Carpal Instability in the Weight-Bearing Upper Extremity*

1996 ◽  
Vol 78 (12) ◽  
pp. 1838-43 ◽  
Author(s):  
WILLIAM SCHROER ◽  
STEPHEN LACEY ◽  
FREDERICH S. FROST ◽  
MICHAEL W. KEITH
Keyword(s):  
Upper Extremity ◽  
Weight Bearing ◽  
Carpal Instability

scholarly journals ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Weight Bearing ◽  
The Body ◽  
Adolescent And Young Adult ◽  
Body Region ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Orthopedic Injuries ◽  
Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

Reliability, validity, and minimal detectable change of the push-off test scores in assessing upper extremity weight-bearing ability

2019 ◽  
Vol 32 (1) ◽  
pp. 103-109 ◽  
Author(s):  
Saurabh P. Mehta ◽  
Hannah R. George ◽  
Christian A. Goering ◽  
Danielle R. Shafer ◽  
Alan Koester ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Test Scores ◽  
Weight Bearing ◽  
Minimal Detectable Change ◽  
Detectable Change

scholarly journals Upper Extremity Overuse Injuries and Obesity After Spinal Cord Injury

2021 ◽  
Vol 27 (1) ◽  
pp. 68-74
Author(s):  
Jose R. Vives Alvarado ◽  
Elizabeth R. Felix ◽  
David R. Gater
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
High Risk ◽  
Upper Extremity ◽  
Weight Bearing ◽  
Functional Decline ◽  
Overuse Injuries ◽  
Cord Injury ◽  
Preserve Function ◽  
The Relationship

Persons with spinal cord injury (SCI) are at high risk for developing neurogenic obesity due to muscle paralysis and obligatory sarcopenia, sympathetic blunting, anabolic deficiency, and blunted satiety. Persons with SCI are also at high risk for shoulder, elbow, wrist, and hand injuries, including neuromusculoskeletal pathologies and nociceptive pain, as human upper extremities are poorly designed to facilitate chronic weight-bearing activities, including manual wheelchair propulsion, transfers, self-care, and day-to-day activities. This article reviews current literature on the relationship between obesity and increased body weight with upper extremity overuse injuries, detailing pathology at the shoulders, elbows, and wrists that elicit pain and functional decline and stressing the importance of weight management to preserve function.

Reaction Force Generation and Mechanical Demand Imposed on the Shoulder When Initiating Manual Wheelchair Propulsion and at Self-Selected Fast Speeds

2019 ◽  
Vol 141 (12) ◽  
Author(s):  
Marisa Papp ◽  
Ian Russell ◽  
Philip S. Requejo ◽  
Jan Furumasu ◽  
Jill L. McNitt-Gray
Keyword(s):  
Upper Extremity ◽  
Daily Living ◽  
Weight Bearing ◽  
Reaction Force ◽  
Joint Kinetics ◽  
Manual Wheelchair ◽  
Fast Speed ◽  
Cord Injury ◽  
Reaction Forces ◽  
Load Exposure

Abstract Manual wheelchair (WC) users with spinal cord injury (SCI) experience shoulder pain and fatigue associated with their increased reliance on the upper extremity during activities of daily living (Bayley et al. 1987, “The Weight-Bearing Shoulder. The Impingement Syndrome in Paraplegics,” J. Bone Jt. Surg. Am., 69(5), pp. 676–678). We hypothesized that the mechanical demand imposed on the shoulder, represented as resultant shoulder net joint moment (NJM) impulse, would be greater when initiating manual WC propulsion from a stationary position without momentum than when manually propelling at speed on a level sidewalk. Thirty manual WC users with paraplegia participated. Each individual initiated manual WC propulsion from a stationary position and propelled on a level sidewalk at their self-selected fast speed. Upper extremity kinematics and pushrim reaction forces (RFs) were measured and upper extremity joint kinetics were calculated and compared (α = 0.05) between cycle 1, initiated without momentum, and cycle 3 with momentum. Results indicate that multiple factors contributing to the mechanical demand imposed on the shoulder were significantly greater when manual WC propulsion was initiated without momentum than with momentum. Significant differences in resultant shoulder NJM impulse, push duration, orientation of RF relative to forearm, and resultant average shoulder NJMs during push were observed between momentum conditions. No significant differences in average resultant RF during push were found. These results indicate that mechanical loading of the shoulder during manual WC propulsion differs between momentum conditions; these differences in resultant shoulder NJM impulse during push need to be considered when assessing shoulder load exposure in stop-and-start activities.

scholarly journals The effect of upper extremity weight bearing on upper extremity function in children with hemiplegic type of cerebral palsy

2010 ◽  
Vol 66 (1) ◽  
Author(s):  
P. Jayaraman ◽  
T. Puckree
Keyword(s):  
Upper Extremity ◽  
Weight Bearing ◽  
Rank Test ◽  
Wrist Flexion ◽  
Upper Limb Function ◽  
Extremity Function ◽  
Post Test ◽  
Quasi Experimental ◽  
Signed Rank Test ◽  
Upper Extremity Function

The main objective of this study was to quantify the effects ofweight bearing on upper limb function in children with hemiplegic cerebralpalsy. This study also sought to monitor the change in spasticity immediatelyfollowing weight bearing exercises. A  quasi-experimental, one group pre-test,post-test design was used. Eleven children with hemiplegic type of cerebral palsyfrom a special school in KwaZulu Natal participated after fully informed consentof the caretaking guardian. The intervention consisted of a standardized programof weight bearing. The Melbourne A ssessment of Upper Extremity function wasused to quantify upper extremity function of reach, grasp and manipulation and the modified A shworth grading of spasticity was used to grade and monitor spasticity. The data was analysed using the Wilcoxon signed rank test.  A  significant decrease in spasticity during elbow extension (p= 0,004), wrist flexion (p=0,026) and extension (p=0,004)was noted. Statistically significant improvement in function, reach (p=0, 00), grasp (p=0, 02) manipulation (p=0, 05)and overall quality of function (p= 0,003) was also found. A n overall significant effect of weight bearing exercises onupper extremity function was noted providing evidence for practice.

scholarly journals Development of a Feedback Training Protocol and Clinical Force Measuring Walker for Older Patients with Restricted Upper Extremity Weight Bearing

2021 ◽  
Author(s):  
Ansel LaPier
Keyword(s):  
Upper Extremity ◽  
Older Patients ◽  
Patient Adherence ◽  
Callus Formation ◽  
Weight Bearing ◽  
Training Session ◽  
Subsequent Development ◽  
Functional Mobility ◽  
Feedback Training ◽  
Training Protocol

Patients recovering from bone disruption due to trauma or surgery need to limit movement to minimize shear force, thereby protecting callus formation and osteogenesis. Patients often use their arms to assist with functional activities, but pushing is frequently limited to <10 lb (4.5 kg). With only verbal instructions, patients’ ability to accurately limit weight-bearing (WB) force is poor. A therapeutic intervention to improve patient adherence with upper extremity (UE) WB guidelines during functional mobility using an instrumented walker could be beneficial. Therefore, the purpose of this article is to describe a feedback training protocol to improve the ability to modulate weight-bearing force in older adults and then provide an overview of the efficacy of this protocol and subsequent development of a Clinical Force Measuring Walker. An instrumented walker was used to measure UE WB during functional mobility in older healthy subjects (n = 30) before, during, and after (immediately and 2 hours) a visual and auditory concurrent feedback training session. During feedback training, force was significantly reduced with all 3 sessions as compared to baseline. When using the front wheeled walker, UE WB force during the second and third feedback training trials went down compared to the first trial. During the third feedback training trial, force was greater than the two previous trials while transferring sit-to-stand and stand-to-sit. After completion of practice with feedback, UE WB force was significantly reduced and remained so 2 hours later. These findings suggest that feedback training is effective for helping patients to modulate UE WB. Use of an instrumented walker and feedback training would be beneficial in clinical practice, especially with older patients. A more intensive feedback training with additional trials and or simultaneous visual and auditory cues during whole-practice may be needed to get UE WB below a 10 lb threshold.

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