Evaluation of Shoulder Instability Braces

Multijoint reflex coupling could impact the voluntary control of functional arm movements in people post stroke. The multijoint responses to active-assist, constant-velocity movements of the elbow joint were measured in 14 individuals post stroke and 9 neurologically intact controls. Resulting responses in the stroke group illustrated a change in the reflex coupling of the elbow and shoulder muscles compared with passive perturbations of the spastic elbow. Voluntary effort during constant-velocity elbow extension resulted in reflex shoulder abduction, differing from the reflex coupling observed between the elbow flexors and shoulder adductors observed during passive elbow extension. These results suggest that post stroke, voluntary drive alters reflex coupling of the elbow and shoulder. Flexion of the elbow during active-assist also resulted in reflex coupling. Shoulder abduction torque decreased with constant-velocity flexion of the elbow; however, no net adduction was observed at the end of the perturbation. Shoulder flexion/extension and internal/external rotation torque responses demonstrated similar modulations to imposed active-assist perturbations of the elbow in subjects post stroke. Responses were absent during passive perturbations of the control elbow; however, shoulder torque modulations were observed during constant-velocity, active-assist tasks. The active-assist response patterns in controls were similar to stroke subjects during the extension task but opposite during flexion of the elbow. This study provides evidence of a neural coupling between elbow and shoulder muscles and a modulation of this coupling during voluntary drive of the spastic arm.

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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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Arthroscopic remplissage: a valuable adjunct to arthroscopic Bankart’s repair in shoulder instability

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210634 ◽

2021 ◽

Vol 7 (2) ◽

pp. 391

Author(s):

Gunjan Upadhyay ◽

Gaurav Gupta

Keyword(s):

Shoulder Instability ◽

External Rotation ◽

Arthroscopic Surgery ◽

Difficult Problem ◽

Capsular Shift ◽

Forward Flexion ◽

Valuable Adjunct ◽

Arthroscopic Shoulder Surgery ◽

The Hill

<p class="abstract">Current study present results of arthroscopic shoulder stabilisation surgery. 46 consecutive patients with recurrent anterior shoulder dislocations and less than 25% Glenoid bone loss were treated with arthroscopic surgery in 2017-2020. Arthroscopic repair of Bankart’s lesion with capsular shift was performed in each. In 8 patients, where the Hill sach’s lesion was “off track” or “engaging”, arthroscopic remplissage was performed along with arthroscopic Bankart’s repair. There was no recurrence of shoulder instability after a mean follow up of 1 year. This included the non-engaging Hill sach’s group (treated with Bankart’s repair) as well as the engaging or off track Hill sach’s group (treated with Bankart’s repair and remplissage). All patients went on to obtain full forward flexion, full abduction and internal rotation. The Bankart’s and remplissage group had a mean of 8 degrees restriction of external rotation. SST scores and oxford scores had improved considerably on follow up in both groups Arthroscopic shoulder surgery provides a safe and reliable option in the management of recurrent shoulder dislocations. Arthroscopic remplissage is a useful adjunct to Bankart’s repair when treating the difficult problem of a large engaging Hill Sachs lesion.</p><p class="abstract"> </p>

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Measures of Interjoint Coordination Post-stroke Across Different Upper Limb Movement Tasks

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2020.620805 ◽

2021 ◽

Vol 8 ◽

Author(s):

Anne Schwarz ◽

Janne M. Veerbeek ◽

Jeremia P. O. Held ◽

Jaap H. Buurke ◽

Andreas R. Luft

Keyword(s):

Upper Limb ◽

Elbow Flexion ◽

Shoulder Abduction ◽

Kinematic Parameters ◽

Limb Function ◽

Interjoint Coordination ◽

Upper Limb Function ◽

Shoulder Flexion ◽

Flexion Extension ◽

Median Slope

Background: Deficits in interjoint coordination, such as the inability to move out of synergy, are frequent symptoms in stroke subjects with upper limb impairments that hinder them from regaining normal motor function. Kinematic measurements allow a fine-grained assessment of movement pathologies, thereby complementing clinical scales, like the Fugl–Meyer Motor Assessment of the Upper Extremity (FMMA-UE). The study goal was to investigate the effects of the performed task, the tested arm, the dominant affected hand, upper limb function, and age on spatiotemporal parameters of the elbow, shoulder, and trunk. The construct validity of the metrics was examined by relating them with each other, the FMMA-UE, and its arm section.Methods: This is a cross-sectional observational study including chronic stroke patients with mild to moderate upper limb motor impairment. Kinematic measurements were taken using a wearable sensor suit while performing four movements with both upper limbs: (1) isolated shoulder flexion, (2) pointing, (3) reach-to-grasp a glass, and (4) key insertion. The kinematic parameters included the joint ranges of shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension; trunk displacement; shoulder–elbow correlation coefficient; median slope; and curve efficiency. The effects of the task and tested arm on the metrics were investigated using a mixed-model analysis. The validity of metrics compared to clinically measured interjoint coordination (FMMA-UE) was done by correlation analysis.Results: Twenty-six subjects were included in the analysis. The movement task and tested arm showed significant effects (p < 0.05) on all kinematic parameters. Hand dominance resulted in significant effects on shoulder flexion/extension and curve efficiency. The level of upper limb function showed influences on curve efficiency and the factor age on median slope. Relations with the FMMA-UE revealed the strongest and significant correlation for curve efficiency (r = 0.75), followed by shoulder flexion/extension (r = 0.68), elbow flexion/extension (r = 0.53), and shoulder abduction/adduction (r = 0.49). Curve efficiency additionally correlated significantly with the arm subsection, focusing on synergistic control (r = 0.59).Conclusion: The kinematic parameters of the upper limb after stroke were influenced largely by the task. These results underpin the necessity to assess different relevant functional movements close to real-world conditions rather than relying solely on clinical measures.Study Registration: clinicaltrials.gov, identifier NCT03135093 and BASEC-ID 2016-02075.

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Design of an Exoskeleton Prototype for Shoulder Rehabilitation

10.17488/rmib.30.1.29 ◽

2017 ◽

Author(s):

◽

D. Sosa-Méndez

Keyword(s):

External Rotation ◽

Adult Population ◽

Target Population ◽

Stress And Strain ◽

Element Analysis ◽

Motor Disability ◽

Shoulder Flexion ◽

Flexion Extension ◽

Robotic Devices ◽

Selection Of

The motor disability is a problem at the global level and according to the census 2010 from INEGI, in Mexico, people with mobility problems represent 58.3 % of the population with disabilities. To face this problem, robotic devices for rehabilitation have emerged which allow to perform therapies with accuracy, efficiency, reduction of physical efforts and the opportunity to perform them in group. However, these devices may not match the mobility of the members to rehabilitate and their adaptation to the mexican anthropometry is limited. In this article, the design of an exoskeleton focused on the Mexican adult population with partial loss of mobility in the shoulder is presented. The objective is to develop an exoskeleton capable of generating the 3 basic movements of the shoulder (flexion-extension, abduction-adduction and internal-external rotation) considering the anthropometric measurements of the target population. For the design of the prototype, an adaptation of the mechatronic design methodology for robots is used. The proposed design is validated kinematically through numerical simulations in Matlab® and ADAMS™, the numerical results prove the range of mobility of each exoskeleton joint. Moreover, a finite element analysis is carried out to quantify the stress and strain levels in the exoskeleton, verifying the selection of materials for its manufacture.

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The effect of smartphone usage on the upper extremity performance among Saudi Youth, KSA

Romanian Journal of Rhinology ◽

10.2478/rjr-2018-0006 ◽

2018 ◽

Vol 8 (29) ◽

pp. 47-53 ◽

Cited By ~ 2

Author(s):

Mohammed Khalid Alruzayhi ◽

Muath Salman Almuhaini ◽

Akrm Ibrahem Alwassel ◽

Osama Mansour Alateeq

Keyword(s):

Upper Extremity ◽

External Rotation ◽

Elbow Flexion ◽

Pain Scale ◽

Shoulder Abduction ◽

Smartphone Addiction ◽

Awareness Campaign ◽

Pain Scores ◽

Shoulder Flexion ◽

The Impact

Abstract The current study aims to investigate the effect of smartphone usage on the upper extremity performance among Saudi youth. A goniometer to measure the Range of Motion (ROM), the Smartphone Addiction Scale (SAS), McGill Pain scale and Chattanooga stabilizer were used to perform the current study on a sample of 300 university students from Al-Imam Mohammed Bin Saud University. The results have shown that smartphone addiction is negatively correlated to the elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. Furthermore, the results have shown that McGill pain scores were positively correlated to elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. The study has concluded that smartphone usage among Saudi youth negatively affects the upper extremity and causes a significant increase in the pain intensity. The study has recommended that there is an urgent need for a significant awareness campaign to warn the community regarding the impact of using smartphones for long periods of time.

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Upper Extremity and Lower Back Moments during Carrying Tasks in Farm Children

Journal of Applied Biomechanics ◽

10.1123/jab.25.2.149 ◽

2009 ◽

Vol 25 (2) ◽

pp. 149-155 ◽

Cited By ~ 8

Author(s):

Jason C. Gillette ◽

Catherine A. Stevermer ◽

Stacey A. Meardon ◽

Timothy R. Derrick ◽

Charles V. Schwab

Keyword(s):

External Rotation ◽

Elbow Flexion ◽

Axial Rotation ◽

Video Data ◽

Upper Body ◽

Shoulder Abduction ◽

Lateral Bending ◽

Joint Moments ◽

Shoulder Flexion ◽

Shoulder External Rotation

Farm youth commonly perform animal care tasks such as feeding and watering. The purpose of this study was to determine the effects of age, bucket size, loading symmetry, and amount of load on upper body moments during carrying tasks. Fifty-four male and female participants in four age groups (8–10 years, 12–14 years, 15–17 years, and adults, 20–26 years) participated in the study. Conditions included combinations of large or small bucket sizes, unilateral or bilateral loading, and load levels of 10% or 20% of body weight (BW). During bucket carrying, elbow flexion, shoulder flexion, shoulder abduction, shoulder external rotation, L5/S1 extension, L5/S1 lateral bending, and L5/S1 axial rotation moments were estimated using video data. The 8–10 year-old group did not display higher proportional joint moments as compared with adults. Decreasing the load from 20% BW to 10% BW significantly decreased maximum normalized elbow flexion, shoulder flexion, shoulder abduction, shoulder external rotation, L5/S1 lateral bending, and L5/S1 axial rotation moments. Carrying the load bilaterally instead of unilaterally also significantly reduced these six maximum normalized joint moments. In addition, modifying the carrying task by using smaller one-gallon buckets produced significant reductions in maximum L5/S1 lateral bending moments.

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Electromyography Signal Pattern Recognition for Movement of Shoulder

Journal of Physics Conference Series ◽

10.1088/1742-6596/2071/1/012049 ◽

2021 ◽

Vol 2071 (1) ◽

pp. 012049

Author(s):

A N Norali ◽

M N Anas ◽

Z Zakaria ◽

M Asymawi ◽

A H Abu Bakar ◽

...

Keyword(s):

Pattern Recognition ◽

Discriminant Analysis ◽

External Rotation ◽

Support Vector ◽

Svm Classifier ◽

Zero Crossing ◽

Linear Discriminant ◽

Emg Signal ◽

Flexion Extension ◽

Male Subjects

Abstract Pectoralis major and deltoid are two muscles that are associated with the movement of the shoulder. Electromyography (EMG) signal acquired from these two muscles can be used to classify the movement of the shoulder based on pattern recognition. In this paper, an experiment for EMG data collection involves eight healthy male subjects who perform four shoulder movements which are flexion, extension, internal rotation and external rotation. Feature extraction of EMG data is done using root mean square (RMS), variance (VAR) and zero crossing (ZC). For pattern recognition, the classifiers that are used are Support Vector Machine (SVM), K-Nearest Neighbour (KNN), Linear Discriminant Analysis (LDA) and Quadratic Discriminant Analysis (QDA). Classification results shows highest accuracy on ZC feature using an SVM classifier with cubic kernel. The study on shoulder movement using EMG of pectoralis and deltoid muscles could be extended on arm amputees based on hypothesis that the EMG signal could be utilized for control of robotic prosthetic arm.

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Design of an Exoskeleton Prototype for Shoulder Rehabilitation

10.17488/rmib.381.29 ◽

2017 ◽

Author(s):

◽

D. Sosa-Méndez

Keyword(s):

External Rotation ◽

Adult Population ◽

Target Population ◽

Stress And Strain ◽

Element Analysis ◽

Motor Disability ◽

Shoulder Flexion ◽

Flexion Extension ◽

Robotic Devices ◽

Selection Of

The motor disability is a problem at the global level and according to the census 2010 from INEGI, in Mexico, people with mobility problems represent 58.3 % of the population with disabilities. To face this problem, robotic devices for rehabilitation have emerged which allow to perform therapies with accuracy, efficiency, reduction of physical efforts and the opportunity to perform them in group. However, these devices may not match the mobility of the members to rehabilitate and their adaptation to the mexican anthropometry is limited. In this article, the design of an exoskeleton focused on the Mexican adult population with partial loss of mobility in the shoulder is presented. The objective is to develop an exoskeleton capable of generating the 3 basic movements of the shoulder (flexion-extension, abduction-adduction and internal-external rotation) considering the anthropometric measurements of the target population. For the design of the prototype, an adaptation of the mechatronic design methodology for robots is used. The proposed design is validated kinematically through numerical simulations in Matlab® and ADAMS™, the numerical results prove the range of mobility of each exoskeleton joint. Moreover, a finite element analysis is carried out to quantify the stress and strain levels in the exoskeleton, verifying the selection of materials for its manufacture.

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Shoulder range of movement in the general population: age and gender stratified normative data using a community-based cohort

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03665-9 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Tiffany K. Gill ◽

E. Michael Shanahan ◽

Graeme R. Tucker ◽

Rachelle Buchbinder ◽

Catherine L. Hill

Keyword(s):

Normative Data ◽

External Rotation ◽

Shoulder Abduction ◽

Computer Assisted ◽

Range Data ◽

Range Of Movement ◽

Community Based ◽

Shoulder Flexion ◽

Shoulder Range ◽

The Average Range

Abstract Background An understanding of the average range of movement of the shoulder that is normally achievable is an important part of treatment for shoulder disorders. The average range of active shoulder flexion, abduction and external rotation was measured in a population cohort aged 20 years and over without shoulder pain and/or stiffness in order to provide normative shoulder range data. Methods Cross-sectional analysis using participants in a community-based longitudinal cohort study. There have been three stages of data collection – Stage 1 (1999–2003), Stage 2 (2004–2006) and Stage 3 (2008–2010). Each stage has consisted a of broad ranging computer assisted telephone interview, a self-complete questionnaire and a clinic assessment. Participants in this study are those who undertook assessments in Stage 2. The main outcome measures were active shoulder range of movement (flexion, abduction and external rotation) measured as part of the clinic assessment using a Plurimeter V inclinometer. Mean values were determined and analyses to examine differences between groups (sex and age) were undertaken using non-parametric tests. Results There were 2404 participants (51.5% male), mean age 45.8 years (SD 17.3, range 20–91). The average range of active right shoulder flexion was 161.5° for males and 158.5° for females, and active right shoulder abduction was 151.5° and 149.7° for males and females respectively. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43° in males and 40.6° in females and right active shoulder abduction by 39.5° and 36.9° respectively. External rotation range also declined, particularly among females. Conclusion To our knowledge this is the largest community-based study providing normative data for active shoulder range of movement. This information can be used to set realistic goals for both clinical practice and clinical trials.

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