Reliability of Impact Forces, Hip Angles and Velocities during Simulated Forward Falls Using a Novel Propelled Upper Limb Fall ARrest Impact System (PULARIS)

2012 ◽  
Vol 134 (1) ◽  
Author(s):  
Timothy A. Burkhart ◽  
Don Clarke ◽  
David M. Andrews
Keyword(s):  
Upper Limb ◽  
Impact System ◽  
Impact Forces ◽  
Steel Tubing ◽  
Directional Motion ◽  
Fall Arrest ◽  
Reported Data ◽  
The Impact ◽  
Forward Falls ◽  
Hand Forces

Previous forward fall simulation methods have provided good kinematic and kinetic data, but are limited in that they have started the falls from a stationary position and have primarily simulated uni-directional motion. Therefore, a novel Propelled Upper Limb fall ARest Impact System (PULARIS) was designed to address these issues during assessments of a variety of fall scenarios. The purpose of this study was to present PULARIS and evaluate its ability to impact the upper extremities of participants with repeatable velocities, hand forces and hip angles in postures and with vertical and horizontal motion consistent with forward fall arrest. PULARIS consists of four steel tubing crossbars in a scissor-like arrangement that ride on metal trolleys within c-channel tracks in the ceiling. Participants are suspended beneath PULARIS by the legs and torso in a prone position and propelled horizontally via a motor and chain drive until they are quick released, and then impact floor-mounted force platforms with both hands. PULARIS velocity, hip angles and velocities and impact hand forces of ten participants (five male, five female) were collected during three fall types (straight-arm, self-selected and bent-arm) and two fall heights (0.05 m and 0.10 m) to assess the reliability of the impact conditions provided by the system. PULARIS and participant hip velocities were found to be quite repeatable (mean ICC = 0.81) with small between trial errors (mean = 0.03 m/s). The ratio of horizontal to vertical hip velocity components (∼0.75) agreed well with previously reported data (0.70-0.80). Peak vertical hand impact forces were also found to be relatively consistent between trials with a mean ICC of 0.73 and mean between trial error of 13.4 N. Up to 83% of the horizontal hand impact forces displayed good to excellent reliability (ICC > 0.6) with small between trial differences. Finally, the ICCs for between trial hip angles were all classified as good to excellent. Overall, PULARIS is a reliable method and is appropriate for studying the response of the distal upper extremity to impact loading during non-stationary, multi-directional movements indicative of a forward fall. This system performed well at different fall heights, and allows for a variety of upper and lower extremity, and hip postures to be tested successfully in different landing scenarios consistent with elderly and sport-related falls.

scholarly journals The Effectiveness of Wrist Guards for Reducing Wrist and Elbow Accelerations Resulting from Simulated Forward Falls

2010 ◽  
Vol 26 (3) ◽  
pp. 281-289 ◽  
Author(s):  
Timothy A. Burkhart ◽  
David M. Andrews
Keyword(s):  
Injury Risk ◽  
Intervention Strategy ◽  
Acceleration Response ◽  
Anatomical Structures ◽  
Response Characteristics ◽  
Wrist Guard ◽  
Upper Extremity Injury ◽  
Fall Arrest ◽  
The Impact ◽  
Forward Falls

The effectiveness of wrist guards and modifying elbow posture for reducing impact-induced accelerations at the wrist and elbow, for the purpose of decreasing upper extremity injury risk during forward fall arrest, has not yet been documented in living people. A seated human pendulum was used to simulate the impact conditions consistent with landing on outstretched arms during a forward fall. Accelerometers measured the wrist and elbow response characteristics of 28 subjects following impacts with and without a wrist guard, and with elbows straight or slightly bent. Overall, the wrist guard was very effective, with significant reductions in peak accelerations at the elbow in the axial and off-axis directions, and in the off-axis direction at the wrist by almost 50%. The effect of elbow posture as an intervention strategy was mixed; a change in magnitude and direction of the acceleration response was documented at the elbow, while there was little effect at the wrist. Unique evidence was presented in support of wrist guard use in activities like in-line skating where impacts to the hands are common. The elbow response clearly shows that more proximal anatomical structures also need to be monitored when assessing the effectiveness of injury prevention strategies.

scholarly journals Parental perspective: The role of prostheses and prosthetics services in adjusting to a child’s upper limb difference

2020 ◽  
pp. 1-7
Author(s):  
Tara Sims
Keyword(s):  
Coping Strategies ◽  
Peer Support ◽  
Upper Limb ◽  
Family Members ◽  
Parental Adjustment ◽  
Prosthetic Devices ◽  
The Family ◽  
The Impact

BACKGROUND: The impact of paediatric upper limb difference may extend beyond the child themselves to their parents and other family members. Previous research has found that feelings of shock, numbness and loss are common amongst parents and that peer support can be a buffer against stress. OBJECTIVE: The current study aimed to explore the experiences of parents of children with limb difference, and the role of services and prosthetic devices in these experiences. METHODS: Nine parents of children with limb difference participated in either a group (n= 2) or individual (n= 7) interview. RESULTS: Analysis of the interview transcripts revealed four themes – ‘grief and guilt’, ‘prosthesis as a tool for parental adjustment’, ‘support’ and ‘fun and humour’. CONCLUSIONS: Parents may employ coping strategies to help them adjust to their child’s limb difference, including use of a prosthesis, accessing support from statutory services and peers, and use of fun and humour within the family.

scholarly journals Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review

2021 ◽  
Vol 10 (8) ◽  
pp. 1740
Author(s):  
Marion Bareille ◽  
Michaël Hardy ◽  
Jonathan Douxfils ◽  
Stéphanie Roullet ◽  
Dominique Lasne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Strength ◽  
Small Sample ◽  
The Common ◽  
Small Sample Sizes ◽  
Definition Of ◽  
Reported Data ◽  
Prophylactic Anticoagulation ◽  
The Impact ◽  
Heparin Neutralization

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until December 31st, 2020. VET methods and parameters, and patients’ features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.

scholarly journals Effect of post-stroke spasticity on voluntary movement of the upper limb

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hadar Lackritz ◽  
Yisrael Parmet ◽  
Silvi Frenkel-Toledo ◽  
Melanie C. Baniña ◽  
Nachum Soroker ◽  
...  
Keyword(s):  
Upper Limb ◽  
Target Location ◽  
Distance Measure ◽  
Movement Time ◽  
Motor Impairment ◽  
Reach To Grasp ◽  
Motion Patterns ◽  
Post Stroke ◽  
The Impact ◽  
Elbow Motion

Abstract Background Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. Methods Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the ‘distance’ between pathological and normal movement, (a) the bidirectional Kullback–Liebler divergence (BKLD) and (b) Hellinger’s distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. Results Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. Conclusions The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints.

scholarly journals Characterising Upper Limb Movements in Huntington's Disease and the Impact of Restricted Visual Cues

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0133709 ◽  
Author(s):  
Jessica Despard ◽  
Anne-Marie Ternes ◽  
Bleydy Dimech-Betancourt ◽  
Govinda Poudel ◽  
Andrew Churchyard ◽  
...  
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Upper Limb ◽  
Visual Cues ◽  
Limb Movements ◽  
Upper Limb Movements ◽  
The Impact

Considerations Concerning Vehicle Collisions Through Simplified Calculations of the Impact Forces

1996 ◽  
Author(s):  
Helcio Onusic ◽  
José Augusto P. Campos ◽  
Paulo Sergio P. dos Santos
Keyword(s):  
Vehicle Collisions ◽  
Impact Forces ◽  
The Impact

scholarly journals Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study

2021 ◽  
Vol 13 (1) ◽  
pp. 46-58
Author(s):  
João Paulo Branco ◽  
Filipa Rocha ◽  
João Sargento-Freitas ◽  
Gustavo C. Santo ◽  
António Freire ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Upper Limb ◽  
Functional Recovery ◽  
Prospective Observational Study ◽  
Positive Impact ◽  
Rehabilitation Program ◽  
Patient Functioning ◽  
The Impact

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

The Effects of Upstream Flexible Barrier on the Debris Flow Entrainment and Impact Dynamics on a Terminal Barrier

2021 ◽  
Author(s):  
Hervé Vicari ◽  
C.W.W. Ng ◽  
Steinar Nordal ◽  
Vikas Thakur ◽  
W.A. Roanga K. De Silva ◽  
...  
Keyword(s):  
Debris Flow ◽  
Debris Flows ◽  
Impact Force ◽  
Dynamic Pressure ◽  
Pressure Coefficient ◽  
Flexible Barrier ◽  
Impact Forces ◽  
Flexible Barriers ◽  
The Impact ◽  
Bed Entrainment

The destructive nature of debris flows is mainly caused by flow bulking from entrainment of an erodible channel bed. To arrest these flows, multiple flexible barriers are commonly installed along the predicted flow path. Despite the importance of an erodible bed, its effects are generally ignored when designing barriers. In this study, three unique experiments were carried out in a 28 m-long flume to investigate the impact of a debris flow on both single and dual flexible barriers installed in a channel with a 6 m-long erodible soil bed. Initial debris volumes of 2.5 m<sup>3</sup> and 6 m<sup>3</sup> were modelled. For the test setting adopted, a small upstream flexible barrier before the erodible bed separates the flow into several surges via overflow. The smaller surges reduce bed entrainment by 70% and impact force on the terminal barrier by 94% compared to the case without an upstream flexible barrier. However, debris overflowing the deformed flexible upstream barrier induces a centrifugal force that results in a dynamic pressure coefficient that is up to 2.2 times higher than those recommended in guidelines. This suggests that although compact upstream flexible barriers can be effective for controlling bed entrainment, they should be carefully designed to withstand higher impact forces.

Resolving the Unique Invariant Slip-Direction in Rigid Three-Dimensional Multi-Point Impacts at Stick-Slip Transitions

2018 ◽  
Author(s):  
Abhishek Chatterjee ◽  
Alan Bowling
Keyword(s):  
Single Point ◽  
Three Dimensional ◽  
Impact Behavior ◽  
Slip Direction ◽  
Stick Slip ◽  
Impact Forces ◽  
Post Impact ◽  
Impact Problems ◽  
Slip Transition ◽  
The Impact

This work presents a new approach for resolving the unique invariant slip direction at Stick-Slip Transition during impact. The solution method presented in this work is applicable to both single-point and multi-point impact problems. The proposed method utilizes rigid body constraints to resolve the impact forces at all collision points in terms of a single independent impact forces parameter. This work also uses an energetic coefficient of restitution to terminate impact events, thereby yielding energetically consistent post-impact behavior.

Response Analysis of van der Pol Vibro-Impact System with Coulomb Friction Under Gaussian White Noise

2018 ◽  
Vol 28 (13) ◽  
pp. 1830043 ◽  
Author(s):  
Meng Su ◽  
Wei Xu ◽  
Guidong Yang
Keyword(s):  
White Noise ◽  
Coulomb Friction ◽  
Gaussian White Noise ◽  
Original System ◽  
Stochastic Averaging ◽  
Response Analysis ◽  
State Variables ◽  
Van Der Pol ◽  
Impact System ◽  
The Impact

In this paper, the stationary response of a van der Pol vibro-impact system with Coulomb friction excited by Gaussian white noise is studied. The Zhuravlev nonsmooth transformation of the state variables is utilized to transform the original system to a new system without the impact term. Then, the stochastic averaging method is applied to the equivalent system to obtain the stationary probability density functions (pdfs). The accuracy of the analytical results obtained from the proposed procedure is verified by those from the Monte Carlo simulation based on the original system. Effects of different damping coefficients, restitution coefficients, amplitudes of friction and noise intensities on the response are discussed. Additionally, stochastic P-bifurcations are explored.

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