1
|
Hameed S, Muhammad F, Haynes G, Smith L, Khan AF, Smith ZA. Early neurological changes in aging cervical spine: insights from PROMIS mobility assessment. GeroScience 2024; 46:3123-3134. [PMID: 38198027 PMCID: PMC11009195 DOI: 10.1007/s11357-023-01050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
Many studies have shown that the prevalence of degenerative spinal cord compression increases with age. However, most cases at early stages are asymptomatic, and their diagnosis remains challenging. Asymptomatic cervical spinal cord compression (ASCC) patients are more likely to experience annular tears, herniated disks, and later develop symptomatic compression. Asymptomatic individuals do not typically undergo spinal cord imaging; therefore, an assessment test that is both sensitive and specific in diagnosing ASCC may be helpful. It has been demonstrated that the Patient Reported Outcome Measure Information System (PROMIS) mobility test is sensitive in detecting degenerative cervical myelopathy (DCM) symptoms. We investigated the use of the PROMIS mobility test in assessing clinical dysfunction in ASCC. In this study, 51 DCM patients and 42 age-matched healthy control (HC) were enrolled. The degree of cervical spinal cord compression was assessed using the high-resolution cervical spinal cord T2 Weighted (T2w) MRIs, which were available for 14 DCM patients. Measurements of the spinal cords anterior-posterior (AP) diameter at the region(s) that were visibly compressed as well as at different cervical spine levels were used to determine the degree of compression. The age-matched HC cohort had a similar MRI to establish the normal range for AP diameter. Twelve (12) participants in the HC cohort had MRI evidence of cervical spinal cord compression; these individuals were designated as the ASCC cohort. All participants completed the PROMIS mobility, PROMIS pain interference (PI), PROMIS upper extremity (UE), modified Japanese orthopedic association (mJOA), and neck disability index (NDI) scoring scales. We examined the correlation between the AP diameter measurements and the clinical assessment scores to determine their usefulness in the diagnosis of ASCC. Furthermore, we examine the sensitivity and specificity of PROMIS mobility test and mJOA. Compared to the HC group, the participants in the ASCC and DCM cohorts were significantly older (p = 0.006 and p < 0.0001, respectively). Age differences were not observed between ASCC and DCM (p > 0.999). Clinical scores between the ASCC and the HC group were not significantly different using the mJOA (p > 0.99), NDI (p > 0.99), PROMIS UE (p = 0.23), and PROMIS PI (p = 0.82). However, there were significant differences between the ASCC and HC in the PROMIS mobility score (p = 0.01). The spinal cord AP diameter and the PROMIS mobility score showed a significant correlation (r = 0.44, p = 0.002). Decreasing PROMIS mobility was significantly associated with a decrease in cervical spinal cord AP diameter independent of other assessment measures. PROMIS mobility score had a sensitivity of 77.3% and specificity of 79.4% compared to 59.1% and 88.2%, respectively, for mJOA in detecting cervical spinal cord compression. Certain elements of ASCC are not adequately captured with the traditional mJOA and NDI scales used in DCM evaluation. In contrast to other evaluation scales utilized in this investigation, PROMIS mobility score shows a significant association with the AP diameter of the cervical spinal cord, suggesting that it is a sensitive tool for identifying early disability associated with degenerative change in the aging spine. In a comparative analysis of PROMIS mobility test against the standard mJOA, the PROMIS mobility demonstrated higher sensitivity for detecting cervical spinal cord compression. These findings underscore the potential use of PROMIS mobility score in clinical evaluation of the aging spine.
Collapse
Affiliation(s)
- Sanaa Hameed
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US
| | - Fauziyya Muhammad
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US.
| | - Grace Haynes
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US
| | - Lonnie Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US
| | - Ali F Khan
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N. Lincoln Blvd, Oklahoma City, OK, 73104-3252, US
| |
Collapse
|
2
|
Lee DY, Yoon JS, Lim S, Eo S. Neglected posterior interosseous nerve injury. Trauma Case Rep 2024; 51:100994. [PMID: 38572423 PMCID: PMC10988121 DOI: 10.1016/j.tcr.2024.100994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
Posterior interosseous nerve (PIN) injury is uncommon due to its anatomically deep location. We report a neglected, rare case of PIN injury presenting the loss of extension of thumb, index, and small fingers with weakness of thumb abduction in a 49-year-old male patient. The patient sustained a penetrating injury to his right forearm caused by a kitchen knife that was repaired primarily through an emergency surgery under general anesthesia. During the regular follow-up on the 52nd postoperative day, the patient presented 20° of extension lags in the right thumb and index finger and 30° in the small finger. Wrist extension was intact, and there was no sensory deficit. We explored the wound and traced the PIN completely, identifying a club-shaped neuroma formation at the proximal cut end of the PIN. Delayed nerve repair was performed with a double-strip cable graft. Hand surgeons should be aware of the probable PIN injury in certain situations of forearm-penetrating injury and perform proper preoperative physical examination to rule out neurovascular deficits. Careful exploration and immediate repair of severe PIN are mandatory, even in emergency situations.
Collapse
Affiliation(s)
- Dong Yun Lee
- Department of Plastic and Reconstructive Surgery, DongGuk University School of Medicine, Seoul, South Korea
| | - Jung Soo Yoon
- Department of Plastic and Reconstructive Surgery, DongGuk University School of Medicine, Seoul, South Korea
| | - SooA Lim
- Department of Plastic and Reconstructive Surgery, DongGuk University School of Medicine, Seoul, South Korea
| | - SuRak Eo
- Department of Plastic and Reconstructive Surgery, DongGuk University School of Medicine, Seoul, South Korea
| |
Collapse
|
3
|
Berkane Y, Giorgino R, Ng ZY, Dukan R, Lellouch AG. Alternative Flap Options for Upper Extremity Reconstruction. Hand Clin 2024; 40:291-299. [PMID: 38553100 DOI: 10.1016/j.hcl.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
For major upper limb defects, a wide range of established pedicled and free flap options can be used. These include the latissimus dorsi/thoracodorsal artery perforator, lateral arm, posterior interosseous artery, rectus abdominis, gracilis, and anterolateral thigh flaps. Technical proficiency is essential, and favorable success rates in terms of functional and esthetic outcomes can be achieved. Herein, alternative flap options (both pedicled and free) are introduced and discussed through a few illustrative case examples.
Collapse
Affiliation(s)
- Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, Rennes University, 16 Boulevard de Bulgarie, 35000 Rennes, France; Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; UMR U1236-MICMAC, Immunology and Cell Therapy Lab, Rennes University Hospital, 2 Rue Henri Le Guillou, 35000 Rennes, France
| | - Riccardo Giorgino
- Residency Program in Orthopaedics and Traumatology, University of Milan, Via Cristina Belgioioso, 173, 20161 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, 173, 20161 Milan, Italy; Plastic Surgery Research Laboratory, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA
| | - Zhi Yang Ng
- Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Ruben Dukan
- Department of Hand, Upper Limb & Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 Rue Leblanc, Paris, France
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, MA 02114, USA; Department of Plastic, Reconstructive & Aesthetic Surgery, Georges-Pompidou European Hospital (HEGP), University of Paris, 20 Rue Leblanc, Paris, France; Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, F-75006, Paris, France.
| |
Collapse
|
4
|
Ng ZY, Chalhoub X, Furniss D. Surgical Treatment of Lymphedema in the Upper Extremity. Hand Clin 2024; 40:283-290. [PMID: 38553099 DOI: 10.1016/j.hcl.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
The advent of supermicrosurgery has led to an increasing interest in the surgical management of lymphedema through the reconstruction of the lymphatic network, that is, the physiologic approach. Broadly, this can be divided into 2 main techniques: lymphaticovenous anastomosis and lymph node transfer. In the United Kingdom, the British Lymphology Society does not provide any recommendations on surgical management. Moreover, surgical treatment of lymphedema is not widely practiced within the National Health Service due to low-certainty evidence. Herein, we discuss our experience in physiologic reconstruction for lymphedema.
Collapse
Affiliation(s)
- Zhi Yang Ng
- Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, OX3 9DU, United Kingdom
| | - Xavier Chalhoub
- Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, United Kingdom
| | - Dominic Furniss
- Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7LD, United Kingdom.
| |
Collapse
|
5
|
Leblebici G, Tarakcı E, Kısa EP, Akalan E, Kasapçopur Ö. The effects of improvement in upper extremity function on gait and balance in children with upper extremity affected. Gait Posture 2024; 110:41-47. [PMID: 38484646 DOI: 10.1016/j.gaitpost.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/03/2023] [Accepted: 02/28/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND This study aimed to investigate the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected. RESEARCH QUESTION What are the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected? METHODS Eighteen children with a diagnosis of rheumatologic diseases and 15 healthy children were evaluated with Shriners Hospital Upper Extremity Assessment, Jebsen-Taylor Hand Function Test, Abilhand Rheumatoid Arthritis Scale, 10-meter walk test and Childhood Health Assessment Questionnaire. For static balance assessment, the Biodex Balance was used. Ground reaction forces (peak forces (heel strike and push-off) and minimum force (loading response), single-limb support duration, Center-of-Force displacement and walking speed were evaluated with the Sensor Medica. Arm swing was evaluated with the Kinovea 2D motion analysis. RESULTS Before treatment, single-limb support duration and push-off force was higher and center-of-force displacement was lower on affected side compared to unaffected side in rheumatologic group. After the 6-week rehabilitation program, upper extremity function, quality of life and functional gait score improved. Single-limb support duration decreased on affected side and increased on unaffected side. On affected side, push-off force decreased. The arm swing parameters were similar before and after treatment. SIGNIFICANCE Improving upper extremity function can help with gait balance by decreasing the difference in walking and balance parameters between the affected and unaffected sides and providing for more symmetrical weight transfer.
Collapse
Affiliation(s)
- Gökçe Leblebici
- Istanbul Medeniyet University, Faculty of Health Science, Physiotherapy and Rehabilitation, Istanbul, Turkey; Istanbul University-Cerrahpasa, Institute of Graduate Studies, Department of Physiotherapy and Rehabilitation.
| | - Ela Tarakcı
- Istanbul University-Cerrahpasa, Faculty of Health Science, Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Eylül Pınar Kısa
- Istanbul University-Cerrahpasa, Faculty of Health Science, Physiotherapy and Rehabilitation, Istanbul, Turkey; Biruni University, Faculty of Health Science, Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Ekin Akalan
- Istanbul Kültür University, Faculty of Health Science- Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Özgür Kasapçopur
- Istanbul University-Cerrahpasa, Cerrahpaşa Faculty of Medicine- Department of Pediatric Rheumatology, Istanbul, Turkey
| |
Collapse
|
6
|
Smith I, Shekouhi R, Mardourian M, Chim H. Thin Profunda Artery Perforator Flap for Hand and Upper Extremity Coverage. Hand Clin 2024; 40:189-198. [PMID: 38553090 DOI: 10.1016/j.hcl.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
The profunda artery perforator (PAP) flap provides a good option for hand and upper extremity reconstruction. The reliable quality, caliber, and number of perforators in the posteromedial thigh support large flaps with long pedicles. The PAP flap has been widely used for breast reconstruction, although its use in the extremities has been slower to catch on due to the bulk and thickness of the subcutaneous tissue. The authors discuss evolution of thin flaps and our application of the thin and superthin PAP flap for upper extremity reconstruction.
Collapse
Affiliation(s)
- Isaac Smith
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Ramin Shekouhi
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Markos Mardourian
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Harvey Chim
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA.
| |
Collapse
|
7
|
Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Participation and autonomy, independence in activities of daily living and upper extremity functioning in individuals with spinal cord injury. Sci Rep 2024; 14:9120. [PMID: 38643334 PMCID: PMC11032406 DOI: 10.1038/s41598-024-59862-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
Improvements in care and rehabilitation have resulted in a higher proportion of people living with spinal cord injury (SCI), which calls for an increased focus on participation and autonomy. This observational cross-sectional study investigated the impact of SCI on autonomy and how it correlates to activity performance and upper extremity functioning. A total of 25 adults (mean age 58 years) with chronic cervical or thoracic SCI were included. Self-perceived autonomy was measured with Impact on Participation and Autonomy questionnaire, independence in activities of daily living (ADL) with Spinal Cord Independence Measure, upper extremity functioning with Action Research Arm Test (ARAT) and kinematic measures of the drinking task. The results showed that most participants perceived injury-related restrictions in outdoor autonomy (80%), family role (76%), and in indoor autonomy (72%). Independence in self-care (r = 0.72), mobility (r = 0.59) and upper extremity kinematics of movement time (r = 0.63) and smoothness (r = 0.49) were correlated to indoors autonomy. Social life autonomy was correlated to self-care (r = 0.50) and ARAT (r = 0.41). In conclusion, autonomy was perceived restricted after SCI in several major life areas and correlated with independence in ADL and upper extremity functioning. The aspects of autonomy should be considered more in goal setting and clinical decision-making.
Collapse
Affiliation(s)
- Lamprini Lili
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Vita Straket 12, plan 4, 41346, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Vita Straket 12, plan 4, 41346, Gothenburg, Sweden
- Department of Neurological Rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tiina Rekand
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Vita Straket 12, plan 4, 41346, Gothenburg, Sweden
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Margit Alt Murphy
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Vita Straket 12, plan 4, 41346, Gothenburg, Sweden.
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
| |
Collapse
|
8
|
Chen W, Lim LJR, Lim RQR, Yi Z, Huang J, He J, Yang G, Liu B. Artificial intelligence powered advancements in upper extremity joint MRI: A review. Heliyon 2024; 10:e28731. [PMID: 38596104 PMCID: PMC11002577 DOI: 10.1016/j.heliyon.2024.e28731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Magnetic resonance imaging (MRI) is an indispensable medical imaging examination technique in musculoskeletal medicine. Modern MRI techniques achieve superior high-quality multiplanar imaging of soft tissue and skeletal pathologies without the harmful effects of ionizing radiation. Some current limitations of MRI include long acquisition times, artifacts, and noise. In addition, it is often challenging to distinguish abutting or closely applied soft tissue structures with similar signal characteristics. In the past decade, Artificial Intelligence (AI) has been widely employed in musculoskeletal MRI to help reduce the image acquisition time and improve image quality. Apart from being able to reduce medical costs, AI can assist clinicians in diagnosing diseases more accurately. This will effectively help formulate appropriate treatment plans and ultimately improve patient care. This review article intends to summarize AI's current research and application in musculoskeletal MRI, particularly the advancement of DL in identifying the structure and lesions of upper extremity joints in MRI images.
Collapse
Affiliation(s)
- Wei Chen
- Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Lincoln Jian Rong Lim
- Department of Medical Imaging, Western Health, Footscray Hospital, Victoria, Australia
- Department of Surgery, The University of Melbourne, Victoria, Australia
| | - Rebecca Qian Ru Lim
- Department of Hand & Reconstructive Microsurgery, Singapore General Hospital, Singapore
| | - Zhe Yi
- Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Jiaxing Huang
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jia He
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Ge Yang
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Bo Liu
- Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
9
|
Adiguzel H, Kirmaci ZIK, Gogremis M, Kirmaci YS, Dilber C, Berktas DT. The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial. Early Hum Dev 2024; 192:106010. [PMID: 38653163 DOI: 10.1016/j.earlhumdev.2024.106010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Proprioceptive neuromuscular facilitation (PNF) is generally used for the lower limbs in children with Cerebral Palsy (CP). This study aimed to determine the effect of PNF and Neurodevelopmental Therapy (NDT) on functional abilities, muscle strength, and trunk control in children with CP. METHODS Thirty spastic CP children classified as either level I-II in the Gross Motor Function Classification System (GMFCS) or level I-II in the Manual Ability Classification System (MACS) were included. The PNF (n = 15) and the NDT group (n = 15) had physiotherapy for six weeks. The ABILHAND-Kids scale, the Purdue Pegboard Test (PBPT), the Nine-Hole Peg Test (9-HPT), and the Jebson-Taylor Hand Function Test (JTHFT) were employed. Pinch meters, Jamar handheld dynamometers, and digital muscular strength assessments were used. RESULTS The PNF group increased shoulder flexion (p < 0.05), adduction (p < 0.05), elevation (p < 0.05), scapular abduction (p < 0.05), elbow extension (right) (p < 0.05), grip (p < 0.05), and pinch strengths (left p < 0.05, right p < 0.05). The PNF group had significantly lower 9-HPT (p < 0.05), JTHFT (card turning), JTHFT (simulated feeding), JTHFT (lifting light cans), and JTHFT (lifting weight cans) durations (p < 0.05), and significantly higher PBPT (right-left) PBPT (bimanual), PBPT (assembly). (p < 0.05), ABILHAND (p < 0.05), and TCMS total scores (p < 0.001). While JTHFT (simulated feeding-left), JTHFT (stacking checkers-left), JTHFT (lifting light cans-left), and JTHFT (lifting weight cans-right/left) (p < 0.05) durations decreased in the NDT group, PBPT (right) (p < 0.05) had an increase in duration. CONCLUSION PNF improves trunk control, upper extremity functional skills, selective proximal muscle strength, and distal upper extremity muscle and grip strength.
Collapse
Affiliation(s)
- Hatice Adiguzel
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey.
| | - Zekiye Ipek Katirci Kirmaci
- Gaziantep Islamic Science and Technology University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 27010 Sahinbey, Gaziantep, Turkey
| | - Mehmet Gogremis
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey
| | - Yusuf Sinasi Kirmaci
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey
| | - Cengiz Dilber
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Child Health and Diseases, 46040 Onikisubat, Kahramanmaras, Turkey
| | - Deniz Tuncel Berktas
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Neurology, 46040 Onikisubat, Kahramanmaras, Turkey
| |
Collapse
|
10
|
Núñez-Cortés R, Espin A, Pérez-Alenda S, López-Bueno R, Cruz-Montecinos C, Vincents-Seeberg KG, Püschel TA, Calatayud J, Andersen LL. Association Between Pain Coping and Symptoms of Anxiety and Depression, and Work Absenteeism in People With Upper Limb Musculoskeletal Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:781-791. [PMID: 37490961 DOI: 10.1016/j.apmr.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/02/2023] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To determine the prospective association of pain coping strategies and symptoms of anxiety and depression with work absenteeism in people with upper limb musculoskeletal disorders. DATA SOURCES A systematic search of PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases was conducted from inception to September 23, 2022. STUDY SELECTION Prospective observational studies of adults with upper limb musculoskeletal disorders were included. Included studies had to provide data on the association of pain coping strategies (catastrophizing, kinesiophobia, self-efficacy or fear avoidance) or symptoms of anxiety and depression with work absenteeism. DATA EXTRACTION Study selection, data extraction, and assessment of methodological quality (Newcastle Ottawa Scale) were performed by 2 independent authors. Random-effects models were used for quantitative synthesis. DATA SYNTHESIS Eighteen studies (n=12,393 participants) were included. Most studies (77.8%) reported at least 1 significant association between 1 or more exposure factors (pain coping strategies or symptoms of anxiety and depression) and work absenteeism. Meta-analyses showed a statistically significant correlation between the exposure factors of catastrophizing (r=0.28, 95% confidence interval [CI]: 0.15 to 0.40; P<.0001) and symptoms of anxiety and depression (r=0.23, 95% CI: 0.10 to 0.34; P=.0003) with work absenteeism. The correlation between self-efficacy and work absenteeism was non-significant (r=0.24, 95% CI: -0.02 to 0.47; P=.0747). CONCLUSIONS Rehabilitation teams should consider assessing catastrophizing and symptoms of anxiety and depression to identify patients at risk for work absenteeism. Addressing these variables may also be considered in return-to-work programs for individuals with upper limb disorders.
Collapse
Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Ander Espin
- National Research Centre for the Working Environment, Copenhagen, Denmark; Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Division of Research, Development and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | | | - Thomas A Püschel
- Ecology and Evolutionary Biology Division, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | | |
Collapse
|
11
|
Böttcher R, Dähne F, Böttcher S, Johl U, Tittel A, Schnick U. [Nerve injuries due to fractures in childhood : Primarily and secondarily on the upper extremity]. Unfallchirurgie (Heidelb) 2024; 127:313-321. [PMID: 38443721 DOI: 10.1007/s00113-024-01423-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
The approach for nerve injuries in children in the context of fractures of the upper extremities is inconsistent in the literature. The underlying mostly retrospective studies do not usually consider the potential diagnostics. The frequency of nerve injuries with a clear need for reconstructive surgery is sometimes estimated so differently that precedent-setting errors in these studies must be assumed; however, as 10-20% of pediatric fractures near the elbow show primary or secondary nerve lesions, timely and appropriate further treatment is necessary. An overview concerning diagnostic tools with an explanation of potential results and an algorithm with a timeline for diagnostic and therapeutic management are presented. Good results after nerve lesions can only be achieved when timely diagnostics without delay and correct detection of axonal lesions which benefit from surgical treatment are carried out.
Collapse
Affiliation(s)
- Richarda Böttcher
- Schwerpunkt für rekonstruktive Chirurgie bei Plexusparese, Tetraplegie und Cerebralparese, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland.
| | - Frank Dähne
- Klinik für Neurologie mit Stroke Unit und Frührehabilitation, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland
| | - Sebastian Böttcher
- Klinik für Neurologie mit Stroke Unit und Frührehabilitation, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland
| | - Ulrike Johl
- Klinik für Neurologie mit Stroke Unit und Frührehabilitation, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland
| | - Anja Tittel
- Institut für Radiologie und Neuroradiologie, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland
| | - Ulrike Schnick
- Schwerpunkt für rekonstruktive Chirurgie bei Plexusparese, Tetraplegie und Cerebralparese, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland
| |
Collapse
|
12
|
Freeman DA, Hao KA, Hones KM, Olowofela BO, Parrish R, Damrow D, King JJ, Farmer KW, Pazik M, Roach RP. Pain scores and functional outcomes of patients with shoulder labral repair using all-suture anchors versus conventional anchors. Eur J Orthop Surg Traumatol 2024; 34:1509-1515. [PMID: 38265743 DOI: 10.1007/s00590-023-03820-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
HYPOTHESIS/PURPOSE The purpose of this study was to compare PROMs in patients undergoing anterior glenoid labral repair using all-suture versus conventional anchors. We hypothesized PROMs would be similar between groups. METHODS We performed a retrospective review of the Arthrex Global Surgical Outcomes System (SOS) database, querying patients who underwent arthroscopic glenoid labral repair between 01/01/2015 and 12/31/2020. Patients aged 18-100, who had isolated glenoid labrum repair with at least 12-month follow-up were included. The visual analog pain scale (VAS), Western Ontario Shoulder Instability Index, Veteran's RAND 12-items health survey, single assessment numeric evaluation and the American Shoulder and Elbow Surgeons score (ASES) were compared preoperatively, 3 months, 6 months, 1 year and 2 years postoperatively in patients who received all-suture anchors versus conventional anchors in the setting of anterior glenoid labrum repair. Our primary aim was comparison of PROMs between patients receiving all-suture versus conventional suture anchors. Secondarily, a sub-analysis was performed comparing outcomes based on anchor utilization for patients with noted anterior instability. RESULTS We evaluated 566 patients, 54 patients receiving all-suture anchors and 512 patients receiving conventional anchors. At two-year follow-up there was no significant difference between the two groups in PROMs. In a sub-analysis of isolated anterior labrum repair, there was an improvement in ASES (P = 0.034) and VAS (P = 0.039) with the all-suture anchor at two-year follow-up. CONCLUSIONS All-suture anchors provide similar or superior pain and functional outcome scores up to 2 years postoperatively compared to conventional anchors. CLINICAL RELEVANCE As all-suture anchors gain popularity among surgeons, this is the largest scale study to date validating their use in the setting of glenoid labrum repair. Institutional Review Board (IRB): IRB202102550.
Collapse
Affiliation(s)
- David A Freeman
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kevin A Hao
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Keegan M Hones
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | | | - Ryan Parrish
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | - Derek Damrow
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | - Joseph J King
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | - Kevin W Farmer
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | - Marissa Pazik
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA
| | - Roach P Roach
- Department of Orthopaedic Surgery and Sports Medicine, UF Orthopaedic Surgery and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA.
| |
Collapse
|
13
|
Le Roy L, van Bladel A, De Mits S, Vanden Bossche L, Van der Looven R. Three-Dimensional Upper Limb Movement Analysis in Children and Adolescents With Brachial Plexus Birth Injury: A Systematic Review. Pediatr Neurol 2024; 153:19-33. [PMID: 38309208 DOI: 10.1016/j.pediatrneurol.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 10/13/2023] [Accepted: 12/25/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND To synthesize the current evidence on clinical use of three-dimensional upper limb movement analysis (3D-ULMA) in children and adolescents with brachial plexus birth injury (BPBI). METHODS MEDLINE, Embase, and Web of Science were searched for relevant studies up to April 2022. An automatic e-mail alert was installed to ensure no eligible article was missed. Articles evaluating 3D-ULMA in children and adolescents with BPBI were included. Covidence web-based platform was used for blind screening of eligible articles. Twenty-one observational studies with a final sample size of 609, encompassing 493 BPBI cases, met the inclusion criteria. Data were extracted using a custom form to support standardized extraction conforming to the Cochrane Checklist of items. Risk of bias was assessed using the Newcastle-Ottawa Scale, the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and a specifically established quality assessment form for kinematic analysis studies. RESULTS Study setups differed, including six different types of kinematic devices. Twelve studies used the (modified) Mallet positions for their 3D-ULMA. Throughout the studies, 3D-ULMA was used for various purposes. The Newcastle-Ottawa Scale scored 16 articles with five stars or more, indicating fair to moderate quality. CONCLUSIONS This systematic review summarizes the different 3D-ULMA kinematic devices, test protocols, and their clinical use for BPBI. The use of 3D-ULMA provides valuable, objective, and quantified data to clinicians with regard to movement strategies; it complements existing clinical scales and can be implemented to evaluate effectiveness of therapy interventions. Implications for future research and clinical practice are discussed.
Collapse
Affiliation(s)
- Laura Le Roy
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
| | - Anke van Bladel
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Sophie De Mits
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Luc Vanden Bossche
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Ruth Van der Looven
- Child Rehabilitation, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
14
|
Abu Awwad D, Ekpo E. Imaging of the adjacent upper limb: Outcomes and diagnostic yield. Radiography (Lond) 2024; 30:753-758. [PMID: 38432174 DOI: 10.1016/j.radi.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Injuries to extremities are a common presentation to emergency departments and may be associated with multiple abnormalities. Patients may be referred for X-ray imaging of multiple adjacent regions, but the diagnostic outcomes of these X-ray examinations have not been fully explored. The aim of this study was to assess the diagnostic efficacy of X-ray examinations of adjacent body regions in the upper limb. METHODS Upper limb X-rays examinations performed over six months were collected from two hospitals, and all patients who had adjacent regions X-rayed were included. Using the radiology reports as a reference standard, the diagnostic yield of these additional adjacent X-ray examinations was assessed. Descriptive statistics and Pearson's Chi Square were used for data analysis. RESULTS 591 patients had 1455 X-ray examinations, ranging from two to six X-ray requests. More than 80% of X-ray examinations were due to an injury, but less than 60% had symptoms mentioned in the clinical history. Overall, 39.1% of initial examinations reported a new finding but only 1.5% of all subsequent imaging had a new abnormality detected. Examinations with symptoms specified in the clinical history were more likely to detect new findings (p=<0.001). CONCLUSION Imaging is an essential diagnostic tool in medical settings, but all radiographic tests should be justified, and adjacent imaging has a low diagnostic yield, hence, all limbs should be carefully assessed individually to assess the need for imaging. Every request should be justified based on presentation and symptoms, particularly when multiple areas may be impacted. IMPLICATIONS FOR PRACTICE Radiographic imaging is easily accessible but adherence to guidelines and assessing the diagnostic yield of common examinations is important to ensure benefits to patients.
Collapse
Affiliation(s)
- D Abu Awwad
- Discipline of Medical Imaging Sciences, The University of Sydney, Susan Wakil Health Building, Camperdown, Sydney, Australia.
| | - E Ekpo
- Discipline of Medical Imaging Sciences, The University of Sydney, Susan Wakil Health Building, Camperdown, Sydney, Australia.
| |
Collapse
|
15
|
Dunn JA, Wong B, Sinclair SK, Henninger HB, Bachus KN, Foreman KB. Extended physiological proprioception is affected by transhumeral Socket-Suspended prosthesis use. J Biomech 2024; 166:112054. [PMID: 38513398 DOI: 10.1016/j.jbiomech.2024.112054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/30/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
The objective of this study was to define targeted reaching performance without visual information for transhumeral (TH) prosthesis users, establishing baseline information about extended physiological proprioception (EPP) in this population. Subjects completed a seated proprioceptive targeting task under simultaneous motion capture, using their prosthesis and intact limb. Eight male subjects, median age of 58 years (range 29-77 years), were selected from an ongoing screening study to participate. Five subjects had a left-side TH amputation, and three a right-side TH amputation. Median time since amputation was 9 years (range 3-54 years). Four subjects used a body-powered prosthetic hook, three a myoelectric hand, and one a myoelectric hook. The outcome measures were precision and accuracy, motion of the targeting hand, and joint angular displacement. Subjects demonstrated better precision when targeting with their intact limb compared to targeting with their prosthesis, 1.9 cm2 (0.8-3.0) v. 7.1 cm2 (1.3-12.8), respectively, p = 0.008. Subjects achieved a more direct reach path ratio when targeting with the intact limb compared to with the prosthesis, 1.2 (1.1-1.3) v. 1.3 (1.3-1.4), respectively, p = 0.039 The acceleration, deceleration, and corrective phase durations were consistent between conditions. Trunk angular displacement increased in flexion, lateral flexion, and axial rotation while shoulder flexion decreased when subjects targeted with their prosthesis compared to the intact limb. The differences in targeting precision, reach patio ratio, and joint angular displacements while completing the targeting task indicate diminished EPP. These findings establish baseline information about EPP in TH prosthesis users for comparison as novel prosthesis suspension systems become more available to be tested.
Collapse
Affiliation(s)
- Julia A Dunn
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States
| | - Bob Wong
- College of Nursing University of Utah, United States
| | - Sarina K Sinclair
- Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States
| | - Heath B Henninger
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States
| | - Kent N Bachus
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States
| | - K Bo Foreman
- Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States; Department of Physical Therapy and Athletic Training University of Utah, United States.
| |
Collapse
|
16
|
Kleeren L, Mailleux L, McLean B, Elliott C, Dequeker G, Van Campenhout A, de Xivry JJO, Verheyden G, Ortibus E, Klingels K, Feys H. Does somatosensory discrimination therapy alter sensorimotor upper limb function differently compared to motor therapy in children and adolescents with unilateral cerebral palsy: study protocol for a randomized controlled trial. Trials 2024; 25:147. [PMID: 38409060 PMCID: PMC10895830 DOI: 10.1186/s13063-024-07967-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the impaired upper limb in daily life activities. Yet, intervention approaches specifically designated to target these somatosensory impairments are insufficiently investigated in children and adolescents with uCP. Therefore, the aim of this randomized controlled trial (RCT) is to compare the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP, who experience somatosensory impairments in the upper limb. We will further explore potential behavioral and neurological predictors of therapy response. METHODS A parallel group, evaluator-blinded, phase-II, single-center RCT will be conducted for which 50 children and adolescents with uCP, aged 7 to 15 years, will be recruited. Participants will be randomized to receive 3 weekly sessions of 45 minutes of either somatosensory discrimination therapy or upper limb motor therapy for a period of 8 weeks. Stratification will be performed based on age, manual ability, and severity of tactile impairment at baseline. Sensorimotor upper limb function will be evaluated at baseline, immediately after the intervention and after 6 months follow-up. The primary outcome measure will be bimanual performance as measured with the Assisting Hand Assessment. Secondary outcomes include a comprehensive test battery to objectify somatosensory function and measures of bimanual coordination, unimanual motor function, and goal attainment. Brain imaging will be performed at baseline to investigate structural brain lesion characteristics and structural connectivity of the white matter tracts. DISCUSSION This protocol describes the design of an RCT comparing the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP. The results of this study may aid in the selection of the most effective upper limb therapy, specifically for children and adolescents with tactile impairments. TRIAL REGISTRATION ClinicalTrials.gov (NCT06006065). Registered on August 8, 2023.
Collapse
Affiliation(s)
- Lize Kleeren
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium.
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium.
- Hasselt University, Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Diepenbeek, B-3590, Belgium.
| | - Lisa Mailleux
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
| | - Belinda McLean
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Kids Rehab WA, Telethon Kids Institute, Perth, Australia
| | - Catherine Elliott
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Kids Rehab WA, Telethon Kids Institute, Perth, Australia
| | - Griet Dequeker
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
| | - Anja Van Campenhout
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
- KU Leuven, Department of Development and Regeneration, Leuven, B-3000, Belgium
| | - Jean-Jacques Orban de Xivry
- KU Leuven, Leuven Brain Institute, Leuven, B-3000, Belgium
- KU Leuven, Department of Movement Sciences, Research Group of Motor Control and Neuroplasticity, Leuven, B-3000, Belgium
| | - Geert Verheyden
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
| | - Els Ortibus
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
- KU Leuven, Department of Development and Regeneration, Leuven, B-3000, Belgium
| | - Katrijn Klingels
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- Hasselt University, Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Diepenbeek, B-3590, Belgium
| | - Hilde Feys
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
| |
Collapse
|
17
|
Bhattacharjee S, Barman A, Patel S, Sahoo J. The Combined Effect of Robot-assisted Therapy and Activities of Daily Living Training on Upper Limb Recovery in Persons With Subacute Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil 2024:S0003-9993(24)00810-4. [PMID: 38367830 DOI: 10.1016/j.apmr.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/22/2024] [Accepted: 01/27/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES To evaluate the effectiveness of robot-assisted therapy (RAT) followed by activities of daily living (ADL) training in comparison with conventional rehabilitation therapy (CRT) and ADL training in individuals with subacute stroke. DESIGN A single-blind, 2-arm, parallel-group, open-level, randomized controlled trial. SETTING A tertiary care teaching hospital in India. PARTICIPANTS Forty-four persons (n=44) with first-ever stroke (in subacute stage) were enrolled from August 2021 to July 2023. INTERVENTION Participants in the RAT group (n=22) received RAT for 30 minutes, followed by ADL training for 30 minutes. In contrast, participants in the CRT group (n=22) received CRT (30 minutes) followed by ADL training (30 minutes). Both groups received allocated interventions for 15 days over 3 weeks (5 days/week, 3 weeks). MAIN OUTCOME MEASURES Primary outcome: Motor domain score of the Fugl-Meyer Assessment scale for upper extremity (FMA-UE). SECONDARY OUTCOMES the other domains scores of FMA-UE (UL -sensation, -joint motions, -joint pain); Modified Ashworth Scale (MAS) (spasticity); hand-function (HF) and ADL-domain scores of the stroke impact scale (SIS); WHOQQL-BREF questionnaires (QOL). Participants were assessed at enrolment and follow-up at 3, 6, and 12 weeks. RESULTS Persons who received RAT and ADL training reported significant improvement (P<.05) in UL motor function (mean difference [MD]=3.54;(95% confidence interval [CI]: 1.28 to 5.79]), UL passive joint motions (MD=2.54; [95% CI: 1.56 to 3.52]), SIS-HF (MD=6.37;[95% CI: 4.75 to 7.99]), SIS-ADL (MD=7.13 [95% CI: 3.52 to 8.74]), and in all domains of WHOQOL-BREF (except environmental domain) compared with persons who received CRT and ADL training at 12 weeks. CONCLUSIONS The findings indicate that RAT followed by ADL training is more effective than CRT followed by ADL training in motor improvement, SIS-HF, SIS-ADL, and QOL at 12 weeks.
Collapse
Affiliation(s)
- Souvik Bhattacharjee
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Apurba Barman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Suman Patel
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jagannatha Sahoo
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| |
Collapse
|
18
|
Mehrabi S, Harnett A, Saikaley M, Fleet JL, Eng JJ, Bayley M, Teasell R. Female Enrollment in Rehabilitation Trials: A Systematic Review of Reporting Sex and Female Participation in Randomized Controlled Trials of Poststroke Upper Extremity Rehabilitation Over 50 Years. Arch Phys Med Rehabil 2024:S0003-9993(24)00812-8. [PMID: 38367832 DOI: 10.1016/j.apmr.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To systematically assess the reporting of sex and the percentage of female participants in randomized controlled trials (RCTs) examining interventions for the post-stroke rehabilitation of upper extremity (UE) motor disorders. DATA SOURCES CINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to April 1, 2021. Additional articles were identified using the Evidence-Based Review of Stroke Rehabilitation. STUDY SELECTION Studies were eligible for inclusion if they (1) were RCTs or crossovers published in English, (2) ≥50% of participants were diagnosed and affected by stroke, (3) included adults ≥18 years old, and (4) applied an intervention to the hemiparetic UE as the primary objective of the study. DATA EXTRACTION Two investigators independently screened the title and abstracts, and duplicates were removed. A full-text review was done for studies that met all inclusion criteria. Data were extracted using a custom data extraction template in Covidence and were transferred to online Excel (V16) for data management. Study characteristics and extracted variables were summarized using standard descriptive statistics. Data analyses were performed using SPSS (V29.0). DATA SYNTHESIS A total of 1276 RCTs met inclusion criteria, and of these, 5.2% did not report results on sex, accounting for 5.6% of participants. Women have been underrepresented in stroke RCTs, accounting for 38.8% of participants. Female participation was greater in the acute poststroke phase than in the chronic and subacute phases. Over almost 5 decades, there has been a small decrease in the proportion of female participants in these trials. CONCLUSIONS Evidence-based medicine for the treatment and prevention of stroke is guided by results from RCTs. Generalizability depends on sufficient representation in clinical trials. Stakeholders, such as funders and journal editors, play a key role in encouraging researchers to enroll enough of both sexes and to report the presence or absence of sex differences in RCTs.
Collapse
Affiliation(s)
| | - Amber Harnett
- Parkwood Institute Research, Parkwood Institute, London, Canada
| | - Marcus Saikaley
- Parkwood Institute Research, Parkwood Institute, London, Canada
| | - Jamie L Fleet
- Parkwood Institute Research, Parkwood Institute, London, Canada; St. Joseph's Health Care London, London, Canada; Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Rehabilitation Research Program, Centre for Aging SMART, Vancouver, Canada
| | - Mark Bayley
- KITE Research Institute, UHN-Toronto Rehabilitation Institute, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Robert Teasell
- Parkwood Institute Research, Parkwood Institute, London, Canada; St. Joseph's Health Care London, London, Canada; Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
| |
Collapse
|
19
|
Kolbaşı EN, Huseyinsinoglu BE, Ozdemir Z, Bayraktaroglu Z, Soysal A. Priming constraint-induced movement therapy with intermittent theta burst stimulation to enhance upper extremity recovery in patients with stroke: protocol for a randomized controlled study. Acta Neurol Belg 2024:10.1007/s13760-024-02472-6. [PMID: 38329642 DOI: 10.1007/s13760-024-02472-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND The treatments based on motor control and motor learning principles have gained popularity in the last 20 years, as well as non-invasive brain stimulations that enhance neuroplastic changes after stroke. However, the effect of intermittent theta burst stimulation (iTBS) in addition to evidence-based, intensive neurorehabilitation approaches such as modified constraint-induced movement therapy (mCIMT) is yet to be investigated. AIM We aim to establish a protocol for a randomized controlled study investigating the efficiency of mCIMT primed with iTBS after stroke. METHODS In this randomized controlled, single-blind study, patients with stroke (N = 17) will be divided into 3 groups: (a) mCIMT + real iTBS, (b) mCIMT + sham iTBS, and (c) mCIMT alone. 600-pulse iTBS will be delivered to the primary motor cortex on the ipsilesional hemisphere, and then, patients will receive mCIMT for 1 h/session, 3 sessions/week for 5 weeks. Upper extremity recovery will be assessed with Fugl-Meyer Test-Upper Extremity and Wolf Motor Function Test. Electrophysiological assessments, such as Motor-Evoked Potentials, Resting Motor Threshold, Short-Intracortical Inhibition, and Intracortical Facilitation, will also be included. CONCLUSIONS In this study, a protocol of an ongoing intervention study investigating the effectiveness of iTBS on ipsilesional M1 prior to the mCIMT in patients with stroke is proposed. This will be the first study to research priming mCIMT with iTBS and it may have the potential to reveal the true effect of the iTBS when it is added to the high-quality neurorehabilitation approaches. TRIAL REGISTRATION Trial registration number: NCT05308667.
Collapse
Affiliation(s)
- Esma Nur Kolbaşı
- Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey
- Institute of Graduate Studies, Physiotherapy and Rehabilitation Department, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burcu Ersoz Huseyinsinoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
| | - Zeynep Ozdemir
- Department of Neurology, Bakırkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey
| | - Zubeyir Bayraktaroglu
- Department of Physiology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Aysun Soysal
- Department of Neurology, Bakırkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
20
|
Judkins JL, Nguyen VT, Richardson MD, Roy TC. Association between availability of direct access to army occupational therapy with return to duty in active-duty soldiers. J Hand Ther 2024:S0894-1130(23)00194-1. [PMID: 38320939 DOI: 10.1016/j.jht.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/17/2023] [Accepted: 12/15/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Upper extremity musculoskeletal injuries are common with active-duty Army Soldiers and result in increased limited duty days. Patient satisfaction and surgery rates improve with direct access to occupational therapy in the civilian community. PURPOSE Examine the amount of time from initial evaluation following an upper extremity musculoskeletal injury (MSKI) to return to full duty plus occupational therapy (OT) utilization in Army Soldiers. STUDY DESIGN Retrospective observational. METHODS Electronic health records and profiles from 18,206 US active-duty Army soldiers with MSKI and OT evaluation between 2017-2018 were examined. Repeated measures generalized estimating equations provided the rate ratios (RRs) for OT healthcare utilization (total number of OT evaluations and treatment visits) by days to first OT evaluation and limited duty profile (total days on profile). RESULTS Soldiers were on average 32.0 (SD = 8.9) y/o, predominantly senior enlisted (45.7%), white (58.0%), male (81.4%), 10.0 (SD = 8.4) years of service, and high school or less educated (51.3%). There were 22,617 UE MSKIs with an OT evaluation and 4936 UE MSKIs with profiles. Compared with UE MSKIs with an OT evaluation on the same day, there was a significant increase in rates of OT utilization for 1-7 days (RR: 1.4, 95% CI: 1.3, 1.5), 8-14 days (RR: 1.3, 95% CI: 1.2, 1.4), 15-30 days (RR: 1.4, 95% CI: 1.3, 1.5), 31-60 days (RR: 1.5, 95% CI: 1.4, 1.6), and +60 days later (RR: 1.6, 95% CI: 1.5, 1.7). Similar differences in rates for limited duty profiles were found. CONCLUSION A greater number of days between diagnosis of UE MSKI and OT evaluation results in greater rates of OT utilization and longer temporary profile. Results suggest that earlier intervention by OT may decrease recovery and healthcare utilization of soldiers.
Collapse
Affiliation(s)
- Jason L Judkins
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA.
| | - Vy T Nguyen
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Melissa D Richardson
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Tanja C Roy
- Occupational Health Sciences, Defense Centers for Public Health, Aberdeen, MD, USA
| |
Collapse
|
21
|
Estanbouli MA, Anadani A, Albobah H, Dakkak T, Mokresh R, Etr A. Late management of amniotic bands syndrome with incomplete syndactyly: A case report of 4-year-old child. Int J Surg Case Rep 2024; 115:109277. [PMID: 38262220 PMCID: PMC10830882 DOI: 10.1016/j.ijscr.2024.109277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Amniotic band syndrome is a fetal entrapment in strands of amniotic tissue. This condition causes multiple deformities ranging from simple constricting bands to lymphedema, autoamputation, syndactyly and other congenital anomalies. Reconstructive surgery is the main treatment for ABS. PRESENTATION OF CASE A 4-year-old male presented with multiple constricting bands affecting both hands in addition to an incomplete syndactyly between the third and fourth left digits. A two-staged operation was performed to repair the deformities with 6 months interval. Series of Z-plasties were used to release the constricting bands and the syndactyly was separated by a web zigzag incision approach and full-thickness skin grafting. DISCUSSION Management of ABS must be individualized. The urgency of the surgical release depends on the depth of the constricting bands and their influence on circulation and lymphatic drainage. Superficial bands can be released electively for cosmetic appearance while deep bands should be released as soon as possible. The separation of syndactyly should be done at the first year of life to maintain the digits functionality and parallel growth. CONCLUSION This paper emphasizes the importance of early repair of constricting bands associated with syndactyly to avoid the consequences of the delay on digital growth.
Collapse
Affiliation(s)
| | | | - Hala Albobah
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Tala Dakkak
- Faculty of Medicine, Hama University, Hama, Syrian Arab Republic
| | - Raneem Mokresh
- Department of Plastic Surgery, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
| | - Aladdin Etr
- Department of Plastic Surgery, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria
| |
Collapse
|
22
|
Merrell LA, Adams JC, Kingery MT, Ganta A, Konda SR, Egol KA. Fracture related infection (FRI) of the upper extremity correlates with poor bone and soft tissue healing. Eur J Orthop Surg Traumatol 2024; 34:1201-1207. [PMID: 38010445 DOI: 10.1007/s00590-023-03750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/25/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the specific course and complication profile following the development of FRI in the upper extremity. METHODS An IRB-approved retrospective review was conducted on a consecutive series of operatively managed patients within an academic medical center between 1/2010 and 6/2022. Included patients met the following criteria: (1) upper extremity fracture definitively treated with internal fixation (2) development of criteria for suggestive or confirmatory FRI (as per the FRI Consensus Group) and (3) age ≥ 18 years. Baseline demographics, medical history, injury information, infection characteristics, hospital quality measures, and outcomes were recorded. A 3:1 propensity-matched control cohort of patients without FRI was obtained using the same dataset. Univariable analysis was performed to compare the outcomes (rate of nonunion, time to bone healing, need for soft tissue coverage, patient reported joint stiffness at final follow-up) of the FRI vs Non-FRI cohorts. RESULTS Of 2827 patients treated operatively for an upper extremity fracture, 43 (1.53%) met criteria for suggestive of confirmatory FRI. The successful propensity match (43 FRI, 129 Non-FRI) revealed no differences in demographics, baseline health status, or fracture location. FRI patients underwent more reoperations (p < 0.001), experienced an increased rate of removal of hardware (p < 0.001), and were admitted more frequently following index operation (p < 0.001). The FRI cohort had higher rates of fracture nonunion (p = 0.003), and a prolonged mean time to bone healing in months (8.37 ± 7.29 FRI vs. 4.14 ± 5.75 Non-FRI, p < 0.001). Additionally, the FRI cohort had a greater need for soft tissue coverage throughout their post-operative fracture treatment (p = 0.014). While there was no difference in eventual bone healing (p = 0.250), FRI patients experienced a higher incidence of affected joint stiffness at final follow-up (p < 0.001). CONCLUSION Patients who develop an FRI of the upper extremity undergo more procedures and experience increased complications throughout their treatment, specifically increased joint stiffness. Despite this, ultimate outcome profiles are similar between patients who experience FRI and those who do not following operative repair of an upper extremity fracture. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Lauren A Merrell
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA
| | - Jack C Adams
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA
| | - Matthew T Kingery
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA
| | - Abhishek Ganta
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY, USA
| | - Sanjit R Konda
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY, USA
| | - Kenneth A Egol
- Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA.
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY, USA.
| |
Collapse
|
23
|
Mattia A, Buchanan PJ, Chopan M, Chim H. Axial-Radial-Ulnar Carpal Dislocation with Divergent Intermetacarpal Dislocations, Peritrapezoid and Scaphotrapezial Dislocations: A Case Report. J Hand Surg Asian Pac Vol 2024; 29:59-63. [PMID: 38299251 DOI: 10.1142/s2424835524720019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
We report a patient with a severe axial-radial-ulnar (ARU) fracture dislocation of the carpus, involving multiple intermetacarpal dislocations as well as divergent carpometacarpal dislocations involving the index, long, ring and small fingers and peritrapezoid and scaphotrapezial dislocations. She also had a degloving injury involving the dorsal hand. Emergent debridement followed by open reduction and internal fixation of all injuries was performed, followed by soft tissue management. At 6-year follow-up, the patient had adequate active range of motion with the ability to make a full fist and was able to use her wrist and hand for most activities of daily living. Disabilities of the arm, shoulder and hand (DASH) score was 47.5. Michigan hand outcomes questionnaire (MHQ) score was 66.8. Mayo wrist score was 65. Patient-rated wrist evaluation (PRWE) score was 42. Severe ARU fracture dislocations of the carpus can result in adequate functional recovery on long-term follow-up. Level of Evidence: Level V (Therapeutic).
Collapse
Affiliation(s)
| | - Patrick J Buchanan
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Mustafa Chopan
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Harvey Chim
- Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| |
Collapse
|
24
|
Wu EJ, Lai CH, Muraoka K, Segovia N, Kleimeyer JP, Yao J. Prospective Analysis of Simulated Pneumatic Tourniquet Use and Oedema Following Axillary Lymph Node Dissection. J Hand Surg Asian Pac Vol 2024; 29:29-35. [PMID: 38299248 DOI: 10.1142/s242483552450005x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Background: Tourniquet use during upper extremity surgery in patients with a history of axillary lymph node dissection (ALND) remains controversial due to the perceived but unproven risk of lymphoedema. We prospectively evaluated upper extremity swelling in patients with a history of unilateral ALND using a standardised tourniquet model. Methods: A tourniquet was applied to the upper arm bilaterally, with the unaffected side serving as an internal control. Each arm was subsequently held in an elevated position to reduce swelling. Hand volume was measured using an aqueous volumeter. Results: The patients' ALND arms experienced slightly greater increases in volume following tourniquet application compared to their healthy control arms. However, this amount of oedema was temporary and reversible, as both arms experienced spontaneous resolution of swelling with no significant difference in residual hand volume at the conclusion of the study. Conclusions: Tourniquet use may be safe in patients with a history of ALND. Further investigation is needed to verify this in a surgical setting. Level of Evidence: Level II (Therapeutic).
Collapse
Affiliation(s)
- Edward J Wu
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
- Department of Orthopedic Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Cara H Lai
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - Kunihide Muraoka
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - Nicole Segovia
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - John P Kleimeyer
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - Jeffrey Yao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| |
Collapse
|
25
|
Jeon SY, Ki M, Shin JH. Resistive versus active assisted robotic training for the upper limb after a stroke: A randomized controlled study. Ann Phys Rehabil Med 2024; 67:101789. [PMID: 38118340 DOI: 10.1016/j.rehab.2023.101789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/11/2023] [Accepted: 09/18/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Selection of a suitable training modality according to the status of upper limb function can maximize the effects of robotic rehabilitation; therefore, it is necessary to identify the optimal training modality. OBJECTIVES This study aimed to compare robotic rehabilitation approaches incorporating either resistance training (RET) or active-assisted training (AAT) using the same rehabilitation robot in people with stroke and moderate impairment. METHODS In this randomized controlled trial, we randomly allocated 34 people with stroke who had moderate impairment to either the experimental group (RET, n = 18) or the control group (AAT, n = 16). Both groups performed robot-assisted therapy for 30 min, 5 days per week, for 4 weeks. The same rehabilitation robot provided resistance to the RET group and assistance to the AAT group. Body function and structure, activity, and participation outcomes were evaluated before, during, and after the intervention. RESULTS RET led to greater improvements than AAT in terms of smoothness (p = 0.006). The Fugl-Meyer Assessment (FMA)-upper extremity (p < 0.001), FMA-proximal (p < 0.001), Action Research Arm Test-gross movement (p = 0.011), and kinematic variables of joint independence (p = 0.017) and displacement (p = 0.011) also improved at the end of intervention more in the RET group. CONCLUSIONS Robotic RET was more effective than AAT in improving upper limb function, structure, and activity among participants with stroke who had moderate impairment.
Collapse
Affiliation(s)
- Sun Young Jeon
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, 58, Samgaksan-ro, Gangbuk-gu, Seoul, Republic of Korea
| | - Myung Ki
- Department of Global Community Health, Graduate School of Public Health, Korea University, Republic of Korea; BK21FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Joon-Ho Shin
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, 58, Samgaksan-ro, Gangbuk-gu, Seoul, Republic of Korea.
| |
Collapse
|
26
|
Maeda H, Hishikawa N, Sawada K, Sakurai M, Ohashi S, Mikami Y. Wearable Integrated Volitional Control Electrical Stimulation Device as Treatment for Paresis of the Upper Extremity in Early Subacute Stroke Patients: A Randomized Controlled Non-inferiority Trial. Arch Phys Med Rehabil 2024; 105:227-234. [PMID: 37714508 DOI: 10.1016/j.apmr.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE To investigate the effect of a wearable integrated volitional control electrical stimulation (WIVES) device that has been developed as more compact and simpler to use in daily life compared with conventional integrated volitional control electrical stimulation (IVES) devices. DESIGN Randomized controlled non-inferiority trial. SETTING Convalescent rehabilitation ward. PARTICIPANTS Patients with paresis of the upper extremity (UE) after early subacute stroke (N=20). INTERVENTIONS Eligible patients were randomized to receive IVES treatment or WIVES treatment for 8 hours per day for 28 days in daily living, in addition to standard rehabilitation treatment. In both groups, the extensor digitorum communis on the affected side was the target muscle for stimulation. MAIN OUTCOME MEASURE Primary outcomes were assessed with Fugl-Meyer Assessment of the UE (FMA-UE) before and after treatment. Non-inferiority was determined with a specified margin of non-inferiority. RESULTS Twenty patients completed the trial (IVES group: n=10, WIVES group: n=10). FMA-UE improved in both groups. The mean change in FMA-UE was 4.7 for the IVES group and 6.0 for the WIVES group (P>.05, 95% confidence interval: -6.73 to 4.13). The mean difference between the groups was 1.3, and the upper 95% confidence interval did not exceed the non-inferiority margin. CONCLUSION The effectiveness of WIVES treatment is non-inferior to that of IVES treatment. As a portable device, IVES may facilitate the use of affected upper extremities in daily living and may help improve paresis of the UE.
Collapse
Affiliation(s)
- Hiroshi Maeda
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Norikazu Hishikawa
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Koshiro Sawada
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Development of Multidisciplinary Promote for Physical Activity, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Momoko Sakurai
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Rehabilitation, Gakusai Hospital, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
| | - Suzuyo Ohashi
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuo Mikami
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
27
|
Negri GA, Andrade Junior AC, Cox MA, Marcatto de Abreu MF, Appenzeller S, Pagnano RG. Preoperative antibiotic prophylaxis and the incidence of surgical site infections in elective clean soft tissue surgery of the hand and upper limb: a systematic review and meta-analysis. J Orthop Traumatol 2024; 25:4. [PMID: 38282128 PMCID: PMC10822832 DOI: 10.1186/s10195-024-00748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Surgical site infections (SSI) are the most frequent early complications of hand surgeries. However, the indications still remain uncertain for antibiotic prophylaxis in elective clean soft tissue surgeries of the hand and upper limb. Therefore, a systematic review of the literature and a meta-analysis was conducted to investigate the impact of antibiotic prophylaxis on the prevention of SSI in these types of surgeries. METHODS An electronic search was performed in the following databases: MEDLINE/Pubmed, PMC/Pubmed, Web of Science/Clarivate Analytics, Embase/Elsevier, Scopus/Elsevier, BVS/Lilacs, and the Cochrane Library, with no restrictions regarding publication language or date. The primary outcome of interest was the occurrence of SSI following elective clean soft tissue surgeries of the hand and upper limb according to the administration of preoperative antibiotic prophylaxis and no antibiotic prophylaxis. Surgeries involving simultaneous bone procedures or orthopedic implants were excluded. Study selection and data extraction were conducted independently by two reviewers. RoB 2.0 and ROBINS-I are Cochrane risk-of-bias tool for randomized trials and non-randomized studies of interventions. The magnitude of the intervention effect was estimated using the relative risk (RR). The meta-analysis was performed with the Review Manager and R software tools, using the Mantel-Haenszel random-effects model and a 95% confidence interval (CI). Results with p ≤ 0.05 were considered statistically significant. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS The initial search yielded 1175 titles, from which 12 articles met the inclusion criteria for the systematic review, and 10 were included in the subsequent meta-analysis. The majority of these studies were nonrandomized intervention trials, exhibiting a moderate risk of bias. According to our review, preoperative antibiotic prophylaxis did not have a statistically significant impact on the incidence of SSI (RR = 1.13, 95% CI 0.91-1.40, p = 0.28). The overall quality of evidence for this outcome was rated as low. Moderate statistical heterogeneity was observed (I2 = 44%), and the prespecified sensitivity analysis highlighted the consistency of the results. CONCLUSIONS While these results were consistent with the findings from individual studies included in this review, it is important to note that, given the threshold of p ≤ 0.05 for statistical significance, no definitive conclusions can be drawn from the quantitative analysis of the data obtained. LEVEL OF EVIDENCE Level 2. TRIAL REGISTRATION CRD42023417786.
Collapse
Affiliation(s)
- Gabrielle Avelar Negri
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil.
- , Campinas, Brazil.
| | - Antônio Clodoildo Andrade Junior
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil
| | - Manuela Amoedo Cox
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil
| | - Marcos Felipe Marcatto de Abreu
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil
| | - Simone Appenzeller
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil
| | - Rodrigo Gonçalves Pagnano
- Department of Orthopedics, Rheumatology and Traumatology-School of Medical Science, University of Campinas (Unicamp), 126 Tessália Vieira de Camargo St, Cidade Universitária, Campinas, SP, 13083-887, Brazil
| |
Collapse
|
28
|
Pyörny J, Sletten IN, Jokihaara J. Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. BMC Musculoskelet Disord 2024; 25:86. [PMID: 38263085 PMCID: PMC10804815 DOI: 10.1186/s12891-024-07183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. METHODS This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland-Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach's alpha coefficients and item-total correlations. RESULTS We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97-0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001). CONCLUSION QuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition. TRIAL REGISTRATION Retrospectively registered.
Collapse
Affiliation(s)
- Joonas Pyörny
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Jarkko Jokihaara
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
- Center for Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland.
| |
Collapse
|
29
|
Bhatia V, Vaishya RO, Jain A, Grover V, Arora S, Das G, Abdulla AM, Sainudeen S, Mohamed Ali AB, Saluja P. Identification of prevalence of musculoskeletal disorders and various risk factors in dentists. Heliyon 2024; 10:e23780. [PMID: 38332878 PMCID: PMC10851298 DOI: 10.1016/j.heliyon.2023.e23780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
Purpose The awkward and repetitive movements lead to tissue straining, potentially leading to painful musculoskeletal disorders (MSDs). MSDs in dentists result in work inefficiency and a reduction in work hours. A survey was conducted to assess the prevalence of MSDs amongst the dental population of interest. Methods Customized individual detail questionnaires, Standard Nordic Musculoskeletal questionnaires, and Level of Pain estimation using the Likert Scale were used to deduce the various responsible risk factors for the occurrence of MSDs in dentists. Inferential statistical analysis was done to identify the prevalence and severity of the MSDs. The Chi-Square test (95 % confidence interval) was used to identify and compare the association of risk factors involved in MSDs with the occurrence of the Effect of MSDs, the presence of MSDs, and the severity of the MSDs. Results The results of the study deduced that the dentists followed the sedentary work practices. The dentists experienced maximum discomfort in the neck region, which was accompanied by the discomfort experienced in the lower back, hands and wrists, making the upper extremity being more susceptible to the MSDs. Gender risk factors the, the prevalence of MSDs in the dentist's upper back, and the severity of pain in the upper back region showed a significant association level. Conclusion The wrist posture, the prevalence of MSDs and the severity of pain in the dentists' neck, shoulder and upper back showed a significant association level.
Collapse
Affiliation(s)
- Vibha Bhatia
- Punjab Engineering College (Deemed to be University), Chandigarh, India
| | - Rahul O. Vaishya
- Punjab Engineering College (Deemed to be University), Chandigarh, India
| | - Ashish Jain
- Dr. H.S.J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Vishakha Grover
- Dr. H.S.J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Gotam Das
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Anshad M. Abdulla
- Department of Pediatric Dentistry & Orthodontics, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Shan Sainudeen
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Ahmed Babiker Mohamed Ali
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Priyanka Saluja
- Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
30
|
Çetin B, Kılınç M, Çakmaklı GY. The effects of exergames on upper extremity performance, trunk mobility, gait, balance, and cognition in Parkinson's disease: a randomized controlled study. Acta Neurol Belg 2024:10.1007/s13760-023-02451-3. [PMID: 38182919 DOI: 10.1007/s13760-023-02451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND In recent years, game-based exercises have been included more in the rehabilitation programs of Parkinson's disease (PD) patients and positive effects have been observed. AIM This study aims to investigate the effects of innovative games particularly designed for neurological patients on upper extremity performance, trunk mobility and cognition in patients with PD. METHOD Twenty-three patients were enrolled in this randomized controlled study and randomly allocated into two groups: Exergames Program (EP) and Conventional Exercise Program (CP). Both groups received supervised physiotherapy sessions for 3 days a week and 8 weeks in total (24 sessions). Each session lasted 1 h. Evaluations were applied before and after the treatment: 9-Hole Peg Test (9-HPT), Minnesota Manual Dexterity Test (MMDT), Trunk Impairment Scale (TIS), Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG), Functional Reach Test (FRT), and Parkinson Disease Questionnaire (PDQ-39). RESULTS Twenty patients were included in the analysis because of the dropouts. Our findings showed that both groups improved significantly in 9-HPT dominant side, MMDT, TIS, MDS-UPDRS, TUG, FRT, and PDQ-39 (p < 0.05). MoCA scores of EP group improved significantly (p < 0.05) while CP group's did not (p > 0.05). It was found that EP group had better improvements in 9-HPT dominant side, MMDT turning test, and MoCA than CP group when the differences in the changes within the groups were compared (p < 0.05). CONCLUSION Game-based training can be a useful rehabilitation tool to improve upper extremities performance, trunk mobility, cognition, functional mobility, balance, and quality of life and may have superiority over conventional exercises in improving cognition and upper extremity functions. CLINICAL TRIAL NUMBER NCT05235880. Release Date: April 1, 2022.
Collapse
Affiliation(s)
- Barış Çetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Muhammed Kılınç
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gül Yalçın Çakmaklı
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
31
|
Kou X, Qi Y, Wang Y, Zhang Y. Surgical microscope-assisted treatment of bilateral median nerve neurilemmoma of the upper extremities: A case report. Asian J Surg 2024; 47:699-700. [PMID: 37833222 DOI: 10.1016/j.asjsur.2023.09.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Affiliation(s)
- Xianshuai Kou
- The First Clinical Medical College of Gansu University of Chinese Medicine(Gansu Provincial Hospital), Lanzhou, 730000, China
| | - Yang Qi
- The First Clinical Medical College of Gansu University of Chinese Medicine(Gansu Provincial Hospital), Lanzhou, 730000, China
| | - Yongjie Wang
- The First Clinical Medical College of Gansu University of Chinese Medicine(Gansu Provincial Hospital), Lanzhou, 730000, China
| | - Yongqiang Zhang
- Department of Orthopedics, The Third People's Hospital of Yuzhong County, Lanzhou, 730000, China.
| |
Collapse
|
32
|
Deemer AR, Solasz S, Ganta A, Egol KA, Konda SR. External fixation about the elbow: Indications and long-term outcomes. J Clin Orthop Trauma 2024; 48:102335. [PMID: 38282805 PMCID: PMC10821167 DOI: 10.1016/j.jcot.2024.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024] Open
Abstract
Background Operative management is often required for fractures of the elbow, with treatment goals aiming to restore stability, reduction, and early range of motion. The purpose of this study was to determine risk factors for necessitating the application of an external fixator, and to compare range of motion and functional outcomes between patients who required an elbow external fixator to those who did not. Hypothesis We hypothesize that patients who require an external fixator will have worse elbow range of motion and functional outcomes when compared to those who did not. Patients and methods This is a retrospective study of 391 patients who presented at a Level-I trauma center between March 2011 and January 2021 for operative management of a fracture/fracture-dislocation of the distal humerus (AO/OTA 13A-C) and/or proximal ulna and/or radius (AO/OTA 21A-C). A primary analysis was performed to determine risk factors for necessitating the application of an external fixator. A secondary analysis was performed comparing elbow range-of-motion and functional outcomes between cases and controls. Results 391 patients were identified; 26 required external fixation (cases) and 365 did not (controls). Significant risk factors for necessitating placement of an external fixator included large BMI (OR = 1.087, 95 % CI = 1.007-1.173, p = 0.033), elbow dislocation (OR = 7.549, 95 % CI = 2.387-23.870, p = 0.001), open wound status (OR = 9.584, 95 % CI = 2.794-32.878, p < 0.001), and additional non-contiguous orthopaedic injury (OR = 9.225, 95 % CI = 2.219-38.360, p = 0.002). Elbow ROM was poorer in the external fixator group with regards to extension (-15°), flexion (+19.4°), and pronation (+14.3°) (p < 0.05). In addition, those who did not need external fixation had better functional scores (+20.4 points MEPI) (p < 0.05). Discussion The use of external fixation about the elbow is associated with significantly worse initial injuries and results in poorer outcomes. These results can be used to inform the surgeon-patient discussion regarding treatment options and expected functional outcomes. Level of evidence III.
Collapse
Affiliation(s)
- Alexa R. Deemer
- NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA
| | - Sara Solasz
- NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA
| | - Abhishek Ganta
- NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA
| | - Kenneth A. Egol
- NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA
| | - Sanjit R. Konda
- NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA
| |
Collapse
|
33
|
Yedikian T, Yoshida R, McCullough M, Deptula P, Kulber D. An Uncommon Case of Upper-Extremity Mucormycosis in a Patient With Acute Myeloid Leukemia. J Hand Surg Glob Online 2024; 6:123-125. [PMID: 38313606 PMCID: PMC10837283 DOI: 10.1016/j.jhsg.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 02/06/2024] Open
Abstract
Upper-extremity mucormycosis is a rare, life-threatening fungal infection mainly affecting immunocompromised patients. We report a case of a 30-year-old woman with acute myelogenous leukemia who developed this infection during her hospital stay. The culprit was Mucorales, a subgroup of Zygomycetes species known for fast-progressing, highly lethal infections. She presented with fever, chills, and a lesion on her left forearm that worsened despite initial broad-spectrum antibiotics. A punch biopsy confirmed the diagnosis, leading to antifungal therapy with isavuconazonium sulfate and later amphotericin B, combined with surgery. Timely intervention is critical because delayed treatment can result in severe complications and death. Early suspicion, histology, microscopy, and fungal cultures are vital for accurate diagnosis. Treatment primarily involves amphotericin B, whereas adjunctive therapies such as topical amphotericin B and hyperbaric oxygen show promise. This case underscores the importance of prompt medical and surgical action, enhancing early detection of mucormycosis in immunocompromised patients.
Collapse
Affiliation(s)
- Teren Yedikian
- Department of Hand and Upper Extremity Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Ryu Yoshida
- Department of Hand and Upper Extremity Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Meghan McCullough
- Department of Hand and Upper Extremity Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Peter Deptula
- Department of Hand and Upper Extremity Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David Kulber
- Department of Hand and Upper Extremity Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| |
Collapse
|
34
|
Pérez-Parra JE, Henao-Lema CP, Arcos-Rodríguez AV, López-Ocampo N, Castaño-García C, Pérez-Gamboa OP. Handgrip strength and upper limb functional performance measures in people over 18 years old: Analysis of relationships and influencing factors. J Hand Ther 2024; 37:101-109. [PMID: 37580200 DOI: 10.1016/j.jht.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Handgrip strength is a common, simple, and inexpensive method to measure muscle strength. On the other hand, the functional performance measurement involves a usual task which implies repeating elements between the individuals' interaction and the environment. This is fundamental for projecting their results to daily life situation. PURPOSE To explore the relationship between grip strength and measures of functional performance of the upper limbs (ULs) in people over 18 years of age, and to determine the influence of sociodemographic and anthropometric variables on the relationship. STUDY DESIGN A cross-sectional study was conducted under the analytical empirical approach, using linear associations between handgrip strength and functional performance measurement tests (correspondence analysis). METHODS Three hundred sixty-two male and female individuals between 18 and 91 years of age from 4 Colombian cities participated. The grip strength of both ULs measured with a digital dynamometry was associated with the Box and Block Test (BBT, manual dexterity), Nine-Hole Peg Test (NHPT, daily living tasks), and Jebsen-Taylor Hand Function Test (JJT, ability to grasp, pick up, and place). Multiple linear regression analyzes were performed to assess possible explanatory factors of a sociodemographic and anthropometric order. RESULTS A significant association was found between the grip strength of dominant and non-dominant ULs with all functional performance tests (ρ > 0.27 and p < .001), except for the writing and simulated feeding subtests of the JJT (ρ ≤ 0.16). An interactive effect of age was found in the relationship between grip strength and the 3 functional performance tests. CONCLUSIONS These results support the association between grip strength with the NHPT, JJT, and BBT measures and the interactive effect of age on the performance of all tests.
Collapse
Affiliation(s)
| | | | | | - Natalia López-Ocampo
- Master in Neurorehabilitation, Universidad Autónoma de Manizales, Manizales, Colombia
| | | | | |
Collapse
|
35
|
Silva EADM, Batista LR, Braga MAF, Teixeira-Salmela LF, Faria CDCDM, Faria-Fortini I. Predicting self-perceived manual ability at three and six months after stroke: A prospective longitudinal study. J Stroke Cerebrovasc Dis 2024; 33:107479. [PMID: 37984045 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Recovery of manual ability is a critical issue in rehabilitation. Currently, little is known regarding the baseline predictors of self-perceived manual ability, which could capture information on individual's perceived functional ability, especially in carrying-out routine tasks outside clinical settings. OBJECTIVE To identify baseline predictors, which can be easily obtained within clinical settings, of self-perceived manual ability at three and six months after discharge from a stroke unit. METHODS A 6-month longitudinal study was carried-out. Participants were recruited from a stroke unit of a public hospital. The dependent outcome was self-perceived manual ability, and the following predictors were investigated: age, stroke severity, upper-limb motor impairments, cognitive function, muscle strength, and functional capacity. Linear regression analyses were employed to identify multivariate predictors of manual ability at three and six months after discharge (α=5%). RESULTS Participated 131 individuals, 69 women (mean age of 60 years). Regression analyses revealed that stroke severity and age accounted for 31% and 47% of the variance in manual ability at three and six months after stroke, respectively. Stroke severity was the best predictor of manual ability at three (R2=29%; F=44.7; p<0.0001) and six months (R2=45%; F=88.2; p<0.0001) after stroke, respectively. CONCLUSION Stroke severity showed to be the best predictor of manual ability at both three and six months after stroke. Although significant, age added little to the explained variance.
Collapse
Affiliation(s)
| | - Ludmilla Ribeiro Batista
- Graduate Program in Occupational Studies, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - Iza Faria-Fortini
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| |
Collapse
|
36
|
Marchese RM, Al-Humadi S, Ruland C, Komatsu DE, Khan F. Elbow sarcoma resection and triceps reconstruction with Achilles allograft: an overview, case report, and technique guide. JSES Int 2024; 8:217-221. [PMID: 38312285 PMCID: PMC10837695 DOI: 10.1016/j.jseint.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Affiliation(s)
- Richard M Marchese
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Samer Al-Humadi
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Christopher Ruland
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - David E Komatsu
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Fazel Khan
- Department of Orthopaedics and Rehabilitation, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
37
|
Jayan J, Narayan SK, Haniffa YN, Kumar N. Somatosensory evoked potentials amplitude is enhanced after non-invasive brain stimulation in chronic ischemic stroke: Preliminary results from a randomised control trial. J Stroke Cerebrovasc Dis 2024; 33:107418. [PMID: 37951083 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 09/15/2023] [Accepted: 10/05/2023] [Indexed: 11/13/2023] Open
Abstract
OBJECTIVE To investigate the effects of transcranial electrical and magnetic non-invasive brain stimulation (NIBS) protocols on somatosensory evoked potential (SEP) in chronic ischemic stroke. METHODS 33 patients were randomly assigned to one of the four treatment groups of the transcranial direct current stimulation (tDCS) and/or repetitive transcranial magnetic stimulation (rTMS) protocol. SEP parameters were recorded before and after ten days of the treatment session. All the statistical analyses were carried out using SPSS version 19. RESULTS It was found that there is a statistically significant improvement in the N20-P22 mean amplitude after treatment sessions in all groups except the group where tDCS and rTMS groups were sham. On paired t-tests, the difference betweeen post and pre-stimulation SEP amplitudes for the real tDCS and real rTMS coupled group was 1.045 ± 0.732 (p value = 0.005). For sham tDCS+real rTMS group, 1.05 ± 0.96 (P = 0.04); for real tDCS+sham rTMS 0.543 ± 0.332 (P = 0.01) and for double sham stimulation, 0.204 ± 0.648 (P = 0.4) respectively CONCLUSION: In ischemic stroke patients, either or coupled true transcranial tDCS and rTMS was found to be safe and significantly enhanced the amplitude of cortical somatosensory potentials when combined with standard physiotherapy, in the interim analysis of an ongoing randomised controlled trial. CLINICAL TRIAL REGISTRY OF INDIA CTRI/2019/11/022009 SIGNIFICANCE: The results of this research indicates the importance of RCTs in developing robust improved NIBS protocols coupled to physiotherapy to enhance the sensory-motor functional recovery following ischemic stroke.
Collapse
Affiliation(s)
- Jeshma Jayan
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Puducherry, India
| | - Sunil K Narayan
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Puducherry, India.
| | - Yasmin Nesha Haniffa
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Puducherry, India
| | - Navin Kumar
- Department of Physical Medicine and Rehabilitation, Jawaharlal Institute of Postgraduate Medical Education Research, Dhanvantri Nagar, Puducherry, India
| |
Collapse
|
38
|
Bayram S, Barğı G, Çelik Z, Boşnak Güçlü M. Effects of pulmonary rehabilitation in hematopoietic stem cell transplantation recipients: a randomized controlled study. Support Care Cancer 2023; 32:72. [PMID: 38158450 DOI: 10.1007/s00520-023-08236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE During hematopoietic stem cell transplantation (HSCT), patients' exercise capacity and quality of life (QOL) are impaired. Exercise training is recommended to preserve cardiorespiratory fitness during the compelling HSCT period. However, studies investigating the effects of pulmonary rehabilitation (PR) in HSCT recipients are limited. Therefore, this study aimed to investigate the effects of two different PR programs on maximal exercise capacity, respiratory muscle strength and endurance, pulmonary function, and QOL. METHODS This is a prospective, randomized, controlled, triple-blinded study. Thirty hospitalized patients undergoing HSCT were randomized to the pulmonary rehabilitation plus inspiratory muscle training (PR + IMT) group and the PR group. PR group performed upper extremity aerobic exercise training (AET) and progressive resistance exercise training (PRET), PR + IMT group performed IMT in addition to the upper extremity AET and PRET. Maximal exercise capacity (cardiopulmonary exercise testing), respiratory muscle strength (mouth pressure device, (MIP and MEP)) and respiratory muscle endurance (threshold loading test), pulmonary function (spirometry), and QOL (European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) were evaluated before HSCT and after discharge. RESULTS Changes in pulmonary function, respiratory muscle strength and endurance, and QOL were similar within groups (p > 0.05). The MEP, peak oxygen consumption, and oxygen pulse significantly decreased in both groups (p < 0.05). CONCLUSION Pulmonary function, inspiratory muscle strength and endurance, and QOL preserved after HSCT. Expiratory muscle strength and maximal exercise capacity decreased even though PR during HSCT. Breathing reserve and restriction improved in the PR + IMT group. In addition, minute ventilation and dyspnea were preserved in the PR + IMT group, while these values were worsened during two structured PR programs. Therefore, PR should be applied in accordance with the patient's current clinical and hematologic status to patients undergoing HSCT. CLINICALTRIALS gov (19/07/2018, NCT03625063).
Collapse
Affiliation(s)
- Selin Bayram
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey.
| | - Gülşah Barğı
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Izmir Democracy University, Izmir, Turkey
| | - Zeliha Çelik
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey
| | - Meral Boşnak Güçlü
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey
| |
Collapse
|
39
|
Nakatake J, Arakawa H, Tajima T, Miyazaki S, Chosa E. Age- and sex-related differences in upper-body joint and endpoint kinematics during a drinking task in healthy adults. PeerJ 2023; 11:e16571. [PMID: 38144196 PMCID: PMC10740664 DOI: 10.7717/peerj.16571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background The objective kinematic assessments of activities of daily living are desired. However, the limited knowledge regarding age- and sex-related differences prevents the adaptation of these measurements to clinical settings and in-home exercises. Therefore, this study aimed to determine the effects of age and sex on joint and endpoint kinematics during a common activity of daily living, specifically, drinking from a glass. Methods In total, 32 healthy adults (18 males and 14 females) aged 22-77 years performed a drinking task comprising reaching for a glass, bringing it forward and sipping, returning it, and placing the hand back to the starting position, which was recorded using a three-dimensional motion-capturing system. A two-way analysis of variance was used to statistically compare joint angles at five different time points and endpoint kinematic variables in the four drinking phases between older and younger age groups and sexes. Results Wrist radial deviation was greater in older adults than in younger participants at all five different time points (F = 5.16-7.34, p ≤ 0.03, η2 = 0.14-0.21). Moreover, lesser shoulder abduction and greater shoulder internal rotation and forearm pronation when moving and returning the hand to the starting position were observed in the female group than in the male group (F = 4.21-20.03, p ≤ 0.0497, η2 = 0.13-0.41). Trunk flexion was lower in the female group than in the male group at all time points (F = 4.25-7.13, p ≤ 0.0485, η2 = 0.12-0.19). Regarding endpoint kinematics, the performance time in the reaching phase was longer in older adults than in younger individuals (F = 4.96, p = 0.03, η2 = 0.14). Furthermore, a shorter time while returning the hand to the starting position was observed in the female group than in the male group (F = 9.55, p < 0.01, η2 = 0.22). Conclusions The joint kinematics of drinking were partially characterized by an age effect, whereas endpoint kinematics were scattered in all drinking phases. Sex-related effects in most upper-body motions and postures may cause rapid motions in females. Therefore, clinicians could use this knowledge for precise assessments and to suggest feasible in-home exercises.
Collapse
Affiliation(s)
- Jun Nakatake
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Hideki Arakawa
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Takuya Tajima
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Shigeaki Miyazaki
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Etsuo Chosa
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| |
Collapse
|
40
|
Shih PC, Steele CJ, Hoepfel D, Muffel T, Villringer A, Sehm B. The impact of lesion side on bilateral upper limb coordination after stroke. J Neuroeng Rehabil 2023; 20:166. [PMID: 38093308 PMCID: PMC10717693 DOI: 10.1186/s12984-023-01288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND A stroke frequently results in impaired performance of activities of daily life. Many of these are highly dependent on effective coordination between the two arms. In the context of bimanual movements, cyclic rhythmical bilateral arm coordination patterns can be classified into two fundamental modes: in-phase (bilateral homologous muscles contract simultaneously) and anti-phase (bilateral muscles contract alternately) movements. We aimed to investigate how patients with left (LHS) and right (RHS) hemispheric stroke are differentially affected in both individual-limb control and inter-limb coordination during bilateral movements. METHODS We used kinematic measurements to assess bilateral coordination abilities of 18 chronic hemiparetic stroke patients (9 LHS; 9 RHS) and 18 age- and sex-matched controls. Using KINARM upper-limb exoskeleton system, we examined individual-limb control by quantifying trajectory variability in each hand and inter-limb coordination by computing the phase synchronization between hands during anti- and in-phase movements. RESULTS RHS patients exhibited greater impairment in individual- and inter-limb control during anti-phase movements, whilst LHS patients showed greater impairment in individual-limb control during in-phase movements alone. However, LHS patients further showed a swap in hand dominance during in-phase movements. CONCLUSIONS The current study used individual-limb and inter-limb kinematic profiles and showed that bilateral movements are differently impaired in patients with left vs. right hemispheric strokes. Our results demonstrate that both fundamental bilateral coordination modes are differently controlled in both hemispheres using a lesion model approach. From a clinical perspective, we suggest that lesion side should be taken into account for more individually targeted bilateral coordination training strategies. TRIAL REGISTRATION the current experiment is not a health care intervention study.
Collapse
Affiliation(s)
- Pei-Cheng Shih
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Sony Computer Science Laboratories, Inc, Tokyo, Japan
| | - Christopher J Steele
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Dennis Hoepfel
- Clinic and Polyclinic for Psychiatry and Psychotherapy, Leipzig, Germany
| | - Toni Muffel
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Department of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany.
- Department of Neurology, University Hospital Halle (Saale), Halle, Germany.
| |
Collapse
|
41
|
Zaidi KF, Harris-Love M. Upper extremity kinematics: development of a quantitative measure of impairment severity and dissimilarity after stroke. PeerJ 2023; 11:e16374. [PMID: 38089910 PMCID: PMC10712307 DOI: 10.7717/peerj.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/08/2023] [Indexed: 12/18/2023] Open
Abstract
Background Strokes are a leading cause of disability worldwide, with many survivors experiencing difficulty in recovering upper extremity movement, particularly hand function and grasping ability. There is currently no objective measure of movement quality, and without it, rehabilitative interventions remain at best informed estimations of the underlying neural structures' response to produce movement. In this article, we utilize a novel modification to Procrustean distance to quantify curve dissimilarity and propose the Reach Severity and Dissimilarity Index (RSDI) as an objective measure of motor deficits. Methods All experiments took place at the Medstar National Rehabilitation Hospital; persons with stroke were recruited from the hospital patient population. Using Fugl-Meyer (FM) scores and reach capacities, stroke survivors were placed in either mild or severe impairment groups. Individuals completed sets of reach-to-target tasks to extrapolate kinematic metrics describing motor performance. The Procrustes method of statistical shape analysis was modified to identify reaching sub-movements that were congruous to able-bodied sub-movements. Findings Movement initiation proceeds comparably to the reference curve in both two- and three-dimensional representations of mild impairment movement. There were significant effects of the location of congruent segments between subject and reference curves, mean velocities, peak roll angle, and target error. These metrics were used to calculate a preliminary RSDI score with severity and dissimilarity sub-scores, and subjects were reclassified in terms of rehabilitation goals as Speed Emphasis, Strength Emphasis, and Combined Emphasis. Interpretation The modified Procrustes method shows promise in identifying disruptions in movement and monitoring recovery without adding to patient or clinician burden. The proposed RSDI score can be adapted and expanded to other functional movements and used as an objective clinical tool. By reducing the impact of stroke on disability, there is a significant potential to improve quality of life through individualized rehabilitation.
Collapse
Affiliation(s)
- Khadija F. Zaidi
- Department of Bioengineering, George Mason University, Fairfax, United States
| | - Michelle Harris-Love
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Medstar National Rehabilitation Hospital, Washington, District of Columbia, United States of America
| |
Collapse
|
42
|
Kerver N, Karssies E, Krabbe PFM, van der Sluis CK, Groen H. Economic evaluation of upper limb prostheses in the Netherlands including the cost-effectiveness of multi-grip versus standard myoelectric hand prostheses. Disabil Rehabil 2023; 45:4311-4321. [PMID: 36533430 PMCID: PMC10721225 DOI: 10.1080/09638288.2022.2151653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the costs, quality of life, and user experiences associated with upper limb prosthesis use, and to evaluate the cost-effectiveness of multi-grip compared to standard myoelectric hand prostheses (MHPs/SHPs). MATERIALS AND METHODS The EQ-5D-5L to assess the quality of life, the patient-reported outcome measure to assess the preferred usage features of upper limb prosthesis (PUF-ULP), and a cost questionnaire (societal perspective) were completed by 242 prosthesis users (57% men; mean age = 58 years). Incremental cost-utility and cost-effectiveness ratios (ICUR/ICER) with respectively the EQ-5D-5L and PUF-ULP were calculated to compare MHPs with SHPs. Statistical uncertainty was estimated using bootstrapping. Netherlands Trial Registry number: NL7682. RESULTS The mean yearly total costs related to prosthesis use of MHPs (€54 112) and SHPs (€23 501) were higher compared to prostheses with tools/accessories (€11 977), body-powered (€11 298), and cosmetic/passive prostheses (€10 132). EQ-5D-5L and PUF-ULP scores did not differ between prosthesis types. ICUR was €-728 833 per quality-adjusted life year; ICER was €-187 798 per PUF-ULP point gained. CONCLUSIONS Myoelectric prostheses, especially MHPs, were most expensive compared to other prostheses, while no differences in quality of life and user experiences were apparent. MHPs were not cost-effective compared to SHPs. When prescribing MHPs, careful consideration of advantages over SHPs is recommended.
Collapse
Affiliation(s)
- Nienke Kerver
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elise Karssies
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul F. M. Krabbe
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Corry K. van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
43
|
Bedar K, Bubanovich C, Rosemore J, Radford K, Taylor KL. Virtual Reality Intervention and Its Impact on Upper Extremity Function in the Stroke Population: A Scoping Review. Games Health J 2023; 12:429-439. [PMID: 37948555 DOI: 10.1089/g4h.2022.0239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
The aim of this scoping review was to examine virtual reality (VR) interventions used within rehabilitation and their effect on the functional outcomes of individuals with stroke. Specifically, this study sought to determine the impact of VR on the upper extremity (UE) use of participants as it relates to body function, occupational participation, and overall UE function (UEfxn). Twenty-six articles were selected for inclusion and results were extracted to determine common themes of outcomes among the effects of VR intervention (VRI). Thematic analysis included details about the VRIs used, as well as the change in UE outcomes post-VRI. Overall, positive change in UEfxn was found across many of the studies, indicating that VR technologies may be an effective intervention technique for individuals, poststroke. Findings of this review encourage clinicians to conduct further research regarding VR technology for UE rehabilitation poststroke.
Collapse
Affiliation(s)
- Kylee Bedar
- Occupational Therapy Program, Murray State University, Paducah, Kentucky, USA
| | - Cara Bubanovich
- Occupational Therapy Program, Murray State University, Paducah, Kentucky, USA
| | - Jordan Rosemore
- Occupational Therapy Program, Murray State University, Paducah, Kentucky, USA
| | - Kayley Radford
- Occupational Therapy Program, Murray State University, Paducah, Kentucky, USA
| | - Kelly L Taylor
- Occupational Therapy Program, Murray State University, Paducah, Kentucky, USA
| |
Collapse
|
44
|
Melchor J, Leong K, Edwards JB. Phlegmasia cerulea dolens of the upper extremity treated with anticoagulation and leech therapy. J Vasc Surg Cases Innov Tech 2023; 9:101296. [PMID: 37767354 PMCID: PMC10520443 DOI: 10.1016/j.jvscit.2023.101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023] Open
Abstract
Phlegmasia cerulea dolens is a serious manifestation of venous thrombosis that has a high risk of morbidity and mortality. If not promptly treated on presentation, progressive extremity ischemia and potential gangrene can lead to emergency amputation of the affected limb. Most commonly, the lower extremities are affected, and reports of upper extremity phlegmasia are scarce. We report the successful treatment of phlegmasia cerulea dolens of the distal upper extremity using leech therapy combined with anticoagulation.
Collapse
Affiliation(s)
- Julian Melchor
- Sarasota Regional Medical School Campus, Florida State University College of Medicine, Sarasota, FL
| | - Kenneth Leong
- Department of Plastic Surgery, Sarasota Memorial Hospital, Sarasota, FL
| | - Jeffrey B. Edwards
- Department of Vascular Surgery, Sarasota Vascular Specialists, Sarasota, FL
| |
Collapse
|
45
|
Borrelli J, Creath RA, Rogers MW. A method for simulating forward falls and controlling impact velocity. MethodsX 2023; 11:102399. [PMID: 37830002 PMCID: PMC10565865 DOI: 10.1016/j.mex.2023.102399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023] Open
Abstract
Assessment of protective arm reactions associated with forward falls are typically performed by dropping research participants from a height onto a landing surface. The impact velocity is generally modulated by controlling the total height of the fall. This contrasts with an actual fall where the fall velocity is dependent on several factors in addition to fall height and not likely predictable at the onset of the fall. A counterweight and pulley system can be used to modulate the fall velocity in simulated forward falls in a manner that is not predictable to study participants, enhancing experimental validity. However, predicting the fall velocity based on participant height and weight and counterweight mass is not straightforward. In this article, the design of the FALL simulator For Injury prevention Training and assessment (FALL FIT) system is described. A dynamic model of the FALL FIT and counterweight system is developed and model parameters are fit using nonlinear optimization and experimental data. The fitted model enables prediction of fall velocity as a function of participant height and weight and counterweight load. The method can be used to provide controllable perturbations thereby elucidating the control strategy used when protecting the body from injury in a forward fall, how the control strategy changes because of aging or dysfunction or as a method for progressive protective arm reaction training.•Construction of device to simulate forward falls with controllable impact velocity using material that are commercially available is described•A dynamic model of the FALL FIT is developed to estimate the impact velocity of a simulated forward fall using participant height and counterweight load•The dynamic model is validated using data from 3 previous studies.
Collapse
Affiliation(s)
| | | | - Mark W. Rogers
- Department of Physical Therapy and Rehabilitation Science, University of Maryland
| |
Collapse
|
46
|
Simón-Pérez C, Chavez Valladares S, Rodríguez-Mateos JI, Plata Garcia M, Garcia Virto V, Aguado HJ, Martín-Ferrero MA. Functional survival of cementless trapeziometacarpal total joint arthroplasty after upper extremity trauma. Injury 2023; 54 Suppl 7:111156. [PMID: 38225159 DOI: 10.1016/j.injury.2023.111156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 01/17/2024]
Abstract
INTRODUCTION Our purpose with this publication is to document the survival of uncemented and unconstrained total trapeziometacarpal arthroplasty after energy trauma to the upper extremity. MATERIAL AND METHODS From 1999 to the present, ten patients carrying total TMC arthroplasty suffered major traumatic injuries on the hand. Eight patients had fractures of the distal radius, one patient had scapho-lunate dissociation and one patient had a dorsal pullout of the triquetrum. A clinical and radiological examination of the patients after the trauma was carried out and compared with the pre-traumatic prosthesis status. RESULTS Three patients required surgical intervention for the associated traumatic injury. The postraumatic clinical and functional follow-up of the patients was good, and no differences were documented with respect to mobility, strength and pain at the level of the thumb with respect to the prior to the trauma. No signs of loosening, instability or alteration in the alignment of the components of the protheses were observed in the radiological examinations following the trauma. CONCLUSIONS There is a high survival rate of uncemented total trapeziometacarpal arthroplasty in the long term, even in the face of energy trauma. It is then a safe implant. Despite of being non-constrained, a good alignment of the prosthetic components is the key to avoid dislocation of the prosthesis.
Collapse
Affiliation(s)
- C Simón-Pérez
- Discipline of Orthopaedics, University of Valladolid, Spain.
| | - S Chavez Valladares
- Department of Orthopaedics, Hospital Clínico Universitario, Valladolid, Spain
| | | | - M Plata Garcia
- Department of Orthopaedics, Hospital Clínico Universitario, Valladolid, Spain
| | - V Garcia Virto
- Department of Orthopaedics, Hospital Clínico Universitario, Valladolid, Spain
| | - H J Aguado
- Discipline of Orthopaedics, University of Valladolid, Spain
| | | |
Collapse
|
47
|
Orlando NA, Qiu CS, ElNemer W, Tuffaha SH. Google Trends Analysis of Peripheral Nerve Disease and Surgery. World Neurosurg 2023; 180:e135-e141. [PMID: 37690579 DOI: 10.1016/j.wneu.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Despite advances in the surgical management of peripheral nerve pathologies over the past several decades, it is unknown how public awareness of these procedures has changed. We hypothesize that Google searches for peripheral nerve surgery have increased over time. METHODS Google Trends was queried for search volumes of a list of 40 keywords related to the following topics in peripheral nerve surgery: spasticity, nerve injury, prosthetics, and nerve pain. Monthly relative search volume over the first 5 years of the study period (2010-2014) was compared with that of the last 5 years (2018-2022) of the study period. RESULTS Search volumes for keywords "nerve injury," "nerve laceration," "peripheral nerve injury," "nerve repair," "nerve transfer", "neuroma," "neuroma pain," "nerve pain," "nerve pain surgery," and "neuroma pain surgery" all increased more than 10% points in relative search volume over the study period (P < 0.0001 for each keyword). In contrast, searches for "rhizotomy," "spasticity surgery," "targeted muscle reinnervation," "bionic arm," and "myoelectric prosthesis" either decreased or remained stable. Technical terms such as "selective neurectomy," "hyperselective neurectomy," "regenerative peripheral nerve interface," and "regenerative peripheral nerve interface surgery" did not have adequate search volume to be reported by Google Trends. CONCLUSIONS The increase in Google searches related to nerve injury and pain between 2010 and 2022 may reflect increasing public recognition of these clinical entities and surgical techniques addressing them. Technical terms relating to nerve pain are infrequently searched, surgeons should use plain English terms for online discovery. Interest in spasticity and myoelectric prosthetics remains stable, indicating an opportunity for better public outreach.
Collapse
Affiliation(s)
- Nicholas A Orlando
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cecil S Qiu
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William ElNemer
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sami H Tuffaha
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| |
Collapse
|
48
|
Proud EL, Miller KJ, Morris ME, McGinley JL, Blennerhassett JM. Effects of Upper Limb Exercise or Training on Hand Dexterity and Function in People With Parkinson Disease: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023:S0003-9993(23)00663-9. [PMID: 38042246 DOI: 10.1016/j.apmr.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE This systematic review investigated the effects of exercise and training on hand dexterity and function outcomes in people with Parkinson disease (PD). DATA SOURCES We searched 5 databases (MEDLINE Ovid, CINAHL, PEDro, PubMed, Cochrane Database) from inception to October 2022. STUDY SELECTION Included studies were randomized controlled trials delivering upper limb exercise or training interventions to people with PD and evaluating 1 or more upper limb activity outcomes. Two independent reviewers screened 668 articles for inclusion. DATA EXTRACTION Two reviewers independently extracted data relating to study participants, intervention characteristics, and key outcomes. Cochrane Risk of Bias and GRADE tools assessed methodological quality of included studies, and strength of evidence for 3 outcomes: hand dexterity, self-reported hand function, and handwriting performance. Meta-analyses synthesized results for within-hand dexterity and self-reported function. RESULTS Eighteen randomized controlled trials (n=704) with low to unclear risk of bias were identified. Experimental interventions varied considerably in their approach and treatment dose, and 3 studies focused on training handwriting. Meta-analysis showed moderate quality evidence of a small positive effect on within-hand dexterity (SMD=0.26; 95% CI 0.07, 0.44). Very low-quality evidence pointed toward a nonsignificant effect on self-reported hand function (SMD=0.67; 95% CI -0.40, 1.75). A narrative review of handwriting interventions showed low quality evidence for improved performance after training. CONCLUSIONS There is moderate certainty of evidence supporting the use of exercise and training to address dexterity problems, but evidence remains unclear for self-reported hand function and handwriting. Our findings suggest that training could employ task-related approaches. Future research should interrogate aspects of clinical practice such as optimal dose and key ingredients for effective interventions.
Collapse
Affiliation(s)
- Elizabeth L Proud
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Kimberly J Miller
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Meg E Morris
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Australia; Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Australia
| | - Jennifer L McGinley
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia
| | | |
Collapse
|
49
|
Fukuchi CA, Leal IO, Fukuchi RK, Tancredo JR, Cliquet A. Upper extremity effort during the sit-to-stand task in able-bodied and in individuals with spinal cord injury: A preliminary study. J Spinal Cord Med 2023:1-6. [PMID: 37982804 DOI: 10.1080/10790268.2023.2273588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE To investigate the association between the presence of spinal cord injury (SCI) on biomechanical variables by comparing individuals with SCI and able-bodied individuals during the sit-to-stand (STS) task assisted by a walker device. Specifically, we compared the upper-extremity joint angles and moments, trunk forward tilt angle, vertical forces of the instrumented walker, and ground reaction forces between groups. DESIGN Case-control study. SETTING Department of Orthopedics and Traumatology, UNICAMP-Brazil. PARTICIPANTS Six individuals with SCI and fourteen able-bodied individuals. MAIN OUTCOME MEASURES Kinematics and kinetics of the shoulder, elbow, and wrist joints; trunk forward tilt angle, vertical walker forces, and ground reaction forces (GRF) were analyzed during the STS task in two phases: before and after the seat-off event. RESULTS A higher peak elbow flexion angle and higher vertical walker forces were observed before the seat-off, whereas the lower peak vertical GRF was found, after the seat-off, in the SCI group compared with the control group. CONCLUSIONS SCI affects kinematics and kinetics variables during the STS task compared to able-bodied controls. Individuals with SCI adopted different standing-up strategies that affected the distribution of the forces in the upper and lower extremities of the human body.
Collapse
Affiliation(s)
- Claudiane Arakaki Fukuchi
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, University of Campinas - UNICAMP, São Paulo, Brazil
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Isadora Oliveira Leal
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, University of Campinas - UNICAMP, São Paulo, Brazil
| | | | - Janaina Roland Tancredo
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Alberto Cliquet
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, University of Campinas - UNICAMP, São Paulo, Brazil
- Department of Electrical Engineering, University of São Paulo - USP, São Paulo, Brazil
| |
Collapse
|
50
|
Zadeh SM, MacDermid J, Johnson J, Birmingham TB, Shafiee E. Applications of wearable sensors in upper extremity MSK conditions: a scoping review. J Neuroeng Rehabil 2023; 20:158. [PMID: 37980497 PMCID: PMC10656914 DOI: 10.1186/s12984-023-01274-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023] Open
Abstract
PURPOSE This scoping review uniquely aims to map the current state of the literature on the applications of wearable sensors in people with or at risk of developing upper extremity musculoskeletal (UE-MSK) conditions, considering that MSK conditions or disorders have the highest rate of prevalence among other types of conditions or disorders that contribute to the need for rehabilitation services. MATERIALS AND METHODS The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews guideline was followed in this scoping review. Two independent authors conducted a systematic search of four databases, including PubMed, Embase, Scopus, and IEEEXplore. We included studies that have applied wearable sensors on people with or at risk of developing UE-MSK condition published after 2010. We extracted study designs, aims, number of participants, sensor placement locations, sensor types, and number, and outcome(s) of interest from the included studies. The overall findings of our scoping review are presented in tables and diagrams to map an overview of the existing applications. RESULTS The final review encompassed 80 studies categorized into clinical population (31 studies), workers' population (31 studies), and general wearable design/performance studies (18 studies). Most were observational, with 2 RCTs in workers' studies. Clinical studies focused on UE-MSK conditions like rotator cuff tear and arthritis. Workers' studies involved industrial workers, surgeons, farmers, and at-risk healthy individuals. Wearable sensors were utilized for objective motion assessment, home-based rehabilitation monitoring, daily activity recording, physical risk characterization, and ergonomic assessments. IMU sensors were prevalent in designs (84%), with a minority including sEMG sensors (16%). Assessment applications dominated (80%), while treatment-focused studies constituted 20%. Home-based applicability was noted in 21% of the studies. CONCLUSION Wearable sensor technologies have been increasingly applied to the health care field. These applications include clinical assessments, home-based treatments of MSK disorders, and monitoring of workers' population in non-standardized areas such as work environments. Assessment-focused studies predominate over treatment studies. Additionally, wearable sensor designs predominantly use IMU sensors, with a subset of studies incorporating sEMG and other sensor types in wearable platforms to capture muscle activity and inertial data for the assessment or rehabilitation of MSK conditions.
Collapse
Affiliation(s)
- Sohrob Milani Zadeh
- Biomedical Engineering, Physical Therapy, Western University, London, ON, Canada.
| | - Joy MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Clinical Research Lab, Hand and Upper Limb Center, St. Joseph's Health Center, London, ON, Canada
- Rehabilitation Science McMaster University, Hamilton, ON, Canada
| | - James Johnson
- Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada
| | - Trevor B Birmingham
- Biomedical Engineering, Physical Therapy, Western University, London, ON, Canada
| | - Erfan Shafiee
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| |
Collapse
|