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1.
BMC Musculoskelet Disord ; 24(1): 42, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653765

RESUMO

BACKGROUND: Overloading is hypothesized to be one of the failure mechanisms following total elbow arthroplasty (TEA). It is unclear whether the current post-operative loading instruction is compliant with reported failure mechanisms. Aim is therefore to evaluate the elbow joint load during activities of daily living (ADL) and compare these loads with reported failure limits from retrieval and finite element studies. METHODS: A scoping review of studies until 23 November 2021 investigating elbow joint load during ADL were identified by searching PubMed/Medline and Web of Science. Studies were eligible when: (1) reporting on the elbow joint load in native elbows or elbows with an elbow arthroplasty in adults; (2) full-text article was available. RESULTS: Twenty-eight studies with a total of 256 participants were included. Methodological quality was low in 3, moderate in 22 and high in 3 studies. Studies were categorized as 1) close to the body and 2) further away from the body. Tasks were then subdivided into: 1) cyclic flexion/extension, 2) push-up, 3) reaching, 4) self-care, 5) work. Mean flexion-extension joint load was 17 Nm, mean varus-valgus joint load 9 Nm, mean pronation-supination joint load 8 Nm and mean bone-on-bone contact force 337 N. CONCLUSION: The results of our scoping review give a first overview of the current knowledge on elbow joint loads during ADL. Surprisingly, the current literature is not sufficient to formulate a postoperative instruction for elbow joint loading, which is compliant with failure limits of the prosthesis. In addition, our current instruction does not appear to be evidence-based. Our recommendations offer a starting point to assist clinicians in providing informed decisions about post-operative instructions for their patients.


Assuntos
Artroplastia de Substituição do Cotovelo , Articulação do Cotovelo , Adulto , Humanos , Articulação do Cotovelo/cirurgia , Atividades Cotidianas , Cotovelo , Fenômenos Biomecânicos , Amplitude de Movimento Articular
2.
J Neuroeng Rehabil ; 20(1): 9, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658605

RESUMO

BACKGROUND: Myoelectric prostheses are a popular choice for restoring motor capability following the loss of a limb, but they do not provide direct feedback to the user about the movements of the device-in other words, kinesthesia. The outcomes of studies providing artificial sensory feedback are often influenced by the availability of incidental feedback. When subjects are blindfolded and disconnected from the prosthesis, artificial sensory feedback consistently improves control; however, when subjects wear a prosthesis and can see the task, benefits often deteriorate or become inconsistent. We theorize that providing artificial sensory feedback about prosthesis speed, which cannot be precisely estimated via vision, will improve the learning and control of a myoelectric prosthesis. METHODS: In this study, we test a joint-speed feedback system with six transradial amputee subjects to evaluate how it affects myoelectric control and adaptation behavior during a virtual reaching task. RESULTS: Our results showed that joint-speed feedback lowered reaching errors and compensatory movements during steady-state reaches. However, the same feedback provided no improvement when control was perturbed. CONCLUSIONS: These outcomes suggest that the benefit of joint speed feedback may be dependent on the complexity of the myoelectric control and the context of the task.


Assuntos
Amputados , Membros Artificiais , Humanos , Punho , Cotovelo , Retroalimentação , Eletromiografia/métodos , Retroalimentação Sensorial , Desenho de Prótese
3.
Arthroscopy ; 39(2): 253-255, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36603995

RESUMO

Lateral epicondylitis is a commonly encountered and persistent problem in the active, middle-aged population, with a reported annual incidence as high as 3.4%. Lateral epicondylitis is often treated successfully with conservative measures but may necessitate surgical intervention in refractory cases. Most of the review literature has failed to definitively identify arthroscopic or open debridement as the superior surgical approach. We favor the arthroscopic approach because it allows for the examination and treatment of concomitant intra-articular pathologies, which may be underappreciated on magnetic resonance imaging, and for minimal disruption of the superficial extensors to access the pathologic structures. In addition, this approach often allows for a quick resolution of symptoms and expeditious return to work and sport with a low rate of complications or revisions. For surgeons who are not experienced in elbow arthroscopy, the option of open debridement remains a reasonable approach. However, our preferred management of surgically indicated tennis elbow is arthroscopic repair of the affected extensor tendons along with addressing any concomitant pathology, when present. In our opinion, this leads to optimized long-term outcomes.


Assuntos
Articulação do Cotovelo , Cirurgiões , Cotovelo de Tenista , Pessoa de Meia-Idade , Humanos , Cotovelo , Cotovelo de Tenista/cirurgia , Artroscopia/métodos , Articulação do Cotovelo/cirurgia , Articulação do Cotovelo/patologia
4.
BMJ Case Rep ; 16(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36596630

RESUMO

Elbow dislocations are commonly seen and can occur after trauma or be congenital. The literature on congenital dislocations is scarce. No cases of an additional luxation of a pre-existing congenital radial head dislocation with a traumatic ulnohumeral dislocation have been described. This case involves a young man with no prior history who presented after trauma of the right elbow. He presented with pain, and his radial head was palpable behind the olecranon, and on imaging it appeared to be more proximal. After additional imaging, the dislocation of the radial head turned out to be congenital combined with an additional luxation of the ulna. This finding influenced our diagnostic approach and reposition method, which, instead of only traction-countertraction, also included pronation and supination.This case highlights the clinical importance of identifying and recognising a patient with a congenital dislocation of the radial head and an additional luxation of the elbow.


Assuntos
Articulação do Cotovelo , Luxações Articulares , Masculino , Humanos , Cotovelo , Luxações Articulares/diagnóstico por imagem , Articulação do Cotovelo/diagnóstico por imagem , Rádio (Anatomia)/diagnóstico por imagem , Ulna , Amplitude de Movimento Articular
5.
J Orthop Sports Phys Ther ; 53(1): 5-6, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36587262

RESUMO

Lateral elbow tendinopathy (LET) is an overuse injury of the common extensor tendon that occurs in active people. Modifiable risk factors include repetitive movements of the elbow, forearm, and hand, and tasks like handling heavy tools, which may overload the tendon. The clinical course of LET varies considerably. Some people experience a single, brief episode of symptoms, whereas others have persistent or recurring episodes of LET. J Orthop Sports Phys Ther 2023;53(1):5-6. doi:10.2519/jospt.2023.0501.


Assuntos
Tendinopatia do Cotovelo , Doenças Musculoesqueléticas , Tendinopatia , Humanos , Tendinopatia do Cotovelo/terapia , Cotovelo , Tendinopatia/reabilitação , Modalidades de Fisioterapia
6.
Bone Joint J ; 105-B(1): 56-63, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36587260

RESUMO

AIMS: This study aimed to answer the following questions: do 3D-printed models lead to a more accurate recognition of the pattern of complex fractures of the elbow?; do 3D-printed models lead to a more reliable recognition of the pattern of these injuries?; and do junior surgeons benefit more from 3D-printed models than senior surgeons? METHODS: A total of 15 orthopaedic trauma surgeons (seven juniors, eight seniors) evaluated 20 complex elbow fractures for their overall pattern (i.e. varus posterior medial rotational injury, terrible triad injury, radial head fracture with posterolateral dislocation, anterior (trans-)olecranon fracture-dislocation, posterior (trans-)olecranon fracture-dislocation) and their specific characteristics. First, fractures were assessed based on radiographs and 2D and 3D CT scans; and in a subsequent round, one month later, with additional 3D-printed models. Diagnostic accuracy (acc) and inter-surgeon reliability (κ) were determined for each assessment. RESULTS: Accuracy significantly improved with 3D-printed models for the whole group on pattern recognition (acc2D/3D = 0.62 vs acc3Dprint= 0.69; Δacc = 0.07 (95% confidence interval (CI) 0.00 to 0.14); p = 0.025). A significant improvement was also seen in reliability for pattern recognition with the additional 3D-printed models (κ2D/3D = 0.41 (moderate) vs κ3Dprint = 0.59 (moderate); Δκ = 0.18 (95% CI 0.14 to 0.22); p ≤ 0.001). Accuracy was comparable between junior and senior surgeons with the 3D-printed model (accjunior = 0.70 vs accsenior = 0.68; Δacc = -0.02 (95% CI -0.17 to 0.13); p = 0.904). Reliability was also comparable between junior and senior surgeons without the 3D-printed model (κjunior = 0.39 (fair) vs κsenior = 0.43 (moderate); Δκ = 0.03 (95% CI -0.03 to 0.10); p = 0.318). However, junior surgeons showed greater improvement regarding reliability than seniors with 3D-printed models (κjunior = 0.65 (substantial) vs κsenior = 0.54 (moderate); Δκ = 0.11 (95% CI 0.04 to 0.18); p = 0.002). CONCLUSION: The use of 3D-printed models significantly improved the accuracy and reliability of recognizing the pattern of complex fractures of the elbow. However, the current long printing time and non-reusable materials could limit the usefulness of 3D-printed models in clinical practice. They could be suitable as a reusable tool for teaching residents.Cite this article: Bone Joint J 2023;105-B(1):56-63.


Assuntos
Articulação do Cotovelo , Luxações Articulares , Fraturas do Rádio , Fraturas da Ulna , Humanos , Cotovelo , Reprodutibilidade dos Testes , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Luxações Articulares/cirurgia , Fraturas da Ulna/cirurgia , Impressão Tridimensional
7.
J Pediatr Orthop ; 43(2): e179-e187, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36607931

RESUMO

BACKGROUND: Limitations to terminal elbow extension (TEE) in pediatric populations have been commonly associated with the degree of ligamentous laxity and not bony factors. Ligamentous laxity, quantified through the Beighton score, is criticized for unreliably assessing joint mobility. This study aims to show that the olecranon-coronoid notch angle (OCNA) affects TEE in healthy children and adolescents. METHODS: A retrospective study of 711 pediatric patients treated for upper extremity and shoulder injuries was cross-sectionally studied at 2 tertiary centers from 2014 to 2021. Radiographs were used to measure the OCNA, humerocondylar angle, proximal anterior ulnar angle, and the presence of secondary centers of ossification. A 2-axis goniometer measured clinical TEE to a firm endpoint. The statistical analysis studied the relationships between OCNA and TEE and the effect that age and sex have on these measurements. RESULTS: Increased TEE was associated with increased OCNA (P<0.001) when accounting for age and sex. The average OCNA was 30.0 degrees (7.5 degrees), and the average TEE was 5.6 degrees (8.0 degrees). There was a difference in OCNA between subjects who had elbow hypoextension, normal TEE, and elbow hyperextension (P<0.001). The most common injuries were distal radius fractures (182, 26%), elbow sprains and contusions (111, 16%), distal both bone forearm fractures (95, 14%), single or both bone shaft fractures (77, 11%), and supracondylar fractures (74, 11%). CONCLUSION: These results show that the orientation of the opening of the olecranon-coronoid notch influences the arc of TEE motion in a healthy pediatric population. The notch restrains TEE by activating the bony block mechanism between the olecranon apophysis and the olecranon fossa. The measurement of the OCNA can serve as a reproducible and quantitative method to predict hypomobility to hypermobility of TEE motion. LEVEL OF EVIDENCE: Prognostic study: Level II.


Assuntos
Articulação do Cotovelo , Instabilidade Articular , Olécrano , Fraturas da Ulna , Humanos , Criança , Adolescente , Olécrano/diagnóstico por imagem , Cotovelo , Estudos Retrospectivos , Articulação do Cotovelo/diagnóstico por imagem , Ulna , Instabilidade Articular/diagnóstico por imagem , Fraturas da Ulna/diagnóstico por imagem , Amplitude de Movimento Articular
8.
J Neurophysiol ; 129(1): 7-16, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36475940

RESUMO

The spinal stretch reflex is a fundamental building block of motor function, with a sensitivity that varies continuously during movement and when changing between movement and posture. Many have investigated task-dependent reflex sensitivity, but few have provided simple, quantitative analyses of the relationship between the volitional control and stretch reflex sensitivity throughout tasks that require coordinated activity of several muscles. Here, we develop such an analysis and use it to test the hypothesis that modulation of reflex sensitivity during movement can be explained by the balance of activity within agonist and antagonist muscles better than by activity only in the muscle homonymous with the reflex. Subjects completed hundreds of flexion and extension movements as small, pseudorandom perturbations of elbow angle were applied to obtain estimates of stretch reflex amplitude throughout the movement. A subset of subjects performed a postural control task with muscle activities matched to those during movement. We found that reflex modulation during movement can be described by background activity in antagonist muscles about the elbow much better than by activity only in the muscle homonymous to the reflex (P < 0.001). Agonist muscle activity enhanced reflex sensitivity, whereas antagonist activity suppressed it. Surprisingly, the magnitude of these effects was similar, suggesting a balance of control between agonists and antagonists very different from the dominance of sensitivity to homonymous activity during posture. This balance is due to a large decrease in sensitivity to homonymous muscle activity during movement rather than substantial changes in the influence of antagonistic muscle activity.NEW & NOTEWORTHY This study examined the sensitivity of the stretch reflexes elicited in elbow muscles to the background activity in these same muscles during movement and postural tasks. We found a heightened reciprocal control of reflex sensitivity during movement that was not present during maintenance of posture. These results help explain previous discrepancies in reflex sensitivity measured during movement and posture and provide a simple model for assessing their contributions to muscle activity in both tasks.


Assuntos
Articulação do Cotovelo , Reflexo de Estiramento , Humanos , Reflexo de Estiramento/fisiologia , Cotovelo , Eletromiografia , Articulação do Cotovelo/fisiologia , Músculo Esquelético/fisiologia
9.
Ann Plast Surg ; 90(1): 41-46, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36534099

RESUMO

BACKGROUND: Heterotopic ossification (HO) is a rare but known complication of brain and nerve trauma, orthopedic trauma, and burns. Nerve compression due to HO is extremely rare; "bony cubital tunnel syndrome," or compression of the ulnar nerve at the elbow due to HO, is an unusual presentation that requires special considerations for treatment. CASE PRESENTATION: We present a 50-year-old man who presented to our hospital after vehicular polytrauma with associated car fire and prolonged extrication. He experienced extensive trauma, with all classically described risks for HO. He developed bony cubital tunnel syndrome, with ulnar neuropathy confirmed on electrodiagnostic studies, and underwent surgical decompression. Surgical decompression revealed circumferential encasement of the ulnar nerve in heterotopic bone, all of which was removed. He demonstrates appropriate recovery of nerve function. LITERATURE REVIEW: All perineural HO should be excised early to prevent nerve injury, because excision within 4 months of development is linked to improved functional outcomes. Measures to prevent nerve compression by HO are all associated with delayed wound or bone healing and should be considered on an individual basis.


Assuntos
Síndrome do Túnel Ulnar , Ossificação Heterotópica , Masculino , Humanos , Pessoa de Meia-Idade , Nervo Ulnar/cirurgia , Cotovelo/cirurgia , Resultado do Tratamento , Descompressão Cirúrgica/efeitos adversos , Ossificação Heterotópica/complicações , Ossificação Heterotópica/cirurgia
10.
Skeletal Radiol ; 52(1): 31-37, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35864196

RESUMO

OBJECTIVE: The ulnar collateral ligament (UCL) supports the medial elbow against valgus torque and is commonly injured in baseball pitchers. Changes in UCL morphology and pathology occur with long-term pitching, with more severe findings at higher competition levels. We examined the bilateral differences and the relationship between UCL morphology, pathology, and ulnohumeral joint laxity in asymptomatic collegiate pitchers using ultrasound. MATERIALS AND METHODS: Division I college pitchers (n = 41) underwent ultrasound scans of their bilateral medial elbows, both at rest and in a valgus-stressed position. The presence of enthesopathy, calcifications, and degeneration was assessed qualitatively. UCL thickness and ulnohumeral joint gap were measured with online calipers. The bilateral differences were analyzed using paired t-tests and chi-square analysis, and the relationships between thickness, gapping, and degenerative changes were analyzed using regression analyses. RESULTS: The throwing arm demonstrated greater distal UCL thickness (mean difference (MD) = 0.2 mm (95%CI = 0.1-0.3), p < 0.01), resting and stressed gap (MD = 0.3 mm (95%CI = 0.0-0.7), p = 0.04; MD = 0.4 (95%CI = 0.0-0.9), p = 0.02), and greater prevalence of degeneration and enthesopathy (p = 0.03) compared bilaterally. Enthesopathy and calcifications predicted increased distal UCL thickness (p = 0.04; p = 0.02). Degenerative scores predicted increased stressed-resting ulnohumeral joint gap (p < 0.01). CONCLUSION: In the throwing arms of collegiate pitchers, ultrasound demonstrated UCL thickening, enthesopathy/intra-ligamentous calcification, and greater laxity of the ulnohumeral joint relative to the non-throwing arm. Degeneration of the UCL, not thickness, was related to greater elbow joint gapping. This study demonstrates the utility of ultrasound for examining sonographic characteristics of the UCL in a sample of college pitchers.


Assuntos
Beisebol , Calcinose , Ligamento Colateral Ulnar , Ligamentos Colaterais , Articulação do Cotovelo , Entesopatia , Humanos , Ligamento Colateral Ulnar/diagnóstico por imagem , Cotovelo , Braço , Articulação do Cotovelo/diagnóstico por imagem , Ligamentos Colaterais/diagnóstico por imagem
11.
Hum Mov Sci ; 87: 103049, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36525823

RESUMO

Continuous steering movement (CSM) is an essential component of the upper extremity (UE) task during vehicle driving, and could be a suitable candidate for multi-joint rehabilitation programs for patients with UE disabilities. This study aims to evaluate the UE muscle activation during CSM and how the rotating speed and direction affect CSM's kinematic and kinetic performance. Surface electromyography (EMG), hand contact information, and steering torque were measured under fast (180°/s) and slow (60°/s) constant-velocity CSM to reveal the activation of shoulder and elbow muscles, temporal characteristics, and force exertion during the stance and swing phases of a CSM cycle. Data from 24 normal young adults showed that shorter contact duration but higher force exertion occurred in the hand moving in an outward steering direction during only fast CSM in either the clockwise (CW) or counterclockwise (CCW) direction. During a steering cycle (either fast or slow speed), the triceps brachii, sternal part of the pectoralis major (PS), and posterior deltoid play major roles in generating steering torque in the CW direction of the CSM. In contrast, the PS, clavicular part of the pectoralis major (PC), and anterior deltoid (AD) largely contribute to torque generation during the CCW CSM. During the swing phase of CSM, AD, PC, and PS are the major muscles that move the hand for the next grasping of the steering wheel in all four conditions. Using the mean activation profiles of the major contributing muscles, the functional roles of these elbow and shoulder muscles were analyzed and are discussed herein. These findings help us to further understand the activation patterns of UE muscles and the kinematic and kinetic changes during two rotating directions and two speeds of CSM, and suggest important implications for future practice in clinical training.


Assuntos
Músculo Esquelético , Extremidade Superior , Adulto Jovem , Humanos , Extremidade Superior/fisiologia , Músculo Esquelético/fisiologia , Eletromiografia , Cotovelo , Braço , Movimento/fisiologia
12.
Surg Radiol Anat ; 45(1): 11-15, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36542111

RESUMO

Variations of the brachialis muscle are uncommon in the literature. During regular cadaveric dissection, we observed the unilateral presence of an accessory muscle in the front of the right arm of a female cadaver, taking its origin from the medial aspect of the brachialis and the adjacent intermuscular septum. The muscle belly descended downwards, crossed the neurovascular bundle in the cubital fossa and merged with the fibres of the pronator teres. There is no doubt regarding its significance in the etiogenesis of numerous compression syndromes due to its close topographical relationship with the neurovascular bundle. In our report, we consider the potential developmental process and therapeutic implications of this variation, which can aid surgeons in their strategy and management.


Assuntos
Nervo Mediano , Anormalidades Musculoesqueléticas , Humanos , Feminino , Nervo Mediano/anatomia & histologia , Músculo Esquelético , Antebraço , Cotovelo , Cadáver
13.
Appl Ergon ; 108: 103952, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36493677

RESUMO

This systematic review updates a previous systematic review on work-related physical and psychosocial risk factors for elbow disorders. Medline, Embase, Web of Science, Cochrane Central and PsycINFO were searched for studies on associations between work-related physical or psychosocial risk factors and the occurrence of elbow disorders. Two independent reviewers selected eligible studies and assessed risk of bias (RoB). Results of studies were synthesized narratively. We identified 17 new studies and lateral epicondylitis was the most studied disorder (13 studies). Five studies had a prospective cohort design, eight were cross-sectional and four were case-control. Only one study had no items rated as high RoB. Combined physical exposure indicators (e.g. physical exertion combined with elbow movement) were associated with the occurrence of lateral epicondylitis. No other consistent associations were observed for other physical and psychosocial exposures. These results prevent strong conclusions regarding associations between work-related exposures, and the occurrence of elbow disorders.


Assuntos
Articulação do Cotovelo , Doenças Profissionais , Cotovelo de Tenista , Humanos , Cotovelo , Cotovelo de Tenista/etiologia , Cotovelo de Tenista/epidemiologia , Cotovelo de Tenista/psicologia , Estudos Prospectivos , Doenças Profissionais/etiologia , Doenças Profissionais/epidemiologia
15.
J Orthop Sports Phys Ther ; 52(12): CPG1-CPG111, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36453071

RESUMO

Although often described as a self-limiting condition and likely to resolve on its own, high recurrence rates and extended sick leave frame a need for effective non-surgical treatment for people with lateral elbow tendinopathy. The interrelationship of histological and structural changes to the tendon, the associated impairments in motor control, and potential changes in pain processing may all drive symptoms. This clinical practice guideline covers the epidemiology, functional anatomy and pathophysiology, risk factors, clinical course, prognosis, differential diagnosis, tests and measures, and interventions for managing lateral elbow tendinopathy in the physical therapy clinic. J Orthop Sports Phys Ther 2022;52(12):CPG1-CPG111. doi:10.2519/jospt.2022.0302.


Assuntos
Tendinopatia do Cotovelo , Doenças Musculoesqueléticas , Tendinopatia , Humanos , Cotovelo , Artralgia , Dor , Músculos
16.
Curr Sports Med Rep ; 21(12): 443-447, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36508600

RESUMO

ABSTRACT: Injury to the flexor pronator mass is a common condition that is especially prevalent in overhead throwing athletes. The increasing incidence of these injuries has promoted considerable efforts in research to better understand the pathology, risk factors, and potential mechanisms to prevent injury in these athletes. While there are numerous intrinsic and extrinsic factors associated with injury, a common theme involves chronic overuse and microtrauma with inadequate resting intervals between performances. The purpose of this review is to discuss medial elbow injuries in young athletes with a particular focus on the flexor pronator mass.


Assuntos
Traumatismos em Atletas , Articulação do Cotovelo , Traumatismos dos Tendões , Humanos , Adolescente , Cotovelo , Tendões , Atletas , Traumatismos dos Tendões/prevenção & controle , Fatores de Risco , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/etiologia
17.
Sensors (Basel) ; 22(24)2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36560219

RESUMO

Human motion analysis using inertial measurement units (IMUs) has recently been shown to provide accuracy similar to the gold standard, optical motion capture, but at lower costs and while being less restrictive and time-consuming. However, IMU-based motion analysis requires precise knowledge of the orientations in which the sensors are attached to the body segments. This knowledge is commonly obtained via time-consuming and error-prone anatomical calibration based on precisely defined poses or motions. In the present work, we propose a self-calibrating approach for magnetometer-free joint angle tracking that is suitable for joints with two degrees of freedom (DoF), such as the elbow, ankle, and metacarpophalangeal finger joints. The proposed methods exploit kinematic constraints in the angular rates and the relative orientations to simultaneously identify the joint axes and the heading offset. The experimental evaluation shows that the proposed methods are able to estimate plausible and consistent joint axes from just ten seconds of arbitrary elbow joint motion. Comparison with optical motion capture shows that the proposed methods yield joint angles with similar accuracy as a conventional IMU-based method while being much less restrictive. Therefore, the proposed methods improve the practical usability of IMU-based motion tracking in many clinical and biomedical applications.


Assuntos
Algoritmos , Articulação do Cotovelo , Humanos , Movimento (Física) , Cotovelo , Articulações dos Dedos , Fenômenos Biomecânicos , Articulações
18.
BMC Musculoskelet Disord ; 23(1): 1137, 2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36581852

RESUMO

BACKGROUND: This study aimed to evaluate the outcome of using an External Joint Stabilizer - Elbow (EJS-E) for persistent elbow instability based on biomechanical experiments and analysis of clinical results. METHODS: An EJS-E was used in 17 elbow instability patients. The median follow-up was 26 months (range, 12-42 months). We evaluated the flexion-extension and pronation-supination movement arcs, visual analog scale (VAS) score, Mayo Elbow Performance Score (MEPS), Broberg and Morrey classification system, and occurrence of complications in these patients. Moreover, construct stiffness and maximum strength tests were performed to evaluate the strength of the fixation techniques. RESULTS: The final median range of the extension-to-flexion and pronation-to-supination arc of the elbow was 135° (range, 110°-150°) and 165° (range, 125°-180°), respectively. The VAS pain scores were > 3 in two patients. The median MEPS was 90 (range, 80-100 points). Five patients showed signs of grade I post-traumatic osteoarthritis according to the Broberg and Morrey radiographic classification system, while grade II changes were observed in three patients. Complications included axis pin loosening with pin-tract infection in two patients, transient ulnar nerve symptoms in two patients, heterotopic ossification in two patients, and suture anchors infection in one patient. Based on the biomechanical testing results, the EJS-E exhibited higher stiffness and resisting force in varus loading. It was 0.5 (N/mm) stiffer and 1.8 (N·m) stronger than the internal joint stabilizer (IJS) by difference of medians (p < 0.05). CONCLUSIONS: Biomechanical and clinical outcomes show that EJS-E via the posterior approach can restore mobility and stability in all patients, thus serving as a valuable alternative option for the treatment of persistent instability of the elbow.


Assuntos
Articulação do Cotovelo , Luxações Articulares , Instabilidade Articular , Humanos , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Cotovelo , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Luxações Articulares/cirurgia , Resultado do Tratamento , Amplitude de Movimento Articular , Estudos Retrospectivos
19.
BMC Musculoskelet Disord ; 23(1): 1126, 2022 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-36566206

RESUMO

BACKGROUND: A safe and effective technique for anterolateral portal placement in elbow arthroscopy is significant. We compared the outcomes of patients who underwent elbow arthroscopy using different ultrasound-assisted techniques. METHODS: From May 2016 to June 2021 a retrospective analysis on all patients who underwent elbow arthroscopy in our department was performed. Patients were separated into three groups: non-ultrasound; preoperative ultrasound; and intraoperative ultrasound. The minimum follow-up period was 1 year. Nerve injuries, visual analog scale (VAS), Mayo elbow-performance score (MEPS), Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and range of motion (ROM) of the elbow were evaluated for comparison among the three groups pre- and post-operatively. RESULTS: All 55 patients completed a 1-year follow-up: non-ultrasound (n = 20); preoperative ultrasound (n = 17); and intraoperative ultrasound (n = 18). There were 3 cases (15.0%) of transient radial nerve palsy in the non-ultrasound group. No nerve complications occurred in preoperative ultrasound and intraoperative ultrasound groups. The probability of postoperative radial nerve injury in the three groups was statistically different (P < 0.05). There was no significant difference in the VAS score, MEPS, DASH score, and ROM among the three groups at the follow-up evaluation (P > 0.05). CONCLUSION: Performing anterolateral portal placement during elbow arthroscopy with ultrasound-assisted techniques successfully avoided radial nerve injury.


Assuntos
Articulação do Cotovelo , Cotovelo , Humanos , Seguimentos , Cotovelo/diagnóstico por imagem , Cotovelo/cirurgia , Nervo Radial/diagnóstico por imagem , Artroscopia/efeitos adversos , Artroscopia/métodos , Estudos Retrospectivos , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Amplitude de Movimento Articular , Resultado do Tratamento
20.
Artigo em Inglês | MEDLINE | ID: mdl-36554736

RESUMO

The objectives of this study were to analyze the injuries suffered during the previous year by amateur padel players according to the characteristics of the racket, their usual volume of practice and their experience in padel. A total of 950 amateur players (X age: 31.68 years; X weight: 70.84 kg; X height: 170.9 cm) participated voluntarily, completing an ad-hoc questionnaire. The results indicated that the appearance of the injuries and their location was different according to the sex of the amateur padel players. Men had a higher incidence of muscle and ligament injuries in the shoulder, and tendon injuries in the elbow. On the other hand, women had a greater probability of having muscle injuries in the shoulder and arm, ligament injuries in the elbow and bone injuries in the wrist and elbow. In general, tendon injuries were the most common injury in padel and the shoulder and elbow were the most affected areas. Moreover, men tend to use heavy (CSR = 6.0), fiberglass or carbon (CSR = 2.1), diamond-shaped rackets (CSR = 3.2), with a hard core (CSR = 4.4) and with two or more over grips (CSR = 2.7). Women usually use less heavy (CSR = 6.0), round-shaped rackets (CSR = 4.9), with a soft core (CSR = 4.4) and with one or no over grips (CSR = 2.7). In addition, men tend to play padel more often and have been practicing for longer. In conclusion, although the risk of injury depends on many factors, we identified that the characteristics of the racket, the volume of weekly practice, the experience of the player and the gender of the player are fundamental aspects to take into account for the prevention of injuries in amateur padel players.


Assuntos
Traumatismos em Atletas , Traumatismos dos Tendões , Masculino , Humanos , Feminino , Adulto , Incidência , Atletas , Ombro , Cotovelo , Traumatismos em Atletas/epidemiologia
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