Quick Reference: Motion at the Wrist, Elbow, and Shoulder

2005 ◽  
Vol 10 (2) ◽  
pp. 6-6
Keyword(s):  
Daily Living ◽  
Patient Advocacy ◽  
Body Part ◽  
Organ System ◽  
The Body ◽  
Organ Function ◽  
Reference Motion ◽  
Whole Person ◽  
Body Organ ◽  
Impairment Ratings

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.

Assessment of hand function during activities of daily living using motion tracking cameras: A systematic review

2019 ◽  
Vol 233 (8) ◽  
pp. 764-783 ◽  
Author(s):  
Lisa Reissner ◽  
Gabriella Fischer ◽  
Renate List ◽  
Pietro Giovanoli ◽  
Maurizio Calcagni
Keyword(s):  
Systematic Review ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Motion Tracking ◽  
Hand Function ◽  
Body Part ◽  
The Body ◽  
Human Hand ◽  
3D Motion Analysis ◽  
Human Kinematics

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.

Acromioplasty: Is It An Impairment?

2002 ◽  
Vol 7 (3) ◽  
pp. 1-3 ◽  
Author(s):  
Charles N. Brooks
Keyword(s):  
Daily Living ◽  
Body Part ◽  
Deltoid Muscle ◽  
Resection Arthroplasty ◽  
Organ Function ◽  
Upper Extremity Impairment ◽  
The One ◽  
Improved Function ◽  
Distal Clavicle Resection ◽  
Clavicular Resection

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.

Longshore and Harbor Workers' Compensation Act: Use of AMA Guides

2003 ◽  
Vol 8 (2) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham
Keyword(s):  
Body Part ◽  
The United States ◽  
The Body ◽  
Workers Compensation ◽  
Lower Extremity Injuries ◽  
Us Congress ◽  
Whole Person ◽  
The Us ◽  
Extremity Injuries ◽  
Compensation Law

Abstract The US Congress passed the Longshore and Harbor Workers’ Compensation Act (LHWCA) in 1927 to provide coverage to longshore laborers working on navigable waters of the United States when no state workers’ compensation law applied. After amendments that extended and standardized the Act, the Longshore Compensation Act provides more than $670 million in monetary, medical, and vocational rehabilitation benefits to more than 72,000 individuals annually. Under the LHWCA, ratings are performed for “scheduled injuries” (ie, a scheduled member of the body), including upper extremity injuries (excluding the shoulder), lower extremity injuries, and hearing loss. Impairment ratings typically are expressed in terms of whole person permanent impairment, but under the LHWCA impairment is expressed in the smallest applicable body part (eg, an injury of two digits is expressed as a hand rating). Definitions of terms such as injury, disability, and impairment are similar in the LHWCA and the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Claims examiners are advised to require any physician selected to evaluate permanent medical impairment to use the AMA Guides, where applicable, to be detailed in their assessment report, and to rate and report permanent impairment according to the AMA Guides. Boxes in the article present portions of the LHWCA that address compensation for disability and the basic elements required to evaluate anatomical impairment.

Erroneous Impairment Ratings

2006 ◽  
Vol 11 (3) ◽  
pp. 1-5, 9-11
Author(s):  
Christopher R. Brigham
Keyword(s):  
Scientific Evidence ◽  
Error Rates ◽  
The Body ◽  
Explanatory Variables ◽  
Reasonable Degree ◽  
Whole Person ◽  
Self Reports ◽  
Impairment Ratings ◽  
Time Frames ◽  
Original Rating

Abstract A nationwide study in 2005 of 2100 cases referred for impairment rating review found 80% to be erroneous, and 89% of these erroneous ratings were higher than appropriate. Among whole person erroneous ratings (839 of 1037 cases critiqued), the original physician's rating averaged 15.5% whole person permanent impairment, but following rerating by physician experts, the corrected rating averaged 5.6%; only 7% of the cases were underrated. All ratings were based on the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), Fifth Edition. Tables and figures show error rates according to portion of the body affected, expert vs original rating, and other explanatory variables. Two physicians who use the AMA Guides should arrive at similar conclusions about impairment ratings, but most physicians have not received instruction about assessing impairment, disability, or causation and lack an adequate ability to assess these issues. Causation requires a given cause and a given effect that are associated with a reasonable degree of medical probability and also requires documentation with appropriate scientific evidence (not self-reports or historical time frames). Those who prepare and review assessments of impairment should ensure that clinical causation assessments were accurate, that the rating was performed at maximal medical improvement, that examination findings were consistent, and that the individual's normal state was determined.

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Spine Impairment Evaluation: Sixth Edition Approaches

2009 ◽  
Vol 14 (1) ◽  
pp. 1-5
Author(s):  
Craig Uejo ◽  
Marjorie Eskay-Auerbach ◽  
Christopher R. Brigham
Keyword(s):  
Functional Status ◽  
Spinal Injury ◽  
Current Medical ◽  
Clinical Testing ◽  
Medical Evidence ◽  
Sixth Edition ◽  
Whole Person ◽  
Rating Process ◽  
Impairment Ratings ◽  
Class Assignment

Abstract Evaluators who use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, should understand the significant changes that have occurred (as well as the Clarifications and Corrections) in impairment ratings for disorders of the cervical spine, thoracic spine, lumbar spine, and pelvis. The new methodology is an expansion of the Diagnosis-related estimates (DRE) method used in the fifth edition, but the criteria for defining impairment are revised, and the impairment value within a class is refined by information related to functional status, physical examination findings, and the results of clinical testing. Because current medical evidence does not support range-of-motion (ROM) measurements of the spine as a reliable indicator of specific pathology or permanent functional status, ROM is no longer used as a basis for defining impairment. The DRE method should standardize and simplify the rating process, improve validity, and provide a more uniform methodology. Table 1 shows examples of spinal injury impairment rating (according to region of the spine and category, with comments about the diagnosis and the resulting class assignment); Table 2 shows examples of spine impairment by region of the spine, class, diagnosis, and associated whole person impairment ratings form the sixth and fifth editions of the AMA Guides.

Analysis of Lead Heavy Metal (Pb) Contamination on Matte Lipstick Preparations for Sale in Banda Aceh City Aceh Market

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Rizki Andalia ◽  
Mulia Aria Suzanni ◽  
Rini Rini
Keyword(s):  
Heavy Metal ◽  
Atomic Absorption ◽  
Atomic Absorption Spectrophotometry ◽  
The Body ◽  
Permissible Limit ◽  
The Sun ◽  
Absorption Spectrophotometry ◽  
Pb Contamination ◽  
Body Organ ◽  
Banda Aceh

Lipstick or lip dye is a cosmetic dose that serves to coloring, decorative the lips, as a moisturizing material and protect the lips from exposure the sun to provide optimum results. Lipstick should not contain chemicals such as lead (Pb) because the Pb is a heavy metal that is very dangerous when continuously used on the skin, because it will be absorbed into the blood and attack the body organ causing the onset of disease. According to BPOM that the lead rate on the lipstick does not exceed the permissible limit of 20 mg/kg or 20 ppm.This research aims to know the levels contained in the samples are 4 brands of matte lipstick that are sold in the Aceh market in Banda Aceh City with the method of atomic absorption spectrophotometry (AAS). The results showed that on the 4 brands of lipstick matte contain heavy metal lead (Pb) with a rate still qualified allowed by BPOM  is samples A, B, C, and D, respectively at 0.24 ppm; 0.10 ppm; 2.87 ppm and 1.32 ppm, so that the 4 brands of lipstick matte are still used.

scholarly journals Experiential ownership and body ownership are different phenomena

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Caleb Liang ◽  
Wen-Hsiang Lin ◽  
Tai-Yuan Chang ◽  
Chi-Hong Chen ◽  
Chen-Wei Wu ◽  
...  
Keyword(s):  
Conscious Experience ◽  
Distinct Type ◽  
Body Part ◽  
The Body ◽  
Body Ownership ◽  
Rubber Hand ◽  
Person Perspective ◽  
The One ◽  
First Time ◽  
Full Body

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.

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