P < .001). In non-centrally obese women (waist circumference <95 cm), in multivariable model plus body mass index and waist circumference, increase in wrist circumference was independently associated with both hypertension (HR, 1.17 [1.02-1.35]) and CVD (HR, 1.29 [1.03-1.61]). However, among centrally obese women (waist circumference ≥95 cm), wrist circumference increase could not predict either hypertension (HR, 0.97 [0.84-1.18]) or CVD events (HR, 0.90 [0.75-1.07]). Wrist circumference as a novel anthropometric measure was an independent predictor for incident hypertension and CVD events among non-centrally obese women. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Wrist joint assembly

NASA Technical Reports Server (NTRS)

Kersten, L.; Johnson, J. D. (Inventor)

1978-01-01

A wrist joint assembly is provided for use with a mechanical manipulator arm for finely positioning an end-effector carried by the wrist joint on the terminal end of the manipulator arm. The wrist joint assembly is pivotable about a first axis to produce a yaw motion, a second axis is to produce a pitch motion, and a third axis to produce a roll motion. The wrist joint assembly includes a disk segment affixed to the terminal end of the manipulator arm and a first housing member, a second housing member, and a third housing member. The third housing member and the mechanical end-effector are moved in the yaw, pitch, and roll motion. Drive means are provided for rotating each of the housings about their respective axis which includes a cluster of miniature motors having spur gears carried on the output drive shaft which mesh with a center drive gear affixed on the housing to be rotated.

Neurologic complications in common wrist and hand surgical procedures

PubMed Central

Verdecchia, Nicole; Johnson, Julie; Baratz, Mark; Orebaugh, Steven

2018-01-01

Nerve dysfunction after upper extremity orthopedic surgery is a recognized complication, and may result from a variety of different causes. Hand and wrist surgery require incisions and retraction that necessarily border on small peripheral nerves, which may be difficult to identify and protect with absolute certainty. This article reviews the rates and ranges of reported nerve dysfunction with respect to common surgical interventions for the distal upper extremity, including wrist arthroplasty, wrist arthrodesis, wrist arthroscopy, distal radius open reduction and internal fixation, carpal tunnel release, and thumb carpometacarpal surgery. A relatively large range of neurologic complications is reported, however many of the studies cited involve relatively small numbers of patients, and only rarely are neurologic complications included as primary outcome measures. Knowledge of these neurologic outcomes should help the surgeon to better counsel patients with regard to perioperative risk, as well as provide insight into workup and management of any adverse neurologic outcomes that may arise.

Constant angular velocity of the wrist during the lifting of a sphere.

PubMed

Chappell, P H; Metcalf, C D; Burridge, J H; Yule, V T; Pickering, R M

2010-05-01

The primary objective of the experiments was to investigate the wrist motion of a person while they were carrying out a prehensile task from a clinical hand function test. A six-camera movement system was used to observe the wrist motion of 10 participants. A very light sphere and a heavy sphere were used in the experiments to study any mass effects. While seated at a table, a participant moved a sphere over a small obstacle using their dominant hand. The participants were observed to move their wrist at a constant angular velocity. This phenomenon has not been reported previously. Theoretically, the muscles of the wrist provide an impulse of force at the start of the rotation while the forearm maintains a constant vertical force on a sphere. Light-heavy mean differences for the velocities, absolute velocities, angles and times taken showed no significant differences (p = 0.05).

Evaluation of skeletal maturation by comparing the hand wrist radiograph and cervical vertebrae as seen in lateral cephalogram.

PubMed

Mahajan, Shally

2011-01-01

Aim of this study was to determine the validity of cervical vertebrae radiographic assessment to predict skeletal maturation. Left-hand wrist and lateral cephalometric radiographs of 100 Bangalore children aged 8-18 years, divided into 10 groups of 10 subjects each with equal distribution of males and females, were measured. On left-hand wrist radiograph, the classification of Fishman was used to assess skeletal maturation. Cervical vertebrae maturation was evaluated with lateral cephalometric radiograph, using the stages developed by Hassel and Farman. The changes in hand wrist and cervical vertebrae were correlated. Significant association was observed between skeletal maturation indicator stages and cervical vertebrae maturation indicator stages. Correlation coefficient was found to be significant (P<0.0001). The results of the study indicated that the cervical vertebrae maturation and hand wrist skeletal maturation was significantly related.

Hyperstaticity for ergonomie design of a wrist exoskeleton.

PubMed

Esmaeili, Mohammad; Jarrassé, Nathanaël; Dailey, Wayne; Burdet, Etienne; Campolo, Domenico

2013-06-01

Increasing the level of transparency in rehabilitation devices has been one of the main goals in robot-aided neurorehabilitation for the past two decades. This issue is particularly important to robotic structures that mimic the human counterpart's morphology and attach directly to the limb. Problems arise for complex joints such as the human wrist, which cannot be accurately matched with a traditional mechanical joint. In such cases, mechanical differences between human and robotic joint cause hyperstaticity (i.e. overconstraint) which, coupled with kinematic misalignments, leads to uncontrolled force/torque at the joint. This paper focuses on the prono-supination (PS) degree of freedom of the forearm. The overall force and torque in the wrist PS rotation is quantified by means of a wrist robot. A practical solution to avoid hyperstaticity and reduce the level of undesired force/torque in the wrist is presented, which is shown to reduce 75% of the force and 68% of the torque.

System characterization of RiceWrist-S: a forearm-wrist exoskeleton for upper extremity rehabilitation.

PubMed

Pehlivan, Ali Utku; Rose, Chad; O'Malley, Marcia K

2013-06-01

Rehabilitation of the distal joints of the upper extremities is crucial to restore the ability to perform activities of daily living to patients with neurological lesions resulting from stroke or spinal cord injury. Robotic rehabilitation has been identified as a promising new solution, however, much of the existing technology in this field is focused on the more proximal joints of the upper arm. A recently presented device, the RiceWrist-S, focuses on the rehabilitation of the forearm and wrist, and has undergone a few important design changes. This paper first addresses the design improvements achieved in the recent design iteration, and then presents the system characterization of the new device. We show that the RiceWrist-S has capabilities beyond other existing devices, and exhibits favorable system characteristics as a rehabilitation device, in particular torque output, range of motion, closed loop position performance, and high spatial resolution.

Automatic Quantification of Radiographic Wrist Joint Space Width of Patients With Rheumatoid Arthritis.

PubMed

Huo, Yinghe; Vincken, Koen L; van der Heijde, Desiree; de Hair, Maria J H; Lafeber, Floris P; Viergever, Max A

2017-11-01

Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies. Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies.

[Cinematography, a new diagnostic procedure in evaluation of the injured painful wrist joint].

PubMed

Werber, K D; Wuttge-Hannig, A; Hannig, C

1990-01-01

By the X-ray Cineradiografie we are able to examine and to judge the dynamic of the wrist bones by 50 pictures/sec. in comparison to one another and also depending on their ligaments. We did an investigation of 170 patients with painful wrist. With the method we were able to make up a clear diagnosis and to propose the therapy. I.e.: If consecutive shortening of the radius after distal radius fracture resulting ingruency of the wrist joint is relevant, or a scaphoid pseudarthrosis is fixed elastically, or a scaphoic dissociation is effective. The variations were shown in comparison to normal circumstances.

Vertical force and wrist deviation angle when using a walker to stand up and sit down.

PubMed

Leung, Cherng-Yee; Yeh, Po-Chan

2011-08-01

Research investigating walkers suggests that safety and assistance for the elderly with weak lower limbs were important. However, the relationship between the use of a walker and the upper limbs has received little investigation. Standing up and sitting down are important daily activities. Therefore, the aim of this study was to explore wrist deviation and vertical force among elderly individuals using a walker for assistance to stand up and sit down. In total, 64 elderly volunteers (M age = 80.22, SD = 9.36) were enrolled. Data were obtained from four load cells and a twin-axis wrist goniometer. Wrist deviation and vertical force were examined when participants used a walker with horizontal handles to assist in standing up and sitting down. Significant wrist angle deviation occurred with the use of a walker, with dorsiflexion of the right hand greater than that of the left. Males exerted significantly greater vertical force. In the sitting position, greater ulnar deviation was seen among experienced walker users, whereas during standing, experienced users exhibited greater dorsiflexion. The horizontal handles of most marketed walkers may cause user wrist deviations, suggesting researchers should pursue improvements in walker design.

A Modular Soft Robotic Wrist for Underwater Manipulation.

PubMed

Kurumaya, Shunichi; Phillips, Brennan T; Becker, Kaitlyn P; Rosen, Michelle H; Gruber, David F; Galloway, Kevin C; Suzumori, Koichi; Wood, Robert J

2018-04-19

This article presents the development of modular soft robotic wrist joint mechanisms for delicate and precise manipulation in the harsh deep-sea environment. The wrist consists of a rotary module and bending module, which can be combined with other actuators as part of a complete manipulator system. These mechanisms are part of a suite of soft robotic actuators being developed for deep-sea manipulation via submersibles and remotely operated vehicles, and are designed to be powered hydraulically with seawater. The wrist joint mechanisms can also be activated with pneumatic pressure for terrestrial-based applications, such as automated assembly and robotic locomotion. Here we report the development and characterization of a suite of rotary and bending modules by varying fiber number and silicone hardness. Performance of the complete soft robotic wrist is demonstrated in normal atmospheric conditions using both pneumatic and hydraulic pressures for actuation and under high ambient hydrostatic pressures equivalent to those found at least 2300 m deep in the ocean. This rugged modular wrist holds the potential to be utilized at full ocean depths (>10,000 m) and is a step forward in the development of jointed underwater soft robotic arms.

Elbow isokinetic strength characteristics among collegiate baseball players.

PubMed

Laudner, Kevin G; Wilson, James T; Meister, Keith

2012-05-01

To compare the bilateral strength characteristics of the wrist flexors, extensors, pronators, and supinators among baseball players. Cross-sectional. Laboratory. 30 collegiate baseball players with no recent history of upper extremity injury. Bilateral pronation, supination, wrist flexion, and wrist extension peak torque (PT) and peak torque to body weight (PT/BW) strength were measured at speeds of 90 and 180°/second. Paired t-tests showed that the throwing arm of baseball players produced significantly less PT/BW strength for supination at 90°/second compared to the non-throwing arm (P = .001). The throwing arm produced significantly more PT/BW strength for pronation (P = .001) at 180°/second compared to the non-throwing arm. Furthermore, the throwing arm had more PT and PT/BW strength for wrist extension (P < .005) at 180°/second. Conversely, the throwing arm had less PT and PT/BW strength for supination (P < .004) and wrist flexion (P < .004) at 180°/second compared to the non-throwing arm. Significant bilateral strength differences exist in pronation, supination, wrist flexion, and wrist extension among collegiate baseball players. With the steady increase in ulnar collateral ligament injuries of the elbow among baseball players and the proven resistance to valgus force provided by the flexor-pronator mass of the elbow, the results of this study may prove beneficial in the prevention, evaluation, and rehabilitation of such dysfunctions. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effect of ball impact location on racket and forearm joint angle changes for one-handed tennis backhand groundstrokes.

PubMed

King, Mark; Hau, Agnes; Blenkinsop, Glen

2017-07-01

Recreational tennis players tend to have higher incidence of tennis elbow, and this has been hypothesised to be related to one-handed backhand technique and off-centre ball impacts on the racket face. This study aimed to investigate for a range of participants the effect of off-longitudinal axis and off-lateral axis ball-racket impact locations on racket and forearm joint angle changes immediately following impact in one-handed tennis backhand groundstrokes. Three-dimensional racket and wrist angular kinematic data were recorded for 14 university tennis players each performing 30 "flat" one-handed backhand groundstrokes. Off-longitudinal axis ball-racket impact locations explained over 70% of the variation in racket rotation about the longitudinal axis and wrist flexion/extension angles during the 30 ms immediately following impact. Off-lateral axis ball-racket impact locations had a less clear cut influence on racket and forearm rotations. Specifically off-longitudinal impacts below the longitudinal axis forced the wrist into flexion for all participants with there being between 11° and 32° of forced wrist flexion for an off-longitudinal axis impact that was 1 ball diameter away from the midline. This study has confirmed that off-longitudinal impacts below the longitudinal axis contribute to forced wrist flexion and eccentric stretch of the wrist extensors and there can be large differences in the amount of forced wrist flexion from individual to individual and between strokes with different impact locations.

A comparison of hand wrist bone analysis with two different cervical vertebral analysis in measuring skeletal maturation.

PubMed

Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

2014-09-01

Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. Hand wrist radiographs and lateral cephalograms of 72 subjects aged between 7 and 16 years both male and female from the patients visiting Department of Orthodontics and Dentofacial Orthopedics, R.V. Dental College and Hospital. The 9 stages were reduced to 5 stages to compare with cervical vertebral maturation stage by Baccetti et al. The Bjork, Grave and Brown stages were reduced to six intervals to compare with cervical vertebral maturational index (CVMI) staging by Hassel and Farman. These measurements were then compared with the hand wrist bone analysis, and the results were statistically analyzed using the Mann-Whitney test. There was no significant difference between the hand wrist analysis and the two different cervical vertebral analyses for assessing skeletal maturation. There was no significant difference between the two cervical vertebral analyses, but the CVMI method, which is visual method is less time consuming. Vertebral analysis on a lateral cephalogram is as valid as the hand wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects.

Associations of work activities requiring pinch or hand grip or exposure to hand-arm vibration with finger and wrist osteoarthritis: a meta-analysis.

PubMed

Hammer, Paula E C; Shiri, Rahman; Kryger, Ann I; Kirkeskov, Lilli; Bonde, Jens Peter

2014-03-01

We systematically reviewed the epidemiologic evidence linking finger and wrist osteoarthritis (OA) with work activities requiring pinch or hand grip or exposure to hand-arm vibration (HAV). PubMed and Embase databases were searched up to June 2013. We selected studies assessing the associations of radiographic diagnosed finger and/or wrist joint OA with work activities involving pinch or hand grip or exposure to HAV. We used specific criteria to evaluate completeness of reporting, potential confounding, and bias. Pooled odds ratios (OR) were computed using random-effects meta-analyses. Of the 19 studies included, 17 were cross-sectional, 1 was a prospective cohort, and 1 a case-control study. The meta-analyses of studies that controlled their estimates for at least age and gender showed the associations of pinch grip work with proximal interphalangeal joint [OR 1.56, 95% confidence interval (95% CI) 1.09-2.23] and the first carpometacarpal joint OA (OR 2.10, 95% CI 1.06-4.17), but not with distal interphalangeal, metacarpalphalangeal, or wrist joints OA. Hand grip work and exposure to HAV were not associated with any finger or wrist OA. Epidemiological studies provide limited evidence that pinch grip may increase the risk of wrist or finger OA, but causal relation cannot be resolved because of cross-sectional designs and inadequate characterization of biomechanical strain to the hand and wrist.

Tool Changer For Robot

NASA Technical Reports Server (NTRS)

Voellmer, George M.

1992-01-01

Mechanism enables robot to change tools on end of arm. Actuated by motion of robot: requires no additional electrical or pneumatic energy to make or break connection between tool and wrist at end of arm. Includes three basic subassemblies: wrist interface plate attached to robot arm at wrist, tool interface plate attached to tool, and holster. Separate tool interface plate and holster provided for each tool robot uses.

Small Business Innovations (Robotic Wrist)

NASA Technical Reports Server (NTRS)

1991-01-01

Under a Langley Research Center Small Business Innovation Research (SBIR) contract, Ross-Hime Designs, Inc. Minneapolis, MN, developed the Omni-Wrist actuator, which has a 25-pound capacity, 180 degrees of pitch/yaw, and 360 degrees of roll. Company literature calls it "the first successful singularity-free high-precision (robotic) wrist." Applications include spray painting, sealing, ultrasonic testing, welding and a variety of nuclear industry, aerospace and military uses.

Reliability, validity, and minimal detectable change of the push-off test scores in assessing upper extremity weight-bearing ability.

PubMed

Mehta, Saurabh P; George, Hannah R; Goering, Christian A; Shafer, Danielle R; Koester, Alan; Novotny, Steven

2017-11-01

Clinical measurement study. The push-off test (POT) was recently conceived and found to be reliable and valid for assessing weight bearing through injured wrist or elbow. However, further research with larger sample can lend credence to the preliminary findings supporting the use of the POT. This study examined the interrater reliability, construct validity, and measurement error for the POT in patients with wrist conditions. Participants with musculoskeletal (MSK) wrist conditions were recruited. The performance on the POT, grip isometric strength of wrist extensors was assessed. The shortened version of the Disabilities of the Arm, Shoulder and Hand and numeric pain rating scale were completed. The intraclass correlation coefficient assessed interrater reliability of the POT. Pearson correlation coefficients (r) examined the concurrent relationships between the POT and other measures. The standard error of measurement and the minimal detectable change at 90% confidence interval were assessed as measurement error and index of true change for the POT. A total of 50 participants with different elbow or wrist conditions (age: 48.1 ± 16.6 years) were included in this study. The results of this study strongly supported the interrater reliability (intraclass correlation coefficient: 0.96 and 0.93 for the affected and unaffected sides, respectively) of the POT in patients with wrist MSK conditions. The POT showed convergent relationships with the grip strength on the injured side (r = 0.89) and the wrist extensor strength (r = 0.7). The POT showed smaller standard error of measurement (1.9 kg). The minimal detectable change at 90% confidence interval for the POT was 4.4 kg for the sample. This study provides additional evidence to support the reliability and validity of the POT. This is the first study that provides the values for the measurement error and true change on the POT scores in patients with wrist MSK conditions. Further research should examine the responsiveness and discriminant validity of the POT in patients with wrist conditions. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis.

PubMed

Zuniga, Jorge M; Dimitrios, Katsavelis; Peck, Jean L; Srivastava, Rakesh; Pierce, James E; Dudley, Drew R; Salazar, David A; Young, Keaton J; Knarr, Brian A

2018-06-08

Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70% in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.

Conformational Changes in the Carpus During Finger Traps Distraction

PubMed Central

Leventhal, Evan L.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

2010-01-01

Introduction Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and mid-carpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the 3-D conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Methods The dominant wrists of 14 healthy volunteers were scanned using computed tomography at rest and during application of 98N of distraction. Load was applied using finger traps and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone was calculated relative to the radius as well as the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal and carpal-metacarpal joints in the direction of loading using the radius, lunate, capitate and 3rd metacarpal. Results With loading, the distance between the radius and 3rd metacarpal increased an average of 3.3±3.1mm in the direction of loading. This separation was primarily located in the axial direction at the radiocarpal (1.0±1.0mm) and midcarpal (2.0±1.7mm) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98±0.7mm. Distraction between the radius and scaphoid (2.5±2.2mm) was 2.4 times greater than between the radius and lunate (1.0±1.0mm). Conclusions Carpal distraction has a significant effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. PMID:20141894

Conformational changes in the carpus during finger trap distraction.

PubMed

Leventhal, Evan L; Moore, Douglas C; Akelman, Edward; Wolfe, Scott W; Crisco, Joseph J

2010-02-01

Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and midcarpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the three-dimensional conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Using computed tomography, the dominant wrists of 14 healthy volunteers were scanned at rest and during application of 98 N of distraction. Load was applied using finger traps, and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone relative to the radius was calculated, as were the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal, and carpometacarpal joints in the direction of loading using the radius, lunate, capitate, and third metacarpal. With loading, the distance between the radius and third metacarpal increased an average of 3.3 mm +/- 3.1 in the direction of loading. This separation was primarily in the axial direction at the radiocarpal (1.0 mm +/- 1.0) and midcarpal (2.0 mm +/- 1.7) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98 mm +/- 0.7. Distraction between the radius and scaphoid (2.5 mm +/- 2.2) was 2.4 times greater than that between the radius and lunate (1.0 mm +/- 1.0). Carpal distraction has a significant (p < .01) effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. Copyright 2010. Published by Elsevier Inc.

Combined functional electrical stimulation (FES) and robotic system for wrist rehabiliation after stroke.

PubMed

Hu, Xiaoling; Tong, K Y; Li, R; Chen, M; Xue, J J; Ho, S K; Chen, P N

2010-01-01

Functional electrical stimulation (FES) and rehabilitation robots are techniques used to assist in post-stroke rehabilitation. However, FES and rehabilitation robots are still separate systems currently; and their combined training effects on persons after experiencing a stroke have not been well studied yet. In this work, a new combined FES-robot system driven by user's voluntary intention was developed for wrist joint training after stroke. The performance of the FES-robot assisted wrist tracking was evaluated on five subjects with chronic stroke. With simultaneous assistance from both the FES and robot parts of the system, the motion accuracy was improved and excessive activation in elbow flexor was reduced during wrist tracking.

Biomechanical analyses of prolonged handwriting in subjects with and without perceived discomfort.

PubMed

Chang, Shao-Hsia; Chen, Chien-Liang; Yu, Nan-Ying

2015-10-01

Since wrist-joint position affects finger muscle length and grip strength, we studied its biomechanical relevance in prolonged handwriting. We recruited participants from young adults, aged 18-24, and separated them into control (n=22) and in-pain (n=18) groups, based whether or not they experience pain while handwriting. The participants then performed a writing task for 30 min on a computerized system which measured their wrist-joint angle and documented their handwriting kinematics. The in-pain group perceived more soreness and had a less-extended wrist joint, longer on-paper time, and slower stroke velocity compared to control group. There was no significant difference in handwriting speed and quality between the two groups. The wrist extension angle significantly correlated with perceived soreness. Ergonomic and biomechanical analyses provide important information about the handwriting process. Knowledge of pen tip movement kinematics and wrist-joint position can help occupational therapists plan treatment for individuals with handwriting induced pain. Copyright © 2015 Elsevier B.V. All rights reserved.

Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple.

PubMed

Gitto, Salvatore; Messina, Carmelo; Mauri, Giovanni; Aliprandi, Alberto; Sardanelli, Francesco; Sconfienza, Luca Maria

2017-02-01

Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool. Although promising results have been published, ultrasound of wrist ligaments is not performed in routine clinical practice, maybe due to its technical feasibility regarded as quite complex. This review article aims to enlighten readers about the normal sonographic appearance of intrinsic and extrinsic carpal ligaments, and describe a systematic approach for their sonographic assessment with detailed anatomic landmarks, dynamic manoeuvres and scanning technique. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Extrinsic wrist ligaments: prevalence of injury by magnetic resonance imaging and association with intrinsic ligament tears.

PubMed

Taneja, Atul K; Bredella, Miriam A; Chang, Connie Y; Joseph Simeone, F; Kattapuram, Susan V; Torriani, Martin

2013-01-01

The objective of this study was to determine the prevalence of extrinsic wrist ligament injury by magnetic resonance imaging and its association with intrinsic ligament tears. We reviewed conventional magnetic resonance images performed over a 5-year period from adult patients in the setting of wrist trauma. Two musculoskeletal radiologists examined the integrity of wrist ligaments and presence of bone abnormalities. In a cohort of 75 subjects, extrinsic ligament injury was present in 75%, with radiolunotriquetral being most frequently affected (45%). Intrinsic ligament injury was present in 60%. Almost half of subjects had combined intrinsic and extrinsic ligament injury. Bone abnormalities were seen in 69%. The rate of extrinsic injury was higher in subjects with bone injury (P = 0.008). There is high prevalence of extrinsic ligament injury in the setting of wrist trauma, especially in the presence of bone abnormalities, with combined injury of intrinsic and extrinsic ligaments in about half of cases.

Analysis of 41 suicide attempts by wrist cutting: a retrospective analysis.

PubMed

Ersen, B; Kahveci, R; Saki, M C; Tunali, O; Aksu, I

2017-02-01

Self-cutting injuries have a low mortality rate, but this type of injuries has special clinical significance because they have the potential of leading to devastating disability and repeated suicide attempts. The purpose of this study is to analyze the nature and outcomes of wrist-cutting injuries. A retrospective study was designed in order to investigate 41 suicide attempts by wrist cutting attended to Uludag University Faculty of Medicine Emergency Department between June 2008 and December 2014. The patients were analyzed for age, gender, alcohol intake, psychological state, prior suicide attempts, and clinical features such as injury side, injury pattern, and used tool. It was seen that the severity of wrist-cutting injury variates between gender and age. Alcohol or drug consumption and having a diagnosed psychiatric disorder create a higher risk for extensive wrist lacerations. It was seen that skin only lacerations were most likely to repeat the act and therefore are most in need of psychiatric intervention. Level III, retrospective study.

[Validation of the Omron HEM-650 wrist blood pressure device using the British Hypertension Society protocol in emergency patients in Hong Kong].

PubMed

Hung, Kevin KC; Lai, W Y; Cocks, Robert A; Rainer, Timothy H; Graham, Colin A

2015-10-01

Automated wrist cuff blood pressure (BP) devices are more compact and easier to use, particularly when access to the upper arm is restricted, for example in emergencies. We tested the Omron HEM-650 wrist device using the validation criteria of the British Hypertension Society (BHS) protocol in a major emergency department (ED) in Hong Kong. 85 patients had three measurements each by both the Omron HEM-650 wrist device and the mercury sphygmomanometer. The conventional automated BP with arm cuff was also measured using an oscillometric (Colin BP-88S NXT) device for comparison. The Omron HEM-650 achieved a grade B for both systolic and diastolic BP and demonstrated acceptable accuracy and reliability in Chinese patients in the emergency setting. The Omron HEM 650 wrist device can be recommended for use in adult emergency patients. Further research is warranted for its use in pregnant women and critically ill patients.

In-vivo confirmation of the use of the dart thrower's motion during activities of daily living.

PubMed

Brigstocke, G H O; Hearnden, A; Holt, C; Whatling, G

2014-05-01

The dart thrower's motion is a wrist rotation along an oblique plane from radial extension to ulnar flexion. We report an in-vivo study to confirm the use of the dart thrower's motion during activities of daily living. Global wrist motion in ten volunteers was recorded using a three-dimensional optoelectronic motion capture system, in which digital infra-red cameras track the movement of retro-reflective marker clusters. Global wrist motion has been approximated to the dart thrower's motion when hammering a nail, throwing a ball, drinking from a glass, pouring from a jug and twisting the lid of a jar, but not when combing hair or manipulating buttons. The dart thrower's motion is the plane of global wrist motion used during most activities of daily living. Arthrodesis of the radiocarpal joint instead of the midcarpal joint will allow better wrist function during most activities of daily living by preserving the dart thrower's motion.

The effects of work surface hardness on mechanical stress, muscle activity, and wrist postures.

PubMed

Kim, Jeong Ho; Aulck, Lovenoor; Trippany, David; Johnson, Peter W

2015-01-01

Contact pressure is a risk factor which can contribute to musculoskeletal disorders. The objective of the present study was to determine whether a work surface with a soft, pliable front edge could reduce contact pressure, muscle activity, and subjective musculoskeletal comfort, and improve wrist posture relative to a conventional, hard work surface. In a repeated-measures blinded experiment with eighteen subjects (8 females and 10 males), contact pressure, wrist posture, typing productivity, perceived fatigue, wrist and shoulder muscle activity, and subjective comfort were compared between the two different work surfaces during keyboard use, mouse use and mixed mouse and keyboard use. The results showed that across the three modes of computer work, the contact pressure was lower on the soft-edge work surface compared to the conventional work surface (p's <0.03) and subjects reported to have less perceived fatigue in the forearms and wrists. No differences in muscle activity, wrist posture, and subjective comfort were measured between the two work surfaces. Given the significant reduction in contact pressure and corresponding lower ratings in perceived fatigue, the soft-edge work surface subjectively and objectively improved measures of contact stress which may reduce physical exposures associated with the onset and development of musculoskeletal disorders.

Variance in direct exposure measures of typing force and wrist kinematics across hours and days among office computer workers.

PubMed

Asundi, Krishna; Johnson, Peter W; Dennerlein, Jack T

2012-01-01

To determine the number of direct measurements needed to obtain a representative estimate of typing force and wrist kinematics, continuous measures of keyboard reaction force and wrist joint angle were collected at the workstation of 22 office workers while they completed their own work over three days, six hours per day. Typing force and wrist kinematics during keyboard, mouse and idle activities were calculated for each hour of measurement along with variance in measurements between subjects and between day and hour within subjects. Variance in measurements between subjects was significantly greater than variance in measurements between days and hours within subjects. Therefore, we concluded a single, one-hour period of continuous measures is sufficient to identify differences in typing force and wrist kinematics between subjects. Within subjects, day and hour of measurement had a significant effect on some measures and thus should be accounted for when comparing measures within a subject. The dose response relationship between exposure to computer related biomechanical risk factors and musculoskeletal disorders is poorly understood due to the difficulty and cost of direct measures. This study demonstrates a single hour of direct continuous measures is sufficient to identify differences in wrist kinematics and typing force between individuals.

The effect of wheelchair propulsion style on changes in time spent in extreme wrist orientations after a bout of fatiguing propulsion.

PubMed

Zukowski, Lisa A; Hass, Chris J; Shechtman, Orit; Christou, Evangelos A; Tillman, Mark D

2017-10-01

This study compared how wheelchair propulsion styles affect changes in percentage of time spent in extreme wrist orientations, which have been associated with median nerve injury, after a fatiguing bout of propulsion. Twenty novice, non-disabled adult males learned arcing (ARC) and semicircular (SEMI) propulsion styles and utilised each to perform a wheelchair fatigue protocol. ARC and SEMI did not significantly differ in terms of changes after the fatigue protocol in percentage of time spent in extreme flexion/extension or radial/ulnar deviation at the push phase beginning or end. A pattern was observed, although not significant, of greater increases in percentage of time spent in extreme wrist extension and ulnar deviation during the push phase beginning and ulnar deviation during the push phase end while utilising SEMI relative to ARC. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles. Practitioner Summary: How wheelchair propulsion styles change with fatigue in terms of extreme wrist orientations was examined. This study evinces that individual differences are greater than observed changes in extreme wrist orientations for both propulsion styles and point towards the need for future research on individual differences utilising propulsion styles.

Robot-Aided Mapping of Wrist Proprioceptive Acuity across a 3D Workspace

PubMed Central

Marini, Francesca; Squeri, Valentina; Morasso, Pietro; Konczak, Jürgen; Masia, Lorenzo

2016-01-01

Proprioceptive signals from peripheral mechanoreceptors form the basis for bodily perception and are known to be essential for motor control. However we still have an incomplete understanding of how proprioception differs between joints, whether it differs among the various degrees-of-freedom (DoFs) within a particular joint, and how such differences affect motor control and learning. We here introduce a robot-aided method to objectively measure proprioceptive function: specifically, we systematically mapped wrist proprioceptive acuity across the three DoFs of the wrist/hand complex with the aim to characterize the wrist position sense. Thirty healthy young adults performed an ipsilateral active joint position matching task with their dominant wrist using a haptic robotic exoskeleton. Our results indicate that the active wrist position sense acuity is anisotropic across the joint, with the abduction/adduction DoF having the highest acuity (the error of acuity for flexion/extension is 4.64 ± 0.24°; abduction/adduction: 3.68 ± 0.32°; supination/pronation: 5.15 ± 0.37°) and they also revealed that proprioceptive acuity decreases for smaller joint displacements. We believe this knowledge is imperative in a clinical scenario when assessing proprioceptive deficits and for understanding how such sensory deficits relate to observable motor impairments. PMID:27536882

Growth indicators in orthodontic patients. Part 1: comparison of cervical vertebral maturation and hand-wrist skeletal maturation.

PubMed

Litsas, G; Ari-Demirkaya, A

2010-12-01

The purpose of this study was to predict the skeletal maturation status based on the assessment of cervical vertebrae from lateral cephalometric radiographs and to compare these findings with the skeletal maturity of the same individuals judged from the hand-wrist radiographs. Lateral cephalometric and left hand-wrist radiographs of 393 Caucasian children from 8 to 18 years old were evaluated. On the hand-wrist radiographs the classification of Bjork [1972] and Grave and Brown [1976] was used to assess skeletal maturity (HWSS). Cervical vertebral maturation was also evaluated on lateral cephalometric radiographs using the improved CVMS method described by Baccetti, Franchi, and McNamara [2002]. These methods were correlated using the chi-square test. The chi-square test showed that skeletal maturational values obtained by the CVMS method were significantly correlated with the skeletal values obtained from the hand-wrist analysis for both genders (p<0.05). However, gender differentiation exists in CVMS method regarding the peak of growth spurt. The results of this study show that the CVMS method was compatible with a commonly used hand-wrist analysis method. The lateral cephalometric radiograph belonging to the standard set of records would be sufficient to evaluate skeletal maturity.

The relationship between frontal sinus morphology and skeletal maturation.

PubMed

Buyuk, Suleyman Kutalmıs; Simsek, Huseyin; Karaman, Ahmet

2018-01-03

The aim of this study is to evaluate the relationship between frontal sinus morphology and hand-wrist bone maturation by using postero-anterior (PA) cephalometric radiographs. The study sample consisted of 220 patients divided into eleven groups based on the hand-wrist radiographs. The right and left maximum height, width and area of the frontal sinus parameters were measured in postero-anterior cephalometric radiographs 220 subjects aged 8-18 years. The hand-wrist skeletal maturation stages were evaluated on the hand-wrist radiographs using the method of Fishman. The Kendall tau-b values were analyzed to evaluate the correlation between the hand-wrist skeletal maturation stages and the frontal sinus parameters. The right and left frontal sinus areas and widths were found to be larger in males than in females (p < 0.05). In males, a significant difference was observed in all frontal sinus parameters in different maturation stages (p < 0.001), while a statistically significant correlation was found in females between the left frontal sinus area, right frontal sinus height, right frontal sinus width and different maturation stages (p < 0.05). In conclusion, the relationship between frontal sinus dimensions obtained from PA cephalometric radiographs and hand-wrist maturation stages suggests that frontal sinuses can be used in determining growth and development.

Excellent Intra and Inter-Observer Reproducibility of Wrist Circumference Measurements in Obese Children and Adolescents

PubMed Central

Campagna, Giuseppe; Zampetti, Simona; Gallozzi, Alessia; Giansanti, Sara; Chiesa, Claudio; Pacifico, Lucia; Buzzetti, Raffaella

2016-01-01

In a previous study, we found that wrist circumference, in particular its bone component, was associated with insulin resistance in a population of overweight/obese children. The aim of the present study was to evaluate the intra- and inter-operator variability in wrist circumference measurement in a population of obese children and adolescents. One hundred and two (54 male and 48 female) obese children and adolescents were consecutively enrolled. In all subjects wrist circumferences were measured by two different operators two times to assess intra- and inter-operator variability. Statistical analysis was performed using SAS v.9.4 and JMP v.12. Measurements of wrist circumference showed excellent inter-operator reliability with Intra class Correlation Coefficients (ICC) of 0.96 and ICC of 0.97 for the first and the second measurement, respectively. The intra-operator reliability was, also, very strong with a Concordance Correlation Coefficient (CCC) of 0.98 for both operators. The high reproducibility demonstrated in our results suggests that wrist circumference measurement, being safe, non-invasive and repeatable can be easily used in out-patient settings to identify youths with increased risk of insulin-resistance. This can avoid testing the entire population of overweight/obese children for insulin resistance parameters. PMID:27294398

Quantitative detection of cartilage surfaces and ligament geometry of the wrist using an imaging cryomicrotome system.

PubMed

Dvinskikh, N A; Blankevoort, L; Foumani, M; Spaan, J A E; Streekstra, G J

2010-03-22

Biomechanical models may aid in improving diagnosis and treatment of wrist joint disorders. As input, geometrical information is required for model development. Previous studies acquired some elements of the average wrist joint geometry. However, there is a close geometric functional match between articulating surfaces and ligament geometry. Therefore, biomechanical models need to be fed with the geometric data of individual joints. This study is aimed at acquiring geometric data of cartilage surfaces and ligaments from individual wrist joints by using a cryomicrotome imaging system and the evaluation of inter- and intra-observer variability of the data. The 3D geometry of 30 cartilage surfaces and 15 ligaments in three cadaver wrists was manually detected and quantitatively reconstructed. The inter- and intra-observer variability of the cartilage surface detection was 0.14 and 0.19 mm, respectively. For the position of the radius attachment of the dorsal radiocarpal ligament (DRC), the observer variations were 0.12 and 0.65 mm, for intra-/inter-observer, respectively. For the DRC attachment on the triquetrum, the observer variations were 0.22 and 1.19 mm. Anatomic reconstruction from 3D cryomicrotome images offer a method to obtain unique geometry data of the entire wrist joint for modeling purposes. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Utility of the iPhone 4 Gyroscope Application in the Measurement of Wrist Motion.

PubMed

Lendner, Nuphar; Wells, Erik; Lavi, Idit; Kwok, Yan Yan; Ho, Pak-Cheong; Wollstein, Ronit

2017-09-01

Measurement of wrist range of motion (ROM) is important to all aspects of treatment and rehabilitation of upper extremity conditions. Recently, gyroscopes have been used to measure ROM and may be more precise than manual evaluations. The purpose of this study was to evaluate the use of the iPhone gyroscope application and compare it with use of a goniometer, specifically evaluating its accuracy and ease of use. A cross-sectional study evaluated adult Caucasian participants, with no evidence of wrist pathology. Wrist ROM measurements in 306 wrists using the 2 methods were compared. Demographic information was collected including age, sex, and occupation. Analysis included mixed models and Bland-Altman plots. Wrist motion was similar between the 2 methods. Technical difficulties were encountered with gyroscope use. Age was an independent predictor of ROM. Correct measurement of ROM is critical to guide, compare, and evaluate treatment and rehabilitation of the upper extremity. Inaccurate measurements could mislead the surgeon and harm patient adherence with therapy or surgeon instruction. An application used by the patient could improve adherence but needs to be reliable and easy to use. Evaluation is necessary before utilization of such an application. This study supports revision of the application on the iPhone to improve ease of use.

Work-Related Musculoskeletal Disorders of the Hand and Wrist: Epidemiology, Pathophysiology, and Sensorimotor Changes

PubMed Central

Barr, Ann E.; Barbe, Mary F.; Clark, Brian D.

2006-01-01

The purpose of this commentary is to present recent epidemiological findings regarding work-related musculoskeletal disorders (WMSDs) of the hand and wrist, and to summarize experimental evidence of underlying tissue pathophysiology and sensorimotor changes in WMSDs. Sixty-five percent of the 333 800 newly reported cases of occupational illness in 2001 were attributed to repeated trauma. WMSDs of the hand and wrist are associated with the longest absences from work and are, therefore, associated with greater lost productivity and wages than those of other anatomical regions. Selected epidemiological studies of hand/wrist WMSDs published since 1998 are reviewed and summarized. Results from selected animal studies concerning underlying tissue pathophysiology in response to repetitive movement or tissue loading are reviewed and summarized. To the extent possible, corroborating evidence in human studies for various tissue pathomechanisms suggested in animal models is presented. Repetitive, hand-intensive movements, alone or in combination with other physical, nonphysical, and nonoccupational risk factors, contribute to the development of hand/wrist WMSDs. Possible pathophysiological mechanisms of tissue injury include inflammation followed by repair and/or fibrotic scarring, peripheral nerve injury, and central nervous system reorganization. Clinicians should consider all of these pathomechanisms when examining and treating patients with hand/wrist WMSDs. PMID:15552707

Estimation of Physical Activity Energy Expenditure during Free-Living from Wrist Accelerometry in UK Adults.

PubMed

White, Tom; Westgate, Kate; Wareham, Nicholas J; Brage, Soren

2016-01-01

Wrist-worn accelerometers are emerging as the most common instrument for measuring physical activity in large-scale epidemiological studies, though little is known about the relationship between wrist acceleration and physical activity energy expenditure (PAEE). 1695 UK adults wore two devices simultaneously for six days; a combined sensor and a wrist accelerometer. The combined sensor measured heart rate and trunk acceleration, which was combined with a treadmill test to yield a signal of individually-calibrated PAEE. Multi-level regression models were used to characterise the relationship between the two time-series, and their estimations were evaluated in an independent holdout sample. Finally, the relationship between PAEE and BMI was described separately for each source of PAEE estimate (wrist acceleration models and combined-sensing). Wrist acceleration explained 44-47% between-individual variance in PAEE, with RMSE between 34-39 J•min-1•kg-1. Estimations agreed well with PAEE in cross-validation (mean bias [95% limits of agreement]: 0.07 [-70.6:70.7]) but overestimated in women by 3% and underestimated in men by 4%. Estimation error was inversely related to age (-2.3 J•min-1•kg-1 per 10y) and BMI (-0.3 J•min-1•kg-1 per kg/m2). Associations with BMI were similar for all PAEE estimates (approximately -0.08 kg/m2 per J•min-1•kg-1). A strong relationship exists between wrist acceleration and PAEE in free-living adults, such that irrespective of the objective method of PAEE assessment, a strong inverse association between PAEE and BMI was observed.

Examination of wrist and hip actigraphy using a novel sleep estimation procedure☆

PubMed Central

Ray, Meredith A.; Youngstedt, Shawn D.; Zhang, Hongmei; Robb, Sara Wagner; Harmon, Brook E.; Jean-Louis, Girardin; Cai, Bo; Hurley, Thomas G.; Hébert, James R.; Bogan, Richard K.; Burch, James B.

2014-01-01

Objective Improving and validating sleep scoring algorithms for actigraphs enhances their usefulness in clinical and research applications. The MTI® device (ActiGraph, Pensacola, FL) had not been previously validated for sleep. The aims were to (1) compare the accuracy of sleep metrics obtained via wrist- and hip-mounted MTI® actigraphs with polysomnographic (PSG) recordings in a sample that included both normal sleepers and individuals with presumed sleep disorders; and (2) develop a novel sleep scoring algorithm using spline regression to improve the correspondence between the actigraphs and PSG. Methods Original actigraphy data were amplified and their pattern was estimated using a penalized spline. The magnitude of amplification and the spline were estimated by minimizing the difference in sleep efficiency between wrist- (hip-) actigraphs and PSG recordings. Sleep measures using both the original and spline-modified actigraphy data were compared to PSG using the following: mean sleep summary measures; Spearman rank-order correlations of summary measures; percent of minute-by-minute agreement; sensitivity and specificity; and Bland–Altman plots. Results The original wrist actigraphy data showed modest correspondence with PSG, and much less correspondence was found between hip actigraphy and PSG. The spline-modified wrist actigraphy produced better approximations of interclass correlations, sensitivity, and mean sleep summary measures relative to PSG than the original wrist actigraphy data. The spline-modified hip actigraphy provided improved correspondence, but sleep measures were still not representative of PSG. Discussion The results indicate that with some refinement, the spline regression method has the potential to improve sleep estimates obtained using wrist actigraphy. PMID:25580202

A Comparison of Hand Wrist Bone Analysis with Two Different Cervical Vertebral Analysis in Measuring Skeletal Maturation

PubMed Central

Pichai, Saravanan; Rajesh, M; Reddy, Naveen; Adusumilli, Gopinath; Reddy, Jayaprakash; Joshi, Bhavana

2014-01-01

Background: Skeletal maturation is an integral part of individual pattern of growth and development and is a continuous process. Peak growth velocity in standing height is the most valid representation of the rate of overall skeletal growth. Ossification changes of hand wrist and cervical vertebrae are the reliable indicators of growth status of individual. The objective of this study was to compare skeletal maturation as measured by hand wrist bone analysis and cervical vertebral analysis. Materials and Methods: Hand wrist radiographs and lateral cephalograms of 72 subjects aged between 7 and 16 years both male and female from the patients visiting Department of Orthodontics and Dentofacial Orthopedics, R.V. Dental College and Hospital. The 9 stages were reduced to 5 stages to compare with cervical vertebral maturation stage by Baccetti et al. The Bjork, Grave and Brown stages were reduced to six intervals to compare with cervical vertebral maturational index (CVMI) staging by Hassel and Farman. These measurements were then compared with the hand wrist bone analysis, and the results were statistically analyzed using the Mann–Whitney test. Results: There was no significant difference between the hand wrist analysis and the two different cervical vertebral analyses for assessing skeletal maturation. There was no significant difference between the two cervical vertebral analyses, but the CVMI method, which is visual method is less time consuming. Conclusion: Vertebral analysis on a lateral cephalogram is as valid as the hand wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects. PMID:25395791

Anterior wrist and medial malleolus as the novel sites of tissue selection: a retrospective study on electric shock death through the hand-to-foot circuit pathway.

PubMed

Xu, Guangtao; Su, Ruibing; Lv, Junyao; Hu, Bo; Gu, Huan; Li, Xianxian; Gu, Jiang; Yu, Xiaojun

2017-05-01

Our previous work demonstrated that characteristic changes could occur in the anterior wrist and medial malleolus in electric deaths through the hand-to-foot electric circuit pathway in an electric shock rat model. However, whether the same phenomenon occurs in humans is unknown. The aim of the present retrospective study was to ascertain whether the anterior wrist and medial malleolus could also be selected as the promising and significant sites in electric death through the hand-to-foot circuit pathway. Nineteen human cases from the autopsy and one clinical survivor who sustained a severe electric shock through the hand-to-foot circuit pathway were analyzed. Additional ten autopsy patients who died from traffic accidents and sudden cardiac attacks were used as the control group. Histopathological changes in the soft tissues of the anterior wrist and medial malleolus in all autopsy patients, as well as the electric current pathway of the survivor, were observed. The results showed that the nuclear polarizations in the anterior wrist and medial malleolus soft tissues of the electric death were extremely noticeable as compared with the controls. The most severe electrical injury in the survivor occurred in the anterior wrist. These findings suggest that the soft tissues of the anterior wrist and/or the medial malleolus as the narrowest parts of the limbs could be used as the complementary sites for tissue selection and considered as necessary locations for examinations to assess the electric death in medicolegal identification.

Development and performance of a new prosthesis system using ultrasonic sensor for wrist movements: a preliminary study

PubMed Central

2014-01-01

Background The design and performance of a new development prosthesis system known as biomechatronics wrist prosthesis is presented in this paper. The prosthesis system was implemented by replacing the Bowden tension cable of body powered prosthesis system using two ultrasonic sensors, two servo motors and microcontroller inside the prosthesis hand for transradial user. Methods The system components and hand prototypes involve the anthropometry, CAD design and prototyping, biomechatronics engineering together with the prosthetics. The modeler construction of the system develop allows the ultrasonic sensors that are placed on the shoulder to generate the wrist movement of the prosthesis. The kinematics of wrist movement, which are the pronation/supination and flexion/extension were tested using the motion analysis and general motion of human hand were compared. The study also evaluated the require degree of detection for the input of the ultrasonic sensor to generate the wrist movements. Results The values collected by the vicon motion analysis for biomechatronics prosthesis system were reliable to do the common tasks in daily life. The degree of the head needed to bend to give the full input wave was about 45° - 55° of rotation or about 14 cm – 16 cm. The biomechatronics wrist prosthesis gave higher degree of rotation to do the daily tasks but did not achieve the maximum degree of rotation. Conclusion The new development of using sensor and actuator in generating the wrist movements will be interesting for used list in medicine, robotics technology, rehabilitations, prosthetics and orthotics. PMID:24755242

A novel method to replicate the kinematics of the carpus using a six degree-of-freedom robot.

PubMed

Fraysse, François; Costi, John J; Stanley, Richard M; Ding, Boyin; McGuire, Duncan; Eng, Kevin; Bain, Gregory I; Thewlis, Dominic

2014-03-21

Understanding the kinematics of the carpus is essential to the understanding and treatment of wrist pathologies. However, many of the previous techniques presented are limited by non-functional motion or the interpolation of points from static images at different postures. We present a method that has the capability of replicating the kinematics of the wrist during activities of daily living using a unique mechanical testing system. To quantify the kinematics of the carpal bones, we used bone pin-mounted markers and optical motion capture methods. In this paper, we present a hammering motion as an example of an activity of daily living. However, the method can be applied to a wide variety of movements. Our method showed good accuracy (1.0-2.6°) of in vivo movement reproduction in our ex vivo model. Most carpal motion during wrist flexion-extension occurs at the radiocarpal level while in ulnar deviation the motion is more equally shared between radiocarpal and midcarpal joints, and in radial deviation the motion happens mainly at the midcarpal joint. For all rotations, there was more rotation of the midcarpal row relative to the lunate than relative to the scaphoid or triquetrum. For the functional motion studied (hammering), there was more midcarpal motion in wrist extension compared to pure wrist extension while radioulnar deviation patterns were similar to those observed in pure wrist radioulnar deviation. Finally, it was found that for the amplitudes studied the amount of carpal rotations was proportional to global wrist rotations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Wrist range of motion and motion frequency during toy and game play with a joint-specific controller specially designed to provide neuromuscular therapy: A proof of concept study in typically developing children.

PubMed

Crisco, Joseph J; Schwartz, Joel B; Wilcox, Bethany; Brideau, Holly; Basseches, Benjamin; Kerman, Karen

2015-08-20

Upper extremities affected by hemiplegic cerebral palsy (CP) and other neuromuscular disorders have been demonstrated to benefit from therapy, and the greater the duration of the therapy, the greater the benefit. A great motivator for participating in and extending the duration of therapy with children is play. Our focus is on active motion therapy of the wrist and forearm. In this study we examine the wrist motions associated with playing with two toys and three computer games controlled by a specially-designed play controller. Twenty children (ages 5-11) with no diagnosis of a muscular disorder were recruited. The play controller was fitted to the wrist and forearm of each child and used to measure and log wrist flexion and extension. Play activity and enjoyment were quantified by average wrist range of motion (ROM), motion frequency measures, and a discrete visual scale. We found significant differences in the average wrist ROM and motion frequency among the toys and games, yet there were no differences in the level of enjoyment across all toys and games, which was high. These findings indicate which toys and games may elicit the greater number of goal-directed movements, and lay the foundation for our long-term goal to develop and evaluate innovative motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conservative treatment of an acute traumatic extensor carpi ulnaris tendon subluxation in a collegiate basketball player: a case report.

PubMed

Patterson, Steve M; Picconatto, William J; Alexander, Julie A; Johnson, Rachel L

2011-01-01

To present the case of an acute traumatic extensor carpi ulnaris (ECU) subluxation in a National Collegiate Athletic Association Division II female basketball player. The ECU tendon is stabilized in the ulnar groove by a subsheath located inferior to the extensor retinaculum. The subsheath can be injured with forced supination, ulnar deviation, and wrist flexion, resulting in the ECU tendon subluxing in the palmar and ulnar directions during wrist circumduction. Several methods of intervention exist, but controversy remains on how to best treat this condition. Distal ulnar fracture, ulnar collateral ligament sprain, triangular fibrocartilage complex lesion, lunotriquetral instability, distal radioulnar joint injury, pisotriquetral joint injury, ECU tendinopathy or subluxation. The wrist was placed in a short-arm cast in slight extension and radial deviation for 4 weeks. At that time, the patient was still able to actively sublux the ECU tendon, so a long-arm cast was applied with the wrist in slight extension, radial deviation, and pronation for an additional 4 weeks. The ECU tendon was then found to be stable. She wore a rigid wrist brace for 3 more weeks while she pursued rehabilitation. At the final follow-up appointment, the ECU tendon remained stable, and the wrist was asymptomatic. Subluxations of the ECU are rare. If the patient does not improve with conservative measures, surgical intervention is warranted to repair the sixth dorsal compartment. A long-arm cast with the elbow flexed to 90° and the wrist in approximately 30° of extension, radial deviation, and pronation was appropriate treatment for this type of injury.

Combined Brain and Peripheral Nerve Stimulation in Chronic Stroke Patients With Moderate to Severe Motor Impairment.

PubMed

Menezes, Isabella S; Cohen, Leonardo G; Mello, Eduardo A; Machado, André G; Peckham, Paul Hunter; Anjos, Sarah M; Siqueira, Inara L; Conti, Juliana; Plow, Ela B; Conforto, Adriana B

2018-02-01

To evaluate effects of somatosensory stimulation in the form of repetitive peripheral nerve sensory stimulation (RPSS) in combination with transcranial direct current stimulation (tDCS), tDCS alone, RPSS alone, or sham RPSS + tDCS as add-on interventions to training of wrist extension with functional electrical stimulation (FES), in chronic stroke patients with moderate to severe upper limb impairments in a crossover design. We hypothesized that the combination of RPSS and tDCS would enhance the effects of FES on active range of movement (ROM) of the paretic wrist to a greater extent than RPSS alone, tDCS alone or sham RPSS + tDCS. The primary outcome was the active ROM of extension of the paretic wrist. Secondary outcomes were ROM of wrist flexion, grasp, and pinch strength of the paretic and nonparetic upper limbs, and ROM of wrist extension of the nonparetic wrist. Outcomes were blindly evaluated before and after each intervention. Analysis of variance with repeated measures with factors "session" and "time" was performed. After screening 2499 subjects, 22 were included. Data from 20 subjects were analyzed. There were significant effects of "time" for grasp force of the paretic limb and for ROM of wrist extension of the nonparetic limb, but no effects of "session" or interaction "session x time." There were no significant effects of "session," "time," or interaction "session x time" regarding other outcomes. Single sessions of PSS + tDCS, tDCS alone, or RPSS alone did not improve training effects in chronic stroke patients with moderate to severe impairment. © 2017 International Neuromodulation Society.

Electrogoniometer measurement and directional analysis of wrist angles and movements during the Sollerman hand function test.

PubMed

Dauncey, Thomas; Singh, Harvinder P; Dias, Joseph J

Clinical measurement. To investigate the characteristics of wrist motion (area, axis, and location) during activities of daily living (ADL) using electrogoniometry. A sample of 83 normal volunteers performed the Sollerman hand function test (SHFT) with a flexible biaxial electrogoniometer applied to their wrists. This technique is accurate and reliable and has been used before for assessment of wrist circumduction in normal volunteers. A software package was used to overlay an ellipse of best fit around the 2-dimensional trace of the electrogoniometer mathematically computing the area, location, and axis angle of the ellipse. Most ADL could be completed within 20% of the total area of circumduction (3686°° ± 1575°°) of a normal wrist. An oblique plane in radial extension and ulnar flexion (dart-throwing motion plane) was used for rotation (-14° ± 32°) and power grip tasks (-29° ± 25°) during ADL; however, precision tasks (4° ± 28°), like writing, were performed more often in the flexion extension plane. In the dominant hand, only 2 power tasks were located in flexion region (cutting play dough [ulnar] and pouring carton [radial]), precision tasks were located centrally, and rotation and other power tasks were located in extension region. This study has identified that wrist motion during the ADL requires varying degrees of movement in oblique planes. Using electrogoniometry, we could visualize the area, location, and plane of motion during ADL. This could assist future researchers to compare procedures leading to loss of motion in specific quadrants of wrist motion and its impact on patient's ability in performing particular ADL. It could guide hand therapists to specifically focus on retraining the ADL that may be affected when wrist range of motion is lost after injury. Diagnostic level III. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Simulated Radioscapholunate Fusion Alters Carpal Kinematics While Preserving Dart-Thrower's Motion

PubMed Central

Calfee, Ryan P.; Leventhal, Evan L.; Wilkerson, Jim; Moore, Douglas C.; Akelman, Edward; Crisco, Joseph J.

2014-01-01

Purpose Midcarpal degeneration is well documented after radioscapholunate fusion. This study tested the hypothesis that radioscapholunate fusion alters the kinematic behavior of the remaining lunotriquetral and midcarpal joints, with specific focus on the dart-thrower's motion. Methods Simulated radioscapholunate fusions were performed on 6 cadaveric wrists in an anatomically neutral posture. Two 0.060-in. carbon fiber pins were placed from proximal to distal across the radiolunate and radioscaphoid joints, respectively. The wrists were passively positioned in a custom jig toward a full range of motion along the orthogonal axes as well as oblique motions, with additional intermediate positions along the dart-thrower's path. Using a computed tomography– based markerless bone registration technique, each carpal bone's three-dimensional rotation was defined as a function of wrist flexion/extension from the pinned neutral position. Kinematic data was analyzed against data collected on the same wrist prior to fixation using hierarchical linear regression analysis and paired Student's t-tests. Results After simulated fusion, wrist motion was restricted to an average flexion-extension arc of 48°, reduced from 77°, and radial-ulnar deviation arc of 19°, reduced from 33°. The remaining motion was maximally preserved along the dart-thrower's path from radial-extension toward ulnar-flexion. The simulated fusion significantly increased rotation through the scaphotrapezial joint, scaphocapitate joint, triquetrohamate joint, and lunotriquetral joint. For example, in the pinned wrist, the rotation of the hamate relative to the triquetrum increased 85%. Therefore, during every 10° of total wrist motion, the hamate rotated an average of nearly 8° relative to the triquetrum after pinning versus 4° in the normal state. Conclusions Simulated radioscapholunate fusion altered midcarpal and lunotriquetral kinematics. The increased rotations across these remaining joints provide one potential explanation for midcarpal degeneration after radioscapholunate fusion. Additionally, this fusion model confirms the dart-thrower's hypothesis, as wrist motion after simulated radioscapholunate fusion was primarily preserved from radial-extension toward ulnar-flexion. PMID:18406953

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

PubMed

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

1995-09-01

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

Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks

DTIC Science & Technology

2016-01-01

Upper ☐Lower Side of amputation: ☐Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee...Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee ☐shoulder/hip Initial Amputation Etiology...extremity: ☐Upper ☐Lower Side of amputation: ☐Right ☐Left Level of original amputation (distal to…): ☐wrist/ ankle ☐elbow/knee

Development of an Underactuated 2-DOF Wrist Joint using McKibben PAMs

NASA Astrophysics Data System (ADS)

Rajagopal, S. P.; Jain, S.; Ramasubramanian, S. N.; Johnson, B. V.; Dwivedy, S. K.

2014-10-01

In this work, model of an underactuated 2-DOF wrist joint with pneumatically actuated muscles is proposed. For the joint, McKibben-type artificial muscles are used in parallel configuration for the actuation. For each Degree of Freedom (DOF) one agonist-antagonist pair arrangement is usually used with a pulley mechanism. A mathematical model of wrist joint is derived using conventional forward kinematic analysis. The static model relating pressure in the muscle with the orientation of the wrist joint is obtained by combining the experimental data and mathematical model. Regulation of pressure can be achieved by pulse width modulation control of on/off solenoid valves. A set of free vibration experiments are done for the dynamic identification of the muscle characteristics.

Different effects of age, adiposity and physical activity on the risk of ankle, wrist and hip fractures in postmenopausal women

PubMed Central

Armstrong, Miranda E.G.; Cairns, Benjamin J.; Banks, Emily; Green, Jane; Reeves, Gillian K.; Beral, Valerie

2012-01-01

While increasing age, decreasing body mass index (BMI), and physical inactivity are known to increase hip fracture risk, whether these factors have similar effects on other common fractures is not well established. We used prospectively-collected data from a large cohort to examine the role of these factors on the risk of incident ankle, wrist and hip fractures in postmenopausal women. 1,155,304 postmenopausal participants in the Million Women Study with a mean age of 56.0 (SD 4.8) years, provided information about lifestyle, anthropometric, and reproductive factors at recruitment in 1996–2001. All participants were linked to National Health Service cause-specific hospital records for day-case or overnight admissions. During follow-up for an average of 8.3 years per woman, 6807 women had an incident ankle fracture, 9733 an incident wrist fracture, and 5267 an incident hip fracture. Adjusted absolute and relative risks (RRs) for incident ankle, wrist, and hip fractures were calculated using Cox regression models. Age-specific rates for wrist and hip fractures increased sharply with age, whereas rates for ankle fracture did not. Cumulative absolute risks from ages 50 to 84 years per 100 women were 2.5 (95%CI 2.2–2.8) for ankle fracture, 5.0 (95%CI 4.4–5.5) for wrist fracture, and 6.2 (95%CI 5.5–7.0) for hip fracture. Compared with lean women (BMI < 20 kg/m2), obese women (BMI ≥ 30 kg/m2) had a three-fold increased risk of ankle fracture (RR = 3.07; 95%CI 2.53–3.74), but a substantially reduced risk of wrist fracture and especially of hip fracture (RR = 0.57; 0.51–0.64 and 0.23; 0.21–0.27, respectively). Physical activity was associated with a reduced risk of hip fracture but was not associated with ankle or wrist fracture risk. Ankle, wrist and hip fractures are extremely common in postmenopausal women, but the associations with age, adiposity, and physical activity differ substantially between the three fracture sites. PMID:22465850

Wrist Traction During MR Arthrography Improves Detection of Triangular Fibrocartilage Complex and Intrinsic Ligament Tears and Visibility of Articular Cartilage.

PubMed

Lee, Ryan K L; Griffith, James F; Ng, Alex W H; Nung, Ryan C H; Yeung, David K W

2016-01-01

The purpose of this study was to assess the effects of traction during MR arthrography of the wrist on joint space widening, cartilage visibility, and detection of tears of the triangular fibrocartilage complex (TFCC) and intrinsic ligaments. A prospective study included 40 wrists in 39 patients (25 men, 14 women; mean age, 35 years). MR arthrography was performed with a 3-T MRI system with and without axial traction. Two radiologists independently measured wrist and carpal joint space widths and semiquantitatively graded articular cartilage visibility. Using conventional arthrography as the reference standard and working in consensus, they assessed for the presence of tears of the TFCC, lunotriquetral ligament (LTL), and scapholunate ligament (SLL). Visibility of a tear before traction was compared with visibility after traction. With traction, all joint spaces in the wrist and carpus were significantly widened (change, 0.15-1.01 mm; all p < 0.006). Subjective cartilage visibility of all joint spaces improved after traction (all p ≤ 0.048) except for that of the radioscaphoid space, which was well visualized even before traction. Conventional arthrography depicted 24 TFCC tears, seven LTL tears, and three SLL tears. The accuracy of tear detection improved after traction for the TFCC (98% after traction vs 83% before traction), the LTL (100% vs 88%), and the SLL (100% vs 95%). Tear visibility improved after traction for 54% of TFCC tears, 71% of LTL tears, and 66% of SLL tears. Wrist MR arthrography with axial traction significantly improved the visibility of articular cartilage and the detection and visibility of tears of the TFCC and intrinsic ligaments. The results favor more widespread use of traction during MR arthrography of the wrist.

Carpal kinematics in quadrupedal monkeys: towards a better understanding of wrist morphology and function

PubMed Central

Daver, Guillaume; Berillon, Gilles; Grimaud-Hervé, Dominique

2012-01-01

The purpose of this study is to provide new data on carpal kinematics in primates in order to deepen our understanding of the relationships between wrist morphology and function. To that end, we provide preliminary data on carpal kinematics in seven species of quadrupedal monkeys that have not been previously investigated in this regard (cercopithecoids, n = 4; ceboids, n = 3). We radiographed wrists from cadavers at their maximum radial and ulnar deviations, as well as at maximum flexion and extension. We took angular measurements to quantify the contribution of the mobility of the two main wrist joints (antebrachiocarpal and midcarpal) with respect to total wrist mobility. We also recorded qualitative observations. Our quantitative results show few clear differences among quadrupedal monkeys for radioulnar deviation and flexion–extension: all the primates studied exhibit a greater midcarpal mobility (approximately 54–83% of the total range of motion) than antebrachiocarpal mobility; however, we identified two patterns of carpal kinematics that show the functional impact of previously recognised morphological variations in quadrupedal monkeys. Firstly, qualitative results show that the partition that divides the proximal joint of the wrist in ceboids results in less mobility and more stability of the ulnar part of the wrist than is seen in cercopithecoids. Secondly, we show that the olive baboon specimen (Papio anubis) is characterised by limited antebrachiocarpal mobility for extension; this effect is likely the result of a radial process that projects on the scaphoid notch, as well as an intraarticular meniscus. Because of these close relationships between carpal kinematics and morphology in quadrupedal monkeys, we hypothesise that, to some extent, these functional tendencies are related to their locomotor hand postures. PMID:22050662

Fasciocutaneous Propeller Flap Based on Perforating Branch of Ulnar Artery for Soft Tissue Reconstruction of the Hand and Wrist.

PubMed

Jang, Hyo Seok; Lee, Young Ho; Kim, Min Bom; Chung, Joo Young; Seok, Hyun Sik; Baek, Goo Hyun

2018-03-01

A skin defect of the hand and wrist is a common manifestation in industrial crushing injuries, traffic accidents or after excision of tumors. We reconstructed a skin defect in the ulnar aspect of the hand and wrist with a perforator-based propeller flap from the ulnar artery. The aims of our study are to evaluate the utility and effectiveness of this flap and to discuss the advantages and disadvantages of the flap in hand and wrist reconstruction with a review of the literature. Between April 2011 and November 2016, five cases of skin defect were reconstructed with a perforator-based propeller flap from the ulnar artery. There were four males and one female. The age of patients ranged from 36 to 73 years. Skin defect sites were on the dorso-ulnar side of the hand in three cases and palmar-ulnar side of the wrist in two cases. The size of the skin defect ranged from 4 × 3 cm to 8 × 5 cm. We evaluated the viability of the flap, postoperative complication and patient's satisfaction. There was no failure of flap in all cases. The size of the flap ranged from 4 × 4 cm to 12 × 4 cm. One patient, who had a burn scar contracture, presented with limited active and passive motion of the wrist after the operation. The other patients had no complications postoperatively. Cosmetic results of the surgery were excellent in one patient, good in three patients, and fair in one patient. The fasciocutaneous propeller flap based on a perforating branch of the ulnar artery is a reliable treatment option for the ulnar side skin defect of the hand and wrist.

Locomotor Hand Postures, Carpal Kinematics During Wrist Extension, and Associated Morphology in Anthropoid Primates.

PubMed

Orr, Caley M

2017-02-01

The biomechanics of wrist extension (or dorsiflexion) are important for understanding functional adaptation of the primate hand because extension mobility varies with habitual locomotor hand posture and facilitates certain manipulative tasks. Here, intercarpal kinematics are employed to investigate mechanisms underlying wrist extension in a sample of anthropoids representing various arboreal and terrestrial locomotor modes. Carpal kinematics are studied using computed-tomography of cadaveric forelimbs, and these data are combined with a morphometric analysis of biomechanically-informative anatomical features. The results indicate that stiff-wristed knuckle-walking chimpanzees and digitigrade baboons are characterized by low ranges of motion (ROMs) at the radiocarpal and midcarpal complexes. Palmigrade-capable monkeys have high extension ROMs at both the radiocarpus and midcarpus, while palmigrade-capable orangutans achieve wrist extension through moderate radiocarpal ROMs and high midcarpal ROMs. Morphometrics demonstrate that a more projecting dorsal ridge of the distal radius corresponds with low-to-moderate radioscaphoid mobility in the apes, but that baboons resemble palmigrade-capable monkeys in this metric. Thus, the dorsal ridge of the radius alone is not a good indicator of wrist mobility and hand posture. However, the extent of the lunate's articular arc on the dorsum of the capitate head is correlated with midcarpal mobility across taxa. These findings suggest that although a precise relationship between wrist extension ROM and morphology is difficult to define, the presence of a pronounced dorsal ridge combined with an abbreviated dorsal capitate articular arc reflects limited overall dorsiflexion with attendant constraints on the adoption of palmigrade hand postures. Anat Rec, 300:382-401, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The prevalence, variety and impact of wrist problems in elite professional golfers on the European Tour

PubMed Central

Hawkes, Roger; O'Connor, Phil; Campbell, Doug

2013-01-01

Objectives Golf is a popular sport played by an estimated 57 million people. Previous studies on wrist injuries in elite golfers have been of simple design and have demonstrated such injuries to be frequent, although no studies report the incidence, variety, severity or impact on the activity of wrist injuries in detail. This prospective cross-sectional study assesses these factors in a cohort of elite professional golfers. Methods European Tour golfers eligible to compete at the 2009 BMW PGA Championship at Wentworth were studied. Study design involved the completion of a structured questionnaire supplemented by interview and examination when required, with performance statistics provided by the European Tour. The severity of injury was assessed by the number of missed tournaments and the amount of time of missed practice. Results 128 of 153 eligible golfers, (84%) completed the study with 38 golfers (30%) reporting 43 problems. The majority of injuries (67%) occurred in the leading wrist at the most common location, the ulnar side of the wrist (35%). 87% of all ulnar-sided and 100% of radial-sided problems were in the leading wrist. Conclusions There were clear side differences reported by the players with the lead wrist demonstrating much higher injury rates in all areas. The most significant injury, in terms of absence from competition, was extensor carpi ulnaris tendon subluxation. Specific injuries are explained in relation to the biomechanics of the golf swing. Most structural injuries have a specific treatment and rehabilitation plan, which can involve significant periods of time away from the sport, while the management of many of the more minor problems is through alterations in technique or practice regimes, aiming to keep a golfer playing during recovery. PMID:24014125

Estimation of daily energy expenditure in pregnant and non-pregnant women using a wrist-worn tri-axial accelerometer.

PubMed

van Hees, Vincent T; Renström, Frida; Wright, Antony; Gradmark, Anna; Catt, Michael; Chen, Kong Y; Löf, Marie; Bluck, Les; Pomeroy, Jeremy; Wareham, Nicholas J; Ekelund, Ulf; Brage, Søren; Franks, Paul W

2011-01-01

Few studies have compared the validity of objective measures of physical activity energy expenditure (PAEE) in pregnant and non-pregnant women. PAEE is commonly estimated with accelerometers attached to the hip or waist, but little is known about the validity and participant acceptability of wrist attachment. The objectives of the current study were to assess the validity of a simple summary measure derived from a wrist-worn accelerometer (GENEA, Unilever Discover, UK) to estimate PAEE in pregnant and non-pregnant women, and to evaluate participant acceptability. Non-pregnant (N = 73) and pregnant (N = 35) Swedish women (aged 20-35 yrs) wore the accelerometer on their wrist for 10 days during which total energy expenditure (TEE) was assessed using doubly-labelled water. PAEE was calculated as 0.9×TEE-REE. British participants (N = 99; aged 22-65 yrs) wore accelerometers on their non-dominant wrist and hip for seven days and were asked to score the acceptability of monitor placement (scored 1 [least] through 10 [most] acceptable). There was no significant correlation between body weight and PAEE. In non-pregnant women, acceleration explained 24% of the variation in PAEE, which decreased to 19% in leave-one-out cross-validation. In pregnant women, acceleration explained 11% of the variation in PAEE, which was not significant in leave-one-out cross-validation. Median (IQR) acceptability of wrist and hip placement was 9(8-10) and 9(7-10), respectively; there was a within-individual difference of 0.47 (p<.001). A simple summary measure derived from a wrist-worn tri-axial accelerometer adds significantly to the prediction of energy expenditure in non-pregnant women and is scored acceptable by participants.

Anterior and Posterior Interosseous Neurectomy for the Treatment of Chronic Dynamic Instability of the Wrist

PubMed Central

Hofmeister, Eric P.; Moran, Steven L.

2006-01-01

The purpose of this study was to determine the results of combined anterior and posterior interosseous neurectomy (AIN/PIN) in patients with chronic wrist pain secondary to dynamic instability, and to determine the predictability of selective AIN/PIN blocks with respect to pain relief, grip strength, and outcome of the neurectomy. A prospectively accrued chronic wrist pain registry was undertaken. Inclusion criteria were patients with arthroscopically confirmed dynamic wrist instability who had undergone a diagnostic AIN/PIN injection, followed by a single dorsal incision neurectomy. All patients completed Disabilities of the Arm, Shoulder and Hand outcome questionnaires preoperatively and at intervals postoperatively. Pre- and postoperative range of motion, grip strength, and percentage pain relief were recorded. Over a 3-year period, 50 wrists (48 patients) were enrolled: average follow-up was 28 months (range: 24–42 months). The average improvement in grip strength after denervation was 16% (p = 0.076), the average improvement in subjective pain rating was 51% (p < 0.0001), and the average improvement in Disabilities of the Arm, Shoulder, and Hand scores was 15 points (p = 0.0039). Improvement of pain from diagnostic injections was not predictive of final improvement of pain; however, improvement in grip strength after diagnostic injections did correlate with improved grip strength after surgery. Lack of improvement in subjective pain rating or grip strength after diagnostic injection approached statistical significance. There was no decrease in range of motion postoperatively. Fourteen patients (16 wrists) failed as defined by need for subsequent surgery. The results of AIN/PIN neurectomy demonstrate that it may be an effective alternative to wrist salvage or reconstructive procedures within the first few years of follow-up. PMID:18780027

Design and Kinematic Evaluation of a Novel Joint-Specific Play Controller: Application for Wrist and Forearm Therapy

PubMed Central

Schwartz, Joel B.; Wilcox, Bethany; Costa, Laura; Kerman, Karen

2015-01-01

Background The wrist extensors and flexors are profoundly affected in most children with hemiparetic cerebral palsy (CP) and are the major target of physical therapists' and occupational therapists' efforts to restore useful hand functions. A limitation of any therapeutic or exercise program can be the level of the child's engagement or adherence. The proposed approach capitalizes on the primary learning avenue for children: toy play. Objective This study aimed to develop and evaluate the measurement accuracy of innovative, motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP. Design Design objectives of the play controller included a cost-effective, home-based supplement to physical therapy, the ability to calibrate the controller so that play can be accomplished with any active range of motion, and the capability of logging play activity and wrist motion over week-long periods. Methods Accuracy of the play controller in measuring wrist flexion-extension was evaluated in 6 children who were developing in a typical manner, using optical motion capture of the wrist and forearm as the gold standard. Results The error of the play controller was estimated at approximately 5 degrees in both maximum wrist flexion and extension. Limitations Measurements were taken during a laboratory session, with children without CP, and no toy or computer game was interfaced with the play controller. Therefore, the potential engagement of the proposed approach for therapy remains to be evaluated. Conclusions This study presented the concept, development, and wrist tracking accuracy of an inexpensive approach to extremity therapy that may have a health benefit for children with hemiparesis, and potentially for patients of any age with a wide range of extremity neuromotor impairments. PMID:25573759

Activity recognition using a single accelerometer placed at the wrist or ankle.

PubMed

Mannini, Andrea; Intille, Stephen S; Rosenberger, Mary; Sabatini, Angelo M; Haskell, William

2013-11-01

Large physical activity surveillance projects such as the UK Biobank and NHANES are using wrist-worn accelerometer-based activity monitors that collect raw data. The goal is to increase wear time by asking subjects to wear the monitors on the wrist instead of the hip, and then to use information in the raw signal to improve activity type and intensity estimation. The purposes of this work was to obtain an algorithm to process wrist and ankle raw data and to classify behavior into four broad activity classes: ambulation, cycling, sedentary, and other activities. Participants (N = 33) wearing accelerometers on the wrist and ankle performed 26 daily activities. The accelerometer data were collected, cleaned, and preprocessed to extract features that characterize 2-, 4-, and 12.8-s data windows. Feature vectors encoding information about frequency and intensity of motion extracted from analysis of the raw signal were used with a support vector machine classifier to identify a subject's activity. Results were compared with categories classified by a human observer. Algorithms were validated using a leave-one-subject-out strategy. The computational complexity of each processing step was also evaluated. With 12.8-s windows, the proposed strategy showed high classification accuracies for ankle data (95.0%) that decreased to 84.7% for wrist data. Shorter (4 s) windows only minimally decreased performances of the algorithm on the wrist to 84.2%. A classification algorithm using 13 features shows good classification into the four classes given the complexity of the activities in the original data set. The algorithm is computationally efficient and could be implemented in real time on mobile devices with only 4-s latency.

Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae?

PubMed

Lai, Eddie Hsiang-Hua; Liu, Jen-Pei; Chang, Jenny Zwei-Chieng; Tsai, Shih-Jaw; Yao, Chung-Chen Jane; Chen, Mu-Hsiung; Chen, Yi-Jane; Lin, Chun-Pin

2008-04-01

The skeletal maturation status of a growing patient can influence the selection of orthodontic treatment procedures. Either lateral cephalometric or hand-wrist radiography can be used to assess skeletal development. In this study, we examined the correlation between the maturation stages of cervical vertebrae and hand-wrist bones in Taiwanese individuals. The study group consisted of 330 male and 379 female subjects ranging in age from 8 to 18 years. A total of 709 hand-wrist and 709 lateral cephalometric radiographs were analyzed. Hand-wrist maturation stages were assessed using National Taiwan University Hospital Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages were determined by the latest Cervical Vertebral Maturation Stage (CVMS) Index. Spearman's rank correlation was used to correlate the respective maturation stages assessed from the hand-wrist bones and the cervical vertebrae. The values of Spearman's rank correlation were 0.910 for males and 0.937 for females, respectively. These data confirmed a strong and significant correlation between CVMS and NTUH-SMI systems (p less than 0.001). After comparison of the mean ages of subjects in different stages of CVMS and NTU-SMI systems, we found that CVMS I corresponded to NTUH-SMI stages 1 and 2, CVMS II to NTUH-SMI stage 3, CVMS III to NTUHSMI stage 4, CVMS IV to NTUH-SMI stage 5, CVMS V to NTUH-SMI stages 6, 7 and 8, and CVMS VI to NTUH-SMI stage 9. Our results indicate that cervical vertebral maturation stages can be used to replace hand-wrist bone maturation stages for evaluation of skeletal maturity in Taiwanese individuals.

Calibration of GENEActiv accelerometer wrist cut-points for the assessment of physical activity intensity of preschool aged children.

PubMed

Roscoe, Clare M P; James, Rob S; Duncan, Michael J

2017-08-01

This study sought to validate cut-points for use of wrist-worn GENEActiv accelerometer data, to analyse preschool children's (4 to 5 year olds) physical activity (PA) levels via calibration with oxygen consumption values (VO 2 ). This was a laboratory-based calibration study. Twenty-one preschool children, aged 4.7 ± 0.5 years old, completed six activities (ranging from lying supine to running) whilst wearing the GENEActiv accelerometers at two locations (left and right wrist), these being the participants' non-dominant and dominant wrist, and a Cortex face mask for gas analysis. VO 2 data was used for the assessment of criterion validity. Location specific activity intensity cut-points were established via receiver operator characteristic curve (ROC) analysis. The GENEActiv accelerometers, irrespective of their location, accurately discriminated between all PA intensities (sedentary, light, and moderate and above), with the dominant wrist monitor providing a slightly more precise discrimination at light PA and the non-dominant at the sedentary behaviour and moderate and above intensity levels (area under the curve (AUC) for non-dominant = 0.749-0.993, compared to AUC dominant = 0.760-0.988). This study establishes wrist-worn physical activity cut-points for the GENEActiv accelerometer in preschoolers. What is Known: • GENEActiv accelerometers have been validated as a PA measurement tool in adolescents and adults. • No study to date has validated the GENEActiv accelerometers in preschoolers. What is New: • Cut-points were determined for the wrist-worn GENEActiv accelerometer in preschoolers. • These cut-points can be used in future research to help classify and increase preschoolers' compliance rates with PA.

Validation of the Leap Motion Controller using markered motion capture technology.

PubMed

Smeragliuolo, Anna H; Hill, N Jeremy; Disla, Luis; Putrino, David

2016-06-14

The Leap Motion Controller (LMC) is a low-cost, markerless motion capture device that tracks hand, wrist and forearm position. Integration of this technology into healthcare applications has begun to occur rapidly, making validation of the LMC׳s data output an important research goal. Here, we perform a detailed evaluation of the kinematic data output from the LMC, and validate this output against gold-standard, markered motion capture technology. We instructed subjects to perform three clinically-relevant wrist (flexion/extension, radial/ulnar deviation) and forearm (pronation/supination) movements. The movements were simultaneously tracked using both the LMC and a marker-based motion capture system from Motion Analysis Corporation (MAC). Adjusting for known inconsistencies in the LMC sampling frequency, we compared simultaneously acquired LMC and MAC data by performing Pearson׳s correlation (r) and root mean square error (RMSE). Wrist flexion/extension and radial/ulnar deviation showed good overall agreement (r=0.95; RMSE=11.6°, and r=0.92; RMSE=12.4°, respectively) with the MAC system. However, when tracking forearm pronation/supination, there were serious inconsistencies in reported joint angles (r=0.79; RMSE=38.4°). Hand posture significantly influenced the quality of wrist deviation (P<0.005) and forearm supination/pronation (P<0.001), but not wrist flexion/extension (P=0.29). We conclude that the LMC is capable of providing data that are clinically meaningful for wrist flexion/extension, and perhaps wrist deviation. It cannot yet return clinically meaningful data for measuring forearm pronation/supination. Future studies should continue to validate the LMC as updated versions of their software are developed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ergonomic Worksite Analysis of an Army Dental Clinic

DTIC Science & Technology

1992-08-01

conducted in which duration of hand grip used (power, pinch, retraction, other) and wrist position (ulnar deviation, radial deviation, neutral...DIAGNOSTIC TESTS percent n Nerve Conduction Study 61 11 X-ray of the wrist or hand 38 7 Grip and/or pinch strength 38 7 Dexterity Testing 33 6 Bone Scan 22 4... hand /wrist symptoms. Back and shoulder pain was reported by 53% of the respondents. Psychosocial factors as well as physical risk factors were found to

Control and postural thixotropy of the forearm muscles: changes caused by cold.

PubMed

Lakie, M; Walsh, E G; Wright, G W

1986-01-01

The forearm was cooled in water at 5-10 degrees C while wrist biodynamics were investigated. Pronounced loosening following a perturbation (thixotropy) was no longer seen. The wrist became stiffer for large or moderate but not small movements; EMG activity did not increase. Cooling the wrist alone, or opposite forearm, was without effect. The ability to make rapid reciprocating movements was reduced and muscle relaxation time was increased. Single movements were not affected.

Control and postural thixotropy of the forearm muscles: changes caused by cold.

PubMed Central

Lakie, M; Walsh, E G; Wright, G W

1986-01-01

The forearm was cooled in water at 5-10 degrees C while wrist biodynamics were investigated. Pronounced loosening following a perturbation (thixotropy) was no longer seen. The wrist became stiffer for large or moderate but not small movements; EMG activity did not increase. Cooling the wrist alone, or opposite forearm, was without effect. The ability to make rapid reciprocating movements was reduced and muscle relaxation time was increased. Single movements were not affected. PMID:3958734

The influence of hand positions on biomechanical injury risk factors at the wrist joint during the round-off skills in female gymnastics.

PubMed

Farana, Roman; Jandacka, Daniel; Uchytil, Jaroslav; Zahradnik, David; Irwin, Gareth

2017-01-01

The aim of this study was to examine the biomechanical injury risk factors at the wrist, including joint kinetics, kinematics and stiffness in the first and second contact limb for parallel and T-shape round-off (RO) techniques. Seven international-level female gymnasts performed 10 trials of the RO to back handspring with parallel and T-shape hand positions. Synchronised kinematic (3D motion analysis system; 247 Hz) and kinetic (two force plates; 1235 Hz) data were collected for each trial. A two-way repeated measure analysis of variance (ANOVA) assessed differences in the kinematic and kinetic parameters between the techniques for each contact limb. The main findings highlighted that in both the RO techniques, the second contact limb wrist joint is exposed to higher mechanical loads than the first contact limb demonstrated by increased axial compression force and loading rate. In the parallel technique, the second contact limb wrist joint is exposed to higher axial compression load. Differences between wrist joint kinetics highlight that the T-shape technique may potentially lead to reducing these bio-physical loads and consequently protect the second contact limb wrist joint from overload and biological failure. Highlighting the biomechanical risk factors facilitates the process of technique selection making more objective and safe.

Assessment of finger forces and wrist torques for functional grasp using new multichannel textile neuroprostheses.

PubMed

Lawrence, Marc; Gross, Gion-Pitschen; Lang, Martin; Kuhn, Andreas; Keller, Thierry; Morari, Manfred

2008-08-01

New multichannel textile neuroprotheses were developed, which comprise multiple sets of transcutaneous electrode arrays and connecting wires embroidered into a fabric layer. The electrode arrays were placed on the forearm above the extrinsic finger flexors and extensors. Activation regions for selective finger flexion and wrist extension were configured by switching a subset of the array elements between cathode, anode, and off states. We present a new isometric measurement system for the assessment of finger forces and wrist torques generated using the new neuroprostheses. Finger forces (from the middle phalanxes) were recorded using five load cells mounted on a "grasp handle" that can be arbitrarily positioned in space. The hand and the grasp handle were rigidly mounted to a 6-degree of freedom load cell, and the forces and torques about the wrist were recorded. A vacuum cushion was used to comfortably fixate the forearm. The position and orientation of the forearm, wrist, fingers, and handle were recorded using a new three-dimensional position measurement system (accuracy <+/-1 mm). The measurement system was integrated into the real-time multichannel transcutaneous electrode environment, which is able to control the spatiotemporal position of multiple activation regions. Using the combined system and textile neuroprosthesis, we were able to optimize the activation regions to produce selective finger and wrist articulation, enabling improved functional grasp.

Strength and fatigability of selected muscles in upper limb: assessing muscle imbalance relevant to tennis elbow.

PubMed

Alizadehkhaiyat, O; Fisher, A C; Kemp, G J; Frostick, S P

2007-08-01

The aetiology of tennis elbow has remained uncertain for more than a century. To examine muscle imbalance as a possible pathophysiological factor requires a reliable method of assessment. This paper describes the development of such a method and its performance in healthy subjects. We propose a combination of surface and fine-wire EMG of shoulder and forearm muscles and wrist strength measurements as a reliable tool for assessing muscle imbalance relevant to the pathophysiology of tennis elbow. Six healthy volunteers participated. EMG data were acquired at 50% maximal voluntary isometric contraction from five forearm muscles during grip and three shoulder muscles during external rotation and abduction, and analysed using normalized median frequency slope as a fatigue index. Wrist extension/flexion strength was measured using a purpose-built dynamometer. Significant negative slope of median frequency was found for all muscles, with good reproducibility, and no significant difference in slope between the different muscles of the shoulder and the wrist. (Amplitude slope showed high variability and was therefore unsuitable for this purpose.) Wrist flexion was 27+/-8% stronger than extension (mean+/-SEM, p=0.006). This is a reliable method for measuring muscle fatigue in forearm and shoulder. EMG and wrist strength studies together can be used for assessing and identifying the muscle balance in the wrist-forearm-shoulder chain.

The wrist of the formula 1 driver

PubMed Central

Masmejean, E. H.; Chavane, H.; Chantegret, A.; Issermann, J. J.; Alnot, J. Y.

1999-01-01

OBJECTIVES: During formula 1 driving, repetitive cumulative trauma may provoke nerve disorders such as nerve compression syndrome as well as osteoligament injuries. A study based on interrogatory and clinical examination of 22 drivers was carried out during the 1998 formula 1 World Championship in order to better define the type and frequency of these lesions. METHODS: The questions investigated nervous symptoms, such as paraesthesia and diminishment of sensitivity, and osteoligamentous symptoms, such as pain, specifying the localisation (ulnar side, dorsal aspect of the wrist, snuff box) and the effect of the wrist position on the intensity of the pain. Clinical examination was carried out bilaterally and symmetrically. RESULTS: Fourteen of the 22 drivers reported symptoms. One suffered cramp in his hands at the end of each race and one described a typical forearm effort compartment syndrome. Six drivers had effort "osteoligamentous" symptoms: three scapholunate pain; one medial hypercompression of the wrist; two sequellae of a distal radius fracture. Seven reported nerve disorders: two effort carpal tunnel syndromes; one typical carpal tunnel syndrome; one effort cubital tunnel syndrome; three paraesthesia in all fingers at the end of a race, without any objective signs. CONCLUSIONS: This appears to be the first report of upper extremity disorders in competition drivers. The use of a wrist pad to reduce the effects of vibration may help to prevent trauma to the wrist in formula 1 drivers. 


 PMID:10450483

Kinematic rate control of simulated robot hand at or near wrist singularity

NASA Technical Reports Server (NTRS)

Barker, K.; Houck, J. A.; Carzoo, S. W.

1985-01-01

A robot hand should obey movement commands from an operator on a computer program as closely as possible. However, when two of the three rotational axes of the robot wrist are colinear, the wrist loses a degree of freedom, and the usual resolved rate equations (used to move the hand in response to an operator's inputs) are indeterminant. Furthermore, rate limiting occurs in close vicinity to this singularity. An analysis shows that rate limiting occurs not only in the vicinity of this singularity but also substantially away from it, even when the operator commands rotational rates of the robot hand that are only a small percentage of the operational joint rate limits. Therefore, joint angle rates are scaled when they exceed operational limits in a real time simulation of a robot arm. Simulation results show that a small dead band avoids the wrist singularity in the resolved rate equations but can introduce a high frequency oscillation close to the singularity. However, when a coordinated wrist movement is used in conjunction with the resolved rate equations, the high frequency oscillation disappears.

Poor results of radio-scaphoid capsulodesis for scapholunate dissociation.

PubMed

Finsen, Vilhjalmur; Borchgrevink, Grethe Elisabeth

2013-01-01

We reviewed 17 patients 64 (range 29-123) months after dorsal radioscaphoid capsulodesis for scapholunate dissociation. Mean loss of key pinch was 13%, grip strength 18%, wrist flexion 22% (p < 0.001), and total wrist ROM 17% (p < 0.005). VAS (0 = best; 100 = worst) was 30(±28) for pain, 43(±30) for function, and 33(±33) for general satisfaction with the outcome. Mean Quick-DASH and PRWE scores were 27 and 34, respectively. The mean scapholunate gap was 3.5 mm before surgery, 1.9 mm after surgery, and 3.3 mm at review. The corresponding scapholunate angles were 63°, 46°, and 70°, respectively. The mean radioscaphoid angle with the wrist maximally flexed was 84° (69-99) for the patients and was 91° (77-103) in ten wrists of volunteers. Six patients had changed their jobs because of the wrist. Three patients stated that they would not have consented to operation if they had known the outcome in advance. Radioscaphoid capsulodesis does not prevent volar flexion of the scaphoid.

Anterior wrist and medial malleolus: the optimal sites for tissue selection in electric death through hand-to-foot circuit pathway.

PubMed

Xu, Guangtao; Su, Ruibing; Lv, Junyao; Lai, Xiaoping; Li, Xianxian; Wu, Jiayan; Hu, Bo; Xu, Long; Shen, Ruilin; Gu, Jiang; Yu, Xiaojun

2017-03-01

Specific morphological changes may be absent in some cases of electrocution shocked by the voltage of 220 V or lower. In this study, we attempted to demonstrate that the anterior wrist and medial malleolus were the optimal sites with promising and significant changes in electric death through the hand-to-foot circuit pathway. We established an electric shock rat model and observed histopathologic changes in the anterior wrist and medial malleolus. The results showed that the current intensities in the left anterior wrist and right medial malleolus were remarkably higher than those in the other sites, and the nuclei long/short (L/S) axis ratios of the arterial endotheliocyte and the skeletal muscle cell in these two areas were significantly higher than those in other parts of the body. These findings suggested that the anterior wrist and/or medial malleolus soft tissues as the narrowest parts of the limbs could be used as promising and useful sites for the assessment of electrical shock death, especially in forensic pathologic evaluation.

A preliminary investigation of trunk and wrist kinematics when using drivers with different shaft properties.

PubMed

Joyce, Christopher; Burnett, Angus; Cochrane, Jodie; Reyes, Alvaro

2016-01-01

It is unknown whether skilled golfers will modify their kinematics when using drivers of different shaft properties. This study aimed to firstly determine if golf swing kinematics and swing parameters and related launch conditions differed when using modified drivers, then secondly, determine which kinematics were associated with clubhead speed. Twenty high level amateur male golfers (M ± SD: handicap = 1.9 ± 1.9 score) had their three-dimensional (3D) trunk and wrist kinematics collected for two driver trials. Swing parameters and related launch conditions were collected using a launch monitor. A one-way repeated measures ANOVA revealed significant (p ≤ 0.003) between driver differences; specifically, faster trunk axial rotation velocity and an early wrist release for the low kick point driver. Launch angle was shown to be 2° lower for the high kick point driver. Regression models for both drivers explained a significant amount of variance (60-67%) in clubhead speed. Wrist kinematics were most associated with clubhead speed, indicating the importance of the wrists in producing clubhead speed regardless of driver shaft properties.

Assessment of skeletal age using MP3 and hand-wrist radiographs and its correlation with dental and chronological ages in children.

PubMed

Bala, M; Pathak, A; Jain, R L

2010-01-01

The purpose of the study was to assess skeletal age using MP3 and hand-wrist radiographs and to find the correlation amongst the skeletal, dental and chronological ages. One hundred and sixty North-Indian healthy children in the age group 8-14 years, comprising equal number of males and females were included in the study. The children were radiographed for middle phalanx of third finger (MP3) and hand-wrist of the right hand and intra oral periapical X-ray for right permanent maxillary canine. Skeletal age was assessed from MP3 and hand-wrist radiographs according to the standards of Greulich and Pyle. The dental age was assessed from IOPA radiographs of right permanent maxillary canine based on Nolla's calcification stages. Skeletal age from MP3 and hand-wrist radiographs shows high correlation in all the age groups for both sexes. Females were advanced in skeletal maturation than males. Skeletal age showed high correlation with dental age in 12-14 years age group. Chronological age showed inconsistent correlation with dental and skeletal ages.

Comparative Study of the Diagnostic Value of Panoramic and Conventional Radiography of the Wrist in Scaphoid Fractures

PubMed Central

Ezoddini Ardakani, Fatemeh; Zangoie Booshehri, Maryam; Banadaki, Seyed Hossein Saeed; Nafisi-Moghadam, Reza

2012-01-01

Background Scaphoid fractures are the most common type of carpal fractures. Objectives The aim of the study was to compare the diagnostic value of panoramic and conventional radiographs of the wrist in scaphoid fractures. Patients and Methods The panoramic and conventional radiographs of 122 patients with acute and chronic wrist trauma were studied. The radiographs were analyzed and examined by two independent radiologist observers; one physician radiologist and one maxillofacial radiologist. The final diagnosis was made by an orthopedic specialist. Kappa test was used for statistical calculations, inter- and intra-observer agreement and correlation between the two techniques. Results Wrist panoramic radiography was more accurate than conventional radiography for ruling out scaphoid fractures. There was an agreement in 85% or more of the cases. Agreement values were higher with better inter and intra observer agreement for panoramic examinations than conventional radiographic examinations. Conclusion The panoramic examination of the wrist is a useful technique for the diagnosis and follow-up of scaphoid fractures. Its use is recommended as a complement to conventional radiography in cases with inconclusive findings. PMID:23599708

Camera-tracking gaming control device for evaluation of active wrist flexion and extension.

PubMed

Shefer Eini, Dalit; Ratzon, Navah Z; Rizzo, Albert A; Yeh, Shih-Ching; Lange, Belinda; Yaffe, Batia; Daich, Alexander; Weiss, Patrice L; Kizony, Rachel

Cross sectional. Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. To test the reliability and validity of a dynamic ROM assessment, the Camera Wrist Tracker (CWT). Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matched controls were assessed with the CWT and with a universal goniometer. One-way model intraclass correlation coefficient analysis indicated high test-retest reliability for extension (ICC = 0.92) and moderate reliability for flexion (ICC = 0.49). Standard error for extension was 2.45° and for flexion was 4.07°. Repeated-measures analysis revealed a significant main effect for group; ROM was greater in the control group (F[1, 28] = 47.35; P < .001). The concurrent validity of the CWT was partially supported. The results indicate that the CWT may provide highly reliable scores for dynamic wrist extension ROM, and moderately reliable scores for flexion, in people recovering from a distal radius fracture. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Advanced servo manipulator

DOEpatents

Holt, W.E.; Kuban, D.P.; Martin, H.L.

1988-10-25

An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.

Advanced servo manipulator

DOEpatents

Holt, William E.; Kuban, Daniel P.; Martin, H. Lee

1988-01-01

An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.

[Treatment of triangular fibrocartilage complex tear under wrist arthroscopy].

PubMed

Mi, Kun; Liu, Wu; Liu, Pengfei; Feng, Zhibin; Li, Yuwen; Hui, Guisheng

2011-01-01

To evaluate the treatment and effects of wrist arthroscopy in tear of triangular fibrocartilage complex (TFCC). Between January 2006 and December 2008, 16 patients with tear of TFCC were treated. Of 16 patients, 11 were male and 5 were female with an average age of 32.5 years (range, 25-51 years). Injury was caused by sprain in 12 cases, and by falling in 4 cases. The locations were the left side in 10 cases and the right side in 6 cases. The mean injury duration was 3 months to 6 years and 2 months. The main clinical symptoms included wrist powerlessness and ulnar-sided wrist pain which was aggravated with clench fist and lifting heavy things. The results of the ulnar-sided wrist stress test were positive in 14 cases and negative in 2 cases. The preoperative values of wrist range of motion (ROM) were (45.58 +/- 5.18) degrees at volar flexion, (41.22 +/- 3.83) degrees at dorsal extension, (17.82 +/- 2.48) degrees at radial deviation, (21.35 +/- 4.61) degrees at ulnar deviation, (69.85 +/- 8.36) degrees at pronation, and (70.13 +/- 6.34) degrees at supination. According to Palmer standard, 10 cases of IA were treated with debridement; 3 cases of IB with suture and 1 of them failed and was partially excised; 2 cases of IC with debridement on triangular fibrocartilage disc, ulnolunate ligament, and ulnotriguetrum ligament; and 1 case of ID with trimming plastic operation. All incisions healed by first intention, and no complications of joint infection or neurovascular injury was found. All patients were followed up 14-38 months (mean, 18.5 months). Fifteen patients were restored to normal life and work without ulnar-sided wrist pain. One patient had no pain, but he had wrist powerless. The values of ROM at last follow-up were (50.16 +/- 6.21) degrees at volar flexion, (45.37 +/- 4.65) degrees at dorsal extension, (18.95 +/- 3.56) degrees at radial deviation, (26.28 +/- 5.09) degrees at ulnar deviation, (78.87 +/- 7.69) degrees at pronation, and (76.46 +/- 8.31) degrees at supination; showing significant differences when compared with preoperative values (P < 0.05). According to Green-O'Brien standard, the results were excellent in 9 cases, good in 6 cases, fair in 1 case, and the excellent and good rate was 93.75%. The wrist arthroscopy not only can definitely diagnose tear of TFCC, but also is useful for treatment. In addition, the incision is small and the function is easy to recover, and the occurrence of chronic ulnar-sided wrist pain can be effectively avoided.

Arm MRI scan

MedlinePlus

... MRI and often available in the emergency room. Alternative Names MRI - arm; Wrist MRI; MRI - wrist; Elbow ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna.

PubMed

Squires, Judy H; England, Eric; Mehta, Kaushal; Wissman, Robert D

2014-07-01

The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities. The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.

Challenges and considerations for the design and production of a purpose-optimized body-worn wrist-watch computer

NASA Astrophysics Data System (ADS)

Narayanaswami, Chandra; Raghunath, Mandayam T.

2004-09-01

We outline a collection of technological challenges in the design of wearable computers with a focus on one of the most desirable form-factors, the wrist watch. We describe our experience with building three generations of wrist watch computers. We built these research prototypes as platforms to investigate the fundamental limitations of wearable computing. Results of our investigations are presented in the form of challenges that have been overcome and those that still remain.

Ulnar-Sided Wrist Pain due to Long Ulnar Styloid: A Case Report

PubMed Central

Ahsan, Zahab S.; Rivlin, Michael; Jupiter, Jesse B.

2016-01-01

Ulnar styloid impaction syndrome involves repetitive friction between an excessively long ulnar styloid and the carpus, resulting in chondromalacia, synovitis, and pain. The arthroscopic diagnosis, evaluation, and management of this syndrome are not well characterized. We present a patient with chronic wrist pain of unknown origin, culminating with arthroscopic findings demonstrating substantial loss of articular cartilage on both the lunate and triquetrum. The patient successfully underwent operative ulnar styloid excision, ultimately resolving chronic wrist pain symptomology. PMID:27777823

Impact of novel shift handle laparoscopic tool on wrist ergonomics and task performance

PubMed Central

Yu, Denny; Lowndes, Bethany; Morrow, Missy; Kaufman, Kenton; Bingener, Juliane; Hallbeck, Susan

2015-01-01

Background Laparoscopic tool handles causing wrist flexion and extension more than 15° from neutral are considered “at-risk” for musculoskeletal strain. Therefore this study measured the impact of laparoscopic tool handle angles on wrist postures and task performance. Methods Eight surgeons performed standard and modified Fundamentals of Laparoscopic Surgery (FLS) tasks with laparoscopic tools. Tool A had three adjustable handle angle configurations, i.e., in-line 0° (A0), 30° (A30), and pistol-grip 70° (A70). Tool B was a fixed pistol-grip grasper. Participants performed FLS peg transfer, inverted peg transfer, and inverted circle-cut with each tool and handle angle. Inverted tasks were adapted from standard FLS tasks to simulate advanced tasks observed during abdominal wall surgeries, e.g., ventral hernia. Motion tracking, video-analysis, and modified NASA-TLX workload questionnaires were used to measure postures, performance (e.g., completion time and errors), and workload. Results Task performance did not differ among tools. For FLS peg transfer, self-reported physical workload was lower for B than A70, and mean wrist postures showed significantly higher flexion for in-line than pistol-grip tools (B and A70). For inverted peg transfer, workload was higher for all configurations. However, less time was spent in at-risk wrist postures for in-line (47%) than pistol-grip (93-94%), and most participants preferred Tool A. For inverted circle cut, workload did not vary across configurations, mean wrist posture was 10° closer to neutral for A0 than B, and median time in at-risk wrist postures was significantly less for A0 (43%) than B (87%). Conclusion The best ergonomic wrist positions for FLS (floor) tasks are provided by pistol-grip tools and for tasks on the abdominal wall (ventral surface) by in-line handles. Adjustable handle angle laparoscopic tools can reduce ergonomic risks for musculoskeletal strain and allow versatility for tasks alternating between the floor and ceiling positions in a surgical trainer without impacting performance. PMID:26541720

Impact of novel shift handle laparoscopic tool on wrist ergonomics and task performance.

PubMed

Yu, Denny; Lowndes, Bethany; Morrow, Missy; Kaufman, Kenton; Bingener, Juliane; Hallbeck, Susan

2016-08-01

Laparoscopic tool handles causing wrist flexion and extension more than 15° from neutral are considered "at risk" for musculoskeletal strain. Therefore, this study measured the impact of laparoscopic tool handle angles on wrist postures and task performance. Eight surgeons performed standard and modified Fundamentals of Laparoscopic Surgery (FLS) tasks with laparoscopic tools. Tool A had three adjustable handle angle configurations, i.e., in-line 0° (A0), 30° (A30), and pistol-grip 70° (A70). Tool B was a fixed pistol-grip grasper. Participants performed FLS peg transfer, inverted peg transfer, and inverted circle cut with each tool and handle angle. Inverted tasks were adapted from standard FLS tasks to simulate advanced tasks observed during abdominal wall surgeries, e.g., ventral hernia. Motion tracking, video analysis, and modified NASA-TLX workload questionnaires were used to measure postures, performance (e.g., completion time and errors), and workload. Task performance did not differ between tools. For FLS peg transfer, self-reported physical workload was lower for B than for A70, and mean wrist postures showed significantly higher flexion for in-line than for pistol-grip tools (B and A70). For inverted peg transfer, workload was higher for all configurations. However, less time was spent in at-risk wrist postures for in-line (47 %) than for pistol-grip (93-94 %), and most participants preferred Tool A. For inverted circle cut, workload did not vary across configurations, mean wrist posture was 10° closer to neutral for A0 than B, and median time in at-risk wrist postures was significantly less for A0 (43 %) than for B (87 %). The best ergonomic wrist positions for FLS (floor) tasks are provided by pistol-grip tools and for tasks on the abdominal wall (ventral surface) by in-line handles. Adjustable handle angle laparoscopic tools can reduce ergonomic risks of musculoskeletal strain and allow versatility for tasks alternating between the floor and ceiling positions in a surgical trainer without impacting performance.

Proximal-distal differences in movement smoothness reflect differences in biomechanics.

PubMed

Salmond, Layne H; Davidson, Andrew D; Charles, Steven K

2017-03-01

Smoothness is a hallmark of healthy movement. Past research indicates that smoothness may be a side product of a control strategy that minimizes error. However, this is not the only reason for smooth movements. Our musculoskeletal system itself contributes to movement smoothness: the mechanical impedance (inertia, damping, and stiffness) of our limbs and joints resists sudden change, resulting in a natural smoothing effect. How the biomechanics and neural control interact to result in an observed level of smoothness is not clear. The purpose of this study is to 1 ) characterize the smoothness of wrist rotations, 2 ) compare it with the smoothness of planar shoulder-elbow (reaching) movements, and 3 ) determine the cause of observed differences in smoothness. Ten healthy subjects performed wrist and reaching movements involving different targets, directions, and speeds. We found wrist movements to be significantly less smooth than reaching movements and to vary in smoothness with movement direction. To identify the causes underlying these observations, we tested a number of hypotheses involving differences in bandwidth, signal-dependent noise, speed, impedance anisotropy, and movement duration. Our simulations revealed that proximal-distal differences in smoothness reflect proximal-distal differences in biomechanics: the greater impedance of the shoulder-elbow filters neural noise more than the wrist. In contrast, differences in signal-dependent noise and speed were not sufficiently large to recreate the observed differences in smoothness. We also found that the variation in wrist movement smoothness with direction appear to be caused by, or at least correlated with, differences in movement duration, not impedance anisotropy. NEW & NOTEWORTHY This article presents the first thorough characterization of the smoothness of wrist rotations (flexion-extension and radial-ulnar deviation) and comparison with the smoothness of reaching (shoulder-elbow) movements. We found wrist rotations to be significantly less smooth than reaching movements and determined that this difference reflects proximal-distal differences in biomechanics: the greater impedance (inertia, damping, stiffness) of the shoulder-elbow filters noise in the command signal more than the impedance of the wrist. Copyright © 2017 the American Physiological Society.

Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients.

PubMed

Charmoy, Alexia; Würzner, Grégoire; Ruffieux, Christiane; Hasler, Christopher; Cachat, François; Waeber, Bernard; Burnier, Michel

2007-10-01

Cuff inflation at the arm is known to cause an instantaneous rise in blood pressure, which might be due to the discomfort of the procedure and might interfere with the precision of the blood pressure measurement. In this study, we compared the reactive rise in blood pressure induced by cuff inflation when the cuff was placed at the upper arm level and at the wrist. The reactive rise in systolic and diastolic blood pressure to cuff inflation was measured in 34 normotensive participants and 34 hypertensive patients. Each participant was equipped with two cuffs, one around the right upper arm (OMRON HEM-CR19, 22-32 cm) and one around the right wrist (OMRON HEM-CS 19, 17-22 cm; Omron Health Care Europe BV, Hoofddorp, The Netherlands). The cuffs were inflated in a double random order (maximal cuff pressure and position of the cuff) with two maximal cuff pressures: 180 and 240 mmHg. The cuffs were linked to an oscillometric device (OMRON HEM 907; Omron Health Care). Simultaneously, blood pressure was measured continuously at the middle finger of the left hand using photoplethysmography. Three measurements were made at each level of blood pressure at the arm and at the wrist, and the sequence of measurements was randomized. In normotensive participants, no significant difference was observed in the reactive rise in blood pressure when the cuff was inflated either at the arm or at the wrist irrespective of the level of cuff inflation. Inflating a cuff at the arm, however, induced a significantly greater rise in blood pressure than inflating it at the wrist in hypertensive participants for both systolic and diastolic pressures (P<0.01), and at both levels of cuff inflation. The blood pressure response to cuff inflation was independent of baseline blood pressure. The results show that in hypertensive patients, cuff inflation at the wrist produces a smaller reactive rise in blood pressure. The difference between the arm and the wrist is independent of the patient's level of blood pressure.

User surveys support designing a prosthetic wrist that incorporates the Dart Thrower's Motion.

PubMed

Davidson, Matthew; Bodine, Cathy; Weir, Richard F Ff

2018-03-07

Prosthetic devices are not meeting the needs of people with upper limb amputations. Due to controlsidelimitations, prosthetic wrists cannot yet be fully articulated. This study sought to determine which wrist motions users felt were most important for completing activities of daily living. We specifically invstigated whether adding a combinationof flexion and deviation known as the Dart Thrower's Motion to a prosthetic wrist would help improve functionality. Fifteen participants with a trans-radial amputation, aged 25-64 years, who use a prosthesis completed an online survey and answered interview questions to determine which types of tasks pose particular challenges. Participants were asked what kinds of improvements they would like to see in a new prosthesis. A subset of five participants were interviewed in-depth to provide further information about difficulties they face using their device. The survey showed that participants had difficulty performing activities of daily living that involve a combination of wrist flexion and deviation known as the "Dart Throwers Motion". Interview responses confirmed that users have difficulty performing these tasks, especially those that require tools. Additionally, users said that they were more interested in having flexion and deviation than rotation in a prosthetic wrist. This research indicates that including the Dart Thrower's Motion in future designs of prosthetic wrists would improve these devices and people with upper limb amputations would be excited to see this improvement in their devices. Implications for Rehabilitation • Over one third of people with upper limb amputations do not use a prosthesis because prosthetic devices do not meet their needs.• The number of motions possible in state of the art prosthetic devices is limited by the small number of control sites available.• The Dart Thrower?s Motion is a wrist motion used for many activities of daily living but unavailable in commercial prosthetics leading many prosthetics users to have difficulty with these tasks.• Prosthetic use, and therefore quality of life, could be improved by including the Dart Thrower's Motion in a prosthesis.

Unusual self-electrocution simulating judicial electrocution by an adolescent.

PubMed

Murty, O P

2008-06-01

Electrocution is one of the rarest modes of suicide. In this case, one school going adolescent committed suicide by electrocution using bare electric wire. This is a rare case of suicidal death by applying live wires around the wrists, simulating the act of judicial electrocution. He positioned himself on armed chair and placed the nude wire loops from a cable around both wrists and switched on the current by plugging in to nearest socket by foot. There were linear electric contact wounds completely encircling around the both wrists. In addition to these linear electric burns all around wrists, there were electrical burns over both hands. This death highlights the need of supervision and close watch on children for self-destructing activities and behavior. This case also highlights unusual method adopted by adolescent to end his life.

Off-road machine controls: investigating the risk of carpal tunnel syndrome.

PubMed

Oliver, M; Rickards, J; Biden, E

2000-11-01

Occupationally induced hand and wrist repetitive strain injuries (RSI) such as carpal tunnel syndrome (CTS) are a growing problem in North America. The purpose of this investigation was to apply a modification of the wrist flexion/ extension models of Armstrong and Chaffin (1978, 1979) to determine if joystick controller use in off-road machines could contribute to the development of CTS. A construction equipment cab in the laboratory was instrumented to allow force, displacement and angle measurements from 10 operators while they completed an approximately 30-min joystick motion protocol. The investigation revealed that both the external fingertip and predicted internal wrist forces resulting from the use of these joysticks were very low, indicating that the CTS risk associated with this factor was slight. However, the results also indicated that, particularly for the 'forward' and 'left' right side motions and for all left side motions, force was exerted by other portions of the fingers and hand, thereby under-predicting the tendon tension and internal wrist forces. Wrist angles observed were highest for motions that moved the joysticks to the sides rather than front to back. Thus, the 'right' and 'left' motions for both hands posed a higher risk for CTS development. When the right hand moved into the 'right' position and the left hand moved into the 'left' position, the wrist went into extension in both cases. Results indicate that neither learning nor fatigue affected the results.

A new design concept for wrist arthroplasty.

PubMed

Shepherd, D E T; Johnstone, A

2005-01-01

The wrist joint is frequently affected by arthritis, which leads to pain, loss of function and ultimately deformity. Various designs of wrist arthroplasty have been introduced to attempt to relieve pain and provide a functional range of motion. The first generation of wrist implant was a one-piece silicone elastomer. Later generations have designs that have two parts that articulate against each other. However, wrist implants have not achieved the same clinical success to date, compared with hip and knee implants, and there is a high revision rate associated with them. This paper describes a new design concept for wrist arthroplasty, based around the idea of combining the principles of an articulating implant with that of a flexible elastomer implant. The design consists of assembling a radial, carpal/metacarpal, plate and flexible parts together. The radial and carpal/metacarpal parts are to be made from ultra high molecular weight polyethylene. The bearing surfaces of the radial and carpal/metacarpal parts articulate against the flat surfaces of the plate, made from cobalt chrome molybdenum alloy. The radius on the bearing surface of the radial part enables flexion/extension, while the radius on the carpal/metacarpal surface enables radial/ulnar deviation. The articulation of the carpal/metacarpal part against the plate also allows for rotation as well as flexion/extension. The flexible part, made from Elast-Eon, which is a silicone polyurethane elastomer, is inserted through the hole of the plate and into the holes of the radial and carpal/metacarpal parts.

Arthroscopic partial wrist fusion.

PubMed

Ho, Pak-Cheong

2008-12-01

The wide intraarticular exposure of the wrist joint under arthroscopic view provides an excellent ground for various forms of partial wrist fusion. Combining with percutaneous fixation technique, arthroscopic partial wrist fusion can potentially generate the best possible functional outcome by preserving the maximal motion pertained with each type of partial wrist fusion because the effect of extraarticular adhesion associated with open surgery can be minimized. From November 1997 to May 2008, the author had performed 12 cases of arthroscopic partial wrist fusion, including scaphotrapeziotrapezoid fusion in 3, scaphoidectomy and 4-corner fusion in 4, radioscapholunate fusion in 3, radiolunate fusion in 1, and lunotriquetral fusion in 1 case. Through the radiocarpal or midcarpal joint, the corresponding articular surfaces were denuded of cartilage using arthroscopic burr and curette. Carpal bones involved in the fusion process were then transfixed with K wires percutaneously after alignment corrected and confirmed under fluoroscopic control. Autogenous cancellous bone graft or bone substitute were inserted and impacted to the fusion site through cannula under direct arthroscopic view. Final fixation could be by multiple K wires or cannulated screw system. Early mobilization was encouraged. Surgical complications were minor, including pin tract infection, skin burn, and delay union in 1 case. Uneventful radiologic union was obtained in 9 cases, stable fibrous union in 2, and nonunion in 1. The average follow-up period was 70 months. Symptom was resolved or improved, and functional motion was gained in all cases. All surgical scars were almost invisible, and aesthetic outcome was excellent.

Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

PubMed

Loosemore, Michael; Lightfoot, Joseph; Gatt, Ian; Hayton, Mike; Beardsley, Chris

2017-03-01

Background: The purpose of this investigation was to explore prospectively the nature and duration of hand and wrist injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2012. Methods: Longitudinal prospective injury surveillance of the GB boxing squad was performed from 2005 to 2012. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 hours. Results: Finger carpometacarpal instability and finger metacarpophalangeal joint extensor hood and capsule sprain also known as "boxer's knuckle" injuries were significantly more common than other injury diagnoses. The number of injuries during training or competition was similar, which is remarkable given the far greater number of training hours than competition hours performed. Injury rate for hand and wrist injuries in competition was 347 injuries per 1000 hours, while the estimated injury rate in training was <0.5 injuries per 1000 hours. Conclusion: Carpometacarpal instability and boxer's knuckle were more common than any other kind of hand and wrist injury in this cohort of elite amateur boxers. The rate of hand and wrist injuries was higher in competition than in training. Our study highlights the importance of hand and wrist injury prevention in the competition environment.

Long-Term Clinical Outcome After Titanium Lunate Arthroplasty for Kienböck Disease.

PubMed

Viljakka, Timo; Tallroth, Kaj; Vastamäki, Martti

2018-04-09

Titanium lunate arthroplasty (TLA) for Kienböck disease was introduced in 1984 to address the silicone-wear particle problem common to silicone lunate implants. We sought to study the outcome of TLA. We identified 11 patients from our hospital database who had undergone TLA between 2001 and 2010. We evaluated pain, range of motion (ROM), function, and radiological outcome at a mean 11 years after surgery. We compared preoperative ROM and radiological findings with final follow-up in the ipsilateral wrist and also made comparisons with the contralateral wrists. No implants were removed, and no wrist joints were fused. Pain on the visual analog scale averaged 0.5 at rest, 0.3 at night, and 2.7 during heavy exertion. Seven patients had no pain at rest and 9 had no pain at night. Range of motion reached 70% of that of the contralateral wrist, and strength reached 81%. The Disabilities of the Arm, Shoulder, and Hand (DASH) score averaged 9.6, optional DASH 9.7, and Mayo wrist score 67.7. Radiologically, only Ståhl and arthrosis indexes differed significantly between affected and unaffected wrists. Two patients had a dorsally dislocated implant, meaning that around 20% of our cases probably meet the criteria for failure. The longer-term results of TLA for stage III Kienböck disease are promising. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The synergic effects of mirror therapy and neuromuscular electrical stimulation for hand function in stroke patients.

PubMed

Yun, Gi Jeong; Chun, Min Ho; Park, Ji Young; Kim, Bo Ryun

2011-06-01

To investigate the synergic effects of mirror therapy and neuromuscular electrical stimulation (NMES) for hand function in stroke patients. Sixty patients with hemiparesis after stroke were included (41 males and 19 females, average age 63.3 years). Twenty patients had NMES applied and simultaneously underwent mirror therapy. Twenty patients had NMES applied only, and twenty patients underwent mirror therapy only. Each treatment was done five days per week, 30 minutes per day, for three weeks. NMES was applied on the surface of the extensor digitorum communis and extensor pollicis brevis for open-hand motion. Muscle tone, Fugl-Meyer assessment, and power of wrist and hand were evaluated before and after treatment. There were significant improvements in the Fugl-Meyer assessment score in the wrist, hand and coordination, as well as power of wrist and hand in all groups after treatment. The mirror and NMES group showed significant improvements in the Fugl-Meyer scores of hand, wrist, coordination and power of hand extension compared to the other groups. However, the power of hand flexion, wrist flexion, and wrist extension showed no significant differences among the three groups. Muscle tone also showed no significant differences in the three groups. Our results showed that there is a synergic effect of mirror therapy and NMES on hand function. Therefore, a hand rehabilitation strategy combined with NMES and mirror therapy may be more helpful for improving hand function in stroke patients than NMES or mirror therapy only.

Altered Gravity Simulated by Parabolic Flight and Water Immersion Leads to Decreased Trunk Motion

PubMed Central

Tian, Yu; Li, Fan; Zhang, Shaoyao; Zhang, Lin; Guo, Yaoyu; Liu, Weibo; Wang, Chunhui; Chen, Shanguang; Guo, Jinhu

2015-01-01

Gravity is one of the important environmental factors that influence the physiologies and behaviors of animals and humans, and changes in gravity elicit a variety of physiological and behavioral alterations that include impaired movement coordination, vertigo, spatial disorientation, and perceptual illusions. To elucidate the effects of gravity on human physiology and behavior, we examined changes in wrist and trunk activities and heart rate during parabolic flight and the activity of wrist and trunk in water immersion experiments. Data from 195 person-time parabolas performed by eight subjects revealed that the trunk motion counts decreased by approximately half during ascending legs (hypergravity), relative to the data acquired before the parabolic flights. In contrast, the wrist activity remained unchanged. The results from the water immersion experiments demonstrated that in the underwater condition, both the wrist and trunk activities were significantly decreased but the latter decreased to a much lower level. Together, these data suggest that gravitational alterations can result in differential influences on the motions of the wrist and the trunk. These findings might be important for understanding the degeneration of skeleton and muscular system and performance of astronauts in microgravity. PMID:26208253

An fMRI compatible wrist robotic interface to study brain development in neonates.

PubMed

Allievi, A G; Melendez-Calderon, A; Arichi, T; Edwards, A D; Burdet, E

2013-06-01

A comprehensive understanding of the mechanisms that underlie brain development in premature infants and newborns is crucial for the identification of interventional therapies and rehabilitative strategies. fMRI has the potential to identify such mechanisms, but standard techniques used in adults cannot be implemented in infant studies in a straightforward manner. We have developed an MR safe wrist stimulating robot to systematically investigate the functional brain activity related to both spontaneous and induced wrist movements in premature babies using fMRI. We present the technical aspects of this development and the results of validation experiments. Using the device, the cortical activity associated with both active and passive finger movements were reliably identified in a healthy adult subject. In two preterm infants, passive wrist movements induced a well localized positive BOLD response in the contralateral somatosensory cortex. Furthermore, in a single preterm infant, spontaneous wrist movements were found to be associated with an adjacent cluster of activity, at the level of the infant's primary motor cortex. The described device will allow detailed and objective fMRI studies of somatosensory and motor system development during early human life and following neonatal brain injury.

Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?

PubMed

Grave, Keith; Townsend, Grant

2003-11-01

Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians. Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt. Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.

Man-equivalent telepresence through four fingered human-like hand system

NASA Technical Reports Server (NTRS)

Jau, Bruno M.

1992-01-01

The author describes a newly developed mechanical hand system. The robot hand is in human-like configuration with a thumb and three fingers, a palm, a wrist, and the forearm in which the hand and wrist actuators are located. Each finger and the wrist has its own active electromechanical compliance system, allowing the joint drive trains to be stiffened or loosened. This mechanism imitates the human muscle dual function of positioner and stiffness controller. This is essential for soft grappling operations. The hand-wrist assembly has 16 finger joints, three wrist joints, and five compliance mechanisms for a total of 24 degrees of freedom. The strength of the hand is roughly half that of the human hand and its size is comparable to a male hand. The hand is controlled through an exoskeleton glove controller that the operator wears. The glove provides the man-machine interface in telemanipulation control mode: it senses the operator's inputs to guide the mechanical hand in hybrid position and force control. The hand system is intended for dexterous manipulations in structured environments. Typical applications will include work in hostile environment such as space operations and nuclear power plants.

Portable and Reconfigurable Wrist Robot Improves Hand Function for Post-Stroke Subjects.

PubMed

Khor, Kang Xiang; Chin, Patrick Jun Hua; Yeong, Che Fai; Su, Eileen Lee Ming; Narayanan, Aqilah Leela T; Abdul Rahman, Hisyam; Khan, Qamer Iqbal

2017-10-01

Rehabilitation robots have become increasingly popular for stroke rehabilitation. However, the high cost of robots hampers their implementation on a large scale. This paper implements the concept of a modular and reconfigurable robot, reducing its cost and size by adopting different therapeutic end effectors for different training movements using a single robot. The challenge is to increase the robot's portability and identify appropriate kinds of modular tools and configurations. Because literature on the effectiveness of this kind of rehabilitation robot is still scarce, this paper presents the design of a portable and reconfigurable rehabilitation robot and describes its use with a group of post-stroke patients for wrist and forearm training. Seven stroke subjects received training using a reconfigurable robot for 30 sessions, lasting 30 min per session. Post-training, statistical analysis showed significant improvement of 3.29 points (16.20%, p = 0.027) on the Fugl-Meyer assessment scale for forearm and wrist components. Significant improvement of active range of motion was detected in both pronation-supination (75.59%, p = 0.018) and wrist flexion-extension (56.12%, p = 0.018) after the training. These preliminary results demonstrate that the developed reconfigurable robot could improve subjects' wrist and forearm movement.

Contact areas of the scaphoid and lunate with the distal radius in neutral and extension: correlation of falling strategies and distal radial anatomy.

PubMed

Chen, Y R; Wu, Y F; Tang, J B; Giddins, G

2014-05-01

The functional neutral of wrist movement is about 10° extension yet the distal radius has a volar tilt. This has not previously been explained. Assuming that the contact area between the carpus and the distal radius increased in wrist extension this would also help stabilize the carpus on the distal radius in positions where typically there is greater loading. To test this hypothesis we reconstructed three-dimensional structures of the carpal bones and distal radius using computed tomography scans of 13 normal wrists. The contact areas of the scaphoid with the distal radius were measured and were found progressively increased from flexion 20°, neutral, extension 20°, to extension 40°. The maximal increases in the contact area of the scaphoid and the distal radius was at full wrist extension. No significant changes in the contact areas of the lunate with the distal radius were found between the different positions. The contact characteristics provide greater stability to the carpus on the distal radius, and to help spread forces from impact to the wrist reducing the transmitted peak forces and thus the risk of distal radius and carpal injuries.

Supinator Extender (SUE): a pneumatically actuated robot for forearm/wrist rehabilitation after stroke.

PubMed

Allington, James; Spencer, Steven J; Klein, Julius; Buell, Meghan; Reinkensmeyer, David J; Bobrow, James

2011-01-01

The robot described in this paper, SUE (Supinator Extender), adds forearm/wrist rehabilitation functionality to the UCI BONES exoskeleton robot and to the ArmeoSpring rehabilitation device. SUE is a 2-DOF serial chain that can measure and assist forearm supination-pronation and wrist flexion-extension. The large power to weight ratio of pneumatic actuators allows SUE to achieve the forces needed for rehabilitation therapy while remaining lightweight enough to be carried by BONES and ArmeoSpring. Each degree of freedom has a range of 90 degrees, and a nominal torque of 2 ft-lbs. The cylinders are mounted away from the patient's body on the lateral aspect of the arm. This is to prevent the danger of a collision and maximize the workspace of the arm robot. The rotation axis used for supination-pronation is a small bearing just below the subject's wrist. The flexion-extension motion is actuated by a cantilevered pneumatic cylinder, which allows the palm of the hand to remain open. Data are presented that demonstrate the ability of SUE to measure and cancel forearm/wrist passive tone, thereby extending the active range of motion for people with stroke.

Muscle recruitment variations during wrist flexion exercise: MR evaluation

NASA Technical Reports Server (NTRS)

Fleckenstein, J. L.; Watumull, D.; Bertocci, L. A.; Nurenberg, P.; Peshock, R. M.; Payne, J. A.; Haller, R. G.; Blomqvist, C. G. (Principal Investigator)

1994-01-01

OBJECTIVE: Many exercise protocols used in physiological studies assume homogeneous and diffuse muscle recruitment. To test this assumption during a "standard" wrist flexion protocol, variations in muscle recruitment were assessed using MRI in eight healthy subjects. MATERIALS AND METHODS: Variations were assessed by comparing the right to the left forearms and the effect of slight (15 degrees) pronation or supination at the wrist. RESULTS: Postexercise imaging showed focal regions of increased signal intensity (SI), indicating relatively strong recruitment, most often in entire muscles, although occasionally only in subvolumes of muscles. In 15 of 26 studies, flexor carpi radialis (FCR) showed more SI than flexor carpi ulnaris, while in 11 studies SI in these muscles increased equivalently. Relatively greater FCR recruitment was seen during pronation and/or use of the nondominant side. Palmaris longus, a wrist flexor, did not appear recruited in 4 of 11 forearms in which it was present. A portion of the superficial finger flexor became hyperintense in 89% of studies, while recruitment of the deep finger flexor was seen only in 43%. CONCLUSION: Inter- and intraindividual variations in forearm muscle recruitment should be anticipated in physiological studies of standard wrist flexion exercise protocols.

Longitudinal, lateral and transverse axes of forearm muscles influence the crosstalk in the mechanomyographic signals during isometric wrist postures.

PubMed

Islam, Md Anamul; Sundaraj, Kenneth; Ahmad, R Badlishah; Sundaraj, Sebastian; Ahamed, Nizam Uddin; Ali, Md Asraf

2014-01-01

In mechanomyography (MMG), crosstalk refers to the contamination of the signal from the muscle of interest by the signal from another muscle or muscle group that is in close proximity. The aim of the present study was two-fold: i) to quantify the level of crosstalk in the mechanomyographic (MMG) signals from the longitudinal (Lo), lateral (La) and transverse (Tr) axes of the extensor digitorum (ED), extensor carpi ulnaris (ECU) and flexor carpi ulnaris (FCU) muscles during isometric wrist flexion (WF) and extension (WE), radial (RD) and ulnar (UD) deviations; and ii) to analyze whether the three-directional MMG signals influence the level of crosstalk between the muscle groups during these wrist postures. Twenty, healthy right-handed men (mean ± SD: age = 26.7±3.83 y; height = 174.47±6.3 cm; mass = 72.79±14.36 kg) participated in this study. During each wrist posture, the MMG signals propagated through the axes of the muscles were detected using three separate tri-axial accelerometers. The x-axis, y-axis, and z-axis of the sensor were placed in the Lo, La, and Tr directions with respect to muscle fibers. The peak cross-correlations were used to quantify the proportion of crosstalk between the different muscle groups. The average level of crosstalk in the MMG signals generated by the muscle groups ranged from: 34.28-69.69% for the Lo axis, 27.32-52.55% for the La axis and 11.38-25.55% for the Tr axis for all participants and their wrist postures. The Tr axes between the muscle groups showed significantly smaller crosstalk values for all wrist postures [F (2, 38) = 14-63, p<0.05, η2 = 0.416-0.769]. The results may be applied in the field of human movement research, especially for the examination of muscle mechanics during various types of the wrist postures.

At Home Photography-Based Method for Measuring Wrist Range of Motion.

PubMed

Trehan, Samir K; Rancy, Schneider K; Johnsen, Parker H; Hillstrom, Howard J; Lee, Steve K; Wolfe, Scott W

2017-11-01

Purpose  To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer. Methods  Sixty-nine postoperative patients were enrolled in this study at least 3 months postoperatively. Active and passive wrist flexion/extension and radial/ulnar deviation were recorded by one of the two attending surgeons with a 1-degree resolution goniometer at the last postoperative office visit. Patients were provided an illustrated instruction sheet detailing how to take digital photographic images at home in six wrist positions (active and passive flexion/extension, and radial/ulnar deviation). Wrist position was measured from digital images by both the attending surgeons in a randomized, blinded fashion on two separate occasions greater than 2 weeks apart using the same goniometer. Reliability analysis was performed using the intraclass correlation coefficient to assess agreement between clinical and photography-based goniometry, as well as intra- and interobserver agreement. Results  Out of 69 enrolled patients, 30 (43%) patients sent digital images. Of the 180 digital photographs, only 9 (5%) were missing or deemed inadequate for WROM measurements. Agreement between clinical and photography-based measurements was "almost perfect" for passive wrist flexion/extension and "substantial" for active wrist flexion/extension and radial/ulnar deviation. Inter- and intraobserver agreement for the attending surgeons was "almost perfect" for all measurements. Discussion  This study validates a photography-based goniometry protocol allowing accurate and reliable WROM measurements without direct physician contact. Passive WROM was more accurately measured from photographs than active WROM. This study builds on previous photography-based goniometry literature by validating a protocol in which patients or their families take and submit their own photographs. Clinical Relevance  Patient-performed photography-based goniometry represents an alternative to traditional clinical goniometry that could enable longer-term follow-up, overcome travel-related impediments to office visits, improve convenience, and reduce costs for patients.

Is the use of the cervical vertebrae maturation method justified to determine skeletal age? A comparison of radiation dose of two strategies for skeletal age estimation.

PubMed

Patcas, Raphael; Signorelli, Luca; Peltomäki, Timo; Schätzle, Marc

2013-10-01

The aim of this study was to assess effective doses of a lateral cephalogram radiograph with and without thyroid shield and compare the differences with the radiation dose of a hand-wrist radiograph. Thermoluminescent dosimeters were placed at 19 different sites in the head and neck of a tissue-equivalent human skull (RANDO phantom). Analogue lateral cephalograms with and without thyroid shield (67 kV, 250 mA, 10 mAs) and hand-wrist radiographs (40 kV, 250 mA, 10 mAs) were obtained. The effective doses were calculated using the 2007 International Commission on Radiological Protection recommendations. The effective dose for conventional lateral cephalogram without a thyroid shield was 5.03 microsieverts (µSv). By applying a thyroid shield to the RANDO phantom, a remarkable dose reduction of 1.73 µSv could be achieved. The effective dose of a conventional hand-wrist radiograph was calculated to be 0.16 µSv. Adding the effective dose of the hand-wrist radiograph to the effective dose of the lateral cephalogram with thyroid shield resulted in a cumulative effective dose of 3.46 µSv. Without thyroid shield, the effective dose of a lateral cephalogram was approximately 1.5-fold increased than the cumulative effective dose of a hand-wrist radiograph and a lateral cephalogram with thyroid shield. Thyroid is an organ that is very sensitive to radiation exposure. Its shielding will significantly reduce the effective dose. An additional hand-wrist radiograph, involving no vulnerable tissues, however, causes very little radiation risk. In accordance with the ALARA (As Low As Reasonably Achievable) principle, if an evaluation of skeletal age is indicated, an additional hand-wrist radiograph seems much more justifiable than removing the thyroid shield.

A frequency and pulse-width co-modulation strategy for transcutaneous neuromuscular electrical stimulation based on sEMG time-domain features

NASA Astrophysics Data System (ADS)

Zhou, Yu-Xuan; Wang, Hai-Peng; Bao, Xue-Liang; Lü, Xiao-Ying; Wang, Zhi-Gong

2016-02-01

Objective. Surface electromyography (sEMG) is often used as a control signal in neuromuscular electrical stimulation (NMES) systems to enhance the voluntary control and proprioceptive sensory feedback of paralyzed patients. Most sEMG-controlled NMES systems use the envelope of the sEMG signal to modulate the stimulation intensity (current amplitude or pulse width) with a constant frequency. The aims of this study were to develop a strategy that co-modulates frequency and pulse width based on features of the sEMG signal and to investigate the torque-reproduction performance and the level of fatigue resistance achieved with our strategy. Approach. We examined the relationships between wrist torque and two stimulation parameters (frequency and pulse width) and between wrist torque and two sEMG time-domain features (mean absolute value (MAV) and number of slope sign changes (NSS)) in eight healthy volunteers. By using wrist torque as an intermediate variable, customized and generalized transfer functions were constructed to convert the two features of the sEMG signal into the two stimulation parameters, thereby establishing a MAV/NSS dual-coding (MNDC) algorithm. Wrist torque reproduction performance was assessed by comparing the torque generated by the algorithms with that originally recorded during voluntary contractions. Muscle fatigue was assessed by measuring the decline percentage of the peak torque and by comparing the torque time integral of the response to test stimulation trains before and after fatigue sessions. Main Results. The MNDC approach could produce a wrist torque that closely matched the voluntary wrist torque. In addition, a smaller decay in the wrist torque was observed after the MNDC-coded fatigue stimulation was applied than after stimulation using pulse-width modulation alone. Significance. Compared with pulse-width modulation stimulation strategies that are based on sEMG detection, the MNDC strategy is more effective for both voluntary muscle force reproduction and muscle fatigue reduction.

A study on the measurement of wrist motion range using the iPhone 4 gyroscope application.

PubMed

Kim, Tae Seob; Park, David Dae Hwan; Lee, Young Bae; Han, Dong Gil; Shim, Jeong Su; Lee, Young Jig; Kim, Peter Chan Woo

2014-08-01

Measuring the range of motion (ROM) of the wrist is an important physical examination conducted in the Department of Hand Surgery for the purpose of evaluation, diagnosis, prognosis, and treatment of patients. The most common method for performing this task is by using a universal goniometer. This study was performed using 52 healthy participants to compare wrist ROM measurement using a universal goniometer and the iPhone 4 Gyroscope application. Participants did not have previous wrist illnesses and their measured values for wrist motion were compared in each direction. Normal values for wrist ROM are 73 degrees of flexion, 71 degrees of extension, 19 degrees of radial deviation, 33 degrees of ulnar deviation, 140 degrees of supination, and 60 degrees of pronation.The average measurement values obtained using the goniometer were 74.2 (5.1) degrees for flexion, 71.1 (4.9) degrees for extension, 19.7 (3.0) degrees for radial deviation, 34.0 (3.7) degrees for ulnar deviation, 140.8 (5.6) degrees for supination, and 61.1 (4.7) degrees for pronation. The average measurement values obtained using the iPhone 4 Gyroscope application were 73.7 (5.5) degrees for flexion, 70.8 (5.1) degrees for extension, 19.5 (3.0) degrees for radial deviation, 33.7 (3.9) degrees for ulnar deviation, 140.4 (5.7) degrees for supination, and 60.8 (4.9) degrees for pronation. The differences between the measurement values by the Gyroscope application and average value were 0.7 degrees for flexion, -0.2 degrees for extension, 0.5 degrees for radial deviation, 0.7 degrees for ulnar deviation, 0.4 degrees for supination, and 0.8 degrees for pronation. The differences in average value were not statistically significant. The authors introduced a new method of measuring the range of wrist motion using the iPhone 4 Gyroscope application that is simpler to use and can be performed by the patient outside a clinical setting.

Wrist arthroscopy

MedlinePlus

... you very sleepy during the operation. During the procedure, the surgeon does the following: Inserts the arthroscope into your wrist through a small incision. The scope is connected to a video monitor in the operating room. This allows the surgeon to view the ...

Identifying Wrist Fracture Patients with High Accuracy by Automatic Categorization of X-ray Reports

PubMed Central

de Bruijn, Berry; Cranney, Ann; O’Donnell, Siobhan; Martin, Joel D.; Forster, Alan J.

2006-01-01

The authors performed this study to determine the accuracy of several text classification methods to categorize wrist x-ray reports. We randomly sampled 751 textual wrist x-ray reports. Two expert reviewers rated the presence (n = 301) or absence (n = 450) of an acute fracture of wrist. We developed two information retrieval (IR) text classification methods and a machine learning method using a support vector machine (TC-1). In cross-validation on the derivation set (n = 493), TC-1 outperformed the two IR based methods and six benchmark classifiers, including Naive Bayes and a Neural Network. In the validation set (n = 258), TC-1 demonstrated consistent performance with 93.8% accuracy; 95.5% sensitivity; 92.9% specificity; and 87.5% positive predictive value. TC-1 was easy to implement and superior in performance to the other classification methods. PMID:16929046

STS-111 Flight Day 09 Highlights

NASA Technical Reports Server (NTRS)

2002-01-01

The STS-111 flight crew consists of Kenneth D. Cockrell, Commander, Paul S. Lockhart, Pilot, Franklin R. Chang-Diaz, Mission Specialist, Philippe Perrin, (CNES), Mission Specialist, Valery G. Korzun, (RSA), ISS Up, Peggy A. Whitson, ISS Up , Sergei Y. Treschev (RSC), ISS Up, Yuri I. Onufriyenko (RSA), ISS Down, Carl E. Walz, and Daniel W. Bursch (ISS) Down. The main goal on this ninth day of flight STS-111, is to replace the wrist roll joint of the Robotic Arm on the International Space Station. Live footage of the wrist roll joint replacement is presented. Paul Lockhart is the spacewalk coordinator for this mission. Franklin Chang-Diaz and Philippe Perrin, are responsible for replacing the wrist roll joint and performing maintenance activities. The spacewalk to repair this joint occurs outside the Space Station's Quest Airlock. The wrist roll joint was replaced successfully. The spacewalk took approximately 7 hours and 17 minutes to complete.

Light propagation along the pericardium meridian at human wrist as evidenced by the optical experiment and Monte Carlo method.

PubMed

Jiang, Yi-fan; Chen, Chang-shui; Liu, Xiao-mei; Liu, Rong-ting; Liu, Song-hao

2015-04-01

To explore the characteristics of light propagation along the Pericardium Meridian and its surrounding areas at human wrist by using optical experiment and Monte Carlo method. An experiment was carried out to obtain the distribution of diffuse light on Pericardium Meridian line and its surrounding areas at the wrist, and then a simplified model based on the anatomical structure was proposed to simulate the light transportation within the same area by using Monte Carlo method. The experimental results showed strong accordance with the Monte Carlo simulation that the light propagation along the Pericardium Meridian had an advantage over its surrounding areas at the wrist. The advantage of light transport along Pericardium Merdian line was related to components and structure of tissue, also the anatomical structure of the area that the Pericardium Meridian line runs.

Acellular dermal matrix as an adjunct in treatment of neuropathic pain at the wrist.

PubMed

Peterson, Steven L; Adham, Mehdi N

2006-08-01

Traumatic or surgical injury to superficial sensory nerves at the wrist can lead to significant morbidity. Multiple treatment modalities have been proposed, including the use of flap coverage to provide soft-tissue padding and decrease tactile irritation. In this report, acellular dermal matrix (AlloDerm) was used as an alternative to flap coverage, thereby avoiding the need for a donor site. Five patients with postsurgical and five patients with posttraumatic neuropathic pain at the wrist underwent neuroma excision and/or neurolysis followed by interposition of acellular dermal matrix allograft between skin and nerve. Patients were followed from 12 to 25 months and demonstrated substantial improvement in pain. Eight previously employed patients returned to their prior occupations. Dermal matrix allograft may provide cushioning and/or a gliding surface for the nerve and represents a simple alternative to flap coverage in the treatment of neuropathic pain at the wrist.

Ultrasonography of the hand, wrist, and elbow.

PubMed

Bodor, Marko; Fullerton, Brad

2010-08-01

High-frequency diagnostic ultrasonography of the hand, wrist and elbow has significant potential to improve the quality of diagnosis and care provided by neuromuscular and musculoskeletal specialists. In patients referred for weakness, pain and numbness of the hand, wrist or elbow, diagnostic ultrasonography can be an adjunct to electrodiagnosis and help in identifying ruptured tendons and treating conditions such as carpal tunnel syndrome or trigger finger. Use of a small high-frequency (>10-15 MHz) transducer, an instrument with a blunt pointed tip to enhance sonopalpation and a model of the hand, wrist and elbow is advised to enhance visualization of small anatomical structures and complex bony contours. A range of conditions, including tendon and ligament ruptures, trigger finger, de Quervain tenosynovitis, intersection syndrome, lateral epicondylitis, and osteoarthritis, is described along with detailed ultrasonography-guided injection techniques for carpal tunnel syndrome and trigger finger. Copyright 2010 Elsevier Inc. All rights reserved.

Clinical Assessment and Diagnostics of Patients With Hand Disorders: A Case Study Approach.

PubMed

Leow, Mabel Qi He; Lim, Rebecca Qian Ru; Tay, Shian Chao

Clinical assessment of the hand is important for diagnosing underlying hand disorders. Using a case study approach, the clinical assessment for three disorders of the hands is presented: trigger finger (stenosing tenosynovitis), carpal tunnel syndrome, and ulnar-sided wrist injury (styloid impingement). We assess the annular one pulley and finger range of motion for patients with trigger finger. To diagnose for carpal tunnel syndrome, assessment for Tinel's sign, Phalen's sign, abductor pollicis brevis muscle bulk, two-point discrimination, and obtaining a nerve conduction study are performed. Assessment for ulnar-sided wrist injury includes wrist range of motion, assessment of distal radial ulnar joint stability, provocation tests, grip strength, x-ray, and magnetic resonance imaging. This article begins with a description of the hand and wrist anatomy. For each case study, the clinical history is described, followed by a discussion of the pathophysiology, clinical assessments, and diagnostic tests.

Surface radiation dose comparison of a dedicated extremity cone beam computed tomography (CBCT) device and a multidetector computed tomography (MDCT) machine in pediatric ankle and wrist phantoms

PubMed Central

Nagy, Eszter; Apfaltrer, Georg; Riccabona, Michael; Singer, Georg; Stücklschweiger, Georg; Guss, Helmuth; Sorantin, Erich

2017-01-01

Objectives To evaluate and compare surface doses of a cone beam computed tomography (CBCT) and a multidetector computed tomography (MDCT) device in pediatric ankle and wrist phantoms. Methods Thermoluminescent dosimeters (TLD) were used to measure and compare surface doses between CBCT and MDCT in a left ankle and a right wrist pediatric phantom. In both modalities adapted pediatric dose protocols were utilized to achieve realistic imaging conditions. All measurements were repeated three times to prove test-retest reliability. Additionally, objective and subjective image quality parameters were assessed. Results Average surface doses were 3.8 ±2.1 mGy for the ankle, and 2.2 ±1.3 mGy for the wrist in CBCT. The corresponding surface doses in optimized MDCT were 4.5 ±1.3 mGy for the ankle, and 3.4 ±0.7 mGy for the wrist. Overall, mean surface dose was significantly lower in CBCT (3.0 ±1.9 mGy vs. 3.9 ±1.2 mGy, p<0.001). Subjectively rated general image quality was not significantly different between the study protocols (p = 0.421), whereas objectively measured image quality parameters were in favor of CBCT (p<0.001). Conclusions Adapted extremity CBCT imaging protocols have the potential to fall below optimized pediatric ankle and wrist MDCT doses at comparable image qualities. These possible dose savings warrant further development and research in pediatric extremity CBCT applications. PMID:28570626

Active commuting reduces the risk of wrist fractures in middle-aged women-the UFO study.

PubMed

Englund, U; Nordström, P; Nilsson, J; Hallmans, G; Svensson, O; Bergström, U; Pettersson-Kymmer, U

2013-02-01

Middle-aged women with active commuting had significantly lower risk for wrist fracture than women commuting by car/bus. Our purpose was to investigate whether a physically active lifestyle in middle-aged women was associated with a reduced risk of later sustaining a low-trauma wrist fracture. The Umeå Fracture and Osteoporosis (UFO) study is a population-based nested case-control study investigating associations between lifestyle and fragility fractures. From a cohort of ~35,000 subjects, we identified 376 female wrist fracture cases who had reported data regarding their commuting habits, occupational, and leisure physical activity, before they sustained their fracture. Each fracture case was compared with at least one control drawn from the same cohort and matched for age and week of reporting data, yielding a total of 778 subjects. Mean age at baseline was 54.3 ± 5.8 years, and mean age at fracture was 60.3 ± 5.8 years. Conditional logistic regression analysis with adjustments for height, body mass index, smoking, and menopausal status showed that subjects with active commuting (especially walking) were at significantly lower risk of sustaining a wrist fracture (OR 0.48; 95 % CI 0.27-0.88) compared with those who commuted by car or bus. Leisure time activities such as dancing and snow shoveling were also associated with a lower fracture risk, whereas occupational activity, training, and leisure walking or cycling were unrelated to fracture risk. This study suggests that active commuting is associated with a lower wrist fracture risk, in middle-aged women.

Characteristics of upper extremity's muscle strength in Turkish national wheelchair basketball players team.

PubMed

Akınoğlu, Bihter; Kocahan, Tuğba

2017-02-01

The objective of this study was to reveal characteristics of muscle strength of upper extremities of wheelchair (WC) basketball players and to ensure more-specific training program preparation. Isokinetic muscle strength of 12 WC basketball players were assessed by ISOMED 2000 device. The assessment protocol was evaluated at 60°/sec velocity with 5 times repeated force and at 240°/sec with 15 times repeated force. This protocol was carried out individually for shoulder flexion-extension and wrist flexion-extension movements at the right and left extremities. The flexion/extension ratio was determined to be outside of the ratios accepted as normal for primarily shoulder joint and for wrist joint. The extension movement was stronger than flexion movement in the shoulders at both velocities and the flexion movement was stronger than ex-tension movement in the wrist. The repeat times where the peak torque occurred were 2-3 repeats at 60°/sec velocity during flexion and extension movements for the wrist and shoulders, and the peak torque occurred at an average of 5-6 repeats in the shoulders at 240°/sec velocity and it occurred at 3-4 repeats in the wrist. The angles where the peak torque of the shoulder flexion and extension occurred varied between 80°-115° at both velocities, and it varied between 5°-30° angles for the wrist. As this study revealed, determination of muscle strength characteristics of WC athletes and especially using objective isokinetic devices will guide the planning of the appropriate training and exercise programs and preventing sports injuries in long term.

A comparison of hand-wrist bone and cervical vertebral analyses in measuring skeletal maturation.

PubMed

Gandini, Paola; Mancini, Marta; Andreani, Federico

2006-11-01

To compare skeletal maturation as measured by hand-wrist bone analysis and by cervical vertebral analysis. A radiographic hand-wrist bone analysis and cephalometric cervical vertebral analysis of 30 patients (14 males and 16 females; 7-18 years of age) were examined. The hand-wrist bone analysis was evaluated by the Bjork index, whereas the cervical vertebral analysis was assessed by the cervical vertebral maturation stage (CVMS) method. To define vertebral stages, the analysis consisted of both cephalometric (13 points) and morphologic evaluation of three cervical vertebrae (concavity of second, third, and fourth vertebrae and shape of third and fourth vertebrae). These measurements were then compared with the hand-wrist bone analysis, and the results were statistically analyzed by the Cohen kappa concordance index. The same procedure was repeated after 6 months and showed identical results. The Cohen kappa index obtained (mean +/- SD) was 0.783 +/- 0.098, which is in the significant range. The results show a concordance of 83.3%, considering that the estimated percentage for each case is 23.3%. The results also show a correlation of CVMS I with Bjork stages 1-3 (interval A), CVMS II with Bjork stage 4 (interval B), CVMS III with Bjork stage 5 (interval C), CVMS IV with Bjork stages 6 and 7 (interval D), and CVMS V with Bjork stages 8 and 9 (interval E). Vertebral analysis on a lateral cephalogram is as valid as the hand-wrist bone analysis with the advantage of reducing the radiation exposure of growing subjects.

Management of an unusual extreme extension contracture of the wrist: role of a custom-designed exercise program in achieving a good range of movement and prevention of recontraction.

PubMed

Saraiya, Hemant

2003-01-01

An extreme extension contracture of wrist with dorsal contracture of fingers 15 years after burn injury is described. Shortening of extensor tendons, secondary lengthening of flexor tendons, contracted wrist joint capsule, unusual dislocation of carpals, dorsal dislocation of metacarpophalangeal joints of fingers, and provision of sufficient amount of good-quality skin were some of the issues that had to be addressed in treatment. The contracture was released, the carpals and metacarpophalangeal joint dislocations were corrected and fixed with K wires, and the resulting defect was covered with a sheet split-thickness skin graft. An exercise program was designed that consisted of isotonic, isokinetic, and isometric resistance exercises and passive, active, and active-assistive range of motion exercises. These exercises were pursued with the intention of increasing dynamic strength, endurance, and overall functional recovery of the flexor muscles by exploiting the immature nature of early scar tissue. The resultant enhanced flexor muscle power from exercises along with the dynamic splint helped in lengthening of extensor tendons, wrist joint capsule, and split-thickness skin graft. It also helped in resisting the recontracting tendency, with further recovery of good range of wrist and fingers movements, obviating the need of tendon-lengthening surgery and flap coverage. One and half years of follow up didn't show any sign of recontracture, and the patient was able to perform his routine activities. Postburn wrist contractures of such magnitude have been seldom described. Emphasis is put on simple contracture release and a postoperative exercise program.

Four-corner arthrodesis with a radiolucent locking dorsal circular plate: technique and outcomes.

PubMed

Rudnick, Benjamin; Goljan, Peter; Pruzansky, Jason S; Bachoura, Abdo; Jacoby, Sidney M; Rekant, Mark S

2014-09-01

Scaphoid excision and four-corner arthrodesis (FCA) is an acceptable motion sparing procedure used to treat wrist arthritis. Recently, a locking dorsal circular plate composed of polyether-ether-ketone has been introduced (Xpode®; TriMed Inc.). The purpose of this study is to assess the efficacy of this specific plate design with regard to FCA. A retrospective chart review of all patients who underwent FCA with an Xpode® between January 1, 2008 and December 31, 2012 was conducted. Patients were contacted and asked to return to clinic for clinical and radiographic follow-up. Patient demographics, range of motion, grip strength, and complications were collected from medical records. Patients completed a patient-rated wrist evaluation (PRWE). A paired t test was used to compare means, and p values <0.05 were considered statistically significant. Twenty-six procedures (24 patients) were identified. One patient required full wrist fusion following the initial procedure. Of the 25 remaining wrists, arthrodesis was successfully achieved in 20 (80 %). Eleven patients (13 wrists, 52 %) returned to clinic for an average follow-up of 28 months. Mean wrist extension improved from 30 to 47°, and flexion decreased from 33 to 23°. Average grip strength was 77 % of the uninjured side. The mean PRWE scores for pain and function were 19.7 and 17.1, respectively. Five patients underwent additional operations (two hardware removals, two contracture releases, and one distal radial ulnar joint arthroplasty). FCA with the Xpode® yielded reasonable results for pain and function and demonstrated a fusion rate of 80 %.

Digital radiographic evaluation of hand-wrist bone maturation and prediction of age in South Indian adolescents.

PubMed

Mohammed, Rezwana Begum; Reddy, M Asha Lata; Jain, Megha; Singh, Johar Rajvinder; Sanghvi, Praveen; Thetay, Anshuj Ajay Rao

2014-09-01

In the growing years, indicators of the level of maturational development of the individual provide the best means for evaluating biologic age and the associated timing of skeletal growth. The relative stage of maturity of a child may be determined by comparing the child's hand-wrist radiograph to the known standards of skeletal development. In this study, we assessed various levels of skeletal maturation and also identified the relationship between chronological age (CA) and maturation stage using the hand-wrist radiographs in adolescents of Indian origin. Three hundred and thirty hand-wrist digital radiographs of individuals aged 8 to 18 years were evaluated for skeletal maturity levels using Fishman's method. The data was analysed using the SPSS software package (version 12, SPSS Inc., Chicago, IL, USA). Regression analysis was performed for calculating bone age of both males and females. Spearman's rank-order correlation coefficients were estimated separately for males and females to assess the relation between CA and maturation level. An association between skeletal maturation indicator stages and CA (r = 0.82) was significant. Interestingly, female subjects were observed to be advanced in skeletal maturity compared to males. Regression equations were derived to calculate bone age in males, females and the whole sample. The results of this study showed significant association between hand-wrist skeletal maturation levels and CA. Digital radiographic assessment of hand-wrist skeletal maturation can be used as a better choice for predicting average bone age of an individual because of its simplicity, reliability and lesser radiation exposure.

An Activity Recognition Framework Deploying the Random Forest Classifier and A Single Optical Heart Rate Monitoring and Triaxial AccelerometerWrist-Band.

PubMed

Mehrang, Saeed; Pietilä, Julia; Korhonen, Ilkka

2018-02-22

Wrist-worn sensors have better compliance for activity monitoring compared to hip, waist, ankle or chest positions. However, wrist-worn activity monitoring is challenging due to the wide degree of freedom for the hand movements, as well as similarity of hand movements in different activities such as varying intensities of cycling. To strengthen the ability of wrist-worn sensors in detecting human activities more accurately, motion signals can be complemented by physiological signals such as optical heart rate (HR) based on photoplethysmography. In this paper, an activity monitoring framework using an optical HR sensor and a triaxial wrist-worn accelerometer is presented. We investigated a range of daily life activities including sitting, standing, household activities and stationary cycling with two intensities. A random forest (RF) classifier was exploited to detect these activities based on the wrist motions and optical HR. The highest overall accuracy of 89.6 ± 3.9% was achieved with a forest of a size of 64 trees and 13-s signal segments with 90% overlap. Removing the HR-derived features decreased the classification accuracy of high-intensity cycling by almost 7%, but did not affect the classification accuracies of other activities. A feature reduction utilizing the feature importance scores of RF was also carried out and resulted in a shrunken feature set of only 21 features. The overall accuracy of the classification utilizing the shrunken feature set was 89.4 ± 4.2%, which is almost equivalent to the above-mentioned peak overall accuracy.

Smaller external notebook mice have different effects on posture and muscle activity.

PubMed

Oude Hengel, Karen M; Houwink, Annemieke; Odell, Dan; van Dieën, Jaap H; Dennerlein, Jack T

2008-07-01

Extensive computer mouse use is an identified risk factor for computer work-related musculoskeletal disorders; however, notebook computer mouse designs of varying sizes have not been formally evaluated but may affect biomechanical risk factors. Thirty adults performed a set of mouse tasks with five notebook mice, ranging in length from 75 to 105 mm and in width from 35 to 65 mm, and a reference desktop mouse. An electro-magnetic motion analysis system measured index finger (metacarpophalangeal joint), wrist and forearm postures, and surface electromyography measured muscle activity of three extensor muscles in the forearm and the first dorsal interosseus. The smallest notebook mice were found to promote less neutral postures (up to 3.2 degrees higher metacarpophalangeal joint adduction; 6.5 degrees higher metacarpophalangeal joint flexion, 2.3 degrees higher wrist extension) and higher muscle activity (up to 4.1% of maximum voluntary contraction higher wrist extensor muscle activity). Participants with smaller hands had overall more non-neutral postures than participants with larger hands (up to 5.6 degrees higher wrist extension and 5.9 degrees higher pronation); while participants with larger hands were more influenced by the smallest notebook mice (up to 3.6 degrees higher wrist extension and 5.5% of maximum voluntary contraction higher wrist extensor values). Self-reported ratings showed that while participants preferred smaller mice for portability; larger mice scored higher on comfort and usability. The smallest notebook mice increased the intensity of biomechanical exposures. Longer term mouse use could enhance these differences, having a potential impact on the prevention of work-related musculoskeletal disorders.

A wrist-walker exhibiting no "Uner Tan Syndrome": a theory for possible mechanisms of human devolution toward the atavistic walking patterns.

PubMed

Tan, Uner

2007-01-01

After discovering two families with handicapped children exhibiting the "Uner Tan syndrome," the author discovered a man exhibiting only wrist-walking with no primitive mental abilities including language. According to his mother, he had an infectious disease with high fever as a three months old baby; as a result, the left leg had been paralyzed after a penicilline injection. This paralysis most probably resulted from a viral disease, possibly poliomyelitis. He is now (2006) 36 years old; the left leg is flaccid and atrophic, with no tendon reflexes; however, sensation is normal. The boy never stood up on his feet while maturing. The father forced him to walk upright using physical devices and making due exercises, but the child always rejected standing upright and walking in erect posture; he always preferred wrist-walking; he expresses that wrist-walking is much more comfortable for him than upright-walking. He is very strong now, making daily body building exercises, and walking quite fast using a "three legs," although he cannot stand upright. Mental status, including the language and conscious experience, is quite normal. There was no intra-familiar marriage as in the two families mentioned earlier, and there is no wrist-walking in his family and relatives. There were no cerebellar signs and symptoms upon neurological examination. The brain-MRI was normal; there was no atrophy in cerebellum and vermis. It was concluded that there may be sporadic wrist-walkers exhibiting no "Uner Tan Syndrome." The results suggest that the cerebellum has nothing to do with human wrist-walking, which may rather be an atavistic trait appearing from time to time in normal individuals, indicating a live model for human reverse evolution. It was concluded that pure quadrupeds may sporadically appear due to random fluctuations in genotypes and/or environmental factors (hormonal or nutritional); the human development following the human evolution may be stopped in the stage of transition from quadrupedality to bipedality. That is, the activity of the philogenetically youngest supraspinal centers for bipedal walking responsible for suppression of the older supraspinal centers for quadrupedal gait may be interrupted at the atavistic level due to genetic and/or environmental factors. Consequently, it is assumed that these individuals prefer their natural wrist-walking to move around more quickly and efficiently.

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... polyethylene intended to be implanted into the intramedullary canal of the bone and held in place by a suture. Its purpose is to cover the resected end of the distal ulna to control bone overgrowth and to provide...

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... polyethylene intended to be implanted into the intramedullary canal of the bone and held in place by a suture. Its purpose is to cover the resected end of the distal ulna to control bone overgrowth and to provide...

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... polyethylene intended to be implanted into the intramedullary canal of the bone and held in place by a suture. Its purpose is to cover the resected end of the distal ulna to control bone overgrowth and to provide...

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... polyethylene intended to be implanted into the intramedullary canal of the bone and held in place by a suture. Its purpose is to cover the resected end of the distal ulna to control bone overgrowth and to provide...

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... polyethylene intended to be implanted into the intramedullary canal of the bone and held in place by a suture. Its purpose is to cover the resected end of the distal ulna to control bone overgrowth and to provide...

Asymptomatic non-union of capitate 14 years postfracture

PubMed Central

Hamed, Yosef; Ashwood, Neil; Fogg, Quentin; Galanopoulos, Ilias

2013-01-01

We report the unusual complication of non-union 14 years following a capitate fracture in a right-hand dominant man. Our patient fell and sustained an injury to his left wrist 14 years ago. At that time he had a swollen painful left wrist. His symptoms subsequently settled and he went back to his normal activities. He lost some power for bench-pressing and had slightly restricted range of motion but remained essentially pain-free. He presented 14 years later with another wrist injury when the original non-union was revealed. PMID:23761606

Optic fiber pulse-diagnosis sensor of traditional Chinese medicine

NASA Astrophysics Data System (ADS)

Ni, J. S.; Jin, W.; Zhao, B. N.; Zhang, X. L.; Wang, C.; Li, S. J.; Zhang, F. X.; Peng, G. D.

2013-09-01

The wrist-pulse is a kind of signals, from which a lot of physiological and pathological status of patients are deduced according to traditional Chinese medicine theories. This paper designs a new optic fiber wrist-pulse sensor that based on a group of FBGs. Sensitivity of the optic fiber wrist-pulse measurement system reaches 0.05% FS and the range reaches 50kPa. Frequency response is from 0 Hz to 5 kHz. A group of typical pulse signal is given out in the paper to compare different status of patient. It will improve quantification of pulse diagnosis greatly.

Hand and Wrist Injuries in Boxing and the Martial Arts.

PubMed

Drury, Benjamin Todd; Lehman, Thomas P; Rayan, Ghazi

2017-02-01

Hand and wrist injuries in martial arts are typically a reflection of the combat nature of this discipline. In striking sports, the axial load mechanism of injury is common and causes fractures and dislocations; in grappling sports, sprain injuries and degenerative changes predominate. There is clear evidence to support that hand protection reduces the risk of hand injury. Traditional training in martial arts on proper technique and target selection in striking sports reduces the risk of hand injury, and is an important component of hand and wrist injury prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

The evidential value of developmental age imaging for assessing age of majority

PubMed Central

Cole, T. J.

2015-01-01

Abstract Aim: To consider the evidential value of developmental age images for identifying age of majority. Methods: The published literature on hand–wrist X-rays, MRI scans of the distal radius and orthopantomograms of the lower left third molar is considered in terms of the mean age of attainment of the adult appearance and the diagnostic test performance of the adult appearance to predict adult status, either administratively (under-17 football) or forensically. Results: The mean age of attainment of a mature hand-wrist X-ray is under 18 years and most individuals are mature before age 18. For the MRI wrist scan and the third molar the age of attainment is over 19 years and the adult appearance is an indicator of adulthood, while the immature appearance is uninformative about likely age. So MRI and third molars have high specificity, but low sensitivity. Conclusions: Bone age assessed by hand–wrist X-ray is uninformative and should not be used. The adult appearance of MRI wrist scans and third molars provide evidence of being over-age, although there remains a small risk of minors being misclassified as adult. The immature appearance is uninformative about likely age and, overall, more than one third of assessments are wrong. PMID:26133364

Persistent ulnar-sided wrist pain after treatment of triquetral dorsal chip fracture: six cases related to triangular fibrocartilage complex injury.

PubMed

Lee, Seoung-joon; Rathod, Chasanal Mohan; Park, Kwang-Won; Hwang, Jin-Ho

2012-05-01

Persistent ulnar-sided wrist pain after treatment of triquetral dorsal chip fracture even after union is a matter of concern. There could be various reasons for this persistent pain like arthritis, instability, fractures and non-union. We correlate our findings of physical examination and wrist arthroscopy as triangular fibrocartilage complex injury to be one of the causes of this persistent pain. Six subjects who had persistent ulnocarpal joint pain and tenderness after triquetral dorsal chip fracture, despite 2 months of conservative treatment, were subjected to physical tests. If the physical examination yields positive results, then magnetic resonance imaging followed by arthroscopic treatment was performed. The six patients were then evaluated using the visual analogue scale, the Mayo modified wrist score, and the grip strength test. Triangular fibrocartilage complex (TFCC) injury was observed in all six cases and partial TFCC resection and synovectomy were performed. Analysis of the visual analogue scale, Mayo modified wrist score, and grip strength test data revealed statistically significant improvements (P < 0.05). In addition to several causes reported in the published literature, TFCC injury can be a cause of persistent ulnar pain after treatment of triquetral dorsal chip fracture. Arthroscopic partial TFCC resection can be considered to be a suitable treatment for such cases.

Comparative evaluation between cervical vertebral morphology and hand-wrist morphology for skeletal maturation assessment.

PubMed

Grippaudo, C; Garcovich, D; Volpe, G; Lajolo, C

2006-05-01

The aim of the study was to find a correlation between the evaluation of skeletal maturation performed by the study of cervical vertebrae maturation indicators and the evaluation obtained by the hand and wrist maturation indicators. Left hand wrist radiographs and the corresponding lateral cephalograms of 90 patients (48 males and 42 females; aged 6 to 14 years) were paired and a study group of 128 pair of radiographs was obtained, having some patients 2 or more radiographs at different times. Hand and wrist radiographs were evaluated according to the protocol proposed by Grave (scores 0 to 9); corresponding lateral cephalograms were evaluated according to the method reported by Baccetti (scores 1 to 5). Values obtained with the 2 methods were analyzed by Spearman's correlation test. When the values were compared globally in the 2 genders a good correlation was obtained (r=0.795; P<0.001); when the correlation was compared separately in the 2 genders a better correlation was observed in females (r=0.84; P<0.001) than in males (r=0.70; P<0.001). The results obtained clearly underline the accuracy of the skeletal maturation evaluation by the analysis of cervical vertebrae in laterolateral cephalograms which can substitute the hand and wrist radiograph for the skeletal maturation evaluation in orthodontic diagnosis.

An Analysis of Intrinsic and Extrinsic Hand Muscle EMG for Improved Pattern Recognition Control.

PubMed

Adewuyi, Adenike A; Hargrove, Levi J; Kuiken, Todd A

2016-04-01

Pattern recognition control combined with surface electromyography (EMG) from the extrinsic hand muscles has shown great promise for control of multiple prosthetic functions for transradial amputees. There is, however, a need to adapt this control method when implemented for partial-hand amputees, who possess both a functional wrist and information-rich residual intrinsic hand muscles. We demonstrate that combining EMG data from both intrinsic and extrinsic hand muscles to classify hand grasps and finger motions allows up to 19 classes of hand grasps and individual finger motions to be decoded, with an accuracy of 96% for non-amputees and 85% for partial-hand amputees. We evaluated real-time pattern recognition control of three hand motions in seven different wrist positions. We found that a system trained with both intrinsic and extrinsic muscle EMG data, collected while statically and dynamically varying wrist position increased completion rates from 73% to 96% for partial-hand amputees and from 88% to 100% for non-amputees when compared to a system trained with only extrinsic muscle EMG data collected in a neutral wrist position. Our study shows that incorporating intrinsic muscle EMG data and wrist motion can significantly improve the robustness of pattern recognition control for application to partial-hand prosthetic control.

An Analysis of Intrinsic and Extrinsic Hand Muscle EMG for Improved Pattern Recognition Control

PubMed Central

Adewuyi, Adenike A.; Hargrove, Levi J.; Kuiken, Todd A.

2015-01-01

Pattern recognition control combined with surface electromyography (EMG) from the extrinsic hand muscles has shown great promise for control of multiple prosthetic functions for transradial amputees. There is, however, a need to adapt this control method when implemented for partial-hand amputees, who possess both a functional wrist and information-rich residual intrinsic hand muscles. We demonstrate that combining EMG data from both intrinsic and extrinsic hand muscles to classify hand grasps and finger motions allows up to 19 classes of hand grasps and individual finger motions to be decoded, with an accuracy of 96% for non-amputees and 85% for partial-hand amputees. We evaluated real-time pattern recognition control of three hand motions in seven different wrist positions. We found that a system trained with both intrinsic and extrinsic muscle EMG data, collected while statically and dynamically varying wrist position increased completion rates from 73% to 96% for partial-hand amputees and from 88% to 100% for non-amputees when compared to a system trained with only extrinsic muscle EMG data collected in a neutral wrist position. Our study shows that incorporating intrinsic muscle EMG data and wrist motion can significantly improve the robustness of pattern recognition control for partial-hand applications. PMID:25955989

Dissociation between behavior and motor cortical excitability before and during ballistic wrist flexion and extension in young and old adults.

PubMed

Hortobágyi, Tibor; Mieras, Adinda; Rothwell, John; Del Olmo, Miguel Fernandez

2017-01-01

Aging is associated with slow reactive movement generation and poor termination. We examined the hypothesis that the build-up of excitability in the primary motor cortex in the agonist muscle to generate ballistic wrist flexion and extension and in the antagonist to stop the movement, is lower and slower in old compared with young adults. We measured the size of the motor potentials evoked (MEP) produced by transcranial magnetic stimulation (TMS), background integrated EMG (iEMG), and the MEP:iEMG ratio in healthy young (23 y, n = 14) and old adults' (73 y, n = 14) wrist flexors and extensors as they rapidly flexed or extended the wrist in response to an auditory cue. TMS was delivered at 80% of resting motor threshold randomly in 20 ms increments between 130 and 430 ms after the tone. Even though old compared to young adults executed the two wrist movements with ~23% longer movement duration and ~15% longer reaction time (both p < 0.05), the rise in MEP:iEMG ratio before the main similar in the two age groups. These data suggest that an adjustment of current models might be needed to better understand how and if age affects the build-up excitability accompanying movement generation and termination.

Measuring agreement between cervical vertebrae and hand-wrist maturation in determining skeletal age: reassessing the theory in patients with short stature.

PubMed

Danaei, Shahla Momeni; Karamifar, Amirali; Sardarian, Ahmadreza; Shahidi, Shoaleh; Karamifar, Hamdollah; Alipour, Abbas; Ghodsi Boushehri, Sahar

2014-09-01

The objective of this study was to determine the degree of agreement between hand-wrist radiography and cervical vertebral maturation analysis in patients diagnosed with short stature. A cross-sectional study was designed; 178 patients (90 girls, 88 boys) diagnosed with short stature and seeking treatment were selected. The patients were divided into 2 groups (76 with familial short stature, 102 with nonfamilial short stature). Hand-wrist and lateral cephalometric radiographs were obtained from the patients. The hand-wrist radiographs were analyzed using the Fishman method, and the lateral cephalometric views were categorized according to the method of Hassel and Farman. The degree of agreement between the 2 methods of predicting skeletal maturation was measured by calculating the contingency coefficient and the weighted kappa statistic. A high degree of agreement was observed between the 2 methods of analyzing skeletal maturation. It was also observed that agreement was higher in girls in the familial short-stature group, whereas boys had higher agreement in the nonfamilial short-stature group. Cervical vertebral maturation can be a valuable substitute for hand-wrist radiography in patients with short stature. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Lateral comparisons using Fishman's skeletal maturation assessment.

PubMed

Safer, Abraham N; Homel, Peter; Chung, David D

2015-05-01

To assess lateral differences between ossification events and stages of bone development in the hands and wrists utilizing Fishman's skeletal maturation indicators (SMIs). The skeletal ages of 125 subjects, aged 8 to 20 years, were determined with left and right hand-wrist radiographs using Fishman's SMI assessment. Each subject was also given the Edinburgh Handedness Questionnaire to assess handedness. The skeletal ages of both hand-wrist radiographs were analyzed against each other, handedness, chronologic age, and gender. There were no significant differences overall in right and left SMI scores (P  =  .70); 79% of all patients showed no difference in right and left SMI scores, regardless of handedness, gender, or age. However, when patients were categorized based on clinical levels of SMI score for the right hand-wrist, there was a significant difference (P  =  .01) between the SMI 1-3 group and the SMI 11 group. Subjects in the SMI 1-3 group were more likely to show a left > right SMI score, while subjects in the SMI 11 group were likely to show a right > left SMI score. Although no significant overall lateral differences in SMI scores were noted, it may be advisable to obtain a left hand-wrist radiograph and/or additional diagnostic information to estimate completion of growth in young surgical patients.

Streamlining emergent hand and wrist radiography with a modified four-view protocol.

PubMed

Chou, Henry Y; Steenburg, Scott D; Dunkle, Jeffrey W; Gussick, Sean D; Petersen, Matthew J; Kohli, Marc D; Shen, Changyu; Lin, Hongbo

2016-08-01

This study aims to determine whether a modified four-view hand and wrist study performs comparably to the traditional seven views in the evaluation of acute hand and wrist fractures. This retrospective study was approved by the institutional review board with waiver of informed consent. Two hundred forty patients (50 % male; ages 18-92 years) with unilateral three-view hand (posteroanterior, oblique, and lateral) and four-view wrist (posteroanterior, oblique, lateral, and ulnar deviation) radiographs obtained concurrently following trauma were included in this study. Four emergency radiologists interpreted the original seven images, with two radiologists independently evaluating each study. The patients' radiographs were then recombined into four-view series using the three hand images and the ulnar deviated wrist image. These were interpreted by the same radiologists following an 8-week delay. Kappa statistics were generated to measure inter-observer and inter-method agreement. Generalized linear mixed model analysis was performed between the seven- and four-view methods. Of the 480 reports generated in each of the seven- and four-view image sets, 142 (29.6 %) of the seven-view and 126 (26.2 %) of the four-view reports conveyed certain or suspected acute osseous findings. Average inter-observer kappa coefficients were 0.7845 and 0.8261 for the seven- and four-view protocols, respectively. The average inter-method kappa was 0.823. The odds ratio of diagnosing injury using the four-view compared to the seven-view algorithm was 0.69 (CI 0.45-1.06, P = 0.0873). The modified four-view hand and wrist radiographic series produces diagnostic results comparable to the traditional seven views for acute fracture evaluation.

The impact of accelerometer wear location on the relationship between step counts and arterial stiffness in adults treated for hypertension and diabetes.

PubMed

Cooke, Alexandra B; Daskalopoulou, Stella S; Dasgupta, Kaberi

2018-04-01

Accelerometer placement at the wrist is convenient and increasingly adopted despite less accurate physical activity (PA) measurement than with waist placement. Capitalizing on a study that started with wrist placement and shifted to waist placement, we compared associations between PA measures derived from different accelerometer locations with a responsive arterial health indicator, carotid-femoral pulse wave velocity (cfPWV). Cross-sectional study. We previously demonstrated an inverse association between waist-worn pedometer-assessed step counts (Yamax SW-200, 7 days) and cfPWV (-0.20m/s, 95% CI -0.28, -0.12 per 1000 step/day increment) in 366 adults. Participants concurrently wore accelerometers (ActiGraph GT3X+), most at the waist but the first 46 at the wrist. We matched this subgroup with participants from the 'waist accelerometer' group (sex, age, and pedometer-assessed steps/day) and assessed associations with cfPWV (applanation tonometry, Sphygmocor) separately in each subgroup through linear regression models. Compared to the waist group, wrist group participants had higher step counts (mean difference 3980 steps/day; 95% CI 2517, 5443), energy expenditure (967kcal/day, 95% CI 755, 1179), and moderate-to-vigorous-PA (138min; 95% CI 114, 162). Accelerometer-assessed step counts (waist) suggested an association with cfPWV (-0.28m/s, 95% CI -0.58, 0.01); but no relationship was apparent with wrist-assessed steps (0.02m/s, 95% CI -0.24, 0.27). Waist but not wrist ActiGraph PA measures signal associations between PA and cfPWV. We urge researchers to consider the importance of wear location choice on relationships with health indicators. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Association between individual DASH tasks and restricted wrist flexion and extension after volar plate fixation of a fracture of the distal radius.

PubMed

Bot, Arjan G J; Souer, J Sebastiaan; van Dijk, C Niek; Ring, David

2012-12-01

Symptoms and psychosocial factors are suggested to account for more of the variation in disability than physical impairment, but perhaps less so at the level of specific tasks. This study assessed the influence of impaired wrist motion on specific tasks on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Sixty-three patients with an operatively treated fracture of the distal radius completed the Pain Catastrophizing Scale (PCS), Pain Anxiety Symptoms Scale, and Center for Epidemiologic Studies Depression Scale (CES-D) just before surgery and the DASH questionnaire 3 months after surgery. Nine questions on the DASH were selected as potentially sensitive to changes in wrist motion and evaluated in bivariate and multivariable analyses. In multivariable models of factors associated with specific tasks, only "Open a tight or new jar" was affected by wrist flexion and PCS accounting for 33 % of the variation. Motion, pain, and PCS were significant predictors of the DASH score. Among the eight tasks not related to wrist motion, 33 % of the variation in disability with writing was accounted for by PCS and limb dominance; 20 % of disability preparing a meal by pain, CES-D, and PCS; 14 % of disability with making a bed by pain and CES-D; and 23 % of changing a light bulb overhead by age, pain, and fracture type. After volar plate fixation of a fracture of the distal radius, upper extremity disability based on select items from the DASH questionnaire correlated minimally with impairment of wrist motion, even at the level of specific tasks. Prognostic Level II.

Evaluation of an Image-Based Tool to Examine the Effect of Fracture Alignment and Joint Congruency on Outcomes after Wrist Fracture.

PubMed

Lalone, Emily A; Grewal, Ruby; King, Graham W; MacDermid, Joy C

2015-01-01

Some mal-alignment of the wrist occurs in up to 71% of patients following a distal radius fracture. A multiple case study was used to provide proof of principle of an image-based technique to investigate the evolution and impact of post-traumatic joint changes at the distal radioulnar joint. Participants who had a unilateral distal radius fracture who previously participated in a prospective study were recruited from a single tertiary hand center. Long term follow-up measures of pain, disability, range of motion and radiographic alignment were obtained and compared to joint congruency measures. The inter-bone distance, a measure of joint congruency was quantified from reconstructed CT bone models of the distal radius and ulna and the clinical outcome was quantified using the patient rated wrist evaluation. In all four cases, acceptable post-reduction alignment and minimal pain/disability at 1-year suggested good clinical outcomes. However, 10 years following injury, 3 out of 4 patients had radiographic signs of degenerative changes occurring in their injured wrist (distal radioulnar joint/radio-carpal joint). Proximity maps displaying inter-bone distances showed asymmetrical congruency between wrists in these three patients. The 10-year PRWE (patient rated wrist evaluation) varied from 4 to 60, with 3 reporting minimal pain/disability and one experiencing high pain/disability. These illustrative cases demonstrate long-term joint damage post-fracture is common and occurs despite positive short-term clinical outcomes. Imaging and functional outcomes are not necessarily correlated. A novel congruency measure provides an indicator of the overall impact of joint mal-alignment that can be used to determine predictors of post-traumatic arthritis and is viable for clinical or large cohort studies.

Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements.

PubMed

Boz, Cavit; Ozmenoglu, Mehmet; Altunayoglu, Vildan; Velioglu, Sibel; Alioglu, Zekeriya

2004-09-01

In this study we aimed to identify the role of the body mass index (BMI), wrist index and hand anthropometric measures as risk factors for carpal tunnel syndrome (CTS) in both genders. Based on clinical and electrophysiologic diagnostic criteria, 154 female and 44 male CTS patients, as well as 150 female and 44 male age-matched control subjects, were selected. BMI, wrist index, hand shape index, digit index and hand length/height ratio were compared between the CTS patients and the control subjects for each gender separately. Mean BMI was found to be a significant risk factor for CTS in both genders. The wrist index was found to be higher in female (P < 0.001) and in male (P = 0.034) CTS groups than in the respective control groups. Logistic regression analysis revealed the wrist index to be an independent risk factor in females, but not in males. Shape and digit indices were significantly higher in female CTS patients than in corresponding control subjects, and regression analysis showed the shape and digit indices to be independent risk factors for CTS. In the male CTS group, the shape and digit indices did not significantly differ from their controls. Differences in the hand length/height ratio were not statistically significant in female and male CTS patients compared to their controls and it was not found to be an independent risk factor for CTS. Our study confirmed BMI as an independent risk factor for CTS in both genders. Hand and wrist anthropometrics were found to be independent risk factors for CTS in females, but not in males.

Estimation of Energy Expenditure for Wheelchair Users Using a Physical Activity Monitoring System.

PubMed

Hiremath, Shivayogi V; Intille, Stephen S; Kelleher, Annmarie; Cooper, Rory A; Ding, Dan

2016-07-01

To develop and evaluate energy expenditure (EE) estimation models for a physical activity monitoring system (PAMS) in manual wheelchair users with spinal cord injury (SCI). Cross-sectional study. University-based laboratory environment, a semistructured environment at the National Veterans Wheelchair Games, and the participants' home environments. Volunteer sample of manual wheelchair users with SCI (N=45). Participants were asked to perform 10 physical activities (PAs) of various intensities from a list. The PAMS consists of a gyroscope-based wheel rotation monitor (G-WRM) and an accelerometer device worn on the upper arm or on the wrist. Criterion EE using a portable metabolic cart and raw sensor data from PAMS were collected during each of these activities. Estimated EE using custom models for manual wheelchair users based on either the G-WRM and arm accelerometer (PAMS-Arm) or the G-WRM and wrist accelerometer (PAMS-Wrist). EE estimation performance for the PAMS-Arm (average error ± SD: -9.82%±37.03%) and PAMS-Wrist (-5.65%±32.61%) on the validation dataset indicated that both PAMS-Arm and PAMS-Wrist were able to estimate EE for a range of PAs with <10% error. Moderate to high intraclass correlation coefficients (ICCs) indicated that the EE estimated by PAMS-Arm (ICC3,1=.82, P<.05) and PAMS-Wrist (ICC3,1=.89, P<.05) are consistent with the criterion EE. Availability of PA monitors can assist wheelchair users to track PA levels, leading toward a healthier lifestyle. The new models we developed can estimate PA levels in manual wheelchair users with SCI in laboratory and community settings. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Comparison of Ulnar Shortening Osteotomy Alone Versus Combined Arthroscopic Triangular Fibrocartilage Complex Debridement and Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome

PubMed Central

Song, Hyun Seok

2011-01-01

Background This study compared the results of patients treated for ulnar impaction syndrome using an ulnar shortening osteotomy (USO) alone with those treated with combined arthroscopic debridement and USO. Methods The results of 27 wrists were reviewed retrospectively. They were divided into three groups: group A (USO alone, 10 cases), group B (combined arthroscopic debridement and USO, 9 cases), and group C (arthroscopic triangular fibrocartilage complex [TFCC] debridement alone, 8 cases). The wrist function was evaluated using the modified Mayo wrist score, disabilities of the arm, shoulder and hand (DASH) score and Chun and Palmer grading system. Results The modified Mayo wrist score in groups A, B, and C was 74.5 ± 8.9, 73.9 ± 11.6, and 61.3 ± 10.2, respectively (p < 0.05). The DASH score in groups A, B, and C was 15.6 ± 11.8, 19.3 ± 11.9, and 33.2 ± 8.5, respectively (p < 0.05). The average Chun and Palmer grading score in groups A and B was 85.7 ± 8.9 and 84.7 ± 6.7, respectively. The difference in the Mayo wrist score, DASH score and Chun and Palmer grading score between group A and B was not significant (p > 0.05). Conclusions Both USO alone and combined arthroscopic TFCC debridement with USO improved the wrist function and reduced the level of pain in the patients treated for ulnar impaction syndrome. USO alone may be the preferred method of treatment in patients if the torn flap of TFCC is not unstable. PMID:21909465

Standardized combined cryotherapy and compression using Cryo/Cuff after wrist arthroscopy.

PubMed

Meyer-Marcotty, M; Jungling, O; Vaske, B; Vogt, P M; Knobloch, Karsten

2011-02-01

cryotherapy and compression as integral part of the RICE regimen are thought to improve treatment outcome after sport injuries. Using standardized cryotherapy and compression perioperatively has been reported with conflicting clinical results. The impact of combined cryotherapy and compression is compared to standard care among patients undergoing wrist arthroscopy. fifty-six patients undergoing wrist arthroscopy were assessed, 54 patients were randomized to either Cryo/Cuff (3 × 10 min twice daily) or standard care over 3 weeks. Follow-up clinical visits were at postoperative days 1, 8, and 21. One patient in each group was lost during follow-up. Fifty-two patients were analyzed. Statistics were performed as Intention-to-treat analysis. Outcome parameters were pain, three-dimensional volume of the wrist, range of motion, and DASH score. the Cryo/Cuffgroup had a 49% reduction in pain level (VAS 3.5 ± 0.4 vs. VAS 1.8 ± 0.2 on the 21st postoperative day) when compared to a reduction of 41% in the control group (VAS 5.1 ± 0.6 preoperatively vs. VAS 3.0 ± 0.5 on the 21st postoperative day). Swelling and range of motion were not as significantly different between the two groups as were DASH scores (DASH-score Cryo/Cuff group preoperatively 37.3 ± 3.5 and postoperatively 36.9 ± 3.5; DASH-score control group preoperatively 42.8 ± 4.3 and postoperatively 41.9 ± 4.9). The CONSORT score reached 17 out of 22. there was no significant effect of additional home-based combined cryotherapy and compression using the Cryo/Cuff wrist bandage, following wrist arthroscopy regarding pain, swelling, range of motion, and subjective impairment assessed using the DASH score over 3 weeks in comparison with the control group.

Robot-Assisted Proprioceptive Training with Added Vibro-Tactile Feedback Enhances Somatosensory and Motor Performance.

PubMed

Cuppone, Anna Vera; Squeri, Valentina; Semprini, Marianna; Masia, Lorenzo; Konczak, Jürgen

2016-01-01

This study examined the trainability of the proprioceptive sense and explored the relationship between proprioception and motor learning. With vision blocked, human learners had to perform goal-directed wrist movements relying solely on proprioceptive/haptic cues to reach several haptically specified targets. One group received additional somatosensory movement error feedback in form of vibro-tactile cues applied to the skin of the forearm. We used a haptic robotic device for the wrist and implemented a 3-day training regimen that required learners to make spatially precise goal-directed wrist reaching movements without vision. We assessed whether training improved the acuity of the wrist joint position sense. In addition, we checked if sensory learning generalized to the motor domain and improved spatial precision of wrist tracking movements that were not trained. The main findings of the study are: First, proprioceptive acuity of the wrist joint position sense improved after training for the group that received the combined proprioceptive/haptic and vibro-tactile feedback (VTF). Second, training had no impact on the spatial accuracy of the untrained tracking task. However, learners who had received VTF significantly reduced their reliance on haptic guidance feedback when performing the untrained motor task. That is, concurrent VTF was highly salient movement feedback and obviated the need for haptic feedback. Third, VTF can be also provided by the limb not involved in the task. Learners who received VTF to the contralateral limb equally benefitted. In conclusion, somatosensory training can significantly enhance proprioceptive acuity within days when learning is coupled with vibro-tactile sensory cues that provide feedback about movement errors. The observable sensory improvements in proprioception facilitates motor learning and such learning may generalize to the sensorimotor control of the untrained motor tasks. The implications of these findings for neurorehabilitation are discussed.

Randomized, sham-controlled trial based on transcranial direct current stimulation and wrist robot-assisted integrated treatment on subacute stroke patients: Intermediate results.

PubMed

Mazzoleni, Stefano; Tran, Vi Do; Iardella, Laura; Dario, Paolo; Posteraro, Federico

2017-07-01

The main goal of this study is to analyse the effects of combined transcranial direct current stimulation (tDCS) and wrist robot-assisted therapy in subacute stroke patients. Twenty-four patients were included in this study and randomly assigned to the experimental (EG) or control group (CG). All participants performed wrist robot-assisted training a) in conjunction with tDCS (real stimulation for patients in EG) or b) without tDCS (sham stimulation for patients in CG). Clinical scales and kinematic parameters recorded by the robot were used for the assessment. Clinical outcome measures show a significant decrease in motor impairment after the treatment in both groups. Kinematic data show several significant improvements after the integrated therapy in both groups. However, no significant differences in both clinical outcome measures and kinematic parameters was found between two groups. The potential advantages of combined tDCS and wrist robot-assisted therapy in subacute stroke patients are still unclear.

Robot-like dexterity without computers and motors: a review of hand-held laparoscopic instruments with wrist-like tip articulation

PubMed Central

Anderson, Patrick L.; Lathrop, Ray A.; Webster, Robert J.

2018-01-01

Introduction Conventional manual laparoscopic instruments for minimally invasive surgery have limited dexterity within the patient, making procedures challenging. Surgical robotic systems offer enhanced articulation, but at substantial financial costs. This has motivated the development of high-dexterity, low-cost laparoscopic instruments. Areas covered This article reviews both commercial and academic results on creating fully mechanical (i.e. non-robotic) laparoscopic instruments that provide wrists or wrist-like dexterity within the patient. We review the state of the art in the development of these mechanical instruments, focusing on the surgeon interface, wrist mechanism, and the kinematic mapping between the two. Expert commentary Current articulated mechanical laparoscopic instruments exhibit a wide range of designs, with no clear consensus on what makes such devices easy to use. As these technologies mature, user studies are needed to determine surgeon preferences. Articulated, low-cost instruments have the potential to impact the minimally invasive surgery market if they provide compelling benefits to surgeons. PMID:26808896

Compressed sensing approach for wrist vein biometrics.

PubMed

Lantsov, Aleksey; Ryabko, Maxim; Shchekin, Aleksey

2018-04-01

The work describes features of the compressed sensing (CS) approach utilized for development of a wearable system for wrist vein recognition with single-pixel detection; we consider this system useful for biometrics authentication purposes. The CS approach implies use of a spatial light modulation (SLM) which, in our case, can be performed differently-with a liquid crystal display or diffusely scattering medium. We show that compressed sensing combined with above-mentioned means of SLM allows us to avoid using an optical system-a limiting factor for wearable devices. The trade-off between the 2 different SLM approaches regarding issues of practical implementation of CS approach for wrist vein recognition purposes is discussed. A possible solution of a misalignment problem-a typical issue for imaging systems based upon 2D arrays of photodiodes-is also proposed. Proposed design of the wearable device for wrist vein recognition is based upon single-pixel detection. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mini open carpal tunnel release using Knifelight: evaluation of the safety and effectiveness of using a single wrist incision (cadaveric study).

PubMed

Teh, K K; Ng, E S; Choon, D S K

2009-08-01

This cadaveric study evaluates the margin of safety and technical efficacy of mini open carpal tunnel release performed using Knifelight (Stryker Instruments) through a transverse 1 cm wrist incision. A single investigator released 32 wrists in 17 cadavers. The wrists were then explored to assess the completeness of release and damage to vital structures including the superficial palmar arch, palmar cutaneous branch and recurrent branch of the median nerve. All the releases were complete and no injury to the median nerve and other structures were observed. The mean distance of the recurrent motor branch to the ligamentous divisions was 5.7 +/- 2.4 mm, superficial palmar arch was 8.7 +/- 3.1 mm and palmar cutaneous branch to the ligamentous division was 7.2 +/- 2.4 mm. The mean length of the transverse carpal ligament was 29.3 +/- 3.7 mm. Guyon's canal was preserved in all cases.

Self-reported wrist and finger symptoms associated with other physical/mental symptoms and use of computers/mobile phones.

PubMed

Korpinen, Leena; Pääkkönen, Rauno; Gobba, Fabriziomaria

2018-03-01

Recently, computer, mobile phone and Internet use has increased. This study aimed to determine the possible relation between self-reported wrist and finger symptoms (aches, pain or numbness) and using computers/mobile phones, and to analyze how the symptoms are specifically associated with utilizing desktop computers, portable computers or mini-computers and mobile phones. A questionnaire was sent to 15,000 working-age Finns (age 18-65). Via a questionnaire, 723 persons reported wrist and finger symptoms often or more with use. Over 80% use mobile phones daily and less than 30% use desktop computers or the Internet daily at leisure, e.g., over 89.8% quite often or often experienced pain, numbness or aches in the neck, and 61.3% had aches in the hips and the lower back. Only 33.7% connected their symptoms to computer use. In the future, the development of new devices and Internet services should incorporate the ergonomics of the hands and wrists.

Effect of Wrist Posture on Carpal Tunnel Pressure while Typing

PubMed Central

Rempel, David M.; Keir, Peter J.; Bach, Joel M.

2009-01-01

Long weekly hours of keyboard use may lead to or aggravate carpal tunnel syndrome. The effects of typing on fluid pressure in the carpal tunnel, a possible mediator of carpal tunnel syndrome, are unknown. Twenty healthy subjects participated in a laboratory study to investigate the effects of typing at different wrist postures on carpal tunnel pressure of the right hand. Changes in wrist flexion/extension angle (p = 0.01) and radial/ulnar deviation angle (p = 0.03) independently altered carpal tunnel pressure; wrist deviations in extension or radial deviation were associated with an increase in pressure. The activity of typing independently elevated carpal tunnel pressure (p= 0.001) relative to the static hand held in the same posture. This information can guide the design and use of keyboards and workstations in order to minimize carpal tunnel pressure while typing. The findings may also be useful to clinicians and ergonomists in the management of patients with carpal tunnel syndrome who use a keyboard. PMID:18383144

Determination of sex by armbone dimensions.

PubMed

Aye, Victor Omakoji

2010-06-15

Sex determination is a vital part of the medico-legal system but can be difficult in cases where the body is damaged. The purpose of this study was to develop a technique for sex determination from three arm-bone dimensions (wrist circumference, arm length and arm span). This knowledge can be applied in cases of mass disaster, homicide and events such as sports. Data were collected for 95 Nigerian male students and 90 Nigerian female students using physical anthropometry. Discriminant function presented the wrist dimension as the dominant contributor in this study. Combination equations for both the wrist and arm-span dimensions correctly classified sex (male/female) with an accuracy rate of 84.9%. On cross-validation, sex was also established with the same 84.9% accuracy rate. Sex determination was higher in males. Sexual dimorphism was established in this study, although the wrist circumference was more distinct than arm span; a combination of both generated sex with an accuracy prediction rate of 84.9%. (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Active range of motion outcomes after reconstruction of burned wrist and hand deformities.

PubMed

Afifi, Ahmed M; Mahboub, Tarek A; Ibrahim Fouad, Amr; Azari, Kodi; Khalil, Haitham H; McCarthy, James E

2016-06-01

This works aim is to evaluate the efficacy of skin grafts and flaps in reconstruction of post-burn hand and wrist deformities. A prospective study of 57 burn contractures of the wrist and dorsum of the hand was performed. Flaps were used only if there was a non-vascularized structure after contracture release, otherwise a skin graft was used. Active range of motion (ROM) was used to assess hand function. The extension deformity cohort uniformly underwent skin graft following contracture release with a mean improvement of 71 degrees (p<0.0001). The flexion deformity cohort was treated with either skin grafts (8 patients) or flaps (9 patients) with a mean improvement of 44 degrees (p<0.0001). Skin grafts suffice for dorsal hand contractures to restore functional wrist ROM. For flexion contractures, flaps were more likely for contractures >6 months. Early release of burn contracture is advisable to avoid deep structure contracture. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Case Report: SPECT/CT as the New Diagnostic Tool for Specific Wrist Pathology.

PubMed

Linde, Musters; Ten Broek, M; Kraan, G A

2017-01-01

Single photon emission computed tomography has been introduced as a promising new diagnostic tool in orthopaedic pathology since the early 90'. Computed tomography, the combined with SPECT, gives insight in the specific sight of wrist pathology. Literature already supports introduction of SPECT/CT in wrist pathology, but clinical application is lagging. A 40yr old patient reported first in 2004 with persisting pain after a right distal radius fracture. Several diagnostics and operative interventions were performed, all unsuccessful. Because of the persisting pain a SPECT-CT was performed which showed a cyst in the hamate bone, which was successfully enucleated. The patient was finally pain free at recent follow-up. With a QDash-score of 43 and a PRW (H) E-DLV-score of 58/150. In this case report, SPECT/CT proved a very sensitive diagnostic tool for specific pathology of the wrist. It offered precise localisation and thereby the clinically suspected diagnosis was confirmed and the patient successfully treated.

Ultrahigh-frequency ultrasound of fascicles in the median nerve at the wrist.

PubMed

Cartwright, Michael S; Baute, Vanessa; Caress, James B; Walker, Francis O

2017-10-01

An ultrahigh-frequency (70 MHZ) ultrasound device has recently been approved for human use. This study seeks to determine whether this device facilitates counting of fascicles within the median nerve at the wrist. Twenty healthy volunteers underwent imaging of the median nerve at the wrist bilaterally. The number of fascicles in each nerve was counted by two independent raters. The mean fascicle number was 22.68. Correlation was strong between the two raters (r = 0.68, P < 0.001). Age, sex, body mass index, and nerve area did not predict fascicle number. Those with bifid median nerves and persistent median arteries had lower fascicle density than those without anatomic anomalies (1.79 vs. 2.29; P = 0.01). Fascicles within the median nerve at the wrist can be readily imaged. Ultrahigh-frequency ultrasound technology may be informative in a variety of disorders affecting the peripheral nervous system. Muscle Nerve 56: 819-822, 2017. © 2017 Wiley Periodicals, Inc.

Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.

PubMed

Flodgren, G; Heiden, M; Lyskov, E; Crenshaw, A G

2007-03-01

In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

Development of wrist rehabilitation robot and interface system.

PubMed

Yamamoto, Ikuo; Matsui, Miki; Inagawa, Naohiro; Hachisuka, Kenji; Wada, Futoshi; Hachisuka, Akiko; Saeki, Satoru

2015-01-01

The authors have developed a practical wrist rehabilitation robot for hemiplegic patients. It consists of a mechanical rotation unit, sensor, grip, and computer system. A myoelectric sensor is used to monitor the extensor carpi radialis longus/brevis muscle and flexor carpi radialis muscle activity during training. The training robot can provoke training through myoelectric sensors, a biological signal detector and processor in advance, so that patients can undergo effective training of extention and flexion in an excited condition. In addition, both-wrist system has been developed for mirror effect training, which is the most effective function of the system, so that autonomous training using both wrists is possible. Furthermore, a user-friendly screen interface with easily recognizable touch panels has been developed to give effective training for patients. The developed robot is small size and easy to carry. The developed aspiring interface system is effective to motivate the training of patients. The effectiveness of the robot system has been verified in hospital trails.

Robot-like dexterity without computers and motors: a review of hand-held laparoscopic instruments with wrist-like tip articulation.

PubMed

Anderson, Patrick L; Lathrop, Ray A; Webster, Robert J

2016-07-01

Conventional manual laparoscopic instruments for minimally invasive surgery have limited dexterity within the patient, making procedures challenging. Surgical robotic systems offer enhanced articulation, but at substantial financial costs. This has motivated the development of high-dexterity, low-cost laparoscopic instruments. This article reviews both commercial and academic results on creating fully mechanical (i.e. non-robotic) laparoscopic instruments that provide wrists or wrist-like dexterity within the patient. We review the state of the art in the development of these mechanical instruments, focusing on the surgeon interface, wrist mechanism, and the kinematic mapping between the two. Expert commentary: Current articulated mechanical laparoscopic instruments exhibit a wide range of designs, with no clear consensus on what makes such devices easy to use. As these technologies mature, user studies are needed to determine surgeon preferences. Articulated, low-cost instruments have the potential to impact the minimally invasive surgery market if they provide compelling benefits to surgeons.

Ultrasound-Guided Steroid Injection of the Pisotriquetral Joint: A Multidisciplinary Effort.

PubMed

Brose, Steven W; Montfort, Janel; Gustafson, Kenneth J; Mittebrun, Ionica; Gauriloff, Samantha; Mosher, Mary; Bourbeau, Dennis J

2017-12-01

From the perspective of a multidisciplinary team, the authors describe the first reported use of ultrasound guidance for steroid injection into the pisotriquetral joint to relieve wrist pain of a person with spinal cord injury undergoing acute inpatient rehabilitation. Musculoskeletal ultrasound guidance was used to improve the accuracy of a corticosteroid injection of the pisotriquetral joint and the basal thumb in a 70-year-old man with paraplegia experiencing multifocal degenerative wrist pain. There was no bleeding or bruising after the injections, and the patient reported complete pain resolution 1 wk after the injections, which continued for over 1 yr. A multidisciplinary team was key in diagnosis, selection of treatment, and evaluation of treatment effect. Corticosteroid injection of the pisotriquetral joint under ultrasound guidance can be used as a treatment modality for managing wrist pain stemming from that joint. Further investigation and studies evaluating the use of ultrasound versus other imaging modalities for injection of the wrist are indicated.

Analysis and design of a six-degree-of-freedom Stewart platform-based robotic wrist

NASA Technical Reports Server (NTRS)

Nguyen, Charles C.; Antrazi, Sami; Zhou, Zhen-Lei

1991-01-01

The kinematic analysis and implementation of a six degree of freedom robotic wrist which is mounted to a general open-kinetic chain manipulator to serve as a restbed for studying precision robotic assembly in space is discussed. The wrist design is based on the Stewart Platform mechanism and consists mainly of two platforms and six linear actuators driven by DC motors. Position feedback is achieved by linear displacement transducers mounted along the actuators and force feedback is obtained by a 6 degree of freedom force sensor mounted between the gripper and the payload platform. The robot wrist inverse kinematics which computes the required actuator lengths corresponding to Cartesian variables has a closed-form solution. The forward kinematics is solved iteratively using the Newton-Ralphson method which simultaneously provides a modified Jacobian Matrix which relates length velocities to Cartesian translational velocities and time rates of change of roll-pitch-yaw angles. Results of computer simulation conducted to evaluate the efficiency of the forward kinematics and Modified Jacobian Matrix are discussed.

Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial.

PubMed

Santamato, Andrea; Micello, Maria Francesca; Panza, Francesco; Fortunato, Francesca; Picelli, Alessandro; Smania, Nicola; Logroscino, Giancarlo; Fiore, Pietro; Ranieri, Maurizio

2015-01-01

To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke. A single-blind randomized trial. Seventy patients with upper limb post-stroke spasticity. Adults with wrist and finger flexor muscles spasticity after stroke were submitted to botulinum toxin type A therapy. After the treatment, the subjects injected were randomly divided into two groups and submitted to adhesive taping (Group A) or daily muscle manual stretching, passive articular mobilization of wrist and fingers, and palmar splint (Group B) for 10 days. We measured spasticity with Modified Ashworth Scale, related disability with Disability Assessment Scale, and fingers position at rest. The measurements were done at baseline, after two weeks, and after one month from the treatment session. After two weeks, subjects in Group A reported a significantly greater decrease in spasticity scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.3±0.6 vs. 2.1±0.6; Modified Ashworth Scale wrist: 1.7 ±0.6 vs. 2.3 ±0.8), and after one month in spasticity and disability scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.9 ±0.7 vs. 2.5 ±0.6; Modified Ashworth Scale wrist: 2.0 ±0.7 vs. 2.6 ±0.6; Disability Assessment Scale: 1.6 ±0.7 vs. 2.1 ±0.7) compared with Group B subjects. Subjects in Group A reported also a significantly improved fingers position at rest compared with Group B subjects after two weeks (2.8 ±0.9 vs. 2.1 ±0.7) and one month (2.3 ±0.7 vs. 1.5 ±0.6). Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint. © The Author(s) 2014.

Accuracy of pulse oximeter readings from probe placement on newborn wrist and ankle.

PubMed

Phattraprayoon, N; Sardesai, S; Durand, M; Ramanathan, R

2012-04-01

To compare the accuracy of pulse oximetry oxygen saturation (SpO(2)) measured on the wrist compared with the ipsilateral palm, and SpO(2) measured on the ankle compared with the ipsilateral sole. In this prospective observational study, neonates admitted to the neonatal intensive care unit were enrolled. We recorded SpO(2) (Masimo Radical-7 pulse oximeter) detected at the palm and ipsilateral wrist initially, then at 30 s, and at 1 min, and we repeated the same procedure over the sole and ipsilateral ankle. We recorded the time to obtain the SpO(2) readings from all these sites. Regression analysis was performed to determine the relationship between paired SpO(2) measurements. The mean difference (bias) and standard deviation of the paired SpO(2) differences (precision) were calculated (Bland-Altman plots). A total of 150 patients (birth weight 2381±1020 g, gestational age 34.3±4.3 weeks, median postnatal age 3.5 days (25th-75th percentile 1-16 days)) were enrolled. There was a good correlation between SpO(2) measured at the palm versus the wrist (r=0.95, P<0.001 (right); r=0.97, P< 0.001 (left)) and between SpO(2) measured at the sole versus the ankle (r=0.92, P<0.001 (right); r=0.91, P<0.001 (left)). There was also a good agreement between paired SpO(2) measurements from these sites. The bias and precision for SpO(2) at the right palm and right wrist was 0.08±0.94% and for the left palm and left wrist 0.22±0.87%. Similarly, the bias and precision for SpO(2) at the right sole and right ankle was -0.03±0.93% and for the left sole and left ankle was -0.01±0.93%. Our results show that the wrist and ankle can be used as alternative sites to measure SpO(2) in newborn infants in place of the routinely used palm or sole.

Habituation of Sleep to Road Traffic Noise as Determined by Polysomnography and AN Accelerometer

NASA Astrophysics Data System (ADS)

KAWADA, T.; XIN, P.; KUROIWA, M.; SASAZAWA, Y.; SUZUKI, S.; TAMURA, Y.

2001-04-01

The habituation of human sleep to a noisy environment was investigated by polysomnography (PSG), a wrist activity device (Actiwatch®), subjective evaluation and a performance test on the following morning. Eleven young male students slept for 17 nights in a sleep laboratory. PSG on the first, fourth, fifth, ninth, 14th, and 17th nights was judged visually. Four of the subjects were continuously monitored by the wrist activity device. From the fifth to 14th nights, there was exposure to road traffic noise all-night long, and consecutive experiments were conducted from the fifth to 17th nights. Agreement of sleep/wake assessment for Actiwatch®and PSG was 88·4%, on average, based on the data for 24 nights. Pearson's correlation coefficient of TST for Actiwatch®and sleep PSG was 0·848. Habituation to noise by wrist movement, sleep latency by PSG, and activity of mental muscles was not recognized. The association between wrist activity and mental muscle activity was significant for three subjects out of four (r=0·56, 0·81, 0·71, respectively). Percentages of positive wrist movement in each sleep stage, such as the 3+4 stages, REM stage and stage MT, were compared with those in other stages. Wrist activity in Stage REM was significantly more frequent than that in other stages for the three subjects. Wrist movement in Stage MT was significantly more frequent than in other stages for the three subjects. REM latency, REM cycle, and five factors of subjective sleep, from the Oguri-Shirakawa-Azumi questionnaire (SQ), showed significant differences by analysis of variance for repeated measurements. When change from the 4th night was checked, sleepiness, worry, integrated sleep feeling and sleep initiation by SQ showed habituation of sleep to noise. Namely, sleep quality recovered to the level on a silent night by the fifth noisy night during the experiment. There is thus a habituation of sleep to noise when a subjective evaluation of sleep, such as the SQ, is used.

A finger-free wrist-worn pulse oximeter for the monitoring of chronic obstructive pulmonary disease

NASA Astrophysics Data System (ADS)

Chu, Chang-Sheng; Chuang, Shuang-Chao; Lee, Yeh Wen; Fan, Chih-Hsun; Chung, Lung Pin; Li, Yu-Tang; Chen, Jyh-Chern

2016-03-01

Herein, a finger-free wrist-worn pulse oximeter is presented. This device allows patients to measure blood oxygen level and pulse rate without hindering their normal finger movement. This wrist-worn pulse oximeter is built with a reflectance oximetry sensor, which consists of light emitting diodes and photodiode light detectors located side by side. This reflectance oximetry sensor is covered with an optical element with micro structured surface. This micro structured optical element is designed to modulate photon propagation beneath the skin tissue so that the photoplethysmogram signals of reflected lights or backscattered lights detected by the photodetector are therefore enhanced.

Intersection Syndrome in a Handcyclist: Case Report and Literature Review

PubMed Central

2013-01-01

Intersection syndrome describes a rare inflammatory condition located at the crossing point between the first dorsal compartment muscles and the radial wrist extensor muscles. It is a repetitive motion injury that affects patients who overuse their wrists. The present report reviews the incidence of the condition as well as the special populations it affects. The anatomy of the wrist is presented and clinical findings and physical examination techniques are reviewed to help the reader reach a quick but correct diagnosis. Finally, the most appropriate treatment approach is presented, incorporating rehabilitative methods designed to ensure a full and prompt functional recovery and resumption of physical activity. PMID:23960708

Load compensating reactions to perturbations at wrist joint in normal man

NASA Technical Reports Server (NTRS)

Jaeger, R. J.; Agarwell, G. C.; Gottlieb, G. L.

1981-01-01

The electromyographic responses to step torque loads were studied in flexors and extensors at the human wrist. Based on temporal bursting patterns and functional behavior, the response was divided into four temporal components. Two early components, the myotatic (30-60 ms) late myotatic (60-120 ms) appears to be reflex response. The third postmyotatic component (120-200 ms) appear to be a triggered reaction, preceeding the fourth, stabilizing component (200-400 ms). A comparison of response at the wrist with similar data at the ankle provides the basis for a generalized classification of the response in various muscles to torque step perturbations.

Wrist muscle activity of khatrah approach in Mameluke technique using traditional bow archery

NASA Astrophysics Data System (ADS)

Ariffin, Muhammad Shahimi; Rambely, Azmin Sham; Ariff, Noratiqah Mohd

2018-04-01

An investigation of khatrah technique in archery was carried out. An electromyography (EMG) experiment was conducted towards six wrist muscles which are flexor carpi radialis, extensor carpi ulnaris and extensor digitorum communis for both arms. The maximum voluntary contraction (MVC) and activity data were recorded. The bow arm produced a higher muscle force compared to draw arm muscles during release phase. However, the muscle forces produced by bow arm had a consistency in term of pattern throughout the phases. In conclusion, the forces generated by the professional archer produced a force benchmark at the wrist joint to alleviate the risk of injury.

Ergonomic material-handling device

DOEpatents

Barsnick, Lance E.; Zalk, David M.; Perry, Catherine M.; Biggs, Terry; Tageson, Robert E.

2004-08-24

A hand-held ergonomic material-handling device capable of moving heavy objects, such as large waste containers and other large objects requiring mechanical assistance. The ergonomic material-handling device can be used with neutral postures of the back, shoulders, wrists and knees, thereby reducing potential injury to the user. The device involves two key features: 1) gives the user the ability to adjust the height of the handles of the device to ergonomically fit the needs of the user's back, wrists and shoulders; and 2) has a rounded handlebar shape, as well as the size and configuration of the handles which keep the user's wrists in a neutral posture during manipulation of the device.

Comparison of dominant hand range of motion among throwing types in baseball pitchers.

PubMed

Wang, Lin-Hwa; Kuo, Li-Chieh; Shih, Sheng-Wen; Lo, Kuo-Cheng; Su, Fong-Chin

2013-08-01

Previous research on baseball pitchers' wrists, elbows, and should joints contributes to our understanding of pitchers' control over delicate joint motion and ball release. However, limited research on forearm, wrist, and hand joints prevents full comprehension of the throwing mechanism. The present descriptive laboratory study quantifies angular performances of hand and wrist joints while pitching breaking balls, including fastballs, curveballs and sliders, among pitchers with different skill levels. Nineteen baseball pitchers performed required pitching tasks (10 from university and 9 from high school). A three-dimensional motion analysis system collected pitching motion data. The range of joint motion in the wrist and proximal interphalangeal (PIP) and metacarpophalangeal (MP) joints of the index and middle fingers were compared among fastballs, curveballs and sliders. Thirteen reflective markers were placed on selected anatomic landmarks of the wrist, middle and index fingers of the hand. Wrist flexion angle in the pitching acceleration phase was larger in fastballs (20.58±4.07°) and sliders (22.48±5.45°) than in curveballs (9.08±3.03°) (p = .001). The flexion angle of the PIP joint was significantly larger in curveballs (38.5±3.8°) than in fastballs (30.3±4.8°) and sliders (30.2±4.5°) (p=.004) of the middle finger. Abduction angle of MP joint on the middle finger was significantly larger in curveballs (15.4 ±3.6°) than in fastballs (8.9±1.2°) and sliders (6.9±2.9°) (p=.001) of the middle finger, and the abduction angle of index finger was significantly larger in sliders (13.5±15.0°) than in fastballs (7.2 ±2.8°) (p=.007). Hand and wrist motion and grip types affect the relative position between fingers and ball, which produces different types of baseball pitches. A larger extension angle of the wrist joint and the coordination of middle and index fingers are crucial when pitching a fastball. Abduction and flexion movement on the MP joint of the middle finger are important for a curveball. MP joint abduction and flexion movement of the index finger produce sliders. Understanding the control mechanism in a throwing hand can help improve training protocols in either injury prevention or performance improvement for baseball pitchers. Copyright © 2013 Elsevier B.V. All rights reserved.

Decoding subtle forearm flexions using fractal features of surface electromyogram from single and multiple sensors.

PubMed

Arjunan, Sridhar Poosapadi; Kumar, Dinesh Kant

2010-10-21

Identifying finger and wrist flexion based actions using a single channel surface electromyogram (sEMG) can lead to a number of applications such as sEMG based controllers for near elbow amputees, human computer interface (HCI) devices for elderly and for defence personnel. These are currently infeasible because classification of sEMG is unreliable when the level of muscle contraction is low and there are multiple active muscles. The presence of noise and cross-talk from closely located and simultaneously active muscles is exaggerated when muscles are weakly active such as during sustained wrist and finger flexion. This paper reports the use of fractal properties of sEMG to reliably identify individual wrist and finger flexion, overcoming the earlier shortcomings. SEMG signal was recorded when the participant maintained pre-specified wrist and finger flexion movements for a period of time. Various established sEMG signal parameters such as root mean square (RMS), Mean absolute value (MAV), Variance (VAR) and Waveform length (WL) and the proposed fractal features: fractal dimension (FD) and maximum fractal length (MFL) were computed. Multi-variant analysis of variance (MANOVA) was conducted to determine the p value, indicative of the significance of the relationships between each of these parameters with the wrist and finger flexions. Classification accuracy was also computed using the trained artificial neural network (ANN) classifier to decode the desired subtle movements. The results indicate that the p value for the proposed feature set consisting of FD and MFL of single channel sEMG was 0.0001 while that of various combinations of the five established features ranged between 0.009 - 0.0172. From the accuracy of classification by the ANN, the average accuracy in identifying the wrist and finger flexions using the proposed feature set of single channel sEMG was 90%, while the average accuracy when using a combination of other features ranged between 58% and 73%. The results show that the MFL and FD of a single channel sEMG recorded from the forearm can be used to accurately identify a set of finger and wrist flexions even when the muscle activity is very weak. A comparison with other features demonstrates that this feature set offers a dramatic improvement in the accuracy of identification of the wrist and finger movements. It is proposed that such a system could be used to control a prosthetic hand or for a human computer interface.

Decoding subtle forearm flexions using fractal features of surface electromyogram from single and multiple sensors

PubMed Central

2010-01-01

Background Identifying finger and wrist flexion based actions using a single channel surface electromyogram (sEMG) can lead to a number of applications such as sEMG based controllers for near elbow amputees, human computer interface (HCI) devices for elderly and for defence personnel. These are currently infeasible because classification of sEMG is unreliable when the level of muscle contraction is low and there are multiple active muscles. The presence of noise and cross-talk from closely located and simultaneously active muscles is exaggerated when muscles are weakly active such as during sustained wrist and finger flexion. This paper reports the use of fractal properties of sEMG to reliably identify individual wrist and finger flexion, overcoming the earlier shortcomings. Methods SEMG signal was recorded when the participant maintained pre-specified wrist and finger flexion movements for a period of time. Various established sEMG signal parameters such as root mean square (RMS), Mean absolute value (MAV), Variance (VAR) and Waveform length (WL) and the proposed fractal features: fractal dimension (FD) and maximum fractal length (MFL) were computed. Multi-variant analysis of variance (MANOVA) was conducted to determine the p value, indicative of the significance of the relationships between each of these parameters with the wrist and finger flexions. Classification accuracy was also computed using the trained artificial neural network (ANN) classifier to decode the desired subtle movements. Results The results indicate that the p value for the proposed feature set consisting of FD and MFL of single channel sEMG was 0.0001 while that of various combinations of the five established features ranged between 0.009 - 0.0172. From the accuracy of classification by the ANN, the average accuracy in identifying the wrist and finger flexions using the proposed feature set of single channel sEMG was 90%, while the average accuracy when using a combination of other features ranged between 58% and 73%. Conclusions The results show that the MFL and FD of a single channel sEMG recorded from the forearm can be used to accurately identify a set of finger and wrist flexions even when the muscle activity is very weak. A comparison with other features demonstrates that this feature set offers a dramatic improvement in the accuracy of identification of the wrist and finger movements. It is proposed that such a system could be used to control a prosthetic hand or for a human computer interface. PMID:20964863

A robot-aided visuo-motor training that improves proprioception and spatial accuracy of untrained movement.

PubMed

Elangovan, Naveen; Cappello, Leonardo; Masia, Lorenzo; Aman, Joshua; Konczak, Jürgen

2017-12-06

Proprioceptive function can become enhanced during motor learning. Yet, we have incomplete knowledge to what extent proprioceptive function is trainable and how a training that enhances proprioception may influence performance in untrained motor skills. To address this knowledge gap, healthy young adults (N = 14) trained in a visuomotor task that required learners to make increasingly accurate wrist movements. Using a robotic exoskeleton coupled with a virtual visual environment, participants tilted a virtual table through continuous wrist flexion/extension movements with the goal to position a rolling ball on table into a target. With learning progress, the level of difficulty increased by altering the virtual ball mechanics and the gain between joint movement and ball velocity. Before and after training, wrist position sense acuity and spatial movement accuracy in an untrained, discrete wrist-pointing task was assessed using the same robot. All participants showed evidence of proprioceptive-motor learning. Mean position sense discrimination threshold improved by 34%. Wrist movement accuracy in the untrained pointing task improved by 27% in 13/14 participants. This demonstrates that a short sensorimotor training challenging proprioception can a) effectively enhance proprioceptive acuity and b) improve the accuracy of untrained movement. These findings provide a scientific basis for applying such somatosensory-based motor training to clinical populations with known proprioceptive dysfunction to enhance sensorimotor performance.

Comparison of carpal tunnel injection techniques: a cadaver study.

PubMed

Ozturk, Kahraman; Esenyel, Cem Zeki; Sonmez, Mesut; Esenyel, Meltem; Kahraman, Sinan; Senel, Berna

2008-01-01

The purpose of the study was to evaluate the accuracy of injections into the carpal tunnel using three different portals in cadavers, and to define safe guidelines. In this study, 150 wrists of 75 cadavers (54 male, 21 female) were included. To compare three injection sites, 50 wrists of 25 cadavers were used for each technique; we used 23 gauge needles, and acrylic dye. The first injection technique: the needle was inserted 1cm proximal to the wrist crease and directed distally by roughly 45 in an ulnar direction through the flexor carpi radialis tendon. The second injection technique: the needle was inserted into the carpal tunnel from a point just ulnar to the palmaris longus tendon and 1cm proximal to the wrist crease. The third injection technique: the needle was inserted just distal to the distal skin crease of the wrist in line with the fourth ray. The first injection technique gave the highest accuracy rate, and this was also the safest injection site. Median nerve injuries caused by injection was seen mostly with the second technique. Although a steroid injection may provide symptomatic relief in patients with carpal tunnel syndrome, the median nerve and other structures in the carpal tunnel are at risk of injury. Because of that, the injection should be given using the correct technique by physicians skilled in carpal tunnel surgery.

Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review.

PubMed

Saltzman, B M; Frank, J M; Slikker, W; Fernandez, J J; Cohen, M S; Wysocki, R W

2015-06-01

We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I-III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11º) versus 43 (SD 11º); wrist flexion, 32 (SD 10º) versus 36 (SD 11º); flexion-extension arc, 62 (SD 14º) versus 75 (SD 10º); radial deviation, 14 (SD 5º) versus 10 (SD 5º); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative radial deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate. © The Author(s) 2014.

[Midcarpal arthrodesis with cortical bolting chip for treatment of grade II/III scaphoid non-union and scapholunate advanced collapse].

PubMed

Zeplin, P H; Kuhfuss, I

2009-06-01

These case reports describe a mediocarpal arthrodesis with excision of the scaphoid using a cortical bolting chip and screw fixation instead of the use of Kirschner wires or Spider plates. Four patients with a symptomatic SLAC/SLAC-wrist >or= grade II were treated. The evaluation occurred six months later. For the evaluation the Cooney and Bussey as well as DASH scores were used (pain, strength, range of motion, functional status, possible limitations of quality of life, subjective perception of the patient). The radiological evaluation was performed by conventional wrist X-ray in two projections. All patients were pain-free after the operation. From the radiological point of view a complete osseous consolidation has set in. The mean strength six months after surgical intervention was 53 % (preoperative 52 %) and the total range of motion 47 % (preoperative 59 %) compared to the opposite side. The Cooney and Bussey scores were at 69 (+ 25 %) and the DASH score at 44 (- 28 %) points. In case of an SNAC/SLAC-wrist a motion-preserving operation should always be given preference to a wrist stiffening procedure. The modified mid-carpal partial arthrodesis is an alternative operating procedure for the treatment of SNAC/SLAC-wrists in stage II/III. However, a higher number of cases and comparative studies are needed to confirm this concept.

Comminuted Distal Radial Fracture with Large Rotated Palmar Medial Osteochondral Fragment in the Joint.

PubMed

Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan

2018-01-01

Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.

The natural angle between the hand and handle and the effect of handle orientation on wrist radial/ulnar deviation during maximal push exertions.

PubMed

Young, Justin G; Lin, Jia-Hua; Chang, Chien-Chi; McGorry, Raymond W

2013-01-01

The purpose of this experiment was to quantify the natural angle between the hand and a handle, and to investigate three design factors: handle rotation, handle tilt and between-handle width on the natural angle as well as resultant wrist radial/ulnar deviation ('RUD') for pushing tasks. Photographs taken of the right upper limb of 31 participants (14 women and 17 men) performing maximal seated push exertions on different handles were analysed. Natural hand/handle angle and RUD were assessed. It was found that all of the three design factors significantly affected natural handle angle and wrist RUD, but participant gender did not. The natural angle between the hand and the cylindrical handle was 65 ± 7°. Wrist deviation was reduced for handles that were rotated 0° (horizontal) and at the narrow width (31 cm). Handles that were tilted forward 15° reduced radial deviation consistently (12-13°) across handle conditions. Manual materials handling (MMH) tasks involving pushing have been related to increased risk of musculoskeletal injury. This study shows that handle orientation influences hand and wrist posture during pushing, and suggests that the design of push handles on carts and other MMH aids can be improved by adjusting their orientation to fit the natural interface between the hand and handle.

Kinematic characteristics of tenodesis grasp in C6 quadriplegia.

PubMed

Mateo, S; Revol, P; Fourtassi, M; Rossetti, Y; Collet, C; Rode, G

2013-02-01

Descriptive control case study. To analyze the kinematics of tenodesis grasp in participants with C6 quadriplegia and healthy control participants in a pointing task and two daily life tasks involving a whole hand grip (apple) or a lateral grip (floppy disk). France. Four complete participants with C6 quadriplegia were age matched with four healthy control participants. All participants were right-handed. The measured kinematic parameters were the movement time (MT), the peak velocity (PV), the time of PV (TPV) and the wrist angle in the sagittal plane at movement onset, at the TPV and at the movement end point. The participants with C6 quadriplegia had significantly longer MTs in both prehension tasks. No significant differences in TPV were found between the two groups. Unlike control participants, for both prehension tasks the wrist of participants with C6 quadriplegia was in a neutral position at movement onset, in flexion at the TPV, and in extension at the movement end point. Two main kinematic parameters characterize tenodesis grasp movements in C6 quadriplegics: wrist flexion during reaching and wrist extension during the grasping phase, and increased MT reflecting the time required to adjust the wrist's position to achieve the tenodesis grasp. These characteristics were observed for two different grips (whole hand and lateral grip). These results suggest sequential planning of reaching and tenodesis grasp, and should be taken into account for prehension rehabilitation in patients with quadriplegia.

Wrist Hypothermia Related to Continuous Work with a Computer Mouse: A Digital Infrared Imaging Pilot Study

PubMed Central

Reste, Jelena; Zvagule, Tija; Kurjane, Natalja; Martinsone, Zanna; Martinsone, Inese; Seile, Anita; Vanadzins, Ivars

2015-01-01

Computer work is characterized by sedentary static workload with low-intensity energy metabolism. The aim of our study was to evaluate the dynamics of skin surface temperature in the hand during prolonged computer mouse work under different ergonomic setups. Digital infrared imaging of the right forearm and wrist was performed during three hours of continuous computer work (measured at the start and every 15 minutes thereafter) in a laboratory with controlled ambient conditions. Four people participated in the study. Three different ergonomic computer mouse setups were tested on three different days (horizontal computer mouse without mouse pad; horizontal computer mouse with mouse pad and padded wrist support; vertical computer mouse without mouse pad). The study revealed a significantly strong negative correlation between the temperature of the dorsal surface of the wrist and time spent working with a computer mouse. Hand skin temperature decreased markedly after one hour of continuous computer mouse work. Vertical computer mouse work preserved more stable and higher temperatures of the wrist (>30 °C), while continuous use of a horizontal mouse for more than two hours caused an extremely low temperature (<28 °C) in distal parts of the hand. The preliminary observational findings indicate the significant effect of the duration and ergonomics of computer mouse work on the development of hand hypothermia. PMID:26262633

Hazardous materials emergency response mobile robot

NASA Technical Reports Server (NTRS)

Stone, Henry W. (Inventor); Lloyd, James (Inventor); Alahuzos, George (Inventor)

1992-01-01

A simple or unsophisticated robot incapable of effecting straight-line motion at the end of its arm inserts a key held in its end effector or hand into a door lock with nearly straight-line motion by gently thrusting its back heels downwardly so that it pivots forwardly on its front toes while holding its arm stationary. The relatively slight arc traveled by the robot's hand is compensated by a complaint tool with which the robot hand grips the door key. A visible beam is projected through the axis of the hand or gripper on the robot arm end at an angle to the general direction in which the robot thrusts the gripper forward. As the robot hand approaches a target surface, a video camera on the robot wrist watches the beam spot on the target surface fall from a height proportional to the distance between the robot hand and the target surface until the beam spot is nearly aligned with the top of the robot hand. Holes in the front face of the hand are connected through internal passages inside the arm to an on-board chemical sensor. Full rotation of the hand or gripper about the robot arm's wrist is made possible by slip rings in the wrist which permit passage of the gases taken in through the nose holes in the front of the hand through the wrist regardless of the rotational orientation of the wrist.

Effect of muscle relaxation in the foot on simultaneous muscle contraction in the contralateral hand.

PubMed

Kato, Kouki; Kanosue, Kazuyuki

2016-10-28

We investigated the effects of foot muscle relaxation and contraction on muscle activities in the hand on both ipsilateral and contralateral sides. The subjects sat in an armchair with hands in the pronated position. They were able to freely move their right/left hand and foot. They performed three tasks for both ipsilateral (right hand and right foot) and contralateral limb coordination (left hand and right foot for a total of six tasks). These tasks involved: (1) wrist extension from a flexed (resting) position, (2) wrist extension with simultaneous ankle dorsiflexion from a plantarflexed (resting) position, and (3) wrist extension with simultaneous ankle relaxation from a dorsiflexed position. The subjects performed each task as fast as possible after hearing the start signal. Reaction time for the wrist extensor contraction (i.e. the degree to which it preceded the motor reaction time), as observed in electromyography (EMG), became longer when it was concurrently done with relaxation of the ankle dorsiflexor. Also, the magnitude of EMG activity became smaller, as compared with activity when wrist extensor contraction was done alone or with contraction of the ankle dorsiflexor. These effects were observed not only for the ipsilateral hand, but also for the contralateral hand. Our findings suggest that muscle relaxation in one limb interferes with muscle contraction in both the ipsilateral and contralateral limbs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Wrist Hypothermia Related to Continuous Work with a Computer Mouse: A Digital Infrared Imaging Pilot Study.

PubMed

Reste, Jelena; Zvagule, Tija; Kurjane, Natalja; Martinsone, Zanna; Martinsone, Inese; Seile, Anita; Vanadzins, Ivars

2015-08-07

Computer work is characterized by sedentary static workload with low-intensity energy metabolism. The aim of our study was to evaluate the dynamics of skin surface temperature in the hand during prolonged computer mouse work under different ergonomic setups. Digital infrared imaging of the right forearm and wrist was performed during three hours of continuous computer work (measured at the start and every 15 minutes thereafter) in a laboratory with controlled ambient conditions. Four people participated in the study. Three different ergonomic computer mouse setups were tested on three different days (horizontal computer mouse without mouse pad; horizontal computer mouse with mouse pad and padded wrist support; vertical computer mouse without mouse pad). The study revealed a significantly strong negative correlation between the temperature of the dorsal surface of the wrist and time spent working with a computer mouse. Hand skin temperature decreased markedly after one hour of continuous computer mouse work. Vertical computer mouse work preserved more stable and higher temperatures of the wrist (>30 °C), while continuous use of a horizontal mouse for more than two hours caused an extremely low temperature (<28 °C) in distal parts of the hand. The preliminary observational findings indicate the significant effect of the duration and ergonomics of computer mouse work on the development of hand hypothermia.

Effects of tool handle dimension and workpiece orientation and size on wrist ulnar/radial torque strength, usability and discomfort in a wrench task.

PubMed

Dianat, Iman; Rahimi, Soleyman; Nedaei, Moein; Asghari Jafarabadi, Mohammad; Oskouei, Ali E

2017-03-01

The effects of tool handle dimension (three modified designs of wrenches with 30-50 mm diameter cylindrical handles and traditional design with rectangular cross-sectional (5 mm × 25 mm) handle), workpiece orientation (vertical/horizontal) and workpiece size (small/large) as well as user's hand size on wrist ulnar/radial (U/R) torque strength, usability and discomfort, and also the relationship between these variables were evaluated in a maximum torque task using wrenches. The highest and lowest levels of maximal wrist U/R torque strength were recorded for the 30 mm diameter handle and traditional wrench design, respectively. The prototype handle with 30 mm diameter, together with 40 mm diameter handle, was also better than other designs as they received higher usability ratings and caused less discomfort. The mean wrist torque strength exerted on a vertically oriented workpiece (in the sagittal plane) was 23.8% higher than that exerted on a horizontally oriented one (in the transverse plane). The user's hand size had no effect on torque exertions. The wrist torque strength and usability were negatively correlated with hand and finger discomfort ratings. The results are also discussed in terms of their implications for hand tool and workstation configuration in torque tasks involving wrenches. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of wrist tendon vibration on arm tracking in people poststroke.

PubMed

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

2011-09-01

The goal of this study was to evaluate the influence of wrist tendon vibration on a multijoint elbow/shoulder tracking task. We hypothesized that tendon vibration applied at the wrist musculature would improve upper arm tracking performance in chronic stroke survivors through increased, Ia-afferent feedback to the central nervous system (CNS). To test this hypothesis, 10 chronic stroke and 5 neurologically intact subjects grasped the handle of a planar robot as they tracked a target through a horizontal figure-8 pattern. A total of 36 trials were completed by each subject. During the middle trials, 70-Hz tendon vibration was applied at the wrist flexor tendons. Position, velocity, and electromyography data were evaluated to compare the quality of arm movements before, during, and after trials with concurrent vibration. Despite tracking a target that moved at a constant velocity, hand trajectories appeared to be segmented, displaying alternating intervals of acceleration and deceleration. Segments were identifiable in tangential velocity data as single-peaked, bell-shaped speed pulses. When tendon vibration was applied at the wrist musculature, stroke subjects experienced improved tracking performance in that hand path lengths and peak speed variability decreased, whereas movement smoothness increased. These performance improvements were accompanied by decreases in the muscle activity during movement. Possible mechanisms behind improved movement control in response to tendon vibration may include improved sensorimotor integration or improved cortical modulation of spinal reflex activity.

Effects of wrist tendon vibration on arm tracking in people poststroke

PubMed Central

Conrad, Megan O.; Scheidt, Robert A.

2011-01-01

The goal of this study was to evaluate the influence of wrist tendon vibration on a multijoint elbow/shoulder tracking task. We hypothesized that tendon vibration applied at the wrist musculature would improve upper arm tracking performance in chronic stroke survivors through increased, Ia-afferent feedback to the central nervous system (CNS). To test this hypothesis, 10 chronic stroke and 5 neurologically intact subjects grasped the handle of a planar robot as they tracked a target through a horizontal figure-8 pattern. A total of 36 trials were completed by each subject. During the middle trials, 70-Hz tendon vibration was applied at the wrist flexor tendons. Position, velocity, and electromyography data were evaluated to compare the quality of arm movements before, during, and after trials with concurrent vibration. Despite tracking a target that moved at a constant velocity, hand trajectories appeared to be segmented, displaying alternating intervals of acceleration and deceleration. Segments were identifiable in tangential velocity data as single-peaked, bell-shaped speed pulses. When tendon vibration was applied at the wrist musculature, stroke subjects experienced improved tracking performance in that hand path lengths and peak speed variability decreased, whereas movement smoothness increased. These performance improvements were accompanied by decreases in the muscle activity during movement. Possible mechanisms behind improved movement control in response to tendon vibration may include improved sensorimotor integration or improved cortical modulation of spinal reflex activity. PMID:21697444

Automated joint space width quantification of hand and wrist joints: a proof of concept study.

PubMed

Huo, Yinghe; Veldhuizen, Renske D; van der Heijde, Desiree M; Besselink, Nick J; Jacobs, Johannes W G; van Laar, Jacob M; Viergever, Max A; Vincken, Koen L; Lafeber, Floris P; de Hair, Maria J H

2016-01-01

To compare as proof of concept the sensitivity to change of automated quantification of radiographic wrist and hand joint space width (JSW) with scoring JSW according to the Sharp/van der Heijde scoring method (SHS) in two strategy groups of a treat-to-target and tight-control early rheumatoid arthritis (RA) study. Digital radiographs were assessed for JSW changes of 134 patients of the 236 patients participating in the second Computer Assisted Management in Early Rheumatoid Arthritis trial, of whom both baseline and year 2 radiographs were available (year 1 radiographs n=125). Of those 134 patients, 70 started with methotrexate and prednisone (MTX+Pred) and 64 with MTX and placebo (MTX+Plac). JSW change over 1 and 2 years of the hands and wrists was assessed, applying both the joint space narrowing (JSN) subscore of the SHS by 2 readers and the automated assessment with the JSW quantification software 'JSQ'. For both methods, progression of JSW change of the hand and wrist was analysed using linear mixed modelling (dependent variable 'JSW', factor 'strategy group', covariate 'follow-up time in years', interaction term 'strategy group*follow-up time'; radiographs of baseline, year 1 and year 2 were used). For each method the standardised mean difference (SMD) for the change in JSW from baseline to year 2 between the treatment strategies was obtained using a non-parametric method. Patient characteristics of the current subpopulation were similar to those of the whole study population. JSN of the hand and wrist according to SHS at 2 years was present in 16 vs. 23% in the MTX+Pred group vs. the MTX+Plac group. The mean yearly progression rates of JSW change of the hands and wrists using JSQ were -0.00mm (95% confidence interval (CI) -0.01; 0.01) for MTX+Pred vs. -0.02mm (95%CI -0.03; -0.01) for MTX+Plac, p=0.045, and using SHS JSN they were 0.19 units (95%CI 0.09; 0.30) vs. 0.30 units (95%CI 0.14; 0.45) for MTX+Pred vs. MTX+Plac, p=0.271. The SMD for the change from baseline to year 2 between the treatment strategies was 0.37 for JSQ and 0.13 for SHS JSN. In this proof of concept study the yearly progression rate of JSW change of hand and wrist joints, according to the automated JSW quantification software package 'JSQ', was higher in the group initiating MTX+Plac than in the group initiating MTX+Pred. A similar trend was seen with the JSN assessment according to the SHS method of the hand and wrist. However, JSN of the hand and wrist according to SHS, the current gold standard to assess radiographic progression, was seen in only about 20%. Therefore, further studies are needed to conclude firmly that JSQ should be incorporated into quantitative scoring of radiographs in RA.

A Conceptual Project of a Device for Human Wrist Functional Rehabilitation

NASA Astrophysics Data System (ADS)

Lewandowski, B.; Olinski, M.; Wudarczyk, S.; Gronowicz, A.

2016-12-01

In the paper, the problems of devices supporting functional rehabilitation of a human wrist were addressed. A literature review and a description of selected devices together with an indication of their advantages and disadvantages were conducted. The biomechanical structure of a human wrist was analyzed. On this basis and after taking into consideration ranges of motion of the selected joints the concept of a new mechanism was developed. A 3D model of the device was built in the Autodesk Inventor system. For the purpose of simulations another model was developed in the MSC Adams system. Issues of drives and sensors selection, as well as requirements for the control system, were examined.

[Carpus and distal radioulnar joint : Clinical and radiological examination].

PubMed

Spies, C K; Langer, M F; Unglaub, F; Mühldorfer-Fodor, M; Müller, L P; Ahrens, C; Schlindwein, S F

2016-08-01

A precise medical history and specific symptom-oriented clinical tests of the wrist joint should always precede any radiological, computed tomography (CT) or magnetic resonance imaging (MRI) diagnostics. In many cases, specific clinical tests of the wrist joint allow at least a preliminary diagnosis, which can be supported by standard radiography using correct projections. A systematic approach is recommended covering the radiocarpal, midcarpal, ulnocarpal and distal radioulnar joints. Exact identification of the palpable anatomic landmarks is mandatory for correct application and interpretation of the various clinical tests. The results of the clinical tests in combination with radiological imaging can often detect precisely ruptures of distinct wrist joint ligaments and localized arthritis.

Modular multimorphic kinematic arm structure and pitch and yaw joint for same

DOEpatents

Martin, H. Lee; Williams, Daniel M.; Holt, W. Eugene

1989-01-01

A multimorphic kinematic manipulator arm is provided with seven degrees of freedom and modular kinematic redundancy through identical pitch/yaw, shoulder, elbow and wrist joints and a wrist roll device at the wrist joint, which further provides to the manipulator arm an obstacle avoidance capability. The modular pitch/yaw joints are traction drive devices which provide backlash free operation with smooth torque transmission and enhanced rigidity. A dual input drive arrangement is provided for each joint resulting in a reduction of the load required to be assumed by each drive and providing selective pitch and yaw motions by control of the relative rotational directions of the input drive.

Ulnar neuropathy at wrist: entrapment at a very "congested" site.

PubMed

Coraci, Daniele; Loreti, Claudia; Piccinini, Giulia; Doneddu, Pietro E; Biscotti, Silvia; Padua, Luca

2018-05-19

Ulnar tunnel syndrome indicates ulnar neuropathy at different sites within the wrist. Several classifications of ulnar tunnel syndrome are present in literature, based upon typical nerve anatomy. However, anatomical variations are not uncommon and can complicate assessment. The etiology is also complex, due to the numerous potential causes of entrapment. Clinical examination, neurophysiological testing, and imaging are all used to support the diagnosis. At present, many therapeutic approaches are available, ranging from observation to surgical management. Although ulnar neuropathy at the wrist has undergone extensive prior study, unresolved questions on diagnosis and treatment remain. In the current paper, we review relevant literature and present the current knowledge on ulnar tunnel syndrome.

Modular multimorphic kinematic arm structure and pitch and yaw joint for same

DOEpatents

Martin, H.L.; Williams, D.M.; Holt, W.E.

1987-04-21

A multimorphic kinematic manipulator arm is provided with seven degrees of freedom and modular kinematic redundancy through identical pitch/yaw, shoulder, elbow and wrist joints and a wrist roll device at the wrist joint, which further provides to the manipulator arm an obstacle avoidance capability. The modular pitch/yaw joints are traction drive devices which provide backlash free operation with smooth torque transmission and enhanced rigidity. A dual input drive arrangement is provided for each joint resulting in a reduction of the load required to be assumed by each drive means and providing selective pitch and yaw motions by control of the relative rotational directions of the input drive means. 12 figs.

Triple-axis common-pivot arm wrist device for manipulative applications

NASA Technical Reports Server (NTRS)

Kersten, L.; Johnston, J. D.

1980-01-01

A concept in manipulator development to overcome the 'weak wrist syndrome', a triple-axis common-pivot arm wrist (TACPAW), is presented. It contains torque motors for actuation, tachometers for measuring rate, and resolvers for position measurements. Furthermore, it provides three degrees of freedom, i.e., pitch, yaw, and roll, in a single manipulator joint. The advantages of this development are increased strength, compactness, and simplification of controls. Designed to be compatible with the protoflight manipulator arm, the joints of TACPAW are back-driveable with + or - 45 deg rotation in pitch, + or - 45 deg in yaw and continuous roll in either direction while delivering 20.5 N-m (15 ft-lb) torque in each of the three movements.

Big Comsats for big jobs at low user cost. [considering wrist telephony, electronic mail transmission and educational television applications

NASA Technical Reports Server (NTRS)

Bekey, I.

1979-01-01

Three examples are used to illustrate what is possible with large space systems: (1) personal communications using wrist telephones, (2) electronic transmission of mail, and (3) wide dissemination of educational TV. Design concepts and costs are explored and compared to alternative ground-based concepts.

Differences in daily rhythms of wrist temperature between obese and normal-weight women: associations with metabolic syndrome features

USDA-ARS?s Scientific Manuscript database

The circadian rhythm of core body temperature is associated with widespread physiological effects. However, studies with other more practical temperature measures, such as wrist (WT) and proximal temperatures, are still scarce. The aim of this study was to investigate whether obesity is associated w...

Association between Computer Use and Entrapment Neuropathies in the Wrist Region

ERIC Educational Resources Information Center

Colak, S.; Bamac, B.; Colak, T.; Ozbek, A.

2013-01-01

There is general consensus in the literature that computer use is often associated with an increased prevalence of hand and wrist disorders. Symptoms may be associated with specific clinical entities such as peripheral nerve entrapment. Motor and sensory nerve conduction velocity and vibration threshold in the hand of computer users have been…

Potentially risky postural behaviors during worksite keyboard use

PubMed Central

Baker, Nancy A.; Redfern, Mark

2016-01-01

Objective This study describes the frequency and distribution of potentially risky postural behaviors of keyboard users. Method Forty-three subjects’ keyboard postural behaviors were rated with the Keyboard – Personal Computer Style instrument (K-PeCS) while they worked at their own workstations. The frequency and distribution of keyboard postural behaviors, and the associations and differences between the right and left sides were assessed. Results Generally, each static body posture had a single criterion that occurred most frequently, (e.g. elbow flexion posture 80 – 120 degrees), while dynamic postures of the wrists and hands were distributed throughout their criteria. Right and left side postural behaviors were significantly associated for shoulder flexion, elbow flexion, hand displacement, wrist extension, forearm rotation, isolated 5th digit, MCP hyperextension, and wrist support use, and significantly different for hand displacement, isolated thumb, number of digits used, and MCP hyperextension. Conclusion Potentially problematic keyboard postural behaviors are common among keyboard users. Our results suggest that occupational therapists must systematically assess body, arm, wrist, and hand postures on both the right and left sides to be able to develop the most effective intervention strategies. PMID:19708467

Magnetic resonance imaging of the wrist: bone and cartilage injury.

PubMed

Hayter, Catherine L; Gold, Stephanie L; Potter, Hollis G

2013-05-01

Magnetic resonance imaging (MRI) is particularly useful for imaging the wrist due to its superior soft tissue contrast and ability to detect subtle bone marrow changes and occult fractures. A high field (1.5T or greater) strength, dedicated wrist coil, and high in-plane and through-plane resolution must be utilized to successfully visualize the relatively thin cartilage of the wrist. MRI can be used to detect occult carpal bone fractures, identify complications following scaphoid fractures, and assess for avascular necrosis in the setting in Kienböck's and Preiser's disease. MRI is useful to identify secondary soft tissue and chondral pathology in impaction/impingement syndromes. The use of an intermediate-echo time fast spin echo sequence allows for accurate assessment of articular cartilage, allowing evaluation of chondral wear in the setting of primary osteoarthritis and posttraumatic degenerative arthrosis. MRI is the most sensitive imaging modality for the detection of early inflammatory arthropathies and can detect synovitis, bone marrow edema, and early erosions in the setting of negative radiographs. Copyright © 2012 Wiley Periodicals, Inc.

Are the yips a task-specific dystonia or "golfer's cramp"?

PubMed

Adler, Charles H; Crews, Debra; Kahol, Kanav; Santello, Marco; Noble, Brie; Hentz, Joseph G; Caviness, John N

2011-09-01

This study compared golfers with and without the yips using joint movement and surface electromyographic detectors. Fifty golfers (25 with and 25 without complaints of the yips) were studied while putting. All putts were videotaped. Surface electromyography assessed arm cocontraction. A CyberGlove II (Immersion Technologies, Palo Alto, CA) assessed right-arm angular movements. Primary analysis was done by subjective complaint of the yips, whereas secondary analysis was done by video evidence of an involuntary movement. When grouped by subjective complaints, there were no differences in any movement parameter. When grouped by video evidence of an involuntary movement, yips cases had more (P < 0.001) angular movement in wrist pronation/supination and a trend (P = 0.08) for wrist flexor/extensor cocontraction (yips: 7 of 17, 41.2%; no yips: 6 of 33, 18.2%). Golfers with video evidence of an involuntary movement while putting have excessive rotation of the right wrist in a pronation/supination motion and, as previously reported, a trend for wrist flexor/extensor cocontraction. Copyright © 2011 Movement Disorder Society.

ELBOW AND WRIST INJURIES IN SPORTS

PubMed Central

Marmor, Leonard; Bechtol, Charles O.

1960-01-01

Any disabling injury of the elbow or wrist should be studied roentgenographically for evidence of fracture which may not be otherwise evident but which may cause permanent disability unless the joint is immobilized for healing. “Tennis elbow” may be treated with physical therapy and analgesic injection but may require splinting or tendon stripping. Elbow sprain can occur in the growing epiphysis but is rare in adults. A jarring fall on the hand may cause fracture or dislocation at the elbow. Full extension of the joint should be restored gradually by active exercise rather than passive or forcible stretching. Fracture at the head of the radius may cause joint hemorrhage with severe pain which can be relieved by aspiration. A displacing fracture at the head of the radius requires removal of the head to prevent arthritic changes. Myositis ossificans contraindicates operation until after it has cleared. Healing of wrist fractures may be facilitated by exercise of the shoulder and elbow while the wrist is still in a cast. Fractures of the navicular bone are difficult to detect even roentgenographically and splinting may have to be done on clinical evidence alone. PMID:14421374

Targeted brain activation using an MR-compatible wrist torque measurement device and isometric motor tasks during functional magnetic resonance imaging.

PubMed

Vlaar, Martijn P; Mugge, Winfred; Groot, Paul F C; Sharifi, Sarvi; Bour, Lo J; van der Helm, Frans C T; van Rootselaar, Anne-Fleur; Schouten, Alfred C

2016-07-01

Dedicated pairs of isometric wrist flexion tasks, with and without visual feedback of the exerted torque, were designed to target activation of the CBL and BG in healthy subjects during functional magnetic resonance imaging (fMRI). Selective activation of the cerebellum (CBL) and basal ganglia (BG), often implicated in movement disorders such as tremor and dystonia, may help identify pathological changes and expedite diagnosis. A prototyped MR-compatible wrist torque measurement device, free of magnetic and conductive materials, allowed safe execution of tasks during fMRI without causing artifacts. A significant increase of activity in CBL and BG was found in healthy volunteers during a constant torque task with visual feedback compared to a constant torque task without visual feedback. This study shows that specific pairs of motor tasks using MR-compatible equipment at the wrist allow for targeted activation of CBL and BG, paving a new way for research into the pathophysiology of movement disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of ice on pain after corticosteroid injection in the hand and wrist: a randomized controlled trial.

PubMed

An, T W; Boone, S L; Boyer, M I; Gelberman, R H; Osei, D A; Calfee, R P

2016-11-01

This prospective, randomized controlled study was designed to determine if applying ice to the site of corticosteroid injections in the hand and wrist reduces post-injection pain. Patients receiving corticosteroid injections in the hand or wrist at a tertiary institution were enrolled. Subjects were randomized to apply ice to the injection site and take scheduled over-the-counter analgesics ( n = 36) or take scheduled over-the-counter analgesics alone ( n = 32). There were no significant differences in the mean pain score between the two groups at any time-point (pre-injection or 1-5 days post-injection). In regression modelling, the application of ice did not predict pain after injection. Visual analogue pain scores increased at least 2 points (0-10 scale) after injection in 17 out of 36 patients in the ice group versus ten out of 32 control patients. We conclude that the application of ice in addition to over-the-counter analgesics does not reduce post-injection pain after corticosteroid injection in the hand or wrist. I Therapeutic Study.

The Manumeter: A non-obtrusive wearable device for monitoring spontaneous use of the wrist and fingers

PubMed Central

Rowe, Justin B.; Friedman, Nizan; Bachman, Mark; Reinkensmeyer, David J.

2014-01-01

This paper describes the design and pilot testing of a novel device for unobtrusive monitoring of wrist and hand movement through a sensorized watch and a magnetic ring system called the manumeter. The device senses the magnetic field of the ring through two triaxial magnetometers and records the data to onboard memory which can be analyzed later by connecting the watch unit to a computer. Wrist and finger joint angles are estimated using a radial basis function network. We compared joint angle estimates collected using the manumeter to direct measurements taken using a passive exoskeleton and found that after a 60 minute trial, 95% of the radial/ulnar deviation, wrist flexion/extension and finger flexion/extension estimates were within 2.4, 5.8, and 4.7 degrees of their actual values respectively. The device measured angular distance traveled for these three joints within 10.4%, 4.5%, and 14.3 % of their actual values. The manumeter has potential to improve monitoring of real world use of the hand after stroke and in other applications. PMID:24187216

Heart Rate Detection During Sleep Using a Flexible RF Resonator and Injection-Locked PLL Sensor.

PubMed

Kim, Sung Woo; Choi, Soo Beom; An, Yong-Jun; Kim, Byung-Hyun; Kim, Deok Won; Yook, Jong-Gwan

2015-11-01

Novel nonintrusive technologies for wrist pulse detection have been developed and proposed as systems for sleep monitoring using three types of radio frequency (RF) sensors. The three types of RF sensors for heart rate measurement on wrist are a flexible RF single resonator, array resonators, and an injection-locked PLL resonator sensor. To verify the performance of the new RF systems, we compared heart rates between presleep time and postsleep onset time. Heart rates of ten subjects were measured using the RF systems during sleep. All three RF devices detected heart rates at 0.2 to 1 mm distance from the skin of the wrist over clothes made of cotton fabric. The wrist pulse signals of a flexible RF single resonator were consistent with the signals obtained by a portable piezoelectric transducer as a reference. Then, we confirmed that the heart rate after sleep onset time significantly decreased compared to before sleep. In conclusion, the RF system can be utilized as a noncontact nonintrusive method for measuring heart rates during sleep.

Intersection Syndrome: The Subtle Squeak of an Overused Wrist.

PubMed

Skinner, Thomas M

2017-01-01

Patient histories that include wrist pain can be pivotal in the distinction between intersection syndrome (IS) and the more common de Quervain's tenosynovitis (DQT). Presented here is a 26-year-old pregnant woman with a history of rowing who developed left radial/dorsal wrist pain and a rubbing/squeaking sensation. Nine months of conservative DQT therapy and a landmark-guided corticosteroid injection failed to relieve her symptoms. An in-clinic ultrasound showed tenosynovitis at the intersection of the first and second compartments, confirming a diagnosis of IS. She found immediate relief with ultrasound-guided saline hydrodissection, the injection of saline into the intercompartmental space to reduce adhesions. Both DQT and IS are overuse injuries caused by repetitive wrist extension, as occurs in rowing, and either condition can worsen after pregnancy. Distinguishing the subtleties between DQT and IS can be challenging. Close attention to the patient's description of the pain can guide treatment, potentially expediting recovery. In addition, saline hydrodissection can be both a diagnostic tool and a potentially therapeutic alternative to steroid injections for such tendinopathies. © Copyright 2017 by the American Board of Family Medicine.

Association between wrist ratio and carpal tunnel syndrome: Effect modification by body mass index.

PubMed

Thiese, Matthew S; Merryweather, Andrew; Koric, Alzina; Ott, Ulrike; Wood, Eric M; Kapellusch, Jay; Foster, James; Garg, Arun; Deckow-Schaefer, Gwen; Tomich, Suzanna; Kendall, Richard; Drury, David L; Wertsch, Jacqueline; Hegmann, Kurt T

2017-12-01

Previous studies have reported higher wrist ratios (WR) related to carpal tunnel syndrome (CTS) but have not assessed effect modification by obesity and may have inadequately controlled for confounders. Baseline data of a multicenter prospective cohort study were analyzed. CTS was defined by nerve conduction study (NCS) criteria and symptoms. Among the 1,206 participants, a square-shaped wrist was associated with CTS after controlling for confounders (prevalence ratio = 2.27; 95% confidence interval [95% CI], 1.33-3.86). Body mass index (BMI) was a strong effect modifier on the relationship between WR and both CTS and abnormal NCS results, with normal weight strata of rectangular versus square wrists = 8.18 (95% CI, 1.63-49.96) and 7.12 (95% CI, 2.19-23.16), respectively. A square wrist is significantly associated with CTS after controlling for confounders. Effect modification by high BMI masked the eightfold magnitude adjusted relationship seen between WR and CTS among normal weight participants. Muscle Nerve 56: 1047-1053, 2017. © 2017 Wiley Periodicals, Inc.

Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel.

PubMed

Balazs, George C; Donohue, Michael A; Drake, Matthew L; Ipsen, Derek; Nanos, George P; Tintle, Scott M

2015-09-01

To examine the most common presenting complaints of active-duty service members with isolated dorsal wrist ganglions and to determine the rate of return to unrestricted duty after open excision. Surgical records at 2 military facilities were screened to identify male and female active duty service members undergoing isolated open excision of dorsal wrist ganglions from January 1, 2006 to January 1, 2014. Electronic medical records and service disability databases were searched to identify the most common presenting symptoms and to determine whether patients returned to unrestricted active duty after surgery. Postoperative outcomes examined were pain persisting greater than 4 weeks after surgery, stiffness requiring formal occupational therapy treatment, surgical wound complications, and recurrence. A total of 125 active duty military personnel (Army, 54; Navy, 43; and Marine Corps, 28) met criteria for inclusion. Mean follow-up was 45 months. Fifteen percent (8 of 54) of the Army personnel were given permanent waivers from performing push-ups owing to persistent pain and stiffness. Pain persisting greater than 4 weeks after surgery was an independent predictor of eventual need for a permanent push-up waiver. The overall recurrence incidence was 9%. No demographic or perioperative factors were associated with recurrence. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations that may occur after open dorsal wrist ganglion excision. Therapeutic IV. Published by Elsevier Inc.

Hazardous materials emergency response mobile robot

NASA Technical Reports Server (NTRS)

Stone, Henry W. (Inventor); Lloyd, James W. (Inventor); Alahuzos, George A. (Inventor)

1995-01-01

A simple or unsophisticated robot incapable of effecting straight-line motion at the end of its arm is presented. This robot inserts a key held in its end effector or hand into a door lock with nearly straight-line motion by gently thrusting its back heels downwardly so that it pivots forwardly on its front toes while holding its arm stationary. The relatively slight arc traveled by the robot's hand is compensated by a complaint tool with which the robot hand grips the door key. A visible beam is projected through the axis of the hand or gripper on the robot arm end at an angle to the general direction in which the robot thrusts the gripper forward. As the robot hand approaches a target surface, a video camera on the robot wrist watches the beam spot on the target surface fall from a height proportional to the distance between the robot hand and the target surface until the beam spot is nearly aligned with the top of the robot hand. Holes in the front face of the hand are connected through internal passages inside the arm to an on-board chemical sensor. Full rotation of the hand or gripper about the robot arm's wrist is made possible by slip rings in the wrist which permit passage of the gases taken in through the nose holes in the front of the hand through the wrist regardless of the rotational orientation of the wrist.

Risks of musculoskeletal disorders among betel quid preparers in Taiwan.

PubMed

Chang, Jer-Hao; Wu, Jyun-De; Chen, Chih-Yong; Sumd, Shih-Bin; Yin, Hsin-I; Hsu, Der-Jen

2014-04-01

Betel quid chewing is common in Taiwan. The work of betel quid preparers is characterized by long hours of static work, awkward working posture and highly repetitive hand/wrist motion. However, the musculoskeletal health of betel quid preparers receives very little attention. The Chinese version of the Standardized Nordic Musculoskeletal Questionnaire (NMQ) was administered, and electrogoniometers and electromyography were used in this cross-sectional study to characterize the hand/wrist motion of the subjects. Physical examinations on the thumbs and wrists of the subjects were conducted by means of Phalen's test and Finkelstein's test, respectively. Among the 225 participants, more than 95% attributed their musculoskeletal complaints to their work, and shoulder, neck, hand/wrist, and lower back discomfort were most frequently reported. More than 70% of the preparers did not seek medical treatment for their musculoskeletal problems. Based on the physical examination, 24% of the participants had suspected symptom of either carpal tunnel syndrome (CTS) or DeQuervain's tenosynovitis. The instrumental measurements indicated that betel quid preparation is characterized by extreme angle ranges and moderate repetition of wrist motion as well as low forceful exertion. This study concludes that betel quid preparers are a high risk group of developing musculoskeletal disorders (MSDs). Future studies by electrogoniometers and detailed physical examination on betel quid preparers are needed to determine the predisposing factors for CTS. Some intervention measures to prevent MSDs and to lessen psychological stress for this group of workers are strongly suggested. © 2014 Wiley Periodicals, Inc.

Actigraphy in the critically ill: correlation with activity, agitation, and sedation.

PubMed

Grap, Mary Jo; Borchers, C Todd; Munro, Cindy L; Elswick, R K; Sessler, Curtis N

2005-01-01

To determine the feasibility of continuous measurement of limb movement via wrist and ankle actigraphy (an activity measure) in critically ill patients and to compare actigraphy measurements with observed activity, subjective scores on sedation-agitation scales, and heart rate and blood pressure of patients. In a prospective, descriptive, correlational study, all activity of 20 adult patients in medical and coronary care units in a university medical center were observed for 2 hours and documented. Wrist and ankle actigraphy, heart rate, and systolic and diastolic blood pressure data were collected every minute. The Comfort Scale and the Richmond Agitation-Sedation Scale were completed at the beginning of the observation period and 1 and 2 hours later. Wrist actigraphy data correlated with scores on the Richmond Agitation-Sedation Scale (r = 0.58) and the Comfort Scale (r = 0.62) and with observed stimulation and activity events of patients (r = 0.45). Correlations with systolic, diastolic, and mean arterial pressures were weaker. Wrist and ankle actigraphy data were significantly correlated (r = 0.69; P < .001); however, their mean values (wrist, 418; ankle, 147) were significantly different (t = 5.77; P < .001). Actigraphy provides a continuous recording of patients' limb movement. Actigraphy measurements correlate well with patients' observed activity and with subjective scores on agitation and sedation scales. Actigraphy may become particularly important as a continuous measurement of activity for use in behavioral research and may enhance early recognition and management of the excessive activity that characterizes agitation.

Distal radius reconstruction with vascularized proximal fibular autograft after en-bloc resection of recurrent giant cell tumor.

PubMed

Yang, Yun-Fa; Wang, Jian-Wei; Huang, Pin; Xu, Zhong-He

2016-08-17

Giant cell tumors (GCTs) located in the distal radius are likely to recur, and the treatment of such recurrent tumors is very difficult. Here, we report our clinical experience in distal radius reconstruction with vascularized proximal fibular autografts after en-bloc excision of the entire distal radius in 17 patients with recurrent GCT (RGCT) of the distal radius. All 17 patients with RGCT in distal radius underwent plain radiography and/or magnetic resonance imaging (MRI) of the distal radius as the initial evaluation after hospitalization. Then the distal radius were replaced by vascularized proximal fibular autografts after en-bloc RGCT resection. We assessed all patients by using clinical examinations, plain radiography of the wrist and chest, and Mayo wrist scores in the follow-ups. After an average follow-up of 4.3 years (range: 1.5-10.0 years), no lung metastasis or local recurrence was detected in any of the 17 patients. In total, 14 patients had excellent or good functional wrist scores, 16 were pain free or had occasional pain, and 15 patients returned to work. The mean range of motion of the wrist was 101° (flexion-extension), and the mean grip strength was 77.2 % of the contralateral normal hand. En-bloc excision of the entire distal radius and distal radius reconstruction with a vascularized proximal fibular autograft can effectively achieve local tumor control and preserve wrist function in patients with RGCT of the distal radius.

Reduced bone mineral density in postmenopausal women self-reporting premenopausal wrist fractures.

PubMed

Fiorano-Charlier, C; Ostertag, A; Aquino, J P; de Vernejoul, M-C; Baudoin, C

2002-07-01

Postmenopausal fractures are associated with low bone mass; however, the role of low peak bone mass in young adults in determining subsequent osteoporosis suggests that premenopausal fractures may also be relevant. We therefore sought to determine whether a self-reported previous history of premenopausal wrist and nonwrist fractures could also be associated with bone density and therefore be used to predict osteoporosis. We recruited 453 volunteer women with a median age of 64 years (range 50-83 years), with no metabolic bone disease, previous femoral neck fracture, or prevalent vertebral fracture. Bone density at the femoral neck (FN) and lumbar spine (LS) was measured using a Lunar DPX-L. As expected, the 319 women who did not report any fracture had a higher T score at LS (-0.93 +/- 1.44) than the 134 women who reported a previous fracture at any site and at any age (T score -1.60 +/- 1.21, p < 0.001). The findings for the FN were similar. Compared with fracture-free women, the women who reported a first wrist fracture before menopause now had a lower LS T score (-1.77 +/- 1.20, n = 15, p < 0.05), whereas those who reported a nonwrist fracture showed no significant decrease in their LS T score (-1.26 +/- 1.00, n = 36). When both wrist and nonwrist fractures had occurred after menopause, the T score was significantly lower. Twenty percent of the fracture-free women were osteoporosis patients. After adjusting for body weight, age, hormonal replacement therapy (HRT), and hip fracture in the family, the relative risk (RR) of osteoporosis for premenopausal wrist fractures was 2.7 (95% confidence interval 1.4-4.3) vs. 1.2 (0.7-2.4) for women with premenopausal nonwrist fractures. We conclude that self-reported premenopausal wrist fractures, but no other fractures occurring before menopause, are likely to be associated with osteoporosis at 65 years of age, and therefore constitute strong grounds for screening.

Psychometrics of the wrist stability and hand mobility subscales of the Fugl-Meyer assessment in moderately impaired stroke.

PubMed

Page, Stephen J; Hade, Erinn; Persch, Andrew

2015-01-01

There remains a need for a quickly administered, stroke-specific, bedside measure of active wrist and finger movement for the expanding stroke population. The wrist stability and hand mobility scales of the upper extremity Fugl-Meyer Assessment (w/h UE FM) constitute a valid, reliable measure of paretic UE impairment in patients with active wrist and finger movement. The aim of this study was to determine performance on the w/h UE FM in a stable cohort of survivors of stroke with only palpable movement in their paretic wrist flexors. A single-center cohort study was conducted. Thirty-two individuals exhibiting stable, moderate upper extremity hemiparesis (15 male, 17 female; mean age=56.6 years, SD=10.1; mean time since stroke=4.6 years, SD=5.8) participated in the study, which was conducted at an outpatient rehabilitation clinic in the midwestern United States. The w/h UE FM and Action Research Arm Test (ARAT) were administered twice. Intraclass correlation coefficients (ICCs), Cronbach alpha, and ordinal alpha were computed to determine reliability, and Spearman rank correlation coefficients and Bland-Altman plots were computed to establish validity. Intraclass correlation coefficients for the w/h UE FM and ARAT were .95 and .99, respectively. The w/h UE FM intrarater reliability and internal consistency were greater than .80, and concurrent validity was greater than .70. This also was the first stroke rehabilitative study to apply ordinal alpha to examine internal consistency values, revealing w/h UE FM levels greater than .85. Concurrent validity findings were corroborated by Bland-Altman plots. It appears that the w/h UE FM is a promising tool to measure distal upper extremity movement in patients with little active paretic wrist and finger movement. This finding widens the segment of patients on whom the w/h UE FM can be effectively used and addresses a gap, as commonly used measures necessitate active distal upper extremity movement. © 2015 American Physical Therapy Association.

Frequency of abnormal hand and wrist radiographs at time of diagnosis of polyarticular juvenile rheumatoid arthritis.

PubMed

Mason, Tom; Reed, Ann M; Nelson, Audrey M; Thomas, Kristen B; Patton, Alice; Hoffman, Alan D; Achenbach, Sara; O'Fallon, William M

2002-10-01

To determine the frequency of radiographic abnormalities in hand/wrist radiographs of children with newly diagnosed polyarticular juvenile rheumatoid arthritis (polyJRA) because radiographs of small joints are an important tool in assessing outcomes in RA and there are clinical similarities between RA and polyJRA. A medical record review was performed to identify cases of polyJRA seen at Mayo Clinic from January 1, 1994, to December 31, 2001. Hand/wrist radiographs, obtained at the time of diagnosis, were reviewed by 3 radiologists with attention to periarticular osteopenia, joint space narrowing (JSN), or erosion. At least 2 radiologists had to independently identify abnormal findings on the same radiograph. The relative carpal length (RCL), judged by Poznanski's method, was also determined. From the review of 159 medical records, 60 cases of newly diagnosed polyJRA were identified. Twenty-five of these had hand/wrist radiographs at diagnosis; 18 sets were available for this study. Of those, 2/3 were female, 6% (1/18) had subcutaneous nodules, 7% (1/14) had elevated levels of serum rheumatoid factor, and 44% (7/16) had elevated serum levels of antinuclear antibodies. Median age at diagnosis was 10.2 years, median duration of hand/wrist symptoms at diagnosis was 10 months, and median number of joints with either swelling, pain on range of motion (ROM), or limited ROM was 14.5. Sixty-one percent of radiographs taken at the time of diagnosis of polyJRA were abnormal. While 44% had periarticular osteopenia, 28% had either erosions or JSN. Six (33%) had RCL > 2 SD below the mean for age. Five (83%) of those with RCL, > 2 SD below the mean for age, had periarticular osteopenia, JSN, or erosion. We conclude the frequency of abnormal hand/wrist radiographs is very high very early in the course of polyJRA. More studies are needed to determine to what extent these radiographic abnormalities correlate with clinical outcomes.

Kinematics of the anthropoid os centrale and the functional consequences of scaphoid-centrale fusion in African apes and hominins.

PubMed

Orr, Caley M

2018-01-01

In most primates, the os centrale is interposed between the scaphoid, trapezoid, trapezium, and head of the capitate, thus constituting a component of the wrist's midcarpal complex. Scaphoid-centrale fusion is among the clearest morphological synapomorphies of African apes and hominins. Although it might facilitate knuckle-walking by increasing the rigidity and stability of the radial side of the wrist, the exact functional significance of scaphoid-centrale fusion is unclear. If fusion acts to produce a more rigid radial wrist that stabilizes the hand and limits shearing stresses, then in taxa with a free centrale, it should anchor ligaments that check extension and radial deviation, but exhibit motion independent of the scaphoid. Moreover, because the centrale sits between the scaphoid and capitate (a major stabilizing articulation), scaphoid-centrale mobility should correlate with scaphocapitate mobility in extension and radial deviation. To test these hypotheses, the centrale's ligamentous binding was investigated via dissection in Pongo and Papio, and the kinematics of the centrale were quantified in a cadaveric sample of anthropoids (Pongo sp., Ateles geoffroyi, Colobus guereza, Macaca mulatta, and Papio anubis) using a computed-tomography-based method to track wrist-bone motion. Results indicate that the centrale rotates freely relative to the scaphoid in all taxa. However, centrale mobility is only correlated with scaphocapitate mobility during extension in Pongo-possibly due to differences in overall wrist configuration between apes and monkeys. If an extant ape-like wrist characterized early ancestors of African apes and hominins, then scaphoid-centrale fusion would have increased midcarpal rigidity in extension relative to the primitive condition. Although biomechanically consistent with a knuckle-walking hominin ancestor, this assumes that the trait evolved specifically for that biological role, which must be squared with contradictory interpretations of extant and fossil hominoid morphology. Regardless of its original adaptive significance, scaphoid-centrale fusion likely presented a constraint on early hominin midcarpal mobility. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Propulsion Style on Wrist Movement Variability During the Push Phase After a Bout of Fatiguing Propulsion.

PubMed

Zukowski, Lisa A; Christou, Evangelos A; Shechtman, Orit; Hass, Christopher J; Tillman, Mark D

2017-03-01

Wheelchair propulsion has been linked to overuse injuries regardless of propulsion style. Many aspects of the arcing (ARC) and semicircular (SEMI) propulsion styles have been compared, but differences in intracycle movement variability, which have been linked to overuse injuries, have not been examined. To explore how ARC and SEMI affect changes in intracycle wrist movement variability after a fatiguing bout of propulsion. Repeated measures crossover design. Wheelchair rollers and wheelchair fatigue course in a research laboratory. Twenty healthy, nondisabled adult men without previous wheelchair experience. Participants learned ARC and SEMI and used each to perform a wheelchair fatigue protocol. Thirty seconds of propulsion on rollers were recorded by motion-capture cameras before and after a fatigue protocol for each propulsion style on 2 testing days. Angular wrist orientations (flexion/extension and radial/ulnar deviation) and linear wrist trajectories (mediolateral direction) were computed, and intracycle movement variability was calculated as standard deviations of the detrended and filtered values during the push phase beginning and end. Paired samples t tests were used to compare ARC and SEMI based on the percent changes from pre- to postfatigue protocol. Both propulsion styles resulted in increased intracycle wrist movement variability postfatigue, but observed increases did not significantly differ between ARC and SEMI. This study evinces that intersubject variability exceeded average changes in intracycle wrist movement variability for both propulsion styles. Neither propulsion style resulting in a greater change in intracycle movement variability may suggest that no single propulsion style is ideal for everyone. The large intersubject variability may indicate that the propulsion style resulting in the smallest increase in intracycle movement variability after a fatiguing bout of propulsion may differ for each person and may help explain why wheelchair users self-select to use different propulsion styles. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Environmental and organizational factors associated with elbow/forearm and hand/wrist disorder among sewing machine operators of garment industry in Ethiopia.

PubMed

Kebede Deyyas, Wakjira; Tafese, Ararso

2014-01-01

Occupational health problems related to upper limp musculoskeletal disorders were the major issue among sewing machine operators of garment industries in Ethiopia. The aim of this study was to assess the prevalence and associated risk factors of work related elbow and wrist musculoskeletal disorders among sewing machine operators of garment industries in Galan City, Oromia Regional State. A cross-sectional study was conducted from April 1 to 30, 2012. A total of 422 study subjects were included in this study. Standard Nordic Musculoskeletal Questionnaire was used to collect detailed information on musculoskeletal symptom, sociodemographic data, and factors associated with the problems through face to face interview. From a total of 422 sewing machine operators included in the study 370 (87.7%) were females and 306 (72.5%) were in the age group of <30 years. The prevalence of self-reported work related elbow and wrist musculoskeletal disorders was 40% and 37.7%, respectively. In multivariate analysis, those who had >16 years of service were about five times more likely to develop elbow and wrist musculoskeletal disorders than those who had short (1-5 years) year of services [AOR = 4.7, 95% CI: 1.55-13.02], physical activities [AOR = 5.02, 95% CI: 1.57-16.00], and methods of payment [AOR = 2.01, 95% CI: 1.23-3.28], factors significantly associated with this disorders. Work related elbow and wrist musculoskeletal disorders were high among sewing machine operators in selected garment industries. Moreover, personal and environmental factors were identified as the potential risk factors related to elbow and wrist musculoskeletal disorders among the study group. Therefore, government and the owner of the garment industries should give special attention to prevent and control the problems through proper occupational health and safety policy implementation in the country.

Environmental and Organizational Factors Associated with Elbow/Forearm and Hand/Wrist Disorder among Sewing Machine Operators of Garment Industry in Ethiopia

PubMed Central

Kebede Deyyas, Wakjira; Tafese, Ararso

2014-01-01

Occupational health problems related to upper limp musculoskeletal disorders were the major issue among sewing machine operators of garment industries in Ethiopia. The aim of this study was to assess the prevalence and associated risk factors of work related elbow and wrist musculoskeletal disorders among sewing machine operators of garment industries in Galan City, Oromia Regional State. A cross-sectional study was conducted from April 1 to 30, 2012. A total of 422 study subjects were included in this study. Standard Nordic Musculoskeletal Questionnaire was used to collect detailed information on musculoskeletal symptom, sociodemographic data, and factors associated with the problems through face to face interview. From a total of 422 sewing machine operators included in the study 370 (87.7%) were females and 306 (72.5%) were in the age group of <30 years. The prevalence of self-reported work related elbow and wrist musculoskeletal disorders was 40% and 37.7%, respectively. In multivariate analysis, those who had >16 years of service were about five times more likely to develop elbow and wrist musculoskeletal disorders than those who had short (1–5 years) year of services [AOR = 4.7, 95% CI: 1.55–13.02], physical activities [AOR = 5.02, 95% CI: 1.57–16.00], and methods of payment [AOR = 2.01, 95% CI: 1.23–3.28], factors significantly associated with this disorders. Work related elbow and wrist musculoskeletal disorders were high among sewing machine operators in selected garment industries. Moreover, personal and environmental factors were identified as the potential risk factors related to elbow and wrist musculoskeletal disorders among the study group. Therefore, government and the owner of the garment industries should give special attention to prevent and control the problems through proper occupational health and safety policy implementation in the country. PMID:25298780

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

PubMed

McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

2017-03-01

Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017 American Physical Therapy Association

Characteristics of Handwriting of People With Cerebellar Ataxia: Three-Dimensional Movement Analysis of the Pen Tip, Finger, and Wrist.

PubMed

Fujisawa, Yuhki; Okajima, Yasutomo

2015-11-01

There are several functional tests for evaluating manual performance; however, quantitative manual tests for ataxia, especially those for evaluating handwriting, are limited. This study aimed to investigate the characteristics of cerebellar ataxia by analyzing handwriting, with a special emphasis on correlation between the movement of the pen tip and the movement of the finger or wrist. This was an observational study. Eleven people who were right-handed and had cerebellar ataxia and 17 people to serve as controls were recruited. The Scale for the Assessment and Rating of Ataxia was used to grade the severity of ataxia. Handwriting movements of both hands were analyzed. The time required for writing a character, the variability of individual handwriting, and the correlation between the movement of the pen tip and the movement of the finger or wrist were evaluated for participants with ataxia and control participants. The writing time was longer and the velocity profile and shape of the track of movement of the pen tip were more variable in participants with ataxia than in control participants. For participants with ataxia, the direction of movement of the pen tip deviated more from that of the finger or wrist, and the shape of the track of movement of the pen tip differed more from that of the finger or wrist. The severity of upper extremity ataxia measured with the Scale for the Assessment and Rating of Ataxia was mostly correlated with the variability parameters. Furthermore, it was correlated with the directional deviation of the trajectory of movement of the pen tip from that of the finger and with increased dissimilarity of the shapes of the tracks. The results may have been influenced by the scale and parameters used to measure movement. Ataxic handwriting with increased movement noise is characterized by irregular pen tip movements unconstrained by the finger or wrist. The severity of ataxia is correlated with these unconstrained movements. © 2015 American Physical Therapy Association.

Correlates of blood pressure in Yanomami Indians of northwestern Brazil.

PubMed

Crews, D E; Mancilha-Carvalho, J J

1993-01-01

We determined associations of measures of body habitus with blood pressure for 100 adult Yanomami Indians (61 men, 39 women) examined during February and March 1990. Measurements included body weight and height, four skinfolds (triceps, subscapular, suprailiac, abdomen), four circumferences (wrist, upper arm, abdomen, hip), systolic and diastolic blood pressures, pulse rate, and estimated age. Various indices of fat distribution were determined from the measurements of skinfolds, circumferences, weight, and height. Estimated age averaged 35.0 years in men and 33.4 years in women (range: 15 to 63 years). Mean systolic and diastolic blood pressures were low in both men (104.8/70.4 mm Hg) and women (94.8/63.5 mm Hg), as was body mass index (men: 20.7; women: 21.4 kg/m2). In Yanomami women, all four skinfolds, wrist circumference, and the indices of hip and abdominal fat were significant correlates of systolic blood pressure, while the abdominal skinfold and wrist and hip circumferences correlated significantly with diastolic blood pressure. Among men, there was a negative correlation between estimated age and systolic blood pressure and a positive correlation between BMI and upper arm and hip circumferences and systolic blood pressure. There was a significant positive correlation between wrist, upper arm, and hip circumferences and diastolic blood pressure among Yanomami men. We used stepwise regression to generate sex-specific predictive equations for blood pressure. For men, estimated age and hip circumference, and for women, abdominal skinfold measurement and age were included in the model for systolic blood pressure. Among men, wrist circumference and height, and among women, wrist circumference alone entered the model for diastolic blood pressure. On the basis of these results, we suggest that even in a low-blood pressure, low-body fat, no-salt setting, systolic blood pressure is associated with the amount and placement of adipose tissue. However, diastolic blood pressure is more closely correlated with skeletal size.

Prevalence of Os Styloideum in National Hockey League Players

PubMed Central

Greditzer, Harry G.; Hutchinson, Ian D.; Geannette, Christian S.; Hotchkiss, Robert N.; Kelly, Bryan T.; Potter, Hollis G.

2017-01-01

Background: Os styloideum describes an accessory carpal ossicle between the trapezoid, the capitate, and the second and third metacarpals. Injuries to this tissue have been described as part of the carpal boss syndrome. While the etiology of os styloideum remains uncertain, it may represent a physiologic response to altered loading forces in the wrist, similar to the development of cam-type deformity in the hips of ice hockey players or the Bennett lesion in the shoulders of baseball pitchers. Hypothesis: Professional hockey players will have a higher prevalence of os styloideum compared with the general population. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of 16 professional hockey players from 4 different National Hockey League (NHL) teams who underwent unilateral imaging of the wrist was performed. Seventeen wrists were reviewed for the presence of os styloideum. Results: Thirteen of 16 players (81%) had an os styloideum, representing an increased prevalence compared with the general population. Previous clinical and cadaveric studies estimated a general prevalence of up to 19% (P < 0.001). For the 10 players who had their leading wrist scanned, 9 had an os styloideum (90%). Ten of 11 (91%) players demonstrated a bone marrow edema pattern within the metacarpal and the os styloideum on magnetic resonance imaging. There was no significant association between the presence of an os styloideum and the player’s position, leading wrist, or years in the league. Conclusion: There appears to be an increased prevalence of os styloideum among NHL players, and team physicians should consider this finding while formulating a differential diagnosis for dorsal wrist pain. Clinical Relevance: This study identified NHL players as having an increased prevalence of os styloideum compared with the general population. By doing so, these findings represent an opportunity to enhance our understanding of the etiology, clinical significance, and treatment of os styloideum. PMID:28504915

Comparability of children's sedentary time estimates derived from wrist worn GENEActiv and hip worn ActiGraph accelerometer thresholds.

PubMed

Boddy, Lynne M; Noonan, Robert J; Kim, Youngwon; Rowlands, Alex V; Welk, Greg J; Knowles, Zoe R; Fairclough, Stuart J

2018-03-28

To examine the comparability of children's free-living sedentary time (ST) derived from raw acceleration thresholds for wrist mounted GENEActiv accelerometer data, with ST estimated using the waist mounted ActiGraph 100count·min -1 threshold. Secondary data analysis. 108 10-11-year-old children (n=43 boys) from Liverpool, UK wore one ActiGraph GT3X+ and one GENEActiv accelerometer on their right hip and left wrist, respectively for seven days. Signal vector magnitude (SVM; mg) was calculated using the ENMO approach for GENEActiv data. ST was estimated from hip-worn ActiGraph data, applying the widely used 100count·min -1 threshold. ROC analysis using 10-fold hold-out cross-validation was conducted to establish a wrist-worn GENEActiv threshold comparable to the hip ActiGraph 100count·min -1 threshold. GENEActiv data were also classified using three empirical wrist thresholds and equivalence testing was completed. Analysis indicated that a GENEActiv SVM value of 51mg demonstrated fair to moderate agreement (Kappa: 0.32-0.41) with the 100count·min -1 threshold. However, the generated and empirical thresholds for GENEActiv devices were not significantly equivalent to ActiGraph 100count·min -1 . GENEActiv data classified using the 35.6mg threshold intended for ActiGraph devices generated significantly equivalent ST estimates as the ActiGraph 100count·min -1 . The newly generated and empirical GENEActiv wrist thresholds do not provide equivalent estimates of ST to the ActiGraph 100count·min -1 approach. More investigation is required to assess the validity of applying ActiGraph cutpoints to GENEActiv data. Future studies are needed to examine the backward compatibility of ST data and to produce a robust method of classifying SVM-derived ST. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

High Temporospatial Resolution Dynamic Contrast Enhanced (DCE) Wrist MRI with Variable-Density Pseudo-Random CIRcular Cartesian UnderSampling (CIRCUS) Acquisition: Evaluation of Perfusion in Rheumatoid Arthritis Patients

PubMed Central

Liu, Jing; Pedoia, Valentina; Heilmeier, Ursula; Ku, Eric; Su, Favian; Khanna, Sameer; Imboden, John; Graf, Jonathan; Link, Thomas; Li, Xiaojuan

2016-01-01

This study is to evaluate highly accelerated 3D dynamic contrast-enhanced (DCE) wrist MRI for assessment of perfusion in rheumatoid arthritis (RA) patients. A pseudo-random variable-density undersampling strategy, CIRcular Cartesian UnderSampling (CIRCUS), was combined with k-t SPARSE-SENSE reconstruction to achieve a highly accelerated 3D DCE wrist MRI. Two healthy volunteers and ten RA patients were studied. Two patients were on methotrexate (MTX) only (Group I) and the other eight were treated with a combination therapy of MTX and Anti-Tumour Necrosis Factor (TNF) therapy (Group II). Patients were scanned at baseline and 3-month follow-up. DCE MR images were used to evaluate perfusion in synovitis and bone marrow edema pattern in the RA wrist joints. A series of perfusion parameters were derived and compared with clinical disease activity scores of 28 joints (DAS28). 3D DCE wrist MR images were obtained with a spatial resolution of 0.3×0.3×1.5mm3 and temporal resolution of 5 s (with an acceleration factor of 20). The derived perfusion parameters, most notably, transition time (dT) of synovitis, showed significant negative correlations with DAS28-ESR (r=-0.80, p<0.05) and DAS28-CRP (r=-0.87, p<0.05) at baseline and also correlated significantly with treatment responses evaluated by clinical score changes between baseline and 3-month follow-up (with DAS28-ESR: r=-0.79, p<0.05, and DAS28-CRP: r=-0.82, p<0.05). Highly accelerated 3D DCE wrist MRI with improved temporospatial resolution has been achieved in RA patients and provides accurate assessment of neovascularization and perfusion in RA joints, showing promise as a potential tool for evaluating treatment responses. PMID:26608949

Validation and Comparison of Accelerometers Worn on the Hip, Thigh, and Wrists for Measuring Physical Activity and Sedentary Behavior.

PubMed

Montoye, Alexander H K; Pivarnik, James M; Mudd, Lanay M; Biswas, Subir; Pfeiffer, Karin A

2016-01-01

Recent evidence suggests that physical activity (PA) and sedentary behavior (SB) exert independent effects on health. Therefore, measurement methods that can accurately assess both constructs are needed. To compare the accuracy of accelerometers placed on the hip, thigh, and wrists, coupled with machine learning models, for measurement of PA intensity category (SB, light-intensity PA [LPA], and moderate- to vigorous-intensity PA [MVPA]) and breaks in SB. Forty young adults (21 female; age 22.0 ± 4.2 years) participated in a 90-minute semi-structured protocol, performing 13 activities (three sedentary, 10 non-sedentary) for 3-10 minutes each. Participants chose activity order, duration, and intensity. Direct observation (DO) was used as a criterion measure of PA intensity category, and transitions from SB to a non-sedentary activity were breaks in SB. Participants wore four accelerometers (right hip, right thigh, and both wrists), and a machine learning model was created for each accelerometer to predict PA intensity category. Sensitivity and specificity for PA intensity category classification were calculated and compared across accelerometers using repeated measures analysis of variance, and the number of breaks in SB was compared using repeated measures analysis of variance. Sensitivity and specificity values for the thigh-worn accelerometer were higher than for wrist- or hip-worn accelerometers, > 99% for all PA intensity categories. Sensitivity and specificity for the hip-worn accelerometer were 87-95% and 93-97%. The left wrist-worn accelerometer had sensitivities and specificities of > 97% for SB and LPA and 91-95% for MVPA, whereas the right wrist-worn accelerometer had sensitivities and specificities of 93-99% for SB and LPA but 67-84% for MVPA. The thigh-worn accelerometer had high accuracy for breaks in SB; all other accelerometers overestimated breaks in SB. Coupled with machine learning modeling, the thigh-worn accelerometer should be considered when objectively assessing PA and SB.

Robot-aided developmental assessment of wrist proprioception in children.

PubMed

Marini, Francesca; Squeri, Valentina; Morasso, Pietro; Campus, Claudio; Konczak, Jürgen; Masia, Lorenzo

2017-01-09

Several neurodevelopmental disorders and brain injuries in children have been associated with proprioceptive dysfunction that will negatively affect their movement. Unfortunately, there is lack of reliable and objective clinical examination protocols and our current knowledge of how proprioception evolves in typically developing children is still sparse. Using a robotic exoskeleton, we investigated proprioceptive acuity of the wrist in a group of 49 typically developing healthy children (8-15 years), and a group of 40 young adults. Without vision participants performed an ipsilateral wrist joint position matching task that required them to reproduce (match) a previously experienced target position. All three joint degrees-of-freedom of the wrist/hand complex were assessed. Accuracy and precision were evaluated as a measure of proprioceptive acuity. The cross-sectional data indicating the time course of development of acuity were then fitted by four models in order to determine which function best describes developmental changes in proprioception across age. First, the robot-aided assessment proved to be an easy to administer method for objectively measuring proprioceptive acuity in both children and adult populations. Second, proprioceptive acuity continued to develop throughout middle childhood and early adolescence, improving by more than 50% with respect to the youngest group. Adult levels of performance were reached approximately by the age of 12 years. An inverse-root function best described the development of proprioceptive acuity across the age groups. Third, wrist/forearm proprioception is anisotropic across the three DoFs with the Abduction/Adduction exhibiting a higher level of acuity than those of Flexion/extension and Pronation/Supination. This anisotropy did not change across development. Proprioceptive development for the wrist continues well into early adolescence. Our normative data obtained trough this novel robot-aided assessment method provide a basis against which proprioceptive function of pediatric population can be compared. This may aid the design of more effective sensorimotor intervention programs.

Effect of simultaneous stretching of the wrist and finger extensors for lateral epicondylitis: a gross anatomical study of the tendinous origins of the extensor carpi radialis brevis and extensor digitorum communis.

PubMed

Shirato, Rikiya; Wada, Takuro; Aoki, Mitsuhiro; Iba, Kousuke; Kanaya, Kohei; Fujimiya, Mineko; Yamashita, Toshihiko

2015-11-01

Pulling the wrist into flexion with the elbow in extension and forearm in pronation has been used as the stretching technique of wrist extensors for lateral epicondylitis. Simultaneous stretching of the fingers in addition to the wrist flexion has also been applied. However, the mechanism of this simultaneous stretching has not been clarified. This study is designed to clarify the mechanism underlying this simultaneous stretching technique based on the anatomical features of the origins of the extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC). Thirty-nine arms from formalin-embalmed Japanese human specimens were dissected. The features of the origins of the ECRB and EDC were macroscopically observed, and the locations of each origin on the lateral epicondyle were measured. The ECRB had a long and wide, purely tendinous origin which originated from the anterior slope of the lateral epicondyle. The tendinous origin of the index finger of the EDC (EDC-IF) arose from the posterior aspect of the ECRB tendinous origin, with a coexisting muscular portion observed at the level of the proximal forearm. The middle finger of the EDC (EDC-MF) had a short tendinous origin with an associated muscular portion and originated proximo-laterally to the origin of the ECRB on the lateral epicondyle. In addition, the muscular origin of the EDC-MF arose on the superficial and posterior aspect of the ECRB tendinous origin. In contrast, the ring and little fingers of the EDC originated from the tendinous septum of the extensor digiti minimi and extensor carpi ulnaris, and had no connection with the ECRB tendinous origin. On the basis of our anatomical findings, simultaneous stretching of the wrist extensors by wrist, index and middle fingers flexion could provide stretching force to both the tendinous origins of the ECRB and EDC through the EDC-IF and EDC-MF.

Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

PubMed

Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

2016-12-01

Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reliability and concurrent validity of a new iPhone® goniometric application for measuring active wrist range of motion: a cross-sectional study in asymptomatic subjects.

PubMed

Pourahmadi, Mohammad Reza; Ebrahimi Takamjani, Ismail; Sarrafzadeh, Javad; Bahramian, Mehrdad; Mohseni-Bandpei, Mohammad Ali; Rajabzadeh, Fatemeh; Taghipour, Morteza

2017-03-01

Measurement of wrist range of motion (ROM) is often considered to be an essential component of wrist physical examination. The measurement can be carried out through various instruments such as goniometers and inclinometers. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for goniometric functions. This study, for the first time, aimed to evaluate the reliability and concurrent validity of a new smartphone goniometric app (Goniometer Pro©) for measuring active wrist ROM. In all, 120 wrists of 70 asymptomatic adults (38 men and 32 women; aged 18-40 years) were assessed in a physiotherapy clinic located at the School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Following the recruitment process, active wrist ROM was measured using a universal goniometer and iPhone ® 5 app. Two blinded examiners each utilized the universal goniometer and iPhone ® to measure active wrist ROM using a volar/dorsal alignment technique in the following sequences: flexion, extension, radial deviation, and ulnar deviation. The second (2 h later) and third (48 h later) sessions were carried out in the same manner as the first session. All the measurements were conducted three times and the mean value of three repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone ® app. Good to excellent intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥ 0.82 and ≥ 0.73 and the iPhone ® app with ICC values of ≥ 0.83 and ≥ 0.79, respectively. Minimum detectable change at the 95% confidence level (MDC 95 ) was computed as 1.96 × standard error of measurement × √2. The MDC 95 ranged from 1.66° to 5.35° for the intra-rater analysis and from 1.97° to 6.15° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r values of ≥ 0.80. From the results of this cross-sectional study, it can be concluded that the iPhone ® app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that this app can be used for the measurement of wrist ROM. However, further research is needed to evaluate symptomatic subjects using this app. © 2016 Anatomical Society.

Ergonomics: The Study of Work

DTIC Science & Technology

2000-01-01

Disease Name thumbs pain at the base of the thumbs twisting and gripping butchers , house- keepers, packers, seam- stresses, cutters fingers De...Quervain’s disease difficulty moving finger; snapping and jerking movements repeatedly using the index fingers meatpackers, poultry workers, carpenters...line workers rotator cuff tendinitis hands, wrists pain, swelling repetitive or forceful hand and wrist motions core making, poultry process- ing

Neural Network Approaches to the Processing of Experimental Electro-Myographic Data from Non-Invasive Sensors

DTIC Science & Technology

2003-07-01

14 PWFI Superior Pectoralis Distal Bicep Medial Trapezius Proximal Wrist Flexors 2 IPec 10 PTri 7 LTrp 15 DWF1 Inferior Pectoralis Proximal Tricep...Lateral Trapezius Distal Wrist Flexors 3 LPec 11 DTri 8 PBic 16 APB Lateral Pectoralis Distal Tricep Proximal Bicep Abductor Pollicus Brevis 4 LDel 12

Compact Telerobot Hand

NASA Technical Reports Server (NTRS)

Rosheim, Mark; Trechsel, Hans

1993-01-01

Anthropomorphic telerobotic hand contains actuators, joints, sensors, and complex wiring harnesses. Glove protects interior components of hand from dirt and damage. Imitates motions of human fingers and wrist in lifelike and dexterous way. Incorporates pitch/yaw joints in wrist and head knuckles. Hand modular; so fingers removable, interchangeable units. Feature simplifies servicing and maintenance, which must be done frequently in such complex mechanism.

Percutaneous Cementoplasty for Kienbock's Disease.

PubMed

Vallejo, Eduardo Crespo; Martinez-Galdámez, Mario; Martin, Ernesto Santos; de Gregorio, Arturo Perera; Gallego, Miriam Gamo; Escobar, Angeles Ramirez

2017-05-01

Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock's disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

Independent evolution of knuckle-walking in African apes shows that humans did not evolve from a knuckle-walking ancestor.

PubMed

Kivell, Tracy L; Schmitt, Daniel

2009-08-25

Despite decades of debate, it remains unclear whether human bipedalism evolved from a terrestrial knuckle-walking ancestor or from a more generalized, arboreal ape ancestor. Proponents of the knuckle-walking hypothesis focused on the wrist and hand to find morphological evidence of this behavior in the human fossil record. These studies, however, have not examined variation or development of purported knuckle-walking features in apes or other primates, data that are critical to resolution of this long-standing debate. Here we present novel data on the frequency and development of putative knuckle-walking features of the wrist in apes and monkeys. We use these data to test the hypothesis that all knuckle-walking apes share similar anatomical features and that these features can be used to reliably infer locomotor behavior in our extinct ancestors. Contrary to previous expectations, features long-assumed to indicate knuckle-walking behavior are not found in all African apes, show different developmental patterns across species, and are found in nonknuckle-walking primates as well. However, variation among African ape wrist morphology can be clearly explained if we accept the likely independent evolution of 2 fundamentally different biomechanical modes of knuckle-walking: an extended wrist posture in an arboreal environment (Pan) versus a neutral, columnar hand posture in a terrestrial environment (Gorilla). The presence of purported knuckle-walking features in the hominin wrist can thus be viewed as evidence of arboreality, not terrestriality, and provide evidence that human bipedalism evolved from a more arboreal ancestor occupying the ecological niche common to all living apes.

Management of a Complex, Multioperated Intra-Articular Distal Radius Fracture

PubMed Central

Giwa, Lolade; Spacey, Kate; Packer, Greg

2015-01-01

Background Intra-articular distal radius fractures can have many complications, including radiocarpal osteoarthritis and distal radioulnar joint (DRUJ) dysfunction leading to pain and restricted wrist function. Case Description We describe the case of a 38-year-old patient who sustained a left distal radius intra-articular fracture, which was treated with volar plating. She developed pain from the radiocarpal joint as a result of intra-articular malunion and was listed for total wrist fusion. On the day of surgery this was converted to a Darrach procedure for minor DRUJ symptoms. This resulted in pain from the DRUJ as a result of instability, in addition to persisting radiocarpal arthritis pain. Due to her subsequent poor wrist function, she presented to the authors and underwent DRUJ arthroplasty with a proximally placed Scheker prosthesis to deal with her DRUJ symptoms and, later, a KinematX radiocarpal hemiarthroplasty for her radiocarpal symptoms. She remains happy with her outcome at 36-month follow-up. Literature Review The complications of the Darrach procedure include painful radioulnar convergence and wrist instability. The Scheker prosthesis allows restoration of stability of the DRUJ with good outcomes and 100% 5-year survival in one series. Sparing the midcarpal joint, the KinematX hemiarthroplasty allows preservation of the dart thrower's motion arc, which is key in many complex wrist movements and functions. Clinical Relevance This case highlights the negative consequences of distal ulna resection and shows both the Scheker and KinematX prostheses as viable, effective means to restore function to young, active patients with posttraumatic radiocarpal arthritis and/or instability. PMID:26261743

Correlation between chronological age, cervical vertebral maturation and Fishman's skeletal maturity indicators in southern Chinese.

PubMed

Alkhal, Hessa Abdulla; Wong, Ricky W K; Rabie, A Bakr M

2008-07-01

To investigate the correlation between chronological age, cervical vertebral maturation (CVM), and Fishman's hand-wrist skeletal maturity indicators in southern Chinese. Four hundred contemporary hand-wrist and lateral cephalometric radiographs of southern Chinese subjects were randomly selected and analyzed. The female subjects were between 10 and 15 years of age, and the male subjects were between 12 and 17 years of age; all subjects were within the circumpubertal period. The CVM was assessed using the method developed by Baccetti and coworkers, but the hand-wrist maturation was assessed using the method developed by Fishman. These two methods and the chronological age were correlated using the Spearman rank correlation analysis. The CVM was significantly correlated with the hand-wrist skeletal age (Spearman r male = 0.9206, female = 0.9363). All patients in the cervical maturation stage (CS3) of CVM were discovered to be in the skeletal maturational indicator (SMI2 or SMI3) stages of hand-wrist maturation (HWM), which was around the peak of the growth spurt. Low correlations were found between the CVM and chronological age (male r = 0.7577; female r = 0.7877) and between the HWM and chronological age (male r = 0.7492; female r = 0.7758). CVM is a valid indicator of skeletal growth during the circumpubertal and has a high correlation with the HWM for the southern Chinese population. However, the low correlations found between the chronological age and both CVM and HWM showed that the chronological age was not suitable to measure skeletal maturity.

Long-term results of bone-retinaculum-bone autograft for scapholunate instability.

PubMed

Soong, Maximillian; Merrell, Gregory A; Ortmann, Fred; Weiss, Arnold-Peter C

2013-03-01

To report long-term follow-up of scapholunate interosseous ligament reconstruction with bone-retinaculum-bone autograft in patients with dynamic scapholunate instability. Of the 14 patients from the previously reported cohort who had bone-retinaculum-bone autograft for dynamic instability, 6 returned for clinical examination and radiographs, 3 were reached by telephone, and 2 were lost to follow-up. The remaining 3 had salvage procedures (2 total wrist arthrodeses and 1 proximal row carpectomy) between the prior report and the current study and thus reached an endpoint, at 2 to 4 years. For the 6 who returned, outcome measurements included scapholunate angle and gap, radiographic evidence of secondary arthritis, wrist extension and flexion, grip strength, and Mayo wrist score. Follow-up averaged 11.9 years (range, 10.7-14.1 y). Clinical and radiographic outcomes deteriorated moderately from the prior report. Mayo wrist score averaged 83. There were 3 failures, resulting in 1 proximal row carpectomy and 2 total wrist arthrodeses. Findings at repeat surgery in the failed group included an intact graft without any apparent abnormalities, a partially ruptured graft (after a subsequent re-injury), and a completely resorbed graft. Bone-retinaculum-bone autograft reconstruction is a viable treatment option for dynamic scapholunate instability in which the scaphoid and lunate can be reduced. Results may deteriorate but are similar to those reported previously from other techniques. Problems with graft strength or stiffness may necessitate further surgery. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Lab-based validation of different data processing methods for wrist-worn ActiGraph accelerometers in young adults.

PubMed

Ellingson, Laura D; Hibbing, Paul R; Kim, Youngwon; Frey-Law, Laura A; Saint-Maurice, Pedro F; Welk, Gregory J

2017-06-01

The wrist is increasingly being used as the preferred site for objectively assessing physical activity but the relative accuracy of processing methods for wrist data has not been determined. This study evaluates the validity of four processing methods for wrist-worn ActiGraph (AG) data against energy expenditure (EE) measured using a portable metabolic analyzer (OM; Oxycon mobile) and the Compendium of physical activity. Fifty-one adults (ages 18-40) completed 15 activities ranging from sedentary to vigorous in a laboratory setting while wearing an AG and the OM. Estimates of EE and categorization of activity intensity were obtained from the AG using a linear method based on Hildebrand cutpoints (HLM), a non-linear modification of this method (HNLM), and two methods developed by Staudenmayer based on a Linear Model (SLM) and using random forest (SRF). Estimated EE and classification accuracy were compared to the OM and Compendium using Bland-Altman plots, equivalence testing, mean absolute percent error (MAPE), and Kappa statistics. Overall, classification agreement with the Compendium was similar across methods ranging from a Kappa of 0.46 (HLM) to 0.54 (HNLM). However, specificity and sensitivity varied by method and intensity, ranging from a sensitivity of 0% (HLM for sedentary) to a specificity of ~99% for all methods for vigorous. None of the methods was significantly equivalent to the OM (p  >  0.05). Across activities, none of the methods evaluated had a high level of agreement with criterion measures. Additional research is needed to further refine the accuracy of processing wrist-worn accelerometer data.

Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke.

PubMed

Hu, Xiao-Ling; Tong, Raymond Kai-yu; Ho, Newmen S K; Xue, Jing-jing; Rong, Wei; Li, Leonard S W

2015-09-01

Augmented physical training with assistance from robot and neuromuscular electrical stimulation (NMES) may introduce intensive motor improvement in chronic stroke. To compare the rehabilitation effectiveness achieved by NMES robot-assisted wrist training and that by robot-assisted training. This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks. Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT) were used to evaluate the training effects before and after the training, as well as 3 months later. An EMG parameter, muscle co-contraction index, was also applied to investigate the session-by-session variation in muscular coordination patterns during the training. The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P < .05). Significant improvement in ARAT was achieved in the NMES robot group (P < .05) but absent in the robot group. NMES robot-assisted training showed better performance in releasing muscle co-contraction than the robot-assisted across the training sessions (P < .05). The NMES robot-assisted wrist training was more effective than the pure robot. The additional NMES application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress. © The Author(s) 2014.

Wrist loading patterns during pommel horse exercises.

PubMed

Markolf, K L; Shapiro, M S; Mandelbaum, B R; Teurlings, L

1990-01-01

Gymnastics is a sport which involves substantial periods of upper extremity support as well as frequent impacts to the wrist. Not surprisingly, wrist pain is a common finding in gymnasts. Of all events, the pommel horse is the most painful. In order to study the forces of wrist impact, a standard pommel horse was instrumented with a specially designed load cell to record the resultant force of the hand on the pommel during a series of basic skills performed by a group of seventeen elite male gymnasts. The highest mean peak forces were recorded during the front scissors and flair exercises (1.5 BW) with peaks of up to 2.0 BW for some gymnasts. The mean peak force for hip circles at the center or end of the horse was 1.1 BW. The mean overall loading rate (initial contact to first loading peak) ranged from 5.2 BWs-1 (hip circles) to 10.6 BW s-1 (flairs). However, many recordings displayed localized initial loading spikes which occurred during 'hard' landings on the pommel. When front scissors were performed in an aggressive manner, the initial loading spikes averaged 1.0 BW in magnitude (maximum 1.8 BW) with an average rise time of 8.2 ms; calculated localized loading rates averaged 129 BW s-1 (maximum 219 BW s-1). These loading parameters are comparable to those encountered at heel strike during running. These impact forces and loading rates are remarkably high for an upper extremity joint not normally exposed to weight-bearing loads, and may contribute to the pathogenesis of wrist injuries in gymnastics.

Estimation of tissue stiffness, reflex activity, optimal muscle length and slack length in stroke patients using an electromyography driven antagonistic wrist model.

PubMed

de Gooijer-van de Groep, Karin L; de Vlugt, Erwin; van der Krogt, Hanneke J; Helgadóttir, Áróra; Arendzen, J Hans; Meskers, Carel G M; de Groot, Jurriaan H

2016-06-01

About half of all chronic stroke patients experience loss of arm function coinciding with increased stiffness, reduced range of motion and a flexed wrist due to a change in neural and/or structural tissue properties. Quantitative assessment of these changes is of clinical importance, yet not trivial. The goal of this study was to quantify the neural and structural properties contributing to wrist joint stiffness and to compare these properties between healthy subjects and stroke patients. Stroke patients (n=32) and healthy volunteers (n=14) were measured using ramp-and-hold rotations applied to the wrist joint by a haptic manipulator. Neural (reflexive torque) and structural (connective tissue stiffness and slack lengths and (contractile) optimal muscle lengths) parameters were estimated using an electromyography driven antagonistic wrist model. Kruskal-Wallis analysis with multiple comparisons was used to compare results between healthy subjects, stroke patients with modified Ashworth score of zero and stroke patients with modified Ashworth score of one or more. Stroke patients with modified Ashworth score of one or more differed from healthy controls (P<0.05) by increased tissue stiffness, increased reflexive torque, decreased optimal muscle length and decreased slack length of connective tissue of the flexor muscles. Non-invasive quantitative analysis, including estimation of optimal muscle lengths, enables to identify neural and non-neural changes in chronic stroke patients. Monitoring these changes in time is important to understand the recovery process and to optimize treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation.

PubMed

Lans, Jonathan; Lasa, Alejandro; Chen, Neal C; Jupiter, Jesse B

2018-01-01

The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable. The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures. We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score. There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL. In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years.

Positioning Techniques to Reduce the Occurrence of DeQuervain's Tendonitis in Nursing Mothers

ERIC Educational Resources Information Center

Virzi, Alison

2010-01-01

DeQuervain's tendonitis is an inflammation of two tendons: the extensor pollicis brevis and the abductor pollicis longus as they cross in the first dorsal compartment of the wrist. Symptoms include pain, swelling along the radial aspect of the wrist, and a decrease in thumb motion. A positive Finkelstein's test at examination is seen. Frequently…

The Sequence of Hip and Selected Upper-Extremity Joint Movements During the Golf Drive.

ERIC Educational Resources Information Center

Hunter, Charles L.

This study analyzed wrist, elbow, and hip actions of golfers who were accurately driving a golf ball a maximum distance. Electrogoniometry and cinematography were used to measure wrist, forearm, elbow, and hip actions during the downswing of 10 low-handicap golfers who were attempting to drive a minimum of 225 yards within a 50-yard corridor.…

Complex Human Activity Recognition Using Smartphone and Wrist-Worn Motion Sensors.

PubMed

Shoaib, Muhammad; Bosch, Stephan; Incel, Ozlem Durmaz; Scholten, Hans; Havinga, Paul J M

2016-03-24

The position of on-body motion sensors plays an important role in human activity recognition. Most often, mobile phone sensors at the trouser pocket or an equivalent position are used for this purpose. However, this position is not suitable for recognizing activities that involve hand gestures, such as smoking, eating, drinking coffee and giving a talk. To recognize such activities, wrist-worn motion sensors are used. However, these two positions are mainly used in isolation. To use richer context information, we evaluate three motion sensors (accelerometer, gyroscope and linear acceleration sensor) at both wrist and pocket positions. Using three classifiers, we show that the combination of these two positions outperforms the wrist position alone, mainly at smaller segmentation windows. Another problem is that less-repetitive activities, such as smoking, eating, giving a talk and drinking coffee, cannot be recognized easily at smaller segmentation windows unlike repetitive activities, like walking, jogging and biking. For this purpose, we evaluate the effect of seven window sizes (2-30 s) on thirteen activities and show how increasing window size affects these various activities in different ways. We also propose various optimizations to further improve the recognition of these activities. For reproducibility, we make our dataset publicly available.

A wrist tendon travel assessment of hand movements associated with industrial repetitive activities.

PubMed

Ugbolue, U Chris; Nicol, Alexander C

2012-01-01

To investigate slow and fast paced industrial activity hand repetitive movements associated with carpal tunnel syndrome where movements are evaluated based on finger and wrist tendon travel measurements. Nine healthy subjects were recruited for the study aged between 23 and 33 years. Participants mimicked an industrial repetitive task by performing the following activities: wrist flexion and extension task, palm open and close task; and pinch task. Each task was performed for a period of 5 minutes at a slow (0.33 Hz) and fast (1 Hz) pace for a duration of 3 minutes and 2 minutes respectively. Tendon displacement produced higher flexor digitorum superficialis (FDS) tendon travel when compared to the flexor digitorum profundus (FDP) tendons. The left hand mean (SD) tendon travel for the FDS tendon and FDP tendon were 11108 (5188) mm and 9244 (4328) mm while the right hand mean tendon travel (SD) for the FDS tendon and FDP tendon were 9225 (3441) mm and 7670 (2856) mm respectively. Of the three tasks mimicking an industrial repetitive activity, the wrist flexion and extension task produced the most tendon travel. The findings may be useful to researchers in classifying the level of strenuous activity in relation to tendon travel.

Wrist Actigraphy

PubMed Central

Hakim, Alex D.

2011-01-01

To record sleep, actigraph devices are worn on the wrist and record movements that can be used to estimate sleep parameters with specialized algorithms in computer software programs. With the recent establishment of a Current Procedural Terminology code for wrist actigraphy, this technology is being used increasingly in clinical settings as actigraphy has the advantage of providing objective information on sleep habits in the patient’s natural sleep environment. Actigraphy has been well validated for the estimation of nighttime sleep parameters across age groups, but the validity of the estimation of sleep-onset latency and daytime sleeping is limited. Clinical guidelines and research suggest that wrist actigraphy is particularly useful in the documentation of sleep patterns prior to a multiple sleep latency test, in the evaluation of circadian rhythm sleep disorders, to evaluate treatment outcomes, and as an adjunct to home monitoring of sleep-disordered breathing. Actigraphy has also been well studied in the evaluation of sleep in the context of depression and dementia. Although actigraphy should not be viewed as a substitute for clinical interviews, sleep diaries, or overnight polysomnography when indicated, it can provide useful information about sleep in the natural sleep environment and/or when extended monitoring is clinically indicated. PMID:21652563

Orthotic intervention incorporating the dart-thrower's motion as part of conservative management guidelines for treatment of scapholunate injury.

PubMed

Anderson, Hamish; Hoy, Greg

2016-01-01

Case series. This paper describes conservative guidelines for the management of scapho-lunate interosseous ligament (SLIL) injury including fabrication of an orthosis that restricts active wrist movement to the dart-throwers (DTM) plane. The dart throwers' orthosis (DTO) was designed as a response to biomechanical studies suggesting that restraining motion to the DTM would off-load a deficient SLIL. After six weeks of wearing the DTO, the 5 patients in this case series initiated an exercise program that incorporated wrist proprioceptive training and specific muscle strengthening. The DTO was designed to incorporate controlled movement in order to better integrate the secondary wrist stabilizers in wrists that had a deficient SLIL. The orthosis and the exercise program harnessed proprioceptive influences using active motion within the DTM plane, and stimulated mechanoreceptors so as to enhance stability. All patients demonstrated improvement in subjective and objective outcomes including self-reported pain and function. Orthotic intervention that controls motion within the DTM, combined with an appropriate proprioceptive rehabilitation program, may provide a viable conservative treatment option for patients with a similar clinical presentation. 4. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Generalized Feature Extraction for Wrist Pulse Analysis: From 1-D Time Series to 2-D Matrix.

PubMed

Dimin Wang; Zhang, David; Guangming Lu

2017-07-01

Traditional Chinese pulse diagnosis, known as an empirical science, depends on the subjective experience. Inconsistent diagnostic results may be obtained among different practitioners. A scientific way of studying the pulse should be to analyze the objectified wrist pulse waveforms. In recent years, many pulse acquisition platforms have been developed with the advances in sensor and computer technology. And the pulse diagnosis using pattern recognition theories is also increasingly attracting attentions. Though many literatures on pulse feature extraction have been published, they just handle the pulse signals as simple 1-D time series and ignore the information within the class. This paper presents a generalized method of pulse feature extraction, extending the feature dimension from 1-D time series to 2-D matrix. The conventional wrist pulse features correspond to a particular case of the generalized models. The proposed method is validated through pattern classification on actual pulse records. Both quantitative and qualitative results relative to the 1-D pulse features are given through diabetes diagnosis. The experimental results show that the generalized 2-D matrix feature is effective in extracting both the periodic and nonperiodic information. And it is practical for wrist pulse analysis.

A correlative study of dental age and skeletal maturation.

PubMed

Sachan, Kiran; Sharma, Vijay Prakash; Tandon, Pradeep

2011-01-01

Skeletal age had been assessed by comparison between maturation of hand-wrist with stages of cervical vertebrae or canine calcification stages in past and this had been closely related to craniofacial growth. The importance of pubertal growth spurt in various types of orthodontic therapies is already established. Hence, this study was aimed to evaluate the relationship of skeletal maturity by hand-wrist with cervical vertebral maturation indicators and canine calcification stages. The study consisted of randomly selected 90 children from Lucknow population with 45 males (age range 10-13 years) and 45 females (age range 9-12 years). Lateral Cephalogram, hand-wrist x-ray, and periapical x-rays of maxillary and mandibular right canines were taken. Mean, standard deviation was calculated of different groups. Correlation was made among cervical vertebral maturation, hand wrist maturation, and canine calcification stages at various age groups. There was strong correlation between skeletal maturation indicator and cervical vertebral maturation indicator for both male (0.849) and female (0.932), whereas correlation between skeletal maturation indicator and canine calcification was good for both male and female (0.635, 0.891). It was concluded that cervical vertebral maturation indicator and canine calcification stages can also be used for assessing skeletal maturity.

Estimation of Finger Joint Angles Based on Electromechanical Sensing of Wrist Shape.

PubMed

Kawaguchi, Junki; Yoshimoto, Shunsuke; Kuroda, Yoshihiro; Oshiro, Osamu

2017-09-01

An approach to finger motion capture that places fewer restrictions on the usage environment and actions of the user is an important research topic in biomechanics and human-computer interaction. We proposed a system that electrically detects finger motion from the associated deformation of the wrist and estimates the finger joint angles using multiple regression models. A wrist-mounted sensing device with 16 electrodes detects deformation of the wrist from changes in electrical contact resistance at the skin. In this study, we experimentally investigated the accuracy of finger joint angle estimation, the adequacy of two multiple regression models, and the resolution of the estimation of total finger joint angles. In experiments, both the finger joint angles and the system output voltage were recorded as subjects performed flexion/extension of the fingers. These data were used for calibration using the least-squares method. The system was found to be capable of estimating the total finger joint angle with a root-mean-square error of 29-34 degrees. A multiple regression model with a second-order polynomial basis function was shown to be suitable for the estimation of all total finger joint angles, but not those of the thumb.

Exploiting arm posture synergies in activities of daily living to control the wrist rotation in upper limb prostheses: A feasibility study.

PubMed

Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

2015-01-01

Although significant technological advances have been made in the last forty years, natural and effortless control of upper limb prostheses is still an open issue. Commercially available myoelectric prostheses present limited Degrees of Freedom (DoF) mainly because of the lack of available and reliable independent control signals from the human body. Thus, despite the crucial role that an actuated wrist could play in a transradial prosthesis in terms of avoiding compensatory movements, commercial hand prostheses present only manually adjustable passive wrists or actuated rotators controlled by (unnatural) sequential control strategies. In the present study we investigated the synergies between the humeral orientation with respect to the trunk and the forearm pronation/supination angles during the execution of a wide range of activities of daily living, in healthy subjects. Our results showed consistent postural synergies between the two selected body segments for almost the totality of the activities of daily living under investigation. This is a promising result because these postural synergies could be exploited to automatically control the wrist rotator unit in transradial prostheses improving the fluency and the dexterity of the amputee.

Notebook computer use on a desk, lap and lap support: effects on posture, performance and comfort.

PubMed

Asundi, Krishna; Odell, Dan; Luce, Adam; Dennerlein, Jack T

2010-01-01

This study quantified postures of users working on a notebook computer situated in their lap and tested the effect of using a device designed to increase the height of the notebook when placed on the lap. A motion analysis system measured head, neck and upper extremity postures of 15 adults as they worked on a notebook computer placed on a desk (DESK), the lap (LAP) and a commercially available lapdesk (LAPDESK). Compared with the DESK, the LAP increased downwards head tilt 6 degrees and wrist extension 8 degrees . Shoulder flexion and ulnar deviation decreased 13 degrees and 9 degrees , respectively. Compared with the LAP, the LAPDESK decreased downwards head tilt 4 degrees , neck flexion 2 degrees , and wrist extension 9 degrees. Users reported less discomfort and difficulty in the DESK configuration. Use of the lapdesk improved postures compared with the lap; however, all configurations resulted in high values of wrist extension, wrist deviation and downwards head tilt. STATEMENT OF RELEVANCE: This study quantifies postures of users working with a notebook computer in typical portable configurations. A better understanding of the postures assumed during notebook computer use can improve usage guidelines to reduce the risk of musculoskeletal injuries.

Effects of wearing rubber gloves on activities of the forearm and shoulder muscles during different dishwashing stages

PubMed Central

Yoo, Won-Gyu

2015-01-01

[Purpose] The present study examined the effects of wearing rubber gloves on the activities of the forearm and shoulder muscles during two dishwashing stages. [Subjects] This study included 10 young females. [Methods] The participants performed two dishwashing stages (washing and rinsing) with and without rubber gloves. The activities of the wrist flexor and upper trapezius muscles were measured using wireless electromyography. [Results] During the washing stage, the activities of the wrist flexor and upper trapezius muscles were significantly greater without gloves than with gloves when performing the same tasks. However, during the rinsing stage, the activities of these muscles did not differ significantly according to the use of gloves. [Conclusion] Dishwashers should wear gloves during the washing stage to prevent wrist and shoulder pain. PMID:26311980

When does tool use become distinctively human?: Hammering in young children

PubMed Central

Kahrs, Björn; Lockman, Jeffrey J.; Jung, Wendy

2013-01-01

This study examines the development of hammering within an ontogenetic and evolutionary framework using motion-capture technology. Twenty-four right-handed toddlers (19–35 months) wore reflective markers while hammering a peg into a peg-board. The study focuses on the motor characteristics that make tool use uniquely human: wrist involvement, lateralization, and handle use. Older children showed more distally controlled movements, characterized by relatively more reliance on the wrist, but only when hammering with their right hand. Greater age, use of the right hand, and more wrist involvement were associated with higher accuracy; handle use did not systematically change with age. Collectively, the results provide new insights about the emergence of hammering in young children and when hammering begins to manifest distinctively human characteristics. PMID:24128178

Percutaneous Cementoplasty for Kienbock’s Disease

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

Vallejo, Eduardo Crespo, E-mail: dreduardocrespo@gmail.com; Martinez-Galdámez, Mario; Martin, Ernesto Santos

Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old manmore » with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.« less

Architectures for wrist-worn energy harvesting

NASA Astrophysics Data System (ADS)

Rantz, R.; Halim, M. A.; Xue, T.; Zhang, Q.; Gu, L.; Yang, K.; Roundy, S.

2018-04-01

This paper reports the simulation-based analysis of six dynamical structures with respect to their wrist-worn vibration energy harvesting capability. This work approaches the problem of maximizing energy harvesting potential at the wrist by considering multiple mechanical substructures; rotational and linear motion-based architectures are examined. Mathematical models are developed and experimentally corroborated. An optimization routine is applied to the proposed architectures to maximize average power output and allow for comparison. The addition of a linear spring element to the structures has the potential to improve power output; for example, in the case of rotational structures, a 211% improvement in power output was estimated under real walking excitation. The analysis concludes that a sprung rotational harvester architecture outperforms a sprung linear architecture by 66% when real walking data is used as input to the simulations.

Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use

PubMed Central

2016-01-01

Background Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public’s concern whether hand activities while using smartphones can lead to median nerve problems. Objective The aims of this study were to 1) develop kinematic graphs and 2) investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities. Methods Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1) thumb opposition with the wrist in neutral position, 2) thumb opposition with the wrist in ulnar deviation and 3) pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1) cross-sectional area (CSA), 2) flattening ratio (FR), 3) rotational displacement (RD) and 4) translational displacement (TD) of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1) two successive time points during a single hand activity and 2) different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities. Results Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex. Conclusion We observed that the median nerve in the carpal tunnel was rotated, deformed and displaced during the hand activities that people may be performed when using a smartphone, suggesting an increased risk of carpal tunnel syndrome (CTS). In addition, the kinematic graphs of median nerve developed in the present study provide new clues for further studies on the pathophysiology of CTS, and alerting smartphone users to establish proper postural habits when using handheld electronic devices. PMID:27367447

CONTROL OF APERTURE CLOSURE INITIATION DURING TRUNK-ASSISTED REACH-TO-GRASP MOVEMENTS

PubMed Central

Rand, Miya K.; Van Gemmert, Arend W. A.; Hossain, Abul B.M.I.; Shimansky, Yury P.; Stelmach, George E.

2012-01-01

The present study investigated how the involvement and direction of trunk movement during reach-to-grasp movements affect the coordination between the transport and grasping components. Seated young adults made prehensile movements in which the involvement of the trunk was varied; the trunk was not involved, moved forward (flexion), or moved backward (extension) in the sagittal plane during the reach to the object. Each of the trunk movements was combined with an extension or flexion motion of the arm during the reach. Regarding the relation between the trunk and arm motion for arm transport, the onset of wrist motion relative to that of the trunk was delayed to a greater extent for the trunk extension than for the trunk flexion. The variability of the time period from the peak of wrist velocity to the peak of trunk velocity was also significantly greater for trunk extension compared to trunk flexion. These findings indicate that trunk flexion was better integrated into the control of wrist transport than trunk extension. In terms of the temporal relationship between wrist transport and grip aperture, the relation between the time of peak wrist velocity and the time of peak grip aperture did not change or became less steady across conditions. Therefore, the stability of temporal coordination between wrist transport and grip aperture was maintained despite the variation of the pattern of intersegmental coordination between the arm and the trunk during arm transport. The transport-aperture coordination was further assessed in terms of the control law according to which the initiation of aperture closure during the reach occurs when the hand crosses a hand-to-target distance threshold for grasp initiation that is a function of peak aperture, wrist velocity and acceleration, trunk velocity and acceleration, and trunk-to-target distance at the time of aperture closure initiation. The participants increased the hand-to-target distance threshold for grasp initiation in the conditions where the trunk was involved compared to the conditions where the trunk was not involved. An increase also occurred when the trunk was extended compared to when it was flexed. The increased distance threshold implies an increase in the hand-to-target distance-related safety margin for grasping when the trunk is involved, especially when it is extended. These results suggest that the CNS significantly utilizes the parameters of trunk movement together with movement parameters related to the arm and the hand for controlling grasp initiation. PMID:22526948

Control of aperture closure initiation during trunk-assisted reach-to-grasp movements.

PubMed

Rand, Miya K; Van Gemmert, Arend W A; Hossain, Abul B M I; Shimansky, Yury P; Stelmach, George E

2012-06-01

The present study investigated how the involvement and direction of trunk movement during reach-to-grasp movements affect the coordination between the transport and grasping components. Seated young adults made prehensile movements in which the involvement of the trunk was varied; the trunk was not involved, moved forward (flexion), or moved backward (extension) in the sagittal plane during the reach to the object. Each of the trunk movements was combined with an extension or flexion motion of the arm during the reach. Regarding the relationship between the trunk and arm motion for arm transport, the onset of wrist motion relative to that of the trunk was delayed to a greater extent for the trunk extension than for the trunk flexion. The variability of the time period from the peak of wrist velocity to the peak of trunk velocity was also significantly greater for trunk extension compared to trunk flexion. These findings indicate that trunk flexion was better integrated into the control of wrist transport than trunk extension. In terms of the temporal relationship between wrist transport and grip aperture, the relationship between the time of peak wrist velocity and the time of peak grip aperture did not change or become less steady across conditions. Therefore, the stability of temporal coordination between wrist transport and grip aperture was maintained despite the variation of the pattern of intersegmental coordination between the arm and the trunk during arm transport. The transport-aperture coordination was further assessed in terms of the control law according to which the initiation of aperture closure during the reach occurs when the hand crosses a hand-to-target distance threshold for grasp initiation, which is a function of peak aperture, wrist velocity and acceleration, trunk velocity and acceleration, and trunk-to-target distance at the time of aperture closure initiation. The participants increased the hand-to-target distance threshold for grasp initiation in the conditions where the trunk was involved compared to the conditions where the trunk was not involved. An increase also occurred when the trunk was extended compared to when it was flexed. The increased distance threshold implies an increase in the hand-to-target distance-related safety margin for grasping when the trunk is involved, especially when it is extended. These results suggest that the CNS significantly utilizes the parameters of trunk movement together with movement parameters related to the arm and the hand for controlling grasp initiation.

Comparison of Activity Type Classification Accuracy from Accelerometers Worn on the Hip, Wrists, and Thigh in Young, Apparently Healthy Adults

ERIC Educational Resources Information Center

Montoye, Alexander H. K.; Pivarnik, James M.; Mudd, Lanay M.; Biswas, Subir; Pfeiffer, Karin A.

2016-01-01

The purpose of this article is to compare accuracy of activity type prediction models for accelerometers worn on the hip, wrists, and thigh. Forty-four adults performed sedentary, ambulatory, lifestyle, and exercise activities (14 total, 10 categories) for 3-10 minutes each in a 90-minute semi-structured laboratory protocol. Artificial neural…

Characterization of a Robotic Manipulator for Dynamic Wind Tunnel Applications

DTIC Science & Technology

2015-03-26

further enhancements would need to be performed individually for each joint. This research effort focused on the improvement of the MTA wrist roll ...Measurement Unit ( IMU ), was used to validate the Euler angle output calculated by the MTA Computer using forward kinematics. Additionally, fast-response...61 3.7 Modeling the Wrist Roll Motor and Controller . . . . . . . . . . . . . . . . . . . . . 64 3.8 Proportional Control for Improved Performance

Breastfeeding protects against hip fracture in postmenopausal women: the Tromsø study.

PubMed

Bjørnerem, Ashild; Ahmed, Luai A; Jørgensen, Lone; Størmer, Jan; Joakimsen, Ragnar M

2011-12-01

Despite reported bone loss during pregnancy and lactation, no study has shown deleterious long-term effects of parity or breastfeeding. Studies have shown higher bone mineral density and reduced risk for fracture in parous than in nulliparous women or no effect of parity and breastfeeding, so long-term effects are uncertain. We studied the effect of parity and breastfeeding on risk for hip, wrist and non-vertebral fragility fractures (hip, wrist, or proximal humerus) in 4681 postmenopausal women aged 50 to 94 years in the Tromsø Study from 1994-95 to 2010, using Cox's proportional hazard models. During 51 906 person-years, and a median of 14.5 years follow-up, 442, 621, and 1105 of 4681 women suffered incident hip, wrist, and fragility fractures, and the fracture rates were 7.8, 11.4, and 21.3 per 1000 person-years, respectively. The risk for hip, wrist, and fragility fracture did not differ between parous (n = 4230, 90.4%) and nulliparous women (n = 451, 9.6%). Compared with women who did not breast-feed after birth (n = 184, 4.9%), those who breastfed (n = 3564, 95.1%) had 50% lower risk for hip fracture (HR 0.50; 95% CI 0.32 to 0.78), and 27% lower risk for fragility fracture (HR 0.73; 95% CI 0.54 to 0.99), but similar risk for wrist fracture, after adjustment for age, BMI, height, physical activity, smoking, a history of diabetes, previous fracture of hip or wrist, use of hormone replacement therapy, and length of education. Each 10 months longer total duration of breastfeeding reduced the age-adjusted risk for hip fracture by 12% (HR 0.88; 95% CI 0.78 to 0.99, p for trend = 0.03) before, and marginally after, adjustment for BMI and other covariates (HR 0.91; 95% CI 0.80 to 1.04). In conclusion, this data indicates that pregnancy and breastfeeding has no long-term deleterious effect on bone fragility and fractures, and that breastfeeding may contribute to a reduced risk for hip fracture after menopause. Copyright © 2011 American Society for Bone and Mineral Research.

Wrist fractures and their impact in daily living functionality on elderly people: a prospective cohort study.

PubMed

Vergara, Itziar; Vrotsou, Kalliopi; Orive, Miren; Garcia-Gutierrez, Susana; Gonzalez, Nerea; Las Hayas, Carlota; Quintana, Jose M

2016-01-14

Wrist fractures are the most common arm fractures in older adults. The impact of wrist fractures on daily functionality has been less studied than that of other types and so, less is known about the complexity of factors related to the functional impact of these fractures. This study is aimed to assess the role of individual and health care factors and its association with daily living functional changes after a wrist fracture. A prospective cohort of patients aged 65 or more, affected by a fracture due to a fall, was conducted. These patients were identified at the emergency rooms of the six participating hospitals. As independent factors, the following were studied: socio-demographic data, characteristics of the fracture, health-related quality of life, wrist function and provided treatment. The main outcome was functional status measured by the Barthel Index for daily living basic activities and the Lawton Instrumental Activities of Daily Living (IADL) Scale for daily living instrumental activities. Data were collected at baseline just after the fall and after six months of follow-up. Patients were considered to have deteriorated if their functional status as measured by Barthel Index or Lawton IADL scores decreased in a significant way during the six months of follow up. Barthel Index and/or Lawton IADL scores fell at six months after the fracture in 33% of participants. This functional decline was more frequent in patients with comorbidity (p < 0.0001), polypharmacy (p < 0.0001), low health-related quality of life prior to the fall (p < 0.0001) and lower educational level (p = 0.009). The derived multivariate models show that patients that become dependent six months after the fall, have advanced age, severe chronic diseases, low functional performance prior to the fracture, and repeated episodes of accidental falls. This profile is consistent with a frailty phenotype. Wrist fractures are associated to the occurrence of dependence, especially in frail patients. These patients could benefit from being identified at the time the fracture is treated, in order to tackle their complex needs and so, prevent some of the burden of dependence generated by these fractures.

Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial.

PubMed

Costa, Matthew L; Achten, Juul; Parsons, Nick R; Rangan, Amar; Griffin, Damian; Tubeuf, Sandy; Lamb, Sarah E

2014-08-05

To compare the clinical effectiveness of Kirschner wire fixation with locking plate fixation for patients with a dorsally displaced fracture of the distal radius. A multicentre two arm parallel group assessor blind randomised controlled trial with 1:1 treatment allocation. 18 trauma centres in the United Kingdom. 461 adults with a dorsally displaced fracture of the distal radius within 3 cm of the radiocarpal joint that required surgical fixation. Patients were excluded if the surgeon thought that the surface of the wrist joint was so badly displaced it required open reduction. Kirschner wire fixation: wires are passed through the skin over the dorsal aspect of the distal radius and into the bone to hold the fracture in the correct anatomical position. Locking plate fixation: a locking plate is applied through an incision over the volar (palm) aspect of the wrist and secured to the bone with fixed angle locking screws. validated patient rated wrist evaluation (PRWE). This rates wrist function in two (equally weighted) sections concerning the patient's experience of pain and disability to give a score out of 100. disabilities of arm, shoulder, and hand (DASH) score, the EuroQol (EQ-5D), and complications related to the surgery. The baseline characteristics of the two groups were well balanced, and over 90% of patients completed follow-up. The wrist function of both groups of patients improved by 12 months. There was no clinically relevant difference in the patient rated wrist score at three, six, or 12 months (difference in favour of the plate group was -1.3, 95% confidence interval -4.5 to 1.8; P=0.40). Nor was there a clinically relevant difference in health related quality of life or the number of complications in each group. Contrary to the existing literature, and against the rapidly increasing use of locking plate fixation, this trial found no difference in functional outcome in patients with dorsally displaced fractures of the distal radius treated with Kirschner wires or volar locking plates. Kirschner wire fixation, however, is cheaper and quicker to perform. Current Controlled Trials ISCRTN 31379280. UKCRN 8956. © Costa et al 2014.

Electrode placement in bioimpedance spectroscopy: evaluation of alternative positioning of electrodes when measuring relative dehydration in athletes.

PubMed

Birkemose, M; Møller, A J; Madsen, M L; Brantlov, S; Sørensen, H; Overgaard, K; Johansen, P

2013-01-01

In order to maintain a homeostatic environment in human cells, the balance between absorption and separation of water must be retained. Imbalance will have consequences on both the cellular and organ levels. Studies performed on athletes have shown coherence between their hydration status and ability to perform. A dehydration of 2-7% of total body weight resulted in a marked decrease in performance. Measurement and monitoring of hydration status may be used to optimize athlete performance. Therefore, in this current study bioimpedance spectroscopy is used to determine the hydration status of athletes. Trials were made to investigate alternative ways of electrode placement when performing bioimpedance spectroscopy in order to measure relative dehydration. A total of 14 test subjects underwent measurements before, during, and after a cycle test of 3×25min. Electrodes where placed to measure body impedance in three different ways: wrist-ankle (recommended method), wrist-wrist, and transthoracic. Furthermore, the relative loss in weight of the subjects during the trial was registered. The study showed no relation between relative weight loss and the wrist-wrist and transthoracic placement method, using bioimpedance spectroscopy to measure relative dehydration. The inability of the method to detect such relative changes in hydration may be due to the bioimpedance spectroscopy technology being extremely sensitive to changes in skin temperature, movement artifacts, thoroughness in placing the electrodes, and the physiological impact on the human body when performing exercise. Therefore, further research into the area of bioimpedance spectroscopy is needed before this methodology can be applied in monitoring active athletes. Hence, a simple weight measurement still seems a more useful way of determining a relative change of hydration in an active setting.

Performance of Activity Classification Algorithms in Free-living Older Adults

PubMed Central

Sasaki, Jeffer Eidi; Hickey, Amanda; Staudenmayer, John; John, Dinesh; Kent, Jane A.; Freedson, Patty S.

2015-01-01

Purpose To compare activity type classification rates of machine learning algorithms trained on laboratory versus free-living accelerometer data in older adults. Methods Thirty-five older adults (21F and 14M ; 70.8 ± 4.9 y) performed selected activities in the laboratory while wearing three ActiGraph GT3X+ activity monitors (dominant hip, wrist, and ankle). Monitors were initialized to collect raw acceleration data at a sampling rate of 80 Hz. Fifteen of the participants also wore the GT3X+ in free-living settings and were directly observed for 2-3 hours. Time- and frequency- domain features from acceleration signals of each monitor were used to train Random Forest (RF) and Support Vector Machine (SVM) models to classify five activity types: sedentary, standing, household, locomotion, and recreational activities. All algorithms were trained on lab data (RFLab and SVMLab) and free-living data (RFFL and SVMFL) using 20 s signal sampling windows. Classification accuracy rates of both types of algorithms were tested on free-living data using a leave-one-out technique. Results Overall classification accuracy rates for the algorithms developed from lab data were between 49% (wrist) to 55% (ankle) for the SVMLab algorithms, and 49% (wrist) to 54% (ankle) for RFLab algorithms. The classification accuracy rates for SVMFL and RFFL algorithms ranged from 58% (wrist) to 69% (ankle) and from 61% (wrist) to 67% (ankle), respectively. Conclusion Our algorithms developed on free-living accelerometer data were more accurate in classifying activity type in free-living older adults than our algorithms developed on laboratory accelerometer data. Future studies should consider using free-living accelerometer data to train machine-learning algorithms in older adults. PMID:26673129

Performance of Activity Classification Algorithms in Free-Living Older Adults.

PubMed

Sasaki, Jeffer Eidi; Hickey, Amanda M; Staudenmayer, John W; John, Dinesh; Kent, Jane A; Freedson, Patty S

2016-05-01

The objective of this study is to compare activity type classification rates of machine learning algorithms trained on laboratory versus free-living accelerometer data in older adults. Thirty-five older adults (21 females and 14 males, 70.8 ± 4.9 yr) performed selected activities in the laboratory while wearing three ActiGraph GT3X+ activity monitors (in the dominant hip, wrist, and ankle; ActiGraph, LLC, Pensacola, FL). Monitors were initialized to collect raw acceleration data at a sampling rate of 80 Hz. Fifteen of the participants also wore GT3X+ in free-living settings and were directly observed for 2-3 h. Time- and frequency-domain features from acceleration signals of each monitor were used to train random forest (RF) and support vector machine (SVM) models to classify five activity types: sedentary, standing, household, locomotion, and recreational activities. All algorithms were trained on laboratory data (RFLab and SVMLab) and free-living data (RFFL and SVMFL) using 20-s signal sampling windows. Classification accuracy rates of both types of algorithms were tested on free-living data using a leave-one-out technique. Overall classification accuracy rates for the algorithms developed from laboratory data were between 49% (wrist) and 55% (ankle) for the SVMLab algorithms and 49% (wrist) to 54% (ankle) for the RFLab algorithms. The classification accuracy rates for SVMFL and RFFL algorithms ranged from 58% (wrist) to 69% (ankle) and from 61% (wrist) to 67% (ankle), respectively. Our algorithms developed on free-living accelerometer data were more accurate in classifying the activity type in free-living older adults than those on our algorithms developed on laboratory accelerometer data. Future studies should consider using free-living accelerometer data to train machine learning algorithms in older adults.

Clinical Utility of Dual-Energy CT Analysis of Bone Marrow Edema in Acute Wrist Fractures.

PubMed

Ali, Ismail T; Wong, William D; Liang, Teresa; Khosa, Faisal; Mian, Memoona; Jalal, Sabeena; Nicolaou, Savvas

2018-04-01

The purpose of this study is to determine the utility of dual-energy CT (DECT) for assessing carpal fractures and to obtain an attenuation value cutoff (in Hounsfield units) to identify bone marrow edema due to an acute carpal fracture. In this retrospective study, 24 patients who presented with wrist fractures from September 3, 2014, through March 9, 2015, underwent imaging with DECT (80 and 140 kVp). Using the three-material decomposition algorithm specific for virtual noncalcium to construct images, two radiologists identified carpal fractures and associated bone marrow edema. Readers noted the attenuation at areas with and without bone marrow edema. The cutoff value was obtained by ROC analysis and was internally validated on 13 separate patients with suspected wrist fractures. A p < 0.05 was considered statistically significant. CT attenuation was significantly higher in areas of bone marrow edema than in areas without it (p < 0.0001, t test). A cutoff of 5.90 HU allows detection of bone marrow edema associated with acute wrist fractures with 100% sensitivity and 99.5% specificity, compared with visual DECT interpretation. In the 13 validation cases, the cutoff of 5.90 HU identified bone marrow edema with 100% accuracy, compared with visual interpretation. Kappa values were 0.83 between the two readings by reader 1, and 0.73 and 0.96 comparing the two readings of reader 1 with the reading by reader 2. DECT is a useful tool for identifying bone marrow edema in the setting of acute wrist fractures, providing an alternative to MRI. A cutoff value of 5.90 HU can be used for accurate diagnosis and exclusion of carpal fractures.

Immediate effect of a functional wrist orthosis for children with cerebral palsy or brain injury: A randomized controlled trial.

PubMed

Jackman, Michelle; Novak, Iona; Lannin, Natasha; Galea, Claire

2017-10-28

Two-group randomized controlled trial. Upper limb orthoses worn during functional tasks are commonly used in pediatric neurologic rehabilitation, despite a paucity of high-level evidence. The purpose of this study was to investigate if a customized functional wrist orthosis, when placed on the limb, leads to an immediate improvement in hand function for children with cerebral palsy or brain injury. A 2-group randomized controlled trial involving 30 children was conducted. Participants were randomized to either receive a customized functional wrist orthosis (experimental, n = 15) or not receive an orthosis (control, n = 15). The box and blocks test was administered at baseline and repeated 1 hour after experimental intervention, with the orthosis on if randomized to the orthotic group. After intervention, there were no significant differences on the box and blocks test between the orthotic group (mean, 10.13; standard deviation, 11.476) and the no orthotic group (mean, 14.07; standard deviation, 11.106; t[28], -0.954; P = .348; and 95% confidence interval, -12.380 to 4.513). In contrast to the findings of previous studies, our results suggest that a functional wrist orthosis, when supporting the joint in a 'typical' position, may not lead to an immediate improvement in hand function. Wearing a functional wrist orthosis did not lead to an immediate improvement in the ability of children with cerebral palsy or brain injury to grasp and release. Further research is needed combining upper limb orthoses with task-specific training and measuring outcomes over the medium to long term. Copyright © 2017 Hanley & Belfus. All rights reserved.

Biologic plating of unstable distal radial fractures.

PubMed

Kwak, Jae-Man; Jung, Gu-Hee

2018-04-14

Volar locking plating through the flexor carpi radialis is a well-established technique for treating unstable distal radial fractures, with few reported complications. In certain circumstances, including metaphyseal comminuted fractures, bridge plating through a pronator quadratus (PQ)-sparing approach may be required to preserve the soft tissue envelope. This study describes our prospective experience with bridge plating through indirect reduction. Thirty-three wrists (four 23A2, six 23A3, 15 23C1, and eight 23C2) underwent bridge plating through a PQ-sparing approach with indirect reduction from June 2006 to December 2010. Mean patient age was 56.8 years (range, 25-83 years), and the mean follow-up period was 47.5 months (range, 36-84 months). Changes in radiologic parameters (volar tilt, radial inclination, radial length, and ulnar variance) were analyzed, and functional results at final follow-up were evaluated by measuring the Modified Mayo Wrist Score (MMWS) and Modified Gartland-Werley Score (MGWS). All wrists achieved bone healing without significant complications after a single operation. At final follow-up, radial length was restored from an average of 3.7 mm to 11.0 mm, as were radial inclination, from 16.4° to 22.5°, and volar tilt, from - 9.1° to 5.5°. However, radial length was overcorrected in three wrists, and two experienced residual dorsal tilt. Excellent and good results on the MGWS were achieved in 30 wrists (90.9%). The average MMWS outcome was 92.6 (range, 75-100). Our experience with bridge plating was similar to that previously reported in the earlier publications. Compared with the conventional technique, bridge plating through a PQ-sparing approach may help in managing metaphyseal comminuted fractures of both cortices with a reduced radio-ulnar index.

Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures

PubMed Central

Mondelli, Mauro; Farioli, Andrea; Mattioli, Stefano; Aretini, Alessandro; Ginanneschi, Federica; Greco, Giuseppe; Curti, Stefania

2016-01-01

Objective To study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales. Methods We performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and likelihood ratios were calculated separately by gender. Results We consecutively enrolled 370 cases and 747 controls. The wrist-palm ratio, waist-hip-height ratio and waist-stature ratio showed the highest proportion of cases with abnormal values in the severe stages of CTS for clinical and electrophysiological severity scales in both genders. Accuracy tended to increase with CTS severity for females and males. In severe stage, most of the indexes presented moderate accuracy in both genders. Among subjects with severe CTS, the wrist-palm ratio presented the highest AUC for hand measures in the clinical and electrophysiological severity scales both in females (AUC 0.83 and 0.76, respectively) and males (AUC 0.91 and 0.82, respectively). Among subjects with severe CTS, the waist-stature ratio showed the highest AUC for body measures in the clinical and electrophysiological severity scales both in females (AUC 0.78 and 0.77, respectively) and males (AUC 0.84 and 0.76, respectively). The results of waist-hip-height ratio AUC were similar. Conclusions Wrist-palm ratio, waist-hip-height ratio and waist-stature ratio could contribute to support the diagnostic hypothesis of severe CTS that however has to be confirmed by nerve conduction study. PMID:27768728

Comparison of the clinical and functional outcomes following 3- and 4-corner fusions.

PubMed

Singh, Harvinder P; Dias, Joseph J; Phadnis, Joideep; Bain, Gregory

2015-06-01

To explore the clinical and functional outcomes of 3-corner fusion (3CF) for stage 2 and 3 scapholunate advanced collapse and scaphoid nonunion advanced collapse. We compared the results with 4-corner fusion (4CF) using a recent published report. Twelve patients (8 men and 4 women) who had a 3CF, mean age 60 years (range, 34-75 y) were reviewed in clinic more than 1 year after surgery. Subjective outcome measures included the Michigan Hand Questionnaire and Patient Evaluation Measure. Objective outcome measures included range of motion with a flexible electrogoniometer and grip strength measured with a digital dynamometer. The results were compared using a recent report of 24 patients (17 men and 7 women) with a 4CF, mean age 55 years (range, 34-68 y) assessed with similar techniques. The patients receiving 3CF had better subjective scores with the Michigan Hand Questionnaire, including the sub-scores for activities of daily living and satisfaction. The radioulnar arc was greater after the 3CF than after the 4CF. Circumduction of the 3CF was more like a normal wrist than the 4CF. This included having faster and smoother motion, with an axis of circumduction closer to the normal wrist. Peak grip strength was similar after either a 3CF or 4CF but grip strength in the 3CF was 82% of the contralateral wrist compared with 59% for the 4CF. The 3CF provided better patient-rated scores and the arc of wrist motion was more extended, with greater ulnar deviation. Motion was smoother and more closely replicated the normal axis and functional motion of the wrist. Therapeutic III. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Computer-based test-bed for clinical assessment of hand/wrist feed-forward neuroprosthetic controllers using artificial neural networks.

PubMed

Luján, J L; Crago, P E

2004-11-01

Neuroprosthestic systems can be used to restore hand grasp and wrist control in individuals with C5/C6 spinal cord injury. A computer-based system was developed for the implementation, tuning and clinical assessment of neuroprosthetic controllers, using off-the-shelf hardware and software. The computer system turned a Pentium III PC running Windows NT into a non-dedicated, real-time system for the control of neuroprostheses. Software execution (written using the high-level programming languages LabVIEW and MATLAB) was divided into two phases: training and real-time control. During the training phase, the computer system collected input/output data by stimulating the muscles and measuring the muscle outputs in real-time, analysed the recorded data, generated a set of training data and trained an artificial neural network (ANN)-based controller. During real-time control, the computer system stimulated the muscles using stimulus pulsewidths predicted by the ANN controller in response to a sampled input from an external command source, to provide independent control of hand grasp and wrist posture. System timing was stable, reliable and capable of providing muscle stimulation at frequencies up to 24Hz. To demonstrate the application of the test-bed, an ANN-based controller was implemented with three inputs and two independent channels of stimulation. The ANN controller's ability to control hand grasp and wrist angle independently was assessed by quantitative comparison of the outputs of the stimulated muscles with a set of desired grasp or wrist postures determined by the command signal. Controller performance results were mixed, but the platform provided the tools to implement and assess future controller designs.

[Automated Assessment for Bone Age of Left Wrist Joint in Uyghur Teenagers by Deep Learning].

PubMed

Hu, T H; Huo, Z; Liu, T A; Wang, F; Wan, L; Wang, M W; Chen, T; Wang, Y H

2018-02-01

To realize the automated bone age assessment by applying deep learning to digital radiography （DR） image recognition of left wrist joint in Uyghur teenagers, and explore its practical application value in forensic medicine bone age assessment. The X-ray films of left wrist joint after pretreatment, which were taken from 245 male and 227 female Uyghur nationality teenagers in Uygur Autonomous Region aged from 13.0 to 19.0 years old, were chosen as subjects. And AlexNet was as a regression model of image recognition. From the total samples above, 60％ of male and female DR images of left wrist joint were selected as net train set, and 10％ of samples were selected as validation set. As test set, the rest 30％ were used to obtain the image recognition accuracy with an error range in ±1.0 and ±0.7 age respectively, compared to the real age. The modelling results of deep learning algorithm showed that when the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the net train set was 81.4% and 75.6% in male, and 80.5% and 74.8% in female, respectively. When the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the test set was 79.5% and 71.2% in male, and 79.4% and 66.2% in female, respectively. The combination of bone age research on teenagers' left wrist joint and deep learning, which has high accuracy and good feasibility, can be the research basis of bone age automatic assessment system for the rest joints of body. Copyright© by the Editorial Department of Journal of Forensic Medicine.

The effect of subthalamic stimulation on viscoelastic stiffness of skeletal muscles in patients with Parkinson's disease.

PubMed

Rätsep, Tõnu; Asser, Toomas

2017-05-01

Myotonometric evaluation of viscoelastic stiffness of skeletal muscles has been proposed to document the effect of surgical or pharmacological treatment on rigidity in patients with Parkinson's disease. The aim of the study was to analyze the changes of viscoelastic stiffness induced by deep brain stimulation. Fifteen patients in an advanced stage of Parkinson's disease participated in the study. The study took place in the off-medication conditions after one night of drug withdrawal. The Unified Parkinson's Disease Rating Scale was used for clinical assessment of the disease. Myotonometry was used to measure viscoelastic stiffness in the resting muscles before and directly after passive wrist movements, commonly used for clinical evaluation of rigidity. The measurements were repeated during the stimulation-on and stimulation-off periods and compared with fifteen healthy control persons. The clinical scores for wrist rigidity improved from 3.0 (1-4) to 0.93 (0-2) (P<0.05) due to brain stimulation. The mean values of viscoelastic stiffness were similar before and after passive wrist movements, but the differences between the patients with high vs. low rigidity values (354.9 vs 310.2N/m; P<0.05) and in stimulation-off vs. stimulation-on conditions (342.7 vs 310.5N/m; P<0.05) were significant only if the measurements had been performed after passive wrist movements. Effective deep brain stimulation and increased rigidity can significantly change viscoelastic stiffness in the resting muscles in patients with Parkinson's disease, especially if evaluated after passive wrist movements. This paper supports the use of myotonometry for objective quantification of parkinsonian rigidity at rest. Copyright © 2017 Elsevier Ltd. All rights reserved.

Limited arthrodesis of the wrist for treatment of giant cell tumor of the distal radius.

PubMed

Flouzat-Lachaniette, Charles-Henri; Babinet, Antoine; Kahwaji, Antoine; Anract, Philippe; Biau, David-Jean

2013-08-01

To present the functional results of a technique of radiocarpal arthrodesis and reconstruction with a structural nonvascularized autologous bone graft after en bloc resection of giant cell tumors of the distal radius. A total of 13 patients with a mean age of 37 years with aggressive giant cell tumor (Campanacci grade III) of distal radius were managed with en bloc resection and reconstruction with a structural nonvascularized bone graft. The primary outcome measure was the disability evaluated by the Musculoskeletal Tumor Society rating score of limb salvage. Secondary outcomes included survival of the reconstruction measured from the date of the operation to revision procedure for any reason (mechanical, infectious, or oncologic). Other outcomes included active wrist motion and ability to resume work. Mean follow-up period was 6 years (range, 2-14 y). The median arc of motion at the midcarpal joint was 40°, median wrist flexion was 20°, and median extension was 10°. The median Musculoskeletal Tumor Society score based on the analysis of factors pertinent to the patient as a whole (pain, functional activities, and emotional acceptance) and specific to the upper limb (positioning of the hand, manual dexterity, and lifting ability) was 86%. Five patients underwent a second surgical procedure. The cumulative probability of reoperation for mechanical reason was 31% at similar follow-up times at 2, 5, and 10 years. This technique provided a stable wrist and partially restored wrist motion with limited pain. However, further surgical procedures may be necessary to reach this goal. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation

PubMed Central

Lans, Jonathan; Lasa, Alejandro; Chen, Neal C.; Jupiter, Jesse B.

2018-01-01

Background: The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable. Objective: The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures. Methods: We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score. Results: There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL. Conclusion: In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years. PMID:29456778

[Contribution of the cervical vertebral maturation (CVM) method to dentofacial orthopedics: update].

PubMed

Elhaddaoui, R; Benyahia, H; Azaroual, F; Zaoui, F

2014-11-01

The successful orthopedic treatment of skeletal Class II malocclusions is closely related to the reasoned determination of the optimal time to initiate the treatment. This is why various methods have been proposed to assess skeletal maturation, such as a hand-wrist radiograph or the cervical vertebral maturation (CVM) method. The hand-wrist radiograph was up to now the most frequently used method to assess skeletal maturation. However, the clinical and biological limitations of this technique, as well as the need to perform an additional radiograph, were reasons to develop another method to explore the maturation stages of visible cervical vertebrae on a simple lateral cephalometric radiograph. The authors compare the 2 methods and prove the greater contribution of the CVM method compared to the hand-wrist radiograph. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Design, Modelling and Teleoperation of a 2 mm Diameter Compliant Instrument for the da Vinci Platform.

PubMed

Francis, P; Eastwood, K W; Bodani, V; Looi, T; Drake, J M

2018-05-07

This work explores the feasibility of creating and accurately controlling an instrument for robotic surgery with a 2 mm diameter and a three degree-of-freedom (DoF) wrist which is compatible with the da Vinci platform. The instrument's wrist is composed of a two DoF bending notched-nitinol tube pattern, for which a kinematic model has been developed. A base mechanism for controlling the wrist is designed for integration with the da Vinci Research Kit. A basic teleoperation task is successfully performed using two of the miniature instruments. The performance and accuracy of the instrument suggest that creating and accurately controlling a 2 mm diameter instrument is feasible and the design and modelling proposed in this work provide a basis for future miniature instrument development.

Acute hand and wrist injuries sustained during recreational mountain biking: a prospective study.

PubMed

Bush, Kevin; Meredith, Steve; Demsey, Daniel

2013-12-01

Recreational mountain biking continues to increase in popularity and is a significant source of traumatic injury, including injuries to the hand and wrist. A prospective survey of all hand and wrist injuries sustained while participating in recreational mountain biking presenting to the emergency department at the Municipality of Whistler and the District of Squamish was conducted over a 12-month consecutive period. An analysis of 765 unique emergency department visits with 1,079 distinct injuries was performed. Of these injuries, 511 were sustained to the upper limb. Injury to the metacarpal and metacarpal phalangeal joints was the most common hand injury (52) followed by proximal phalanx and proximal interphalangeal joint (20). Mountain biking is a frequent source of a variety of upper limb trauma, and preventative efforts are necessary to minimize the burden of these injuries.

Compliant Robot Wrist

NASA Technical Reports Server (NTRS)

Voellmer, George

1992-01-01

Compliant element for robot wrist accepts small displacements in one direction only (to first approximation). Three such elements combined to obtain translational compliance along three orthogonal directions, without rotational compliance along any of them. Element is double-blade flexure joint in which two sheets of spring steel attached between opposing blocks, forming rectangle. Blocks moved parallel to each other in one direction only. Sheets act as double cantilever beams deforming in S-shape, keeping blocks parallel.

An alternative fabrication method of the dart thrower's motion orthosis (also known as the dart orthosis).

PubMed

Schwartz, Deborah A

2016-01-01

To allow safe early wrist motion after wrist injury, this author has modified an earlier version of a dart thrower's motion orthotic device using material that is currently available on the market and an inexpensive paper fastener as the rivet. - KristinValdes, OTD, OT, CHT, Practice Forum Editor. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

How Accurately Can Your Wrist Device Recognize Daily Activities and Detect Falls?

PubMed Central

Gjoreski, Martin; Gjoreski, Hristijan; Luštrek, Mitja; Gams, Matjaž

2016-01-01

Although wearable accelerometers can successfully recognize activities and detect falls, their adoption in real life is low because users do not want to wear additional devices. A possible solution is an accelerometer inside a wrist device/smartwatch. However, wrist placement might perform poorly in terms of accuracy due to frequent random movements of the hand. In this paper we perform a thorough, large-scale evaluation of methods for activity recognition and fall detection on four datasets. On the first two we showed that the left wrist performs better compared to the dominant right one, and also better compared to the elbow and the chest, but worse compared to the ankle, knee and belt. On the third (Opportunity) dataset, our method outperformed the related work, indicating that our feature-preprocessing creates better input data. And finally, on a real-life unlabeled dataset the recognized activities captured the subject’s daily rhythm and activities. Our fall-detection method detected all of the fast falls and minimized the false positives, achieving 85% accuracy on the first dataset. Because the other datasets did not contain fall events, only false positives were evaluated, resulting in 9 for the second, 1 for the third and 15 for the real-life dataset (57 days data). PMID:27258282

High-Resolution 3T MR Imaging of the Triangular Fibrocartilage Complex

PubMed Central

von Borstel, Donald; Wang, Michael; Small, Kirstin; Nozaki, Taiki; Yoshioka, Hiroshi

2017-01-01

This study is intended as a review of 3Tesla (T) magnetic resonance (MR) imaging of the triangular fibrocartilage complex (TFCC). The recent advances in MR imaging, which includes high field strength magnets, multi-channel coils, and isotropic 3-dimensional (3D) sequences have enabled the visualization of precise TFCC anatomy with high spatial and contrast resolution. In addition to the routine wrist protocol, there are specific techniques used to optimize 3T imaging of the wrist; including driven equilibrium sequence (DRIVE), parallel imaging, and 3D imaging. The coil choice for 3T imaging of the wrist depends on a number of variables, and the proper coil design selection is critical for high-resolution wrist imaging with high signal and contrast-to-noise ratio. The TFCC is a complex structure and is composed of the articular disc (disc proper), the triangular ligament, the dorsal and volar radioulnar ligaments, the meniscus homologue, the ulnar collateral ligament (UCL), the extensor carpi ulnaris (ECU) tendon sheath, and the ulnolunate and ulnotriquetral ligaments. The Palmer classification categorizes TFCC lesions as traumatic (type 1) or degenerative (type 2). In this review article, we present clinical high-resolution MR images of normal TFCC anatomy and TFCC injuries with this classification system. PMID:27535592

High-Resolution 3T MR Imaging of the Triangular Fibrocartilage Complex.

PubMed

von Borstel, Donald; Wang, Michael; Small, Kirstin; Nozaki, Taiki; Yoshioka, Hiroshi

2017-01-10

This study is intended as a review of 3Tesla (T) magnetic resonance (MR) imaging of the triangular fibrocartilage complex (TFCC). The recent advances in MR imaging, which includes high field strength magnets, multi-channel coils, and isotropic 3-dimensional (3D) sequences have enabled the visualization of precise TFCC anatomy with high spatial and contrast resolution. In addition to the routine wrist protocol, there are specific techniques used to optimize 3T imaging of the wrist; including driven equilibrium sequence (DRIVE), parallel imaging, and 3D imaging. The coil choice for 3T imaging of the wrist depends on a number of variables, and the proper coil design selection is critical for high-resolution wrist imaging with high signal and contrast-to-noise ratio. The TFCC is a complex structure and is composed of the articular disc (disc proper), the triangular ligament, the dorsal and volar radioulnar ligaments, the meniscus homologue, the ulnar collateral ligament (UCL), the extensor carpi ulnaris (ECU) tendon sheath, and the ulnolunate and ulnotriquetral ligaments. The Palmer classification categorizes TFCC lesions as traumatic (type 1) or degenerative (type 2). In this review article, we present clinical high-resolution MR images of normal TFCC anatomy and TFCC injuries with this classification system.

Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability.

PubMed

Luchetti, R; Atzei, A; Cozzolino, R; Fairplay, T; Badur, N

2014-10-01

The aim of this study was to assess the objective and subjective functional outcomes after foveal reattachment of proximal or complete ulnar-sided triangular fibrocartilage complex lesions by two surgical procedures: an open technique or an arthroscopically assisted repair. The study was done prospectively on 49 wrists affected by post-traumatic distal radio-ulnar joint instability. Twenty-four patients were treated with the open technique (Group 1) and 25 by the arthroscopically assisted technique (Group 2). Magnetic resonance imaging demonstrated a clear foveal detachment of the triangular fibrocartilage complex in 67% of the cases. Arthroscopy showed a positive ulnar-sided detachment of the triangular fibrocartilage complex (positive hook test) in all cases. Distal radio-ulnar joint stability was obtained in all but five patients at a mean follow-up of 6 months. Both groups had improvement of all parameters with significant differences in wrist pain scores, Mayo wrist score, Disability of the Arm, Shoulder and Hand questionnaire and Patient-Rated Wrist/Hand Evaluation questionnaire scores. There were no significant post-operative differences between the two groups in the outcome parameters except for the Disability of the Arm Shoulder and Hand questionnaire score, which was significantly better in Group 2 (p < 0.001). © The Author(s) 2013.

A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke.

PubMed

Fakhari, Zahra; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Mansouri, Korosh; Radinmehr, Hojjat

2017-01-01

Spasticity is a common complication after stroke. Dry needling (DN) is suggested as a novel method for treatment of muscle spasticity. To explore the effects of DN on wrist flexors spasticity poststroke. A single group, pretest-posttest clinical trial was used. Twenty nine patients with stroke (16 male; mean age 54.3 years) were tested at baseline (T0), immediately after DN (T1), and one hour after DN (T2). DN was applied for flexor carpi radialis (FCR) and flexor carpi ulnaris on the affected arm for single session, one minute per muscle. The Modified Modified Ashworth Scale (MMAS), passive resistance force, wrist active and passive range of motion, Box and Block Test, and FCR H-reflex were outcome measures. Significant reductions in MMAS scores were seen both immediately after DN and at 1-hour follow-up (median 2 at T0 to 1 at T1 and T2). There were significant improvements in other measures between the baseline values at T0 and those recorded immediately after the DN at T1 or one hour later at T2. This study suggests that DN reduced wrist flexors spasticity and alpha motor neuron excitability in patients with stroke, and improvements persisted for one hour after DN.

Level of evidence in wrist ligament repair and reconstruction research: a systematic review.

PubMed

Andersson, Jonny K; Rööser, Bo; Karlsson, Jón

2018-06-07

There have been numerous studies on surgery of wrist ligament injuries, but a quick assessment reveals few with a high level of evidence (LoE). The primary aim of this study was to categorize the study type and LoE of studies on repair and reconstruction of the scapholunate ligament, the lunotriquetral ligament and the triangular fibrocartilage complex by applying the LoE rating system proposed by the Oxford Centre for Evidence-Based Medicine. The secondary aims were to evaluate the journal- and geographic- distribution of the included studies.An electronic literature search of articles published 1985-2016, in PubMed, Embase, and Cochrane Library was carried out in May 2016 and updated in April 2017. Therapeutic studies written in English were included. The PRISMA checklist guided the extraction and reporting of data.A total of 1889 studies were analyzed, of which 362 were included. Three journals represented 40% of the included studies and American authors dominated.Most studies (97%) had low LoE (IV-V). No studies of LoE I-II were found. There is insufficient evidence to recommend one technique over the other in terms of wrist ligament surgery in clinical practice. There is an immense lack of comparison studies with high level of evidence in the area of wrist ligament repair and reconstruction.

Electromyography of wrist and finger flexor muscles in olive baboons (Papio anubis).

PubMed

Patel, Biren A; Larson, Susan G; Stern, Jack T

2012-01-01

Some non-human primates use digitigrade hand postures when walking slowly on the ground. As a component of an extended limb, a digitigrade posture can help minimize wrist joint moments thereby requiring little force production directly from wrist flexors (and/or from the assistance of finger flexors) to maintain limb posture. As a consequence, less active muscle volume would be required from these anti-gravity muscles and overall metabolic costs associated with locomotion could be reduced. To investigate whether the use of digitigrade hand postures during walking in primates entails minimal use of anti-gravity muscles, this study examined electromyography (EMG) patterns in both the wrist and finger flexor muscles in facultatively digitigrade olive baboons (Papio anubis) across a range of speeds. The results demonstrate that baboons can adopt a digitigrade hand posture when standing and moving at slow speeds without requiring substantial EMG activity from distal anti-gravity muscles. Higher speed locomotion, however, entails increasing EMG activity and is accompanied by a dynamic shift to a more palmigrade-like limb posture. Thus, the ability to adopt a digitigrade hand posture by monkeys is an adaptation for ground living, but it was never co-opted for fast locomotion. Rather, digitigrady in primates appears to be related to energetic efficiency for walking long distances.

Complex Human Activity Recognition Using Smartphone and Wrist-Worn Motion Sensors

PubMed Central

Shoaib, Muhammad; Bosch, Stephan; Incel, Ozlem Durmaz; Scholten, Hans; Havinga, Paul J. M.

2016-01-01

The position of on-body motion sensors plays an important role in human activity recognition. Most often, mobile phone sensors at the trouser pocket or an equivalent position are used for this purpose. However, this position is not suitable for recognizing activities that involve hand gestures, such as smoking, eating, drinking coffee and giving a talk. To recognize such activities, wrist-worn motion sensors are used. However, these two positions are mainly used in isolation. To use richer context information, we evaluate three motion sensors (accelerometer, gyroscope and linear acceleration sensor) at both wrist and pocket positions. Using three classifiers, we show that the combination of these two positions outperforms the wrist position alone, mainly at smaller segmentation windows. Another problem is that less-repetitive activities, such as smoking, eating, giving a talk and drinking coffee, cannot be recognized easily at smaller segmentation windows unlike repetitive activities, like walking, jogging and biking. For this purpose, we evaluate the effect of seven window sizes (2–30 s) on thirteen activities and show how increasing window size affects these various activities in different ways. We also propose various optimizations to further improve the recognition of these activities. For reproducibility, we make our dataset publicly available. PMID:27023543

Transverse maxillary deficit and its influence on the cervical vertebrae maturation index.

PubMed

Cossellu, G; Farronato, G; Nicotera, O; Biagi, R

2016-06-01

The aim of this study is to evaluate whether a transverse maxillary deficit can cause an alteration of vertebral development and therefore of the skeletal maturation comparing the cervical maturation stages index with the hand-wrist index. For the study were selected 200 patients aged 7-14 years, equally distributed by gender and divided into 100 study subjects with maxillary deficit and 100 controls without maxillary deficit. The skeletal maturation index (SM according to Fishman) was evaluated and compared with the hand-wrist x-rays and the cervical vertebrae maturation (CVM according to Hassel and Farmann). Forty-one per cent of the subjects in the test group show a discrepancy between CVM and SM. Among these 73% (30 subjects) present an advanced stage of CVM compared with the corresponding SM. Only 16% of the subjects in the control group show a discrepancy between CVM and SM. Among these 69% (11 subjects) appear in an advanced CVM stage. The analysis of the CVM stage in subjects with transverse maxillary deficit appears to be altered compared with the SM identified through a hand-wrist x-ray. In the case of individuals with transverse maxillary deficit it is advisable to use also a hand-wrist x-ray, thus not relying only on CVM for the evaluation of the skeletal growth stages.

Cortical activation and inter-hemispheric sensorimotor coherence in individuals with arm dystonia due to childhood stroke

PubMed Central

Kukke, Sahana N.; de Campos, Ana Carolina; Damiano, Diane; Alter, Katharine E.; Patronas, Nicholas; Hallett, Mark

2014-01-01

Objective Dystonia is a disabling motor disorder often without effective therapies. To better understand the genesis of dystonia after childhood stroke, we analyzed electroencephalographic (EEG) recordings in this population. Methods Resting spectral power of EEG signals over bilateral sensorimotor cortices (Powrest), resting inter-hemispheric sensorimotor coherence (Cohrest), and task-related changes in power (TRPow) and coherence (TRCoh) during wrist extension were analyzed in individuals with dystonia (age 20±3 years) and healthy volunteers (age 17±5 years). Results Ipsilesional TRPow decrease was significantly lower in patients than controls during the more affected wrist task. Force deficits of the affected wrist correlated with reduced alpha TRPow decrease on the ipsilesional and not the contralesional hemisphere. Cohrest was significantly lower in patients than controls, and correlated with more severe dystonia and poorer hand function. Powrest and TRCoh were similar between groups. Conclusions The association between weakness and cortical activation during wrist extension highlights the importance of ipsilesional sensorimotor activation on function. Reduction of Cohrest in patients reflects a loss of inter-hemispheric connectivity that may result from structural changes and neuroplasticity, potentially contributing to the development of dystonia. Significance Cortical and motor dysfunction are correlated in patients with childhood stroke and may in part explain the genesis of dystonia. PMID:25499610

Cortical activation and inter-hemispheric sensorimotor coherence in individuals with arm dystonia due to childhood stroke.

PubMed

Kukke, Sahana N; de Campos, Ana Carolina; Damiano, Diane; Alter, Katharine E; Patronas, Nicholas; Hallett, Mark

2015-08-01

Dystonia is a disabling motor disorder often without effective therapies. To better understand the genesis of dystonia after childhood stroke, we analyzed electroencephalographic (EEG) recordings in this population. Resting spectral power of EEG signals over bilateral sensorimotor cortices (Powrest), resting inter-hemispheric sensorimotor coherence (Cohrest), and task-related changes in power (TRPow) and coherence (TRCoh) during wrist extension were analyzed in individuals with dystonia (age 20±3years) and healthy volunteers (age 17±5years). Ipsilesional TRPow decrease was significantly lower in patients than controls during the more affected wrist task. Force deficits of the affected wrist correlated with reduced alpha TRPow decrease on the ipsilesional and not the contralesional hemisphere. Cohrest was significantly lower in patients than controls, and correlated with more severe dystonia and poorer hand function. Powrest and TRCoh were similar between groups. The association between weakness and cortical activation during wrist extension highlights the importance of ipsilesional sensorimotor activation on function. Reduction of Cohrest in patients reflects a loss of inter-hemispheric connectivity that may result from structural changes and neuroplasticity, potentially contributing to the development of dystonia. Cortical and motor dysfunction are correlated in patients with childhood stroke and may in part explain the genesis of dystonia. Published by Elsevier Ireland Ltd.

Validation of the A&D BP UB-542 wrist device for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Saladini, Francesca; Benetti, Elisabetta; Fania, Claudio; Palatini, Paolo

2013-08-01

The objective of this study was to determine the accuracy of the A&D BP UB-542 wrist device for home blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension (ESH). Device evaluation was carried out in 33 patients. The mean age was 50.9±10.1 years, the mean systolic BP was 141.6±22.8 mmHg (range 92 : 189), the mean diastolic BP was 89.2±11.4 mmHg (range 62 : 120), the mean arm circumference was 28.8±3.2 cm (range 23-35), and the mean wrist circumference was 17.1±1.4 cm (range 14-19.5). The protocol requirements were followed precisely. The device passed all requirements, fulfilling the standards of the protocol. On average, the device overestimated the systolic BP by 1.8±7.2 mmHg and diastolic BP by 1.6±5.7 mmHg. These data show that the A&D BP UB-542 wrist device met the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

Effects of combined wrist flexion/extension and forearm rotation and two levels of relative force on discomfort.

PubMed

Khan, Abid Ali; O'Sullivan, Leonard; Gallwey, Timothy J

2009-10-01

This study investigated perceived discomfort in an isometric wrist flexion task. Independent variables were wrist flexion/extension (55%, 35% flexion, neutral, 35% and 55% extension ranges of motion (ROM)), forearm rotation (60%, 30% prone, neutral, 30% and 60% supine ROM) and two levels of flexion force (10% and 20% maximum voluntary contraction (MVC)). Discomfort was significantly affected by flexion force, forearm rotation and a two-way interaction of force with forearm rotation (each p < 0.05). High force for 60%ROM forearm pronation and supination resulted in increasingly higher discomfort for these combinations. Flexion forces were set relative to the MVC in each wrist posture and this appears to be important in explaining a lack of significant effect (p = 0.34) for flexion/extension on discomfort. Regression equations predicting discomfort were developed and used to generate iso-discomfort contours, which indicate regions where the risk of injury should be low and others where it is likely to be high. Regression equations predicting discomfort and iso-discomfort contours are presented, which indicate combinations of upper limb postures for which discomfort is predicted to be low, and others where it is likely to be high. These are helpful in the study of limits for risk factors associated with upper limb musculoskeletal injury in industry.

Detecting periods of eating during free-living by tracking wrist motion.

PubMed

Dong, Yujie; Scisco, Jenna; Wilson, Mike; Muth, Eric; Hoover, Adam

2014-07-01

This paper is motivated by the growing prevalence of obesity, a health problem affecting over 500 million people. Measurements of energy intake are commonly used for the study and treatment of obesity. However, the most widely used tools rely upon self-report and require a considerable manual effort, leading to underreporting of consumption, noncompliance, and discontinued use over the long term. The purpose of this paper is to describe a new method that uses a watch-like configuration of sensors to continuously track wrist motion throughout the day and automatically detect periods of eating. Our method uses the novel idea that meals tend to be preceded and succeeded by the periods of vigorous wrist motion. We describe an algorithm that segments and classifies such periods as eating or noneating activities. We also evaluate our method on a large dataset (43 subjects, 449 total h of data, containing 116 periods of eating) collected during free-living. Our results show an accuracy of 81% for detecting eating at 1-s resolution in comparison to manually marked event logs of periods eating. These results indicate that vigorous wrist motion is a useful indicator for identifying the boundaries of eating activities, and that our method should prove useful in the continued development of body-worn sensor tools for monitoring energy intake.

Effects of static fingertip loading on carpal tunnel pressure

NASA Technical Reports Server (NTRS)

Rempel, D.; Keir, P. J.; Smutz, W. P.; Hargens, A.

1997-01-01

The purpose of this study was to explore the relationship between carpal tunnel pressure and fingertip force during a simple pressing task. Carpal tunnel pressure was measured in 15 healthy volunteers by means of a saline-filled catheter inserted percutaneously into the carpal tunnel of the nondominant hand. The subjects pressed on a load cell with the tip of the index finger and with 0, 6, 9, and 12 N of force. The task was repeated in 10 wrist postures: neutral; 10 and 20 degrees of ulnar deviation; 10 degrees of radial deviation; and 15, 30, and 45 degrees of both flexion and extension. Fingertip loading significantly increased carpal tunnel pressure for all wrist angles (p = 0.0001). Post hoc analyses identified significant increase (p < 0.05) in carpal tunnel pressure between unloaded (0 N) and all loaded conditions, as well as between the 6 and 12 N load conditions. This study demonstrates that the process whereby fingertip loading elevates carpal tunnel pressure is independent of wrist posture and that relatively small fingertip loads have a large effect on carpal tunnel pressure. It also reveals the response characteristics of carpal tunnel pressure to fingertip loading, which is one step in understanding the relationship between sustained grip and pinch activities and the aggravation or development of median neuropathy at the wrist.

Cortical Decoding of Individual Finger and Wrist Kinematics for an Upper-Limb Neuroprosthesis

PubMed Central

Aggarwal, Vikram; Tenore, Francesco; Acharya, Soumyadipta; Schieber, Marc H.; Thakor, Nitish V.

2010-01-01

Previous research has shown that neuronal activity can be used to continuously decode the kinematics of gross movements involving arm and hand trajectory. However, decoding the kinematics of fine motor movements, such as the manipulation of individual fingers, has not been demonstrated. In this study, single unit activities were recorded from task-related neurons in M1 of two trained rhesus monkey as they performed individuated movements of the fingers and wrist. The primates’ hand was placed in a manipulandum, and strain gauges at the tips of each finger were used to track the digit’s position. Both linear and non-linear filters were designed to simultaneously predict kinematics of each digit and the wrist, and their performance compared using mean squared error and correlation coefficients. All models had high decoding accuracy, but the feedforward ANN (R=0.76–0.86, MSE=0.04–0.05) and Kalman filter (R=0.68–0.86, MSE=0.04–0.07) performed better than a simple linear regression filter (0.58–0.81, 0.05–0.07). These results suggest that individual finger and wrist kinematics can be decoded with high accuracy, and be used to control a multi-fingered prosthetic hand in real-time. PMID:19964645

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

PubMed

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

2011-01-01

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

Resonance at the wrist demonstrated by the use of a torque motor: an instrumental analysis of muscle tone in man.

PubMed Central

Lakie, M; Walsh, E G; Wright, G W

1984-01-01

The resonance of the relaxed wrist for flexion-extension movements in the horizontal plane has been investigated by using rhythmic torques generated by a printed motor. In the normal subject the resonant frequency of the wrist is ca. 2 Hz unless the torque is reduced below a certain critical value when the system is no longer linear and the resonant frequency rises. This critical torque level, and the damping are both less in women than men. The resonant frequency is uninfluenced by surgical anaesthesia. With added bias the increase of resonant frequency at low torques still occurs although the hand is now oscillating about a displaced mean position. It follows that the stiffening implied by this elevation of resonant frequency for small movements is neither the result of pre-stressing of the muscles nor of reflex activity. With velocity feed-back of appropriate polarity the system will oscillate spontaneously at its resonant frequency. If the peak driving torque is progressively reduced the resonant frequency increases abruptly, indicating that the system has stiffened. Perturbations delivered to the wrist may reduce its stiffness. The postural system is thixotropic with a 'memory time' of 1-2 s. The resonant frequency is elevated in voluntary stiffening. PMID:6481624

Crosshift Vibrometry: Biomarker for Ergonomic Stress

DTIC Science & Technology

1994-09-01

identification of high risk tasi that may lead to the development of carpal tunnel syndrome. This dissertation consisted of three field studies conducted at... risk for development of CTS. Repeated exertions with a flexed or hyperextended wrist, pressure at the base of the palm or wrist, and low frequency hand...The 12 females came from a variety of clerical and industrial jobs. Four groups were established for comparison (control (no CTS symptoms), at- risk (no

Abductor pollicis longus: a case of mistaken identity.

PubMed

Elliott, B G

1992-08-01

Abductor pollicis longus, long regarded as a motor for the thumb, is anatomically and functionally a radial deviator of the wrist and should be so named. The abductor carpi is proposed. If the other radial deviators of the wrist are acting this tendon can be selectively utilized as a transfer without loss of function. Reflex spasm of this muscle probably plays an important role in the radial deviation deformity seen in the rheumatoid hand.

Anthropometric-Arm Radiogrammetric Assessment of Body Composition, Muscularity and Frame Size.

DTIC Science & Technology

1983-06-01

ribs was measured during normal breathing (nipple line in males and upper part of breasts in females). 5. Wrists: subject seated with the hands...then sign your name in the space provided. The following guidelines are established in accord with the Code of Federal Regulations 45, Public Welfare ...measurements will be taken with a wooden caliper. The sites include: shoulders, chest, hips, ankles, knees, wrists, elbows. 4. Five surface fat

Wrist Pulse Rate Monitor Using Self-Injection-Locked Radar Technology

PubMed Central

Wang, Fu-Kang; Tang, Mu-Cyun; Su, Sheng-Chao; Horng, Tzyy-Sheng

2016-01-01

To achieve sensitivity, comfort, and durability in vital sign monitoring, this study explores the use of radar technologies in wearable devices. The study first detected the respiratory rates and heart rates of a subject at a one-meter distance using a self-injection-locked (SIL) radar and a conventional continuous-wave (CW) radar to compare the sensitivity versus power consumption between the two radars. Then, a pulse rate monitor was constructed based on a bistatic SIL radar architecture. This monitor uses an active antenna that is composed of a SIL oscillator (SILO) and a patch antenna. When attached to a band worn on the subject’s wrist, the active antenna can monitor the pulse on the subject’s wrist by modulating the SILO with the associated Doppler signal. Subsequently, the SILO’s output signal is received and demodulated by a remote frequency discriminator to obtain the pulse rate information. PMID:27792176

External Versus Two Different Internal Foci of Attention in Long-Distance Throwing.

PubMed

Oki, Yuta; Kokubu, Masahiro; Nakagomi, Shiro

2018-02-01

The present study examined the influence of attentional focus on performance during a long-distance throwing task. Twelve participants executed three maximum-effort, long-distance baseball throwing attempts in three focus conditions: internal focus on wrist flexion (wrist internal focus), internal focus on the separation between pelvis and upper torso orientations (torso internal focus), and external focus on the ball path (external focus). Compared with the external focus and torso internal focus conditions, performance was poorer in the wrist internal focus condition. Performances were not different in the torso internal and external focus conditions. In addition, attentional focus affected the release angle of the ball but not its initial velocity. Our results reveal that the body part targeted for internal focus of attention and the forcefulness of the motor activity can be as important to motor performance as whether the attention is internal or external.

Indium-111 leukocyte imaging in patients with rheumatoid arthritis

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

Uno, K.; Matsui, N.; Nohira, K.

1986-03-01

This study evaluates the usefulness of labeled leukocyte imaging in patients with rheumatoid arthritis. In 33 patients, the incidence of pain and swelling in 66 wrist joints and 66 knee joints was compared with the accumulation of (/sup 111/In)leukocytes. No accumulation of (/sup 111/In)leukocytes was seen in any of the patients' wrists (0/12) or knee joints (0/14) when both pain and swelling were absent. In contrast, 93% (25/27) of wrist joints and 80% (24/30) of knee joints with both pain and swelling were positive by (/sup 111/In)leukocyte scintigraphy. There was little correlation between the stage of the disease, as determinedmore » by radiography, and (/sup 111/In)leukocyte accumulation. This study suggests that (/sup 111/In)leukocyte imaging may be a reliable procedure for monitoring the activity of rheumatoid arthritis, especially for confirming the lack of an ongoing inflammatory response.« less

Wearable Stretch Sensors for Motion Measurement of the Wrist Joint Based on Dielectric Elastomers.

PubMed

Huang, Bo; Li, Mingyu; Mei, Tao; McCoul, David; Qin, Shihao; Zhao, Zhanfeng; Zhao, Jianwen

2017-11-23

Motion capture of the human body potentially holds great significance for exoskeleton robots, human-computer interaction, sports analysis, rehabilitation research, and many other areas. Dielectric elastomer sensors (DESs) are excellent candidates for wearable human motion capture systems because of their intrinsic characteristics of softness, light weight, and compliance. In this paper, DESs were applied to measure all component motions of the wrist joints. Five sensors were mounted to different positions on the wrist, and each one is for one component motion. To find the best position to mount the sensors, the distribution of the muscles is analyzed. Even so, the component motions and the deformation of the sensors are coupled; therefore, a decoupling method was developed. By the decoupling algorithm, all component motions can be measured with a precision of 5°, which meets the requirements of general motion capture systems.

Improvement of a sensor unit for wrist blood pressure monitoring system

NASA Astrophysics Data System (ADS)

Koo, Sangjun; Kwon, Jongwon; Park, Yongman; Ayuzenara, Odgerel; Kim, Hiesik

2007-12-01

A blood pressure sensor unit for ubiquitous healthcare monitoring was newly developed. The digital wrist band-type blood pressure devices for home are popular already in the market. It is useful for checking blood pressure level at home and control of hypertension. Especially, it is very essential home device to check the health condition of blood circulation disease. Nowadays many product types are available. But the measurement of blood pressure is not accurate enough compared with the mechanical type. It needs to be upgraded to assure the precise health data enough to use in the hospital. The structure, feature and output signal of capacitor type pressure sensors are analyzed. An improved design of capacitor sensor is suggested. It shows more precise health data after use on a wrist band type health unit. They can be applied for remote u-health medical service.

[Kinematics of the triangular fibrocartilage complex during forearm rotation in vivo].

PubMed

Xu, Jing; Tang, Jin-bo; Jia, Zhong-zheng; Xie, Ren-guo

2009-11-01

To investigate three-dimensional kinematics of the superficial and deep portion of triangular fibrocartilage complex (TFCC) in different parts of the forearm rotation. Six wrists of 6 volunteers were used to obtain CT scans at different positions of the wrist. The wrists were scanned from 90 degrees of pronation to 90 degrees of supination at an interval of 30 degrees. The 3-dimensional radius and ulna were reconstructed with customized software and changes in length of the superficial and deep portion of TFCC during forearm rotation. In forearm pronation, the superficial dorsal portion and the deep palmar portion of the TFCC were tight. While the superficial palmar portion and the deep dorsal potion of the TFCC were lax. In supination, the changes in length of all these fibers were reverse. In forearm rotation one portion fibers of dorsal TFCC and one portion fibers of palmar TFCC are tight, and this mechanism controls stability during DRUJ rotation.

Tendon transfer to reconstruct wrist extension in children with obstetric brachial plexus palsy.

PubMed

Al-Qattan, M M

2003-04-01

This study reports on 20 children with obstetric brachial plexus palsy who underwent a tendon transfer to reconstruct wrist extension. The mean age at the time of tendon transfer was 8 years. There were seven patients with Erb's palsy and the remaining 13 had total palsy. The flexor carpi ulnaris was utilized 15 times and the flexor carpi radialis five times. The transferred tendon was sutured to the tendon of the extensor carpi radialis brevis. The result of the transfer was assessed according to a modified Medical Research Council (MRC) muscle grading system. A good result was obtained in 18 patients (modified MRC grade of 4) and a fair result (modified MRC grade of 3) in two. The choice of tendon transfer to reconstruct the wrist drop deformity in various conditions including adult traumatic brachial plexus injuries is discussed.

Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Caused by Crystal-Induced Arthritis of the Wrist: A Case Report

PubMed Central

Hakozaki, Michiyuki; Fukuda, Hironari; Tajino, Takahiro; Kikuchi, Shinichi; Abe, Satoshi; Konno, Shinichi

2013-01-01

Objective To describe a rare case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome caused by gouty arthritis. Clinical Presentation and Intervention A 76-year-old man presented with swelling and pain in the dorsum of feet and hands bilaterally. From the laboratory and radiologic findings, the diagnosis of gout-induced RS3PE syndrome was made. Conservative therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and intra-articular corticosteroid injection in the wrist joint completely and rapidly resolved all symptoms. The patient was successfully treated with oral administration of NSAIDs and a one-time intra-articular corticosteroid injection in the left wrist joint. Conclusion This case demonstrated the importance of considering the possibility of crystal-induced arthritis such as gout and pseudogout, as well as malignant disease, when diagnosing the primary disease responsible for RS3PE syndrome. PMID:23006891

Wrist Pulse Rate Monitor Using Self-Injection-Locked Radar Technology.

PubMed

Wang, Fu-Kang; Tang, Mu-Cyun; Su, Sheng-Chao; Horng, Tzyy-Sheng

2016-10-26

To achieve sensitivity, comfort, and durability in vital sign monitoring, this study explores the use of radar technologies in wearable devices. The study first detected the respiratory rates and heart rates of a subject at a one-meter distance using a self-injection-locked (SIL) radar and a conventional continuous-wave (CW) radar to compare the sensitivity versus power consumption between the two radars. Then, a pulse rate monitor was constructed based on a bistatic SIL radar architecture. This monitor uses an active antenna that is composed of a SIL oscillator (SILO) and a patch antenna. When attached to a band worn on the subject's wrist, the active antenna can monitor the pulse on the subject's wrist by modulating the SILO with the associated Doppler signal. Subsequently, the SILO's output signal is received and demodulated by a remote frequency discriminator to obtain the pulse rate information.

Effects of neoprene wrist/hand splints on handwriting for students with joint hypermobility syndrome: a single system design study.

PubMed

Frohlich, Lauren; Wesley, Alison; Wallen, Margaret; Bundy, Anita

2012-08-01

Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Multiple baseline, single system design (SSD) methodology was used. Four ninth grade students with handwriting difficulties because of joint hypermobility syndrome participated in this study. Visual and statistical (two standard deviation band method) analyses indicated a significant decrease in handwriting speed when using the splint for three out of four participants. No significant change in pain or endurance was noted during intervention. There was a significant decrease in pain following withdrawal of the splint for three participants. Evidence from this study does not support use of this particular splint for decreasing pain and increasing handwriting speed and endurance for ninth grade students with joint hypermobility syndrome.

Wrist Camera Orientation for Effective Telerobotic Orbital Replaceable Unit (ORU) Changeout

NASA Technical Reports Server (NTRS)

Jones, Sharon Monica; Aldridge, Hal A.; Vazquez, Sixto L.

1997-01-01

The Hydraulic Manipulator Testbed (HMTB) is the kinematic replica of the Flight Telerobotic Servicer (FTS). One use of the HMTB is to evaluate advanced control techniques for accomplishing robotic maintenance tasks on board the Space Station. Most maintenance tasks involve the direct manipulation of the robot by a human operator when high-quality visual feedback is important for precise control. An experiment was conducted in the Systems Integration Branch at the Langley Research Center to compare several configurations of the manipulator wrist camera for providing visual feedback during an Orbital Replaceable Unit changeout task. Several variables were considered such as wrist camera angle, camera focal length, target location, lighting. Each study participant performed the maintenance task by using eight combinations of the variables based on a Latin square design. The results of this experiment and conclusions based on data collected are presented.

[The surgeon as a hand patient: the clinical and psychological impact of hand and wrist fractures].

PubMed

Chin, K R; Lonner, J H; Jupiter, B S; Jupiter, J B

2010-03-01

To gain insight into the management of patients with hand and wrist injuries, a series of clinical and psychological analyses was performed on 9 surgeons, each of whom underwent operative fixation of a hand or wrist fracture. The results of these analyses suggest that the functional outcome after hand surgery was affected by the surgeons' personality, motivation, and ability to accept and adapt to the injury, the nature of the injury, and the importance of the hand to the surgeons' careers. Surgeons are highly motivated and compulsive individuals who consider their career involvement a major source of identity and self-worth. Most returned to their operative duties ahead of the schedule set by their hand surgeons (average, 25 days after surgery), regarded their injuries as a positive challenge, and changed their lifestyles after injury to protect their hands.

A Comparison and Calibration of a Wrist-Worn Blood Pressure Monitor for Patient Management: Assessing the Reliability of Innovative Blood Pressure Devices

PubMed Central

Melville, Sarah; Teskey, Robert; Philip, Shona; Simpson, Jeremy A; Lutchmedial, Sohrab

2018-01-01

Background Clinical guidelines recommend monitoring of blood pressure at home using an automatic blood pressure device for the management of hypertension. Devices are not often calibrated against direct blood pressure measures, leaving health care providers and patients with less reliable information than is possible with current technology. Rigorous assessments of medical devices are necessary for establishing clinical utility. Objective The purpose of our study was 2-fold: (1) to assess the validity and perform iterative calibration of indirect blood pressure measurements by a noninvasive wrist cuff blood pressure device in direct comparison with simultaneously recorded peripheral and central intra-arterial blood pressure measurements and (2) to assess the validity of the measurements thereafter of the noninvasive wrist cuff blood pressure device in comparison with measurements by a noninvasive upper arm blood pressure device to the Canadian hypertension guidelines. Methods The cloud-based blood pressure algorithms for an oscillometric wrist cuff device were iteratively calibrated to direct pressure measures in 20 consented patient participants. We then assessed measurement validity of the device, using Bland-Altman analysis during routine cardiovascular catheterization. Results The precalibrated absolute mean difference between direct intra-arterial to wrist cuff pressure measurements were 10.8 (SD 9.7) for systolic and 16.1 (SD 6.3) for diastolic. The postcalibrated absolute mean difference was 7.2 (SD 5.1) for systolic and 4.3 (SD 3.3) for diastolic pressures. This is an improvement in accuracy of 33% systolic and 73% diastolic with a 48% reduction in the variability for both measures. Furthermore, the wrist cuff device demonstrated similar sensitivity in measuring high blood pressure compared with the direct intra-arterial method. The device, when calibrated to direct aortic pressures, demonstrated the potential to reduce a treatment gap in high blood pressure measurements. Conclusions The systolic pressure measurements of the wrist cuff have been iteratively calibrated using gold standard central (ascending aortic) pressure. This improves the accuracy of the indirect measures and potentially reduces the treatment gap. Devices that undergo auscultatory (indirect) calibration for licensing can be greatly improved by additional iterative calibration via intra-arterial (direct) measures of blood pressure. Further clinical trials with repeated use of the device over time are needed to assess the reliability of the device in accordance with current and evolving guidelines for informed decision making in the management of hypertension. Trial Registration ClinicalTrials.gov NCT03015363; https://clinicaltrials.gov/ct2/show/NCT03015363 (Archived by WebCite at http://www.webcitation.org/6xPZgseYS) PMID:29695375

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

PubMed Central

2009-01-01

Background In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom). Methods The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE), Abduction/Adduction (AA) and Pronation/Supination (PS). Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns. Results Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the beginning and at the end of the test therapy session and the results suggest a positive trend. Conclusion The positive outcomes of the preliminary tests motivate the planning of a clinical trial and provide experimental evidence for defining appropriate inclusion/exclusion criteria. PMID:19968873

Age-Related Decline of Wrist Position Sense and its Relationship to Specific Physical Training

PubMed Central

Van de Winckel, Ann; Tseng, Yu-Ting; Chantigian, Daniel; Lorant, Kaitlyn; Zarandi, Zinat; Buchanan, Jeffrey; Zeffiro, Thomas A.; Larson, Mia; Olson-Kellogg, Becky; Konczak, Jürgen; Keller-Ross, Manda L.

2017-01-01

Perception of limb and body positions is known as proprioception. Sensory feedback, especially from proprioceptive receptors, is essential for motor control. Aging is associated with a decline in position sense at proximal joints, but there is inconclusive evidence of distal joints being equally affected by aging. In addition, there is initial evidence that physical activity attenuates age-related decline in proprioception. Our objectives were, first, to establish wrist proprioceptive acuity in a large group of seniors and compare their perception to young adults, and second, to determine if specific types of training or regular physical activity are associated with preserved wrist proprioception. We recruited community-dwelling seniors (n = 107, mean age, 70 ± 5 years, range, 65–84 years) without cognitive decline (Mini Mental State Examination-brief version ≥13/16) and young adult students (n = 51, mean age, 20 ± 1 years, range, 19–26 years). Participants performed contralateral and ipsilateral wrist position sense matching tasks with a bimanual wrist manipulandum to a 15° flexion reference position. Systematic error or proprioceptive bias was computed as the mean difference between matched and reference position. The respective standard deviation over five trials constituted a measure of random error or proprioceptive precision. Current levels of physical activity and previous sport, musical, or dance training were obtained through a questionnaire. We employed longitudinal mixed effects linear models to calculate the effects of trial number, sex, type of matching task and age on wrist proprioceptive bias and precision. The main results were that relative proprioceptive bias was greater in older when compared to young adults (mean difference: 36% ipsilateral, 88% contralateral, p < 0.01). Proprioceptive precision for contralateral but not for ipsilateral matching was smaller in older than in young adults (mean difference: 38% contralateral, p < 0.01). Longer years of dance training were associated with smaller bias during ipsilateral matching (p < 0.01). Other types of training or physical activity levels did not affect bias or precision. Our findings demonstrate that aging is associated with a decline in proprioceptive bias in distal arm joints, but age does not negatively affect proprioceptive precision. Further, specific types of long-term dance related training may attenuate age-related decline in proprioceptive bias. PMID:29209188

Age-Related Decline of Wrist Position Sense and its Relationship to Specific Physical Training.

PubMed

Van de Winckel, Ann; Tseng, Yu-Ting; Chantigian, Daniel; Lorant, Kaitlyn; Zarandi, Zinat; Buchanan, Jeffrey; Zeffiro, Thomas A; Larson, Mia; Olson-Kellogg, Becky; Konczak, Jürgen; Keller-Ross, Manda L

2017-01-01

Perception of limb and body positions is known as proprioception. Sensory feedback, especially from proprioceptive receptors, is essential for motor control. Aging is associated with a decline in position sense at proximal joints, but there is inconclusive evidence of distal joints being equally affected by aging. In addition, there is initial evidence that physical activity attenuates age-related decline in proprioception. Our objectives were, first, to establish wrist proprioceptive acuity in a large group of seniors and compare their perception to young adults, and second, to determine if specific types of training or regular physical activity are associated with preserved wrist proprioception. We recruited community-dwelling seniors ( n = 107, mean age, 70 ± 5 years, range, 65-84 years) without cognitive decline (Mini Mental State Examination-brief version ≥13/16) and young adult students ( n = 51, mean age, 20 ± 1 years, range, 19-26 years). Participants performed contralateral and ipsilateral wrist position sense matching tasks with a bimanual wrist manipulandum to a 15° flexion reference position. Systematic error or proprioceptive bias was computed as the mean difference between matched and reference position. The respective standard deviation over five trials constituted a measure of random error or proprioceptive precision . Current levels of physical activity and previous sport, musical, or dance training were obtained through a questionnaire. We employed longitudinal mixed effects linear models to calculate the effects of trial number, sex, type of matching task and age on wrist proprioceptive bias and precision. The main results were that relative proprioceptive bias was greater in older when compared to young adults (mean difference: 36% ipsilateral, 88% contralateral, p < 0.01). Proprioceptive precision for contralateral but not for ipsilateral matching was smaller in older than in young adults (mean difference: 38% contralateral, p < 0.01). Longer years of dance training were associated with smaller bias during ipsilateral matching ( p < 0.01). Other types of training or physical activity levels did not affect bias or precision. Our findings demonstrate that aging is associated with a decline in proprioceptive bias in distal arm joints, but age does not negatively affect proprioceptive precision. Further, specific types of long-term dance related training may attenuate age-related decline in proprioceptive bias.

Initial experience with 3D isotropic high-resolution 3 T MR arthrography of the wrist.

PubMed

Sutherland, John K; Nozaki, Taiki; Kaneko, Yasuhito; J Yu, Hon; Rafijah, Gregory; Hitt, David; Yoshioka, Hiroshi

2016-01-16

Our study was performed to evaluate the image quality of 3 T MR wrist arthrograms with attention to ulnar wrist structures, comparing image quality of isotropic 3D proton density fat suppressed turbo spin echo (PDFS TSE) sequence versus standard 2D 3 T sequences as well as comparison with 1.5 T MR arthrograms. Eleven consecutive 3 T MR wrist arthrograms were performed and the following sequences evaluated: 3D isotropic PDFS, repetition time/echo time (TR/TE) 1400/28.3 ms, voxel size 0.35x0.35x0.35 mm, acquisition time 5 min; 2D coronal sequences with slice thickness 2 mm: T1 fat suppressed turbo spin echo (T1FS TSE) (TR/TE 600/20 ms); proton density (PD) TSE (TR/TE 3499/27 ms). A 1.5 T group of 18 studies with standard sequences were evaluated for comparison. All MR imaging followed fluoroscopically guided intra-articular injection of dilute gadolinium contrast. Qualitative assessment related to delineation of anatomic structures between 1.5 T and 3 T MR arthrograms was carried out using Mann-Whitney test and the differences in delineation of anatomic structures among each sequence in 3 T group were analyzed with Wilcoxon signed-rank test. Quantitative assessment of mean relative signal intensity (SI) and relative contrast measurements was performed using Wilcoxon signed-rank test. Mean qualitative scores for 3 T sequences were significantly higher than 1.5 T (p < 0.01), with isotropic 3D PDFS sequence having highest mean qualitative scores (p < 0.05). Quantitative analysis demonstrated no significant difference in relative signal intensity among the 3 T sequences. Significant differences were found in relative contrast between fluid-bone and fluid-fat comparing 3D and 2D PDFS (p < 0.01). 3D isotropic PDFS sequence showed promise in both qualitative and quantitative assessment, suggesting this may be useful for MR wrist arthrograms at 3 T. Primary reasons for diagnostic potential include the ability to make reformations in any obliquity to follow the components of ulnar side wrist structures including triangular fibrocartilage complex. Additionally, isotropic imaging provides thinner slice thickness with less partial volume averaging allowing for identification of subtle injuries.

Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial.

PubMed

Hannemann, Pascal; Göttgens, Kevin W A; van Wely, Bob J; Kolkman, Karel A; Werre, Andries J; Poeze, Martijn; Brink, Peter R G

2011-05-06

The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning).Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory.Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional status of the wrist, including assessment by means of the patient rated wrist evaluation (PRWE) questionnaire and quality of life using SF-36 health survey questionnaire.Primary endpoint is number of scaphoid unions at six weeks, secondary endpoints are time interval to clinical and radiological consolidation, number of non-unions, functional status at 52 weeks and non-adherence to the treatment protocol. Netherlands Trial Register (NTR): NTR2064. © 2011 Hannemann et al; licensee BioMed Central Ltd.