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1.
Am J Occup Ther ; 74(1): 7401205030p1-7401205030p15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32078514

RESUMO

IMPORTANCE: Poor outcomes after upper extremity peripheral nerve injury (PNI) may arise, in part, from the challenges and complexities of cortical plasticity. Occupational therapy practitioners need to understand how the brain changes after peripheral injury and how principles of cortical plasticity can be applied to improve rehabilitation for clients with PNI. OBJECTIVE: To identify the mechanisms of cortical plasticity after PNI and describe how cortical plasticity can contribute to rehabilitation. DATA SOURCES: PubMed and Embase (1900-2017) were searched for articles that addressed either (1) the relationship between PNI and cortical plasticity or (2) rehabilitative interventions based on cortical plastic changes after PNI. Study Selection and Data Collectio: : PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Articles were selected if they addressed all of the following concepts: human PNI, cortical plasticity, and rehabilitation. Phantom limb pain and sensation were excluded. FINDINGS: Sixty-three articles met the study criteria. The most common evidence level was Level V (46%). We identified four commonly studied mechanisms of cortical plasticity after PNI and the functional implications for each. We found seven rehabilitative interventions based on cortical plasticity: traditional sensory reeducation, activity-based sensory reeducation, selective deafferentation, cross-modal sensory substitution, mirror therapy, mental motor imagery, and action observation with simultaneous peripheral nerve stimulation. CONCLUSION AND RELEVANCE: The seven interventions ranged from theoretically well justified (traditional and activity-based sensory reeducation) to unjustified (selective deafferentation). Overall, articles were heterogeneous and of low quality, and future research should prioritize randomized controlled trials for specific neuropathies, interventions, or cortical plasticity mechanisms. WHAT THIS ARTICLE ADDS: This article reviews current knowledge about how the brain changes after PNI and how occupational therapy practitioners can take advantage of those changes for rehabilitation.


Assuntos
Encéfalo/fisiologia , Traumatismos dos Nervos Periféricos , Extremidade Superior/fisiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
PLoS One ; 15(1): e0226611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31910214

RESUMO

The number of people who use computers for business and personal purposes increases as technology grows. The application of ergonomic practices on computer workstations reduces the musculoskeletal discomfort experienced and increases the overall satisfaction of the users. Keyboards are available in various systems, from computers to mobile devices, and have difference shapes and sizes. The keyboard size and shape is known to influence the user's upper extremities. Alternative keyboard designs help diminish the pain in the arms that occurs due to awkward arm postures. Most previous studies tried to optimize the keyboard layout based on ergonomic typing and the frequency of letters' co-occurrence. This research considers the frequency of the appearance of the most used 3,000 words in the English language. First, the frequency of each letter pair is calculated by the Text Analyzer. Then, a genetic algorithm is applied to design an ergonomically optimized keyboard to minimize the total distance of finger travel among the selected alphanumeric characters. The results showed that the distance travelled obtained by the proposed keyboard layout is less than that for the QWERTY keyboard in all different types of texts, in which an average of 6.04% improvement was achieved. Therefore, the proposed design can be used for keyboards to reduce time and fatigue.


Assuntos
Algoritmos , Periféricos de Computador/estatística & dados numéricos , Ergonomia/instrumentação , Modelos Estatísticos , Postura/fisiologia , Análise e Desempenho de Tarefas , Extremidade Superior/fisiologia , Fenômenos Biomecânicos , Desenho de Equipamento , Humanos , Idioma
3.
PLoS One ; 15(1): e0226563, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978051

RESUMO

Motor learning and compensatory movement are important aspects of prosthesis training yet relatively little quantitative evidence supports our current understanding of how motor control and compensation develop in the novel body-powered prosthesis user. The goal of this study is to assess these aspects of prosthesis training through functional, kinematic, and kinetic analyses using a within-subject paradigm compared across two training time points. The joints evaluated include the left and right shoulders, torso, and right elbow. Six abled-bodied subjects (age 27 ± 3) using a body-powered bypass prosthesis completed the Jebsen-Taylor Hand Function Test and the targeted Box and Blocks Test after five training sessions and again after ten sessions. Significant differences in movement parameters included reduced times to complete tasks, reduced normalized jerk for most joints and tasks, and more variable changes in efficiency and compensation parameters for individual tasks and joints measured as range of motion, maximum angle, and average moment. Normalized jerk, joint specific path length, range of motion, maximum angle, and average moment are presented for the first time in this unique training context and for this specific device type. These findings quantitatively describe numerous aspects of motor learning and control in able-bodied subjects that may be useful in guiding future rehabilitation and training of body-powered prosthesis users.


Assuntos
Amputados/reabilitação , Membros Artificiais/estatística & dados numéricos , Destreza Motora/fisiologia , Movimento , Amplitude de Movimento Articular/fisiologia , Análise e Desempenho de Tarefas , Extremidade Superior/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Modalidades de Fisioterapia , Próteses e Implantes , Desenho de Prótese , Adulto Jovem
4.
Int J Sports Med ; 41(5): 318-327, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31975360

RESUMO

The anaerobic threshold (AnT) seems to be not only a physiologic boundary but also a transition after which swimmers technique changes, modifying their biomechanical behaviour. We expanded the AnT concept to a biophysical construct in the four conventional swimming techniques. Seventy-two elite swimmers performed a 5×200 m incremental protocol in their preferred swimming technique (with a 0.05 m·s-1 increase and a 30 s interval between steps). A capillary blood samples were collected from the fingertip and stroke rate (SR) and length (SL) determined for the assessment of [La], SR and SL vs. velocity inflexion points (using the interception of a pair of linear and exponential regression curves). The [La] values at the AnT were 3.3±1.0, 3.9±1.1, 2.9±1 .34 and 4.5±1.4 mmol·l-1 (mean±SD) for front crawl, backstroke, breaststroke and butterfly, and its corresponding velocity correlated highly with those at SR and SL inflection points (r=0.91-0.99, p<0.001). The agreement analyses confirmed that AnT represents a biophysical boundary in the four competitive swimming techniques and can be determined individually using [La] and/or SR/SL. Blood lactate increase speed can help characterise swimmers' anaerobic behaviour after AnT and between competitive swimming techniques.


Assuntos
Limiar Anaeróbio/fisiologia , Natação/fisiologia , Adolescente , Fenômenos Biomecânicos , Comportamento Competitivo/fisiologia , Feminino , Humanos , Ácido Láctico/sangue , Extremidade Inferior/fisiologia , Masculino , Condicionamento Físico Humano , Análise e Desempenho de Tarefas , Extremidade Superior/fisiologia , Adulto Jovem
5.
J Sports Sci ; 38(3): 280-287, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31766951

RESUMO

Delivering a cricket ball with a wrist-spin (WS) bowling technique is considered one of the game's most difficult skills. Limited biomechanical information exists for WS bowlers across skill levels. The purpose of this study was to compare biomechanical, isokinetic strength and anthropometric measures between elite (12) and pathway bowlers (eight). Data were collected using a motion analysis system, dynamometer and a level-two anthropometrist. A regression analysis identified that performance was best explained by increased wrist radial deviation torque and longitudinal axis rotational moments at the shoulder and wrist. From back foot impact (BFI) to ball release (BR), elite bowlers rotated their trunks less, experienced less trunk deceleration resulting in a more front-on position and increased pelvis rotation angular velocity. They also displayed an increased shoulder internal rotation moment as the upper arm moved from external into internal rotation and was a major contributor in the subsequent differences observed in the distal segments of the bowling limb. Anthropometric differences were observed at the wrist and finger joints and may be used to form the basis for talent identification programmes. This study highlights the important contribution to bowling performance of the musculature responsible for producing long axis rotations of the bowling limb.


Assuntos
Antropometria , Desempenho Atlético/fisiologia , Destreza Motora/fisiologia , Força Muscular/fisiologia , Extremidade Superior/fisiologia , Adolescente , Adulto , Humanos , Masculino , Pelve/fisiologia , Amplitude de Movimento Articular/fisiologia , Rotação , Tórax/fisiologia , Estudos de Tempo e Movimento , Adulto Jovem
6.
Gait Posture ; 75: 1-7, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31586751

RESUMO

BACKGROUND: Coordination is the ability to assemble and maintain appropriate relations between joints. Investigating limb coordination in curve-turning (CT) walking could provide insightful information about the coordinating strategies and neuro-musculoskeletal system (NMSS) control in human motion. RESEARCH QUESTION: Although preschoolers have already established an adult-like gait, how preschoolers perform their specific gait pattern when walking in CT and what coordination strategies they would choose during the turning process have not yet been systematically considered. Therefore, this study was aimed to investigate preschoolers' coordination mechanism during asymmetric motion, in order to understand the development of their NMSS control in locomotion. METHODS: Kinematics data in the lower and upper limbs of 45 healthy preschoolers walking with the curve-turning task was measured by the Coda Motion System. The Continuous Relative Phase (CRP) angle and the variability between the knee and ankle, hip and knee, as well as the thorax-humerus joint (THJ) and elbow were calculated. RESULTS: The outcome demonstrates that as the curve angles increased, the stride length and Froude number of preschoolers significantly decreased (p < 0.05 for all); meanwhile, a more out of phase coordination pattern in CRP and an increase in VCRP values were found. Group analysis showed that the significant differences in CRP and VCRP between preschoolers and adults increased with curve angles in all coupled joints - the highest in that of the Knee-Ankle coupling, followed by those of the Hip-Knee and THJ-Elbow. SIGNIFICANCE: Our results suggest that to achieve curve-turning, preschoolers first chose to modify their STP, then to adjust coordination for coupling-joints in the Knee-Ankle, Hip-Knee, and THJ-Elbow systems. Additionally, preschoolers are still in a gait fine-tuning period and their NMSS control of motion is not as precise as that of adults.


Assuntos
Marcha/fisiologia , Nível de Saúde , Extremidade Inferior/fisiologia , Extremidade Superior/fisiologia , Caminhada/fisiologia , Adulto , Articulação do Tornozelo , Fenômenos Biomecânicos , Pré-Escolar , Feminino , Voluntários Saudáveis , Humanos , Masculino
7.
J Sports Sci ; 38(4): 470-475, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31856662

RESUMO

This project examined the interrelationships between power production and upper body kinematics during a series of medicine ball push-press (MBP-P) throws. Twenty-five regular weight trainers (body mass = 86 ± 10 kg) performed a series of ballistic vertical MBP-P throws at loads representing 5% and 10% of their assessed 5RM bench press. Throws were performed lying supine on a force platform (1 kHz) with upper body kinematics assessed using standard infra-red motion capture techniques (0.5 kHz). Gross measures of performance and power production such as peak vertical ball velocity (Velpeak), peak force (Fpeak) and power (Ppeak) were recorded during the propulsive phase of the movement. Comparative analyses indicated that despite significant reductions in Velpeak from the 5% to 10% loads (P < 0.001), Fpeak remained largely unchanged (P = 0.167). Analysis of inter-trial variability showed that the gross measures of performance and power were relatively stable (Coefficient of Variation [CV%] <13%), while most upper limb segmental kinematics varied considerably between trials (CV% up to 70%). This project highlights the complexity of the relationships between power production and upper body kinematics during light load ballistic MBP-P throwing. Additionally, it shows how trained athletes can achieve similar outcomes during ballistic movements using a variety of movement strategies.


Assuntos
Força Muscular/fisiologia , Condicionamento Físico Humano/métodos , Extremidade Superior/fisiologia , Fenômenos Biomecânicos , Teste de Esforço/métodos , Humanos , Condicionamento Físico Humano/fisiologia , Equipamentos Esportivos , Estudos de Tempo e Movimento , Levantamento de Peso/fisiologia
8.
J Sports Med Phys Fitness ; 59(11): 1835-1844, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31808330

RESUMO

BACKGROUND: Police institutions often use Occupational Physical Ability Tests (OPATs) as a measure of occupational performance. These tests are utilized to mimic the daily and essential tasks performed by the police officers, but few are performed with load carriage (LC). The purpose of this study was to examine the physical performance predictors of an OPAT performed without (NPPE) and with (WPPE) LC. METHODS: Thirteen federal highway police officers (age: 36.8±3.7 years, body mass: 89±10.7 kg, height: 180±5.6 cm) volunteered to complete a battery of physical fitness tests (aerobic power and capacity, muscular endurance, lower limb power, upper limb strength, agility and anaerobic power) and anthropometrics. Occupational performance was measured by the total OPAT time consisting of 7 sequential police tasks. All subjects randomly completed the tests on both LC conditions. RESULTS: Agility (P<0.01), lower limb power and height (P<0.05) were significantly related to performance in the NPPE OPAT. In the WPPE condition, aerobic power (absolute and relative) (P<0.01), lower limb power and agility (P<0.05). The best predictors for OPAT performance were agility (R2=0.45, P<0.01) in the NPPE condition, as well as relative aerobic power, upper limb strength and agility in the WPPE condition (R2=0.81, P<0.01). CONCLUSIONS: Different conditions of LC have distinct occupational performance predictors. Thus, considering LC, physical exercise programs aimed at improving police occupational performance should aim at improving agility, upper limb strength and aerobic fitness.


Assuntos
Aptidão Física , Polícia/estatística & dados numéricos , Competência Profissional , Extremidade Superior/fisiologia , Adulto , Exercício Físico , Teste de Esforço , Feminino , Humanos , Extremidade Inferior/fisiologia , Masculino , Força Muscular , Equipamento de Proteção Individual , Resistência Física
9.
J Sports Sci Med ; 18(4): 645-652, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31827348

RESUMO

This study aimed to analyze the influence of range of motion (ROM) on main biomechanical parameters of the bench press (BP) exercise: i) load-velocity relationship by mean (MV) and mean propulsive velocity (MPV), ii) one-repetition maximum strength (1RM); iii) contribution of the propulsive and braking phases, and iv) presence of the sticking region key parameters (first peak barbell velocity: Vmax1, minimum velocity: Vmin and second peak barbell velocity: Vmax2). Forty-two strength-trained males performed a progressive loading test, starting at 20 kg and gradually increasing the load in 10 kg until MPV ≤ 0.50 m·s-1 and 5 down to 2.5 kg until 1RM, in three different ROMs: full ROM (BPFULL), two-thirds (BP2/3) and one-third (BP1/3). While significant differences were detected in the velocity attained against loads between 30-95% 1RM (BPFULL, BP2/3 and BP1/3, p < 0.05), both MV and MPV showed a very close relationship to %1RM for the three BP variations (R2 = 0.935-0.966). The contribution of the braking phase decreased progressively until it completely disappeared at the 80%, 95% and 100% 1RM loads in BP1/3, BP2/3 and BPFULL, respectively. The 1RM increased as the ROM decreased (BPFULL < BP2/3 < BP1/3, p < 0.05). Despite the three biomechanical parameters that define the sticking region on the velocity-time curves were only observed in BPFULL variation, in 54.5% of the cases the subjects started their BP2/3 displacement before reaching the position at which the Vmin occurs in their BPFULL exercise. The complete or partial presence of the sticking region during the concentric action of the lift seems to underlie the differences in the 1RM strength, load-velocity profiles and the contribution of the propulsive phase in the BP exercise at different ROMs.


Assuntos
Treinamento de Resistência/métodos , Extremidade Superior/fisiologia , Levantamento de Peso/fisiologia , Adulto , Fenômenos Biomecânicos , Humanos , Masculino , Força Muscular/fisiologia , Amplitude de Movimento Articular , Adulto Jovem
10.
PLoS One ; 14(12): e0219333, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31887218

RESUMO

BACKGROUND: Successful hand-object interactions require precise hand-eye coordination with continual movement adjustments. Quantitative measurement of this visuomotor behaviour could provide valuable insight into upper limb impairments. The Gaze and Movement Assessment (GaMA) was developed to provide protocols for simultaneous motion capture and eye tracking during the administration of two functional tasks, along with data analysis methods to generate standard measures of visuomotor behaviour. The objective of this study was to investigate the reproducibility of the GaMA protocol across two independent groups of non-disabled participants, with different raters using different motion capture and eye tracking technology. METHODS: Twenty non-disabled adults performed the Pasta Box Task and the Cup Transfer Task. Upper body and eye movements were recorded using motion capture and eye tracking, respectively. Measures of hand movement, angular joint kinematics, and eye gaze were compared to those from a different sample of twenty non-disabled adults who had previously performed the same protocol with different technology, rater and site. RESULTS: Participants took longer to perform the tasks versus those from the earlier study, although the relative time of each movement phase was similar. Measures that were dissimilar between the groups included hand distances travelled, hand trajectories, number of movement units, eye latencies, and peak angular velocities. Similarities included all hand velocity and grip aperture measures, eye fixations, and most peak joint angle and range of motion measures. DISCUSSION: The reproducibility of GaMA was confirmed by this study, despite a few differences introduced by learning effects, task demonstration variation, and limitations of the kinematic model. GaMA accurately quantifies the typical behaviours of a non-disabled population, producing precise quantitative measures of hand function, trunk and angular joint kinematics, and associated visuomotor behaviour. This work advances the consideration for use of GaMA in populations with upper limb sensorimotor impairment.


Assuntos
Medições dos Movimentos Oculares/normas , Movimentos Oculares/fisiologia , Mãos/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Medições dos Movimentos Oculares/instrumentação , Feminino , Fixação Ocular/fisiologia , Força da Mão/fisiologia , Humanos , Masculino , Movimento/fisiologia , Desempenho Psicomotor , Amplitude de Movimento Articular/fisiologia , Reprodutibilidade dos Testes , Extremidade Superior/fisiologia
11.
Medicine (Baltimore) ; 98(46): e17929, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725646

RESUMO

BACKGROUND: Upper limb dysfunction is one of common sequelae of stroke which limits daily activities and decreases quality of life of patients, as well as increasing caregiving burden on families. Theta burst stimulation (TBS) is considered to be a beneficial therapy for post-stroke patients with upper limb motor dysfunction, but there is a lack of a high quality evidence. We aim to investigate the effectiveness and safety of TBS for upper limb motor dysfunction in patients with stroke. METHODS: The following databases will be searched: PubMed, EMBASE, The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP) and WanFang Data from the inception to October 2019. All relevant randomized controlled trials (RCTs) using TBS to treat poststroke patients with upper limb motor dysfunction will be included. The primary outcome is Upper Limb Fugl-Meyer Assessment (UL-FMA). Secondary outcomes will include Action Research Arm Test (ARAT), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), Motor Assessment Scale (MAS), Nine Hole Peg Test (NHPT), Grip strength and other scales evaluating the upper limb motor function. Adverse effects will also be evaluated. Two reviewers will screen studies, extract data and assess the risk of bias of included studies independently. Data analysis will be conducted using Review Manager software (RevMan, version 5.3.5) and R software (version 3.6.1). RESULTS: Our SR will be conducted according to AMSTAR 2.0 and reported in compliance with PRISMA. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. CONCLUSION: Our study will provide evidence for the effectiveness and safety of theta burst stimulation for upper limb motor dysfunction in patients with stroke. ETHICS AND DISSEMINATION: This systematic review (SR) does not require formal ethical approval since no privacy health information will be included. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019142462.


Assuntos
Paralisia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Magnética Transcraniana/métodos , Extremidade Superior/fisiopatologia , Força da Mão , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Estimulação Magnética Transcraniana/efeitos adversos , Extremidade Superior/fisiologia
12.
Int J Sports Med ; 40(13): 831-841, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31533156

RESUMO

The main purpose of this study was to compare the effects on strength and muscle power of a training program based on two different modalities of whole-body electrostimulation (WB-EMS) with respect to a resistance-training program aimed at improving dynamic strength. Twenty-two subjects participated in this study: Thirteen male (age 25.2±2.8 years; height 1.78±0.1 m; body mass 72.8±6.4 kg; body fat 11.6±2.3%) and nine female (age 28.2±3.5 years; height 1.63±0.05 m; body mass 56.8±7.6 kg; body fat 19.1±4.7%). Participants were randomly assigned to three groups that underwent three different 6-week training programs: two modalities of WB-EMS, based on different electrical parameters (experimental), and circuit training with overloads (control). Force-velocity curves were calculated for each participant before and after treatment. All groups improved their level of strength and muscle power (paired sample t-Test, p<0.01; d>1) with a similar magnitude. No significant differences were observed between groups (two-way 2×3 Anova, p>0.05) at the end of the experimentation. This study suggests that WB-EMS might be considered as a valid and faster alternative - or an important complementary procedure - to a traditional overload-based resistance-training program for the development of the DS.


Assuntos
Exercícios em Circuitos/métodos , Estimulação Elétrica/métodos , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Treinamento de Resistência/instrumentação , Adulto , Teste de Esforço/métodos , Feminino , Humanos , Extremidade Inferior/fisiologia , Masculino , Extremidade Superior/fisiologia , Levantamento de Peso , Adulto Jovem
13.
J Electromyogr Kinesiol ; 49: 102351, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31473453

RESUMO

Middle-aged individuals cocontract with adductor muscles during abduction. This may be crucial for counteracting deltoid forces, depressing the humerus and ensuring free passage of subacromial tissues underneath the acromion during abduction. We questioned whether adductor co-contraction is always present, or develops during ageing, in which case it may explain the age-related character of common shoulder conditions such as Subacromial Pain Syndrome. In a cross-sectional analysis with electromyography (EMG), activation patterns of the latissimus dorsi, teres major, pectoralis major and deltoid muscle were assessed during isometric force tasks in 60 asymptomatic individuals between 21 and 60 years old. Cocontraction was expressed as the degree of antagonistic activation relative to the same muscle's degree of agonistic activation, resulting in an activation ratio between -1 and 1, where lower values indicate more cocontraction. Using linear regression analyses, we found age-related decreases in the activation ratio of the latissimus dorsi (regression estimate: -0.004, 95% CI: -0.007 to 0.0, p-value: 0.042) and teres major (regression estimate: -0.013, 95% CI: -0.019 to -0.008, p-value: <0.001). In contrast to young individuals, middle-aged individuals showed a high degree of adductor cocontraction during abduction. This may indicate that during ageing, alterations in activation patterns are required for preserving pain-free shoulder function.


Assuntos
Adaptação Fisiológica , Envelhecimento/fisiologia , Contração Muscular , Extremidade Superior/fisiologia , Adulto , Músculo Deltoide/crescimento & desenvolvimento , Músculo Deltoide/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Amplitude de Movimento Articular , Articulação do Ombro/fisiologia , Dor de Ombro/etiologia
14.
J Allied Health ; 48(3): e73-e77, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487365

RESUMO

AIMS: Constraint induced movement therapy improves upper extremity (UE) function in children with unilateral cerebral palsy (CP). Impact of intervention setting is unknown. The current investigation aimed to determine impact of therapy setting on UE function in children with unilateral CP. METHODS: Children were assigned to either center-based (CB) or home-based (HB) interventions using a single-blind cross-over design. RESULTS: UE function improved significantly in all children; greater improvements were found in the CB group. After the HB group received 10 additional weeks of CB intervention, between-group scores were not different but within-group changes were also not significant. CONCLUSIONS: Dose may be more important than setting but CB may be more effective than HB in the short term.


Assuntos
Paralisia Cerebral/terapia , Movimento , Modalidades de Fisioterapia , Extremidade Superior/fisiologia , Adolescente , Criança , Feminino , Instalações de Saúde , Habitação , Humanos , Masculino , Resultado do Tratamento
15.
Med Probl Perform Art ; 34(3): 132-140, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31482171

RESUMO

OBJECTIVE: This study examined intra- and inter-individual variability in upper limb movements of ballet dancers when performing flapping swan-wing movements, and it assessed differences in joint angles of upper limbs between dancers of different skill levels. METHODS: 23 female ballet dancers (3 professional, 6 advanced, and 14 intermediate dancers) and 21 age-matched females without previous dance experience participated in this study. Thirty-three reflective markers were attached to each participant's trunk and upper limbs, and the flapping upper limb motions from Swan Lake were subsequently captured with eight optical cameras. Peak values of upper limb joint angles (shoulder, elbow, and wrist joint) were obtained, and intra- and inter-individual movement variability of each joint angle were compared between groups. RESULTS: In joint angles of the shoulder, elbow, and wrist, there were few differences among professional, advanced, and intermediate groups. The intra-individual movement variability in upward arm movements was significantly larger for professional and control groups than for advanced and intermediate groups, while in downward arm movement, variability became significantly smaller as technical level increased. Moreover, inter-individual movement variability was larger in the upward arm movement as technical level increased, and smaller in the downward arm movement for the professional group. The results suggested that the upward arm movements reflect dancers' individual expression, while the downward arm movements reflect their technical competence at this swan-like movement. CONCLUSION: The complicated swan-like movements performed by skilled dancers in this study indicate that they execute expressive and technical components in sequence.


Assuntos
Dança , Movimento , Dança/fisiologia , Feminino , Humanos , Articulações , Extremidade Superior/fisiologia
16.
J Rehabil Med ; 51(10): 813-816, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31529136

RESUMO

OBJECTIVE: To compare walking speed in patients with spastic hemiparesis who received abobotulinumtoxinA either in the lower limb or simultaneously in both the lower and upper limbs. DESIGN: Post hoc analysis from a phase 3 study of abobotulinumtoxinA (Dysport®, NCT01251367). PATIENTS: Adult patients with spastic hemiparesis causing gait dysfunction. METHODS: Comfortable barefoot walking speed over 10 m was evaluated in patients receiving lower limb vs lower and upper limb injections over ≤4 treatment cycles; 1,000 U or 1,500 U in lower limb for cycle 1/2; optional upper limb injections from cycle 3 (500 U: upper limb, 1,000 U: lower limb). RESULTS: Mean (standard deviation; SD) lower limb cycle 3/4 doses were lower in the lower plus upper limb group vs lower limb only (1,000 U (SD 50), 1,000 U (SD 50) vs 1,380 U (SD 210), 1,360 U (SD 220). Baseline comfortable barefoot walking speed was similar between groups. Changes at cycle 3 week 4, in m/s, were: lower and upper limb: +0.063 (SD 0.131); lower limb only: +0.078 (SD 0.114), and cycle 4 week 4: lower and upper limb: +0.086 (SD 0.166); lower limb only: +0.086 (SD 0.123). CONCLUSION: Simultaneous lower and upper limb abobotulinumtoxinA treatment does not hamper improvement in walking speed compared with lower limb treatment alone. Thus, physicians may split the 1,500 U abobotulinumtoxinA dose as needed to best treat patients with spastic paresis.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Lesões Encefálicas/complicações , Espasticidade Muscular , Paresia , Acidente Vascular Cerebral/complicações , Caminhada/fisiologia , Adulto , Humanos , Extremidade Inferior/fisiologia , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Paresia/tratamento farmacológico , Paresia/fisiopatologia , Extremidade Superior/fisiologia
17.
J Sports Sci ; 37(22): 2625-2630, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31379263

RESUMO

The dynamics of tremulous motion in the upper limb is complex. We aimed to explore the relationship between the complexity of upper limb tremor when aiming and aiming performance and the influences of physical load on the two outcomes. Fifteen modern pentathlon athletes were recruited and completed two 1000-m treadmill running and three 60-s standard aiming task trials: one at baseline and each of the other two immediately after each running. The time series of light spot trace on the target was measured using a high-speed camera. The complexity of this time series was quantified using multiscale entropy. The effective aiming rate was used to assess the aiming performance. We observed that participants with lower tremor complexity had lower effective aiming rate across three physical load conditions (r2 > 0.38, p < 0.01). Physical load decreased both tremor complexity (F = 4.8, p = 0.01) and effective aiming rate (F = 13.5, p < 0.0001), but no difference was observed after 1000-m running compared to that after 2000-m running. The per cent change of tremor complexity associated with the change of effective aiming rate (r2 = 0.55, p < 0.0001). This pilot study demonstrates that multiscale complexity of tremulous motion in the upper limb when aiming may serve as a novel marker to assess the physiologic system functionality when aiming.


Assuntos
Desempenho Atlético/fisiologia , Movimento/fisiologia , Esportes/fisiologia , Extremidade Superior/fisiologia , Adulto , Feminino , Armas de Fogo , Humanos , Masculino , Projetos Piloto , Corrida/fisiologia , Análise e Desempenho de Tarefas , Tremor/fisiopatologia , Suporte de Carga , Adulto Jovem
18.
J Med Eng Technol ; 43(4): 235-247, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31414614

RESUMO

This paper proposes a low-cost and sensitive surface electromyography (sEMG) sensor for the myoelectric prosthesis. The sensor consists of a skin interface, signal conditioning circuitry and power supply unit all encased in a single package. The tuned RC parameters based envelope detection scheme employed in the sensor enables faster as well as reliable recognition of EMG signal patterns regardless of its strength and subject variability. The output performance of the developed sensor was compared with a commercial EMG sensor regarding signal-to-noise ratio (SNR), amplitude sensitivity and response time. EMG signals with both the devices were acquired for 10 subjects (three amputees and seven healthy subjects), to perform this comparative analysis. The results showed 4× greater SNR values and 50% higher sensitivity of the developed sensor than the commercial EMG sensor. Also, the proposed sensor was 57% faster than the commercial sensor in producing the output response. The sensor was successfully tested on amputees for controlling a 3D printed hand prototype utilising a proportional control strategy. The enhanced output parameters of the sensor were responsible for smooth, faster and intuitive actuation of the prosthetic hand fingers.


Assuntos
Membros Artificiais , Eletromiografia/instrumentação , Extremidade Superior/fisiologia , Dispositivos Eletrônicos Vestíveis , Adulto , Amputados , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Adulto Jovem
19.
J Pediatr Orthop ; 39(8): 387-393, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31393289

RESUMO

BACKGROUND: Throwing requires proper stability and orientation of the pelvis and scapula for efficient energy transfer during pitching. Fatigue of the pelvis and scapular musculature throughout the course of a game can impair pitching performance, and place excessive demands on the throwing arm leading to injury. The purpose of this study was to examine differences in pelvis, torso, and upper extremity pitching mechanics and muscle activations between the fastball, change-up, and curveball pitches in youth baseball pitchers following a simulated game. METHODS: Fourteen youth baseball pitchers with no history of injury participated. Pitching mechanics were collected using an electromagnetic tracking system. Surface electromyography data were collected on the bilateral gluteus medius and maximus; and throwing arm side latissimus dorsi, lower trapezius, upper trapezius, and serratus anterior. Participants were instructed to throw maximum effort pitches during a simulated game that provided random game situations similar to those that occur in competition. Participants were limited to 85 pitches based on age-restricted pitch counts. Data from 3 fastballs, curveballs, and change-ups thrown in the first and last innings were selected for analysis. RESULTS: Repeated measures multivariate analyses of variance revealed that neither pitch type nor the effect of a simulated game resulted in statistically significant changes in pitching mechanics (F(10,600)=0.55, P=0.85), or muscle activations (pelvic: F(4,195)=0.07, P=0.85; scapular: F(4,118)=0.09, P=0.52). CONCLUSIONS: The principle findings of this study revealed that pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches. These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown. This is supported by the pitcher's ability to maintain a proper arm slot during all 3 pitches and indicates that they are obtaining the spin on the ball from their grip and not by altering upper extremity mechanics. LEVEL OF EVIDENCE: Level 5.


Assuntos
Beisebol/fisiologia , Eletromiografia/métodos , Músculo Esquelético/fisiologia , Escápula/fisiologia , Articulação do Ombro/fisiologia , Extremidade Superior/fisiologia , Adolescente , Fenômenos Biomecânicos , Humanos , Masculino
20.
IEEE Int Conf Rehabil Robot ; 2019: 766-771, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374723

RESUMO

This paper introduces an adaptive integral sliding mode controller for exoskeletons. The controller design is based on the hypothesis that only classical properties are known such as parameters' bounds, and all other functions are unknown. To ensure the convergence in position, velocity and acceleration for desired trajectories, disturbances are supposed to be bounded. The closed-loop stability of the system in the sense of Lyapunov is demonstrated. The effectiveness of the proposed approach is proved in real time using a 2-DOF upper limb exoskeleton in the rehabilitation context taking into account the security and the safety of the user.


Assuntos
Algoritmos , Exoesqueleto Energizado , Robótica , Extremidade Superior/fisiologia , Dispositivos Eletrônicos Vestíveis , Aceleração , Adulto , Humanos , Articulações/fisiologia , Masculino , Torque
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