PubMed · 4790907
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P J Holt. 1973. Upper-limb endoprostheses.. https://pubmed.ncbi.nlm.nih.gov/4790907/
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Segmentation of apparently continuous movement has been reported for over a century by human movement researchers, but the existence of primitive submovements has never been proved. In 20 patients recovering from a single cerebral vascular accident (stroke), we identified the apparent submovements that composed a continuous arm motion in an unloaded task. Kinematic analysis demonstrated a submovement speed profile that was invariant across patients with different brain lesions and provided experimental verification of the detailed shape of primitive submovements. The submovement shape was unaffected by its peak speed, and to test further the invariance of shape with speed, we analyzed movement behavior in a patient with myoclonus. This patient occasionally made involuntary shock-like arm movements, which occurred near the maximum capacity of the neuromuscular system, exhibited speed profiles that were comparable to those identified in stroke patients, and were also independent of speed.
Automatic blood pressure measuring devices with digital display are now in common use, both among lay persons and physicians. The oscillometric method is, however, associated with a number of possible sources of error which, among other things, make comparison with the standard Riva-Rocci method difficult. Methodological errors arise from physiological/anatomical variations: circumference of the forearm and wrist, position of the arteries, structure of the surrounding tissue, arterial diameter and also vasomotor function. The latter represents an appreciable uncertainty factor, in particular with measurements obtained from the finger. Technological sources of error play a role in pronounced hypotension or severe hypertension, since the devices are calibrated only for a range extending from 120 to 180 mmHg. The processing by the device of arrhythmic pulses is also critical. Additional sources of error are in handling and interpretation. Overall, these sources of error are such that not all the various types of device available are equally suitable for use by the patient, and it is necessary to place limitations on the application of such devices and to establish rules for their use.
Studies have shown that both laypersons and doctors and medical staff have insufficient knowledge of the proper handling of blood pressure measurement. The resulting deviations in the measured values are of a diagnostically relevant order of magnitude capable of leading, for example, to an erraneous diagnosis of hypertension. Some of the factors frequently receiving too little attention are, for example, the use of an inappropriate cuff size, failure to ensure that the patient is adequately rested, and inappropriate positioning of the arm during measurement. Attention is drawn to the recommendations of the various hypertension societies.