Search

To determine the criterion validity of the SET-ULM (Spatial Exploration Test of Upper Limb Mobility), a functional workspace test. A prospective study from July 2017 to November 2018 in 30 children with SMA type 1 or 2. All children underwent assessment with the SET-ULM and the Motor Function Measure (MFM). We included 30 children. Median (Q1; Q3) MFM D1 (standing ability, ambulation and transfers), D2 (axial and proximal motor function), D3 (distal motor function) scores, Total MFM and Total SET-ULM active score were respectively 2.6% (2.6–3.8); 45.8% (19.9–65.3); 57.7% (36.9–80.9); 35.4% (16.7–43.2) and 70.2% (49.7–97.9). Total SET-ULM active score was strongly correlated with the MFM D2 dimension score (rho 0.82; p < 001), with the D3 dimension (rho 0.86; p < 0.001) and with the Total MFM score (rho 0.89; p < 0.005). Total SET-ULM active score differed between SMA types (p < 0.01). The SET-ULM has good criterion validity for the evaluation of available horizontal active upper limb workspace in children with SMA1 and SMA2. Future studies should evaluate reliability and sensitivity to change during a longitudinal follow-up study, as well as in a longitudinal trial of therapeutic effectiveness. NCT03223051 The Spatial Exploration Test for Upper Limb Mobility is a useful adjunct to the Motor Function Measure. It provides a precise evaluation of horizontal reaching ability. The Spatial Exploration Test for Upper Limb Mobility will be of great clinical utility for the evaluation of the effects of treatments for spinal muscular atrophy. [ABSTRACT FROM AUTHOR]

Objective The objectives of this study were to establish the short-term feasibility and usability of wrist-worn wearable sensors for capturing the arm and hand activity of people with stroke and to explore the association between factors related to the use of the paretic arm and hand. Methods Thirty people with chronic stroke were monitored with wrist-worn wearable sensors for 12 hours per day for a 7-day period. Participants also completed standardized assessments to capture stroke severity, arm motor impairments, self-perceived arm use, and self-efficacy. The usability of the wearable sensors was assessed using the adapted System Usability Scale and an exit interview. Associations between motor performance and capacity (arm and hand impairments and activity limitations) were assessed using Spearman correlations. Results Minimal technical issues or lack of adherence to the wearing schedule occurred, with 87.6% of days procuring valid data from both sensors. The average sensor wear time was 12.6 (standard deviation [SD] = 0.2) hours per day. Three participants experienced discomfort with 1 of the wristbands, and 3 other participants had unrelated adverse events. There were positive self-reported usability scores (mean = 85.4/100) and high user satisfaction. Significant correlations were observed for measures of motor capacity and self-efficacy with paretic arm use in the home and the community (Spearman correlation coefficients = 0.44–0.71). Conclusions This work demonstrates the feasibility and usability of a consumer-grade wearable sensor for capturing paretic arm activity outside the laboratory. It provides early insight into the everyday arm use of people with stroke and related factors, such as motor capacity and self-efficacy. Impact The integration of wearable technologies into clinical practice offers new possibilities to complement in-person clinical assessments and to better understand how each person is moving outside of therapy and throughout the recovery and reintegration phase. Insight gained from monitoring the arm and hand use of people with stroke in the home and community is the first step toward informing future research with an emphasis on causal mechanisms with clinical relevance. [ABSTRACT FROM AUTHOR]

(1) Background: The most common musculoskeletal pathology among healthcare professionals is neck and/or shoulder pain. The aim of this study was to determine the dominant upper limb functionality concerning the ability to replicate a given movement pattern among employees reporting neck or upper limb pain while using a computer during the COVID-19 pandemic. (2) Methods: The study was conducted from March to April 2021 on a group of 45 medical employees who used a computer workstation for 4 to 6 h of their working time. In the design of this study, three study groups were created: a group of patients with pain syndrome of segment C5/C7 of the spine, a group of patients with shoulder pain syndrome, and a control group of healthy volunteers. (3) Results: The examined groups significantly differed in the correctness of performing the given movement (p = 0.001) and the minimum value of inclination during the exercise session (p = 0.026), as well as the maximum lowering (p = 0.03) in relation to the control group. (4) Conclusions: The VECTIS device can be used to assess the accuracy of reflecting the prescribed movement of the upper limb in rehabilitation programs for patients with cervical spine pain syndrome and shoulder pain syndrome. [ABSTRACT FROM AUTHOR]

Background: A disorder characterized by airway obstruction and breathing difficulty is known as chronic obstructive pulmonary disease. Fatigue is one of the typical signs and symptoms of COPD. Fatigue is the term used to describe a persistent feeling of exhaustion, and it can have a significant negative influence on person's capacity to carry out everyday tasks. Purpose: The purpose of this study is to analyze how low impact aerobic training and upper limb strengthening exercise is effective in dyspnea and fatigue level among individuals with COPD. Materials and Methods: The 106 subjects were selected based on inclusion and exclusion criteria from Hepziba Chest Clinic and Spirometry centre, Nagercoil. The pre and post-test values were measured using the BORG scale and Fatigue Severity Scale. The subjects were allocated into two groups. Low impact Aerobic training group:(n=53) received aerobic training with conventional exercise and Upper limb strengthening group:(n=53) received upper limb strengthening exercise with conventional exercise. The study was done for four weeks. The entire procedure was performed from October 2022 to july 2023 Results: When comparing the low impact Aerobic training group with upper limb strengthening group, the low impact Aerobic training group indicates significant (p<0.0001) effect in lowering the fatigue level as assessed by Borg scale and Fatigue Severity Scale. Conclusion: The study concluded that Low impact Aerobic training had a significant effect compared to upper limb strengthening exercise on Dyspnea and Fatigue Severity Scale among individuals with COPD. [ABSTRACT FROM AUTHOR]

Background: Stroke is the quickly developing clinical indication of a focal disruption of brain function that lasts more than 24 hours or results in death, with no discernible cause other than vascular origin. Despite the fact that the majority of patients are able to walk again, 30% to 60% of survivors are no longer able to use the arm that was injured. CIMT aims at improves both the motor and functional capacities of a paretic arm. PNF exercises alter the order in which muscles are stimulated, increases the efficiency of joint movement. Purpose: To compare the effectiveness of Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation for treating upper extremity functions in stroke. Materials and Methods: A total of 30 participants were selected from Sree Annai Physiotherapy Clinic Chennai. According to the inclusion and exclusion criteria. Subjects willing to participate were allocated into two groups Constraint Induced Movement Therapy group and Proprioceptive Neuromuscular Facilitation group. The participants underwent Pre-test measurement with Fugl-Meyer Assessment Upper Extremity FMA-UE and were repeated for Post-test measurement. Study period: November 2022 to April 2023. Results: When comparing the mean differences of the two groups, Constraint Induced Movement Therapy group displays a greater difference than Proprioceptive Neuromuscular Facilitation group. Therefore, it can be said that Constraint Induced Movement Therapy is more advantageous for the upper extremity functions than Proprioceptive Neuromuscular Facilitation. Conclusion: The study concluded that Constraint Induced Movement Therapy is found to be more effective than Proprioceptive neuromuscular facilitation technique for upper extremity function recovery. [ABSTRACT FROM AUTHOR]

Background: The background of the study focuses on addressing the challenges in hand function that these children face due to their condition. Action observation training aims to leverage the brain's mirror neuron system to improve motor skills by observing and imitating actions. Bimanual arm training involves coordinated movement of both arms to enhance functional abilities. Purpose: The study compared the effects of action observation training and bimanual arm training on hand function in children with hemiparetic cerebral palsy. Materials and Methods: A total of 30 children were chosen according to the inclusion and exclusion criteria. The subjects were separated into two groups: action observation training (AOT) and bimanual arm training (BAT). The Fugl Meyer assessment scale (FMA) and the Box and Block test (BBT) were used for evaluating the result. Results: Both groups were homogenous at baseline, with a p value of 0.7866 in FMA and 0.6002 in BBT. The result of this study demonstrated that the action observation training group showed a better improvement than bimanual arm training with a p value of < 0.0001. Conclusion: This study concluded that AOT improved hand function in cerebral palsy children. [ABSTRACT FROM AUTHOR]

Background: Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities. Aim: To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP. Design: This was a double‐masked, randomized, controlled clinical trial. Setting: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al‐Agouza Hospital, Giza, Egypt. Population: Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers. Method: Children were allocated to receive conventional therapy (CONV‐group; n = 20) or plyometric exercises (PLYO‐group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3‐month. The intervention was delivered on non‐consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively. Results: Overall, 35 children (18 in the CONV‐group, 17 in the PLYO‐group) completed data collection and treatment. With‐in group comparison showed significant improvement in the study groups while post‐treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO‐group. Conclusions: Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP. [ABSTRACT FROM AUTHOR]

Introduction: Lumbar lordosis is important for the spine and pelvis to work in harmony in providing trunk control and maintaining sagittal balance. Children with cerebral palsy (CP) have difficulties in providing trunk postural control and balance, which is critical for independence in daily living activities. This study was planned to examine the immediate effect of a lower-trunk orthosis supporting physiological lumbar lordosis on trunk control and upper-limb functionality in children with CP. Objectives and Methods: A total of 30 children with CP, 13 diparetic, 11 hemiparetic, and 6 ataxic, 21 ambulatory (GMFCS I/II), and 9 nonambulatory (GMFCS III/IV) aged 3-16 years were included in the study. The Pediatric Functional Reach Test (PFRT) and the Seated Postural Control Measure (SPCM) were used to assess trunk control; the Pediatric Berg Balance Scale (PBBS) was used to assess balance; and the Box and Block Test (BBT) and the Nine-Hole Peg Test (9HPT) were used to evaluate upper-limb functions. All tests were performed with and without a soft lumbosacral brace. The braces were made of soft, elastic fabric with steel, and weremade by the orthotic technician in four different sizes. The angle of lordosis was adjusted with steel underwires according to each child. The existing physiological lordosis of the child is supported by the brace. It is not intended to increase or decrease. Results: In the study, the results of all evaluations with a brace were better than those without a brace (P < 0.05). No significant difference was found only in the functional part of the SPCM test (P > 0.05). Conclusions: Our study revealed that soft lumbosacral orthosis, which supports physiological lordosis, has a positive effect on trunk stability and upper-limb functionality in children with CP. Clinical Relevance: In children's trunk stability and upper-limb functionality studies, the use of soft lumbosacral orthosis that supports physiological lordosis can be added to rehabilitation programs and daily living activities as a support. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the construct validity of the Both Hands Assessment (BoHA) using activity of the upper limbs as detected by accelerometry in children with bilateral cerebral palsy (CP). Observational study of children with CP (n = 44, n = 27 boys, aged 9.1 ± 1.6 years; Manual Ability Classification Scale I: n = 15, II: n = 22, III: n = 7) completing a BoHA assessment while wearing a triaxial accelerometer on each wrist. BoHA Each-Hand sub-scores, BoHA percentage difference between hands, BoHA Units, mean activity for each hand, mean activity asymmetry index and total mean activity were calculated. Linear regressions were used to analyze associations between measures. There were significant, positive associations between BoHA Units and total mean activity (B = 0.86, 95%CI: 0.32, 1.40), BoHA Percentage difference between hands and mean activity asymmetry index (B = 0.95, 95%CI: 0.75,1.15), and BoHA Each-Hand sub-score and mean activity for the non-dominant hand (B = 1.71, 95%CI: 1.16, 2.28), but not the dominant hand (B = 0.50, 95%CI: −0.45, 1.45). This study provides further evidence for the construct validity of the BoHA as a measure of upper limb performance. Wearable wrist sensors such as accelerometers capture and quantify gross upper limb movement in children with CP but cannot measure fine finger movements captured by the BoHA. Australian New Zealand Clinical Trials Registry (ACTRN12616001488493 and ACTRN12618000164291) [ABSTRACT FROM AUTHOR]

To examine whether accelerometry can quantitate asymmetry of upper limb activity in infants aged 3–12 months at risk for developing unilateral spastic cerebral palsy (USCP). A prospective study was performed in 50 infants with unilateral perinatal brain injury at high risk of developing USCP. Triaxial accelerometers were worn on the ipsilateral and contralesional upper limb during the Hand Assessment for Infants (HAI). Infants were grouped in three age intervals (3–5 months, 5–7.5 months and 7.5 until 12 months). Each age interval group was divided in a group with and without asymmetrical hand function based on HAI cutoff values suggestive of USCP. In a total of 82 assessments, the asymmetry index for mean upper limb activity was higher in infants with asymmetrical hand function compared to infants with symmetrical hand function in all three age groups (ranging from 41 to 51% versus − 2–6%, p < 0.01), while the total activity of both upper limbs did not differ. Upper limb accelerometry can identify asymmetrical hand function in the upper limbs in infants with unilateral perinatal brain injury from 3 months onwards and is complementary to the Hand Assessment for Infants. [ABSTRACT FROM AUTHOR]

Enormous assistance is required during rehabilitation activities, which might result in a variety of complications if performed manually. To solve this issue, several solutions in the form of assistive devices have been presented recently. Another issue highlighted is the lack of kinematic compatibility in low degrees-of-freedom (dof) systems. The proposed approach of developing a human-motion-oriented rehabilitation device deals with the problem through hybrid architectures. A novel modular synthesis approach is used for the purpose to induce generality in the design process. Using a modular strategy, three planar hybrid configurations are generated for two-dof mechanisms for supporting flexion/extension motion. Three such architectures are optimally synthesised and kinematically analysed over the entire workspace. A Genetic Algorithm (GA) is used to synthesise the architecture parameters optimally. Moreover, the outcomes are evaluated against a set of seven poses and posture locations of the wrist to choose the most suitable configuration among the others. Subsequently, kinematic compatibility is analysed for the coupled system – formed by the selected architecture and the human arm – while wearing the proposed mechanism. According to the findings of optimal synthesis, workspace and singularity analysis, configuration-III is capable of achieving the optimal postures for all task space locations (TSLs). Further, the work modifies the design by attaching additional three revolute passive joints for correcting misalignment concerns using coupled mobility analysis. The modular strategy for hybrid architectures and the subsequent mobility analysis provides an algorithmic framework for synthesising a task-based rehabilitation device. Manual physiotherapy is reported as repeated task, expensive and time-consuming, and considered stressful for the therapist or assistants to provide one-on-one physiotherapy to each patient in the traditional method. Robotic rehabilitation is, therefore, a viable option. In the several reported works on robotic rehabilitation exoskeletons, misalignment of the exoskeleton and the human motion is considered an open challenge. Normally, it is being managed through large number of degrees of freedom, which is certainly expensive and complex in control. The proposed approach of developing a human-motion-oriented rehabilitation device deals with the problem through hybrid architectures and modular strategy to develop them. While focusing upon the emulation of natural human motion trajectory, the compatibility of orthotic joint and human joint motion needs attention. As biological joint possesses complex kinematic characteristics, closed-loops are used in the design. Overall, a complete framework of a cost effective low-dof rehabilitation device is proposed and detailed through coupled analysis. [ABSTRACT FROM AUTHOR]

To investigate the usefulness of inertial measurement units (IMUs) in the assessment of motor function of the upper limb (UL) in accordance with the international classification of functioning (ICF). PubMed; Scopus; Embase; WoS and PEDro databases were searched from inception to 1 February 2022. The current systematic review follows PRISMA recommendations. Articles including IMU assessment of UL in stroke individuals have been included and divided into four ICF categories (b710, b735, b760, d445). We used correlation meta-analysis to pool the Fisher Z-score of each correlation between kinematics and clinical assessment. A total of 35 articles, involving 475 patients, met the inclusion criteria. In the included studies, IMUs have been employed to assess the mobility of joint functions (n = 6), muscle tone functions (n = 4), control of voluntary movement functions (n = 15), and hand and arm use (n = 15). A significant correlation was found in overall meta-analysis based on 10 studies, involving 213 subjects: (r = 0.69) (95% CI: 0.69/0.98; p < 0.001) as in the d445 (r = 0.71) and b760 (r = 0.64) ICF domains, with no heterogeneity across the studies. The literature supports the integration of IMUs and conventional clinical assessment in functional evaluation of the UL after a stroke. The use of a limited number of wearable sensors can provide additional kinematic features of UL in all investigated ICF domains, especially in the ADL tasks when a strong correlation with clinical evaluation was found. [ABSTRACT FROM AUTHOR]

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. 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. A cross-sectional study was conducted under the analytical empirical approach, using linear associations between handgrip strength and functional performance measurement tests (correspondence analysis). 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. 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. 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. • Handgrip strength is a simple method used in rehabilitation to assess physical ability. • Handgrip strength is a prognostic predictor in different health conditions. • Functional performance measures project their results to situations of daily life. • Functional performance measures involve a habitual task. [ABSTRACT FROM AUTHOR]

Background: Upper limb neuromuscular impairments can adversely impact function. This case report investigates the process and outcomes of occupational therapy (OT) for training in the use of the NuroSleeve, a novel research-grade exoskeletal powered orthosis, with a participant with chronic right hemiparesis following a stroke. Method: The participant engaged in 24 OT sessions using the NuroSleeve over 10 weeks. Therapeutic interventions included neuromuscular reeducation, device management, and engagement in occupationbased activities with training to use the NuroSleeve. The Canadian Occupational Performance Measure (COPM), ABILHAND, Patient Reported Outcomes Measurement Information System Upper Extremity Short Form 7a (PROMIS UE SF), Action Research Arm Test (ARAT), and Manual Muscle Testing (MMT) were administered before and after the 24 sessions. Results: With the NuroSleeve, there were clinically important increases in COPM performance and satisfaction for 6/8 and 7/8 goals, respectively; ABILHAND showed a clinically important increase of 4.959 logits; and there was an 11-point increase on the ARAT, indicating a clinically important difference. T-score on the PROMIS UE SF was 33.7 (SD = 2) compared to 23 (SD = 2.8) without the device. MMT remain unchanged. Conclusion: The data suggest that the NuroSleeve was the primary source of increased function and that incorporating OT with the NuroSleeve has benefits. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to investigate the relationship between upper extremity lateralization and dual-task cost in individuals with Hemiplegic Cerebral Palsy (HCP). This is a new and unknown issue in Cerebral Palsy. Material and methods: The descriptive, cross-sectional study was conducted with 63 individuals between the ages of 7 and 17 years: 40 with Hemiplegic Cerebral Palsy and 23 typically-developing peers. The individuals with HCP received a pre-assessment performed with the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System. Left-right judgement was assessed by the laterality judgement task, and manual ability was evaluated with the Nine Hole Peg Test (NHPT). Functional tests included upper extremity functional tests; dual-task interference was also assessed between this test and the NHPT. Results: A significant difference was found between the HCP group and the typically-developing group regarding lateralization accuracy and dual-task cost (p < 0.05). Lateralization response time was related with dominant cognitive NHPT dual-task cost (r = 0.327, p = 0.040). Lateralization accuracy was also related to dominant cognitive NHPT dual-task cost, and lateralization response time with non-dominant motor NHPT dual-task cost (r = -0.360, p = 0.023; r = 0.312, p = 0.050, respectively). Conclusions: Individuals with HCP have difficulty with dual tasks compared to typically developing peers. A relationship was observed between upper extremity lateralization and dual-task cost in individuals with HCP. This can be a significant consideration when designing more effective intervention approaches on upper extremity lateralization and dual-task individuals with HCP. [ABSTRACT FROM AUTHOR]

In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems. [ABSTRACT FROM AUTHOR]

Tailoring motor activities to the unique needs of children with special educational requirements has shown considerable efficacy. Our study aimed to develop a structured program specifically designed to enhance psychomotor abilities, focusing on balance and motor–cognitive skills among 28 students (aged 12–14) from two institutional centers in Romania. The program spanned 36 weeks, with biweekly 30 min sessions. Psychomotor skills were assessed through tests measuring balance, speed of movements, and upper limb motor laterality. Initial and final data were collected for evaluation. A statistical analysis, employing the Kolmogorov–Smirnov and Wilcoxon Z tests, compared the assessments. The results indicated significant improvements in movement speed, with a notable increase in stimulus identification (averaging from approximately 13 to 14) (p < 0.05) and reduced processing time (decreasing from about 28.7 to 28 s) (p < 0.05). However, while the structured program demonstrated substantial enhancements in specific motor and cognitive–motor skills, it did not yield significant changes in dynamic balance, maintaining values close to 0.9 (p > 0.05) for open-eyed balance and 0.88 (p > 0.05) for closed-eyed balance. Additionally, an analysis of the processing speed in pulses per second showcased a marginal decline, from approximately 0.46 to 0.45, revealing notable disparities between the initial and final measurements (p < 0.05). [ABSTRACT FROM AUTHOR]

To assess changes in treatment modalities for supracondylar humerus fractures (SCHFs) at a large pediatric university hospital, we analyzed patient data from 2014 to 2022. A total of 233 SCHFs treated surgically at our hospital were included. To evaluate postoperative outcome and quality of life, DASH and EuroQol-5D-Y questionnaires were sent to patients. In addition to a significant fluctuation in fracture severity, we found an increase in training interventions (more surgeries were performed by trainees) and a significant decrease in surgery times after 2016. From 2020, there was a significant shift in the type of surgical method away from closed reduction with elastic stable intramedullary nailing (ESIN) and towards closed reduction and crossed K-wire osteosynthesis (CRK). Surgeries performed in the morning and evening hours increased, while those performed in the afternoon and after midnight decreased. After a mean follow-up of 4 years, there was no difference in elbow function between ESIN and open reduction and K-wires (ORK). Treatment with ESIN was equivalent to ORK in terms of function, at least in the medium-term follow-up. In summary, the combination of shifting treatment from SCHF to daytime hours, increasing trainee participation and using cross K-wire fixation instead of ESIN had no negative impact on surgery times. In our setting, these measures have reduced resource utilization and increased efficiency without compromising patient care. [ABSTRACT FROM AUTHOR]

This study is aimed at investigating the factors influencing the change (improvement) in the performance of activities of daily living (ADL) in stroke patients. This study utilized data collected from 123 stroke patients at admission and discharge from a local rehabilitation hospital in South Korea between 2019 and 2022. We analyzed the correlations between ADL (Korean version of the Modified Barthel Index) and spasticity (Modified Ashworth Scale), muscle strength (Manual Muscle Test), gait ability (Functional Ambulation Category), cognitive function (Korean version of Mini Mental Status Examination), upper extremity function (Manual Function Test), and balance function (Berg Balance Scale). In addition, to identify the factors influencing the change in ADL in line with the 3 months of rehabilitation, a multiple regression analysis was performed. The results of the correlation analysis showed that balance function (r = 0.925 , p < 0.01) and gait ability (r = 0.921 , p < 0.01) had strong positive correlations with ADL. Multiple regression analysis (F = 34.547 , p ≤ 0.001 , adj. R 2 = 0.466) indicated that changes in the upper extremity (β = 0.494 , p ≤ 0.001), cognitive (β = 0.197 , p = 0.008), and balance (β = 0.163 , p = 0.029) functions influenced changes in ADL. Our results found that the recovery of upper extremity function along with the improvement of cognitive and balance functions had a significant effect on the improvement of independence in ADL in stroke patients. [ABSTRACT FROM AUTHOR]

Important properties have been studied using the Action Research Arm Test (ARAT) in patients with stroke. However, whether the ARAT subtests constitute a Guttman scale (i.e., items hierarchically ordered according to difficulty) remains unclear. Guttman scales can define decision rules for skipping items in patients with low endurance. This study investigated the psychometric properties of the ARAT when applying decision rules for post-stroke hemiparetic patients. A retrospective, single-institution study was conducted between 2020 and 2021. Datasets of 30 patients with stroke-induced hemiparesis were collected from a previous study which employed the ARAT without decision rules, Fugl-Meyer assessment (FMA), Box and Block Test (BBT), and Motor Activity Log (MAL). The ARAT was rescored with decision rules for this study, and inter-rater reliability/agreement, parallel forms reliability, and construct validity were assessed. Parallel forms reliability (Spearman's rho) was 0.99 (95% CI, 0.99–0.99) for both raters. The lower 95% CI limits of the sum and individual item scores in the reliability analysis exceeded the planned value (0.8). Construct validity values exceeded the planned value (0.8) for FMA, BBT, and MAL. Decision rules can be used to skip ARAT items when assessing upper extremity motor function in stroke patients. The Action Research Arm Test with decision rules for skipping items was valid and reliable for measuring upper extremity motor function in hemiparetic patients after stroke. The decision rules may reduce the burden of both patients and evaluators by decreasing the number of Action Research Arm Test items to be administrated. [ABSTRACT FROM AUTHOR]

Background. Stroke is one of the causes of long-term morbidity. Despite rehabilitation strategies, most survivors live with motor deficits in the upper limbs. Objectives. The aim of the study was to compare the effect of contralateral cross education (CE) and high-frequency repetitive magnetic stimulation (HF-rTMS) on the function of upper extremity in subacute phase of stroke. Methods. Forty patients were randomly assigned into 4 groups. Group "A" received physical therapy (PT) for 10 sessions, 3 times per week. Group "B" received PT and HF-rTMS as follows: stimulation of 20 Hz for 5 s, intertrain interval for 50 s, 20 trains, 2000 pulses at 90% resting motor threshold, and conventional PT. Group "C" was treated with CE and PT. In group "D," HF-rTMS, CE, and PT were administered. Results. Significant differences were found in the Fugl-Meyer scale between "A" and "C" (P = 0.01), "A" and "D" (P = 0.02), and "B" and "C" groups (P = 0.01). In the box-block test, there were significant differences between "A" and "B" (P = 0.01), "A" and "C" (P < 0.001), "B" and "D" (P = 0.001), and "B" and "C" groups (P = 0.01). Statistical differences were observed in grip strength between "A" and "B" (P = 0.01) and "A" and "C" groups (P = 0.02). Conclusions. It is suggested that clinicians select the therapeutic methods in line with their expected goal. When the goal is to improve upper extremity function, CE+PT could be more effective than HF-rTMS+PT. Also, CE+PT and HF-rTMS+PT were more effective than CE+HF-rTMS+PT at improving grip strength. Therefore, combining several methods would not always lead to better results. [ABSTRACT FROM AUTHOR]

Purpose: To identify acute predictors of both generic and specific health-related quality of life (HRQoL) 3 months after stroke in individuals from a middle-income country. Materials and methods: A 3-month prospective study with individuals who had suffered their first stroke, without previous disability, discharged from a stroke unit. The dependent outcomes, assessed 3 months after stroke, were generic and specific HRQoL (SF-36 and SSQOL total scores, respectively). The predictors assessed in the stroke unit were age, sex, education level, duration of hospital stay, current living arrangement, stroke severity (National Institutes of Health Stroke Scale-NIHSS), functional independence (Modified Barthel Index-MBI), motor impairment (Fugl-Meyer Assessment), and lower- and upperlimb residual muscle strength deficits. Linear multiple regression analyses were employed to identify predictors of both generic (model-1) and specific (model-2) HRQoL (α=5%). Results: One hundred twenty-six individuals were assessed at 3-month post-stroke (61.3 ± 13.6 years). Regression analysis showed that functional independence was the best predictor of both generic (R²=21%; F=34.82; p<0.001) and specific (R²=29%; F=51.71; p<0.001) HRQoL at 3-month poststroke. Conclusion: Both generic and specific HRQoL at 3-month post-stroke can be predicted by functional independence assessed in the acute phase with the MBI. [ABSTRACT FROM AUTHOR]

Spinal cord injury has a major impact on both the individual and society. This damage can cause permanent loss of sensorimotor functions, leading to structural and functional changes in somatotopic regions of the spinal cord. The combined use of a brain–machine interface and virtual reality offers a therapeutic alternative to be considered in the treatment of this pathology. This systematic review aimed to evaluate the effectiveness of the combined use of virtual reality and the brain–machine interface in the treatment of spinal cord injuries. A search was performed in PubMed, Web of Science, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Medline, including articles published from the beginning of each database until January 2023. Articles were selected based on strict inclusion and exclusion criteria. The Cochrane Collaboration's tool was used to assess the risk of bias and the PEDro scale and SCIRE systems were used to evaluate the methodological quality of the studies. Eleven articles were selected from a total of eighty-two. Statistically significant changes were found in the upper limb, involving improvements in shoulder and upper arm mobility, and weaker muscles were strengthened. In conclusion, most of the articles analyzed used the electroencephalogram as a measurement instrument for the assessment of various parameters, and most studies have shown improvements. Nonetheless, further research is needed with a larger sample size and long-term follow-up to establish conclusive results regarding the effect size of these interventions. [ABSTRACT FROM AUTHOR]

Background: Ultrasound-guided supraclavicular brachial plexus block is widely used in upper limb surgery; however, it requires a higher dose (20–30 mL) of local anesthetic. In this study, we aimed to determine the 90% minimum effective volume for ultrasound-guided supraclavicular brachial plexus block. Methods: All patients received an ultrasound-guided two-point injection of 0.5% ropivacaine at a starting volume of 0.18 mL/mm2 cross-sectional nerve area. In cases of a successful block, the next patient had the same volume with a probability of 0.89, and the volume was reduced by 0.04 mL/mm2 cross-sectional nerve area with a probability of 0.11. When the block failed, the dose was increased by 0.04 mL/mm2 cross-sectional nerve area. After 45 cases of successful blocks, the 90% minimum effective volume of local anesthetic was calculated using the centered isotonic regression function. Results: Centered isotonic regression analysis resulted in a 90% minimum effective volume and a 95% confidence interval of 0.189 mL/mm2 and 0.176–0.225 mL/mm2 for the supraclavicular brachial plexus block. Conclusion: A good blocking effect can be achieved with 0.189 mL/mm2 of 0.5% ropivacaine with more precise dosing, thereby reducing the risk of local anesthetic poisoning. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the effects of free-weight andmachine-based resistance training on strength, hypertrophy, and joint discomfort. Methods: Thirty-eight resistance-trained men participated in an 8-wk resistance program allocated into free-weight (n = 19) or machine-based (n = 19) groups. Training variables were identical for both modalities, so they only differed in the use of barbells or machines to execute the full squat, bench press, prone bench pull, and shoulder press exercises. The velocity-based method was implemented to accurately adjust the intensity throughout the program. Strength changes were evaluated using eight velocity-monitored loading tests (four exercises two modalities) and included the relative one-repetition maximum (1RMRel), as well as the mean propulsive velocity against low (MPVLow) and high (MPVHigh) loads. Ultrasound-derived cross-sectional area of quadriceps (proximal and distal regions), pectoralis major, and rectus abdominis was measured to examine hypertrophy. Complementarily, Western Ontario and McMaster Universities and Disabilities of the Arm, Shoulder and Hand questionnaires were administrated to assess changes in lower- and upper-limb joint discomfort. Outcomes were compared using ANCOVA and percentage of change (Δ) statistics. Results: Each group significantly ( P < 0.001) increased 1RMRel, MPVLow, and MPVHigh for both modalities tested, but especially in the one they trained.When considering together the eight exercises tested, strength changes for both modalities were similar (Δ differences ≤1.8%, P ≥ 0.216). Likewise, the cross-sectional area of all the muscles evaluated was significantly increased by both modalities, with no significant differences between them (Δ difference ≤2.0%, P ≥ 0.208). No between-group differences ( P ≥ 0.144) were found for changes in stiffness, pain, and functional disability levels, which were reduced by both modalities. Conclusions: Free-weight and machine-based modalities are similarly effective to promote strength and hypertrophy without increasing joint discomfort. [ABSTRACT FROM AUTHOR]

BACKGROUND: Upper limb motor dysfunction after stroke is an important factor affecting patients' motor function and daily life. Acupuncture and repetitive transcranial magnetic stimulation are effective methods for stroke rehabilitation. However, a systematic and comprehensive overview of the combined efficacy of the two is lacking. OBJECTIVE: Through a systematic review and meta-analysis of randomized controlled trials, this study aimed to assess the effectiveness of acupuncture combined with repetitive transcranial magnetic stimulation on upper extremity motor function in post-stroke patients. METHODS: The relevant randomized controlled trials on acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of upper limb motor disorders after stroke were searched in PubMed, Embase, Cochrane Library, Web of Science CNKI, VIP, Wanfang, and CBM databases. After screening clinical trials that met the inclusion criteria, data extraction was conducted independently by two investigators. Meta-analysis was performed using RevMan 5.4 software. RESULTS: After the screening, 18 articles were included, with a total of 1083 subjects. The results of meta-analysis showed that combination therapy could effectively improve the patients' upper limb motor function (MD = 7.77, 95%CI [6.32, 9.22], P < 0.05), ability of daily living (MD = 8.53, 95%CI [6.28, 10.79], P < 0.05), and hemiplegic shoulder pain (MD = – 1.72, 95%CI [– 2.26, – 1.18], P < 0.05). Meanwhile, for neurophysiological indexes, combined treatment could significantly shorten the latency of motor evoked potential and central motor conduction time (MD = – 1.42, 95%CI [– 2.14, – 0.71], P < 0.05); (MD = – 0.47, 95%CI [– 0.66, – 0.29], P < 0.05), and also could increase the amplitude of motor evoked potential (SMD = 0.71, 95%CI [0.28, 1.14], P < 0.05). CONCLUSION: According to the results of the meta-analysis, we can conclude that acupuncture combined with repeated transcranial magnetic stimulation can significantly improve the upper limb motor function and daily living ability of stroke patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Dual-task involves performing cognitive and motor tasks together, which requires executive functions that may be impaired in individuals with neurological conditions. Therefore, it is important to accurately assess executive functions to plan a therapeutic intervention. OBJECTIVE: To characterize the use of upper extremity-cognitive dual-task assessment and to describe variables correlated with dual-task ability. METHODS: An electronic search of databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) was carried out using a combination of the following terms: upper-extremity, dual/concurrent task, and cognitive/motor tasks. Two reviewers independently completed data extraction and assessed study quality. RESULTS: 1,946 studies were identified; 25 studies met the inclusion criteria. The purpose of using an upper extremity-cognitive dual-task assessment varied between studies as well as the upper extremity motor tasks used: pegboard (N = 14), arm curl (N = 9), finger-tapping (N = 3), and reaching (N = 1) tests. Dual-task ability was reported as the motor-cognitive interference (N = 15) and as motor cost (N = 12). Dual-task ability was correlated to cognition, brain activity, and daily function, and was significantly different between healthy and neurological individuals. CONCLUSION: Upper extremity cognitive dual-task paradigm is gaining popularity in clinical research, but lacks standardized tools, testing procedures, and calculations. A structured assessment procedure is needed for clinical use and future research. [ABSTRACT FROM AUTHOR]

Background: Concomitant upper extremity and hip fractures present a challenge in postoperative mobilization in the geriatric population. Operative fixation of proximal humerus fractures allows for upper extremity weight bearing. This retrospective study compared outcomes between operative and non-operative proximal humerus fracture patients with concomitant hip fractures. Methods: A trauma database of 13,396 patients age > 55 years old was queried for concomitant hip and proximal humerus fracture patients between 2014–2021. Medical records were reviewed for demographics, hospital quality measures, Neer classification, morphine milligram equivalents (MME), and outcomes. All hip fractures were treated operatively. Patients were grouped based on operative vs. non-operative treatment of their proximal humerus fracture. Primary outcomes included comparing postoperative ambulatory status, pain, length of stay (LOS), intensive care unit (ICU) need, discharge disposition, and readmission rates. Results: Forty-eight patients (0.4%) met inclusion criteria. Twelve patients (25%) underwent operative treatment for their proximal humerus fracture and 36 (75%) received non-operative treatment. Patients with operative fixations were younger (p < 0.01), had more complex Neer classifications (p = 0.031), more likely to be community ambulators (p < 0.01), and required more inpatient MMEs (p < 0.01). There were no differences in LOS (p = 0.415), need for ICU (p = 0.718), discharge location (p = 0.497), 30-day readmission (p = 0.228), or 90-day readmission (p = 0.135) between cohorts. At 6 months postoperatively, among community or household ambulators, a higher percentage of operative patients returned to their baseline ambulatory functional status, however, this was not significant (70% vs. 52%, p = 0.342). There were three deaths in the non-operative cohort and no deaths in the operative cohort. Conclusion: Patients with hip fractures and concomitant proximal humerus fractures treated operatively required more inpatient MMEs and trended toward maintaining baseline ambulatory function. There were no differences in inpatient LOS, ICU need, discharge location, or readmissions. Future larger, multicenter studies are needed to further delineate if operative repair of concomitant proximal humerus fractures provides a benefit in the geriatric population. [ABSTRACT FROM AUTHOR]

The aim of this study was to review the literature on front crawl swimming biomechanics, focusing on propulsive and resistive forces at different swimming velocities. Recent studies show that the resistive force increases in proportion to the cube of the velocity, which implies that a proficient technique to miminise the resistive (and maximise the propulsive) force is particularly important in sprinters. To increase the velocity in races, swimmers increase their stroke frequency. However, experimental and simulation studies have revealed that there is a maximum frequency beyond which swimmers cannot further increase swimming velocity due to a change in the angle of attack of the hand that reduces its propulsive force. While the results of experimental and simulation studies are consistent regarding the effect of the arm actions on propulsion, the findings of investigations into the effect of the kicking motion are conflicting. Some studies have indicated a positive effect of kicking on propulsion at high swimming velocities while the others have yielded the opposite result. Therefore, this review contributes to knowledge of how the upper-limb propulsion can be optimised and indicates a need for further investigation to understand how the kicking action can be optimised in front crawl swimming. Abbreviations: C: Energy cost [kJ/m]; Ė: Metabolic power [W, kJ/s]; Fhand: Fluid resultant force exerted by the hand [N]; Ftotal: Total resultant force [N] (See Appendix A); Fnormal: The sum of the fluid forces acting on body segments toward directions perpendicular to the segmental long axis, which is proportional to the square of the segmental velocity. [N] (See Appendix A); Ftangent: The sum of the fluid forces acting on body segments along the direction parallel to the segmental long axis, which is proportional to the square of the segmental velocity. [N] (See Appendix A); Faddmass: The sum of the inertial force acting on the body segments due to the acceleration of a mass of water [N] (See Appendix A); Fbuoyant: The sum of the buoyant forces acting on the body segments [N] (See Appendix A); D: Fluid resistive force acting on a swimmer's body (active drag) [N]; T: Thrust (propulsive) force acting in the swimming direction in reaction to the swimmer's actions [N]; Thand: Thrust force produced in reaction to the actions of the hand [N]; Tupper_limb: Thrust force produced in reaction to the actions of the upper limbs [N]; Tlower_limb: Thrust force produced in reaction to the actions of the lower limbs [N]; Mbody: Whole-body mass of the swimmer [kg]; SF: Stroke frequency (stroke number per second) [Hz]; SL: Stroke length (distance travelled per stroke) [m]; v: Instantaneous centre of mass velocity of the swimmer [m/s]; V ˉ : Mean of the instantaneous centre of mass velocities in the swimming direction over the period of the stroke cycle [m/s]; a: Centre of mass acceleration of the swimmer [m/s2]; V ˉ hand: Mean of the instantaneous magnitudes of hand velocity over a period of time [m/s]; Ẇtot: Total mechanical power [W]; Ẇext: External mechanical power [W]; Ẇd: Drag power (mechanical power needed to overcome drag) [W, Nm/s]; α: Angle of attack of the palm plane with respect to the velocity vector of the hand [deg]; ηo: Overall efficiency [%]; ηp: Propelling efficiency [%]; MAD-system: Measuring Active Drag system; MRT method: Measuring Residual Thrust method. [ABSTRACT FROM AUTHOR]

Swimming performances are multifactorial and primarily include anthropometric, hydrodynamic, bioenergetic and biomechanical factors whose contributions depend on age, gender, swimming distance and swimming stroke. An integrative and multivariate approach to swimming captures the complexity and various pathways of performance, but swimming technique is generally examined through such parameters as stroke index, propelling efficiency, stroke length and stroke rate. The first originality of our narrative review is to present the state of art of the methods to collect and measure inter-limb coordination in the four swimming techniques, with a particular focus on the effect of skill. The second part provides readers with an overview of the current findings on the main factors that influence inter-limb coordination (i.e., swimming speed, drag and the manipulation of stroke rate) following a physical approach. [ABSTRACT FROM AUTHOR]

Objectives: Transcranial direct current stimulation and robotic therapy (RT) are two modalities in neurorehabilitation for the improvement of upper limb function in stroke patients. However, the additional effects of the concurrent application of these two techniques compared to RT alone on upper limb function in stroke patients have not been studied yet. We analyzed the effectiveness of concurrent tDCS and RT compared to RT alone on upper limb motor function in stroke patients. Methods: A systematic search of PubMed, Scopus, Web of Science, CENTRAL, EMBASE, and Physiotherapy Evidence Database was performed from 2000 to January 1, 2021. The quality of the included studies was evaluated using the Cochrane risk-of-bias assessment tool. All statistical analyses were performed in STATA software, version 14, and the Mean±SD was used as the pooled statistics. Results: The result showed that concurrent tDCS and RT had moderate but non-significant pooled effect sizes for upper limb Fugl-Meyer assessment (SMD=0.31, 95% CI, -0.20%, 0.83%, I2=84.1%). Discussion: According to the results of this study, no difference was obtained in the efficacy of concurrent tDCS and RT compared to RT alone on upper limb function in stroke survivors. [ABSTRACT FROM AUTHOR]

Background: Currently, most pitching instructors suggest a shorter arm path—the total distance the arm travels during pitching. Theoretically, this combination allows for better body segment sequencing, a more efficient energy transfer through the kinetic chain, and increased ball velocity, while limiting elbow varus torque. Hypothesis: Shorter arm paths would be associated with increased ball velocity and decreased elbow varus torque. Study Design: Descriptive laboratory study. Methods: A total of 182 professional pitchers threw 8 to 12 fastball pitches while evaluated by 3-dimensional motion capture (480 Hz). The arm path was calculated as the total distance the hand marker traveled during the pitch. The pitch was divided into early, late, and total arm paths. A linear regression model assessed the interpitcher relationship between arm path, elbow varus torque, and ball velocity. A linear mixed-effects model with random intercepts assessed intrapitcher relationships. Results: Interpitcher comparison showed that total arm path weakly correlated with greater elbow varus torque (P =.025). Strong correlations were found between ball velocity and early (R 2 = 0.788; P <.001), late (R 2 = 0.787; P =.024), and total arm paths (R 2 = 0.792; P <.001). Strong positive intrapitcher correlations were found between elbow varus torque and early (R 2 = 0.962; P <.001) and total arm path (R 2 = 0.964; P <.001). For individual pitchers, there was a large variation in the early (30.1 ± 15.7 cm) and late (21.4 ± 12.1 cm) arm path. For every 30-cm (11.8-inch) increase in early arm path (the mean range for an individual pitcher), there was a 1.29-N (β = 0.0429) increase in elbow varus torque and a 0.354 m/s (0.79 mph) (β = 0.0118) increase in ball velocity. Conclusion: A shorter arm path correlated with decreased elbow varus torque and decreased ball velocity in intrapitcher comparisons. Determining the individual mechanics that decrease elbow varus torque may help coaches and trainers correct these patterns. Clinical Significance: A shorter arm path during the pitch can decrease elbow varus torque, which limits the load on the medial elbow but also has a detrimental effect on ball velocity. An improved understanding of the impact of shortening arm paths on stresses on the throwing arm may help minimize injury risk. [ABSTRACT FROM AUTHOR]

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors. This prospective pragmatic, knowledge translation study involves four new specialist therapy centers to deliver best-evidence upper-limb sensory rehabilitation (known as SENSe therapy) for survivors of stroke in the community. A knowledge-transfer intervention will be used to upskill therapists and guide implementation. Specialist centers will deliver SENSe therapy, an effective and recommended therapy, to stroke survivors in the community. Outcomes include number of successful deliveries of SENSe therapy by credentialled therapists; improved somatosensory function for stroke survivors; improved performance in self-selected activities, arm use, and quality of life; treatment fidelity and confidence to deliver therapy; and for future implementation, expert therapist effect and cost-effectiveness. In summary, we will determine the effect of a national partnership to increase access to evidence-based upper-limb sensory rehabilitation following stroke. If effective, this knowledge-transfer intervention could be used to optimize the delivery of other complex, evidence-based rehabilitation interventions. [ABSTRACT FROM AUTHOR]

This study aims at evaluating upper limb muscle coordination and activation in workers performing an actual use-case manual material handling (MMH). The study relies on the comparison of the workers' muscular activity while they perform the task, with and without the help of a dual-arm cobot (BAZAR). Eleven participants performed the task and the flexors and extensors muscles of the shoulder, elbow, wrist, and trunk joints were recorded using bipolar electromyography. The results showed that, when the particular MMH was carried out with BAZAR, both upper limb and trunk muscular co-activation and activation were decreased. Therefore, technologies that enable human-robot collaboration (HRC), which share a workspace with employees, relieve employees of external loads and enhance the effectiveness and calibre of task completion. Additionally, these technologies improve the worker's coordination, lessen the physical effort required to interact with the robot, and have a favourable impact on his or her physiological motor strategy. Practitioner summary: Upper limb and trunk muscle co-activation and activation is reduced when a specific manual material handling was performed with a cobot than without it. By improving coordination, reducing physical effort, and changing motor strategy, cobots could be proposed as an ergonomic intervention to lower workers' biomechanical risk in industry. [ABSTRACT FROM AUTHOR]

Copyright of Spor Hekimligi Dergisi/Turkish Journal of Sports Medicine is the property of Turkish Journal of Sports Medicine / Spor Hekimleri Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: With progressing technology in the portable computing field, laptops are now integral for work, home and social settings. Different working postures adopted by laptop users impose different loads on the relevant muscles, which can be associated with musculoskeletal discomfort in the various body regions. Some Arabic and Asian cultures adopted postures are not well investigated, particularly for the 20–30 years age-group. OBJECTIVE: This study compared muscle activity in the cervical spine, arm, and wrist among different laptop workstation setups. METHODS: In this cross-sectional study, 23 healthy female university students (age = 24.2±2.28 years, range 20–26 years) performed a standardized 10 minute typing task in four different laptop workstation setups: DESK, SOFA, GROUND sitting with back support, and laptop table (LAP-Tab). Differences between electromyography (EMG) muscle activity recorded in the trapezius (TR), cervical extensors (CE), deltoid (DEL), and wrist extensors (WE) were determined using one-way repeated ANOVA measures with a post-hoc Bonferroni test. RESULTS: Significantly higher muscle activity was observed respectively in the workstations of DESK > LAP-Tab > SOFA > GROUND. Significant differences were found between WE muscle activity and the three other muscle groups (p < 0.001). There was a significant interaction between workstations and muscle activity (F(9,264) = 3.81, p < 0.001, = 0.11), where the WE and DEL muscles showed respectively higher and lower muscle activity in all setups. CONCLUSION: Muscles showed variable activity in different workstations such that the GROUND workstation provided the minimum load, while the DESK workstation showed the maximum load on the measured muscle groups. These findings require further investigation in different cultural and gender specific groups. [ABSTRACT FROM AUTHOR]

Context: Fatigue of the scapular stabilizing muscles resulting from repeated arm motion has been reported to alter scapular kinematics, which could result in shoulder pathology, especially impingement. Objective: This study aimed to examine the effects of fatigue of the serratus anterior muscle on scapular kinematics, specifically, decrease scapular posterior tilt and upward scapular rotation during arm elevation. Design: Repeated measures. Setting: Laboratory. Participants: Thirty participants were included in the investigation. Interventions: Scapular kinematics and shoulder strength were measured before and immediately following a serratus anterior fatigue protocol. Main Outcome: Scapular 3-dimensional position during arm elevation. Results: No difference in upward rotation of the scapula between prefatigue and postfatigue conditions (ascending: P =.188; descending: P =.798). Scapular posterior tilt decreased during arm elevation following the fatigue protocol between 60° and 90° and 90° and 120° of arm elevation during the ascent (P =.004) and the descent (P =.013). Fatigue by arm elevation angle interaction was found for clavicular elevation during the ascent (P =.050) between 90° and 120° of arm elevation. Scapular internal rotation increased during the ascent (P =.027). There was no difference in clavicular protraction between the prefatigue and postfatigue conditions (ascending: P ≤.001; descending: P ≤.001). Conclusion: Fatigue of the serratus anterior decreases posterior scapular tilt and greater clavicular elevation and scapular internal rotation at higher arm elevation angles. These findings are consistent with the scapular kinematic patterns associated with shoulder pain. Improving serratus anterior endurance might delay the changes in scapular kinematics associated with repeated arm motion and shoulder injury mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: Repetitive and asymmetric movements in tennis can result in biomechanical adaptation in shoulder joint. The aim of this study was to investigate the differences in shoulder range of motion (ROM), strength, and functional performance tests between the dominant and nondominant shoulders, as well as to identify gender differences in junior tennis players. Methods: Forty-two junior tennis players (age mean: 11.3 [1.2] y, body mass index 18.3 [2.4] kg/m2) were included in the study. Shoulder internal rotation (IR), external rotation (ER) ROM, and total ROM, IR and ER isokinetic strength and closed kinetic chain upper-extremity stability, seated medicine ball throw used, grip hold tests were applied bilaterally. Paired sample t test and Student t test were used to compare the differences. Results: ER ROM was greater, while IR ROM and total ROM were lower on the dominant shoulder (all P values <.05). Nineteen players had glenohumeral IR deficit (IR ROM difference >13°). The players had a greater ER strength on the dominant side and similar IR strength between shoulders. There was significant difference in seated medicine ball throw results between the dominant and nondominant sides (P <.001). The mean distance for bilateral seated medicine ball throw was 377.02 (85.70) m, and closed kinetic chain upper-extremity stability results were calculated as a mean of 15.85 (1.72) touches. Differences between the genders: total ROM of the dominant shoulder was higher in female players (P =.045), the IR PT/BW at 60°/s angular speed was higher in male players' dominant shoulder (P =.030), and closed kinetic chain upper-extremity stability performance was higher in male players (P =.019). Conclusions: Adolescent tennis players demonstrated differences in strength, ROM, and functional performance results between the dominant and nondominant shoulders. Gender differences were also seen in the aforementioned parameters in junior tennis players. Determining these differences may improve our understanding of sport-specific shoulder joint adaptations in tennis. [ABSTRACT FROM AUTHOR]

Context: Maximal power describes the ability to immediately produce power with the maximal velocity at the point of release, impact, and/or take off—the greater an athlete's ability to produce maximal power, the greater the improvement of athletic performance. In reference to boxing performance, regular consistent production of high muscular power during punching is considered an essential prerequisite. Despite the importance of upper limb power to athletic performance, presently, there is no gold standard test for upper limb force development performance. Objective: To investigate the test–retest reliability of the force plate–derived measures of countermovement push-up in elite boxers. Design: Test–retest design. Setting: High Performance Olympic Training Center. Participants: Eighteen elite Olympic boxers (age = 23 [3] y; height = 1.68 [0.39] m; body mass = 70.0 [17] kg). Intervention: Participants performed 5 repetitions of countermovement push-up trials on FD4000 Forcedeck dual force platforms on 2 separate test occasions 7 days apart. Main Outcome Measures: Peak force, mean force, flight time, rate of force development, impulse, and vertical stiffness of the bilateral and unilateral limbs from the force–time curve. Results: No significant differences between the 2 trial occasions for any of the derived bilateral or unilateral performance measures. Intraclass correlation coefficients indicated moderate to high reliability for performance parameters (intraclass correlation coefficients =.68–.98) and low coefficient of variation (3%–10%) apart from vertical stiffness (coefficient of variation = 16.5%–25%). Mean force demonstrated the greatest reliability (coefficient of variation = 3%). In contrast, no significant differences (P <.001) were noted between left and right limbs (P =.005–.791), or between orthodox or southpaw boxing styles (P =.19–.95). Conclusion: Force platform–derived kinetic bilateral and unilateral parameters of countermovement push-up are reliable measures of upper limb power performance in elite-level boxers; results suggest unilateral differences within the bilateral condition are not the norm for an elite boxing cohort. [ABSTRACT FROM AUTHOR]

Context: Sport-related concussion (SRC) elevates risk for subsequent injury, which may relate to impaired perceptual-motor processes that are potentially modifiable. Objective: To assess a possible upper-extremity (UE) training effect on whole-body (WB) reactive agility performance among elite athletes with history of SRC (HxSRC) and without such history of SRC. Design: Cohort study. Setting: Residential training center. Participants: Elite athletes (12 males and 8 females), including 10 HxSRC and 10 without such history of SRC. Intervention: One-minute training sessions completed 2 to 3 times per week over a 3-week period involved verbal identification of center arrow direction for 10 incongruent and 10 congruent flanker test trials with simultaneous reaching responses to deactivate illuminated buttons. Main Outcome Measures: Pretraining and posttraining assessments of UE and WB reactive responses included flanker test conflict effect (incongruent minus congruent reaction time) and WB lateral average asymmetry derived from reaction time, speed, acceleration, and deceleration in opposite directions. Discrimination was assessed by receiver operating characteristic analysis, and training effect was assessed by repeated-measures analysis of variance. Results: Pretraining discrimination between HxSRC and without such history of SRC was greatest for conflict effect ≥80 milliseconds and WB lateral average asymmetry ≥18%. Each athlete completed 6 training sessions, which improved UE mean reaction time from 767 to 646 milliseconds (P <.001) and reduced mean conflict effect from 96 to 53 milliseconds (P =.039). A significant group × trial interaction was evident for WB lateral average asymmetry (P =.004), which was reduced from 24.3% to 12.5% among those with HxSRC. Conclusions: Suboptimal perceptual-motor performance may represent a subtle long-term effect of concussion that is modifiable through UE training, which appears to improve WB reactive capabilities. [ABSTRACT FROM AUTHOR]

Context: Fast visuomotor reaction time (VMRT), the time required to recognize and respond to sequentially appearing visual stimuli, allows an athlete to successfully respond to stimuli during sports participation, while slower VMRT has been associated with increased injury risk. Light-based systems are capable of measuring both upper- and lower-extremity VMRT; however, the reliability of these assessments are not known. Objective: To determine the reliability of an upper- and lower-extremity VMRT task using a light-based trainer system. Design: Reliability study. Setting: Laboratory. Patients (or Other Participants): Twenty participants with no history of injury in the last 12 months. Methods: Participants reported to the laboratory on 2 separate testing sessions separated by 1 week. For both tasks, participants were instructed to extinguish a random sequence of illuminated light-emitting diode disks, which appeared one at a time as quickly as possible. Participants were provided a series of practice trials before completing the test trials. VMRT was calculated as the time in seconds between target hits, where higher VMRT represented slower reaction time. Main Outcome Measures: Separate intraclass correlation coefficients (ICCs) with corresponding 95% confidence intervals (CIs) were calculated to determine test–retest reliability for each task. The SEM and minimal detectable change values were determined to examine clinical applicability. Results: The right limb lower-extremity reliability was excellent (ICC2,1 =.92; 95% CI,.81–.97). Both the left limb (ICC2,1 =.80; 95% CI,.56–.92) and upper-extremity task (ICC2,1 =.86; 95% CI,.65–.95) had good reliability. Conclusions: Both VMRT tasks had clinically acceptable reliability in a healthy, active population. Future research should explore further applications of these tests as an outcome measure following rehabilitation for health conditions with known VMRT deficits. [ABSTRACT FROM AUTHOR]

Objective: The wrist is the second most commonly involved location for GCTB, while distal ulna is a relatively rare location and limited evidence exists on which surgical approaches and reconstruction techniques are optimal. We carried out a multicenter retrospective study to evaluate the recurrence rate of distal ulna GCTB and the long-term functional outcomes of different surgery options. Methods: All 28 patients received surgical treatment for distal ulna GCTB in one of three tertiary bone tumor centers between May 2007 and January 2021 with a minimum two-year follow-up. Surgical options included intralesional curettage or en bloc resection (one of 3 types). Functional outcomes were assessed by the MSTS score, the QuickDASH instrument, MWS, and MHQ according to the latest treatment. Results: Overall recurrence rate was 14.2%. The curettage group (N = 7) had a significantly higher recurrence rate compared to en bloc resection (N = 21) (42.9% vs 4.8%) (mean follow-up: 88.8 mo). Seven patients received the Darrach procedure, 5 received the original Sauvé–Kapandji procedure, and 9 received the modified Sauvé–Kapandji procedure with extensor carpi ulnaris (ECU) tenodesis. Of the 4 patients having a recurrence, 1 received the Darrach EBR, 2 received the modified Sauvé–Kapandji procedure, and 1 received resection for soft tissue recurrence. Only MWS and esthetics in the MHQ scores were different (curettage, Darrach, Sauvé–Kapandji, and Sauvé–Kapandji with ECU tenodesis [MWS: 96.5 ± 1.3 vs 91.5 ± 4.7 vs 90.8 ± 2.8 vs 91.5 ± 3.6; esthetics in MHQ: 98.5 ± 3.1 vs 89.9 ± 4.7 vs 93.8 ± 4.4 vs 92.6 ± 3.8], respectively). Conclusions: En bloc resection for distal ulna GCTB had a significantly lower recurrence rate compared with curettage and achieved favorable functional outcome scores. Given the higher recurrence rate after curettage, patients should be well informed of the potential benefits and risks of selecting the distal radioulnar joint-preserving procedure. Moreover, reconstructions after tumor resection of the ulna head do not appear to be necessary. [ABSTRACT FROM AUTHOR]

Introduction: This pilot study employed a non-randomized control trial design to explore the impact of physical activity within a virtual reality (VR) environment on multisensory processing among community-dwelling older adults. Methods: The investigation compared both chronic (over 6 weeks) and acute effects of VR-based physical activity to a reading control group. The evaluation metrics for multisensory processing included audiovisual response time (RT), simultaneity judgments (SJ), sound-induced flash illusion (SIFI), and temporal order judgments (TOJ). A total of 13 older adults were provided with VR headsets featuring custom-designed games, while another 14 older adults were assigned to a reading-based control group. Results: Results indicated that acute engagement in physical activity led to higher accuracy in the SIFI task (experimental group: 85.6%; control group: 78.2%; p = 0.037). Additionally, both chronic and acute physical activity resulted in quicker response times (chronic: experimental group = 336.92; control group = 381.31; p = 0.012; acute: experimental group = 333.38; control group = 383.09; p = 0.006). Although the reading group showed a non-significant trend for greater improvement in mean RT, covariate analyses revealed that this discrepancy was due to the older age of the reading group. Discussion: The findings suggest that immersive VR has potential utility for enhancing multisensory processing in older adults. However, future studies must rigorously control for participant variables like age and sex to ensure more accurate comparisons between experimental and control conditions. [ABSTRACT FROM AUTHOR]

Purpose: For wheelchair users with a spinal cord injury, the lower body may be a more convenient cooling site than the upper body. However, it remains unknown if leg cooling reduces thermal strain in these individuals. We compared the impact of upper-body versus lower-body cooling on physiological and perceptual outcomes during submaximal arm-crank exercise under heat stress in individuals with paraplegia. Methods: Twelve male participants with paraplegia (T4-L2, 50% complete lesion) performed a maximal exercise test in temperate conditions, and three heat stress tests (32°C, 40% relative humidity) in which they received upper-body cooling (COOL-UB), lower-body cooling (COOL-LB), or no cooling (CON) in a randomized counterbalanced order. Each heat stress test consisted of four exercise blocks of 15 min at 50% of peak power output, with 3 min of rest in between. Cooling was applied using water-perfused pads, with 14.8-m tubing in both COOL-UB and COOL-LB. Results: Gastrointestinal temperature was 0.2°C (95% confidence interval (CI), 0.1°C to 0.3°C) lower during exercise in COOL-UB versus CON (37.5°C ± 0.4°C vs 37.7°C ± 0.3°C, P = 0.009), with no difference between COOL-LB and CON (P = 1.0). Heart rate was lower in both COOL-UB (-7 bpm; 95% CI, -11 to -3 bpm; P = 0.01) and COOL-LB (-5 bpm; 95% CI, -9 to -1 bpm; P = 0.049) compared with CON. The skin temperature reduction at the cooled skin sites was larger in COOL-LB (-10.8°C ± 1.1°C) than in COOL-UB (-6.7°C ± 1.4°C, P < 0.001), which limited the cooling capacity in COOL-LB. Thermal sensation of the cooled skin sites was improved and overall thermal discomfort was lower in COOL-UB (P = 0.01 and P = 0.04) but not in COOL-LB (P = 0.17 and P = 0.59) compared with CON. Conclusions: Upper-body cooling more effectively reduced thermal strain than lower-body cooling in individuals with paraplegia, as it induced greater thermophysiological and perceptual benefits. [ABSTRACT FROM AUTHOR]

Background: Persons with tetraplegia rank improved upper extremity (UE) function as the most important rehabilitation outcome because it allows them greater independence in activities of daily living (ADL). The aim of this study was to describe UE status in patients with tetraplegia using the International Spinal Cord Injury Upper Extremity Basic Data Set version 1.1 (ISCI-UE 1.1) and to determine differences in UE status between tetraplegic individuals with traumatic and non-traumatic SCIs. Methods: This cross-sectional study was conducted among patients with tetraplegia who attended the SCI rehabilitation clinic of a tertiary hospital from September 2021 to August 2022. Both upper limbs were assessed using ISCI-UE 1.1. Results: One hundred patients were included in this study, of whom 80 were men. The mean (SD) age of the patients was 54.30 (16.95) years old. In these patients, most SCIs (62%) were of traumatic origin. Two hundred UEs were evaluated, of which 109 showed good hand function (level 5) and 10 had the poorest hand function (level 1). Meanwhile, 130 UEs showed good shoulder function (level D) and 10 had the poorest shoulder function (level A). A statistically significant association with UE status (reach-and-grasp ability and shoulder function) was found in both the non-traumatic and traumatic SCI groups, with better hand and shoulder functions in the non-traumatic SCI group (right-hand, P = 0.004 and left hand, P = 0.001; right shoulder, P < 0.001 and left shoulder, P = 0.002). Conclusion: ISCI-UE 1.1 is a feasible tool for documenting UE function in patients with tetraplegia. Compared with the individuals with traumatic SCI in this study, those with non-traumatic SCI demonstrated better upper extremity functionality. [ABSTRACT FROM AUTHOR]

The initial stride down the mound is an important aspect of the baseball pitch. Understanding the implications of stride length is essential to appropriately coach baseball pitchers. The purpose of this study was to determine the association between normalised stride length and the elbow varus and glenohumeral internal rotation moments, ball velocity, trunk and pelvic rotation and forward trunk tilt. Motion analysis data collected from 99 collegiate pitchers were analysed for this study. A random intercept, mixed-effects regression model was used to determine if there were statistically significant associations between normalised stride length and the variables of interest. Secondary analyses were conducted to determine if an optimal stride length existed in this cohort. No significant associations were found between normalised stride length, ball velocity, or upper extremity joint moments. Additionally, no optimal stride length was identified; however, trends indicate that stride lengths between 131%–137% of a pitcher's leg length may be beneficial. Normalised stride length was associated with both trunk and pelvic rotation at foot contact (p < 0.001). Trunk and pelvic rotation has been previously shown to be associated with ball velocity and joint moments, indicating that stride length may have an indirect effect on ball velocity and joint moments. [ABSTRACT FROM AUTHOR]

To develop a self-report measure of activity performance for upper limb prosthesis users that quantifies outcomes by level of amputation and prosthesis type. Telephone survey of 423 adults with major upper limb amputation (ULA) who used a prosthesis. Item generation, cognitive, and pilot testing were followed by field testing. Items were categorized as one- or two-handed. Factor and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning (DIF), and reliability. Test–retest reliability was evaluated with intraclass correlation coefficients (ICCs). Known group validity was assessed with ANOVAs. Respondents with unilateral ULA utilized prosthesis for 24% of unilateral and 38% of bilateral tasks. Those with bilateral ULA utilized prostheses for 64% of unilateral and 46% of bilateral tasks. Factor analyses identified a One-handed Task factor (CFI = 0.963, TLI = 0.950, and RMSEA = 0.064) and a Two-Handed Task factor (CFI = 0.958, TLI = 0.953, and RMSEA = 0.053). Response categories were collapsed to address monotonicity. After DIF adjustment, person reliability was 0.49 and 0.82 for One-handed and Two-handed Task scales, respectively, and ICCs were 0.88 and 0.91. Both scales differed by amputation level (p < 0.001). The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) measure of upper limb function of prosthesis users has promising psychometric properties. Measurement of upper limb function in persons with amputation is challenging, given currently available measures which do not explicitly grade activity performance with a prosthesis. The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) builds upon the original Orthotics and Prosthetics User Survey (OPUS) UEFS Scale with modified instructions, a revised item set, response categories and scoring algorithm. The UEFS-P consists of two unidimensional scales, the One-handed Tasks scale and the Two-handed Tasks scale. The UEFS-P scales have clear advantages over existing self-report measures of upper limb function that ask about difficulty with performing functional activities without accounting for prosthesis use, and do not differentiate persons who use and do not use a prosthesis. [ABSTRACT FROM AUTHOR]

Background: Previous studies identified physical function limitations in older cancer survivors, but few have included objective measures and most focused on breast and prostate cancer survivors. The current study compared patient‐reported and objective physical function measures between older adults with and without a cancer history. Methods: Our cross‐sectional study used a nationally representative sample of community‐dwelling, Medicare beneficiaries from the 2015 National Health and Aging Trends Study (n = 7495). Data collected included patient‐reported physical function, including a composite physical capacity score and limitations in strength, mobility, and balance, and objectively measured physical performance metrics, including gait speed, five time sit‐to‐stand, tandem stand, and grip strength. All analyses were weighted to account for the complex sampling design. Results: Thirteen percent of participants (n = 829) reported a history of cancer, of which more than half (51%) reported a diagnosis other than breast or prostate cancer. In models adjusted for demographics and health history, older cancer survivors had lower Short Physical Performance Battery scores (unstandardized beta [B] = −0.36; 95% CI: −0.64, −0.08), slower gait speed (B = −0.03; 95% CI: −0.05, −0.01), reduced grip strength (B = −0.86; 95% CI: −1.44, −0.27), worse patient‐reported composite physical capacity (B = −0.43; 95% CI: −0.67, −0.18) and patient‐reported upper extremity strength (B = 1.27; 95% CI: 1.07, 1.50) compared to older adults without cancer. Additionally, the burden of physical function limitations was greater in women than in men, which may be explained by cancer type. Conclusions: Our results extend studies in breast and prostate cancer to show worse objective and patient‐reported physical function outcomes in older adults with a range of cancer types compared to those without a cancer history. Moreover, these burdens seem to disproportionately affect older adult women, underscoring the need for interventions to address functional limitations and prevent further health consequences of cancer and its treatment. [ABSTRACT FROM AUTHOR]

Harrison, PW, Kelly, VG, Jenkins, DG, McGuigan, MR, Holmberg, PM, and James, LP. Does moderate-load priming activity influence maximal upper-body performance and perceptual state?. J Strength Cond Res 37(11): e581-e587, 2023--The results of previous research indicate that resistance exercise "priming" may improve strength-power measures within 48 hours after their completion. Although researchers have primarily examined performance responses after lower-body priming stimuli, investigations examining the effects of upper-body resistance priming exercises are presently limited. Therefore, the aim of this study was to examine upper-body pushing and pulling performance in addition to perceptual responses 3 and 27 hours after moderate-load (ML) upper-body resistance priming exercise. Fourteen resistance-trained men were assigned to complete ML priming (4 3 3 bench press and bench pull at 65% 1RM [repetition maximum]) and control (rest) protocols in a randomized and counterbalanced order. Peak velocity during the bench throw and bench pull tests involving different loads (25, 50, and 75% 1RM) showed no practical change at 3 and 27 hours after the priming session (p 5 0.216-0.99, Cliff's d520.041 to 0.225). Small effect size increases in perceptual measures ("physical feeling," "physical performance," "aggression" [p 5 0.400-0.553, Cliff's d 5 0.183-0.201], and "muscular heaviness" [p 5 0.178, Cliff's d 5 0.231]) were found at 3 hours postpriming. A moderate practical increase was observed in perceived "physical feeling" compared with control (p 5 0.385, Cliff's d 5 0.349) in addition to small effect size increases in perceived "physical performance" and "aggression" (Cliff's d50.243-0.290) at 27 hours after priming activities. These results indicate that upper-body strength-power changes within 27 hours after ML upper-body resistance exercise priming are not practically meaningful. [ABSTRACT FROM AUTHOR]