scholarly journals Clinical evaluation of the revolutionizing prosthetics modular prosthetic limb system for upper extremity amputees

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kristin E. Yu ◽  
Briana N. Perry ◽  
Courtney W. Moran ◽  
Robert S. Armiger ◽  
Matthew S. Johannes ◽  
...  
Keyword(s):  
Pattern Recognition ◽  
Upper Extremity ◽  
Recognition Accuracy ◽  
Hand Function ◽  
Myoelectric Prostheses ◽  
Prosthetic Limb ◽  
Non Invasive ◽  
Function Test ◽  
Control Pattern ◽  
Congenital Limb

AbstractIndividuals with upper extremity (UE) amputation abandon prostheses due to challenges with significant device weight—particularly among myoelectric prostheses—and limited device dexterity, durability, and reliability among both myoelectric and body-powered prostheses. The Modular Prosthetic Limb (MPL) system couples an advanced UE prosthesis with a pattern recognition paradigm for intuitive, non-invasive prosthetic control. Pattern recognition accuracy and functional assessment—Box & Blocks (BB), Jebsen-Taylor Hand Function Test (JHFT), and Assessment of Capacity for Myoelectric Control (ACMC)—scores comprised the main outcomes. 10 participants were included in analyses, including seven individuals with traumatic amputation, two individuals with congenital limb absence, and one with amputation secondary to malignancy. The average (SD) time since limb loss, excluding congenital participants, was 85.9 (59.5) months. Participants controlled an average of eight motion classes compared to three with their conventional prostheses. All participants made continuous improvements in motion classifier accuracy, pathway completion efficiency, and MPL manipulation. BB and JHFT improvements were not statistically significant. ACMC performance improved for all participants, with mean (SD) scores of 162.6 (105.3), 213.4 (196.2), and 383.2 (154.3), p = 0.02 between the baseline, midpoint, and exit assessments, respectively. Feedback included lengthening the training period to further improve motion classifier accuracy and MPL control. The MPL has potential to restore functionality to individuals with acquired or congenital UE loss.

Hand Function Following Silastic Arthroplasty of the Metacarpophalangeal Joints in the Rheumatoid Hand

1997 ◽  
Vol 22 (1) ◽  
pp. 90-93 ◽  
Author(s):  
A. G. ROTHWELL ◽  
K. J. CRAGG ◽  
L. B. O’NEILL
Keyword(s):  
Upper Extremity ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Finger Joint ◽  
Joint Motion ◽  
Metacarpophalangeal Joints ◽  
Function Test ◽  
Upper Extremity Function ◽  
Preoperative Score

Twenty-one consecutive rheumatoid patients (23 hands, 92 joints) who underwent Silastic metacarpophalangeal joint arthroplasty between 1989 and 1993 had the 33-task Baltimore quantitative upper extremity function test prior to surgery and then repeated at intervals from 6 weeks to 1 year for all 23 hands and 3 to 4 years for 14 of the hands. In addition all hands had goniometer measurement of active range of finger joint motion and ulnar drift at each assessment. The average preoperative score was 71 improving rapidly to 89 at 6 weeks, to 91 at 1 year and 92 at 3 to 4 years. Most improvement occurred in functions requiring pinch span or hook grip and could be attributed largely to correction of ulnar drift and the change of metacarpophalangeal arc of motion. These results confirm that the Silastic metacarpophalangeal joint arthroplasty significantly improves hand function and that the improvement is maintained over a 3- to 4-year period.

scholarly journals Effect of Standing on a Standardized Measure of Upper Extremity Function

2020 ◽  
pp. 153944922093705
Author(s):  
Jill Campbell Stewart ◽  
Ashley Saba ◽  
Jessica F. Baird ◽  
Melissa B. Kolar ◽  
Michael O’Donnell ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Completion Time ◽  
Hand Function ◽  
Daily Activities ◽  
Extremity Function ◽  
Function Test ◽  
Upper Extremity Function ◽  
Standardized Measure ◽  
The Right ◽  
Insight Into

Although many daily activities that require the upper extremity are performed in standing, arm motor function is generally measured in sitting. The purpose of this study was to examine the effect of standing on a measure of upper extremity function, the Jebsen Hand Function Test (JHFT). Twelve nondisabled adults (26.3 ± 3.1 years) completed the JHFT with the right and left arms under two conditions: sitting and standing. Total time to complete the JHFT increased when performed in standing compared with sitting in both arms ( p = .005); mean increase was 4.4% and 5.6% for the right and left arms, respectively. Checker stacking was the only subtest that showed a significant increase in completion time in standing for both arms ( p = .001); card turning showed an increase for the left arm only ( p = .002). Measurement of upper extremity function in standing may provide insight into arm motor capacity within the context of standing postural control demands.

Using a template to improve the accuracy and efficiency of the Jebsen–Taylor Hand Function Test: A comparative study

Hand Therapy ◽  
2014 ◽  
Vol 19 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Daniel Harte ◽  
Denise Curran ◽  
Philip Hamill ◽  
Alison Porter-Armstrong ◽  
Lynn Wilson
Keyword(s):  
Comparative Study ◽  
Hand Function ◽  
Function Test

Abstract 2580: How Frequent Is Impaired Arm And Hand Function After First Occasion Of Stroke? An Unselected Population From A Stroke Unit With A Geographical Catchment.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Katharina Stibrant Sunnerhagen ◽  
Hanna C Persson
Keyword(s):  
Upper Extremity ◽  
Stroke Unit ◽  
Catchment Area ◽  
Hand Function ◽  
Stroke Onset ◽  
Stroke Patients ◽  
Extremity Function ◽  
Unselected Population ◽  
Upper Extremity Function ◽  
Impaired Motor Function

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.

A critical reappraisal of corticospinal tract somatotopy and its role in traumatic cervical spinal cord syndromes

2021 ◽  
pp. 1-7
Author(s):  
Allan D. Levi ◽  
Jan M. Schwab
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Corticospinal Tract ◽  
Cervical Spinal Cord ◽  
Hand Function ◽  
Cervical Spinal Cord Injury ◽  
Pathophysiological Mechanism ◽  
Cord Injury ◽  
Central Cord Syndrome

The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.

scholarly journals Pattern recognition control of multifunction myoelectric prostheses by patients with congenital transradial limb defects: a preliminary study

2011 ◽  
Vol 35 (4) ◽  
pp. 395-401 ◽  
Author(s):  
Michael Kryger ◽  
Aimee E Schultz ◽  
Todd Kuiken
Keyword(s):  
Pattern Recognition ◽  
Success Factors ◽  
Performance Metrics ◽  
Cross Sectional Study ◽  
Residual Limb ◽  
Cross Sectional ◽  
Linear Discriminant ◽  
Myoelectric Prostheses ◽  
Preliminary Study ◽  
Emg Pattern Recognition

Background: Electromyography (EMG) pattern recognition offers the potential for improved control of multifunction myoelectric prostheses. However, it is unclear whether this technology can be successfully used by congenital amputees. Objective: The purpose of this investigation was to assess the ability of congenital transradial amputees to control a virtual multifunction prosthesis using EMG pattern recognition and compare their performance to that of acquired amputees from a previous study. Study Design: Preliminary cross-sectional study. Methods: Four congenital transradial amputees trained and tested a linear discriminant analysis (LDA) classifier with four wrist movements, five hand movements, and a no-movement class. Subjects then tested the classifier in real time using a virtual arm. Results: Performance metrics for the residual limb were poorer than those with the intact limb (classification accuracy: 52.1%±15.0% vs. 93.2%±15.8%; motion-completion rate: 49.0%±23.0% vs. 84.0%±9.4%; motion-completion time: 2.05±0.75 s vs. 1.13±0.05 s, respectively). On average, performance with the residual limb by congenital amputees was reduced compared to that reported for acquired transradial amputees. However, one subject performed similarly to acquired amputees. Conclusions: Pattern recognition control may be a viable option for some congenital amputees. Further study is warranted to determine success factors.

scholarly journals Validation of the Supine Venous Pump Function Test: A New Non-Invasive Tool in the Assessment of Deep Venous Insufficiency

1996 ◽  
Vol 91 (4) ◽  
pp. 483-488 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. A. H. R. Claassen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
M. J. M. De Rooij ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Normal Values ◽  
Venous Pressure ◽  
Calf Muscle ◽  
Pressure Measurements ◽  
Limits Of Agreement ◽  
Pump Function ◽  
Non Invasive ◽  
Calf Muscle Pump ◽  
Function Test

1. A new non-invasive test was developed to assess calf muscle pump function: the supine venous pump function test. The technique uses strain-gauge plethysmography and is performed in the supine position. The method is superior to other non-invasive methods because basically the most essential haemodynamic parameter, venous pressure decrease, is used by properly converting venous volume measurements into venous pressure. The validity of this test was established by comparison with invasive venous pressure measurements and by determining the reproducibility. Additionally, normal values were determined. 2. In 28 extremities the supine venous pump function test was performed simultaneously with invasive venous pressure measurements. The reproducibility of the test was assessed in 10 randomly chosen volunteers. In 34 volunteers normal values were obtained and 26 patients with clinical venous insufficiency were examined. 3. Comparison of the two methods revealed a correlation coefficient of r = 0.98 (P < 0.001). A mean difference of 3.9%pf between both methods was found with limits of agreement of − 6.3%pf to 14.1%pf. The coefficient of repeatability was 13%pf and the coefficient of variation was 9%. The normal range was found to be >60%pf. The mean pump function in the patient group was 45%pf. 4. The limits of agreement are small enough to be confident that the supine venous pump function test can be used instead of invasive venous pressure measurements to assess calf muscle pump function in clinical practice. The reproducibility of the test is good.

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