scholarly journals The Influence of Age and Feedback Training on Ability to Modulate Upper Extremity Weight Bearing Force and Pectoralis Major Muscle Recruitment While Following Sternal Precautions

2021 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Ansel LaPier ◽  
Kimberly Cleary
Keyword(s):  
Upper Extremity ◽  
Weight Bearing ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Muscle Recruitment ◽  
Feedback Training ◽  
Bearing Force

scholarly journals Feedback Training Improves Compliance with Sternal Precaution Guidelines during Functional Mobility: Implications for Optimizing Recovery in Older Patients after Median Sternotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Ansel LaPier ◽  
Kimberly Cleary
Keyword(s):  
Older Patients ◽  
Heart Surgery ◽  
Weight Bearing ◽  
Pectoralis Major Muscle ◽  
Open Heart Surgery ◽  
Pectoralis Major ◽  
Functional Mobility ◽  
Functional Activities ◽  
Feedback Training ◽  
Bearing Force

Patients often need to use their arms to assist with functional activities, but after open heart surgery, pushing with the arms is limited to <10 lb (4.5 kg) to help minimize force across the healing sternum. The main purposes of this study were to determine if older patients (>60 years old) (1) accurately estimated upper extremity (UE) weight bearing force of 10 lb or less and (2) if feedback training improved their ability to limit UE force and pectoralis major muscle contraction during functional activities. An instrumented walker was used to measure UE weight bearing force, and electromyography was used to measure pectoralis major muscle activity simultaneously during 4 functional mobility tasks. After baseline testing, healthy older subjects ( n = 30 ) completed a brief session of visual and auditory concurrent feedback training. Results showed that the self-selected UE force was >10 lb for all tasks (20.0-39.7 lb [9.1-18.0 kg]), but after feedback training, it was significantly reduced (10.6-21.3 lb [4.8-9.7 kg]). During most trials (92%), study participants used >12 lb (5.5 kg) of arm weight bearing force. Pectoralis major muscle peak electromyography activity was <23% of maximal voluntary isometric contraction and was reduced (9.8-14.9%) after feedback training. Older patients may not be able to accurately estimate UE arm force used during weight bearing activities, and visual and auditory feedback improves accuracy and also modulation of pectoralis major muscle activation. Results suggest that an instrumented walker and feedback training could be clinically useful for older patients recovering from open heart surgery.

Breast and Pectoralis Muscle Hypoplasia

1996 ◽  
Vol 37 (3P2) ◽  
pp. 759-762 ◽  
Author(s):  
J. M. Perez Aznar ◽  
J. Urbano ◽  
E. Garcia Laborda ◽  
P. Quevedo Moreno ◽  
L. Ferrer Vergara
Keyword(s):  
Upper Extremity ◽  
Male Patient ◽  
Clinical Manifestation ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Breast Size ◽  
Pectoralis Muscle ◽  
Clinical Expression ◽  
Poland’S Syndrome ◽  
Poland's Syndrome

Purpose: Poland's syndrome is a congenital and unilateral aplasia of the pectoralis major muscle (PMM), with other anomalies of the ipsilateral upper extremity. We present 6 cases in which the only clinical expression was asymmetry of the breasts associated with partial absence of the PMM. Material and Methods: We reviewed 95000 mammograms (obtained 1985–1995) to find patients with asymmetrical breast size. Where the asymmetry could not be ascribed to any other cause, the patients were recalled for an examination of the PMM which was conducted at rest and with active contraction of the muscle. Results: Unilateral volume reduction of the PMM was found in 5 women of whom 2 were studied with MR. A 6th case was a fortuitous finding in a male patient. Conclusion: Mild forms of Poland's syndrome are more frequent than severe forms, and may go undiagnosed. Hypoplasia of one breast or a horizontal anterior axillary fold may be the sole clinical manifestation of this syndrome.

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 &lt;10 lb (4.5 kg). With only verbal instructions, patients&rsquo; 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.

Possibility of simultaneous transposition of segments of the pectoralis major muscle to restore flexion in the shoulder and elbow joints (clinical observation)

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 61-68
Keyword(s):  
Anterior Part ◽  
Pectoralis Major Muscle ◽  
Elbow Flexion ◽  
Functional Results ◽  
Proximal Part ◽  
Deltoid Muscle ◽  
Pectoralis Major ◽  
Orthopedic Surgeons ◽  
Active Function ◽  
Head Neck

The pectoralis major is a widely used muscle in reconstruction surgery for replacement soft tissue defects of a head, neck, thorax, upper limbs and restoration of muscle active function. The peculiarities of anatomy of the pectoralis major makes it possible to divide the muscle into several segments with their own innervations and supply and use them independently from each other. This article describes the anatomy of the pectoralis major and the opportunity for clinical applications of different segments of this muscle. The authors demonstrate the result of the restoration of shoulder and elbow flexion in a patient with arthrogryposis due to simultaneous transfer of the proximal part of pectoralis major to the anterior part of the deltoid muscle and the distal part of pectoralis major to the biceps with good functional results. The article will be useful for plastic surgeons, orthopedic surgeons and physiotherapists.

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