scholarly journals Arthroscopic Release of Severe Flexion- and Extension-Impeding Knee Stiffness With Inaccessible Joint

Author(s):  
Jinzhong Zhao
2004 ◽  
Vol 9 (5) ◽  
pp. 1-11
Author(s):  
Patrick R. Luers

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.


2014 ◽  
Vol 644-650 ◽  
pp. 879-883
Author(s):  
Jing Jing Yu

In various forms of movement of finger rehabilitation training, Continuous Passive Motion (CPM) of single degree of freedom (1 DOF) has outstanding application value. Taking classic flexion and extension movement for instance, this study collected the joint angle data of finger flexion and extension motion by experiments and confirmed that the joint motion of finger are not independent of each other but there is certain rule. This paper studies the finger joint movement rule from qualitative and quantitative aspects, and the conclusion can guide the design of the mechanism and control method of finger rehabilitation training robot.


Author(s):  
Mansoor Amiri ◽  
Farhad Tabatabai Ghomsheh ◽  
Farshad Ghazalian

The purpose of this study was to model the resistance mechanism of Passive Knee Joint Flexion and Extension to create a similar torque mechanism in rehabilitation equipment. In order to better model the behavior of passive knee tissues, it is necessary to exactly calculate the two coefficients of elasticity of time-independent and time-dependent parts. Ten healthy male volunteers (mean height 176.4+/−4.59 cm) participated in this study. Passive knee joint flexion and extension occurred at velocities of 15, 45, and 120 (degree/s), and in five consecutive cycles and within the range of 0 to 100° of knee movement on the sagittal plane on Cybex isokinetic dynamometer. To ensure that the muscles were relaxed, the electrical activity of knee muscles was recorded. The elastic coefficient, (KS) increased with elevating the passive velocity in flexion and extension. The elastic coefficient, (KP) was observed to grow with the passive velocity increase. While, the viscous coefficient (C) diminished with passive velocity rise in extension and flexion. The heightened passive velocity of the motion resulted in increased hysteresis (at a rate of 42%). The desired of passive velocity is lower so that there is less energy lost and the viscoelastic resistance of the tissue in the movement decreases. The Coefficient of Determination, R2 between the model-responses and experimental curves in the extension was 0.96 < R2 < 0.99 and in flexion was 0.95 < R2 < 0.99. This modeling is capable of predicting the true performance of the components of passive knee movement and we can create a resistance mechanism in the rehabilitation equipment to perform knee joint movement. Quantitative measurements of two elastic coefficients of Time-independent and Time-dependent parts passive knee joint coefficients should be used for better accurate simulation the behavior of passive tissues in the knee which is not seen in other studies.


2021 ◽  
pp. 1-7
Author(s):  
Mercè Torra ◽  
Eduard Pujol ◽  
Anna Maiques ◽  
Salvador Quintana ◽  
Roser Garreta ◽  
...  

BACKGROUND: The difference between isokinetic eccentric to concentric strength ratios at high and low velocities (DEC) is a powerful tool for identifying submaximal effort in other muscle groups but its efficiency in terms of the wrist extensors (WE) and flexors (WF) isokinetic effort has hitherto not been studied. OBJECTIVE: The objective of the present study is to examine the usefulness of the DEC for identifying suboptimal wrist extensor and flexor isokinetic efforts. METHODS: Twenty healthy male volunteers aged 20–40 years (28.5 ± 3.2) were recruited. Participants were instructed to exert maximal and feigned efforts, using a range of motion of 20∘ in concentric (C) and eccentric (E) WE and WF modes at two velocities: 10 and 40∘/s. E/C ratios (E/CR) where then calculated and finally DEC by subtracting low velocity E/CR from high velocity ones. RESULTS: Feigned maximal effort DEC values were significantly higher than their maximal effort counterparts, both for WF and WE. For both actions, a DEC cutoff level to detect submaximal effort could be defined. The sensitivity of the DEC was 71.43% and 62.5% for WE ad WF respectively. The specificity was 100% in both cases. CONCLUSION: The DEC may be a valuable parameter for detecting feigned maximal WF and WE isokinetic effort in healthy adults.


Entropy ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 443
Author(s):  
Hongbo Liang ◽  
Shota Maedono ◽  
Yingxin Yu ◽  
Chang Liu ◽  
Naoya Ueda ◽  
...  

Electroencephalography neurofeedback (EEG-NFB) training can induce changes in the power of targeted EEG bands. The objective of this study is to enhance and evaluate the specific changes of EEG power spectral density that the brain-machine interface (BMI) users can reliably generate for power augmentation through EEG-NFB training. First, we constructed an EEG-NFB training system for power augmentation. Then, three subjects were assigned to three NFB training stages, based on a 6-day consecutive training session as one stage. The subjects received real-time feedback from their EEG signals by a robotic arm while conducting flexion and extension movement with their elbow and shoulder joints, respectively. EEG signals were compared with each NFB training stage. The training results showed that EEG beta (12–40 Hz) power increased after the NFB training for both the elbow and the shoulder joints’ movements. EEG beta power showed sustained improvements during the 3-stage training, which revealed that even the short-term training could improve EEG signals significantly. Moreover, the training effect of the shoulder joints was more obvious than that of the elbow joints. These results suggest that NFB training can improve EEG signals and clarify the specific EEG changes during the movement. Our results may even provide insights into how the neural effects of NFB can be better applied to the BMI power augmentation system and improve the performance of healthy individuals.


Author(s):  
Tarek A. El-Gammal ◽  
Amr El-Sayed ◽  
Mohamed M. Kotb ◽  
Waleed Riad Saleh ◽  
Yasser Farouk Ragheb ◽  
...  

Abstract Background Traumatic brachial plexus injuries in children represent a definite spectrum of injuries between adult and neonatal brachial plexus injuries. Their characteristics have been scarcely reported in the literature. The priority of functional restoration is not clear. Materials and Methods In total, 52 children with surgically treated traumatic brachial plexus injuries, excluding Erb's palsy, were reviewed after a minimum follow-up of 2 years. All children except nine were males, with an average age at surgery of 8 years. Forty-five children had exclusive supraclavicular plexus injuries. Twenty-one of them (46%) had two or more root avulsions. Seven children (13.5%) had infraclavicular plexus injuries. Time from trauma to surgery varied from 1 to 15 months (mean = 4.7 months). Extraplexal neurotization was the most common surgical technique used. Results Shoulder abduction and external rotation were restored to an average of 83 and 26 degrees, respectively. Elbow flexion and extension were restored to grade ≥3 in 96 and 91.5% of cases, respectively. Finger flexion and extension were restored to grade ≥4 in 29 and 32% of cases, respectively. Wrist flexion and extension were restored to grade ≥4 in 21 and 27% of cases, respectively. Results of neurotization were superior to those of neurolysis and nerve grafting. Among the 24 children with insensate hands, 20 (83.3%) recovered S3 sensation, 3 recovered S2, and 1 recovered S1. No case complained of neuropathic pain. Functional recovery correlated negatively but insignificantly with the age at surgery and time from injury to surgery. Conclusion Brachial plexus injuries in children are associated with a high incidence root avulsions and no pain. Neurotization is frequently required and the outcome is not significantly affected by the delay in surgery. In total plexus injuries, some useful hand function can be restored, and management should follow that of obstetric palsy and be focused on innervating the medial cord.


Author(s):  
Bahram Amirshakeri ◽  
Minoo Khalkhali Zavieh ◽  
Mandana Rezaei ◽  
Hakimeh Adigozali

BACKGROUND: Force perception as a contributor to the neuromuscular control of the knee joint may be altered after anterior cruciate ligament (ACL) injury. OBJECTIVE: This study aimed to compare the force perception accuracy in the knee joints of patients with ACL injury and healthy subjects. METHODS: Twenty-six patients with ACL injury and 26 healthy subjects participated in this case-control study. Participants were asked to produce 50% of the maximum voluntary isometric contraction of the knee muscles as a target force and reproduce it in their limbs in flexion and extension directions. RESULTS: There were significant interactions between group and condition as well as group, condition, and limb in the force perception error respectively (P< 0.05). The highest amount of error was seen in the contralateral limb of the ACL injury group when the reference force was produced in the injured limb (P< 0.05). CONCLUSION: The findings revealed that the force perception accuracy in the knee flexor/extensor muscles of individuals with ACL injury is impaired. Moreover, error is most evident when the patient produces force in the injured limb and replicates it in the uninjured limb in both flexion and extension directions. Therefore, the rehabilitation programs should encompass neuromuscular training in both quadriceps and hamstrings after ACL injury.


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