Automatic estimation of continuous elbow flexion–extension movement based on electromyographic and electroencephalographic signals

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.

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Clinical findings in C5-C6 and C5-C7 root palsies with brachial plexus traction lesions

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412471009 ◽

2012 ◽

Vol 38 (3) ◽

pp. 237-241 ◽

Cited By ~ 8

Author(s):

J. A. Bertelli ◽

M. F. Ghizoni

Keyword(s):

Brachial Plexus ◽

External Rotation ◽

Elbow Flexion ◽

Clinical Findings ◽

Hand Strength ◽

Shoulder Abduction ◽

Finger Extension ◽

Root Injury ◽

Flexion Extension

Stretch injuries of the C5-C7 roots of the brachial plexus traditionally have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. Based on current myotome maps we hypothesized that, as far as motion is concerned, palsies involving C5-C6 and C5-C7 root injuries should be similar. In 38 patients with upper-type palsies of the brachial plexus, we examined for correlations between clinical findings and root injury level, as documented by CT tomomyeloscan. Contrary to commonly held beliefs, C5-C7 root injuries were not associated with loss of extension of the elbow, wrist, thumb, or fingers, but residual hand strength was much lower with C5-C7 vs C5-C6 lesions.

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Increased bradykinesia in Parkinson’s disease with increased movement complexity: elbow flexion–extension movements

Journal of Computational Neuroscience ◽

10.1007/s10827-008-0091-9 ◽

2008 ◽

Vol 25 (3) ◽

pp. 501-519 ◽

Cited By ~ 21

Author(s):

Rachel Moroney ◽

Ciska Heida ◽

Jan Geelen

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Elbow Flexion ◽

Flexion Extension ◽

Movement Complexity

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Analysis of human-exoskeleton interactions: an elbow flexion/extension case study

Computer Methods in Biomechanics & Biomedical Engineering ◽

10.1080/10255842.2017.1382835 ◽

2017 ◽

Vol 20 (sup1) ◽

pp. S9-S10 ◽

Cited By ~ 1

Author(s):

S. Bastide ◽

N. Vignais ◽

F. Geffard ◽

B. Berret

Keyword(s):

Elbow Flexion ◽

Flexion Extension

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Kinematics and Laxity of Ulnohumeral Joint Under Valgus-Varus Stress

Journal of Musculoskeletal Research ◽

10.1142/s021895779800007x ◽

1998 ◽

Vol 02 (01) ◽

pp. 45-54 ◽

Cited By ~ 39

Author(s):

Shinji Tanaka ◽

Kai-Nan An ◽

Bernard F. Morrey

Keyword(s):

Elbow Joint ◽

Three Dimensional ◽

Elbow Flexion ◽

Axial Rotation ◽

Joint Laxity ◽

Treatment Modalities ◽

Trochlear Groove ◽

Flexion Extension ◽

Varus Stress ◽

Baseline Information

Three-dimensional kinematics of the ulnohumeral joint under simulated active elbow joint flexion-extension was obtained by using an electromagnetic tacking device. The joint motion was analyzed based on Eulerian angle description. In order to minimize the effect of "downstream cross-talk" on calculation of the three Eulerian angles, an optimal axis to best represent flexion-extension of the elbow joint was established. This axis, on average, is close to the line joining the centers of the capitellum and the trochlear groove. Furthermore, joint laxity under valgus-varus stress was also examined. With the weight of the forearm as the stress, maximums of 7.6° valgus-varus laxity and 5.3° axial rotation laxity were observed within a range of elbow flexion. The results of this study provide useful baseline information on joint laxity for the evaluation of elbow joints with implant replacements and other surgical treatment modalities.

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The effect of washing on the electrical performance of knitted textile strain sensors for quantifying joint motion

Journal of Industrial Textiles ◽

10.1177/15280837211059210 ◽

2021 ◽

pp. 152808372110592

Author(s):

Cristina Isaia ◽

Simon McMaster ◽

Donal McNally

Keyword(s):

Elbow Flexion ◽

Strain Sensors ◽

Electrical Performance ◽

Market Penetration ◽

Maximum Extension ◽

Maximum Flexion ◽

Flexion Extension ◽

Textile Sensor ◽

Simulated Training

Successful market penetration of textile-based strain sensors requires long-term reliability which in turn relies on the washability of the sensor. First, this paper presents an evaluation of the effect of 5 washing cycles on the electrical performance of a knitted conductive transducer, over 1500 cycles of repetitive elongation. The promising behaviour of the textile sensor in this study showed that it might be possible to make a smart garment, capable of quantifying elbow flexion-extension motion, by integrating it into an elbow sleeve. Second, a prototype sleeve, incorporating a knitted sensor (the so-called smart sleeve), was tested in a simulated training/clinical setting by performing 50 flexion-extension cycles after 1, 5, 15, 25, 50 and 75 washes. In both studies, the electrical resistance of the sensor increased with the number of washes in a predictable manner and exhibited a repeatable, reliable and prompt response to elongation. In particular, the electrical pattern representing flexion-extension motion measured using the sleeve was clear and distinguishable up to the 75th wash. Moreover, resistance measurements within the same trial were repeatable at maximum flexion (≤2% variation) and at maximum extension (≤3% variation) and predictable with increasing washes (R2 = 0.992 at maximum flexion and R2 = 0.989 at maximum extension). The good washability of the smart sleeve, evidenced by its ability to detect, distinguish and measure parameters of flexion-extension motion up to 75 washes, makes it a suitable and sustainable choice for applications, such as strength conditioning or rehabilitation, where repetition count and speed are useful.

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Biomechanical Role and Motion Contribution of Ligaments and Bony Constraints in the Elbow Stability: A Preliminary Study

Bioengineering ◽

10.3390/bioengineering6030068 ◽

2019 ◽

Vol 6 (3) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Elisa Panero ◽

Laura Gastaldi ◽

Mara Terzini ◽

Cristina Bignardi ◽

Arman Sard ◽

...

Keyword(s):

Motion Capture ◽

Elbow Joint ◽

Large Deflection ◽

Elbow Flexion ◽

Elbow Instability ◽

Joint Stability ◽

Coronoid Fracture ◽

Flexion Extension ◽

Preliminary Study ◽

Functional Investigation

In flexion–extension motion, the interaction of several ligaments and bones characterizes the elbow joint stability. The aim of this preliminary study was to quantify the relative motion of the ulna with respect to the humerus in two human upper limbs specimens and to investigate the constraints role for maintaining the elbow joint stability in different section conditions. Two clusters of four markers were fixed respectively to the ulna and humerus, and their trajectory was recorded by a motion capture system during functional orthopedic maneuver. Considering the posterior bundle of medial collateral complex (pMUCL) and the coronoid, two section sequences were executed. The orthopedic maneuver of compression, pronation and varus force was repeated at 30°, 60° and 90° flexion for the functional investigation of constraints. Ulna deflection was compared to a baseline elbow flexion condition. With respect to the intact elbow, the coronoid osteotomy influences the elbow stability at 90° (deflection = 11.49 ± 17.39 mm), while small differences occur at 30° and 60°, due to ligaments constraint. The contemporary pMUCL section and coronoid osteotomy causes elbow instability, with large deflection at 30° (deflection = 34.40 ± 9.10 mm), 60° (deflection = 45.41 ± 18.47 mm) and 90° (deflection = 52.16 ± 21.92 mm). Surgeons may consider the pMUCL reconstruction in case of unfixable coronoid fracture.

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Biomechanical Analysis of Nonconstrained and Semiconstrained Total Elbow Replacements: A Preliminary Report

Journal of Mechanics ◽

10.1017/s172771910000160x ◽

2008 ◽

Vol 24 (1) ◽

pp. 103-110 ◽

Cited By ~ 6

Author(s):

K.-S. Shih ◽

T.-W. Lu ◽

Y.-C. Fu ◽

S.-M. Hou ◽

J.-S. Sun ◽

...

Keyword(s):

Motion Analysis ◽

Elbow Flexion ◽

Mathematic Model ◽

Clinical Results ◽

Biomechanical Analysis ◽

External Loading ◽

Motion Patterns ◽

Total Elbow Replacement ◽

Flexion Extension ◽

Elbow Motion

ABSTRACTThe development of elbow arthroplasties has significantly improved the quality of life for many patients suffering from disabling elbow disorders. However, the high complication rate such as loosening and instability limits the long term use of total elbow replacement (TER). In the present study, biomechanical analyses on patients with unilateral nonconstrained (Souter-Strathclyde) and semiconstrained (Coonard-Morrey) TER subjects were performed to investigate differences of their motion patterns under unloaded and loaded conditions. In a biomechanical laboratory, each subject performed vertical and horizontal elbow flexion/extension first without and then with external loading (5 lb). The kinematic data were measured using 3D motion analysis system and the motion axis of the elbow was calculated by a well-defined mathematic model. During these tests, the upperarm was fixed with a special fixation device and their forearms fully supinated. The elbow motion patterns of the affected sides were compared with those of the normal sides and between different conditions. The results revealed that the elbows moved about a relatively fixed axis both in the semiconstrained and nonconstrained groups in the vertical flexion/extension with or without external loading, compatible with the normal elbows. However, the nonconstrained elbows were less stable during horizontal flexion/externsion motion with or without external loading and the elbow axis moved significantly, indicating of less stability. We conclude that this methodology of elbow motion analysis is acceptable and can be widely recommended for total elbow study. Moreover, the nonconstrained TER is less stable than the semiconstrained TER during the horizontal movement, which was compatible with previous clinical results. The patients with nonconstrained TER are suggested to avoid using their elbows in horizontal motion, especially in loaded conditions.

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Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa

African Health Sciences ◽

10.4314/ahs.v19i3.32 ◽

2019 ◽

Vol 19 (3) ◽

pp. 2565-2570

Author(s):

Claude Kasereka Masumbuko ◽

Edward Gakuya Mutheke ◽

Benjamin Mbindyo ◽

Michael T Hawkes

Keyword(s):

Surgical Care ◽

Elbow Flexion ◽

Operative Management ◽

Humeral Fractures ◽

Sub Saharan Africa ◽

Delayed Surgery ◽

Flexion Extension ◽

Supracondylar Humeral Fractures ◽

Sub Saharan

Background: Supracondylar humeral fractures (SHFs) in children are associated with morbidity due to elbow stiffness. Timely operative management and/or physiotherapy are thought to reduce this complication, but pose challenges in settings with limited resources for health.Methods: This prospective cohort study included 45 pediatric patients with isolated SHF at a large tertiary hospital in Nairobi, Kenya. Patients were managed non-operatively or operatively with varying wait times to surgery, with or without physiotherapy. The measurement of elbow ROM was done up to 12 weeks after removal of Kirshner wires and/or backslab.Results: Elbow ROM increased in the follow-up period, yet residual restricted mobility in the flexion-extension plane was common. Delayed surgical management ≥7days was associated with reduced elbow ROM in the flexion-extension plane at 12 weeks median IQR 105° 92°-118° vs 120° 108°-124°, p=0.029. Physiotherapy was associated with reduced ROM at 12 weeks p=0.003, possibly due to the use of prolonged immobilization.Conclusion: In this study of pediatric SHFs at a resource-limited hospital, elbow flexion was restricted at 12 weeks follow-up and was associated with major delays in operative management. Quality of orthopedic surgical care and physiotherapy services in low-resource settings deserves further attention.Keywords: Delayed surgery, reduced elbow range, supracondylar humeral fractures, sub-Saharan Africa.

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Arthroscopic Excision of Intra-Articular Osteoid Osteoma at the Elbow

Case Reports in Orthopedics ◽

10.1155/2019/8505382 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Taku Hatta ◽

Masami Hosaka ◽

Munenori Watanuki ◽

Toshihisa Yano ◽

Shinichirou Yoshida ◽

...

Keyword(s):

Osteoid Osteoma ◽

Treatment Options ◽

Elbow Flexion ◽

Arthroscopic Treatment ◽

En Bloc ◽

Invasive Approach ◽

Arthroscopic Excision ◽

Flexion Extension ◽

Definition Of

Osteoid osteoma (OO) apparent in the intra-articular region of the elbow is very rare. Although computed tomography-guided excision and radiofrequency ablation have been recognized as useful treatment options, arthroscopic excision has recently received focus as an alternative strategy for lesions close to neurovascular structures or intra- and juxta-articular lesions. We herein report a 17-year-old female who underwent arthroscopic treatment for intra-articular OO located at the olecranon/coronoid fossa. Her symptoms included elbow pain that was exacerbated at night and contracture of elbow flexion-extension, and she was diagnosed with intra-articular OO after 12 months of symptomatic history. Arthroscopically, thorough synovectomy for both the anterior and posterior aspects of the joint enabled definition of the tumor margin with hyperemic alteration and excision of the lesion as an en bloc specimen. At the 12-month follow-up, the patient had no recurrence of elbow limitation or pain. This case report describes the advantages of arthroscopic treatment, including a low-invasive approach and easy accessibility to the whole intra-articular space, which can provide clear visualization of the tumorous lesion.

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