scholarly journals Evaluation of functional outcomes after brachial plexus injury

2019 ◽  
Vol 45 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Tom J. Quick ◽  
Hazel Brown
Keyword(s):  
Brachial Plexus ◽  
Functional Outcomes ◽  
Current Practice ◽  
Brachial Plexus Injury ◽  
Correct Selection ◽  
Assessment And Evaluation ◽  
Significant Challenge ◽  
The World ◽  
Research Findings ◽  
Selection Of

Major nerve injuries such as those of the brachial plexus present a significant challenge for both rehabilitation and evaluation of outcome. With these often complex and multi-faceted injuries, correct selection of outcome measures is important. Healthy nerve function in humans heightens our interactions with the world, creating quality and enjoyment through our experiences of movement and touch. Therefore, assessments should be holistic and representative of all of these features. This article considers the assessment and evaluation of all of the features of nerve injury: sensorimotor, sensation (including that of pain), function and the psychosocial aspects. Current practice is described and combined with clinical experience and research findings to provide suggestions and recommendations for the selection of the most appropriate tools for use with this patient group.

Minimum Ten-Year Outcomes of Partial Ulnar Nerve Transfer for Restoration of Elbow Flexion in Patients with Upper Brachial Plexus Injury

2019 ◽  
Vol 24 (03) ◽  
pp. 283-288
Author(s):  
Yusuke Nagano ◽  
Daisuke Kawamura ◽  
Alaa Terkawi ◽  
Atsushi Urita ◽  
Yuichiro Matsui ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
The Mean ◽  
Flexion Strength

Background: Partial ulnar nerve transfer to the biceps motor branch of the musculocutaneous nerve (Oberlin’s transfer) is a successful approach to restore elbow flexion in patients with upper brachial plexus injury (BPI). However, there is no report on more than 10 years subjective and objective outcomes. The purpose of this study was to clarify the long-term outcomes of Oberlin’s transfer based on the objective evaluation of elbow flexion strength and subjective functional evaluation of patients. Methods: Six patients with BPI who underwent Oberlin’s transfer were reviewed retrospectively by their medical records. The mean age at surgery was 29.5 years, and the mean follow-up duration was 13 years. The objective functional outcomes were evaluated by biceps muscle strength using the Medical Research Council (MRC) grade at preoperative, postoperative, and final follow-up. The patient-derived subjective functional outcomes were evaluated using the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at final follow-up. Results: All patients had MRC grade 0 (M0) or 1 (M1) elbow flexion strength before operation. Four patients gained M4 postoperatively and maintained or increased muscle strength at the final follow-up. One patient gained M3 postoperatively and at the final follow-up. Although one patient achieved M4 postoperatively, the strength was reduced to M2 due to additional disorder. The mean score of QuickDASH was 36.5 (range, 7–71). Patients were divided into two groups; three patients had lower scores and the other three patients had higher scores of QuickDASH. Conclusions: Oberlin’s transfer is effective in the restoration of elbow flexion and can maintain the strength for more than 10 years. Patients with upper BPI with restored elbow flexion strength and no complicated nerve disorders have over ten-year subjective satisfaction.

scholarly journals Quantifying Real-World Upper-Limb Activity Via Patient-Initiated Movement After Nerve Reconstruction for Upper Brachial Plexus Injury

Neurosurgery ◽  
2018 ◽  
Vol 85 (3) ◽  
pp. 369-374
Author(s):  
Brandon W Smith ◽  
Kate W-C Chang ◽  
Serena J Saake ◽  
Lynda J-S Yang ◽  
Kevin C Chung ◽  
...  
Keyword(s):  
Pilot Study ◽  
Brachial Plexus ◽  
Range Of Motion ◽  
Real World ◽  
Functional Outcomes ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Shoulder Abduction ◽  
Patient Reported ◽  
Motion Detectors

Abstract BACKGROUND A critical concept in brachial plexus reconstruction is the accurate assessment of functional outcomes. The current standard for motor outcome assessment is clinician-elicited, outpatient clinic-based, serial evaluation of range of motion and muscle power. However, discrepancies exist between such clinical measurements and actual patient-initiated use. We employed emerging technology in the form of accelerometry-based motion detectors to quantify real-world arm use after brachial plexus surgery. OBJECTIVE To evaluate (1) the ability of accelerometry-based motion detectors to assess functional outcome and (2) the real-world arm use of patients after nerve transfer for brachial plexus injury, through a pilot study. METHODS Five male patients who underwent nerve transfer after brachial plexus injury wore bilateral motion detectors for 7 d. The patients also underwent range-of-motion evaluation and completed multiple patient-reported outcome surveys. RESULTS The average age of the recruits was 41 yr (±17 yr), and the average time from operation was 2 yr (±1 yr). The VT (time of use ratio) for the affected side compared to the unaffected side was 0.73 (±0.27), and the VM (magnitude ratio) was 0.63 (±0.59). VT strongly and positively correlated with shoulder flexion and shoulder abduction: 0.97 (P = .008) and 0.99 (P = .002), respectively. CONCLUSION Accelerometry-based activity monitors can successfully assess real-world functional outcomes after brachial plexus reconstruction. This pilot study demonstrates that patients after nerve transfer are utilizing their affected limbs significantly in daily activities and that recovery of shoulder function is critical.

Analysis on Selection of Water Ring Vacuum Pumps in the Chemical Industry

2013 ◽  
Vol 325-326 ◽  
pp. 1435-1439 ◽  
Author(s):  
Hong Mei Yu
Keyword(s):  
Chemical Industry ◽  
World Economy ◽  
Development Process ◽  
Rapid Development ◽  
Correct Selection ◽  
Consumption Reduction ◽  
The World ◽  
Water Ring ◽  
Energy Equipment ◽  
Selection Of

With the rapid development of the world economy, energy has become tighter. Industrial equipments play an important role in the development process of the world economy, at the same time they also consume a lot of energy. Equipment selections are related to the different working conditions, such as temperature, pressure, load, economy etc. Reasonable and scientifically select the equipment and the auxiliary devices can meet the specifications required, while also help on energy saving and consumption reduction. In this article, this paper discusses on the reasonable correct selection of the 2BE1 series water ring vacuum pumps in the chemical industry.

scholarly journals Seating and Mobility Considerations for People With Spinal Cord Injury

2000 ◽  
Vol 80 (7) ◽  
pp. 701-709 ◽  
Author(s):  
Jean L Minkel
Keyword(s):  
Spinal Cord ◽  
Current Practice ◽  
Spinal Cord Injuries ◽  
Overuse Injuries ◽  
Community Environment ◽  
Cord Injury ◽  
Research Findings ◽  
Seated Posture ◽  
The Impact ◽  
Selection Of

Abstract For people with spinal cord injuries, the selection of a wheelchair and seating system involves many factors. This clinical perspective describes a model that includes consideration of the person, the wheelchair, the immediate environment between the person and the wheelchair, the intermediate environment of the home and work, and the community environment. The seated posture is examined biomechanically, and literature is reviewed that highlights the differences in the seated position of people with spinal cord injuries and people without spinal cord injuries. Reports regarding overuse injuries of the shoulder and wrists are discussed along with methods of relieving pressure at the buttock and seat interface. The impact that research findings should have on current clinical practice and the need for more research to provide evidence to either support or change current practice are discussed.

Children's Photograph Selections and Verbal Reports in a Spatial Task

Perception ◽  
1983 ◽  
Vol 12 (5) ◽  
pp. 599-606 ◽  
Author(s):  
Rachel M Calam
Keyword(s):  
Mental Rotation ◽  
Three Dimensional ◽  
Spatial Task ◽  
Correct Selection ◽  
Two Dimensional ◽  
Verbal Reports ◽  
Verbal Cues ◽  
Shift Task ◽  
The World ◽  
Selection Of

The tendency for children to select a photograph of their own view of a scene when asked to represent the view seen by another observer in a different position has been attributed to an egocentric view of the world. It seems likely, however, that the egocentric response need not necessarily be related to the question of sensitivity to the viewpoints of others. Rather, it may reflect the way in which children treat two-dimensional representations of three-dimensional arrays in mental-rotation tasks. In the present investigation, strong visual and verbal cues were given for correct selection of a photograph of another observer's view in a perspective-shift task. Justifications for choices were required. Whilst floor effects were seen with children 3 to 4 years old, the responses of 8-year olds polarised into a choice between the correct and egocentric view, as Freeman would predict. Verbal justifications for these choices were mainly in terms of appropriate content. After first selection, this chosen view was removed from the array. Two-thirds of children who had chosen egocentrically then went on to choose correctly on a second attempt. It is suggested that the egocentric response may form an easier alternative for the child, but that the provision of such an alternative may prevent the child from displaying the knowledge that he or she has.

scholarly journals Sociological study of the internet: Towards the establishment of digital sociology in Serbia

Sociologija ◽  
2019 ◽  
Vol 61 (4) ◽  
pp. 478-496
Author(s):  
Jelisaveta Petrovic
Keyword(s):  
Digital Technologies ◽  
The Internet ◽  
Sociological Study ◽  
Valuable Contribution ◽  
Theoretical Approaches ◽  
The Social ◽  
The World ◽  
Scientific Papers ◽  
Research Findings ◽  
Selection Of

The aim of this paper is to identify core topics, theoretical approaches and methodological techniques applied in the sociological study of the internet in Serbia. Moreover, the paper assesses obstacles and potentials for the establishment of a specialized sociological discipline - digital sociology - in Serbia. Method of content analysis is applied to the selection of scientific papers published in the two most important sociological journals in Serbia: Sociology and Sociological Review, in the period 1994-2018. Research findings show that topics typical for digital sociology do not receive enough attention among Serbian scholars, but that there are some indications of growing interest in the field. While there is still some lagging behind the developments of digital sociology in the world, the research findings suggest that the major trends have been followed. Empirical findings on the social impacts of digital technologies in Serbia present a valuable contribution to the international research efforts in this area of study.

scholarly journals Pearls and Pitfalls of Phrenic Nerve Transfer for Shoulder Reconstruction in Brachial Plexus Injury

2021 ◽  
Vol 16 (01) ◽  
pp. e1-e9
Author(s):  
Kazuteru Doi ◽  
Sei Haw Sem ◽  
Bipin Ghanghurde ◽  
Yasunori Hattori ◽  
Sotetsu Sakamoto
Keyword(s):  
Brachial Plexus ◽  
Phrenic Nerve ◽  
Functional Outcomes ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Suprascapular Nerve ◽  
Pulmonary Complications ◽  
Predisposing Factors ◽  
Shoulder Range Of Motion ◽  
Shoulder Reconstruction

Abstract Objectives The purpose of this study was to report the functional outcomes of phrenic nerve transfer (PNT) to suprascapular nerve (SSN) for shoulder reconstruction in brachial plexus injury (BPI) patients with total and C5–8 palsies, and its pulmonary complications. Methods Forty-four out of 127 BPI patients with total and C5–8 palsies who underwent PNT to SSN for shoulder reconstruction were evaluated for functional outcomes in comparison with other types of nerve transfers. Their pulmonary function was analyzed using vital capacity in the percentage of predicted value and Hugh-Jones (HJ) breathless classification. The predisposing factors to develop pulmonary complications in those patients were examined as well. Results PNT to SSN provided a better shoulder range of motion significantly as compared with nerve transfer from C5 root and contralateral C7. The results between PNT and spinal accessory nerve transfer to SSN were comparable in all directions of shoulder motions. There were no significant respiratory symptoms in majority of the patients including six patients who were classified into grade 2 HJ breathlessness grading. Two predisposing factors for poorer pulmonary performance were identified, which were age and body mass index, with cut-off values of younger than 32 years old and less than 23, respectively. Conclusions PNT to SSN can be a reliable reconstructive procedure in restoration of shoulder function in BPI patients with total or C5–8 palsy. The postoperative pulmonary complications can be prevented with vigilant patient selection.

Functioning Free Muscle Transfer for Brachial Plexus Injury: A Systematic Review and Pooled Analysis Comparing Functional Outcomes of Intercostal Nerve and Spinal Accessory Nerve Grafts

2020 ◽  
Vol 36 (08) ◽  
pp. 567-571
Author(s):  
Jeremie D. Oliver ◽  
Chase Beal ◽  
Emily M. Graham ◽  
Katherine B. Santosa ◽  
Michael S. Hu
Keyword(s):  
Brachial Plexus ◽  
Functional Outcomes ◽  
Latissimus Dorsi ◽  
Brachial Plexus Injury ◽  
Rectus Femoris ◽  
Elbow Flexion ◽  
Intercostal Nerve ◽  
The Mean ◽  
Lost To Follow Up

Abstract Background The aim of this study was to compare postoperative elbow flexion outcomes in patients receiving functioning free muscle transplantation (FFMT) innervated by either intercostal nerve (ICN) or spinal accessory nerve (SAN) grafts. Methods A comprehensive systematic review on FFMT for brachial plexus reconstruction was conducted utilizing Medline/PubMed database. Analysis was designed to compare functional outcomes between (1) nerve graft type (ICN vs. SAN) and (2) different free muscle graft types to biceps tendon (gracilis vs. rectus femoris vs. latissimus dorsi). Results A total of 312 FFMTs innervated by ICNs (169) or the SAN (143) are featured in 10 case series. The mean patient age was 28 years. Patients had a mean injury to surgery time of 31.5 months and an average follow-up time of 39.1 months with 18 patients lost to follow-up. Muscles utilized included the gracilis (275), rectus femoris (28), and latissimus dorsi (8). After excluding those lost to follow-up or failures due to vascular compromise, the mean success rates of FFMTs innervated by ICNs and SAN were 64.1 and 65.4%, respectively. Conclusion This analysis did not identify any difference in outcomes between FFMTs via ICN grafts and those innervated by SAN grafts in restoring elbow flexion in traumatic brachial plexus injury patients.

scholarly journals Evaluation of roadside service centers. Case study: Zahedan to Khash Road

2017 ◽  
Vol 7 (4) ◽  
pp. 374-381
Author(s):  
Maryam Karimiyan Bostani ◽  
Fateme Hashemzehi ◽  
Mahmood Reza Anvari
Keyword(s):  
Correct Selection ◽  
Transportation Industry ◽  
Related Factors ◽  
Job Opportunities ◽  
Selection Systems ◽  
Research Findings ◽  
The City ◽  
Selection Of

In the recent century, the excessive and unplanned growth of urbanism and inattention to the proper and correct selection of locations for roadside uses, especially roadside services, have led to the appearance of problems such as lack of spaces for service centers, inappropriate access, and other problems. The strategic location of the city of Zahedan among other cities of Sistan and Baluchistan Province and its connection to the national corridors requires development and growth of transportation industry and improvement of its performance. Some of the utmost important centers that have to be established for this purpose on the roadsides in the required quantities are roadside service and welfare centers. Therefore, in order to maintain and promote the security of the roads in the country, the establishment of such centers requires studies, evaluations and eventually, determination of appropriate and secure locations. In this study, considering the necessity of establishing service and welfare centers on the Zahedan to Khash Road, first, the existing centers were evaluated from the perspectives of passengers, then, by the use of site selection systems, some locations were determined in the high traffic parts of this road. The research methodology in this study is descriptive-analytical which is used in order to analyze the collected data. The research findings show that according to the passengers, the conditions of roadside services on the Zahedan to Khash Road and the existing infrastructures are weak. However, they are satisfied with social and security-related factors. The passengers also stated that these roadside service centers have created job opportunities in the region. They also have been effective in providing security of the roads.

scholarly journals Administration of Oral Therapy For Gonorrheal Urethritis Patients With Local Complications In Men: Case Reports

2017 ◽  
Vol 3 (3) ◽  
pp. 1
Author(s):  
Citra Dwi Harningtyas
Keyword(s):  
Oral Therapy ◽  
Small Volume ◽  
Case Reports ◽  
Venereal Disease ◽  
Correct Selection ◽  
Purulent Discharge ◽  
Gram Negative ◽  
The World ◽  
The Individual ◽  
Selection Of

Urethritis gonorrhea is the most prevalent venereal disease today and can be found all over the world. Timeliness of treatment, correct selection of drugs with adequate doses can eliminate infections that affect the individual, prevent the development of complications, prevent further transmission and avoid germ resistance. This article reports, 24-year-old male patient with a diagnosis of gonore urethritis who came to polyclinic Skin and Veneral at Hospital Syaiful Anwar Malang. Patients come with complaints of pus out of the genitals without itching. Patients also complain of pain during urination, as well as urinating in small volume and often. On examination of external urethra urifisium area obtained ectropion, purulent discharge, and hyperemia macula. There is a lump and duh at the tip of the genitalia caused by inflammation of the paraurethral glands. From the investigation found diplococcus bacteria Gram negative intrasellular PMN. The causative therapy given is a single oral dose of Oral 400mg. Evaluation was done 3 days after treatment and improvement was obtained. Keywords: gonorrhea urethritis; oral urethritis therapy; uretritis gonorrhea complications

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