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1.
J Biomech ; 134: 111002, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35202964

RESUMO

Whether muscle properties gradually change with age and how muscle properties are affected by sex remain unclear. In this study, we investigated the influence of age and sex on the biomechanical and viscoelastic properties of arm muscles in middle-aged and older adults. In this cross-sectional study, 80 healthy participants were divided by sex (male and female), and each sex group, by 10-year age ranges (40-49, 50-59, 60-69, and 70-79 years). Muscle properties, including tone, stiffness, elasticity, and mechanical stress relaxation time, were measured with the MyotonPRO. Our results showed that the muscle tone and elasticity of the deltoid and flexor carpi radialis, and the muscle tone of the flexor carpi ulnaris, were significantly greater in men than in women, whereas the stress relaxation time of the triceps was significantly greater in women than in men. Significantly greater muscle stiffness in the biceps brachii was found in the participants over 50 years old. Less muscle elasticity was found in the deltoid, triceps, and flexor carpi ulnaris in those over 70 years old. In conclusion, age and sex have considerable impacts on upper-limb muscle properties in middle-aged and older adults, which should be taken into consideration when planning health promotion projects.


Assuntos
Caracteres Sexuais , Extremidade Superior , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Projetos Piloto
3.
Int J Yoga Therap ; 32(2022)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35533407

RESUMO

Burn scar contracture greatly limits function for burn survivors, particularly when the scarring crosses multiple joints. Previous research has identified fields of skin recruited during single joint motion, called cutaneous functional units (CFU), indicating that impairments may be seen distal to the injured tissue. This case report connects the principles of CFU and yoga-inspired therapy modalities in improving clinical outcomes for a burn survivor. The patient is a 38-year-old male who sustained deep partial-thickness electrical burns to his neck, chest, and bilateral upper extremities, presenting with significantly decreased range of motion. The patient attended physical therapy 4 days a week, where he performed a specific yoga asana program during each session. Outcomes including standard range of motion measures, the Vancouver Scar Scale (VSS), and the Neck Disability Index (NDI), which were recorded every 10 sessions. CFUs of cervical extension and shoulder flexion were analyzed via photographs comparing cutaneous position during specified yoga poses and resting anatomical position in standing. Over 30 visits, cervical and shoulder range of motion increased, although the VSS and NDI did not show significant improvement. Yoga poses showed overall cutaneous recruitment distal to the targeted joints, and burned skin was recruited similarly to nonburned skin in positions of stretch. Incorporating multijoint approaches for stretching, like yoga, appears to contribute to improved clinical range-of-motion outcomes when paired with traditional burn-rehabilitation interventions. Yoga poses involving multiple joints align with the principle of CFUs, warranting continued investigation.


Assuntos
Queimaduras , Contratura , Ioga , Adulto , Queimaduras/reabilitação , Queimaduras/terapia , Cicatriz/complicações , Cicatriz/terapia , Contratura/etiologia , Contratura/terapia , Humanos , Masculino , Extremidade Superior
4.
Ann Plast Surg ; 88(3 Suppl 3): S163-S169, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35513315

RESUMO

ABSTRACT: Upper extremity infections (UEIs), commonly caused by intravenous drug use and direct trauma to the hand, can be devastating. Many studies support hand therapy postoperatively to improve outcomes. This population of patients often experience increased returns to the emergency department (ED) for treatment, repeat surgery, poor function, and increased hospital expenditure.This is a 2-phase study to investigate and intervene on the care pathway for patients undergoing surgery for UEI at a single urban university hospital. For the first 6-month phase, all patients with UEI requiring surgery received the standard of care, including written discharge instructions, a scheduled follow-up, and a determination for hand therapy based on evaluation. During the second phase, over the following 6 months, all patients with UEI requiring surgery received an intervention before discharge, in addition to standard of care, including a scripted educational session on the importance of hand therapy by a resident physician, home exercise program instructions, and a referral to hand therapy before discharge. Outcome measures were assessed for 6 months. Outcome measures included follow-up, hand therapy attendance, ED visits for the same complaint, readmissions, and reoperations.Forty-seven patients were in the first control group without intervention and 41 patients were in the second intervention group. Of the control group, 43% attended a follow-up appointment, 2% attended hand therapy, and 45% presented to the ED, resulting in a total of 167 visits. Eleven presented to the ED and were readmitted for complications from surgery, all 11 required a second operation. In the intervention group, 54% attended a follow-up appointment (P = 0.044), more patients attended hand therapy (22% P = 0.013), and 24% presented to the ED (P = 0.047), resulting in 40 ED visits.Seven were readmitted for complications from surgery and 4 required a second operation (P = 0.1). Early, simple intervention and education prove to be an effective method to decrease emergency department burden and healthcare expenditure for treatment of a challenging population. Although additional education and referral to hand therapy utilization do not change operation rates, it decreased returns to the ED, readmissions, and increased follow-up.


Assuntos
Alta do Paciente , Readmissão do Paciente , Agendamento de Consultas , Serviço Hospitalar de Emergência , Humanos , Extremidade Superior/cirurgia
5.
J Med Syst ; 46(6): 36, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35522356

RESUMO

The World Health Organization (WHO) recommends a six-step hand hygiene technique. Although multiple studies have reported that this technique yields inadequate skin coverage outcomes, they have relied on manual labeling that provided low-resolution estimations of skin coverage outcomes. We have developed a computational system to precisely quantify hand hygiene outcomes and provide high-resolution skin coverage visualizations, thereby improving hygiene techniques. We identified frequently untreated areas located at the dorsal side of the hands around the abductor digiti minimi and the first dorsal interosseous. We also estimated that excluding Steps 3, 6R, and 6L from the six-step hand hygiene technique leads to cumulative coverage loss of less than 1%, indicating the potential redundancy of these steps. Our study demonstrates that the six-step hand hygiene technique could be improved to reduce the untreated areas and remove potentially redundant steps. Furthermore, our system can be used to computationally validate new proposed techniques, and help optimise hand hygiene procedures.


Assuntos
Infecção Hospitalar , Higiene das Mãos , Mãos , Desinfecção das Mãos/métodos , Higiene das Mãos/métodos , Humanos , Músculo Esquelético , Extremidade Superior , Organização Mundial da Saúde
6.
Sci Rep ; 12(1): 7447, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523915

RESUMO

Current training interventions assessing pediatric functional motor skills do not account for children and adolescents with upper limb reductions who utilize a prosthesis. Prosthesis rejection showed that 1 out of 5 prosthesis users will reject their prosthesis due to lack of durability, lack of function, not meeting the participant's needs, perceived lack of need, and medical restrictions indicating that prosthetic users believed they were more functional without the device. It was hypothesized that an 8-week Home Intervention program will result in significant improvements in gross manual dexterity, bimanual coordination, and the functional activities performed during the program. It was also hypothesized that the novel Prosthesis Measurement of Independent Function (PMIF) score will reflect the Home Intervention performance improvements. Five pediatric participants (ages 5-19 years) with congenital upper limb reductions were fitted with a 3D printed upper extremity prosthesis for their affected limb. Participants then completed the 8-week Home Intervention which included Training activities completed 2×/week for 8 weeks and Non-Training activities completed only at week 1 and week 8. Participant's times were recorded along with each participant receiving a PMIF score ranging from 0 = unable to complete activity, to 7 = complete independence with activity completion. Results showed a decrease in overall averaged activity times amongst all activities. For all activities performed, individual averaged time decreased with the exception of Ball Play which increased over the 8-week intervention period. There was significant interaction for Home Intervention performance with F = 2.904 (p = 0.003). All participants increased their PMIF scores to 7 (complete independence) at the end of the 8 week intervention period. Decreases in time averages and increases in PMIF scores indicate that learning and functional use of the prostheses have occurred amongst the pediatric participants.


Assuntos
Membros Artificiais , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Destreza Motora , Artéria Radial , Extremidade Superior , Articulação do Punho , Adulto Jovem
7.
J Neuroeng Rehabil ; 19(1): 44, 2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35525970

RESUMO

BACKGROUND: Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited. OBJECTIVE: To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance. METHODS: Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into one motion parameter, per sensor pair, using a novel algorithm. This motion parameter was compared in a group-by-task analysis of variance as a similarity score (0-1) between key sensor pairs: sternum to wrist, wrist to wrist, and wrist to upper arm. A use ratio (paretic/non-paretic arm) was calculated in persons post-stroke from wrist sensor data for each modality and compared to scores from the Adult Assisting Hand Assessment (Ad-AHA Stroke) and UE Fugl-Meyer (UEFM). RESULTS: A significant group × task interaction in the similarity score was found for all key sensor pairs. Post-hoc tests between task type revealed significant differences in similarity for sensor pairs in 8/9 comparisons for controls and 3/9 comparisons for persons post stroke. The use ratio was significantly predictive of the Ad-AHA Stroke and UEFM scores for each modality. CONCLUSIONS: Our algorithm and sensor data analyses distinguished task type within and between groups and were predictive of clinical scores. Future work will assess reliability and validity of this novel metric to allow development of an easy-to-use app for clinicians.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adulto , Humanos , Paresia/etiologia , Reprodutibilidade dos Testes , Acidente Vascular Cerebral/complicações , Extremidade Superior
8.
Acta Orthop Belg ; 88(1): 190-197, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35512171

RESUMO

The aim of this study was to present and discuss our clinical experience of patients presenting with a mass in the upper extremity, in respect of demographic characteristics, localisation of the mass, clinical and pathological characteristics. A retrospective evaluation was made of 114 cases (60 females, 54 males) who presented at our clinic with complaints of localised pain and swelling in the upper extremity between 1 June 2016 and 31 December 2018. The cases were separated into 3 groups; Group 1 with a mass determined in the carpal region, Group 2 with localisation between the wrist and the metacarpophalangeal joint, and Group 3, in the distal of the metacarpophalangeal joint. The mass was of soft tissue origin in 90 cases, and of bone origin in 24 cases. The distribution of cases was 6 in Group 1, 20 cases in Group 2, and 88 in Group 3. The tumour was benign in 105 (92%) cases and a primary malignancy in 9 (7.8%) cases. Recurrence occurred in 4 cases, of which 2 were enchondroma, 1 was a giant cell tendon sheath tumour, and 1 was hemangioma The majority of painful masses seen in the hand are benign and very few are malignant. In the approach to hand tumours, clinical evaluation guided by demo- graphic data, and the evaluation of diagnostic and treatment options according to the radiological ap- pearance and anatomic localisation will determine the ideal approach providing a full cure.


Assuntos
Neoplasias de Tecidos Moles , Feminino , Mãos , Humanos , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos , Extremidade Superior
9.
Top Spinal Cord Inj Rehabil ; 28(2): 139-152, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35521056

RESUMO

Objectives: To evaluate upper extremity (UE) function, strength, and dynamic sitting balance in individuals with spinal cord injury (SCI) who received an intensive outpatient therapy program focused on UE training augmented with wide pulse/high frequency functional electrical stimulation (WPHF-FES). Methods: This prospective case series was conducted in an outpatient (OP) clinic in an SCI-specific rehabilitation hospital. Participants were a convenience sample (N = 50) of individuals with tetraplegia receiving OP therapy focused on UE recovery. Individuals participated in 60 minutes of UE functional task-specific practice (FTP) in combination with WPHF-FES 5 times/week for an average of 72 sessions. The primary outcome for this analysis was the Capabilities of Upper Extremity Test (CUE-T). Secondary outcomes include UE motor score (UEMS) and the modified functional reach (MFR). Results: Fifty individuals (13 motor complete; 37 motor incomplete SCI) completed an OP UE training program incorporating WPHF-FES and were included in this analysis. On average, participants demonstrated significant improvements in the total CUE-T score of 14.1 (SD = 10.0, p < .0001) points; significant changes were also noted in UEMS and MFR, improving an average of 4.6 (SD = 5.2, p < .0001) points and 13.6 (SD = 15.8, p < .0001) cm, respectively. Conclusion: Individuals with tetraplegia demonstrated significant improvements in UE strength, function, and dynamic sitting trunk balance after receiving UE training augmented with WPHF-FES. Future comparative effectiveness studies need to be completed to guide efficacious treatment interventions in OP therapy.


Assuntos
Terapia por Estimulação Elétrica , Traumatismos da Medula Espinal , Estimulação Elétrica , Humanos , Modalidades de Fisioterapia , Quadriplegia/terapia , Traumatismos da Medula Espinal/complicações , Extremidade Superior
10.
Ann Med ; 54(1): 1265-1276, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35510813

RESUMO

BACKGROUND: Lower socioeconomic status (SES) is associated with higher mortality rates and the likelihood of receiving less evidence-based treatment after stroke. In contrast, little is known about the impact of SES on recovery after discharge from inpatient rehabilitation. The aim of this study was to investigate the influence of SES on long-term recovery after stroke. PATIENTS AND METHODS: In a prospective, observational, multicentre study, inpatients were recruited towards the end of rehabilitation. The 12-month follow-up focussed on upper limb motor recovery, measured by the Fugl-Meyer score. A clinically relevant improvement of ≥5.25 points was considered recovery. Patient-centric measures such as the Patient-reported Outcomes Measurement Information System-Physical Health (PROMIS-10 PH) provided secondary outcomes. Information on schooling, vocational training, income and occupational status pre-stroke entered a multidimensional SES index. Multivariate logistic regression models calculating odds ratios (ORs) and corresponding confidence intervals (CIs) were applied. SES was added to an initial model including age, sex and baseline neurological deficit. Additional exploratory analyses examined the association between SES and outpatient treatment. RESULTS: One hundred and seventy-six patients were enrolled of whom 98 had SES and long-term recovery data. Model comparisons showed the SES-model superior to the initial model (Akaike information criterion (AIC): 123 vs. 120, Pseudo R2: 0.09 vs. 0.13). The likelihood of motor recovery (OR = 17.12, 95%CI = 1.31; 224.18) and PROMIS-10 PH improvement (OR = 20.76, 95%CI = 1.28; 337.11) were significantly increased with higher SES, along with more frequent use of outpatient therapy (p = .02). CONCLUSIONS: Higher pre-stroke SES is associated with better long-term recovery after discharge from rehabilitation. Understanding these factors can improve outpatient long-term stroke care and lead to better recovery.KEY MESSAGEHigher pre-stroke socioeconomic status (SES) is associated with better long-term recovery after discharge from rehabilitation both in terms of motor function and self-reported health status.Higher SES is associated with significantly higher utilization of outpatient therapies.Discharge management of rehabilitation clinics should identify and address socioeconomic factors in order to detect individual needs and to improve outpatient recovery. Article registration: clinicaltrials.gov NCT04119479.


Assuntos
Reabilitação Neurológica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Pacientes Internados , Estudos Prospectivos , Recuperação de Função Fisiológica , Classe Social , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Extremidade Superior
11.
BMC Neurol ; 22(1): 154, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35468766

RESUMO

BACKGROUND: It is common for people with persistent spasticity due to a stroke to receive an injection of botulinum toxin-A in the upper limb, however post-injection intervention varies. AIM: To determine the long-term effect of additional upper limb rehabilitation following botulinum toxin-A in chronic stroke. METHOD: An analysis of long-term outcomes from national, multicenter, Phase III randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis was carried out. Participants were 140 stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke greater than 3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus 3 months of evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scale) and upper limb activity (Box and Block Test) at 12 months (ie, 9 months beyond the intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. RESULTS: By 12 months, the experimental group scored the same as the control group on the Goal Attainment Scale (MD 0 T-score, 95% CI -5 to 5) and on the Box and Block Test (MD 0.01 blocks/s, 95% CI -0.01 to 0.03). There were no differences between groups on any secondary outcome. CONCLUSION: Additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not more effective in the long-term. TRIAL REGISTRATION: ACTRN12615000616572 (12/06/2015).


Assuntos
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Toxinas Botulínicas Tipo A/uso terapêutico , Dano Encefálico Crônico , Humanos , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Fármacos Neuromusculares/uso terapêutico , Qualidade de Vida , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do Tratamento , Extremidade Superior
12.
Spinal Cord Ser Cases ; 8(1): 44, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35468891

RESUMO

INTRODUCTION: Finger trembling is a characteristic physical finding in Hirayama disease. Although conservative treatment is recommended to stop disease progression, surgery is optional in some cases. However, the postoperative recovery of finger trembling is scarcely reported. CASE PRESENTATION: A 26-year-old Japanese female patient whose chief complaint was left finger trembling with active finger extension presented at our hospital. Hand weakness without muscle atrophy of the left arm was observed. MRI showed left-side oriented intramedullary signal change with concomitant cord atrophy at C4-5 and C5-6. The CT myelogram (CTM) on flexion showed anterior cord compression and anterior shift of posterior dura matter from C4 to C6. And CTM on extension showed the resolution of both findings. Electrophysiological studies showed active and chronic neuronal damage and preserved motor neuron pool of hand muscle. Since she had exhibited a gradual aggravation of symptoms over a period of 5 years, she underwent anterior cervical discectomy and fusion after careful assessment of both conservative and surgical treatment. Finger trembling recovered soon after surgery. DISCUSSION: Finger trembling is an unfamiliar physical finding in terms of postoperative recovery prediction. Anterior horn cell impairment is postulated as a cause of finger trembling. Postural restoration of spinal cord shape and cerebrospinal fluid around the cord with preserved neural function could facilitate functional recovery.


Assuntos
Compressão da Medula Espinal , Atrofias Musculares Espinais da Infância , Adulto , Vértebras Cervicais/cirurgia , Feminino , Humanos , Compressão da Medula Espinal/etiologia , Atrofias Musculares Espinais da Infância/complicações , Atrofias Musculares Espinais da Infância/diagnóstico , Atrofias Musculares Espinais da Infância/cirurgia , Extremidade Superior
13.
Medicine (Baltimore) ; 101(15): e28047, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35475793

RESUMO

INTRODUCTION: Ischemic stroke (IS) is the one of the most severe neurological disease, survivors may live with upper limb motor dysfunction (ULMD) resulting in heavy social and economic burden. Nowadays, there are few approaches to promote the rehabilitation of ULMD. Auricular acupuncture (electroacupuncture [EA]) has long been used in the treatment of neurological disorders in China. This treatment has become an attractive treatment option due to its low cost, portability, minimal side effects, and ease of use in clinical and operational environments. However, its efficacy and safety in consciousness recovery remain to be proved. METHODS: A total of 80 IS patients with single upper limb motor function impairment will be recruited in the trial and randomized into EA or control groups. Patients in the control group will receive routine conventional treatment alone while patients in the EA group will receive EA treatment for 3 consecutive weeks based on routine conventional treatment. Baseline evaluation was carried out on day of enrollment, post-treatment evaluation was carried out 14 and 21 days after enrollment, and the 2 groups were follow-ups in 3 and 6 months after the end of the trial. The efficacy will be assessed with the changes in the upper limb Fugl-Meyer assessment, Wolf motor function test, action research arm test, active range of motion, and Barthel index. The safety of EA will be estimated by monitoring the incidence of adverse events and changes in vital signs during the study period. Analysis of feasibility will be descriptive and the change in outcome measures between groups will be analyzed using an independent sample t test. DISCUSSION: This study tried to narrow the evidence gap on the efficacy of EA at the auricular on the recovery of ULMD in patients with IS. The results of this trial will provide strong evidence for the efficacy and safety of EA of auricular concha region stimulation for IS patients.Trial registration: This trial has been registered at the Chinese Clinical Trial Registry, numbered ChiCTR2100049678.


Assuntos
Eletroacupuntura , AVC Isquêmico , Acidente Vascular Cerebral , Eletroacupuntura/métodos , Humanos , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Extremidade Superior
14.
Sensors (Basel) ; 22(8)2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35458943

RESUMO

Current literature lacks a comparative analysis of different motion capture systems for tracking upper limb (UL) movement as individuals perform standard tasks. To better understand the performance of various motion capture systems in quantifying UL movement in the prosthesis user population, this study compares joint angles derived from three systems that vary in cost and motion capture mechanisms: a marker-based system (Vicon), an inertial measurement unit system (Xsens), and a markerless system (Kinect). Ten healthy participants (5F/5M; 29.6 ± 7.1 years) were trained with a TouchBionic i-Limb Ultra myoelectric terminal device mounted on a bypass prosthetic device. Participants were simultaneously recorded with all systems as they performed standardized tasks. Root mean square error and bias values for degrees of freedom in the right elbow, shoulder, neck, and torso were calculated. The IMU system yielded more accurate kinematics for shoulder, neck, and torso angles while the markerless system performed better for the elbow angles. By evaluating the ability of each system to capture kinematic changes of simulated upper limb prosthesis users during a variety of standardized tasks, this study provides insight into the advantages and limitations of using different motion capture technologies for upper limb functional assessment.


Assuntos
Membros Artificiais , Fenômenos Biomecânicos , Humanos , Movimento , Amplitude de Movimento Articular , Extremidade Superior
15.
Sensors (Basel) ; 22(8)2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35458975

RESUMO

In post-stroke motor rehabilitation, treatment dose description is estimated approximately. The aim of this retrospective study was to quantify the treatment dose using robot-measured variables during robot-assisted training in patients with subacute stroke. Thirty-six patients performed fifteen 60 min sessions (Session 1-Session 15) of planar, target-directed movements in addition to occupational therapy over 4 (SD 2) weeks. Fugl-Meyer Assessment (FMA) was carried out pre- and post-treatment. The actual time practiced (percentage of a 60 min session), the number of repeated movements, and the total distance traveled were analyzed across sessions for each training modality: assist as needed, unassisted, and against resistance. The FMA score improved post-treatment by 11 (10) points (Session 1 vs. Session 15, p < 0.001). In Session 6, all modalities pooled, the number of repeated movements increased by 129 (252) (vs. Session 1, p = 0.043), the total distance traveled increased by 1743 (3345) cm (vs. Session 1, p = 0.045), and the actual time practiced remained unchanged. In Session 15, the actual time practiced showed changes only in the assist-as-needed modality: -13 (23) % (vs. Session 1, p = 0.013). This description of changes in quantitative-practice-related variables when using different robotic training modalities provides comprehensive information related to the treatment dose in rehabilitation. The treatment dose intensity may be enhanced by increasing both the number of movements and the motor difficulty of performing each movement.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Acidente Vascular Cerebral/terapia , Resultado do Tratamento , Extremidade Superior
16.
Sensors (Basel) ; 22(8)2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35458977

RESUMO

This article presents the possibilities of newly developed middleware dedicated for distributed and modular control systems. The software enables the exchange of information locally, within one control module, and globally, between many modules. The executed information exchange system speed tests confirmed the correct operation of the software. The middleware was used in the control system of the active upper-limb exoskeleton. The upper-limb rehabilitation exoskeleton structure with six degrees of mechanical freedom is presented. The tests were performed using the prototype with three joints. The drives' models of individual joints were developed and simulated. As a result, the courses of the motion trajectory were shown for different kinds of pressure on the force sensors, and different methods of signal filtering. The tests confirmed a correct operation of middleware and drives control system.


Assuntos
Exoesqueleto Energizado , Fenômenos Biomecânicos , Gravitação , Movimento , Extremidade Superior
17.
Sensors (Basel) ; 22(8)2022 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-35459065

RESUMO

Shoulder kinematics is a measure of interest in the clinical setting for diagnosis, evaluating treatment, and quantifying possible changes. The aim was to compare shoulder scaption kinematics between symptomatic and asymptomatic subjects by inertial sensors. METHODS: Scaption kinematics of 27 subjects with shoulder symptomatology and 16 asymptomatic subjects were evaluated using four inertial sensors placed on the humerus, scapula, forearm, and sternum. Mobility, velocity, and acceleration were obtained from each sensor and the vector norm was calculated from the three spatial axis (x,y,Z). Shoulder function was measured by Upper Limb Functional Index and Disabilities of the Arm, Shoulder, and Hand questionnaires. One way ANOVA was calculated to test differences between the two groups. Effect size was calculated by Cohen's d with 95% coefficient Intervals. Pearson's correlation analysis was performed between the vector norms humerus and scapula kinematics against DASH and ULFI results in symptomatic subjects. RESULTS: The asymptomatic group showed higher kinematic values, especially in the humerus and forearm. Symptomatic subjects showed significantly lower values of mobility for scapular protraction-retraction (Cohen's d 2.654 (1.819-3.489) and anteriorisation-posteriorisation (Cohen's d 1.195 (0.527-1.863). Values were also lower in symptomatic subjects for velocity in all scapular planes of motion. Negative correlation showed that subjects with higher scores in ULFI or DASH had lower kinematics values. CONCLUSION: Asymptomatic subjects tend to present greater kinematics in terms of mobility, velocity, and linear acceleration of the upper limb, and lower humerus and scapula kinematics in symptomatic subjects is associated with lower levels of function.


Assuntos
Escápula , Ombro , Fenômenos Biomecânicos , Estudos Transversais , Humanos , Amplitude de Movimento Articular , Extremidade Superior
18.
Sensors (Basel) ; 22(8)2022 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-35459078

RESUMO

Wearable technology has advanced significantly and is now used in various entertainment and business contexts. Authentication methods could be trustworthy, transparent, and non-intrusive to guarantee that users can engage in online communications without consequences. An authentication system on a security framework starts with a process for identifying the user to ensure that the user is permitted. Establishing and verifying an individual's appearance usually requires a lot of effort. Recent years have seen an increase in the usage of activity-based user identification systems to identify individuals. Despite this, there has not been much research into how complex hand movements can be used to determine the identity of an individual. This research used a one-dimensional residual network with squeeze-and-excitation (SE) configurations called the 1D-ResNet-SE model to investigate hand movements and user identification. According to the findings, the SE modules have enhanced the one-dimensional residual network's identification ability. As a deep learning model, the proposed methodology is capable of effectively identifying features from the input smartwatch sensor and could be utilized as an end-to-end model to clarify the modeling process. The 1D-ResNet-SE identification model is superior to the other models. Hand movement assessment based on deep learning is an effective technique to identify smartwatch users.


Assuntos
Extremidade Superior , Dispositivos Eletrônicos Vestíveis , Mãos , Humanos , Movimento
19.
Trials ; 23(1): 301, 2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35413931

RESUMO

BACKGROUND: Functional task performance requires proper control of both movement and force generation in three-dimensional space, especially for the hand. Control of force in three dimensions, however, is not explicitly treated in current physical rehabilitation. To address this gap in treatment, we have developed a tool to provide visual feedback on three-dimensional finger force. Our objective is to examine the effectiveness of training with this tool to restore hand function in stroke survivors. METHODS: Double-blind randomized controlled trial. All participants undergo 18 1-h training sessions to practice generating volitional finger force of various target directions and magnitudes. The experimental group receives feedback on both force direction and magnitude, while the control group receives feedback on force magnitude only. The primary outcome is hand function as measured by the Action Research Arm Test. Other outcomes include the Box and Block Test, Stroke Impact Scale, ability to direct finger force, muscle activation pattern, and qualitative interviews. DISCUSSION: The protocol for this clinical trial is described in detail. The results of this study will reveal whether explicit training of finger force direction in stroke survivors leads to improved motor control of the hand. This study will also improve the understanding of neuromuscular mechanisms underlying the recovery of hand function. TRIAL REGISTRATION: ClinicalTrials.gov NCT03995069 . Registered on June 21, 2019.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Mãos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Extremidade Superior
20.
Artigo em Inglês | MEDLINE | ID: mdl-35457566

RESUMO

OBJECTIVE: The stroke is considered a common disease of the elderly. Young people also get sick, but the risk of stroke increases with the age of 60. Stroke, regardless of the age of the patients, causes functional deficits; therefore, the aim of the study was to analyze the significance of the body position and examined upper limb on the parameters of motor coordination and handgrip strength in various age groups of people after stroke and healthy people. MATERIAL AND METHOD: This is an observational study. A total of 117 people participated in the study (60 stroke patients and 57 healthy people without neurological disorders). Both patients and healthy volunteers were prospectively divided into three age groups: 18-45, 46-60, and 61+. The tests were carried out in two starting positions: sitting without back support and lying on the back with the upper limb stabilized against the body. HandTutorTM and a hand dynamometer were used to assess the motor coordination, including the maximum range of motion and frequency of movement, as well as the grip strength. RESULTS: The passive stabilization of the trunk and shoulder improved the maximum wrist ROM (p < 0.001) and frequency of finger movements (Hz F5 p = 0.018; F3 p = 0.010; F2 p = 0.011), especially in the oldest stroke patients. In the group of healthy volunteers, the most statistically significant results were obtained in the age range of 46-60. They occurred in both stable (wrist maxROM p = 0.041 and Hz F5 p = 0.034; Hz F4 p = 0.010; Hz F3 p = 0.028; Hz F1 p = 0.034, maxROM F1 p = 0.041) and unstable positions (maxROM F5 p = 0.034; maxROM F4 p = 0.050; maxROM F3 p = 0.002; maxROM F2 p = 0.002). In the group of the oldest healthy people, only one significant result was obtained in the stable position (Hz F3 p = 0.043). CONCLUSION: Passive stabilization of the trunk and examined upper limb improves the results of motor coordination of the distal part of the upper limb in both study groups. Passive stabilization of the trunk and upper limb improves motor coordination, especially in the oldest group of patients, after stroke.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adolescente , Idoso , Força da Mão , Voluntários Saudáveis , Humanos , Extremidade Superior
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