Providing unloading by exoskeleton improves shoulder flexion performance after stroke

2021 ◽  
Author(s):  
Bonnie Perry ◽  
Jenn Sivak ◽  
Dobrivoje Stokic
Keyword(s):  
Shoulder Flexion

Nerve graft versus nerve transfer for neonatal brachial plexus: shoulder outcomes

2021 ◽  
Vol 27 (1) ◽  
pp. 87-92
Author(s):  
Brandon W. Smith ◽  
Kate W. C. Chang ◽  
Sravanthi Koduri ◽  
Lynda J. S. Yang
Keyword(s):  
Brachial Plexus ◽  
Clinical Data ◽  
External Rotation ◽  
Nerve Transfer ◽  
Shoulder Function ◽  
Nerve Transfers ◽  
Shoulder Flexion ◽  
Significant Difference ◽  
Transfer Strategies ◽  
Shoulder External Rotation

OBJECTIVEThe decision-making in neonatal brachial plexus palsy (NBPP) treatment continues to have many areas in need of clarification. Graft repair was the gold standard until the introduction of nerve transfer strategies. Currently, there is conflicting evidence regarding outcomes in patients with nerve grafts versus nerve transfers in relation to shoulder function. The objective of this study was to further define the outcomes for reconstruction strategies in NBPP with a specific focus on the shoulder.METHODSA cohort of patients with NBPP and surgical repairs from a single center were reviewed. Demographic and standard clinical data, including imaging and electrodiagnostics, were gathered from a clinical database. Clinical data from physical therapy evaluations, including active and passive range of motion, were examined. Statistical analysis was performed on the available data.RESULTSForty-five patients met the inclusion criteria for this study, 19 with graft repair and 26 with nerve transfers. There were no significant differences in demographics between the two groups. Understandably, there were no patients in the nerve grafting group with preganglionic lesions, resulting in a difference in lesion type between the cohorts. There were no differences in preoperative shoulder function between the cohorts. Both groups reached statistically significant improvements in shoulder flexion and shoulder abduction. The nerve transfer group experienced a significant improvement in shoulder external rotation, from −78° to −28° (p = 0.0001), whereas a significant difference was not reached in the graft group. When compared between groups, there appeared to be a trend favoring nerve transfer in shoulder external rotation, with the graft patients improving by 17° and the transfer patients improving by 49° (p = 0.07).CONCLUSIONSIn NBPP, patients with shoulder weakness experience statistically significant improvements in shoulder flexion and abduction after graft repair or nerve transfer, and patients with nerve transfers additionally experience significant improvement in external rotation. With regard to shoulder external rotation, there appear to be some data supporting the use of nerve transfers.

scholarly journals Corticospinal excitability of the biceps brachii is shoulder position dependent

2017 ◽  
Vol 118 (6) ◽  
pp. 3242-3251 ◽  
Author(s):  
Brandon Wayne Collins ◽  
Edward W. J. Cadigan ◽  
Lucas Stefanelli ◽  
Duane C. Button
Keyword(s):  
Evoked Potentials ◽  
Maximal Voluntary Contraction ◽  
Biceps Brachii ◽  
Motor Evoked Potentials ◽  
Voluntary Contraction ◽  
Corticospinal Excitability ◽  
State Dependent ◽  
Shoulder Flexion ◽  
Erb’S Point ◽  
Shoulder Position

The purpose of this study was to examine the effect of shoulder position on corticospinal excitability (CSE) of the biceps brachii during rest and a 10% maximal voluntary contraction (MVC). Participants ( n = 9) completed two experimental sessions with four conditions: 1) rest, 0° shoulder flexion; 2) 10% MVC, 0° shoulder flexion; 3) rest, 90° shoulder flexion; and 4) 10% MVC, 90° shoulder flexion. Transcranial magnetic, transmastoid electrical, and Erb’s point stimulation were used to induce motor-evoked potentials (MEPs), cervicomedullary MEPs (CMEPs), and maximal muscle compound potentials (Mmax), respectively, in the biceps brachii in each condition. At rest, MEP, CMEP, and Mmax amplitudes increased ( P < 0.01) by 509.7 ± 118.3%, 113.3 ± 28.3%, and 155.1 ± 47.9%, respectively, at 90° compared with 0°. At 10% MVC, MEP amplitudes did not differ ( P = 0.08), but CMEP and Mmax amplitudes increased ( P < 0.05) by 32.3 ± 10.5% and 127.9 ± 26.1%, respectively, at 90° compared with 0°. MEP/Mmax increased ( P < 0.01) by 224.0 ± 99.1% at rest and decreased ( P < 0.05) by 51.3 ± 6.7% at 10% MVC at 90° compared with 0°. CMEP/Mmax was not different ( P = 0.22) at rest but decreased ( P < 0.01) at 10% MVC by 33.6 ± 6.1% at 90° compared with 0°. EMG increased ( P < 0.001) by 8.3 ± 2.0% at rest and decreased ( P < 0.001) by 21.4 ± 4.4% at 10% MVC at 90° compared with 0°. In conclusion, CSE of the biceps brachii was dependent on shoulder position, and the pattern of change was altered within the state in which it was measured. The position-dependent changes in Mmax amplitude, EMG, and CSE itself all contribute to the overall change in CSE of the biceps brachii. NEW & NOTEWORTHY We demonstrate that when the shoulder is placed into two common positions for determining elbow flexor force and activation, corticospinal excitability (CSE) of the biceps brachii is both shoulder position and state dependent. At rest, when the shoulder is flexed from 0° to 90°, supraspinal factors predominantly alter CSE, whereas during a slight contraction, spinal factors predominantly alter CSE. Finally, the normalization techniques frequently used by researchers to investigate CSE may under- and overestimate CSE when shoulder position is changed.

scholarly journals Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0141777 ◽  
Author(s):  
M. Eriksson Crommert ◽  
K. Halvorsen ◽  
M. M. Ekblom
Keyword(s):  
Muscle Activation ◽  
Trunk Muscle ◽  
Shoulder Flexion

scholarly journals GAMBARAN KEKUATAN OTOT PADA LANSIA DI BPLU SENJA CERAH PANIKI BAWAH

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Prisilia M. Pinontoan ◽  
Sylvia R. Marunduh ◽  
Herlina I. S. Wungouw
Keyword(s):  
Muscle Strength ◽  
Elderly Women ◽  
Elbow Flexion ◽  
Knee Extension ◽  
Shoulder Abduction ◽  
Elderly Men ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Shoulder Flexion ◽  
Cross Sectional Design

Abstract: The aim of this study was to find out the profile of muscle strength on elderly at BPLU Senja Cerah Paniki Bawah. This was a descriptive study with cross sectional design. There were 26 respondents who met the inclusion criteria, consisted of 10 elderly men and 16 elderly women. Respondents were selected by using purposive sampling method. The measurements of the muscle strength were done by using 1 RM method while doing elbow flexion, elbow extension, shoulder flexion, shoulder extension, shoulder abduction, knee flexion, knee extension and dorsoflexion. Data were analyzed manually and computerized then presented in tabular form. The result shows that the average muscle strength in elderly men were greater than women and the average muscle strength of respondents that were included in the age group 60-79 years old were greater than those in 80-99 years.Keywords: muscle strength, elderly.1 RMAbstrak: Tujuan dari penelitian ini yaitu untuk mengetahui gambaran kekuatan otot pada Lansia di BPLU Senja Cerah Paniki Bawah. Penelitian ini merupakan peneliltian deskriptif dengan rancangan potong lintang. Responden yang memenuhi kriteria inklusi terdiri dari 26 orang yang terdiri dari 10 orang laki-laki dan 16 orang perempuan. Sampel dipilih menggunakan cara purposive sampling. Kekuatan otot pada lansia diukur dengan menggunakan metode 1 RM yang diukur pada gerakan fleksi siku, ekstensi siku, fleksi bahu, ekstensi bahu, abduksi bahu, fleksi lutut, ekstensi lutut serta dorsofleksi. Data yang sudah didapatkan kemudian dikumpul dan diolah secara manual dan komputerisasi serta disajikan dalam bentuk tabel. Hasil penelitian menunjukkan rerata kekuatan otot responden laki-laki lebih besar dibanding perempuan dan rerata kekuatan responden yang termasuk dalam kelompok umur 60-79 tahun lebih besar dibanding kelompok umur 80-99 tahun.Kata kunci: kekuatan otot, lansia, 1 RM.

scholarly journals Regaining motion among patients with shoulder pathology - are all exercises equal?

2021 ◽  
pp. 175857322110671
Author(s):  
Alon Rabin ◽  
Eran Maman ◽  
Oleg Dolkart ◽  
Efi Kazum ◽  
Zvi Kozol ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Range Of Motion ◽  
Motion Analysis ◽  
The Self ◽  
Flexion Angle ◽  
Shoulder Range Of Motion ◽  
Shoulder Flexion ◽  
Shoulder Disorders ◽  
Level Of Difficulty ◽  
Shoulder Range

Background Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises. Methods Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). Pain intensity and the perceived level of difficulty associated with each exercise were also recorded. Results The forward bow and table slide generated significantly greater ROM compared with the self-assisted flexion and rope-and-pulley (P ≤ 0.005). The self-assisted flexion was associated with a greater pain intensity compared with the table slide and rope-and-pulley (P = 0.002) and a greater perceived level of difficulty compared with the table slide (P = 0.006). Conclusions Due to the greater ROM allowed, and similar or even lower level of pain or difficulty, clinicians may wish to initially recommend the forward bow and table slide for regaining shoulder flexion ROM.

scholarly journals The Effect of Shoulder Flexion Angles on the Recruitment of Upper-extremity Muscles during Isometric Contraction

2013 ◽  
Vol 25 (10) ◽  
pp. 1299-1301 ◽  
Author(s):  
Jeheon Moon ◽  
Insik Shin ◽  
Myoungsoo Kang ◽  
Yeonghun Kim ◽  
Kunwoo Lee ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Isometric Contraction ◽  
Shoulder Flexion

Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

2019 ◽  
Vol 48 (2) ◽  
pp. 481-487
Author(s):  
Justin M. Chan ◽  
John Zajac ◽  
Brandon J. Erickson ◽  
David W. Altchek ◽  
Christopher Camp ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
External Rotation ◽  
Significant Risk ◽  
Case Series ◽  
Significant Risk Factor ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Shoulder Flexion

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR ( P = .010), and TROM ( P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER ( P = .005), TROM ( P = .042), and horizontal adduction ( P < .001) significantly increased over the course of the season. Position player shoulder flexion ( P = .046), hip ER ( P < .001, lead leg; P < .001, trail leg), and hip TROM ( P = .001; P = .002) decreased over the course of the season. Position player shoulder ER ( P = .031) and humeral adduction ( P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR ( P = .014), increased shoulder horizontal adduction ( P < .001), and hip IR ( P = .042) and hip TROM ( P = .027) for the lead leg. Position players experienced loss of hip TROM ( P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

Self-Managed Surveillance for Breast Cancer–Related Upper Body Issues: A Feasibility and Reliability Study

2020 ◽  
Vol 100 (3) ◽  
pp. 468-476 ◽  
Author(s):  
Bolette S Rafn ◽  
Chiara A Singh ◽  
Julie Midtgaard ◽  
Pat G Camp ◽  
Margaret L McNeely ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Interrater Reliability ◽  
Physical Therapist ◽  
Retention Rates ◽  
Upper Body ◽  
Intrarater Reliability ◽  
Prospective Surveillance ◽  
Reliability Study ◽  
Shoulder Flexion ◽  
Arm Circumference

Abstract Background Early identification of breast cancer–related upper body issues is important to enable timely physical therapist treatment. Objective This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program. Design This was a prospective, single-site, single-group feasibility and reliability study. Methods Presurgery arm circumference measurements were completed at home and at the hospital by participants and by a physical therapist. Instruction in self-measurement was provided using a video guide. After surgery, all circumference measurements were repeated along with self-assessment and therapist assessment for shoulder flexion and abduction active range of motion. Feasibility was determined by recruitment/retention rates and participant-reported ease of performing self-measurements (1 [very difficult] to 10 [very easy]). Reliability was determined as intrarater reliability, interrater reliability, and agreement. Results Thirty-three women who were 53.4 (SD = 11.4) years old participated, with recruitment and retention rates of 79% and 94%, respectively. Participant-reported ease of measurement was 8.2 (SD = 2.2) before surgery and 8.0 (SD = 1.9) after surgery. The intrarater reliability and interrater reliability were excellent before surgery (intraclass correlation coefficient [ICC] ≥ 0.94; 95% confidence interval = 0.87–0.97) and after surgery (ICC ≥ 0.91; 95% confidence interval = 0.76–0.96). Agreement between self-assessed and therapist-assessed active shoulder flexion (κ = 0.79) and abduction (κ = 0.71) was good. Limitations Further testing is needed using a prospective design with a longer follow-up to determine whether self-managed prospective surveillance and timely treatment can hinder the development of chronic breast cancer–related upper body issues Conclusions Self-measured arm circumference and shoulder range of motion are reliable, and their inclusion in a hospital-based program of prospective surveillance for upper body issues seems feasible. This approach may improve early detection and treatment

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