scholarly journals Usability, functionality, and efficacy of a custom myoelectric elbow-wrist-hand orthosis to assist elbow function in individuals with stroke

2021 ◽  
Vol 8 ◽  
pp. 205566832110350
Author(s):  
Shenan Hoppe-Ludwig ◽  
Jodi Armitage ◽  
Kristi L Turner ◽  
Megan K O’Brien ◽  
Chaithanya K Mummidisetty ◽  
...  
Keyword(s):  
Adverse Events ◽  
Range Of Motion ◽  
Upper Limb ◽  
Daily Living ◽  
Upper Limbs ◽  
Single Session ◽  
Everyday Objects ◽  
Elbow Function ◽  
Upper Extremity Impairment ◽  
Shoulder Position

Introduction After stroke, upper limb impairment affects independent performance of activities of daily living. We evaluated the usability, functionality, and efficacy of a myoelectric elbow-wrist-hand orthosis to provide support, limit unsafe motion, and enhance the functional motion of paralyzed or weak upper limbs. Methods Individuals with stroke participated in a single-session study to evaluate the device. Ability to activate the device was tested in supported and unsupported shoulder position, as well as the elbow range of motion, ability to maintain elbow position, and ability to lift and hold a range of weights while using the device. Results No adverse events were reported. 71% of users were able to operate the device in all three active myoelectric activation modes (Biceps, Triceps, Dual) during testing. Users were able to hold a range of wrist weights (0.5–2 lbs) for 10–120 seconds, with the largest percentage of participants able to hold weights with the device in Biceps Mode. Conclusions The myoelectric elbow-wrist-hand orthosis improved range of motion during use and was efficacious at remediating upper extremity impairment after stroke. All users could operate the device in at least one mode, and most could lift and hold weights representative of some everyday objects using the device.

scholarly journals Facilitating Upper Limb Function using Assistive Technology in a Neurological Patient with Bilateral Upper Limb Impairment: A Case Report

2020 ◽  
Author(s):  
Shelley Fulton ◽  
Laura Wilkinson ◽  
Kathy Stiller
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Assistive Technology ◽  
Upper Limb ◽  
Daily Living ◽  
Assistive Device ◽  
Outpatient Rehabilitation ◽  
Upper Limbs ◽  
Cord Injury

Purpose: A combination of a stroke and spinal cord injury adversely affecting both upper limbs is an unusual combination for a patient presenting for outpatient rehabilitation services. Although the management of these conditions in isolation is well documented, there is limited literature regarding rehabilitation for these conditions in combination, particularly the use of assistive technology in this setting. Methods: A case report is presented of a 53-year-old male referred for outpatient rehabilitation following a left-sided stroke, with resultant dense right sided hemiplegia. A pre-existing spinal cord injury had affected his left upper limb such that he had marked proximal weakness. This combination of impairments meant he was unable to perform even basic activities of daily living involving the upper limbs. A therapy program, led by an occupational therapist with support and input from the multi-disciplinary team, included the use of an assistive device (a mobile arm support) to facilitate functional upper limb activities. This greatly improved his ability to do upper limb functional activities. Conclusion: The use of an assistive device enabled the patient to engage in meaningful activities of daily living involving the upper limbs.

scholarly journals Demography and Function of Children with Limb Loss

2005 ◽  
Vol 29 (2) ◽  
pp. 131-138 ◽  
Author(s):  
K. Yiİĝiİter ◽  
Ö. Ülger ◽  
G. Şener ◽  
S. Akdoğan ◽  
F. Erbahçecî ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Gait Pattern ◽  
Limb Loss ◽  
Upper Limbs ◽  
Congenital Limb ◽  
And Function ◽  
Functional Gait

This retrospective study was designed for the period 1982 – 2002 to collect the basic data on the demography, level and side of the amputation, involved limbs, age, gender, and prosthetic functional level in children with limb loss. A total of 232 children were assessed through their prosthetic records. Seventy-two percent (195 children) presented lower-limb involvement, and 28% (77 children) had upper-limb loss. The age of the children varied between 1 and 15 years with a mean age of 9.90 ± 2.32 years. Results of the study revealed that the leading amputation cause in children was congenital limb absence. The most frequent levels were determined as trans-tibial and trans-radial in lower and upper limbs, respectively. Findings showed that more boys (60%) were affected, and 84% of all amputations were found to be unilateral. It was also seen that right-side amputations (54%) were more common than left-side amputations (46%). The outcome of the study showed that 96% of children with lower-limb loss reached a functional gait pattern without any aids, while the percentage of independence in activities of daily living was found to be 88% in upper-limb loss.

scholarly journals Scapular Malalignment in Patients with Stroke: A Narrative Review

2021 ◽  
Vol 9 (6) ◽  
pp. 4051-4057
Author(s):  
Eram N Kazi ◽  
◽  
Suvarna S Ganvir ◽  
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Shoulder Joint ◽  
Daily Living ◽  
Observational Studies ◽  
Chronic Stroke ◽  
Functional Mobility ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Inferior Angle

Background: Scapular Malalignment leads to functional incapacity in stroke patients. This malalignment hampers the functional mobility and stability of shoulder joint in stroke patients due to which there is reduced range of motion and hampers activities of daily living in stroke patients. So, to investigate the extent of scapular malalignment in patients with acute, chronic and sub-acute stroke. Methods: Four databases (PubMed, Google Scholar, Cochrane, Science Direct) were searched to identify eligible studies using the keywords Scapular Malalignment and Stroke. Only observational studies published in last 10 years (2010-2020) were included in this review. Results: Eight Studies, included in the review were conducted on patients with acute, sub-acute and chronic stage. The results showed that there is more of inferior angle tilting seen in patients with stroke and it increases with spasticity and alters functional mobility in patients with stroke. Discussion: All studies were consistent in using the appropriate tools for measurement of scapular malalignment. Literature showed scapular malalignment affects scapular balance angle, functional mobility of hand and range of motion in patients with acute, sub-acute and chronic stroke. Most of the literature includes patients with sub-acute and chronic stroke. There was no conflict of evidence observed among all articles. Conclusion: There is influence of Scapular malalignment on spasticity, duration of stroke, upper limb mobility, and range of motion in stroke patients. Scapular Malalignment is observed in acute, sub-acute and chronic rotation and there is more of inferior angle tilting and rotation of scapula observed. KEY WORDS: Scapular Malalignment, stroke.

scholarly journals A Double-blind Randomized Controlled Trial for the Effects of Dry Needling on Upper Limb Dysfunction in Patients with Stroke

2021 ◽  
Vol 45 (2) ◽  
pp. 115-124
Author(s):  
Zahra Tavakol ◽  
Ardalan Shariat ◽  
Noureddin Nakhostin Ansari ◽  
Shima Ghannadi ◽  
Roshanak Honarpishe ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Upper Limb ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Upper Limbs ◽  
Dry Needling ◽  
Double Blind ◽  
Randomized Controlled

Spasticity is one of the main complications of a stroke. This double-blind, randomized controlled trial aimed to compare the result of three sessions of dry needling (DN) versus sham DN on the affected upper limbs in post-stroke survivors. We recruited 24 patients (age 57.0 ± 9.6 years; male 71%). Patients were randomly allocated to two groups: a DN group and a sham DN group. The primary outcome measures were the Modified Modified Ashworth Scale (MMAS) and the Box and Block Test (BBT). Secondary outcome measures included active and passive wrist range of motion (AROM and PROM). All assessments were measured at baseline, immediately after the last session of the intervention, and one month later. Patients in the DN group had improved upper limb spasticity and passive wrist range of motion compared to control group (P < 0.05). There were no between-group differences in other outcome measures (P > 0.05). Dry needling is a useful method for improving muscle spasticity in the upper limbs of patients with stroke.

Image registration analysis of the motion characteristics of sternoclavicular joints in sagittal motion of the upper limbs

2020 ◽  
pp. 1-9
Author(s):  
Peng Su ◽  
Junlin Zhou ◽  
Cai Yun ◽  
Feng Liu ◽  
Yi Zhang
Keyword(s):  
Image Registration ◽  
3D Reconstruction ◽  
Range Of Motion ◽  
Upper Limb ◽  
Human Anatomy ◽  
Horizontal Position ◽  
Upper Limbs ◽  
Axial Angle ◽  
Rest Position ◽  
Dominant Side

OBJECTIVE: This study aims to accurately measure the range of motion of the sternoclavicular (SC) joint using 3D reconstruction and image registration. The motion of the SC joint is analyzed by means of axial angle representation to identify the kinematical characteristics of this joint. METHODS: A total of 13 healthy volunteers were enrolled in the study. The limit postures of four SC joint movements were scanned by computerized tomography. The images were integrated with reconstruction and registration techniques. The range of motion of the SC joint was measured using 3D modelling. The axial angle was used to indicate the range of motion of the SC joint. The difference between the dominant side and non-dominant side was compared and the differences in axial angle of the SC joint in different postures were compared. RESULTS: The active axial angle of the SC joint on the dominant side was approximately 1∘ higher than that of the non-dominant side when the upper limb moved from a rest position to a posteroinferior position. In the sagittal motion of the upper limbs, the axial angle of the SC joint was greatest when moving from a horizontal position to a posterosuperior position, with an average of 23.55∘. Of the flexion and extension movements of the upper limbs from a rest position to a horizontal position, 13.66% (the smallest proportion) were completed by the SC joint. CONCLUSION: The combination of 3D reconstruction and image registration is a direct and accurate method of measuring the motion of the SC joint. Axial angle representation is an intuitive method of expressing rotation in a 3D space that allows for more convenient comparison; it is also more in line with the characteristics of human anatomy and kinesiology and therefore more accurately reflects the characteristics of joint motion. It is therefore useful for guiding clinical practice. In a physical examination, the extension of the upper limb from the horizontal position to the posterosuperior position and from the rest position to the posteroinferior position can best reflect the rotation function of the SC joint in the combined motion of shoulder joints.

Botulinum Toxin Type A and Post-stroke Spasticity of the Upper Limbs

US Neurology ◽  
2009 ◽  
Vol 05 (01) ◽  
pp. 38
Author(s):  
Cindy B Ivanhoe ◽  
Natasha K Eaddy-Rose ◽  
◽  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Daily Living ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Upper Limbs ◽  
Post Stroke ◽  
The Us ◽  
Developed Nations

Background:Stroke is a significant contributor to morbidity and mortality in the US and other developed nations. Stroke and its side effects are the primary cause of disability in the US and worldwide. Upper limb mobility factors are particularly detrimental to activities of daily living. Successful treatments to improve post-stroke spasticity are required.Objective:To assess the relevant medical literature related to the use of botulinum toxin type A and post-stroke spasticity of the upper limb.Methods:Literature review utilizing Medline with keywords of botulinum toxin, stroke, spasticity, and upper extremity since 2003.Results:Thirteen criteria-based articles investigated botulinum toxin type and poststroke spasticity of the upper limbs. Discussion: Botulinum toxin type A is an effective agent in reducing post-stroke spasticity of the upper limbs.

Comprehensive physiotherapy in traumatic brachial plexus injuries conducted in health-resort conditions

Physiotherapy ◽  
2013 ◽  
Vol 21 (1) ◽  
Author(s):  
Małgorzata Zgorzalewicz-Stachowiak ◽  
Krystyna Zeńczak ◽  
Lucyna Tomczewska ◽  
Zuzanna Bartkowiak
Keyword(s):  
Muscle Strength ◽  
Brachial Plexus ◽  
Range Of Motion ◽  
Upper Limb ◽  
Brachial Plexus Injury ◽  
Road Traffic ◽  
Whole Body ◽  
Brachial Plexopathy ◽  
Upper Limbs ◽  
Health Resort

AbstractTraumatic brachial plexus palsy is one of the most frequent injuries of the upper limbs in our society. Road-traffic accidents are its most common cause. Due to the clinical picture of brachial plexopathy that can vary to a great extent, its treatment is complicated and long-term. The aim of the study was to evaluate the effectiveness of physiotherapeutic procedures in patients with traumatic brachial plexus injury. A group of 31 patients were investigated during their stay in Szczawno-Jedlina health-resort. The mean age was 43.3. The average time that passed from injury was 34 months. The patients were examined twice: before and after a 3-week motor therapy which consisted of kinesiotherapy after whole-body cryotherapy, magnet therapy, laser therapy, electrotherapy and massage. The following parameters were measured and analyzed: pain intensity on the verbal scale, the range of motion in the shoulder joint, the circumference of the upper limbs and muscle strength on the Lovett scale. The upper limb functional use was evaluated using the Smól and Nowak scale. Additionally, patients’ subjective opinion about the effectiveness of therapy was evaluated. After therapy the intensity of pain decreased and the functional use of the upper limbs improved significantly. The range of motion around the joint increased, but statistically significant results were recorded only in the passive abduction of the arm. There was a slight improvement in muscle strength and circumference of the limbs, but the results were not statistically significant. Most patients claimed that physiotherapy was definitely effective or quite effective. A comprehensive physiotherapy used in patients with traumatic brachial plexus injury in health-resort conditions contributed to pain reduction and improvement in the functional use of the upper limb.

scholarly journals Range of Motion Requirements for Upper-Limb Activities of Daily Living

2015 ◽  
Vol 70 (1) ◽  
pp. 7001350010p1 ◽  
Author(s):  
Deanna H. Gates ◽  
Lisa Smurr Walters ◽  
Jeffrey Cowley ◽  
Jason M. Wilken ◽  
Linda Resnik
Keyword(s):  
Activities Of Daily Living ◽  
Range Of Motion ◽  
Upper Limb ◽  
Daily Living

Physical Activity in Aging Population

2019 ◽  
Vol 5 (3) ◽  
pp. 74
Author(s):  
Rezarta Stena ◽  
Klara Hysenaj ◽  
Mitilda Gugu Karoli ◽  
Armelda Teta ◽  
Gjergji Doka
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Heart Rate ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Training Program ◽  
Grip Strength ◽  
Upper Limb ◽  
Hand Grip ◽  
Trunk Flexibility

It is known that worldwide populations are aging, and also that physical activity can play an important role in minimizing impairments characteristic of old age. Adopting a more active lifestyle and doing regular physical activity, including aerobic and resistance exercises, daily walking etc. have been demonstrated to improve cardiovascular, respiratory, and musculoskeletal parameters in older adults. We assessed a potential participant from Elbasan (Albania), 67 years, for eligibility to participate in a 5 month training program. The subject gave written informed consent before inclusion.The following parameters were measured at the beginning (baseline) and end of the training period: BMI, body fat percentage, hand grip strength, lower/upper limb and trunk flexibility and range of motion, heart rate, balance, pain intensity, as well as VO2 max, directly and/or an estimate using the Rockport fitness test estimate. An initial evaluation was carried out just before starting the training (baseline). A second evaluation was made 5 months after starting the program of physical exercise (post training). Each evaluation included the recording of health related events, such as any changes in previous symptoms, as well as measurements of balance, flexibility, body composition, coordination, muscle strength, and aerobic capacity, to detect any changes that might have been induced specifically by physical activity. The subject’s attendance and participation in the program was also recorded. Range of motion for each part evaluated (trunk, hip, cervical region and shoulder) is improved about 15-20° degree. BMI, hand grip strength, lower/upper limb and trunk flexibility, heart rate, balance, pain intensity, VO2 max are also improved after training program. Following a training program or a regular physical activity in older adults minimise impairments characteristics in this age and cardiovascular, respiratory, and musculoskeletal parameters. According to the low importance shown in my country for the physical activity in older adults, I want to emphasize the importance of state structures involvement and the sensibilization of this group of age to stimulate an actively participation in physical training programs followed by professionals for bests life parameters. A higher investment for this age group, building as many facilities as possible for activation and spending quality free time, hiring more physiotherapists in nursing homes will increase life motivation and improve the quality and the parameters of living.

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