Development of a Meso-Scale SMA-Based Torsion Actuator for Image-Guided Procedures.

This paper presents the design, modeling, and control of a meso-scale torsion actuator based on shape memory alloy (SMA) for image-guided surgical procedures. Developing a miniature torsion actuator is challenging, but it opens the possibility of significantly enhancing the robot agility and maneuverability. The proposed torsion actuator is bi-directionally actuated by a pair of antagonistic SMA torsion springs through alternate Joule heating and natural cooling. The torsion actuator is integrated into a surgical robot prototype to demonstrate its working performance in the humid environment under C-Arm CT image guidance.

Generation of vertical angular momentum in single, double, and triple-turn pirouette en dehors in ballet.

The purpose of this study was to investigate the vertical angular momentum generation strategies used by skilled ballet dancers in pirouette en dehors. Select kinematic parameters of the pirouette preparation (stance depth, vertical center-of-mass motion range, initial shoulder line position, shoulder line angular displacement, and maximum trunk twist angle) along with vertical angular momentum parameters during the turn (maximum momentums of the whole body and body parts, and duration and rate of generation) were obtained from nine skilled collegiate ballet dancers through a three-dimensional motion analysis and compared among three turn conditions (single, double, and triple). A one-way ('turn') multivariate analysis of variance of the kinematic parameters and angular momentum parameters of the whole body and a two-way analysis of variance ('turn' × 'body') of the maximum angular momentums of the body parts were conducted. Significant 'turn' effects were observed in the kinematic/angular momentum parameters (both the preparation and the turn) (p <  0.05). As the number of turns increased, skilled dancers generated larger vertical angular momentums by predominantly increasing the rate of momentum generation using rotation of the upper trunk and arms. The trail (closing) arm showed the largest contribution to whole-body angular momentum followed by the lead arm.

Improved spatial-temporal graph convolutional networks for upper limb rehabilitation assessment based on precise posture measurement.

After regular rehabilitation training, paralysis sequelae can be significantly reduced in patients with limb movement disorders caused by stroke. Rehabilitation assessment is the basis for the formulation of rehabilitation training programs and the objective standard for evaluating the effectiveness of training. However, the quantitative rehabilitation assessment is still in the experimental stage and has not been put into clinical practice. In this work, we propose improved spatial-temporal graph convolutional networks based on precise posture measurement for upper limb rehabilitation assessment. Two Azure Kinect are used to enlarge the angle range of the visual field. The rigid body model of the upper limb with multiple degrees of freedom is established. And the inverse kinematics is optimized based on the hybrid particle swarm optimization algorithm. The self-attention mechanism map is calculated to analyze the role of each upper limb joint in rehabilitation assessment, to improve the spatial-temporal graph convolution neural network model. Long short-term memory is built to explore the sequence dependence in spatial-temporal feature vectors. An exercise protocol for detecting the distal reachable workspace and proximal self-care ability of the upper limb is designed, and a virtual environment is built. The experimental results indicate that the proposed posture measurement method can reduce position jumps caused by occlusion, improve measurement accuracy and stability, and increase Signal Noise Ratio. By comparing with other models, our rehabilitation assessment model achieved the lowest mean absolute deviation, root mean square error, and mean absolute percentage error. The proposed method can effectively quantitatively evaluate the upper limb motor function of stroke patients.

Range of Motion and Muscle Strength Changes in Japanese Professional Pitchers During the Baseball Season.

BACKGROUND: There are no studies examining changes in the physical function throughout the baseball season in Japanese professional players. We examined the range of motion (ROM) and muscle strength changes in professional baseball pitchers as the season progresses. MATERIALS AND METHODS: Five professional baseball pitchers were included. ROM, flexibility, and muscle strength of the trunk and shoulder, elbow, hip, knee, and ankle joints were measured pre-season (PRE), mid-season (MID), and post-season (POST). RESULTS: The total shoulder arc ROM of the dominant sides significantly decreased compared to that of the nondominant sides at MID and POST. Shoulder abduction muscle strength of the dominant sides significantly decreased at POST compared to that at PRE. In the trunk, lateral flexion ROM of bilateral sides significantly decreased at MID and POST compared to that at PRE, and the duration time of the side bridge test of the dominant sides significantly decreased at POST to that at PRE. Hip extension ROM and muscle strength and internal rotation ROM of the push-off leg significantly decreased at POST compared to that at PRE. CONCLUSION: The total shoulder arc ROM and shoulder abductor muscle strength of the dominant sides, trunk lateral flexion ROM and muscle strength, push-off leg hip joint extension muscle strength and ROM, and internal rotation ROM were more susceptible to changes as the season progressed. In order to maintain performance and prevent a throwing disorder, it is necessary to focus on these movements during the season and to appropriately train and condition these muscle groups.

The significance of the supratrochlear aperture (STA) in elbow range of motion: an anatomical study.

Assessment of the range of motion at a joint is among the methods employed by orthopedic surgeons and physiotherapists to determine courses of therapy and joint recovery. Females tend to have a greater range of motion at the elbow joint than males. In the present case-control study, the elbow extension angle was compared between males and females with and without the supratrochlear aperture. A total of 453 dry humeri and their corresponding ulnae were included in the study, and elbow extension angle was measured using a goniometer. The average extension angle in this sample was 173°, and it was significantly greater when the STA was present ([Formula: see text] = 175.4°) than when it was absent ([Formula: see text] = 171°). It was greater in females ([Formula: see text] = 174.5°) than in males ([Formula: see text] = 171.3°) irrespective of STA status, and was greater on the left in both sexes. Hyperextension characterized 13 % of the sample, whereas the majority (76 %) showed hypoextension and only a few (11 %) exhibited normal extension. Trochlear notch depth and olecranon-coronoid distance would found to be useful for predicting the presence of the supratrochlear aperture, while the transverse and vertical diameters of the supratrochlear aperture were found to be the most useful parameters when predicting the degree of extension. The functional benefits of hyperextension at the elbow joint are not fully understood. However, these results are important to orthopedic surgeons and physiotherapists as they permit a greater understanding of normal elbow range of motion in the South African population.

Functional outcome after arthroscopic repair of triple shoulder instability.

OBJECTIVE: To evaluate the functional outcomes of patients submitted to arthroscopic repair of triple labral lesion. METHODS: This was an analytical retrospective study of patients who underwent arthroscopic treatment of triple labral lesion from March 2005 to December 2014. Patients with at least one year of postoperative follow-up were included. A total of nine patients were evaluated. The mean age was 32.3 years and the dominant side was affected in five patients. Patients were functionally assessed regarding the range of motion (ROM) in elevation, external rotation with the arm close to the body the arm in abduction of 90°, and internal rotation, and by the Carter-Rowe score. The degree of satisfaction was assessed at the end of the follow-up period. RESULTS: Three patients had less than five episodes of instability, four patients had between five and ten episodes, and two patients had more than ten episodes. Seven patients had positive O'Brien test for SLAP lesions and positive apprehension test in abduction and external rotation, and only one patient had apprehension in adduction and internal rotation. Three patients persisted with positive O'Brien test and one with apprehension in abduction and external rotation at the end of follow-up. The range of motion was complete in all cases. The median Carter-Rowe score increased from 40 preoperatively to 90 (p = 0.008). CONCLUSION: The arthroscopic repair of triple labral lesions allows for the restoration of the stability of the glenohumeral joint, achieving excellent functional results.

OBJETIVO: Avaliar os resultados funcionais dos pacientes submetidos a reparo artroscópico da tríplice lesão labral do ombro. MÉTODOS: Estudo analítico retrospectivo de pacientes com tríplice lesão labral do ombro, submetidos a tratamento artroscópico de março de 2005 a dezembro de 2014. Foram incluídos pacientes com pelo menos um ano de seguimento pós-operatório. Nove pacientes foram avaliados. A média foi de 32,3 anos e o lado dominante foi afetado em cinco pacientes. Os pacientes foram avaliados funcionalmente por meio da amplitude de movimento em elevação, rotação externa com o braço junto ao corpo e com o braço em abdução de 90°, rotação interna e por meio do escore de Carter-Rowe. O grau de satisfação foi avaliado no fim do seguimento. RESULTADOS: Três pacientes tiveram menos de cinco episódios de instabilidade, quatro entre cinco e dez e dois mais de dez. Sete pacientes tiveram teste de O'Brien positivo para lesão do lábio superior de anterior para posterior (Slap, do inglês superior labrum anterior to posterior lesion) e apreensão em abdução e rotação externa positiva; apenas um apresentou apreensão em adução e rotação interna. Três pacientes persistiram com teste de O'Brien positivo e um com apreensão em abdução e rotação externa no fim do seguimento. A amplitude de movimento esteve completa em todos os casos na última avaliação. A média do escore de Carter-Rowe aumentou de 40 no pré-operatório para 90 (p = 0,008). CONCLUSÃO: O reparo artroscópico da tríplice lesão labral permite restaurar a estabilidade da articulação glenoumeral e alcança excelentes resultados funcionais.

Functional outcome after arthroscopic repair of triple shoulder instability / Resultado funcional após reparo artroscópico da tríplice instabilidade do ombro

ABSTRACT OBJECTIVE: To evaluate the functional outcomes of patients submitted to arthroscopic repair of triple labral lesion. METHODS: This was an analytical retrospective study of patients who underwent arthroscopic treatment of triple labral lesion from March 2005 to December 2014. Patients with at least one year of postoperative follow-up were included. A total of nine patients were evaluated. The mean age was 32.3 years and the dominant side was affected in five patients. Patients were functionally assessed regarding the range of motion (ROM) in elevation, external rotation with the arm close to the body the arm in abduction of 90°, and internal rotation, and by the Carter-Rowe score. The degree of satisfaction was assessed at the end of the follow-up period. RESULTS: Three patients had less than five episodes of instability, four patients had between five and ten episodes, and two patients had more than ten episodes. Seven patients had positive O'Brien test for SLAP lesions and positive apprehension test in abduction and external rotation, and only one patient had apprehension in adduction and internal rotation. Three patients persisted with positive O'Brien test and one with apprehension in abduction and external rotation at the end of follow-up. The range of motion was complete in all cases. The median Carter-Rowe score increased from 40 preoperatively to 90 (p = 0.008). CONCLUSION: The arthroscopic repair of triple labral lesions allows for the restoration of the stability of the glenohumeral joint, achieving excellent functional results.

RESUMO OBJETIVO: Avaliar os resultados funcionais dos pacientes submetidos a reparo artroscópico da tríplice lesão labral do ombro. MÉTODOS: Estudo analítico retrospectivo de pacientes com tríplice lesão labral do ombro, submetidos a tratamento artroscópico de março de 2005 a dezembro de 2014. Foram incluídos pacientes com pelo menos um ano de seguimento pós-operatório. Nove pacientes foram avaliados. A média foi de 32,3 anos e o lado dominante foi afetado em cinco pacientes. Os pacientes foram avaliados funcionalmente por meio da amplitude de movimento em elevação, rotação externa com o braço junto ao corpo e com o braço em abdução de 90°, rotação interna e por meio do escore de Carter-Rowe. O grau de satisfação foi avaliado no fim do seguimento. RESULTADOS: Três pacientes tiveram menos de cinco episódios de instabilidade, quatro entre cinco e dez e dois mais de dez. Sete pacientes tiveram teste de O'Brien positivo para lesão do lábio superior de anterior para posterior (Slap, do inglês superior labrum anterior to posterior lesion) e apreensão em abdução e rotação externa positiva; apenas um apresentou apreensão em adução e rotação interna. Três pacientes persistiram com teste de O'Brien positivo e um com apreensão em abdução e rotação externa no fim do seguimento. A amplitude de movimento esteve completa em todos os casos na última avaliação. A média do escore de Carter-Rowe aumentou de 40 no pré-operatório para 90 (p = 0,008) . CONCLUSÃO: O reparo artroscópico da tríplice lesão labral permite restaurar a estabilidade da articulação glenoumeral e alcança excelentes resultados funcionais.