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Movement intentions of motor impaired individuals can be detected in laboratory settings via electroencephalography Brain–Computer Interfaces (EEG-BCIs) and used for motor rehabilitation and external system control. The real-world BCI use is limited by the costly, time-consuming, obtrusive, and uncomfortable setup of scalp EEG. Ear-EEG offers a faster, more convenient, and more aesthetic setup for recording EEG, but previous work using expensive amplifiers detected motor intentions at chance level. This study investigates the feasibility of a low-cost ear-EEG BCI for the detection of tongue and hand movements for rehabilitation and control purposes. In this study, ten able-bodied participants performed 100 right wrist extensions and 100 tongue-palate movements while three channels of EEG were recorded around the left ear. Offline movement vs. idle activity classification of ear-EEG was performed using temporal and spectral features classified with Random Forest, Support Vector Machine, K-Nearest Neighbours, and Linear Discriminant Analysis in three scenarios: Hand (rehabilitation purpose), hand (control purpose), and tongue (control purpose). The classification accuracies reached 70%, 73%, and 83%, respectively, which was significantly higher than chance level. These results suggest that a low-cost ear-EEG BCI can detect movement intentions for rehabilitation and control purposes. Future studies should include online BCI use with the intended user group in real-life settings. [ABSTRACT FROM AUTHOR]

Featured Application: The serious game could be used for hand rehabilitation, since it is controlled using five hand movements: wrist extension, wrist flexion, ulnar and radial deviations, and fist movements. Moreover, it has two game modes: a non-tailored mode in which the game difficulty is set randomly, and a tailored mode in which the game difficulty is adjusted according to the participants' range of motion, determined during the hand movements. Background: Traditional physical rehabilitation involves participants performing repetitive body movements with the assistance of physiotherapists. Owing to the exercises' monotonous nature and lack of reward, participants may become disinterested and cease their recovery. Games could be used as tools to engage participants in the rehabilitation process. Consequently, participants could perform rehabilitation exercises while playing the game, receiving rewards from the experience. Maintaining the players' engagement requires regularly adjusting the game difficulty. The players' engagement can be measured using questionnaires and biosignals (e.g., electroencephalography signals—EEG). This study aims to determine whether there is a significant difference in players' engagement between two game modes with different game difficulty adjustments: non-tailored and tailored modes. Methods: We implemented two game modes which were controlled using hand movements. The features of the game rewards (position and size) were changed in the game scene; hence, the game difficulty could be modified. The non-tailored mode set the features of rewards in the game scene randomly. Conversely, the tailored mode set the features of rewards in the game scene based on the participants' range of motion using fuzzy logic. Consequently, the game difficulty was adjusted dynamically. Additionally, engagement was computed from 53 healthy participants in both game modes using two EEG sensors: Bitalino Revolution and Unicorn. Specifically, the theta (θ) and alpha (α) bands from the frontal and parietal lobes were computed from the EEG data. A questionnaire was applied to participants after finishing playing both game modes to collect their impressions on the following: their favorite game mode, the game mode that was the easiest to play, the game mode that was the least frustrating to play, the game mode that was the least boring to play, the game mode that was the most entertaining to play, and the game mode that had the fastest game response time. Results: The non-tailored game mode reported the following means of engagement: 6.297 ± 11.274 using the Unicorn sensor, and 3.616 ± 0.771 using the Bitalino sensor. The tailored game mode reported the following means of engagement: 4.408 ± 6.243 using the Unicorn sensor, and 3.619 ± 0.551 using Bitalino. The non-tailored mode reported the highest mean engagement (6.297) when the Unicorn sensor was used to collect EEG signals. Most participants selected the non-tailored game mode as their favorite, and the most entertaining mode, irrespective of the EEG sensor. Conversely, most participants chose the tailored game mode as the easiest, and the least frustrating mode to play, irrespective of the EEG sensor. Conclusions: A Wilcoxon-Signed-Rank test revealed that there was only a significant difference in engagement between game modes when the EEG signal was collected via the Unicorn sensor (p value = 0.04054). Fisher's exact tests showed significant associations between the game modes (non-tailored, tailored) and the following players' variables: ease of play using the Unicorn sensor (p value = 0.009341), and frustration using Unicorn sensor (p value = 0.0466). [ABSTRACT FROM AUTHOR]

Birds have remarkable flight capabilities due to their adaptive wing morphology. However, studying live birds is time-consuming and laborious, and obtaining information about the complete wingbeat cycle is difficult. To address this issue and provide a complete dataset, we recorded comprehensive motion capture wing trajectory data from five free-flying pigeons (Columba livia). Five key motion parameters are used to quantitatively characterize wing kinematics: flapping, sweeping, twisting, folding and bending. In addition, the forelimb skeleton is mapped using an open-chain three-bar mechanism model. By systematically evaluating the relationship of joint degrees of freedom (DOFs), we configured the model as a 3-DOF shoulder, 1-DOF elbow and 2-DOF wrist. Based on the correlation analysis between wingbeat kinematics and joint movement, we found that the strongly correlated shoulder and wrist roll within the stroke plane cause wing flap and bending. There is also a strong correlation between shoulder, elbow and wrist yaw out of the stroke plane, which causes wing sweep and fold. By simplifying the wing morphing, we developed three flapping wing robots, each with different DOFs inside and outside the stroke plane. This study provides insight into the design of flapping wing robots capable of mimicking the 3D wing motion of pigeons. [ABSTRACT FROM AUTHOR]

Thumb carpometacarpal (CMC) osteoarthritis (OA) is caused by the degeneration of joint surfaces at the base of the thumb. If conservative treatments have failed, surgery may be needed to improve symptoms. Typically, standard clinical tools, such as the pinch gauge, are used to measure thumb force. However, these devices have utilized multiple digits and do not represent forces specifically generated by the thumb. Therefore, different devices are necessary to accurately measure isolated thumb force. The primary objective was to research the effect of thumb force after ligament reconstruction with tendon interposition surgery. To accomplish this, several sub-objectives were implemented: (1) create a testing device to collect isolated thumb forces, (2) collect a normative thumb force data set of males and females to compare the impact of aging and surgery, (3) collect and compare clinical data to see if these data sets matched isolated thumb forces, (4) determine the effect of wrist position on isolated thumb force data in different wrist positions, and (5) collect thumb force in directions that mimic daily activities, a directional force downward (push) and inward (pull). On average, older participants generated statistically larger forces than younger participants. Additionally, only 50% of CMC OA participants showed greater than 5 N of improvement at 6-months post-surgery compared to pre-surgery, but did not reach healthy force levels. When evaluating wrist rotation, OA participants' push and pull decreased by 8 N and 7 N in the horizontal wrist position, and their push and pull increased by 2 N and 5 N in the vertical wrist position. Evaluation and results with standard clinical tools showed different post-surgery trends than isolated force data, which suggested the clinical approach has mixed results and may be under- or over-estimating the recovery process. These data sets allow surgeons and hand therapists to identify changes in isolated thumb force generation to create specialized therapies and treatment options, which is an improvement upon current clinical measurement tools. [ABSTRACT FROM AUTHOR]

Background: Tremor is the most common movement disorder, with significant functional and psychosocial consequences. Oral medications have been disappointing or limited by side effects. Surgical techniques are effective but associated with risks and adverse events. Botulinum toxin (BT) represents a promising avenue but there is still no double-blind evidence of efficacy on upper limb function. A systematic review on the effects of BT in upper-limb tremor was conducted. Methods: A systematic search of the literature was conducted up to July 2023, including the keywords "botulinum toxin" and "tremor". All randomized controlled trials (RCTs) and open-label studies were analyzed. Independent reviewers assessed their methodological quality. Results: There were only eight published RCTs and seven published open-label studies, with relatively small sample sizes. This review suggests that BT is more effective when injections are patient-tailored, with analyses based on clinical judgement or kinematics. Subjective and objective measures frequently improve but transient weakness may occur after injections, especially if wrist or fingers extensors are targeted. A number of studies had methodological limitations. Conclusions: The authors discuss how to optimize tremor assessments and effects of BT injection. Controlled evidence is still lacking but it is suggested that distal "asymmetric" BT injections (targeting flexors/pronators while sparing extensors/supinators) and proximal injections, involving shoulder rotators when indicated, may avoid excessive weakness while optimizing functional benefit. [ABSTRACT FROM AUTHOR]

Background/Objectives: A pronator quadratus pedicled bone graft (PQPBG) is a distal radius volar vascularized bone graft used not only for avascular necrosis of the lunate but also for scaphoid nonunion. Despite its potency and its possession of a muscular shield, this vascularized graft has a disadvantage in that the potential shortness of the muscular leash may limit the distal transfer of the bone graft. Releasing of the pronator quadratus (PQ) ulnar origin was used to enhance the distal mobility of the graft. We aimed to investigate the effect of a PQ release on the surgical outcomes of scaphoid nonunions that were operated on with the PQPBG technique. Methods: Patients with scaphoid nonunion that were treated with PQPBG from 2009 to 2020 were reviewed. Patient demographic characteristics, surgical notes, physical examinations, and radiological evaluation data were collected. Wrist range of motion, grip strength, modified Mayo wrist score, and Quick-DASH score were used to evaluate the outcomes. The included patients were divided into two groups based on the origin release status of their PQ, i.e., with and without release. Results: This study included 37 patients, 17 of whom underwent a PQ release and 20 of whom did not. The failure rates for the two groups were one and four patients, respectively, and there was no significant difference between them (p = 0.11). The postoperative mean wrist extension in the patients with a PQ release was significantly greater than that in the patients without a release (43.5 ± 6.8 vs. 36.5 ± 7.7, p = 0.0038). Although wrist flexion, ulnar deviation, radial deviation, mean outcome assessment scores, and grip strength were greater in the patients with a PQ release than in those without, no statistically significant intergroup differences were observed (p > 0.05). Conclusions: The PQPBG technique is a viable option for achieving bony union in patients with scaphoid nonunion, but it results in the postoperative restriction of wrist extension. PQ release during a graft transfer may have a favorable effect on both bone union and clinical outcomes. [ABSTRACT FROM AUTHOR]

Musculoskeletal Disorders (MSDs) stand as a prominent cause of injuries in modern agriculture. Scientific research has highlighted a causal link between MSDs and awkward working postures. Several methods for the evaluation of working postures, and related risks, have been developed such as the Rapid Upper Limb Assessment (RULA). Nevertheless, these methods are generally applied with manual measurements on pictures or videos. As a consequence, their applicability could be scarce, and their effectiveness could be limited. The use of wearable sensors to collect kinetic data could facilitate the use of these methods for risk assessment. Nevertheless, the existing system may not be usable in the agricultural and vine sectors because of its cost, robustness and versatility to the various anthropometric characteristics of workers. The aim of this study was to develop a technology capable of collecting accurate data about uncomfortable postures and repetitive movements typical of vine workers. Specific objectives of the project were the development of a low-cost, robust, and wearable device, which could measure data about wrist angles and workers' hand positions during possible viticultural operations. Furthermore, the project was meant to test its use to evaluate incongruous postures and repetitive movements of workers' hand positions during pruning operations in vineyard. The developed sensor had 3-axis accelerometers and a gyroscope, and it could monitor the positions of the hand–wrist–forearm musculoskeletal system when moving. When such a sensor was applied to the study of a real case, such as the pruning of a vines, it permitted the evaluation of a simulated sequence of pruning and the quantification of the levels of risk induced by this type of agricultural activity. [ABSTRACT FROM AUTHOR]

Surface electromyography (sEMG) offers a novel method in human–machine interactions (HMIs) since it is a distinct physiological electrical signal that conceals human movement intention and muscle information. Unfortunately, the nonlinear and non-smooth features of sEMG signals often make joint angle estimation difficult. This paper proposes a joint angle prediction model for the continuous estimation of wrist motion angle changes based on sEMG signals. The proposed model combines a temporal convolutional network (TCN) with a long short-term memory (LSTM) network, where the TCN can sense local information and mine the deeper information of the sEMG signals, while LSTM, with its excellent temporal memory capability, can make up for the lack of the ability of the TCN to capture the long-term dependence of the sEMG signals, resulting in a better prediction. We validated the proposed method in the publicly available Ninapro DB1 dataset by selecting the first eight subjects and picking three types of wrist-dependent movements: wrist flexion (WF), wrist ulnar deviation (WUD), and wrist extension and closed hand (WECH). Finally, the proposed TCN-LSTM model was compared with the TCN and LSTM models. The proposed TCN-LSTM outperformed the TCN and LSTM models in terms of the root mean square error (RMSE) and average coefficient of determination (R2). The TCN-LSTM model achieved an average RMSE of 0.064, representing a 41% reduction compared to the TCN model and a 52% reduction compared to the LSTM model. The TCN-LSTM also achieved an average R2 of 0.93, indicating an 11% improvement over the TCN model and an 18% improvement over the LSTM model. [ABSTRACT FROM AUTHOR]

Our study presents a novel design for a cable-driven robotic arm, emphasizing low cost, low inertia movement, and long-term cable durability. The robotic arm shares similar specifications with the UR5 robotic arm, featuring a total of six degrees of freedom (DOF) distributed in a 1:1:1:3 ratio at the arm base, shoulder, elbow, and wrist, respectively. The three DOF at the wrist joints are driven by a cable system, with heavy motors relocated from the end-effector to the shoulder base. This repositioning results in a lighter cable-actuated wrist (weighing 0.8 kg), which enhances safety during human interaction and reduces the torque requirements for the elbow and shoulder motors. Consequently, the overall cost and weight of the robotic arm are reduced, achieving a payload-to-body weight ratio of 5:8.4 kg. To ensure good positional repeatability, the shoulder and elbow joints, which influence longer moment arms, are designed with a direct-drive structure. To evaluate the design's performance, tests were conducted on loading capability, cable durability, position repeatability, and manipulation. The tests demonstrated that the arm could manipulate a 5 kg payload with a positional repeatability error of less than 0.1 mm. Additionally, a novel cable tightener design was introduced, which served dual functions: conveniently tightening the cable and reducing the high-stress concentration near the cable locking end to minimize cable loosening. When subjected to an initial cable tension of 100 kg, this design retained approximately 80% of the load after 10 years at a room temperature of 24 °C. [ABSTRACT FROM AUTHOR]

Isolated musculoskeletal infantile myofibroma is a rare tumor of pediatric age. The majority of cases are seen in children under two years old, but it can occur at any age as a painless enlarging mass that involves bone, skin, or soft tissue, typically accompanied by compression symptoms. Perineural involvement is extremely rare in myofibromas. Neurological impairment can occur during infancy but isolated nerve palsy, particularly in peripheral nerves within the upper extremity, is very uncommon. Neonatal radial nerve palsy is a rare entity caused by different conditions. Among these, we mention local tumors affecting peripheral nerves, such as myofibroma. There are few cases described in the literature, which mainly concern adult patients. The authors present a case of congenital isolated radial nerve palsy in a newborn with MF of the right elbow, which resulted in impairment of the wrist and finger extension. Following a six-month monitoring period, the patient underwent surgical treatment to restore function to his right wrist and hand. This involved excising the infiltrated radial nerve segment associated with palliative surgery. Despite the benignity of this lesion, severe nerve damage and perineural involvement may require surgical treatment with nerve resection and reconstruction. [ABSTRACT FROM AUTHOR]

The seven-degree-of-freedom space manipulator, characterized by its redundant and aspheric wrist structure, is extensively used in space missions due to its exceptional dexterity and multi-joint capabilities. However, the non-spherical wrist structure presents challenges in solving inverse kinematics, as it cannot decouple joints using the Pieper criterion, unlike spherical wrist structures. To address this issue, this paper presents a closed-form analytical method for solving the inverse kinematics of seven-degree-of-freedom aspheric wrist space manipulators. The method begins by identifying the redundant joint through comparing the volumes of the workspace with different joints fixed. The redundant joint angle is then treated as a parametric joint angle, enabling the derivation of closed-form expressions for the non-parametric joint angles using screw theory. The optimal solution branch is identified through a comparative analysis of various self-motion manifold branches. Additionally, a hybrid approach, combining analytical and numerical methods, is proposed to optimize the parametric joint angle for a trajectory tracking task. Simulation results confirm the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Background: In volleyball, the upper limb dimensions and grip strength greatly influence offensive and defensive movements during a match. However, the relationship between these parameters remains underexplored in elite female volleyball players. Objective: This study aimed to contrast the upper limb anthropometric characteristics and handgrip strength (HGS) of female elite volleyball players against a control group. Methods: Selected upper limb anthropometric parameters and maximal HGS of 42 female volleyball players and 40 non-athletes were measured. Results: Players exhibited higher values in almost all variables studied than non-athletes. The differences were statistically significant (p < 0.001) except for body mass index and elbow and wrist diameters. Players showed a moderate correlation between dominant HGS and hand parameters (length r = 0.43 and breadth r = 0.63; p < 0.05). Weak correlations were identified with height, upper arm length, elbow diameter, and hand shape index (r = 0.32 to 0.38; p < 0.05). In the non-dominant hand, a moderate correlation with handbreadth (r = 0.55, p ≤ 0.01) and weak correlations with upper arm length, wrist diameter, hand length, and hand shape index (r = 0.32 to 0.35; p ≤ 0.05) was found. Conclusions: These findings underscore the importance of the upper limb anthropometric parameters as predictors of HGS and their utility in athlete selection. Future research should investigate biomechanical factors influencing HGS and injury prevention. [ABSTRACT FROM AUTHOR]

Hand tendinopathies represent a pathological condition associated with significant disability. However, due to this high heterogeneity of the treatments and their efficacy, there is still a lack of consensus on the infiltrative therapy of the hand. This systematic review aimed to investigate the efficacy of injection techniques in the treatment of pain related to the main hand tendinopathies. We searched online medical databases (PubMed, Pedro, Cochrane Library, Scopus, and WoS). Only RCTs published in the last 10 years (up to 5 August 2024), written in English, and related to infiltrative treatment in wrist and hand tendinopathies were evaluated. The risk of bias in RCTs was assessed with Version 2 of the Cochrane Risk of Bias tool for randomized trials (RoB 2). Out of 641 articles identified, 23 were included in the final synthesis: 14 RCTs on trigger finger, and 9 RCTs on de Quervain's tenosynovitis. The present systematic review showed that infiltrative therapy of trigger finger and de Quervain's tenosynovitis constitutes a fundamental element in the treatment of these pathological conditions, in terms of pain reduction and improvement in the functionality of the hand. [ABSTRACT FROM AUTHOR]

Brain–computer interfaces (BCIs) are pivotal in translating neural activities into control commands for external assistive devices. Non-invasive techniques like electroencephalography (EEG) offer a balance of sensitivity and spatial-temporal resolution for capturing brain signals associated with motor activities. This work introduces MOVING, a Multi-Modal dataset of EEG signals and Virtual Glove Hand Tracking. This dataset comprises neural EEG signals and kinematic data associated with three hand movements—open/close, finger tapping, and wrist rotation—along with a rest period. The dataset, obtained from 11 subjects using a 32-channel dry wireless EEG system, also includes synchronized kinematic data captured by a Virtual Glove (VG) system equipped with two orthogonal Leap Motion Controllers. The use of these two devices allows for fast assembly (∼1 min), although introducing more noise than the gold standard devices for data acquisition. The study investigates which frequency bands in EEG signals are the most informative for motor task classification and the impact of baseline reduction on gesture recognition. Deep learning techniques, particularly EEGnetV4, are applied to analyze and classify movements based on the EEG data. This dataset aims to facilitate advances in BCI research and in the development of assistive devices for people with impaired hand mobility. This study contributes to the repository of EEG datasets, which is continuously increasing with data from other subjects, which is hoped to serve as benchmarks for new BCI approaches and applications. [ABSTRACT FROM AUTHOR]

Human–Machine Interfaces (HMIs) have gained popularity as they allow for an effortless and natural interaction between the user and the machine by processing information gathered from a single or multiple sensing modalities and transcribing user intentions to the desired actions. Their operability depends on frequent periodic re-calibration using newly acquired data due to their adaptation needs in dynamic environments, where test–time data continuously change in unforeseen ways, a cause that significantly contributes to their abandonment and remains unexplored by the Ultrasound-based (US-based) HMI community. In this work, we conduct a thorough investigation of Unsupervised Domain Adaptation (UDA) algorithms for the re-calibration of US-based HMIs during within-day sessions, which utilize unlabeled data for re-calibration. Our experimentation led us to the proposal of a CNN-based architecture for simultaneous wrist rotation angle and finger gesture prediction that achieves comparable performance with the state-of-the-art while featuring 87.92 % less trainable parameters. According to our findings, DANN (a Domain-Adversarial training algorithm), with proper initialization, offers an average 24.99 % classification accuracy performance enhancement when compared to no re-calibration setting. However, our results suggest that in cases where the experimental setup and the UDA configuration may differ, observed enhancements would be rather small or even unnoticeable. [ABSTRACT FROM AUTHOR]

This study evaluates the R3THA™ assessment protocol (R3THA-AP™), a technology-supported testing module for personalized rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of the R3THA-AP in assessing hand and arm function, by comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study assessed the functional and impairment levels of children with CP aged 3–18. The findings suggest that R3THA is more reliable for children aged 8 and older, indicating that age significantly influences the protocol's effectiveness. The results also showed that the R3THA-AP's kinematic measurements of hand and wrist movements are positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, the R3THA-AP's accuracy metrics for hand and wrist activities align with the Melbourne Assessment 2's Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between the R3THA-AP and MA2's accuracy and dexterity measurements, indicating areas for further research. These findings validate the R3THA-AP's utility in assessing motor abilities in CP patients, supporting its integration into clinical practice. [ABSTRACT FROM AUTHOR]

Diabetic Foot Ulcers (DFUs) are a major complication of diabetes, with treatment requiring offloading. This study aimed to capture how the accelerometer-assessed physical activity profile differs in those with DFUs compared to those with diabetes but without ulceration (non-DFU). Participants were requested to wear an accelerometer on their non-dominant wrist for up to 8days. Physical activity outcomes included average acceleration (volume), intensity gradient (intensity distribution), the intensity of the most active sustained (continuous) 5–120 min of activity (MXCONT), and accumulated 5–120 min of activity (MXACC). A total of 595 participants (non-DFU = 561, DFU = 34) were included in the analysis. Average acceleration was lower in DFU participants compared to non-DFU participants (21.9 mg [95%CI:21.2, 22.7] vs. 16.9 mg [15.3, 18.8], p < 0.001). DFU participants also had a lower intensity gradient, indicating proportionally less time spent in higher-intensity activities. The relative difference between DFU and non-DFU participants was greater for sustained activity (MXCONT) than for accumulated (MXACC) activity. In conclusion, physical activity, particularly the intensity of sustained activity, is lower in those with DFUs compared to non-DFUs. This highlights the need for safe, offloaded modes of activity that contribute to an active lifestyle for people with DFUs. [ABSTRACT FROM AUTHOR]

Background: Distal forearm fractures were defined as distal radius fractures with concomitant distal ulna fractures, except ulna styloid fractures. Distal forearm fractures are common among geriatric populations, particularly those with osteoporosis. Conventionally, distal forearm fractures are reduced by a double incision approach; however, malreduction and instability of the distal radioulnar joint were not uncommon. We introduced a modified volar dual window approach to treat the distal forearm fracture and evaluate the functional outcomes and complications. Methods: From January 2020 to June 2023, 13 patients with distal forearm fractures underwent open reduction by the modified dual window approach with locking plate fixation. After surgery, splints were applied for two weeks, and the patients underwent postoperative hand therapy for three months. The mean Quick Disabilities of the Arm, Shoulder, and Hand scores, range of motions, grip strength, postoperative radiographic parameters, and complications data were collected. Results: The mean follow-up period was 12.1 months, and the mean age was 52.3 years. Average wrist flexion was 67°, extension 69°, pronation 81°, and supination 79°. Grip strength was 28.3 ± 11.5 kg, which was 88% of the uninjured opposite side. The Visual Analog Scale score during activities was recorded as 0.5 ± 0.9. The mean Quick Disabilities of the Arm, Shoulder, and Hand score was 14 ± 11.5. The postoperative radiographic parameters were as follows: radial height: 10.8 ± 1.7 mm, radial inclination: 22.6 ± 3.7°, volar tilting: 4.0 ± 3.9°, and ulnar variance: −0.4 ± 1.4 mm. All the patients achieved bone union at the final follow-up. Two patients underwent ulnar implant removal due to irritation symptoms. Neither infection, nor neurovascular injury, nor malreduction developed in these patients. Conclusions: The modified volar dual window approach can achieve good wrist function and distal forearm fracture reduction without increasing neurovascular or wound healing complications. This method is an alternative approach for distal forearm fracture, especially in comminuted distal ulna fracture or distal radioulnar joint incongruity. [ABSTRACT FROM AUTHOR]

Dehydration is a common problem in the aging population. Medical professionals can detect dehydration using either blood or urine tests. This requires experimental tests in the lab as well as urine and blood samples to be obtained from the patients. This paper proposed 100 GHz millimeter wave radiometry for early detection of dehydration. Reflectance measurements were performed on healthy and dehydrated patients of both genders (120 males and 80 females) in the aging population. Based on the cause of dehydration, the patient groups were divided into three categories: (1) patients dehydrated due to less thirst sensation, (2) patients dehydrated due to illnesses (vomiting and diarrhea), and (3) patients dehydrated due to diabetes. Reflectance measurements were performed on eight locations: (1) the palm, (2) the back of the hand, (3) the fingers, (4) the inner wrist, (5) the outer wrist, (6) the volar side of the arm, (7) the dorsal surface of the arm, and (8) the elbow. Skin dehydrated due to vomiting and diarrhea was found to have lower reflectance at all the measurement locations compared with healthy and other types of dehydrated skin. The elbow region showed the highest difference in reflectance between healthy and dehydrated skin. This indicates that radiometric sensitivity is sufficient to detect dehydration in a few seconds. This will reduce the patient's waiting time and the healthcare professional's intervention time as well as allow early treatment of dehydration, thus avoiding admission to hospitals. [ABSTRACT FROM AUTHOR]

Featured Application: Practical information is provided, aimed at reducing the manufacturing time for customized 3D-printed orthoses by analyzing factors such as build orientation and process parameters. This includes comparing flat and thermoformed orthoses with those customized based on 3D scans. Printability issues are addressed for these thin prints that include many open pockets and another one of their dimensions around two-thirds of the forearm length. This paper investigated the feasibility of using 3D printing processes, specifically material extrusion (MEX) and vat photopolymerization (DLP—Digital Light Processing), to produce customized wrist–hand orthoses. Design, printability, and usability aspects were addressed. It was found that minimizing printing time for orthoses with intricate shapes, ventilation pockets, and minimal thickness is difficult. The influence of build orientation and process parameters, such as infill density, pattern, layer thickness, and wall thickness, on printing time for ten parameter configurations of orthoses in both ready-to-use and flat thermoformed shapes was examined. The findings revealed that the optimized orientations suggested by Meshmixer and Cura (Auto-orient option) did not reliably yield reduced printing times for each analyzed orthoses. The shortest printing time was achieved with a horizontal orientation (for orthoses manufactured in their ready-to-use form, starting from 3D scanning upper limb data) at the expense of surface quality in contact with the hand. For tall and thin orthoses, 100% infill density is recommended to ensure mechanical stability and layer fill, with caution required when reducing the support volume. Flat and thermoformed orthoses had the shortest printing times and could be produced with lower infill densities without defects. For the same design, the shortest printing time for an orthosis 3D-printed in its ready-to-use form was 8 h and 24 min at 60% infill, while the same orthosis produced as flat took 4 h and 37 min for the MEX process and half of this time for DLP. Usability criteria, including perceived immobilization strength, aesthetics, comfort, and weight, were evaluated for seven orthoses. Two healthy users, with previous experience with traditional plaster splints, tested the orthoses and expressed satisfaction with the 3D-printed designs. While the Voronoi design of DLP orthoses was visually more appealing, it was perceived as less stiff compared to those produced by MEX. [ABSTRACT FROM AUTHOR]

The capability to record data in passive, image-based wearable sensors can simplify data readouts and eliminate the requirement for the integration of electronic components on the skin. Here, we developed a skin-strain-actuated microfluidic pump (SAMP) that utilizes asymmetric aspect ratio channels for the recording of human activity in the fluidic domain. An analytical model describing the SAMP's operation mechanism as a wearable microfluidic device was established. Fabrication of the SAMP was achieved using soft lithography from polydimethylsiloxane (PDMS). Benchtop experimental results and theoretical predictions were shown to be in good agreement. The SAMP was mounted on human skin and experiments conducted on volunteer subjects demonstrated the SAMP's capability to record human activity for hundreds of cycles in the fluidic domain through the observation of a stable liquid meniscus. Proof-of-concept experiments further revealed that the SAMP could quantify a single wrist activity repetition or distinguish between three different shoulder activities. [ABSTRACT FROM AUTHOR]

Hand-intensive work is strongly associated with work-related musculoskeletal disorders (WMSDs) of the hand/wrist and other upper body regions across diverse occupations, including office work, manufacturing, services, and healthcare. Addressing the prevalence of WMSDs requires reliable and practical exposure measurements. Traditional methods like electrogoniometry and optical motion capture, while reliable, are expensive and impractical for field use. In contrast, small inertial measurement units (IMUs) may provide a cost-effective, time-efficient, and user-friendly alternative for measuring hand/wrist posture during real work. This study compared six orientation algorithms for estimating wrist angles with an electrogoniometer, the current gold standard in field settings. Six participants performed five simulated hand-intensive work tasks (involving considerable wrist velocity and/or hand force) and one standardised hand movement. Three multiplicative Kalman filter algorithms with different smoothers and constraints showed the highest agreement with the goniometer. These algorithms exhibited median correlation coefficients of 0.75–0.78 for flexion/extension and 0.64 for radial/ulnar deviation across the six subjects and five tasks. They also ranked in the top three for the lowest mean absolute differences from the goniometer at the 10th, 50th, and 90th percentiles of wrist flexion/extension (9.3°, 2.9°, and 7.4°, respectively). Although the results of this study are not fully acceptable for practical field use, especially for some work tasks, they indicate that IMU-based wrist angle estimation may be useful in occupational risk assessments after further improvements. [ABSTRACT FROM AUTHOR]

Background and Objectives: Biodex System® is an advanced dynamometer used for testing various biomechanical parameters of muscles. Test outcomes allow for the identification of muscle pathology and consequently lead to a clinical diagnosis. Despite being widely used for the testing and rehabilitation of the human musculoskeletal system, no universal and acceptable protocol for wrist examination has been proposed for patients with wrist pathology. In this study, the authors aim to identify the most appropriate protocol for testing the biomechanical parameters of flexors and extensors of the wrist. Materials and Methods: A group of 20 patients with symptomatic tennis elbow and 26 healthy volunteers were examined using three different protocols: isokinetic, isometric and isotonic. Protocol order for each study participant was assigned at random with a minimum of a 24 h break between protocols. All protocol parameters were set according to data obtained from a literature review and an earlier pilot study. Following completion of each protocol, participants filled out a questionnaire-based protocol, assessing pain intensity during the exam, difficulty with exam performance and post-exam muscle fatigue. Results: The isotonic protocol showed the best patient tolerance and the highest questionnaire score. There was a significant difference (p < 0.05) between the three protocols in average pain intensity reported by study participants. All participants completed the isotonic protocol, but not all patients with symptomatic tennis elbow were able to complete the isometric and isokinetic protocols. The isotonic protocol was deemed "difficult but possible to complete" by study participants. Conclusions: The isotonic protocol is most suitable for testing the flexors and extensors of the wrist. It gives the most biomechanical data of all protocols, is well tolerated by patients and rarely causes pain during examination even in symptomatic participants. [ABSTRACT FROM AUTHOR]

Background and Objectives: Non-specific chronic wrist pain is wrist pain that occurs without a specific cause, such as trauma, and may limit the range of motion of the joints of the wrist and hand, affecting muscle strength, grip strength, and function. This study aimed to determine the effects of grip-strengthening exercises combined with wrist stability training on pain and function in patients with non-specific chronic wrist pain. Materials and Methods: The subjects of the study were 31 patients with wrist pain. To determine the effect of grip-strengthening exercises combined with wrist stability training, 15 participants participated in grip-strengthening exercises combined with wrist stability training and 16 control subjects participated. The experimental group participated in wrist-stability training. Grip-strengthening exercises combined with wrist stability training were performed for 20 min/day twice a week for 4 weeks, and relaxation massage and conservative physical therapy were performed for 20 min/day twice a week for 4 weeks. The control group received relaxation massage and conservative physical therapy for 40 min/day twice a week for 4 weeks. A visual pain scale was used to evaluate the degree of pain before and after treatment, and a patient-rated wrist evaluation was used to evaluate wrist function. Results: The results showed that the visual score significantly decreased in the time effect before and after the intervention in both groups (p < 0.001), patient-rated wrist evaluation significantly decreased (p < 0.001), and grip strength and muscle strength significantly increased (p < 0.001). The results of this study showed that grip-strengthening exercises combined with wrist stability training were effective in improving pain, function, grip strength, and muscle strength in patients with non-specific chronic wrist pain. Conclusions: Grip-strengthening exercises combined with wrist stability training can be used as an effective intervention method to improve pain, function, grip strength, and muscle strength, emphasizing the need for wrist exercise interventions in patients with non-specific chronic wrist pain in the future. [ABSTRACT FROM AUTHOR]

Flexible conductive films are a key component of strain sensors, and their performance directly affects the overall quality of the sensor. However, existing flexible conductive films struggle to maintain high conductivity while simultaneously ensuring excellent flexibility, hydrophobicity, and corrosion resistance, thereby limiting their use in harsh environments. In this paper, a novel method is proposed to fabricate flexible conductive films via centrifugal spinning to generate thermoplastic polyurethane (TPU) nanofiber substrates by employing carbon nanotubes (CNTs) and carbon nanofibers (CNFs) as conductive fillers. These fillers are anchored to the nanofibers through ultrasonic dispersion and impregnation techniques and subsequently modified with polydimethylsiloxane (PDMS). This study focuses on the effect of different ratios of CNTs to CNFs on the film properties. Research demonstrated that at a 1:1 ratio of CNTs to CNFs, with TPU at a 20% concentration and PDMS solution at 2 wt%, the conductive films crafted from these blended fillers exhibited outstanding performance, characterized by electrical conductivity (31.4 S/m), elongation at break (217.5%), and tensile cycling stability (800 cycles at 20% strain). Furthermore, the nanofiber-based conductive films were tested by attaching them to various human body parts. The tests demonstrated that these films effectively respond to motion changes at the wrist, elbow joints, and chest cavity, underscoring their potential as core components in strain sensors. [ABSTRACT FROM AUTHOR]

Skin is the largest organ in the human body and requires proper dressing to facilitate healing after an injury. Wounds on movable parts, such as the elbow, knee, wrist, and neck, usually undergo delayed and inefficient healing due to frequent movements. To better accommodate movable wounds, a variety of functional hydrogels have been successfully developed and used as flexible wound dressings. On the one hand, the mechanical properties, such as adhesion, stretchability, and self-healing, make these hydrogels suitable for mobile wounds and promote the healing process; on the other hand, the bioactivities, such as antibacterial and antioxidant performance, could further accelerate the wound healing process. In this review, we focus on the recent advances in hydrogel-based movable wound dressings and propose the challenges and perspectives of such dressings. [ABSTRACT FROM AUTHOR]

Upper-limb paralysis requires extensive rehabilitation to recover functionality for everyday living, and such assistance can be supported with robot technology. Against such a background, we have proposed an electromyography (EMG)-driven hybrid rehabilitation system based on motion estimation using a probabilistic neural network. The system controls a robot and functional electrical stimulation (FES) from movement estimation using EMG signals based on the user's intention, enabling intuitive learning of joint motion and muscle contraction capacity even for multiple motions. In this study, hybrid and visual-feedback training were conducted with pointing movements involving the non-dominant wrist, and the motor learning effect was examined via quantitative evaluation of accuracy, stability, and smoothness. The results show that hybrid instruction was as effective as visual feedback training in all aspects. Accordingly, passive hybrid instruction using the proposed system can be considered effective in promoting motor learning and rehabilitation for paralysis with inability to perform voluntary movements. [ABSTRACT FROM AUTHOR]

The growth of wearable technology has enabled the collection of even more personalized information on individuals. New health-related devices marketed to consumers collect health information that might not fall under the traditional category of Protected Health Information, and thus, HIPAA protections do not fully apply. Meaning, commercial wearable health devices do not fall under FDA oversight, and data not paired with a doctor–patient relationship do not fall under HIPAA privacy protection; thus, much of the gathered health-related metrics are left without regulation and open to be sold to data brokers. As such, these data can be leveraged by health insurance, law enforcement, and employers, to name a few. This manuscript explores the loopholes in current regulations and suggests a framework that categorizes wearable data and addresses challenges in data transfer. Furthermore, taking a user perspective, the suggested framework offers solutions that aim to guide users and policymakers in navigating privacy issues in wearable technology. [ABSTRACT FROM AUTHOR]

Wrist injuries, driven by factors such as an aging population and the popularity of high-impact sports, have become increasingly prevalent. In response, this study focuses on developing a serious game for wrist injury rehabilitation within a virtual environment, aiming to enhance motivation and therapeutic adherence while highlighting the potential of virtual rehabilitation. Extensive literature research and the involvement of five experts during the game's design led to the creation of "WristBreakout", which successfully integrated 13 out of 15 recommended movements into gameplay. In addition, the technical feasibility of the VR headset "MetaQuest" within the domain of wrist rehabilitation was shown. A preliminary evaluation with six healthy participants showed positive results in terms of usability and acceptance (SUS average was 69; UES categories were between 3.97 and 4.77). This work contributes to the broader context of serious games and virtual reality (VR) applications in healthcare, exemplifying how technology can positively impact the rehabilitation experience. [ABSTRACT FROM AUTHOR]

Hand dysfunction is a common symptom in stroke patients. This paper presents a robotic device which assists the rehabilitation process in order to reduce the need of physical therapy, i.e., a 3UPS/S parallel robotic device is employed for repetitive robot-assisted rehabilitation. Euler angle representation was used to solve the robot's inverse kinematics. The robot's joint space and rotational workspace were determined for two scenarios. In the first scenario, the workspace was obtained considering the actuator's stroke limitations, while in the second scenario, the workspace was determined by adding a second condition, i.e., the range of motion of the spherical joints. Singularity analysis was performed using the geometric algebra approach. The robot was manufactured using additive manufacturing technology. The solution of the inverse kinematic problem was employed to control the robot. The robot can perform a full range of motion during wrist ulnar deviation and radial deviation motions, with the exception of limited wrist flexion and extension motions. The robot has singular configurations within its workspace. Although the spherical joints have roles in reducing the workspace, the primary causes are actuator selection, radii of the base and moving platforms, and the length of the central leg. These factors can be considered to improve the workspace. Singularity can be avoided by carefully selecting the rotation of the moving platform about the Z-axis and avoiding same leg lengths. [ABSTRACT FROM AUTHOR]

Modular control of the muscle, which is called muscle synergy, simplifies control of the movement by the central nervous system. The purpose of this study was to explore the synergy in both the frequency and movement domains based on the non-negative Tucker decomposition (NTD) method. Surface electromyography (sEMG) data of 8 upper limb muscles in 10 healthy subjects under wrist flexion (WF) and wrist extension (WE) were recorded. NTD was selected for exploring the multi-domain muscle synergy from the sEMG data. The results showed two synergistic flexor pairs, Palmaris longus–Flexor Digitorum Superficialis (PL-FDS) and Extensor Carpi Radialis–Flexor Carpi Radialis (ECR-FCR), in the WF stage. Their spectral components are mainly in the respective bands 0–20 Hz and 25–50 Hz. And the spectral components of two extensor pairs, Extensor Digitorum–Extensor Carpi Ulnar (ED-ECU) and Extensor Carpi Radialis–Brachioradialis (ECR-B), are mainly in the respective bands 0–20 Hz and 7–45 Hz in the WE stage. Additionally, further analysis showed that the Biceps Brachii (BB) muscle was a shared muscle synergy module of the WE and WF stage, while the flexor muscles FCR, PL and FDS were the specific synergy modules of the WF stage, and the extensor muscles ED, ECU, ECR and B were the specific synergy modules of the WE stage. This study showed that NTD is a meaningful method to explore the multi-domain synergistic characteristics of multi-channel sEMG signals. The results can help us to better understand the frequency features of muscle synergy and shared and specific synergies, and expand the study perspective related to motor control in the nervous system. [ABSTRACT FROM AUTHOR]

Metabolic syndrome poses a significant health challenge worldwide, prompting the need for comprehensive strategies integrating physical activity monitoring and energy expenditure. Wearable sensor devices have been used both for energy intake and energy expenditure (EE) estimation. Traditionally, sensors are attached to the hip or wrist. The primary aim of this research is to investigate the use of an eyeglass-mounted wearable energy intake sensor (Automatic Ingestion Monitor v2, AIM-2) for simultaneous recognition of physical activity (PAR) and estimation of steady-state EE as compared to a traditional hip-worn device. Study data were collected from six participants performing six structured activities, with the reference EE measured using indirect calorimetry (COSMED K5) and reported as metabolic equivalents of tasks (METs). Next, a novel deep convolutional neural network-based multitasking model (Multitasking-CNN) was developed for PAR and EE estimation. The Multitasking-CNN was trained with a two-step progressive training approach for higher accuracy, where in the first step the model for PAR was trained, and in the second step the model was fine-tuned for EE estimation. Finally, the performance of Multitasking-CNN on AIM-2 attached to eyeglasses was compared to the ActiGraph GT9X (AG) attached to the right hip. On the AIM-2 data, Multitasking-CNN achieved a maximum of 95% testing accuracy of PAR, a minimum of 0.59 METs mean square error (MSE), and 11% mean absolute percentage error (MAPE) in EE estimation. Conversely, on AG data, the Multitasking-CNN model achieved a maximum of 82% testing accuracy in PAR, a minimum of 0.73 METs MSE, and 13% MAPE in EE estimation. These results suggest the feasibility of using an eyeglass-mounted sensor for both PAR and EE estimation. [ABSTRACT FROM AUTHOR]

The problem of supporting visually impaired and blind people in meaningful interactions with objects is often neglected. To address this issue, we adapted a tactile belt for enhanced spatial navigation into a bracelet worn on the wrist that allows visually impaired people to grasp target objects. Participants' performance in locating and grasping target items when guided using the bracelet, which provides direction commands via vibrotactile signals, was compared to their performance when receiving auditory instructions. While participants were faster with the auditory commands, they also performed well with the bracelet, encouraging future development of this system and similar systems. [ABSTRACT FROM AUTHOR]

Myoelectric hands are beneficial tools in the daily activities of people with upper-limb deficiencies. Because traditional myoelectric hands rely on detecting muscle activity in residual limbs, they are not suitable for individuals with short stumps or paralyzed limbs. Therefore, we developed a novel electric prosthetic hand that functions without myoelectricity, utilizing wearable wireless sensor technology for control. As a preliminary evaluation, our prototype hand with wireless button sensors was compared with a conventional myoelectric hand (Ottobock). Ten healthy therapists were enrolled in this study. The hands were fixed to their forearms, myoelectric hand muscle activity sensors were attached to the wrist extensor and flexor muscles, and wireless button sensors for the prostheses were attached to each user's trunk. Clinical evaluations were performed using the Simple Test for Evaluating Hand Function and the Action Research Arm Test. The fatigue degree was evaluated using the modified Borg scale before and after the tests. While no statistically significant differences were observed between the two hands across the tests, the change in the Borg scale was notably smaller for our prosthetic hand (p = 0.045). Compared with the Ottobock hand, the proposed hand prosthesis has potential for widespread applications in people with upper-limb deficiencies. [ABSTRACT FROM AUTHOR]

Recent studies have highlighted the possibility of using surface electromyographic (EMG) signals to develop human–computer interfaces that are also able to recognize complex motor tasks involving the hand as the handwriting of digits. However, the automatic recognition of words from EMG information has not yet been studied. The aim of this study is to investigate the feasibility of using combined forearm and wrist EMG probes for solving the handwriting recognition problem of 30 words with consolidated machine-learning techniques and aggregating state-of-the-art features extracted in the time and frequency domains. Six healthy subjects, three females and three males aged between 25 and 40 years, were recruited for the study. Two tests in pattern recognition were conducted to assess the possibility of classifying fine hand movements through EMG signals. The first test was designed to assess the feasibility of using consolidated myoelectric control technology with shallow machine-learning methods in the field of handwriting detection. The second test was implemented to assess if specific feature extraction schemes can guarantee high performances with limited complexity of the processing pipeline. Among support vector machine, linear discriminant analysis, and K-nearest neighbours (KNN), the last one showed the best classification performances in the 30-word classification problem, with a mean accuracy of 95% and 85% when using all the features and a specific feature set known as TDAR, respectively. The obtained results confirmed the validity of using combined wrist and forearm EMG data for intelligent handwriting recognition through pattern recognition approaches in real scenarios. [ABSTRACT FROM AUTHOR]

Various conditions, including traffic accidents, sports injuries, and neurological disorders, can impair human wrist movements, underscoring the importance of effective rehabilitation methods. Robotic devices play a crucial role in this regard, particularly in wrist rehabilitation, given the complexity of the human wrist joint, which encompasses three degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. This paper provides a comprehensive review of wrist rehabilitation devices, employing a methodological approach based on primary articles sourced from PubMed, ScienceDirect, Scopus, and IEEE, using the keywords "wrist rehabilitation robot" from 2007 onwards. The findings highlight a diverse array of wrist rehabilitation devices, systematically organized in a tabular format for enhanced comprehension. Serving as a valuable resource for researchers, this paper enables comparative analyses of robotic wrist rehabilitation devices across various attributes, offering insights into future advancements. Particularly noteworthy is the integration of serious games with simplified wrist rehabilitation devices, signaling a promising avenue for enhancing rehabilitation outcomes. These insights lay the groundwork for the development of new robotic wrist rehabilitation devices or to make improvements to existing prototypes incorporating a forward-looking approach to improve rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Upper limb functionality is essential to perform activities of daily living. It is critical to investigate neurorehabilitation therapies in order to improve upper limb functionality in post-stroke patients. This paper presents a soft-robotic bilateral system to provide rehabilitation therapy for hand and wrist joints. A sensorized glove that tracks finger and wrist joint movements is worn on the healthy limb, which guides the movement of the paretic limb. The input of sensors from the healthy limb is provided to the soft robotic exoskeleton attached to the paretic limb to mimic the motion. A proportional derivative flow-based control algorithm is used to perform bilateral therapy. To test the feasibility of the developed system, two different applications are performed experimentally: (1) Wrist exercise with a dumbbell, and (2) Object pick-and-place task. The initial tests of the developed system verified its capability to perform bilateral therapy. [ABSTRACT FROM AUTHOR]

Optical Motion Capture Systems (OMCSs) are considered the gold standard for kinematic measurement of human movements. However, in situations such as measuring wrist kinematics during a hairdressing activity, markers can be obscured, resulting in a loss of data. Other measurement methods based on non-optical data can be considered, such as magneto-inertial measurement units (MIMUs). Their accuracy is generally lower than that of an OMCS. In this context, it may be worth considering a hybrid system [MIMU + OMCS] to take advantage of OMCS accuracy while limiting occultation problems. The aim of this work was (1) to propose a methodology for coupling a low-cost MIMU (BNO055) to an OMCS in order to evaluate wrist kinematics, and then (2) to evaluate the accuracy of this hybrid system [MIMU + OMCS] during a simple hairdressing gesture. During hair cutting gestures, the root mean square error compared with the OMCS was 4.53° (1.45°) for flexion/extension, 5.07° (1.30°) for adduction/abduction, and 3.65° (1.19°) for pronation/supination. During combing gestures, they were significantly higher, but remained below 10°. In conclusion, this system allows for maintaining wrist kinematics in case of the loss of hand markers while preserving an acceptable level of precision (<10°) for ergonomic measurement or entertainment purposes. [ABSTRACT FROM AUTHOR]

The accurate estimation of energy expenditure from simple objective accelerometry measurements provides a valuable method for investigating the effect of physical activity (PA) interventions or population surveillance. Methods have been evaluated previously, but none utilize the temporal aspects of the accelerometry data. In this study, we investigated the energy expenditure prediction from acceleration measured at the subjects' hip, wrist, thigh, and back using recurrent neural networks utilizing temporal elements of the data. The acceleration was measured in children (N = 33) performing a standardized activity protocol in their natural environment. The energy expenditure was modelled using Multiple Linear Regression (MLR), stacked long short-term memory (LSTM) networks, and combined convolutional neural networks (CNN) and LSTM. The correlation and mean absolute percentage error (MAPE) were 0.76 and 19.9% for the MLR, 0.882 and 0.879 and 14.22% for the LSTM, and, with the combined LSTM-CNN, the best performance of 0.883 and 13.9% was achieved. The prediction error for vigorous intensities was significantly different (p < 0.01) from those of the other intensity domains: sedentary, light, and moderate. Utilizing the temporal elements of movement significantly improves energy expenditure prediction accuracy compared to other conventional approaches, but the prediction error for vigorous intensities requires further investigation. [ABSTRACT FROM AUTHOR]

Physiologic hand tremors are a critical factor affecting the aim of air pistol shooters. However, the extent of the effect of hand tremors on shooting performance is unclear. In this study, we aim to explore the relationship between hand tremors and shooting performance scores as well as investigate potential links between muscle activation and hand tremors. In this study, 17 male air pistol shooters from China's national team and the Air Pistol Sports Center were divided into two groups: the elite group and the sub-elite group. Each participant completed 40 shots during the experiment, with shooters' hand tremors recorded using three-axis digital accelerometers affixed to their right hands. Muscle activation was recorded using surface electromyography on the right anterior deltoid, posterior deltoid, biceps brachii (short head), triceps brachii (long head), flexor carpi radialis, and extensor carpi radialis. Our analysis revealed weak correlations between shooting scores and hand tremor amplitude in multiple directions (middle-lateral, ML: r2 = −0.22, p < 0.001; vertical, VT: r2 = −0.25, p < 0.001), as well as between shooting scores and hand tremor complexity (ML: r2 = −0.26, p < 0.001; VT: r2 = −0.28, p < 0.001), across all participants. Notably, weak correlations between shooting scores and hand tremor amplitude (ML: r2 = −0.27, p < 0.001; VT: r2 = −0.33, p < 0.001) and complexity (ML: r2 = −0.31, p < 0.001) were observed in the elite group but not in the sub-elite group. Moderate correlation were found between the biceps brachii (short head) RMS and hand tremor amplitude in the VT and ML directions (ML: r2 = 0.49, p = 0.010; VT: r2 = 0.44, p = 0.025) in all shooters, with a moderate correlation in the ML direction in elite shooters (ML: r2 = 0.49, p = 0.034). Our results suggest that hand tremors in air pistol shooters are associated with the skill of the shooters, and muscle activation of the biceps brachii (long head) might be a factor affecting hand tremors. By balancing the agonist and antagonist muscles of the shoulder joint, shooters might potentially reduce hand tremors and improve their shooting scores. [ABSTRACT FROM AUTHOR]

Background: Elective soft-tissue-only wrist arthroscopy is a standard procedure in hand surgery for the diagnosis and treatment of wrist pain. A number of pathologies can be treated arthroscopically, with the aim of pain reduction and improved wrist mobility. A postinterventional evaluation of the treatment using objective and patient-reported outcome measures (PROMs) allows for an evidence-based statement about the benefits of soft-tissue-only wrist arthroscopy. Methods: A dual-center study combining retro- and prospective clinical analyses of patient outcomes after soft-tissue-only wrist arthroscopies was performed. The data were collected at two hospitals with departments specializing in hand surgery. The outcome was measured by assessing the range of motion of the wrist and its manual strength, as well as PROMs, including Disabilities of the Arm, Shoulder and Hand (DASH) scores. Results: A total of 154 soft interventions met the study criteria and could be included. Seven months after the elective soft-tissue-only wrist arthroscopies, mobility improved significantly for active extension and flexion, as well as the ulnar and radial abduction of the wrist. The grip strength also improved significantly, by an average of 6 kg, during this period. The DASH score improved significantly, from 35 points to 14 points. Additionally, wrist pain at rest was reduced significantly. Conclusions: After elective soft-tissue-only wrist arthroscopy, patients showed an overall functional improvement in their wrist, with a significant reduction in pain and improvement of mobility and grip strength. This study emphasizes the importance of wrist arthroscopy as a successful treatment option for soft tissue pathologies of the wrist. [ABSTRACT FROM AUTHOR]

Objective: Six months after the onset of stroke, over 60% of patients experience upper limb dysfunction, with spasticity being a major contributor alongside muscle weakness. This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) with taping on wrist spasticity, strength, and upper extremity function in patients with stroke. Methods: In total, 40 patients with stroke were included and randomly divided into two groups: the TENS + taping (n = 20, age 52.4 ± 9.3 (range: 39 to 70)) and TENS (n = 20, age 53.5 ± 10.8 (range: 39 to 74)) groups. All subjects performed 30 sessions of task-related training, which included 10 min of postural control training and 20 min of task performance. Additionally, all subjects received TENS on the spastic muscle belly for 30 min before task-related training. In the TENS + taping group, taping was additionally applied to the forearm and wrist but not in the TENS group. The Modified Ashworth Scale was used to measure spasticity, and a handheld dynamometer was used to measure muscle strength. The Fugl–Meyer Assessment of Upper Extremity was used to evaluate the functional ability of the upper extremity. Results: In the TENS + taping group, spasticity and upper extremity function were significantly improved as compared to those in the TENS group (p < 0.05). However, no significant difference in muscle strength was observed between the two groups (p > 0.05). Conclusions: This study demonstrated that the combination of TENS and taping for spasticity and function of the upper extremity was more effective in relieving the spasticity than TENS alone. Therefore, we suggest this combination as an additional treatment for spasticity and function of the upper extremity. [ABSTRACT FROM AUTHOR]

Pattern recognition in myoelectric control that relies on the myoelectric activity associated with arm motions is an effective control method applied to myoelectric prostheses. Individuals with transhumeral amputation face significant challenges in effectively controlling their prosthetics, as muscle activation varies with changes in arm positions, leading to a notable decrease in the accuracy of motion pattern recognition and consequently resulting in a high rejection rate of prosthetic devices. Therefore, to achieve high accuracy and arm position stability in upper-arm motion recognition, we propose a Deep Adversarial Inception Domain Adaptation (DAIDA) based on the Inception feature module to enhance the generalization ability of the model. Surface electromyography (sEMG) signals were collected from 10 healthy subjects and two transhumeral amputees while performing hand, wrist, and elbow motions at three arm positions. The recognition performance of different feature modules was compared, and ultimately, accurate recognition of upper-arm motions was achieved using the Inception C module with a recognition accuracy of 90.70% ± 9.27%. Subsequently, validation was performed using data from different arm positions as source and target domains, and the results showed that compared to the direct use of a convolutional neural network (CNN), the recognition accuracy on untrained arm positions increased by 75.71% (p < 0.05), with a recognition accuracy of 91.25% ± 6.59%. Similarly, in testing scenarios involving multiple arm positions, there was a significant improvement in recognition accuracy, with recognition accuracy exceeding 90% for both healthy subjects and transhumeral amputees. [ABSTRACT FROM AUTHOR]

Non-linear and dynamic systems analysis of human movement has recently become increasingly widespread with the intention of better reflecting how complexity affects the adaptability of motor systems, especially after a stroke. The main objective of this scoping review was to summarize the non-linear measures used in the analysis of kinetic, kinematic, and EMG data of human movement after stroke. PRISMA-ScR guidelines were followed, establishing the eligibility criteria, the population, the concept, and the contextual framework. The examined studies were published between 1 January 2013 and 12 April 2023, in English or Portuguese, and were indexed in the databases selected for this research: PubMed®, Web of Science®, Institute of Electrical and Electronics Engineers®, Science Direct® and Google Scholar®. In total, 14 of the 763 articles met the inclusion criteria. The non-linear measures identified included entropy (n = 11), fractal analysis (n = 1), the short-term local divergence exponent (n = 1), the maximum Floquet multiplier (n = 1), and the Lyapunov exponent (n = 1). These studies focused on different motor tasks: reaching to grasp (n = 2), reaching to point (n = 1), arm tracking (n = 2), elbow flexion (n = 5), elbow extension (n = 1), wrist and finger extension upward (lifting) (n = 1), knee extension (n = 1), and walking (n = 4). When studying the complexity of human movement in chronic post-stroke adults, entropy measures, particularly sample entropy, were preferred. Kinematic assessment was mainly performed using motion capture systems, with a focus on joint angles of the upper limbs. [ABSTRACT FROM AUTHOR]

The assessment of fine motor competence plays a pivotal role in neuropsychological examinations for the identification of developmental deficits. Several tests have been proposed for the characterization of fine motor competence, with evaluation metrics primarily based on qualitative observation, limiting quantitative assessment to measures such as test durations. The Placing Bricks (PB) test evaluates fine motor competence across the lifespan, relying on the measurement of time to completion. The present study aims at instrumenting the PB test using wearable inertial sensors to complement PB standard assessment with reliable and objective process-oriented measures of performance. Fifty-four primary school children (27 6-year-olds and 27 7-year-olds) performed the PB according to standard protocol with their dominant and non-dominant hands, while wearing two tri-axial inertial sensors, one per wrist. An ad hoc algorithm based on the analysis of forearm angular velocity data was developed to automatically identify task events, and to quantify phases and their variability. The algorithm performance was tested against video recordings in data from five children. Cycle and Placing durations showed a strong agreement between IMU- and Video-derived measurements, with a mean difference <0.1 s, 95% confidence intervals <50% median phase duration, and very high positive correlation (ρ > 0.9). Analyzing the whole population, significant differences were found for age, as follows: six-year-olds exhibited longer cycle durations and higher variability, indicating a stage of development and potential differences in hand dominance; seven-year-olds demonstrated quicker and less variable performance, aligning with the expected maturation and the refined motor control associated with dominant hand training during the first year of school. The proposed sensor-based approach allowed the quantitative assessment of fine motor competence in children, providing a portable and rapid tool for monitoring developmental progress. [ABSTRACT FROM AUTHOR]

Background: Chronic lateral epicondylitis challenges the therapeutical approach; underlying mechanisms are incompletely understood; neuropathic pain and central and peripheral sensitization may explain the fact that botulinum toxin has been found to play a role in pain and function management. Methods: We searched the literature for MeSH terms: lateral epicondylitis or synonyms and botulinum toxin. Results: We found 14 papers containing trials on botulinum toxin injection into the tendon or into the extensor muscles (specifically, extensor carpi radialis brevis and extensor communis digitorum). We followed the administration pathways, doses, timing, and side effects. Conclusions: With a chronic course, the focus of the therapy shifts from the afflicted tendon to the inserting muscles, as muscle contracture may create a vicious loop to perpetuate and aggravate the disease. Doses, timing, and side effects are discussed. [ABSTRACT FROM AUTHOR]

The pilot study assessed the utility of a training program using modified, commercially available dual-joystick-operated ride-on toys to promote unimanual and bimanual upper extremity (UE) function in children with cerebral palsy (CP). The ride-on-toy training was integrated within a 3-week, intensive, task-oriented training camp for children with CP. Eleven children with hemiplegia between 4 and 10 years received the ride-on-toy training program 20–30 min/day, 5 days/week for 3 weeks. Unimanual motor function was assessed using the Quality of Upper Extremity Skills Test (QUEST) before and after the camp. During ride-on-toy training sessions, children wore activity monitors on both wrists to assess the duration and intensity of bimanual UE activity. Video data from early and late sessions were coded for bimanual UE use, independent navigation, and movement bouts. Children improved their total and subscale QUEST scores from pretest to post-test while increasing moderate activity in their affected UE from early to late sessions, demonstrating more equal use of both UEs across sessions. There were no significant changes in the rates of movement bouts from early to late sessions. We can conclude that joystick-operated ride-on toys function as child-friendly, intrinsically rewarding tools that can complement conventional therapy and promote bimanual motor functions in children with CP. [ABSTRACT FROM AUTHOR]

The light weight and compliance of exosuits are valuable benefits not present rigid exoskeleton devices, yet these intriguing features make it challenging to properly model and simulate their interaction with the musculoskeletal system. Tendon-driven exosuits adopt an electrical motor combined with pulleys and cable transmission in the actuation stage. An important aspect of the design of these systems for the load transfer efficacy and comfort of the user is the anchor point positioning. In this paper, we propose a framework, whose first purpose is as a design methodology for the synthesis of an exosuit device, achieved by optimizing the anchor point location. The optimization procedure finds the best 3D position of the anchor points based on the interaction forces between the exosuit and the upper arm. The computation of the forces is based on the combination of a mathematical model of a wrist–elbow exosuit and a dynamic model of the upper arm. Its second purpose is the simulation of the kinematic and physiological effects of the interaction between the arm, the exosuit, and the complex upper limb musculoskeletal system. It offers insights into muscular and exoskeleton loading during operation. The presented experiments involve the development and validation of personalized musculoskeletal models, with kinematic, anthropometric, and electromyographic data measured in a load-lifting task. Simulation of the exosuit operation—coupled with the musculoskeletal model—showed the efficacy of the suit in assisting the wrist and elbow muscles and provided interesting highlights about the impact of the assistance on shoulder muscles. Finally, we provide a possible design of an elbow and wrist exosuit based on the optimized results. [ABSTRACT FROM AUTHOR]

We present the case of a 14-year-old patient who suffered fracture dislocation of the pisiform bone (PB) along with fractures of the scaphoid, proximal radius, and proximal phalanx of the thumb due to high-energy trauma directly to the extended wrist. This combination of fractures has not been previously reported in the literature. Currently, there is no consensus in the literature regarding the optimal treatment approach for such cases. In our management, initial attempts at closed and open reduction were unsuccessful, leading to the decision for primary pisiformectomy. Our report includes a follow-up of 3.5 years, demonstrating a very good outcome. Based on this case and a few similar published cases, primary pisiformectomy appears to be a viable and well-accepted option, particularly among young patients. Additionally, we conducted a review of radiographic criteria and management strategies for this specific injury and related conditions. [ABSTRACT FROM AUTHOR]

To obtain precise positional information, in this study, we propose an adaptive expectation–maximization (EM)-based Kalman filter (KF)/finite impulse response (FIR) integrated filter for inertial navigation system (INS)-based posture capture of human upper limbs. Initially, a data fusion model for wrist and elbow position is developed. Subsequently, the Mahalanobis distance is utilized to evaluate the performance of the filter. The integrated filter employs the EM-based KF to enhance noise estimation accuracy when the performance of KF declines. Conversely, upon deterioration in the performance of the EM-based KF, which is evaluated using the Mahalanobis distance, the FIR filter is employed to maintain the effectiveness of the data fusion filter. This research utilizes the proposed EM-based KF/FIR integrated filter to ascertain wrist and elbow positions. The empirical results demonstrate the proficiency of the proposed approach in estimating these positions, thereby overcoming the challenge and highlighting its inherent effectiveness. [ABSTRACT FROM AUTHOR]