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1.
Skeletal Radiol ; 52(1): 23-29, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35831718

RESUMO

OBJECTIVE: To compare the image quality of ultra-high-resolution wrist CTs acquired on photon-counting detector CT versus conventional energy-integrating-detector CT systems. MATERIALS AND METHODS: Participants were scanned on a photon-counting-detector CT system after clinical energy-integrating detector CTs. Energy-integrating-detector CT scan parameters: comb filter-based ultra-high-resolution mode, 120 kV, 250 mAs, Ur70 or Ur73 kernel, 0.4- or 0.6-mm section thickness. Photon-counting-detector CT scan parameters: non-comb-based ultra-high-resolution mode, 120 kV, 120 mAs, Br84 kernel, 0.4-mm section thickness. Two musculoskeletal radiologists blinded to CT system, scored specific osseous structures using a 5-point Likert scale (1 to 5). The Wilcoxon rank-sum test was used for statistical analysis of reader scores. Paired t-test was used to compare volume CT dose index, bone CT number, and image noise between CT systems. P-value < 0.05 was considered statistically significant. RESULTS: Twelve wrists (mean participant age 55.3 ± 17.8, 6 females, 6 males) were included. The mean volume CT dose index was lower for photon-counting detector CT (9.6 ± 0.1 mGy versus 19.0 ± 6.7 mGy, p < .001). Photon-counting-detector CT images had higher Likert scores for visualization of osseous structures (median score = 4, p < 0.001). The mean bone CT number was higher in photon-counting-detector CT images (1946 ± 77 HU versus 1727 ± 49 HU, p < 0.001). Conversely, there was no difference in the mean image noise of the two CT systems (63 ± 6 HU versus 61 ± 6 HU, p = 0.13). CONCLUSION: Ultra-high-resolution imaging with photon-counting-detector CT depicted wrist structures more clearly than conventional energy-integrating-detector CT despite a 49% radiation dose reduction.


Assuntos
Fótons , Punho , Masculino , Feminino , Humanos , Imagens de Fantasmas , Punho/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Doses de Radiação
2.
Skeletal Radiol ; 52(1): 67-72, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35920932

RESUMO

OBJECTIVE: To quantify the shear velocity and stiffness of the median nerve (MN) with shear wave elastography (SWE) at the carpal tunnel entrance and determine whether SWE is useful for diagnosing and staging carpal tunnel syndrome (CTS). MATERIALS AND METHODS: The study included 58 patients (79 wrists) with clinical and electroneuromyographic diagnoses of CTS and 55 healthy controls (63 wrists). MN shear velocity and stiffness were measured by SWE on the axial plane in both groups. The differences between CTS patients and controls and between different grades of CTS based on electrodiagnostic tests were studied using Student's t test and ANOVA with ROC analysis. RESULTS: The mean MN shear velocity and stiffness were significantly greater in CTS patients (2.5 ± 0.37 m/s and 19.4 ± 5.8 kPa) than in controls (1.91 ± 0.24 m/s and 11.1 ± 3.0 kPa) (p < 0.001) and greater in the severe CTS group (2.69 ± 0.39 m/s and 22.4 ± 7.1 kPa) than in the mild CTS group (2.37 ± 0.35 m/s and 17.3 ± 4,8 kPa). The cutoff value for the shear velocity was 2.13 m/s, with 86% and 82% sensitivity and specificity, respectively, and the cutoff value for stiffness was 13.6 kPa, with 87% and 82% sensitivity and specificity. CONCLUSION: MN shear velocity and stiffness are significantly higher in CTS patients. SWE can be used to diagnose CTS and distinguish between patients with mild and severe disease.


Assuntos
Síndrome do Túnel Carpal , Técnicas de Imagem por Elasticidade , Humanos , Síndrome do Túnel Carpal/diagnóstico por imagem , Nervo Mediano/diagnóstico por imagem , Punho/diagnóstico por imagem , Sensibilidade e Especificidade
3.
Sci Rep ; 12(1): 20558, 2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36446832

RESUMO

Non-invasive blood glucose sensing can be achieved using mid-infrared spectroscopy, although no practical device based on this method has yet been developed. Here, we propose mid-infrared passive spectroscopic imaging for glucose measurements from a distance. Spectroscopic imaging of thermal radiation from the human body enabled, for the first time in the world, the detection of glucose-induced luminescence from a distance. In addition, glucose emission spectra of the wrist acquired at regular intervals up to 60 min showed that there was a strong correlation between the glucose emission intensity and blood glucose level measured using an invasive sensor. Thus, the new technology proposed here is expected to be applied to real-time monitoring of diabetic patients to detect hypoglycemic attacks during sleep and to detect hyperglycemia in a population. Moreover, this technology could lead to innovations that would make it possible to remotely measure a variety of substances.


Assuntos
Glucose , Punho , Humanos , Glicemia , Articulação do Punho , Espectrofotometria Infravermelho
6.
BMC Musculoskelet Disord ; 23(1): 980, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371190

RESUMO

BACKGROUND: Tendon and nerve transfers are used for functional reconstruction in cases of proximal radial nerve injury complicated by humeral fractures in patients who do not show functional recovery after primary nerve repair. The effectiveness of pronator teres (PT) nerve branch transfer to the extensor carpi radialis brevis (ERCB) nerve branch for wrist extension reconstruction was investigated and compared to the results of tendon transfer. METHODS: This study included 10 patients with proximal radial nerve injury, who did not show functional recovery after primary nerve repair at our hospital between April 2016 and May 2019. The nerve transfer procedure included PT nerve branch transfer to the ECRB nerve branch to restore wrist extension and the flexor carpi radialis (FCR) nerve branch to the posterior interosseous nerve (PIN) to restore thumb and finger extension. Tendon transfer procedures included PT transfer to the ECRB for wrist extension, FCR transfer to the extensor digitorum communis (EDC) for finger extension and palmaris longus (PL) transfer to the extensor pollicis longus (EPL) for thumb extension. RESULTS: Five patients recovered Medical Research Council grade M4 muscle strength in the ECRB and EPL in both tendon and nerve groups. Two patients recovered grade M3 strength and three patients recovered grade M4 strength in the EDC in the tendon transfer group, and all five patients recovered grade M4 strength in the EDC in the nerve transfer group. Limited wrist flexion was observed only in one patient in the tendon transfer group. CONCLUSION: PT nerve branch transfer to the ECRB nerve branch combined with FCR nerve branch transfer to PIN is a useful strategy for wrist and fingers extension reconstruction in patients with proximal radial nerve injuries.


Assuntos
Fraturas do Úmero , Transferência de Nervo , Humanos , Transferência de Nervo/métodos , Nervo Radial/cirurgia , Nervo Radial/lesões , Punho/cirurgia , Fraturas do Úmero/cirurgia , Úmero
7.
J Med Case Rep ; 16(1): 415, 2022 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-36371272

RESUMO

BACKGROUND: There are few reports of trigger wrist in the literature, as it is a rare pathology. Furthermore, various authors report that it is also hard to diagnose. It manifests with neurological symptoms at the affected wrist, which are usually induced by wrist movement, and can lead to partial or full loss of wrist function and sensitivity. The reason for reporting this specific case is that it was hard to differentiate between trigger finger and trigger wrist by clinical symptoms; no pathology was palpable or clearly seen on magnetic resonance imaging scan of the wrist. We propose a new diagnostic statement relative to this pathology. CASE PRESENTATION: A case of a 45-year-old white slavic man with trigger wrist associated with carpal tunnel syndrome, caused by a fibroma of the flexor tendon sheath, is reported. Despite careful clinical examination, it was not possible to differentiate between trigger finger and trigger wrist. Magnetic resonance imaging was performed to arrive at the right diagnosis but did not reveal any pathology in the wrist area. Carpal tunnel release was performed with a fibroma identified and excised. Wrist function was maintained well; no signs of carpal tunnel syndrome were seen at last follow-up. CONCLUSIONS: Trigger wrist can be misdiagnosed as trigger finger even if adequate clinical evaluation is performed, and this can lead to inadequate treatment. We state that, when clinical symptoms of both trigger wrist and trigger finger are present, except painful palpation of the A-1 pulley region, the case should be referred to as trigger wrist.


Assuntos
Síndrome do Túnel Carpal , Fibroma , Dedo em Gatilho , Masculino , Humanos , Pessoa de Meia-Idade , Punho/diagnóstico por imagem , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/cirurgia , Dedo em Gatilho/diagnóstico por imagem , Dedo em Gatilho/etiologia , Dedo em Gatilho/cirurgia , Articulação do Punho/diagnóstico por imagem , Fibroma/complicações , Fibroma/diagnóstico por imagem , Fibroma/cirurgia
8.
Zhonghua Shao Shang Za Zhi ; 38(11): 1040-1046, 2022 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-36418261

RESUMO

Objective: To investigate the regularity of sensory recovery after repairing the wounds on the wrist and back of hand with anterolateral femoral flap without nerve anastomosis. Methods: A cross-sectional study was conducted. From January 2018 to December 2020, patients who underwent free anterolateral femoral flaps without nerve anastomosis to repair wounds on the wrist and back of hand and met the inclusion criteria in Changshu Hai Yu Health Centre and Suzhou Ruihua Orthopedic Hospital were included in this study. Depending on the time interval between the day of the patient's surgery and the day of the cross-sectional survey, 80 patients were divided into 6-month group (15 males and 5 females, aged 22-63 years), 12-month group (16 males and 4 females, aged 21-65 years), 18-month group (15 males and 5 females, aged 25-61 years), and 24-month group (14 males and 6 females, aged 20-65 years), with 20 patients in each group. The area of skin and soft tissue defects after debridement ranged from 6.0 cm×4.5 cm to 18.0 cm×9.0 cm. Anterolateral femoral flaps were cut with areas of 7 cm×5 cm to 20 cm×10 cm and a thickness of 1.0 to 2.5 cm. Each transplanted flap was divided into A (proximal), B/D (bilateral), C (distal), and E (central) regions. The pain sensation, touch sensation, cold sensation, warmth sensation, and two-point discrimination (2-PD) in the aforementioned five regions and the differences in the five senses of the whole flap were tested and compared. Data were statistically analyzed with one-way analysis of variance, Fisher's exact probability test, chi-square test, or McNemar test. Results: In A region of anterolateral femoral flap without nerve anastomosis, compared with those in 6-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 12-month group were significantly recovered (with χ2 values of 10.10, 14.55, 12.13, and 4.29, respectively, P<0.05 or P<0.01); compared with that in 12-month group, the warmth sensation of flap of patients in 18-month group recovered significantly (χ2=5.23, P<0.05). In B region, compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of flap of patients in 12-month group recovered significantly (with χ2 values of 5.58, 3.96, and 4.29, respectively, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ2 values of 5.58, 3.96, 7.03, and 12.38, respectively, P<0.05 or P<0.01). In C region, compared with that in 6-month group, the pain sensation of flap of patients in 12-month group recovered significantly (χ2=4.80, P<0.05); Compared with that in 12-month group, the warmth sensation of flap of patients in 18-month group recovered significantly (χ2=10.16, P<0.01). In D region, compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of flap of patients in 12-month group recovered significantly (with χ2 values of 5.58, 4.29, and 3.96, respectively, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ2 values of 5.58, 4.29, 3.96, and 10.10, respectively, P<0.05 or P<0.01). In E region, compared with that in 6-month group, the cold sensation of flap of patients in 12-month group recovered significantly (χ2=4.80, P<0.05); compared with those in 12-month group, the pain sensation, touch sensation, and warmth sensation of flap of patients in 18-month group recovered significantly (with χ2 values of 6.47, 4.91, and 9.23, respectively, P<0.05 or P<0.01). The five senses in the 5 regions of flap of patients in 24-month group were similar to those in 18-month group (P>0.05). The recovery of 2-PD in the 5 regions of flap of patients was similar between the two adjacent groups (P>0.05). In 12-month group, the recoveries of pain sensation, touch sensation, and cold sensation of flap of patients in A region were better than those in the other 4 regions (P<0.05 or P<0.01), the recovery of warmth sensation was better than that of B region, C region, and E region (P<0.05 or P<0.01); in 18-month group, the recovery of pain sensation, touch sensation, cold sensation, and warmth sensation of flap of patients in A region of was better than those in area C region (P<0.05). Compared with those in 6-month group, the pain sensation, touch sensation, and cold sensation of the whole flap of patients in 12-month group recovered significantly (with χ2 values of 7.62, 7.03, and 5.58, respectively, P<0.05 or P<0.01). Compared with the 12-month group in which 10, 11, 10, and 4 patients had a recovery of pain, touch sensation, cold sensation, and warmth sensation in the whole flap, the 18-month group had significantly more patients with sensations recovered, which were 17, 17, 16, and 14, respectively (with χ2 values of 5.58, 4.29, 3.96, and 10.10, respectively, P<0.05 or P<0.01). The five senses of the whole flap of patients in 24-month group were similar to those in 18-month group (P>0.05). Conclusions: In the anterolateral femoral flap without nerve anastomosis for repairing wounds on the wrist and back of hand, the sensation gradually recovered from the proximal end to the distal end. The sensation of touch, pain, and cold began to recover from 6 months after operation, and entered the stable recover period at 18 months after operation. Warmth sensation began to recover from 12 months after operation, and entered the stable recovery period at 18 months after operation. The 2-PD of most flaps was still not recovered 2-year after operation.


Assuntos
Tato , Punho , Masculino , Feminino , Humanos , Estudos Transversais , Tato/fisiologia , Dor , Anastomose Cirúrgica
9.
BMC Musculoskelet Disord ; 23(1): 969, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36348303

RESUMO

BACKGROUND: Carpal Tunnel Syndrome (CTS) is the most prevalent peripheral nerve entrapment disease. Its pathophysiology is multifactorial and defined as idiopathic in most cases. We present a rare case of CTS secondary to tumoral calcinosis and then searched the English literature to present the details of all published cases with this entity. CASE PRESENTATION: A 52-year-old woman presented for a one-year history of numbness and paresthesia in her right hand. The patient's signs, symptoms, physical examination, and nerve electrodiagnostic testing suggested median nerve compression at the level of the carpal tunnel. However, a confirmatory magnetic resonance imaging of the wrist showed a localized calcareous lesion in the carpal tunnel. Subsequently, carpal tunnel release and mass excision were successfully performed with no recurrence at a 3-month interval. CONCLUSION: CTS secondary to tumoral calcinosis is a rare benign condition. Physicians should remain vigilant and include it in their differential diagnosis when facing a previously healthy patient presenting for chronic CTS symptoms.


Assuntos
Calcinose , Síndrome do Túnel Carpal , Humanos , Feminino , Pessoa de Meia-Idade , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/cirurgia , Punho/patologia , Mãos/patologia , Parestesia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Calcinose/cirurgia , Nervo Mediano
10.
BMC Musculoskelet Disord ; 23(1): 971, 2022 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-36352375

RESUMO

Previous studies have shown radioulnar wrist compression augments carpal arch space. This study investigated the effects of radioulnar wrist compression on patient-reported outcomes associated with carpal tunnel syndrome. Subjects underwent thrice-daily (15 min each time 45 min daily) wrist compression over 4 weeks with an additional four weeks of follow-up without treatment. Primary outcomes included Boston Carpal Tunnel Questionnaire symptom and functional severity scales (SSS and FSS) and symptoms of numbness/tingling based on Visual Analog Scales. Our results showed that radioulnar wrist compression improved SSS by 0.55 points after 2 weeks (p < 0.001) and 0.51 points at 4 weeks (p < 0.006) compared to the baseline scale. At the four-week follow-up, SSS remined improved at 0.47 points (p < 0.05). Symptoms of numbness/tingling improved at two and 4 weeks, as well as the follow-up (p < 0.05). Hand motor impairment such as weakness had a lower frequency across carpal tunnel syndrome sufferers and does not significantly improve (p > 0.05). Radioulnar wrist compression might be an effective alternative treatment in improving sensory related symptoms in patients with mild to moderate carpal tunnel syndrome.


Assuntos
Síndrome do Túnel Carpal , Humanos , Síndrome do Túnel Carpal/complicações , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/terapia , Punho , Hipestesia/diagnóstico , Hipestesia/etiologia , Articulação do Punho , Medidas de Resultados Relatados pelo Paciente
11.
BMC Prim Care ; 23(1): 274, 2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333651

RESUMO

BACKGROUND: Knowledge on the course, disability and functionality of wrist complaints is still compendious in primary care guidelines, despite the high prevalence in primary care. Valid questionnaires can facilitate the monitoring of patients in primary care and research initiatives. In this study, we aimed to study the psychometric qualities of the Dutch version of the Patient Rated Wrist/Hand Evaluation (PRWHE-DLV) among adults with (sub)acute wrist complaints in primary care. METHODS: An observational cohort of 35 adults with (sub)acute wrist complaints in Dutch primary care was established. The content validity of the PRWHE-DLV was validated by assessing the floor and ceiling effects at baseline (T0). Reproducibility was assessed by the test-retest reliability between T0 and T1 (2-5 days after T0), using the Intra-class Correlation Coefficient. The construct validity was assessed based on the correlation between the PRWHE-DLV and the Quick-DASH, Physical Component Score (SF-12), VAS-function, Physical Functioning (SF-12), VAS-pain and Bodily Pain (SF-12) at T0. Responsiveness was defined as the ability of the PRWHE-DLV to measure change 3 weeks after T0 (internal) and the relation of these changes to clinically important outcomes (external). RESULTS: Psychometric qualities of the PRWHE-DLV demonstrated high content validity with no floor or ceiling effects, excellent reliability (Intra-class correlation coefficient = 0.90; 95% CI 0.80-0.95), high construct validity with the validated Quick-DASH and VAS score (r = 0.85 with Quick-DASH, r = 0.75 with VAS-function and r = 0.78 with VAS-pain) and high responsiveness. CONCLUSION: The PRWHE-DLV provided reliable and adequate information for primary care clinical practice.


Assuntos
Avaliação da Deficiência , Punho , Adulto , Humanos , Psicometria , Reprodutibilidade dos Testes , Dor , Atenção Primária à Saúde
12.
BMJ Open ; 12(11): e063135, 2022 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-36323474

RESUMO

OBJECTIVES: Using commercial activity monitors may advance research with older adults. However, usability for the older population is not sufficiently established. This study aims at evaluating the usability of three wrist-worn monitors for older adults. In addition, we report on usability (including data management) for research. DESIGN: Data were collected cross-sectionally. Between-person of three activity monitor type (Apple Watch 3, Fitbit Charge 4, Polar A370) were made. SETTING: The activity monitors were worn in normal daily life in an urban community in Germany. The period of wear was 2 weeks. PARTICIPANTS: Using convenience sampling, we recruited N=27 healthy older adults (≥60 years old) who were not already habitual users of activity monitors. OUTCOMES: To evaluate usability from the participant perspective, we used the System Usability Scale (SUS) as well as a study-specific qualitative checklist. Assessment further comprised age, highest academic degree, computer proficiency and affinity for technology interaction. Usability from the researchers' perspective was assessed using quantitative data management markers and a study-specific qualitative check-list. RESULTS: There was no significant difference between monitors in the SUS. Female gender was associated with higher SUS usability ratings. Qualitative participant-usability reports revealed distinctive shortcomings, for example, in terms of battery life and display readability. Usability for researchers came with problems in data management, such as completeness of the data download. CONCLUSION: The usability of the monitors compared in this work differed qualitatively. Yet, the overall usability ratings by participants were comparable. Conversely, from the researchers' perspective, there were crucial differences in data management and usability that should be considered when making monitor choices for future studies.


Assuntos
Monitores de Aptidão Física , Punho , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Estudos Transversais , Monitorização Fisiológica , Pesquisadores
13.
J Vis Exp ; (188)2022 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-36342145

RESUMO

The use of neuromuscular ultrasound greatly enhances the evaluation of carpal tunnel syndrome as an adjunct diagnostic tool as it provides dynamic and structural information about the median nerve and its surrounding anatomy. Neuromuscular ultrasound aids in diagnostic accuracy (when used with electrodiagnostic testing) and offers etiologic information as a non-invasive, painless, cost-effective, and radiation-free imaging technology that can be easily carried out at the bedside for immediate interpretation. Neuromuscular ultrasound has the limitation of subjectivity, and the need for training and experience will affect the interpretation of results. This article describes a basic practical guide to visualizing the median nerve using neuromuscular ultrasound in a step-by-step manner to aid in the evaluation of carpal tunnel syndrome. Even though the use of ultrasound in the assessment of median nerve entrapment has been long established, there has been no recognized standard protocol. The present protocol aims to provide clear and concise instructions to describe a standard technique to visualize the median nerve through diagnostic ultrasound.


Assuntos
Síndrome do Túnel Carpal , Nervo Mediano , Humanos , Nervo Mediano/diagnóstico por imagem , Síndrome do Túnel Carpal/diagnóstico por imagem , Punho , Ultrassonografia
14.
BMC Med Res Methodol ; 22(1): 292, 2022 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357847

RESUMO

BACKGROUND: To report our recommended methodology for extracting and then confirming research uncertainties - areas where research has failed to answer a research question - derived from previously published literature during a broad scope Priority Setting Partnership (PSP) with the James Lind Alliance (JLA). METHODS: This process was completed in the UK as part of the PSP for "Common Conditions Affecting the Hand and Wrist", comprising of health professionals, patients and carers and reports the data (uncertainty) extraction phase of this. The PSP followed the robust methodology dictated by the JLA and sought to identify knowledge gaps, termed "uncertainties" by the JLA. Published Cochrane Systematic Reviews, Guidelines and Protocols, NICE (National Institute for Health and Care Excellence) Guidelines, and SIGN (Scottish Intercollegiate Guidelines Network) Guidelines were screened for documented "uncertainties". A robust method of screening, internally verifying and then checking uncertainties was adopted. This included independent screening and data extraction by multiple researchers and use of a PRISMA flowchart, alongside steering group consensus processes. Selection of research uncertainties was guided by the scope of the Common Conditions Affecting the Hand and Wrist PSP which focused on "common" hand conditions routinely treated by hand specialists, including hand surgeons and hand therapists limited to identifying questions concerning the results of intervention, and not the basic science or epidemiology behind disease. RESULTS: Of the 2358 records identified (after removal of duplicates) which entered the screening process, 186 records were presented to the PSP steering group for eligibility assessment; 79 were deemed within scope and included for the purpose of research uncertainty extraction (45 full Cochrane Reviews, 18 Cochrane Review protocols, 16 Guidelines). These yielded 89 research uncertainties, which were compared to the stakeholder survey, and added to the longlist where necessary; before derived uncertainties were checked against non-Cochrane published systematic reviews. CONCLUSIONS: In carrying out this work, beyond reporting on output of the Common Conditions Affecting the Hand and Wrist PSP, we detail the methodology and processes we hope can inform and facilitate the work of future PSPs and other evidence reviews, especially those with a broader scope beyond a single disease or condition.


Assuntos
Pesquisa Biomédica , Prioridades em Saúde , Humanos , Pesquisadores , Inquéritos e Questionários , Incerteza , Punho
15.
Sci Data ; 9(1): 733, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36450807

RESUMO

Surface electromyography (sEMG) signals have been used for advanced prosthetics control, hand-gesture recognition (HGR), and more recently as a novel biometric trait. For these sEMG-based applications, the translation from laboratory research setting to real-life scenarios suffers from two major limitations: (1) a small subject pool, and (2) single-session data recordings, both of which prevents acceptable generalization ability. In this longitudinal database, forearm and wrist sEMG data were collected from 43 participants over three different days with long separation (Days 1, 8, and 29) while they performed static hand/wrist gestures. The objective of this dataset is to provide a comprehensive dataset for the development of robust machine learning algorithms of sEMG, for both HGR and biometric applications. We demonstrated the high quality of the current dataset by comparing with the Ninapro dataset. And we presented its usability for both HGR and biometric applications. Among other applications, the dataset can also be used for developing electrode-shift invariant generalized models, which can further bolster the development of wristband and forearm-bracelet sensors.


Assuntos
Antebraço , Gestos , Punho , Humanos , Biometria , Eletromiografia
16.
Eur Rev Med Pharmacol Sci ; 26(1 Suppl): 92-99, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36448861

RESUMO

OBJECTIVE: Advanced forms of wrist osteoarthritis in the elderly are quite common and often under-treated, preferring a conservative management of the condition due to the age of the patient. However, in elderly people who are still active, sporty and physically demanding, surgical management of wrist osteoarthritis should be considered. Proximal Row Carpectomy associated with a Resurfacing Capitate Pyrocarbon Implant (RCPI), allows the management of a wide range of wrist arthrosis, involving both the radio-carpal and the mid-carpal joints. This treatment has been already reported as a solution in younger people affected by degenerative pathologies of the wrist, giving overall good results. Authors aimed at verifying how this technique could be useful in elderly patients, resolving the severe pain often related to this pathology and letting them recover strength and motion. PATIENTS AND METHODS: This is a retrospective analysis involving 7 cases of elderly men (mean age = 68 y.o.), suffering from severe wrist arthritis and treated with RCPI between 2016 and 2021. RESULTS: All patients reported a return to manual activities between 6 and 12 months after surgery, significantly improving pain. Two patients complained moderate pain under strain at follow-up, with residual difficulty in performing manual tasks. In all cases, an increase of strength and improvement in terms of stiffness was registered. No cases of infections or implant mobilization were reported. CONCLUSIONS: RCPI combined with proximal row carpectomy shows satisfying results in all published studies and it has been confirmed in our series as well. Indications for this procedure should be widened to elderly people, as useful alternatives to more aggressive salvage procedures, such as total prosthesis or arthrodesis.


Assuntos
Osteoartrite , Punho , Idoso , Masculino , Humanos , Estudos Retrospectivos , Próteses e Implantes , Osteoartrite/cirurgia , Dor
17.
PLoS One ; 17(11): e0277234, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36449537

RESUMO

Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5° to 15° radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 ± 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.


Assuntos
Síndrome do Túnel Carpal , Osso Escafoide , Feminino , Masculino , Humanos , Punho/diagnóstico por imagem , Síndrome do Túnel Carpal/diagnóstico por imagem , Extremidade Superior , Postura
18.
Sensors (Basel) ; 22(22)2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36433494

RESUMO

Industries need a mechanism to monitor the workers' safety and to prevent Work-related Musculoskeletal Disorders (WMSDs). The development of ergonomics assessment tools helps the industry evaluate workplace design and worker posture. Many studies proposed the automated ergonomics assessment method to replace the manual; however, it only focused on calculating body angle and assessing the wrist section manually. This study aims to (a) propose a wrist kinematics measurement based on unobtrusive sensors, (b) detect potential WMSDs related to wrist posture, and (c) compare the wrist posture of subjects while performing assembly tasks to achieve a comprehensive and personalized ergonomic assessment. The wrist posture measurement is combined with the body posture measurement to provide a comprehensive ergonomics assessment based on RULA. Data were collected from subjects who performed the assembly process to evaluate our method. We compared the risk score assessed by the ergonomist and the risk score generated by our method. All body segments achieved more than an 80% similarity score, enhancing the scores for wrist position and wrist twist by 6.8% and 0.3%, respectively. A hypothesis analysis was conducted to evaluate the difference across the subjects. The results indicate that every subject performs tasks differently and has different potential risks regarding wrist posture.


Assuntos
Articulação do Punho , Punho , Humanos , Movimento (Física) , Indústrias , Postura
19.
BMJ Case Rep ; 15(11)2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36428034

RESUMO

Syringomyelia is uncommonly revealed by a neuropathic arthropathy (Charcot joint) and characterised by its slow progression with late neurological symptoms. In this particular field, neuropathic arthropathies mainly affect the shoulders and the elbows.We report a new case of neuropathic arthropathy of the wrist caused by syringomyelia, because of the rarity of this condition as well as its uncommon location.Neuropathic arthropathy caused by syringomyelia is poorly published in the literature. This atypical entity should be considered in case of Charcot arthropathy associated with neurological loss, especially when it affects the upper limbs.


Assuntos
Artropatia Neurogênica , Siringomielia , Humanos , Siringomielia/complicações , Siringomielia/diagnóstico por imagem , Artropatia Neurogênica/diagnóstico por imagem , Artropatia Neurogênica/etiologia , Punho , Articulação do Punho/diagnóstico por imagem , Extremidade Superior
20.
Sensors (Basel) ; 22(19)2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-36236292

RESUMO

There are situations where manipulating subjective time would be desirable, such as reducing waiting time, and there are many studies to manipulate subjective time. However, it is not easy to use previous methods in various situations because most of them use visual and auditory information. This study proposes a method to manipulate the subjective time by the tactile stimuli from wrist-worn devices. We designed three types of tactile stimuli presentation methods that change the number, the duration, and the time interval of the stimuli. The evaluation result clarified the elements of the tactile stimuli that intentionally changed the subjective time and confirmed that our method can change the subjective time by about 23% (from -6% to +17%). Since few studies have focused on the phenomenon in which the subjective time changes depending on the tactile stimuli from information devices, our findings can contribute to designing information devices and user experiences.


Assuntos
Ilusões , Percepção do Tempo , Humanos , Tato , Punho , Articulação do Punho
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