Effect of Stretching of Spastic Elbow Under Intelligent Control in Chronic Stroke Survivors—A Pilot Study

Objective: To assess the short-term effects of strenuous dynamic stretching of the elbow joint using an intelligent stretching device in chronic spastic stroke survivors.Methods: The intelligent stretching device was utilized to provide a single session of intensive stretching to the spastic elbow joint in the sagittal plane (i.e., elbow flexion and extension). The stretching was provided to the extreme range, safely, with control of the stretching velocity and torque to increase the joint range of motion (ROM) and reduce spasticity and joint stiffness. Eight chronic stroke survivors (age: 52.6 ± 8.2 years, post-stroke duration: 9.5 ± 3.6 years) completed a single 40-min stretching intervention session. Elbow passive and active ROM, strength, passive stiffness (quantifying the non-reflex component of spasticity), and instrumented tendon reflex test of the biceps tendon (quantifying the reflex component of the spasticity) were measured before and after stretching.Results: After stretching, there was a significant increase in passive ROM of elbow flexion (p = 0.021, r = 0.59) and extension (p = 0.026, r = 0.59). Also, elbow active ROM and the spastic elbow flexors showed a trend of increase in their strength.Conclusion: The intelligent stretching had a short-term positive influence on the passive movement ROM. Hence, intelligent stretching can potentially be used to repeatedly and regularly stretch spastic elbow joints, which subsequently helps to reduce upper limb impairments post-stroke.

Diagnosis and Surgical Management of Intestinal Intussusception by Open Lumina Technique in Dairy Heifers (Bos taurus)

The present study was conducted in ten dairy heifers (Bos taurus) suffering from intestinal intussusception. All these cases exhibited the clinical signs of bouts of colicky pain for 6-12 hours followed by anorexia and cessation of faeces. In all cases, the onset of disease was between 72-120 hours. Per-rectal palpation revealed spiral-shaped mass and distended intestinal loops. Ultrasonographically, distended loops, ileus, passive movement of ingesta and presence of peritoneal fluid were consistent findings. The diagnosis of intestinal intussusception was made on the basis of clinical signs, per-rectal palpation and trans-abdominal ultrasonography. Further it was confirmed on full abdominal right flank exploratory laparotomy. All the heifers were subjected for standing right flank laparotomy under linear infiltration of local anaesthesia followed by exteriorization and resection of intussucepted intestinal mass. The side-to-side entero-anastomosis was done by open lumina technique using gastro-intestinal anastomotic (GIA) stapled devices. Signalment, duration of surgery and anastomotic time were recorded in all cases. Thus, Intestinal intussusception in dairy heifers was diagnosed on the basis of clinical signs, per-rectal palpation, trans-abdominal ultrasonography which was further confirmed by full abdominal right flank exploratory laparotomy. The GIA staples applied for side-to-side entero-anastomosis by open lumina technique took less total surgical and anastomotic time. Moreover, there was reduction in tissue trauma/manipulation and in contamination by intestinal contents. The closure of bowel was easy and secured. GIA staples can be used effectively for entero-anastomosis in cattle affected with intestinal intussusception.

EFFECTS OF A DEEP LEARNING-BASED SMARTPHONE APPLICATION ON SHOULDER ABDUCTION KINEMATICS AND BRAIN ACTIVATION IN ADHESIVE CAPSULITIS: A RANDOMIZED CONTROLLED TRIAL

Patients with adhesive capsulitis (AC) demonstrate limited shoulder movement, often accompanied by pain. Common treatment methods include pain medication, and continuous passive movement (CPM). However, it is sometimes difficult to improve the reduction of pain and movement using a CPM intervention because the patient’s interest is diminished. In this study, we developed an innovative deep learning-based smartphone application (Funrehab exercise game (FEG)) to provide accurate kinematics movement and motivation as well as high-intensity and repetitive movements using deep learning. We compared the effects of CPM and FEG on brain activity and shoulder range of motion in patients with AC. Sixteen patients (males, [Formula: see text]; females, [Formula: see text]; mean age, [Formula: see text] years) with acute AC were randomized into either CPM group or FEG group 4 days/week for 2 weeks. The outcome measures were shoulder abduction kinematics movement and electroencephalography (EEG) brain activity (bilateral prefrontal, bilateral sensorimotor cortex, and somatosensory association cortex) during the intervention. The analysis of variance (ANOVA) test was performed at [Formula: see text], and the analysis demonstrated that FEG showed superior effects on shoulder abduction kinematics and brain [Formula: see text] and [Formula: see text]-wave activations compared to CPM. Our results provide a novel and promising clinical evidence that FEG can more effectively improve neurophysiological EEG data and shoulder abduction movements than CPM in patients with AC.

Morphological Change in the Biceps Brachii Muscles during Shoulder Rotation: A Cadaver Study

In the literature, the passive movement of the biceps brachii during shoulder motion is unclear. This study investigated the passive movement of the long head (LHBB) and short head (SHBB) of the biceps brachii during shoulder rotation. We included 18 shoulders from 15 cadavers. At three shoulder positions (internal rotation [IR]20°, 0°, external rotation [ER]20°), the three sides of the triangle consisting of the confluence of the SHBB and LHBB, coracoid processes, and lesser tubercles were measured. The confluence angle of the LHBB and SHBB (Angle A) was calculated using the cosine theorem. The mean values for Angle A and standardized three sides of the triangle were statistically compared among the three shoulder positions. Angle A values were 13.5° ± 7.6° at IR20°, 15.2° ± 5.8° at 0°, and 15.7° ± 4.3° at ER20° with no significant difference (p = 0.096). The lengths of all three sides and Angle A were the smallest at IR20° and highest at ER20°. All the three sides revealed significant differences among the three shoulder positions (p < 0.0001). These results imply that morphological changes of the biceps brachii occur during shoulder rotation. These morphological changes in biceps brachii may contribute to shoulder joint stabilization by adjusting the forces the act on the tendons of both heads.

Capsule Endoscopy: Pitfalls and Approaches to Overcome

Capsule endoscopy of the gastrointestinal tract is an innovative technology that serves to replace conventional endoscopy. Wireless capsule endoscopy, which is mainly used for small bowel examination, has recently been used to examine the entire gastrointestinal tract. This method is promising for its usefulness and development potential and enhances convenience by reducing the side effects and discomfort that may occur during conventional endoscopy. However, capsule endoscopy has fundamental limitations, including passive movement via bowel peristalsis and space restriction. This article reviews the current scientific aspects of capsule endoscopy and discusses the pitfalls and approaches to overcome its limitations. This review includes the latest research results on the role and potential of capsule endoscopy as a non-invasive diagnostic and therapeutic device.

Fascia Thickness Increases Following Eccentric Exercise Leading to Delayed Onset Muscle Soreness

Background: The deep fascia fuses tightly with the skeletal muscle and, thus, may be damaged by eccentric loading. Methods: To study its possible involvement in delayed onset muscle soreness, 11 healthy participants (♂= 7; 24±2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24-96 hours post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100-mm visual analog scale), biceps brachii fascia thickness and fascia/muscle mobility during passive movement (both high-resolution ultrasound) were examined. Results: Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p<.05). Relative to CE, EE increased fascia thickness at 48 (+17%), 72 (+14%) and 96 (+15%) hours post-exercise (p<.05). At 96 hours post-EE, the increase in fascia thickness correlated with palpation pain (r=.68; p<.05). Fascia mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+31%), 72 (+31%), and 96 (+41%) hours post-EE (p<.05). Conclusion: Collectively, these results suggest an involvement of the deep fascia in delayed onset muscle soreness.

INFLUENCE OF PERIODIC MODERATE LINEAR ACCELERATIONS OF VARIABLE DIRECTION ON CENTRAL HEMODYNAMICS

It was examined 19 male fencers aged 18 to 24 years , who had sports experience from 8 to 14 years and high sports qualifications in the chosen sport (masters of sports and candidates for masters of sports). Subjects had no significant differences in height and body weight. Linear horizontal accelerations were created using a movable platform with a chair, which housed the athlete. Passive movement of fencers on the platform corresponded to their usual parameters of movement on the fencing track during a sports match. It has been shown that the short-term effect of horizontal moderate accelerations of the variable direction when using the functional test (FT) led to small but statistically significant changes in heart rate (HR), stroke volume (SV) and volumetric blood ejection rate (VER). In all subjects, the changes in these indicators after FT were as follows: heart rate decreased slightly, and SV and VER increased. FT revealed that in persons who are accustomed to moving with moderate horizontal linear accelerations of variable direction, the shortterm effect of this factor was accompanied by a tendency to decrease the minute volume of blood flow (MVB) due to decreased of heart rate. Increasing of SV and VER can be considered as an immediate compensatory response aimed at maintaining MVB. Thus, in athletes whose long-term sports activities are associated with the action on the body of periodic moderate horizontal linear accelerations of variable direction, no adaptation to the action of this specified factor is formed.

Numerical Simulation of Supraglacial Debris Mobility: Implications for Ablation and Landform Genesis

Supraglacial debris does not remain fixed atop ablating ice, but can move across the ice surface as supraglacial topography evolves. This active debris movement (distinct from passive movement due to underlying ice motion) affects landform genesis as well as the rate and spatial distribution of ablation. While observations of debris transport across evolving supraglacial topography are abundant, models of these coupled processes over timescales of decades and longer are few. Here I adapt a numerical model of coupled ablation and downslope debris transport to simulate the evolution of an idealized debris-covered glacier on the timescale of complete de-icing. The model includes ablation that depends on supraglacial debris thickness and a hillslope-scale debris transport function that scales non-linearly with slope angle. Ice thickness and debris distribution evolve with model time, allowing complete simulation of de-icing and landform construction in an idealized glacier test-section. The model produces supraglacial relief that leads to topographic inversions consistent with conceptual models of hummocky landform genesis. Model results indicate that the relief of the glacier surface and postglacial hummocks depend on the relationship between characteristic timescales for ablation and debris transport, which is defined as an index of debris mobility. When debris mobility is high, topographic inversions are rapid and supraglacial and postglacial relief are subdued. When debris mobility is low, more pronounced supraglacial relief is produced, but postglacial relief remains subdued. An intermediate mobility appears to optimize both postglacial relief and the rate of de-icingcompared with both highly-mobile and immobile debris. This enhancement of de-icing due to debris mobility could contribute to the observed anomalous rates of ablation in some debris-covered glaciers.

Quantitative Evaluation of the Movement Distance of Deep Fascia and Change of Muscle Shape Related to Chain Response in Fascia Tissue of Lower Limb

By using ultrasonography, we measured the longitudinal movement distance of the deep fascia (LMDDF), change of the pennation angle (PA) and muscle thickness (MT) in both the tensor fasciae latae muscle (TFL) and the gluteus medius muscle (G-Med) during passive movement of the toes/ankle joints. 21 right lower limbs of 21 healthy males were evaluated in this study. We measured the LMDDF of the TFL and G-Med by measuring distance between the designated landmark on skin and the intersection of the major deep-fascia (D-fascia) and the fascial bundle. We also measured change of the PA and MT of both muscles. Additionally, we also measured the reliability of the measurement and the measurement error. The measurement was performed during three manual positions on the toes/ankle; manual holding of the toes and ankle joint in neutral, toes flexion and ankle plantar flexion/inversion position, toes extension and ankle extension/valgus position. The existence of muscle contraction of both the muscles during passive motion was monitored by active surface electrodes. This study confirmed mobility of the D-fascia in which the TFL’s D-fascia moves and change of muscle shape in the distal direction during no muscle contraction due to passive movement. This fact suggests the possibility that passive tension on fascia tissue of the ankle extends to the proximal part of the limb, i.e., to the D-fascia of the TFL.