Acromioplasty: Is It An Impairment?

2002 ◽  
Vol 7 (3) ◽  
pp. 1-3 ◽  
Author(s):  
Charles N. Brooks

Abstract Acromioplasty can be performed open or arthroscopically and removes the spurred, curved, or hooked portion of the acromion. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has not addressed whether acromioplasty itself constitutes an impairment. On the one hand, if impairment is defined as “a loss, loss of use, or derangement of any body part, organ system, or organ function,” then acromioplasty is an impairment because of the loss of a small portion of the scapula. On the other hand, acromioplasty generally results in improved function (ie, no or negative impairment) and may increase rather than decrease an individual's ability to perform the activities of daily living. This does not indicate that patients who undergo acromioplasty have no impairment whatsoever, and remaining motion deficits should be rated according to existing criteria in the AMA Guides. For example, failure to properly reattach the deltoid muscle or excessive acromial resection may result in deltoid weakness or strength. Often during acromioplasty, the removal of the clavicular spur is accomplished via excision of distal clavicle (resection arthroplasty), which is a permanent impairment. Acromionectomy, which is functionally similar to distal clavicular resection, and transposing the 10% upper extremity impairment rating for distal clavicular resection to a total acromionectomy appears to be justified.

2012 ◽  
Vol 17 (1) ◽  
pp. 13-16
Author(s):  
Charles N. Books ◽  
James B. Talmage ◽  
J. Mark Melhorn

Abstract Indications for excision of the distal clavicle include symptomatic degenerative arthritis of the acromioclavicular joint, impingement syndrome, and osteolysis of the distal clavicle if nonoperative treatment has failed. Distal clavicular resection (DCR), one could argue, is by definition an impairment because of the loss of a portion of a body part, the clavicle. Yet a competently performed and uncomplicated DCR generally results in improved function, not loss of use. DCR was first mentioned in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, which stated that a resection arthroplasty of the acromioclavicular joint warrants 10% upper extremity impairment (UEI). Rating DCR using the AMA Guides, Fifth Edition, is almost the same as using the fourth edition, but evaluators can use one of two approaches: The rating physician can select a 3% rating for DCR using the fifth edition and claim to be literally following the instructions and providing a sensible rating in view of the generally good results reported in the orthopedic literature following a DCR. Alternatively, a rating physician who is aware of the historical precedent underlying the 10% UEI in Table 16-27 could cite this and the absence of an instruction in the Arthroplasty section to justify a 10% impairment rating. In the sixth edition, DCR is a key factor in classifying an acromioclavicular joint injury or disease but is disregarded in the rating of rotator cuff or glenohumeral pathology.


2005 ◽  
Vol 10 (2) ◽  
pp. 6-6

Abstract When they assess impairment, examiners must determine what “loss, loss of use, or derangement of any body part, organ system, or organ function,” occurred, according to the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), Fifth Edition. At the same time, the AMA Guides cautions examiners to avoid “double dipping,” or rating the same impairment twice: “Related but separate conditions are rated separately[,] and impairment ratings are combined unless criteria for the second impairment are included in the primary impairment.” For example, it is not appropriate for an examiner who is rating spinal impairment using a Diagnosis-related estimate (DRE) category to award an additional 3% whole person impairment (WPI) beyond the baseline rating for the category because of limitation in activities of daily living (ADLs), presumably at least in part because of residual pain, and then to award a further impairment rating for pain based on Chapter 18. Rather, the AMA Guides notes that “the impairment ratings in the body organ system chapters make allowance for any accompanying pain.” Duplicative and, therefore, erroneously inflated ratings sometimes are performed by physicians who are less experienced in using the AMAGuides or those who, due to patient advocacy or other reason, want to maximize ratings.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Caleb Liang ◽  
Wen-Hsiang Lin ◽  
Tai-Yuan Chang ◽  
Chi-Hong Chen ◽  
Chen-Wei Wu ◽  
...  

AbstractBody ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness.


2020 ◽  
Vol 8 (1) ◽  
pp. 101-111
Author(s):  
Alifah Nuke Febrianty ◽  
Alabanyo Brebahama ◽  
Melok Roro Kinanthi

Tunagrahita merupakan salah satu jenis disabilitas yang membuat penyandangnya memiliki inteligensi jauh di bawah rata-rata serta kemampuan bina bantu diri yang terbatas. Hambatan tersebut membuat anak tunagrahita menjadi kurang mandiri sehingga orang tua harus memberikan perhatian serta bantuan yang lebih besar dibandingkan dengan anak pada umumnya. Hal inilah yang dapat menjadi stressor bagi keluarga terutama ibu yang merupakan caregiver utama pada anak karena ibulah yang paling banyak meluangkan waktu untuk pengasuhan sang anak. Oleh karena itu dibutuhkan ketangguhan keluarga dalam menghadapi masalah terkait kehadiran anak tunagrahita. Resiliensi keluarga dianggap sukses bila keluarga dapat bertahan dari kesulitan dan mengambil makna dari kesulitan yang dihadapi. Salah satu cara untuk dapat resilien adalah dengan mengembangkan pandangan positif saat menghadapi masalah yang disebut juga sebagai koherensi keluarga. Penelitian ini bertujuan untuk mengetahui sejauh mana peran koherensi keluarga terhadap resiliensi keluarga yang memiliki anak tunagrahita dari perspektif ibu. Partisipan pada penelitian ini sebanyak 60 orang ibu yang memiliki anak tunagrahita, berdomisili di wilayah Jakarta, Bogor, Depok, Tangerang, dan Bekasi yang dipilih menggunakan metode  purposive sampling ­. Alat ukur yang digunakan yaitu Walsh Family Resilience Questionnaire (WFRQ) untuk mengukur resiliensi keluarga dan Family Sense of Coherence Scale (FSOCS) untuk mengukur family sense of coherence. Berdasarkan hasil uji regresi, didapatkan hasil bahwa family sense of coherence berperan secara signifikan (p 0,05) terhadap resiliensi keluarga (R-square= 0,235). Hal ini berarti koherensi keluarga berperan sebesar 23,5% terhadap resiliensi keluarga dan 76,5% lainnya dipengaruhi oleh faktor lain. Terkait dengan hal ini, upaya meningkatkan resiliensi keluarga dapat dilakukan dengan membantu keluarga mengembangkan perspektif positif dalam melihat situasi yang terjadi, menumbuhkan optimisme, dan mengedukasi keluarga untuk dapat memanfaatkan sumber daya di sekitarnya untuk membantu atasi situasi. Intellectual disability is the one of disability in which the individu has intellectual far below the average, and limitation in activity daily living. This limitation makes the children with intellectual disability have low autonomy cause parents should give care and assitaant more then usual. This condition can be the one of stressor for family, especially for the mother as caregiver who give more time to practice parenting for their children. So, family resillience is very important to face the emergence of intellectual disability children in family. In order to be resillient, a family should have positive perspective when facing the problem, called sense of coherence. The purpose of this research is finding the role of family sense of coherence towards family resillience among family who has intellectual disability children. The participant of this research is 60 mothers who have intellectual disability children and live in Jakarta, Bogor, Depok, Tangerang, and Bekasi (Jabodetabek). The participants is selected by using purposive sampling method. This research uesd Family Resilience Questionnaire (WFRQ) to measure family resillience, and Family Sense of Coherence Scale (FSOCS) to measure family sense of corerence. Based on regression test, family sense of corerence has significant role towards family resilience (R Square = 0,235, p 0,05). It meanse that family sense of coherence gives contribution about 23,5 % to family resillience, and 76,5 % influenced by another factors. As the conslusion, family can be more resillient if it develops positive perspective when facing problem, build optimism, and use every resources wisely in order to solve problem. 


2016 ◽  
Vol 84 (2) ◽  
pp. 10-11
Author(s):  
Brandon Chau ◽  
Alexander Levit

The volume of geriatric surgery is expected to increase dramatically by 2020, requiring a more widespread appreciation of the unique risks and challenges of anesthesia in the elderly. Changes in pharmacokinetics along with age-related changes in organ function have important implications for patient monitoring and dosing of anesthetic, analgesic, and sedative medications. Preoperative screening for risk of postoperative morbidity is improved with an assessment of activities of daily living, and regional anesthesia may be considered to reduce the risk of postoperative delirium, although this remains controversial. Specific homeostatic parameters should be closely monitored in the perioperative period. The approach to anesthesia in geriatric patients should not be merely extrapolated from younger patients, and further evidence specific to geriatric anesthesia will improve surgical outcomes.


2019 ◽  
Vol 10 (1) ◽  
pp. 89-112
Author(s):  
Chunyi Lei ◽  
Pamies Antonio

Abstract This study, based on the Cognitive Theory of Metaphor and Conventional Figurative Language Theory, presents a cross-linguistic comparison of the idioms on drunkenness in Chinese and Spanish, applying the analytical method with three hierarchical levels (iconic models > archi-metaphors > particular metaphors). The findings show that, on the one hand, though linguistically and culturally very distant, these two languages share some iconic models (i.e. animal, movement, body part, plant and aggression) in their idioms on inebriation; on the other hand, they also have their own ways in expressing drunkenness, due to their particular cultural backgrounds, i.e. religions, superstitions, history, ethnic prejudices, legends, etc. The present investigation also proves the universality of the cognitive thinking model of human beings as well as the cognitive specialization in different cultures, giving an insight into idiom comprehension and intercultural communication.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jessica Simard ◽  
Maude Chalifoux ◽  
Véronique Fortin ◽  
Maude Jeanson Archambault ◽  
Anne St-Cerny-Gosselin ◽  
...  

The aim of this study was to identify questions that could estimate grip strength. Twenty-six questions about the degree of perceived difficulty performing manual tasks as well as two questions concerning self-rated grip strength were developed and completed by 123 community-dwelling older adults, followed by grip strength measurements using a Martin vigorimeter. Multiple regression analyses with all of the participants revealed that the question about the difficulty of opening a jar (question 4) was most associated with grip strength. When analyses were done by gender, the same question showed the best correlation for women, whereas the one for men was self-rated grip strength compared with people the same age (question 28). For the women, age and question 4 together explained 54% of the variance in their grip strength and for the men, age and question 28 explained 46%. Further studies are needed to identify other information that could help to better estimate grip strength for use in epidemiological surveys.


Author(s):  
Lisa Reissner ◽  
Gabriella Fischer ◽  
Renate List ◽  
Pietro Giovanoli ◽  
Maurizio Calcagni

The human hand is the most frequently used body part in activities of daily living. With its complex anatomical structure and the small size compared to the body, assessing the functional capability is highly challenging. The aim of this review was to provide a systematic overview on currently available 3D motion analysis based on skin markers for the assessment of hand function during activities of daily living. It is focused on methodology rather than results. A systematic review according to the PRISMA guidelines was performed. The systematic search yielded 1349 discrete articles. Of 147 articles included on basis of title, 123 were excluded after abstract review, and 24 were included in the full-text analysis with 13 key articles. There is still limited knowledge about hand and finger kinematics during activities of daily living. A standardization of the task is required in order to overcome the nonrepetitive nature and high variability of upper limb motion and ensure repeatability of task performance. To yield a progress in the analysis of human hand movements, an assessment of human kinematics including fingers, wrist, and thumb and an identification of relevant parameters that characterize a healthy motion pattern during functional tasks are needed.


1998 ◽  
Vol 23 (4) ◽  
pp. 453-456 ◽  
Author(s):  
C. W. C. TONG ◽  
L. K. HUNG ◽  
J. C. Y. CHENG

An 8-year-old girl presented with marked shortening of the right forearm due to destruction of both the radius and ulna secondary to neonatal osteomyelitis. A one-bone forearm operation was performed to achieve a stable forearm. Two years later, the one-bone forearm was lengthened for 6 months by callus distraction (callotasis) achieving 12 cm of extra length. The patient was last followed up at the age of 16. The appearance and functional outcome of the right upper limb had been improved and she was independent in all activities of daily living.


2017 ◽  
Vol 12 (2) ◽  
pp. 71-134
Author(s):  
Daniel Couto-Vale

 In this paper, I use Braga Bianchet’s model of Latin and her translation of Satyricon as tools to describe the causal chain from a theory of language to a linguistic model and from that model to our comprehension skills. In one route, I sketch an alternative description of Latin. In the other, I show how little explanatory power comes from Braga Bianchet’s claims. In the end, I extract a passage with a reference to a character’s body part in Braga Bianchet’s translation of Satyricon, then I demonstrate that any translator using her model of Latin would be lead to recognise an equivalent reference in the original. Finally, I show that such a miscomprehension does not happen when a translator uses a functional model of Latin such as the one sketched in this paper. 


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