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Copyright of Plastic Surgery is the property of Sage Publications Inc. 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.)

Human Pose Estimation (HPE) is a computer vision application that utilizes deep learning techniques to precisely locate Key Joint Points (KJPs), enabling the accurate description of a person's pose. HPE models can be extended to facilitate Range of Motion (ROM) assessment by leveraging patient photographs. This study aims to evaluate and compare the performance of HPE models for assessing upper limbs ROM. A physiotherapist evaluated the degrees of ROM in shoulders (flexion, extension, and abduction) and elbows (flexion and extension) for fifty-two participants using both Universal Goniometer (UG) and five HPE models. Participants were instructed to repeat each movement three times to obtain measurements with the UG, then positioned while photos were captured using the NLMeasurer mobile application. The paired t-test, bias, and error measures were employed to evaluate the difference and agreement between measurement methods. Results indicated that the MoveNet Thunder INT16 model exhibited superior performance. Root Mean Square Errors obtained through this model were <10° in 8 of 10 analyzed movements. HPE models demonstrated better performance in shoulder flexion and abduction movements while exhibiting unsatisfactory performance in elbow flexion. Challenges such as image perspective distortion, environmental lighting conditions, images in monocular view, and complications in the pose may influence the models' performance. Nevertheless, HPE models show promise in identifying KJPs and facilitating ROM measurements, potentially enhancing convenience and efficiency in assessments. However, their current accuracy for this application is unsatisfactory, highlighting the need for caution when considering automated upper limb ROM measurement with them. The implementation of these models in clinical practice does not diminish the crucial role of examiners in carefully inspecting images and making adjustments to ensure measurement reliability. [ABSTRACT FROM AUTHOR]

One of the practical applications in the field of soft robotics involves the development of soft robotic wearable devices. These devices make use of their intrinsically compliant structures to interact safely and harmoniously with the human body. While soft wearable robots demonstrate their utility in lower‐limb applications for locomotion, the upper‐limb domain offers significant prospects in a wide range of applications that soft robotic technology can address. In this review, the current state of technology in the field of soft wearable upper limbs is systematically analyzed and categorized. Categorizations are made based on their applications in rehabilitation, activities of daily living support, and human augmentation. Furthermore, in this study, also contemporary technological aspects, encompassing sensing technology and control systems, are explored. Despite exciting potential in this domain, several limitations from existing devices inherently impede widespread adoption and thus hinder further progress in the field. In this study, also an overview of the different facets of the domain is provided and key considerations for the advancement of soft wearable robotic devices intended for upper‐limb applications are prescribed. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica 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.)

Copyright of E-balonmano.com: Journal of Sports Science / Revista de Ciencias del Deporte is the property of Federacion Extremena de Balonmano 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.)

Motor impairment is a common issue in stroke patients, often affecting the upper limbs. To this standpoint, robotic neurorehabilitation has shown to be highly effective for motor function recovery. Notably, Machine learning (ML) may be a powerful technique able to identify the optimal kind and intensity of rehabilitation treatments to maximize the outcomes. This retrospective observational research aims to assess the efficacy of robotic devices in facilitating the functional rehabilitation of upper limbs in stroke patients through ML models. Specifically, clinical scales, such as the Fugl-Meyer Assessment (A-D) (FMA), the Frenchay Arm Test (FAT), and the Barthel Index (BI), were used to assess the patients' condition before and after robotic therapy. The values of these scales were predicted based on the patients' clinical and demographic data obtained before the treatment. The findings showed that ML models have high accuracy in predicting the FMA, FAT, and BI, with R-squared (R2) values of 0.79, 0.57, and 0.74, respectively. The findings of this study suggest that integrating ML into robotic therapy may have the capacity to establish a personalized and streamlined clinical practice, leading to significant improvements in patients' quality of life and the long-term sustainability of the healthcare system. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco 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.)

ABSTRACT Objective: The objective of this study was to report a case of bilateral ulnar longitudinal deficiency with oligodactyly in a male newborn. Case description: A full-term male newborn, born following an uncomplicated gestation with no abnormalities detected on prenatal ultrasounds, presented upper limb malformations described as shortening of the left forearm and absence of three digits bilaterally upon neonatal physical examination. Diagnostic investigations including X-rays, abdominal ultrasound, head ultrasound, echocardiogram, and karyotype analysis were conducted, facilitating detailed identification of the malformations and exclusion of other anomalies, thereby suggesting the diagnosis of congenital longitudinal deficiency of the ulna. Discharge planning encompassed supportive care and rehabilitation as per the patient’s needs. Comments: Ulnar longitudinal deficiency is a rare congenital upper limb malformation, whose estimated incidence is 1:100,000 newborns. It is believed to be related to the Sonic Hedgehog gene, and the upper limb anomalies vary according to the ulnar involvement. The early diagnosis is not routine, being more common at the first physical examination with the aid of imaging tests.

BACKGROUND: Assistive technology is often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force to the joints of users with muscle weakness. Actuated devices allow dynamic movement compared to splints, therefore improving the ability to complete activities of daily living. However, these devices are not often prescribed and are underrepresented in research and clinical settings. OBJECTIVE: This review examines the current body of literature concerning devices designed to aid the hands and wrists in daily activities. Focusing on active, powered, and actuated devices, to gain a clearer understanding of the current limitations in their design and prescription. METHODOLOGY: The scoping review was conducted using the PRISMA-ScR guidelines. A systematic search was done on MEDLINE, EMBASE, Scopus, Web of Science, and NHS the Knowledge Network from inception to May 2023. Articles were included if the device was portable; supported the hands and wrist actively using an actuator; and could be used for assistive living during or post-rehabilitation period. FINDINGS: A total of 135 studies were included in the analysis of which 34 were clinical trials. The design and control methods of 121 devices were analyzed. Electrical stimulation and direct mechanical transmission were popular actuation methods. Electromyography (EMG) and joint movement detection were highly used control methods to translate user intentions to device actuation. A total of 226 validation methods were reported, of which 44% were clinically validated. Studies were often not conducted in operational environments with 69% at technology readiness levels ≤ 6, indicating that further development and testing is required. CONCLUSION: The existing literature on hand and wrist exoskeletons presents large variations in validation methods and technical requirements for user-specific characteristics. This suggests a need for well-defined testing protocols and refined reporting of device designs. This would improve the significance of clinical outcomes and new assistive technology. Layman's Abstract Assistive devices are often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force for users with muscle weakness. Unlike splints, these devices do not constrict movement, therefore improving the ability to complete activities of daily living. However, these devices are rarely prescribed or presented in research and clinical settings. This review examines the current literature concerning powered devices that aid the hands and wrists to investigate who uses them, how they are designed and how they are validated. The scoping review was conducted using a validated guideline. A systematic search was done on 5 databases up to May 2023. Articles were included if the device was portable; supported the hands and wrist using motors; and could be used for everyday tasks. A total of 135 studies were included in the analysis, of which 34 were clinical trials. The design and method of device function of 121 devices were analysed. Muscle and joint movement detection were highly used to control device movement. A total of 226 validation methods were reported, of which 44% were clinically validated. Studies were often conducted in research and clinical environments (69%) rather than at home settings. In conclusion, existing literature on hand and wrist exoskeletons presents large variations in design, control methods and validation practices. This suggests a need for well-defined testing protocols. This would improve the significance of clinical outcomes of new assistive technology. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/43827/33279 How To Cite: Galbert A, Buis A. Active, actuated, and assistive: A scoping review of exoskeletons for the hands and wrists. Canadian Prosthetics & Orthotics Journal. 2024; Volume 7, Issue 1, No.9. https://doi.org/10.33137/cpoj.v7i1.43827 Corresponding Author: Professor Arjan Buis, PhD Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, Scotland. E-Mail: arjan.buis@strath.ac.uk ORCID ID: https://orcid.org/0000-0003-3947-293X

Objective This research aims to investigate the issues arising from prolonged usage of modern electronic technologies by reviewing relevant literature. Specifically, we examine the impact of mobile phones, tablets, and computers on postural control and skeletal abnormalities among children. Methods Articles were selected based on the research objective by conducting a thorough review of specialized biomechanics databases and considering input and output indicators. Results The investigation revealed that modern electronic technologies, particularly among children aged 6 to 11 years, can contribute to various skeletal and muscular abnormalities in the upper limbs (e.g., rounded shoulders). Body postures adopted while using these technologies (e.g., sitting, lying down), as well as the use of one-handed versus two-handed postures, significantly affect pressure distribution and muscle and skeletal health. Other notable issues include vision problems, adaptability challenges during childhood, and psychological and social implications. Conclusion The review of studies underscores the potential adverse effects of prolonged usage of modern electronic technologies, particularly among elementary school children. With the rise of virtual education in recent years, these technologies have become increasingly prevalent and may contribute to significant limb abnormalities and associated problems. Vision impairments due to prolonged screen time, as well as psychological, social, and adaptational challenges, add further pressure on children.

Background: Spasticity is a motor disorder characterised by exaggerated movements of the tendons and accompanied by hyperreflexia and hypertonia. Extracorporeal shock wave therapy (ESWT) is used as a treatment for spasticity, although more evidence is needed on the effectiveness of this therapy in the treatment of spasticity. Therefore, the aim of this study was to assess the effectiveness ESWT in the treatment of upper and lower limbs spasticity in both children and adults through different aetiologies. Methods: A systematic search was performed in different databases from inception to December 2023. Random-effects meta-analysis was used to estimate the efficacy of ESWT on spasticity using the Modified Ashworth Scale. Results: Sixteen studies were included in the systematic review and meta-analysis. The effect of ESWT on spasticity measured with the Modified Ashworth Scale shows a significant decrease in spasticity in the upper limbs and in the lower limbs in adults with chronic stroke and in children with cerebral palsy, is more effective immediately after application, and maintains its effect up to 12 weeks post treatment. Conclusions: These findings are important for clinical practice since they show evidence that ESWT is effective in reducing spasticity in both children and adults. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal disorders (MSDs) have a multifactorial nature. Biomechanical factors are one of the most important factors. Consequently, the precise identification of effective factors plays a significant role in controlling and preventing these disorders. Therefore, the current study aimed to identify the awkward upper body postures and their effect on the prevalence of MSDs in office workers in both women and men groups by objective methods. Material and Methods: In this cross-sectional study, the participants were 36 office workers (18 women and 18 men). The prevalence of musculoskeletal discomfort was evaluated using the Nordic questionnaire. The upper limbs posture, including the back, neck, and wrists, was evaluated continuously with an electronic inclinometer and an electrogoniometer for 30 min, followed by analyzing the collected data. Results: The results revealed that the highest prevalence of musculoskeletal symptoms in both gender groups was in the neck (58.33%), trunk (52.77%), and wrist (47.22%), respectively. The results disclosed that the median trunk and neck flexion in both groups is over 20° and the posture angle in women is higher than that of men (P

An 80-year-old woman affected by rheumatoid arthritis on immunosuppressive therapy was evaluated for an 11-month history of swelling of her left upper limb. The patient did not report systemic symptoms. Ultrasonographic examination showed hypoechoic masses in the upper limb soft tissue, brachial vein thrombosis, and suspected malignant axillary lymphadenopathy. The patient underwent an excisional biopsy of the lymphadenopathy for histologic examination; a diagnosis of diffuse large B-cell lymphoma was made. The patient started anticoagulation therapy and chemotherapy, with a follow-up at a hematology clinic. At a 3-month follow-up visit in our clinic, the swelling of her left upper limb decreased, and an ultrasonographic control demonstrated a reduction in the size and number of the soft tissue masses and resolution of vein thrombosis.

Infantile myofibromatosis (IM) is a mesenchymal tumor that may present in infants in a couple of major forms: solitary (myofibroma) and multicentric (myofibromatosis) which can be more subdivided into IM without or with visceral involvement. The tumors present as nodular lesions in the soft tissues, bones, and/or internal organs. Although the success of imaging in suggesting the correct diagnosis can't be denied, histopathology and Immunohistochemical examinations are necessary to confirm the diagnosis of IM as it might be misdiagnosed as a malignant tumor. We report a case of solitary infantile myofibromatosis in the upper extremities discovered in a 9-year-old girl. She had swelling and an enlargement on the posterior forearm on the ulnar side. The X-ray showed a lytic lesion with swollen soft tissue. The patient underwent an MRI which suggested the diagnosis of myofibroma. Then, solitary myofibroma was confirmed histologically. Infancy's most prevalent fibrous tumor is IM. Its prognosis depends on the visceral involvement. Imaging, especially MRI is the ideal tool to diagnose it.

This present work is aimed at conducting fundamental and exploratory studies of the mechanisms of electrical impedance signal formation. This paper also considers morphofunctional changes in forearm tissues during the performance of basic hand actions. For this purpose, the existing research benches were modernized to conduct experiments of mapping forearm muscle activity by electrode systems on the basis of complexing the electrical impedance signals and electromyography signals and recording electrode systems' pressing force using force transducers. Studies were carried out with the involvement of healthy volunteers in the implementation of vertical movement of the electrode system and ultrasound transducer when the subject's upper limb was positioned in the bed of the stand while performing basic hand actions in order to identify the relationship between the morphofunctional activity of the upper limb muscles and the recorded parameters of the electro-impedance myography signal. On the basis of the results of the studies, including complex measurements of neuromuscular activity on healthy volunteers such as the signals of electro-impedance myography and pressing force, analyses of the morphofunctional changes in tissues during action performance on the basis of ultrasound and MRI studies and the factors influencing the recorded signals of electro-impedance myography are described. The results are of fundamental importance and will enable reproducible electro-impedance myography signals, which, in turn, allow improved anthropomorphic control. [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]

Background: Shoulder injuries are substantial problems in overhead athletes, and more studies are necessary to deepen the knowledge on this type of injury. The objective of this study was to compare the overall function and performance of female overhead athletes with and without a previous history of shoulder injuries. Methods: In this cross-sectional study, female overhead athletes with and without a previous shoulder injury were included. Muscular impairment, the stability of the shoulder, strength, scapular dyskinesia, functionality and sports performance were evaluated. A total of 50 females were included. Results: There were significant differences in strength (p = 0.046) and stability (p = 0.039) between groups, with a poorer score in the group with a history of shoulder injury. Regarding scapular dyskinesia, significant differences were also observed between groups (p = 0.048), with higher levels of dyskinesia in the group with previous shoulder injury. Also, muscular impairment showed significant differences between groups for the three muscles evaluated (p < 0.005). Additionally, the group without a previous shoulder injury presented with a significantly greater score in functionality (p = 0.046) and sports performance (p = 0.004). Conclusion: In conclusion, previous shoulder injuries are an important factor to take into account in female overhead athletes. Players with a history of shoulder injury present clinical impairments during the game, leading to poorer functional status and performance in sport. [ABSTRACT FROM AUTHOR]

The correction of the biomechanics of human movements is an extremely important activity both for the civilian environment (in which we include: domestic, lucrative activities and those related to sports training) and for the military, as this allows the optimization of neuromuscular control and also the increase of the efficacy of physical and mental resources allocation, in humans. This fact leads to a reduction of the injury risks, to the correction of certain anatomical-functional deficiencies/limitations and last but not least, it allows the improvement of the individual's quality of life. The non-invasive character of certain biomechanical analyses gives them a privileged status because the degree of intrusion and discomfort endured by the human subject subjected to the analysis is minimal, a fact that allows a better interaction with him in terms of he's availability of physical and mental involvement. From the category of these non-invasive systems for biomechanical analysis of motion, as well as of posture, the most used (due to their facilities) are video and inertial ones. They allow qualitative/quantitative evaluations of posture (static determinations) and/or human motion (dynamic determinations). [ABSTRACT FROM AUTHOR]

Purpose: To compare the force-production capacities among boulderers, lead climbers, and speed climbers during a pull-up test using a force–velocity–power profile. Methods: In total, 24 high-elite climbers (11 boulderers, 8 lead climbers, and 5 speed climbers) did 2 pull-ups at different percentages of their body mass (0%, 30%, 45%, 60%, and 70%). Force–velocity–power profile analyses were performed with the use of an accelerometer for each load. The intraclass correlation and coefficients of variation were calculated. A 1-way analysis of variance was performed with a Tukey post hoc test to assess the difference between the groups. Results: Regarding force, the coefficient of variation ranged from 1.00% to 6.18% and the intraclass correlation ranged from.98 to.99. For velocity, the coefficient of variation ranged from 2.75% to 6.62% and the intraclass correlation ranged from.84 to.95. The linear regression slope showed R2 to be between.93 and.99, confirming the high quality of the linear relationship between velocity and the external force produced during a pull-up. Boulderers presented significantly higher (P <.05) maximal power (+22.30% and +26.29%), mean power for the pull-up at body weight (+23.49% and +25.35%), and theoretical maximal velocity at zero force (+23.92% and +21.53%) than lead and speed climbers and a more significant curve increase (+35.21% compared with lead climbers). Conclusions: The reliability of the method was shown to be high. Moreover, boulderers were able to develop an important external force and had the capacity to maintain high speed when force production increased. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the effects of arm movements on postural control when standing under different sensory conditions in healthy young and older adults. Fifteen young (mean ± SD age; 21.3 ± 4.2 years) and 15 older (mean ± SD age; 73.3 ± 5.0 years) adults completed the modified Romberg test, which uses four task manipulations (i.e. eyes open and eyes closed on a firm and foam surface) to compromise the fidelity of sensory feedback mechanisms. Each participant completed the tasks under two arm movement conditions: restricted and free arm movements. Centre of pressure (COP) range and frequency were calculated to characterise postural performance and strategy, respectively. Older adults showed greater COP range with restricted compared to free arm movements during all modified sensory conditions, with these effects most prominent in the medio-lateral (ML) plane (all p

In recent years, wearable systems based on inertial sensors opened new perspectives for functional motor assessment with respect to the gold standard motion capture systems. The aim of this study was to validate an experimental set-up based on 17 body-worn inertial sensors (Awinda, Xsens, The Netherlands), addressing specific body segments with respect to the state-of-the art system (VICON, Oxford Metrics Ltd., Oxford, UK) to assess upper limb kinematics in obese, with respect to healthy subjects. Twenty-three obese and thirty healthy weight individuals were simultaneously acquainted with the two systems across a set of three tasks for upper limbs (i.e., frontal arm rise, lateral arm rise, and reaching). Root Mean Square error (RMSE) was computed to quantify the differences between the measurements provided by the systems in terms of range of motion (ROM), whilst their agreement was assessed via Pearson's correlation coefficient (PCC) and Bland–Altman (BA) plots. In addition, the signal waveforms were compared via one-dimensional statistical parametrical mapping (SPM) based on a paired t-test and a two-way ANOVA was applied on ROMs. The overall results partially confirmed the correlation and the agreement between the two systems, reporting only a moderate correlation for shoulder principal rotation angle in each task (r~0.40) and for elbow/flexion extension in obese subjects (r = 0.66), whilst no correlation was found for most non-principal rotation angles (r < 0.40). Across the performed tasks, an average RMSE of 34° and 26° was reported in obese and healthy controls, respectively. At the current state, the presence of bias limits the applicability of the inertial-based system in clinics; further research is intended in this context. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine influence of upper limbs on the ball throwing velocity. A total of 10 professional handball players (25.74±4.84 years) participated in this study. All of them were playing in the top Montenegrin professional handball league. The results obtained in this study shows that upper limbs have high influence on ball throwing velocity. This study provides normative data and performance standards for professional handball. Coaches can use this information to determine the type of anthropometric characteristics that are needed for handball. Anthropometric parameters such as arm length, wrist diameter, hand length and arm span are the most relevant aspects related to ball throwing speed, given that these parameters cannot be changed through training, they should be taken into account when discovering talents. [ABSTRACT FROM AUTHOR]

Given the widespread debate on the definition of the terms "Body Schema" and "Body Image", this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role. [ABSTRACT FROM AUTHOR]

Introduction: Wheelchair tennis (WT) players are prone to developing shoulder and upper-limb injuries due to the combination of wheelchair propulsion, overhead activities, and training loads. Despite these characteristics, little is known about possible associations between reported pain and injuries and the psychological health perceptions of experienced athletes. The objective of this study was to verify the existence of correlations between pain in the upper limbs (UL) with psychobiological aspects after the return to activity following the confinement period of the COVID-19 pandemic. Material and methods: 18 WT athletes (16 males and 2 females; age: 31.2 ± 10.4; weight: 65.8 ± 16.8; height: 160 ± 30; BMI: 29.6 ± 21.5) participated in the study. For data collection, five instruments were used: (1) the Disabilities of the Arm Shoulder and Hand questionnaire, (2) the Nordic Musculoskeletal Questionnaire, (3) the Athlete Burnout Questionnaire, (4) the Generalized Anxiety Disorder questionnaire and, (5) the Pittsburgh Sleep Quality Index. Data were analyzed by correlation and simple linear regressions. We adopted p < 0.05 as the significance threshold. Results: No significant correlations were found between pain in the upper limbs and psychobiological aspects. However, the dimension of physical and emotional exhaustion correlated with anxiety (R² = 0.257; p = 0.032) and devaluation in sport was associated with poor sleep quality (R² = 0.324; p = 0.014). Conclusions: Although there are no correlations between pain in the upper limbs and psychobiological strain, mental aspects influence each other. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica 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.)

This study aimed to analyze the time under tension (TUT) behavior in the bench press exercise performance in recreationally trained individuals. A systematic review was performed based on the PRISMA recommendations and registered on PROSPERO (CRD42022301830). MEDLINE (PubMed), Scopus, SPORTDiscus, and Lilacs (BVS) databases were consulted with the terms (resistance training [Title/ Abstract]) OR (strength training [Title/ Abstract]) AND (time under tension [Title/Abstract]). Cohort studies that analyzed the TUT in the bench press exercise in individuals with experience in resistance training were included. We used the Critical Appraisal Skills Program tool to analyze the methodological quality of the included studies. Thirteen studies met the inclusion criteria. The total number of participants was 215 individuals (179 men and 36 women). TUT was analyzed from the manipulation of each study variable. The behavior of the TUT in the bench press exercise varies according to the training protocol and method used. The TUT and the number of repetitions can vary to quantify the training volume [ABSTRACT FROM AUTHOR]

ObjectiveTo analyse the clinical features on sensory dysfunction of upper limbs of patients with unilateral stroke by sensory function assessment.MethodsA total of 122 patients with unilateral stroke treated in five hospitals (including Jing'an District Hospital of Huashan Hospital Affiliated to Fudan University, etc.) were divided into cerebral infarction group and cerebral hemorrhage group according to the type of stroke, and the sensory function of both groups was evaluated respectively. The sensory function assessment mainly included superficial sensations (pinprick, temperature and tactile sensation), deep sensations (position sensation, kinesthesia and vibration), and complex sensations (tactile localization, stereognosis and two-point discrimination).Results(1) The distribution of different types of sensory impairment: the most common sensory impairments in patients with unila-teral stroke were the combination of superficial sensation impairments, deep sensation impairments, and complex sensations impairments (58.20%); the incidence of tactile sensation impairment was the highest (83.61%). (2) Types of sensory dysfunction: compared with the cerebral infarction group, the incidence of different types of sensory dysfunction was lower in the cerebral hemorrhage group, and some patients in the cerebral infarction group had no sensory impairment. There were statistically significant differences in the types of sensory dysfunction between the two groups (P

BackgroundAny form of physical activity is recommended for the older adults to maintain their physical function; however, the effect of daily activities on muscle function still needs to be investigated. Humans always use one dominant hand to perform tasks, providing a natural situation for research on the effect of daily activities on muscle function.MethodsFive hundred and twenty-six healthy adults were recruited from the community in Beijing. Muscle strength was assessed using a handgrip dynamometer, lean mass, fat mass, bone area and bone mineral content of upper limbs were assessed using dual-energy X ray-absorptiometry. The results were compared between the dominant and non-dominant upper limbs.ResultsThe dominant upper limb had better muscle strength, lean mass, bone area and bone mineral content than the non-dominant side. The difference in muscle strength and lean mass between the two upper limbs decreased with the advanced age. In older age, fat mass of upper limbs increased in men, but not in women.ConclusionDaily activities can maintain better muscle function in the dominant upper limb than in the non-dominant side; however, the delaying effect on age-related decline in muscle function was limited.

Introduction: Interlimb asymmetry of strength and/or motor coordination could limit the performance of wheelchair athletes or increase their risk of injury. Studies of interlimb asymmetry in the lower limbs have shown high between‐subject variability that does not depend on the side of dominance and that does not change with fatigue. Upper limb asymmetry is particularly large in manual wheelchair athletes with a lower degree of impairment. The aim of this study was to evaluate interlimb asymmetry of forces developed during an upper limb Wingate anaerobic test, the effects of fatigue on force, and differences between high‐ and low‐point players. Method: Twenty‐five wheelchair basketball players (13 females and 12 males) of male and female national French teams performed a 30s anaerobic Wingate test on an arm ergometer. Participants were classified into two functional categories, high‐point (classed from 3 to 4.5) and low‐point (classed from 1 to 2.5), according to the International Wheelchair Basketball Federation classification. Left and right arm forces were measured during the pushing and pulling phases at peak power, 10s, and the end of the 30s test. Results: Upper limb asymmetry changed with fatigue during each phase. Force asymmetry differed between peak power, 10s and 30s, with no consistent increase or decrease. Asymmetry did not differ significantly between low‐ and high‐point players but tended to be greater in high‐point players. Asymmetry tended to be greater in the females, with significant differences between the males and females in the push phase. Conclusion: Inter‐subject variability was high, but forces were asymmetric for most participants, especially females. The Wingate anaerobic test could highlight problematic asymmetries that might impact daily life or sports performance. [ABSTRACT FROM AUTHOR]

Parkinson’s Disease (PD) is among the most frequent neurological disorders. Approaches that employ artificial intelligence and notably deep learning, have been extensively embraced with promising outcomes. This study dispenses an exhaustive review between 2016 and January 2023 on deep learning techniques used in the prognosis and evolution of symptoms and characteristics of the disease based on gait, upper limb movement, speech and facial expression-related information as well as the fusion of more than one of the aforementioned modalities. The search resulted in the selection of 87 original research publications, of which we have summarized the relevant information regarding the utilized learning and development process, demographic information, primary outcomes, and sensory equipment related information. Various deep learning algorithms and frameworks have attained state-of-the-art performance in many PD-related tasks by outperforming conventional machine learning approaches, according to the research reviewed. In the meanwhile, we identify significant drawbacks in the existing research, including a lack of data availability and interpretability of models. The fast advancements in deep learning and the rise in accessible data provide the opportunity to address these difficulties in the near future and for the broad application of this technology in clinical settings. [ABSTRACT FROM AUTHOR]

Recently, significant efforts have been made to develop prostheses, soft rehabilitation, and assistive devices that enhance the quality of life of limb amputees and the activities of daily living (ADL) of stroke patients. Therefore, this present study provides a general overview of the current prosthetic, assistive, and rehabilitative devices with a focus on actuators that provide actuation via shape-memory alloys (SMA). Shape-memory alloy (SMA)-based actuators are the subject of considerable research as they possess high force-to-weight ratio, quiet operation, muscular mobility, bio-compatibility, and accessible design options, all of which can potentially be used to develop inventive actuating systems. Several studies have examined the use of SMA-actuated devices in the medical and engineering industry. They have also, more recently, been used to develop soft robotic systems. This present review primarily focuses on the characterization, number, type of actuator, degrees of freedom (DOF), weight, cooling technique, control strategies, and applications as well as the advantages and disadvantages of plate, spring, and wire-based SMA actuators. Composite-based upper limb SMA actuators were also reviewed and compared in terms of the matrix, reinforcing materials, SMA configuration actuator dimensions, and manufacturing method as well as their advantages and disadvantages. The findings indicate that, in the last few years, more studies have examined developing novel intelligent materials with which to improve hand flexibility. Therefore, SMA materials have a promising future in the development of intelligent designs for hand-robots. They may also be used to improve control robustness as well as the accuracy of hand functions for ADL and effective rehabilitation.

Background: Upper limb (UL) muscle dysfunction is a common extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD). UL muscle dysfunction is associated with muscle weakness, dyspnea, and exercise intolerance. Although upper limb exercise training (ULET) is typically incorporated in pulmonary rehabilitation programs, its effects on UL muscle strength remains unclear. Objectives: The purpose of this systematic review was to investigate the effectiveness of ULET, in UL muscle strength of people with COPD. Design: This is systematic review and meta-analysis study. Data Sources and Methods: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols 2020 guidelines were used for this study. PubMed, Cochrane, CINAHL Plus and SPORTDiscus and clinicaltrials.gov registry were searched from inception to July 2022. Included studies were randomized controlled trials, assessing the effectiveness in muscle strength of ULET, compared with other types of upper or lower limb exercise or no exercise. The quality and risk of bias were assessed using the Physiotherapy Evidence Database (PEDro) scale and certainty of evidence with the Grading of Recommendations, Assessment, Development, and Evaluations approach. Treatment effects of ULET were calculated using standardized mean differences and 95% confidence intervals. Results: Twenty-four studies, with a total sample of 882 patients, were included. Most studies were of moderate quality and high risk of bias. Very low to low certainty evidence indicates a significant difference in UL muscle strength in favor of resistance ULET, compared with lower limb exercise alone or no exercise. No significant differences were found in different types of ULET comparisons. Conclusion: The results of this review showed that resistance ULET could improve UL muscle strength in people with COPD. Most studies, however, were of moderate quality and high risk of bias. Further studies with larger sample sizes, better methodological quality, and standardized training protocols are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Bilateral index for upper limbs was determined for maximal force, speed and power in 18 male handball players. Variables were individually assessed with a functional electromechanical dynamometer during unilateral and bilateral bench press push-off for 40%, 60%, and 75% of the maximal isometric force. Limb dominance (symmetry indices) and load effects in the bilateral index were analysed. Bilateral index showed a bilateral deficit for power (range = −8.50 to −41.48) and velocity (range = −11.15 to −38.41), that increases with the load (p < 0.05). For maximum force, a bilateral facilitation (range = 2.26–5.57), which did not vary significantly as a function of load, was observed. Symmetry indices showed no association with the bilateral index (40% load: r = 0.45, 60% load: r = 0.05, 75% load: r = 0.39). These results contribute to understanding the phenomenon; however, individual-to-individual observation reflects that caution should be kept when assessing an individual athlete. In conclusion, bilateral deficit or facilitation for bench press depends on the variable considered, whereas its magnitude depends on the load. Moreover, limb dominance does not affect it. This finding must be regarded as a general trend, but a different situation may occur during the assessment of a particular athlete. [ABSTRACT FROM AUTHOR]

Muscle synergies are extensively studied to understand how the neuromusculoskeletal system deals with abundance. The synergies represent covariant muscles that act as building blocks for movement production. Nevertheless, little is known on how those synergies evolve after training, learning, and expertise. To this aim, this study reports the influence of 4-wk upper limb submaximal training with arm cranking on novice participants' muscle synergies. Twelve participants performed eight sessions of submaximal training for 4 wk. One session consisted of two 30-s maximal power tests followed by six 2-min bouts at 30% of maximal recorded power. Cranking torque and electromyogram (EMG) of 11 representative muscles were recorded during the entire protocol. After EMG normalization, muscle synergies were extracted with nonnegative matrix factorization (NNMF). Similarity was computed with cross correlation and cosine similarities, and statistical evolution across training days was tested by repeated-measures ANOVA. Although maximal power increased across training days, neither torque management, EMG, nor muscle synergies (4 synergies) were significantly affected by submaximal training. Nevertheless, results suggest slight modifications of muscle synergies across days despite nonsignificant differences. Despite the strong complexity of the upper limb anatomy, our results showed that training did not induce significant changes in movement realization (mechanical and coordination level). A low-dimensional organization of covariant muscles (muscle synergies) is selected from the first day and maintained through the following training days, despite slight but nonsignificant modifications. This study supports the hypothesis that motor control for movement production could be simplified by using low-dimensional building blocks (muscle synergies). Such building blocks allow stability in movement execution and are slightly adjusted to fit movement requirements with training. [ABSTRACT FROM AUTHOR]

This present work is aimed at conducting fundamental and exploratory studies of the mechanisms of electrical impedance signal formation. This paper also considers morphofunctional changes in forearm tissues during the performance of basic hand actions. For this purpose, the existing research benches were modernized to conduct experiments of mapping forearm muscle activity by electrode systems on the basis of complexing the electrical impedance signals and electromyography signals and recording electrode systems’ pressing force using force transducers. Studies were carried out with the involvement of healthy volunteers in the implementation of vertical movement of the electrode system and ultrasound transducer when the subject’s upper limb was positioned in the bed of the stand while performing basic hand actions in order to identify the relationship between the morphofunctional activity of the upper limb muscles and the recorded parameters of the electro-impedance myography signal. On the basis of the results of the studies, including complex measurements of neuromuscular activity on healthy volunteers such as the signals of electro-impedance myography and pressing force, analyses of the morphofunctional changes in tissues during action performance on the basis of ultrasound and MRI studies and the factors influencing the recorded signals of electro-impedance myography are described. The results are of fundamental importance and will enable reproducible electro-impedance myography signals, which, in turn, allow improved anthropomorphic control.

Bilateral index for upper limbs was determined for maximal force, speed and power in 18 male handball players. Variables were individually assessed with a functional electromechanical dynamometer during unilateral and bilateral bench press push-off for 40%, 60%, and 75% of the maximal isometric force. Limb dominance (symmetry indices) and load effects in the bilateral index were analysed. Bilateral index showed a bilateral deficit for power (range = −8.50 to −41.48) and velocity (range = −11.15 to −38.41), that increases with the load (p < 0.05). For maximum force, a bilateral facilitation (range = 2.26–5.57), which did not vary significantly as a function of load, was observed. Symmetry indices showed no association with the bilateral index (40% load: r = 0.45, 60% load: r = 0.05, 75% load: r = 0.39). These results contribute to understanding the phenomenon; however, individual-to-individual observation reflects that caution should be kept when assessing an individual athlete. In conclusion, bilateral deficit or facilitation for bench press depends on the variable considered, whereas its magnitude depends on the load. Moreover, limb dominance does not affect it. This finding must be regarded as a general trend, but a different situation may occur during the assessment of a particular athlete.

Objective: The aim of the study is to assess the effects of neuromuscular electrical stimulation on the upper limbs of patients with cerebral palsy. Design: We searched PubMed, Cochrane, Embase, and Scopus databases for randomized controlled trials examining the effects of neuromuscular electrical stimulation on the upper limbs of children with cerebral palsy. Results: Eight randomized controlled trials (N = 294) were included in the meta-analysis. Compared with traditional physical therapy, sensorimotor training and task-oriented training, constraint-induced movement therapy, dynamic bracing, and conventional robot-assisted therapy, neuromuscular electrical stimulation in combination with these therapies resulted in significantly greater functional scale scores (standardized mean difference = 0.80; 95% confidence interval = 0.54 to 1.06), muscle strength of upper limbs (standardized mean difference = 0.57; 95% confidence interval = 0.25 to 0.88), and spasticity of upper limbs (relative risk = 2.53; 95% confidence interval = 1.46 to 4.39; standardized mean difference = −0.18; 95% confidence interval = −0.29 to −0.06) but did not improve the wrist range of motion (standardized mean difference = 0.43; 95% confidence interval = −0.04 to 0.91). In addition, the effect of neuromuscular electrical stimulation on functional scale scores remained after 3-mo follow-up (standardized mean difference = 0.68; 95% confidence interval = 0.16 to 1.2). Conclusions: Neuromuscular electrical stimulation effectively improved hand function, muscle strength, and spasticity in patients with cerebral palsy. [ABSTRACT FROM AUTHOR]

Neurological examination is an important tool in diagnosing patients with neurological and neurosurgical conditions. As the complexity and knowledge of neurological and neurosurgical conditions increases, we are now required to learn and indoctrinate our peers and students with the correct skills and methods of examination. Emphasis on the correct techniques of testing muscle strength is essential to avoid errors in recording muscle power and in testing specific muscles which may have overlapping functions. The manual muscle testing of muscles of scapula and upper limbs was performed as to mimic a bedside clinical examination and involved an examiner, a patient and a videographer. The manual muscle testing has been performed in rostrocaudal manner starting from the scapula and ending with the thumbs. A reliable and consistent method of manual muscle testing is lacking among students and clinicians. By adhering to the methods delineated in our text and accompanying video, we hope to reduce inter-examiner variability and increase the reliability and validity of this important examination. [ABSTRACT FROM AUTHOR]

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Featured Application: This manuscript performs an electromyographic analysis of two exercises for conditioning the upper muscle extremities. Thus, a greater knowledge for prescribing these exercises in strengthening or functional recovery programs will be obtained. Pullover and straight arm pulldown exercises are commonly used in resistance exercise programs to improve sports performance or in physical activity health programs. This study aimed to evaluate the individual electromyographic (EMG) activity of the pectoralis major (clavicular, sternal, and costal portions), latissimus dorsi, anterior deltoid, triceps brachii, and rectus abdominis muscles in a barbell pullover exercise at a 100% biacromial width and a straight arm pulldown exercise at a 100% and 150% biacromial width and to compare the EMG activity in these selected muscles and exercises. Twenty healthy and physically active adults performed a set of eight repetitions of each exercise against 30% of their body mass. The barbell pullover exercise presented a higher EMG activity (p ≤ 0.01) than the straight arm pulldown exercise in both biacromial widths in all evaluated muscles except for the latissimus dorsi and the triceps brachii. These muscles showed the highest EMG activity in the straight arm pulldown exercise at both biacromial widths. In all of the exercises and muscles evaluated, the concentric phase showed a greater EMG activity than the eccentric phase. In conclusion, the barbell pullover exercise can highlight muscle activity in the pectoralis major (mainly in the sternal and lower portions), triceps brachii, and rectus abdominis muscles. However, the straight arm pulldown exercise at 100% and 150% biacromial widths could be a better exercise to stimulate the latissimus dorsi and triceps brachii muscles. Moreover, all exercises showed significantly greater EMG activity (p < 0.001) in the concentric phase than in the eccentric phase for all the evaluated muscles. [ABSTRACT FROM AUTHOR]

(1) Background: The increase in the number of bariatric surgery procedures has led plastic surgeons to look for new approaches to improve outcomes of body-contouring surgeries. A major concern in brachioplasty is the scarring process. Here, we propose a novel technique to minimize the incidence of pathological or unsatisfactory scars from brachioplasty. A video of the entire procedure is provided. (2) Methods: From January 2016 to August 2020, we performed the "Jaws" brachioplasty on 16 post-bariatric patients. We evaluated the effectiveness of the technique through pre- and postoperative assessments by patients and surgeons, the Vancouver Scar Scale, and the detection of major and minor complications within 12 months of follow-up. (3) Results: Thirteen patients were female and three were male, with a mean age of 32.5 ± 6.8 years (range: 22–47 years). The BODY-Q© Arms Section scores improved significantly, with no incidence of major or minor complications over 1 year of follow-up, and favorable aesthetic outcomes. (4) Conclusions: We believe that the "Jaws" technique is a valid contribution to post-bariatric surgery, as it aims to solve specific aesthetic problems of scarring from brachioplasty. The small number of patients does not allow the comparison of our original technique to others previously described in the literature. [ABSTRACT FROM AUTHOR]