scholarly journals Parsonage–Turner syndrome following coronavirus disease 2019 immunization with ChAdOx1-S vaccine: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Bruno Kusznir Vitturi ◽  
Marina Grandis ◽  
Sabrina Beltramini ◽  
Andrea Orsi ◽  
Angelo Schenone ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Turner Syndrome ◽  
Upper Limb ◽  
Biceps Brachii ◽  
Progressive Increase ◽  
Strenuous Exercise ◽  
Pharmacovigilance System ◽  
Triceps Brachii ◽  
Patient Reported ◽  
Brachial Plexus Neuritis

Abstract Background Parsonage–Turner syndrome is an acute peripheral neuropathy that affects the upper brachial plexus region. Previously published reports demonstrate that the condition can be triggered by surgery, infection, autoimmune diseases, strenuous exercise, trauma, radiation, and vaccination. Parsonage–Turner syndrome has already been reported in three other patients who were vaccinated against coronavirus disease 2019. Case presentation We report the case of a 51-year-old Caucasian man without comorbidities who received the first dose of the ChAdOx1-S recombinant vaccine (Vaxzevria, AstraZeneca, Oxford, UK) against coronavirus disease 2019 and was diagnosed with Parsonage–Turner syndrome. A few days after getting vaccinated, the patient reported a progressive increase in pain in the region of vaccine administration. One month later, the shoulder pain was followed by symptoms of hypoesthesia and muscle weakness on abduction and elevation of the left upper limb. Neurological examination revealed an atrophy of the proximal muscles of the left upper limb, accompanied by paresis of the left deltoid, biceps brachii, triceps brachii, and infraspinatus muscles. Electroneuromyography carried out 3 months after the onset of symptoms showed signs consistent with brachial plexus neuritis. The adverse reaction has been properly reported to the Italian Pharmacovigilance System (Italian Medicines Agency—Agenzia Italiana del Farmaco. Conclusion The increased awareness of such association is essential for early identification and diagnosis and, thus, better clinical outcomes.

Heteronymous reflex connections in human upper limb muscles in response to stretch of forearm muscles

2011 ◽  
Vol 106 (3) ◽  
pp. 1489-1499 ◽  
Author(s):  
Curtis D. Manning ◽  
Parveen Bawa
Keyword(s):  
Upper Limb ◽  
Biceps Brachii ◽  
Monosynaptic Reflex ◽  
Electromyographic Activity ◽  
Response Patterns ◽  
Triceps Brachii ◽  
Limb Muscles ◽  
Abductor Digiti Minimi ◽  
Human Upper Limb ◽  
Wrist Flexors

Torque motor produced stretch of upper limb muscles results in two distinct reflex peaks in the electromyographic activity. Whereas the short-latency reflex (SLR) response is mediated largely by the spinal monosynaptic reflex pathway, the longer-latency reflex (LLR) is suggested to involve a transcortical loop. For the SLRs, patterns of heteronymous monosynaptic Ia connections have been well-studied for a large number of muscles in the cat and in humans. For LLRs, information is available for perturbations to proximal joints, although the protocols for most of these studies did not focus on heteronymous connections. The main objective of the present study was to elicit both SLRs and LLRs in wrist flexors and extensors and to examine heteronymous connections from these muscles to elbow flexors (biceps brachii; BiBr) and extensors (triceps brachii; TriBr) and to selected distal muscles, including abductor pollicis longus (APL), first dorsal interosseous (FDI), abductor digiti minimi (ADM), and Thenars. The stretch of wrist flexors produced SLR and LLR peaks in APL, FDI, ADM, Thenars, and BiBr while simultaneously inducing inhibition of wrist extensors and TriBr. When wrist extensors were stretched, SLR and LLR peaks were observed in TriBr, whereas the primary wrist flexors, APL and BiBr, were inhibited; response patterns of FDI, ADM, and Thenars were less consistent. The main conclusions from the observed data are that: 1) as in the cat, afferents from wrist flexors and extensors make heteronymous connections with proximal and distal upper limb muscles; and 2) the strength of heteronymous connections is greater for LLRs than SLRs in the distal muscles, whereas the opposite is true for the proximal muscles. In the majority of observations, SLR and LLR excitatory peaks were observed together. However, on occasion, LLRs were observed without the SLR response in hand muscles when wrist extensors were stretched.

PATTERNS AND CONSISTENCY OF MUSCLE RECRUITMENT FOR A KARATE JAB

2011 ◽  
Vol 23 (01) ◽  
pp. 75-82 ◽  
Author(s):  
Yu-Lin Ning ◽  
Jia-Da Li ◽  
Wei-Ching Lo ◽  
Chih-Hung Huang ◽  
Chu-Fen Chang ◽  
...  
Keyword(s):  
Upper Limb ◽  
Muscle Activation ◽  
Biceps Brachii ◽  
Erector Spinae ◽  
Lower Limbs ◽  
Medial Gastrocnemius ◽  
Muscle Recruitment ◽  
Triceps Brachii ◽  
Motor Time ◽  
Karate Athletes

Adequate pattern and consistency of the muscle recruitment is essential to symbolize the destruction of the opponent with high movement velocities and precise targeting of the opponent's head and body during a karate jab. The purpose of this study was to evaluate the reaction time (RT), motor time (MT), and total response time (TRT), as well as their correlation during a karate jab, and to investigate the recruitment pattern and consistency of muscles during motor time. As many as 14 professional karate athletes (age: 23.67 ± 2.64 years; height: 174.57 ± 7.13 cm; and weight: 72.75 ± 10.65 kg) participated in the current study. Each subject was instructed to pose in combat stance first and then to use their left hand to jab at an instrumented kicking target as soon as they saw the start signal. Surface electromyograms (EMGs) were recorded from 16 muscles, namely the pronator teres, biceps brachii, triceps brachii, and deltoid of the left upper limb, right erector spinae, left rectus abdominis, and gluteus maximus, rectus femoris, biceps femoris, tibialis anterior, and medial gastrocnemius of the right and left lower limbs. Start and stop signals from the instrumented target were also recorded synchronously to obtain the TRT. Significant correlation between MT and TRT indicated that MT was a key determinant for the TRT of the jab. When performing a karate jab, the karate athletes initiated the movement with postural adjustments of the legs and trunk prior to the onset of the voluntary jab by the upper limb, and with a proximal-to-distal sequence of muscle activation in the left arm. Good consistencies of muscle recruitment of the trunk, left arm, and leg, and cocontraction of the left triceps and biceps brachii also indicated a well-controlled jab by the left arm. These results provide important information on the patterns and the consistencies of the muscle recruitment for coaching a karate jab, which should be helpful for a better understanding of the motor control strategies of a karate jab and for developing a suitable training protocol.

scholarly journals Modulation of Stretch Reflexes of the Finger Flexors by Sensory Feedback From the Proximal Upper Limb Poststroke

2009 ◽  
Vol 102 (3) ◽  
pp. 1420-1429 ◽  
Author(s):  
Gilles Hoffmann ◽  
Derek G. Kamper ◽  
Jennifer H. Kahn ◽  
William Z. Rymer ◽  
Brian D. Schmit
Keyword(s):  
Upper Limb ◽  
Stretch Reflex ◽  
Sensory Input ◽  
Biceps Brachii ◽  
Elbow Flexion ◽  
Spinal Reflex ◽  
Reflex Response ◽  
Emg Activity ◽  
Triceps Brachii ◽  
Flexor Digitorum

Neural coupling of proximal and distal upper limb segments may have functional implications in the recovery of hemiparesis after stroke. The goal of the present study was to investigate whether the stretch reflex response magnitude of spastic finger flexor muscles poststroke is influenced by sensory input from the shoulder and the elbow and whether reflex coupling of muscles throughout the upper limb is altered in spastic stroke survivors. Through imposed extension of the metacarpophalangeal (MCP) joints, stretch of the relaxed finger flexors of the four fingers was imposed in 10 relaxed stroke subjects under different conditions of proximal sensory input, namely static arm posture (3 different shoulder/elbow postures) and electrical stimulation (surface stimulation of biceps brachii or triceps brachii, or none). Fast (300°/s) imposed stretch elicited stretch reflex flexion torque at the MCP joints and reflex electromyographic (EMG) activity in flexor digitorum superficialis. Both measures were greatest in an arm posture of 90° of elbow flexion and neutral shoulder position. Biceps stimulation resulted in greater MCP stretch reflex flexion torque. Fast imposed stretch also elicited reflex EMG activity in nonstretched heteronymous upper limb muscles, both proximal and distal. These results suggest that in the spastic hemiparetic upper limb poststroke, sensorimotor coupling of proximal and distal upper limb segments is involved in both the increased stretch reflex response of the finger flexors and an increased reflex coupling of heteronymous muscles. Both phenomena may be mediated through changes poststroke in the spinal reflex circuits and/or in the descending influence of supraspinal pathways.

scholarly journals High-density surface electromyography signals during isometric contractions of elbow muscles of healthy humans

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Mónica Rojas-Martínez ◽  
Leidy Yanet Serna ◽  
Mislav Jordanic ◽  
Hamid Reza Marateb ◽  
Roberto Merletti ◽  
...  
Keyword(s):  
Upper Limb ◽  
Biceps Brachii ◽  
High Density ◽  
Isometric Contractions ◽  
Myoelectric Activity ◽  
Electrode Arrays ◽  
Triceps Brachii ◽  
Healthy Humans ◽  
Limb Muscles ◽  
Density Surface

AbstractThis paper presents a dataset of high-density surface EMG signals (HD-sEMG) designed to study patterns of sEMG spatial distribution over upper limb muscles during voluntary isometric contractions. Twelve healthy subjects performed four different isometric tasks at different effort levels associated with movements of the forearm. Three 2-D electrode arrays were used for recording the myoelectric activity from five upper limb muscles: biceps brachii, triceps brachii, anconeus, brachioradialis, and pronator teres. Technical validation comprised a signals quality assessment from outlier detection algorithms based on supervised and non-supervised classification methods. About 6% of the total number of signals were identified as “bad” channels demonstrating the high quality of the recordings. In addition, spatial and intensity features of HD-sEMG maps for identification of effort type and level, have been formulated in the framework of this database, demonstrating better performance than the traditional time-domain features. The presented database can be used for pattern recognition and MUAP identification among other uses.

IDIOPATHIC BRACHIAL NEURITIS

Neurosurgery ◽  
2009 ◽  
Vol 65 (suppl_4) ◽  
pp. A150-A152 ◽  
Author(s):  
Austin J. Sumner
Keyword(s):  
Brachial Plexus ◽  
Turner Syndrome ◽  
Motor Neurons ◽  
Severe Pain ◽  
Sudden Onset ◽  
Common Condition ◽  
Upper Arm ◽  
Neuralgic Amyotrophy ◽  
Brachial Neuritis ◽  
Brachial Plexus Neuritis

Abstract Parsonage-Turner syndrome (PTS) is a rare syndrome of unknown cause, affecting mainly the lower motor neurons of the brachial plexus. The brachial plexus is a group of nerves that conduct signals from the spine to the shoulder, arm, and hand. PTS is usually characterized by the sudden onset of severe 1-sided shoulder pain, followed by paralysis of the shoulder and lack of muscle control in the arm, wrist, or hand several days later. PTS can vary greatly in presentation and nerve involvement. Also known as brachial plexus neuritis or neuralgic amyotrophy, PTS is a common condition characterized by inflammation of a network of nerves that control and supply, or innervate, the muscles of the chest, shoulders, and arms. Individuals with the condition first experience severe pain across the shoulder and upper arm. Within a few hours or days, weakness, wasting (atrophy), and paralysis may affect the muscles of the shoulder. Although individuals with the condition may experience paralysis of the affected areas for months or, in some cases, years, recovery is usually eventually complete.

scholarly journals Feasibility of Brachial Plexus Schwannoma Enucleation With Intraoperative Neuromonitoring

2020 ◽  
Vol 13 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Doh Young Lee ◽  
Jeong-Yeon Chi ◽  
Jungirl Seok ◽  
Sungjun Han ◽  
Min-Hyung Lee ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Retrospective Review ◽  
Nerve Root ◽  
Postoperative Morbidity ◽  
Biceps Brachii ◽  
Preoperative Assessment ◽  
Patient Characteristics ◽  
Intraoperative Neuromonitoring ◽  
Triceps Brachii ◽  
Postoperative Function

Objectives. To evaluate the feasibility of brachial plexus schwannoma enucleation under intraoperative neuromonitoring. Methods. Five patients who were treated for brachial plexus schwannoma under intraoperative neuromonitoring from 2008 to 2018 were included in this retrospective review. Neuromonitoring was performed with a 100-μV event threshold of the neuromonitoring system (NIM-2 or 3) at the deltoid, biceps brachii, triceps brachii, and brachioradialis muscles. Patient characteristics, tumor size and location, intraoperative neuromonitoring findings, and postoperative function were evaluated. Results. The intraoperative neuromonitoring findings were in accordance with the preoperative assessment of the included nerve root. Three patients had no postoperative morbidity, one patient had temporary paresthesia of the forearm for 2 months, and one patient mild loss of grip strength for 1 month. Conclusion. Intraoperative neuromonitoring of the arm and forearm muscles during enucleation of brachial plexus schwannoma promoted confident and successful surgery with minimal postoperative morbidity.

scholarly journals Home-based self-help telerehabilitation of the upper limb assisted by an electromyography-driven wrist/hand exoneuromusculoskeleton after stroke

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chingyi Nam ◽  
Bingbing Zhang ◽  
Tszying Chow ◽  
Fuqiang Ye ◽  
Yanhuan Huang ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Biceps Brachii ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Muscle Coordination ◽  
Triceps Brachii ◽  
Abductor Pollicis Brevis ◽  
Self Help ◽  
Home Based

Abstract Background Most stroke survivors have sustained upper limb impairment in their distal joints. An electromyography (EMG)-driven wrist/hand exoneuromusculoskeleton (WH-ENMS) was developed previously. The present study investigated the feasibility of a home-based self-help telerehabilitation program assisted by the aforementioned EMG-driven WH-ENMS and its rehabilitation effects after stroke. Methods Persons with chronic stroke (n = 11) were recruited in a single-group trial. The training progress, including the training frequency and duration, was telemonitored. The clinical outcomes were evaluated using the Fugl–Meyer Assessment (FMA), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Functional Independence Measure (FIM), and Modified Ashworth Scale (MAS). Improvement in muscle coordination was investigated in terms of the EMG activation level and the Co-contraction Index (CI) of the target muscles, including the abductor pollicis brevis (APB), flexor carpi radialis-flexor digitorum (FCR-FD), extensor carpi ulnaris-extensor digitorum (ECU-ED), biceps brachii (BIC), and triceps brachii (TRI). The movement smoothness and compensatory trunk movement were evaluated in terms of the following two kinematic parameters: number of movement units (NMUs) and maximal trunk displacement (MTD). The above evaluations were conducted before and after the training. Results All of the participants completed the home-based program with an intensity of 63.0 ± 1.90 (mean ± SD) min/session and 3.73 ± 0.75 (mean ± SD) sessions/week. After the training, motor improvements in the entire upper limb were found, as indicated by the significant improvements (P < 0.05) in the FMA, ARAT, WMFT, and MAS; significant decreases (P < 0.05) in the EMG activation levels of the APB and FCR-FD; significant decreases (P < 0.05) in the CI of the ECU–ED/FCR–FD, ECU–ED/BIC, FCR–FD/APB, FCR–FD/BIC, FCR–FD/TRI, APB/BIC and BIC/TRI muscle pairs; and significant reductions (P < 0.05) in the NMUs and MTD. Conclusions The results suggested that the home-based self-help telerehabilitation program assisted by EMG-driven WH-ENMS is feasible and effective for improving the motor function of the paretic upper limb after stroke. Trial registration ClinicalTrials.gov. NCT03752775; Date of registration: November 20, 2018.

The use of cooled saline during bone drilling to reduce the incidence of upper-limb palsy after cervical laminoplasty

2013 ◽  
Vol 19 (4) ◽  
pp. 420-427 ◽  
Author(s):  
Shota Takenaka ◽  
Noboru Hosono ◽  
Yoshihiro Mukai ◽  
Toshitada Miwa ◽  
Takeshi Fuji
Keyword(s):  
Muscle Strength ◽  
Upper Limb ◽  
High Speed ◽  
Biceps Brachii ◽  
Deltoid Muscle ◽  
Cervical Laminoplasty ◽  
Bone Drilling ◽  
Triceps Brachii ◽  
Simple Method ◽  
Previous Hypothesis

Object No previous hypothesis has attempted to fully account for the occurrence of upper-limb palsy (ULP) after cervical laminoplasty. The authors propose that friction-generated heat from a high-speed drill may cause thermal injury to the nerve roots close to the drilled bone, which may then lead to ULP. The authors investigated the effect of cooling the saline used for irrigation during the drilling on the incidence of upper-limb (C-5) palsy following cervical laminoplasty. Methods The irrigation saline for drilling was used at room temperature (RT, average temperature of 25.6°C) in operations of 79 patients (the RT group) and cooled to an average of 12.1°C in operations of 80 patients (the low-temperature [LT] group). The authors used a hand-held dynamometer to precisely assess muscle strength presurgery and 2 weeks postsurgery. Results There was a 7.6% and 1.9% decrease in the strength of the deltoid muscle, a 10.1% and 4.4% decrease in the strength of the biceps brachii, a 1.3% and 0.6% decrease in the strength of the triceps brachii, and a 7.6% and 3.1% decrease in grip strength in the RT and LT groups, respectively. Multivariate analysis revealed that a significant predictor for decreased deltoid muscle strength was the use of irrigation saline at RT. Conclusions Using cooled irrigation saline during bone drilling significantly decreased the incidence of ULP and can thus be recommended as a simple method for the prevention of ULP.

Development of Upper-Limb Power-Assist Machine Using Linkage Mechanism – Mechanism and its Fundamental Motion –

2014 ◽  
Vol 8 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Hiroyuki Inoue ◽  
◽  
Toshiro Noritsugu
Keyword(s):  
Upper Limb ◽  
Biceps Brachii ◽  
Worm Gear ◽  
Input Device ◽  
Linkage Mechanism ◽  
Triceps Brachii ◽  
User Intention ◽  
Link Mechanism ◽  
Parallel Link ◽  
Human Upper Limb

This paper proposes an upper-limb power-assist machine that is driven by a single actuator to reduce its weight and cost. The assist machine is intended for supporting shoulder and elbow movements during work in the field of viticulture. It consists of an arm part, a mounting part, and a drive part, the last of which contains an actuator and a worm gear. The arm part is equipped with a parallel link mechanism. In order to realize natural upper-limb motion, the length of the arm part is designed on the basis of human upper-limb motion. The assist machine is controlled by user intention through the use of bending sensors attached to the input device. The assistance effectiveness of the proposed assist machine is verified experimentally by measuring the EMG signals of the deltoid, biceps brachii, and triceps brachii muscles.

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