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PubMed2001

A study of inter-arm blood pressure differences in primary care.

OBJECTIVES: To investigate whether there are inter-arm blood pressure differences that are of clinical importance to general practice. DESIGN AND SETTING: Pragmatic study with randomised order of use of left or right arm carried out in routine surgeries in an inner city and suburban general practice. SUBJECTS: There were 237 patients presenting opportunistically for blood pressure measurement to a nurse or general practitioner. MAIN OUTCOME MEASURES: 95% limits of agreement between measurements on the left and right arm and bias between arms. RESULTS: Large inter-arm blood pressure differences exist reflected in wide 95% limits of agreement; -16 mm Hg to 24 mm Hg for the right minus the left arm diastolic blood pressure. There is a small but statistically significant bias to the right arm blood pressure measuring higher than the left (3.7 mm Hg diastolic, 2.4 to 5 mm Hg 95% confidence intervals). An interarm difference of 10 mm Hg or greater for diastolic blood pressure occurred in 40% of subjects and a difference of 20 mm Hg or more for systolic blood pressure occurred in 23% of subjects. CONCLUSIONS: In a primary care setting blood pressure should be measured routinely in both arms. If one arm is to be preferred for pragmatic clinical purposes, then this should be the right arm.

Adolescent↗
PubMed2005

Lipid profiles are influenced by arm cranking exercise and training in individuals with spinal cord injury.

STUDY DESIGN: A prospective, two-group comparative intervention study. OBJECTIVE: To determine the acute and training effects of arm cranking exercise on blood lipid profiles in wheel chair bound individuals with spinal cord injury (SCI) and normal able-bodied subjects. SETTING: Faculty of Science, School of Sport and Exercise Science, Liverpool John Moores University, England. METHODS: Total cholesterol, triglyceride and high-density lipoprotein cholesterol (HDL-C) at rest and in response to arm cranking exercise before and after 12 weeks of training were compared between individuals with SCI (N = 5) and able-bodied subjects (N = 7). Following the determination of peak oxygen consumption (VO2peak), all subjects performed a submaximal arm cranking exercise at an intensity corresponding to 60-65% VO2peak for 30 min. Venous blood samples were obtained before and after submaximal exercise and measured for total cholesterol, triglycerides and HDL-C concentrations. These lipid parameters were remeasured in all subjects at rest and in response to the same submaximal arm cranking exercise after 12 weeks of individually supervised arm cranking training programme. RESULTS: Before training, the resting mean value of triglyceride in individuals with SCI was significantly (P < 0.05) higher than that found in able-bodied persons. Acute arm cranking exercise did not change total cholesterol or triglyceride concentrations in either the SCI or the able-bodied groups. However, HDL-C increased significantly following exercise in the able-bodied subjects. Following training, the resting mean value of total cholesterol in the group with SCI was significantly (P < 0.05) higher compared with able-bodied individuals. Furthermore, the resting and post submaximal arm cranking exercise mean values of total cholesterol in the able-bodied group, but not in the group with SCI, were significantly lower than those observed before training. While the resting mean value of HDL-C before training in the group with SCI was lower than that found in the able-bodied, this difference did not reach the designated level of significance (P > 0.05). Submaximal arm cranking exercise was followed by a significant increase in HDL-C only in the able-bodied individuals. Compared to pretraining, the resting and post arm cranking exercise levels of HDL-C in the group with SCI increased significantly (P < 0.05) after training. CONCLUSION: It is concluded that acute arm cranking exercise and training in individuals with SCI is associated with favourable effects on HDL-C, whereas total cholesterols and triglycerides were not altered. The mechanism responsible for the increase in HDL-C with training in individuals with SCI is not known, but it is likely to be related to increased activity of cholesterol transport enzymes lipoprotein lipase and acyltransferase.

Adult↗
PubMed2001

Neuronal coordination of arm and leg movements during human locomotion.

We aimed to study the neuronal coordination of lower and upper limb muscles. We therefore evaluated the effect of small leg displacements during gait on leg and arm muscle electromyographic (EMG) activity in walking humans. During walking on a split-belt treadmill (velocity 3.5 km/h), short accelerations or decelerations were randomly applied to the right belt during the mid or end stance phase. Alternatively, trains of electrical stimuli were delivered to the right distal tibial nerve. The EMG activity of the tibialis anterior (TA), gastrocnemius medialis (GM), deltoideus (Delt), triceps (Tric) and biceps brachii (Bic) of both sides was analysed. For comparison, impulses were also applied during standing and sitting. The displacements were followed by specific patterns of right leg and bilateral arm muscle EMG responses. Most arm muscle responses appeared with a short latency (65-80 ms) and were larger in Delt and Tric than in Bic. They were strongest when deceleration impulses were released during mid stance, associated with a right compensatory TA response. A similar response pattern in arm muscles was obtained following tibial nerve stimulation. The arm muscle responses were small or absent when stimuli were applied during standing or sitting. The arm muscle responses correlated more closely with the compensatory TA than with the compensatory GM responses. The amplitude of the responses in most arm muscles correlated closely with the background EMG activity of the respective arm muscle. The observations suggest the existence of a task-dependent, flexible neuronal coupling between lower and upper limb muscles. The stronger impact of leg flexors in this interlimb coordination indicates that the neuronal control of leg flexor and extensor muscles is differentially interconnected during locomotion. The results are compatible with the assumption that the proximal arm muscle responses are associated with the swinging of the arms during gait, as a residual function of quadrupedal locomotion.

Adult↗
PubMed1993

Angioscopically directed interventions improve arm vein bypass grafts.

PURPOSE: Our purpose was to determine the incidence and segmental distribution of intraluminal disease in the arm veins of patients in whom saphenous vein was unavailable or inadequate for bypass, determine whether angioscopic evaluation and directed interventions can upgrade the quality of arm vein conduit and improve early graft patency, and describe the angioscopic technique of in situ retrograde arm vein inspection. METHODS: Retrospective review of 109 infrainguinal arm vein bypass grafts in 104 patients performed with intraoperative angioscopic vein preparation and monitoring between August 1989 and March 1992 was undertaken. Four additional arm veins harvested were discarded because of diffuse disease. RESULTS: Intraluminal disease was noted in 71 (62.8%) of 113 arm veins, "webs" in 61 (54%), vein sclerosis in 25 (22.1%), localized stenosis in 11 (9.7%), and thrombus in 7 (6.2%). Intraluminal disease was most common in the cephalic (forearm 49.2%; arm 35.1%) and median cubital (33.3%) veins and least common in the basilic vein (11.7%). Eighty-three angioscopically directed interventions in 68 of 71 abnormal arm veins resulted in upgraded vein conduit quality in 47 (66.1%) of 71. Primary patency (< 30 days) was 99 (90.8%) of the 109 grafts, 85 (95.5%) of 89 grafts with normal or upgraded quality conduits, and 14 (70%) of 20 inferior-quality grafts (p = 0.0024). These differences persisted through 1 year by life-table analysis, (p < 0.001). CONCLUSIONS: Not only is the routine use of the angioscope in arm vein bypass grafting a sensitive technique to detect the intraluminal diseases so prevalent in arm veins but it can also direct endoluminal and surgical interventions that upgrade the quality of the vein conduit and improve early graft patency.

Adult↗
PubMed1998

Prediction of acceptable physical work loads based on responses to prolonged arm and leg exercise.

Nine healthy men (aged 54-59 years) performed arm crank and leg cycle exercises for 30 min at relative work loads of 50 and 75% of peak oxygen uptake (VO2) for the corresponding muscle group, and for 60 min at a relative work load of 30% of peak VO2 for the corresponding muscle group. In the tests, heart rate (HR), blood pressure, gas exchange variables, rating of perceived exertion (RPE) and blood lactate were measured. At the 75% target exercise level, four subjects interrupted the arm-cranking test, and one subject interrupted the leg-cycle test. Owing to differences in peak values during arm-cranking and leg-cycling, the work load and the VO2 were higher during leg-cycling than during arm-cranking. There was no difference in HR between the work modes, but the HR increased to a greater extent during arm-cranking compared to leg-cycling at the 30% (NS) and 50% (P < 0.05) exercise levels. Similarly, the RPE increased more during arm-cranking compared to leg-cycling at each exercise level. The blood lactate concentration was higher after arm-cranking than after leg-cycling; at the 50% exercise level the difference was statistically significant. The results indicate a higher physiological strain with time during arm exercise than during leg exercise at the same muscle group-specific relative work load. The acceptable physical work load, expressed as the percentage peak VO2 for the corresponding muscle group, should thus be lower during arm exercise than during leg exercise. The RPE and the relative HR, expressed as percentage of peak HR for the corresponding muscle group, however, seem to be comparable indicators for the physiological strain during arm and leg exercise.

Arm↗
PubMed2004

Effect of swimming velocity on arm coordination in the front crawl: a dynamic analysis.

We examined the preferred mode of arm coordination in 14 elite male front-crawl swimmers. Each swimmer performed eight successive swim trials in which target velocity increased from the swimmer's usual 3000-m velocity to his maximal velocity. Actual swim velocity, stroke rate, stroke length and the different arm stroke phases were then calculated from video analysis. Arm coordination was quantified by an index of coordination based on the lag time between the propulsive phases of each arm. The index expressed the three coordination modes in the front crawl: opposition, catch-up and superposition. First, in line with the dynamic approach to movement coordination, the index of coordination could be considered as an order parameter that qualitatively captured arm coordination. Second, two coordination modes were observed: a catch-up pattern (index of coordination= -8.43%) consisting of a lag time between the propulsive phases of each arm, and a relative opposition pattern (index of coordination= 0.89%) in which the propulsive phase of one arm ended when the propulsive phase of the other arm began. An abrupt change in the coordination pattern occurred at the critical velocity of 1.8 m. s(-1), which corresponded to the 100-m pace: the swimmers switched from catch-up to relative opposition. This change in coordination resulted in a reorganization of the arm phases: the duration of the entry and catch phase decreased, while the duration of the pull and push phases increased in relation to the whole stroke. Third, these changes were coupled to increased stroke rate and decreased stroke length, indicating that stroke rate, stroke length, the stroke rate/stroke length ratio, as well as velocity, could be considered as control parameters. The control parameters can be manipulated to facilitate the emergence of specific coordination modes, which is highly relevant to training and learning. By adjusting the control and order parameters within the context of a specific race distance, both coach and swimmer will be able to detect the best adapted pattern for a given race pace and follow how arm coordination changes over the course of training.

Adult↗
PubMedDate not supplied

Correlations among height, leg length and arm span in growing Korean children.

A cross-sectional study was performed to find out if any specific correlations exist among height, leg length and arm span in growing Korean children. Height, leg length and arm span were measured in 10,322 healthy children (4740 males and 5582 females). Computed ratios of leg length to height, leg length to arm span and arm span to height for the 3rd, 25th, 50th, 75th and 97th percentiles were made. It was found that the ratios of leg length to height, leg length to arm span, and arm span to height were bigger in taller children in the same age group than the shorter ones in both sexes. All the ratios were bigger in older children in the same percentile than the younger ones in both sexes, showing that the growth rates of leg length and arm span were bigger than that of height in general. However, growth of leg length is faster in shorter children than in taller children until the onset of puberty, after which growth of leg length in taller children is faster than in shorter children. The first and most rapid growth of leg length is seen from birth to 2 years, the second growth spurt is seen during the pubertal period. An exceptional increment in leg length between ages from 10 to 15 is also noted in taller children. After puberty, arm span grows faster than height until 17 years of age in the tallest male child, and taller children have longer arm span than height, while arm span in the shortest children never exceeds height.

Adolescent↗
PubMedDate not supplied

Comparison of forearm and upper arm blood pressures.

OBJECTIVE: In the prehospital setting it is not always feasible to obtain blood pressure (BP) readings from the upper arm. This study was performed to compare BPs obtained from subjects' forearms and upper arms in order to assess the utility of forearm BP as a surrogate for standard BP. METHODS: The authors performed a prospective, cross-sectional, convenience study in a sample of ambulatory university ED patients, where each subject had sequential determinations of left upper arm and forearm BPs with an automated monitor at ED triage. The order of measurement was determined by the day of the week. Demographic and clinical data were also recorded. The main outcome measure was the correlation between upper arm and forearm systolic and diastolic BPs. Pearson's correlation coefficient and Student's t-test were used to analyze the data. RESULTS: 151 patients were enrolled. The mean age was 35.3+/-15.7 years; 40% were female and 78% were white. The mean forearm and upper arm systolic BPs were 129.8+/-20.7 mm Hg and 126.2+/-17.6 mm Hg (p = 0.002). The mean forearm and upper arm diastolic BPs were 80.7+/-14.5 mm Hg and 76.8+/-13.4 mm Hg (p<0.001). The correlations between forearm and upper arm systolic and diastolic BPs were 0.75 (p<0.001) and 0.72 (p<0.001). The differences between forearm and upper arm systolic and diastolic BPs were within 20 mm Hg in 86% and 94% of patients, respectively. CONCLUSION: Forearm BP is a fairly good predictor of standard upper arm BP in most patients. Forearm BP may be used when measurement of upper arm BP is not feasible.

Adult↗
PubMed1991

Right- and left-arm blood pressure discrepancies in vascular surgery patients.

To identify a relationship between atherosclerotic vascular disease and differences in blood pressure between the right and left arms, blood pressure differences between arms were measured in patients with peripheral vascular disease (PVD, n = 58), in patients with coronary artery disease (CAD, n = 38), and in patients with no evidence of atherosclerotic disease, who served as a control group (n = 38). The incidence and magnitude of right and left arm pressure difference determined by the oscillometric technique were compared between the patient groups. The incidence of systolic pressure difference greater than or equal to 20 mmHg between arms in patients with PVD (21%) was greater than that in either those with CAD (3%) (P less than or equal to 0.05) or control subjects (0%) (P less than 0.01). The incidence of systolic pressure difference greater than or equal to 45 mmHg between arms in patients with PVD (10%) was greater than that in either those with CAD (0%) (P less than 0.05) or control subjects (0%) (P less than 0.05). Patients with PVD also had a greater incidence of right and left arm difference than did those with CAD or controls for mean and diastolic blood pressures. Of all patients with a systolic difference greater than 10 mmHg, neither the right nor the left arm blood pressure was consistently higher: 21 of 35 (60%) had a higher pressure in the right arm, and 14 of 35 (40%) had a higher pressure in the left arm (P = 0.33). Gender, diabetes, hypertension, smoking, and age were not associated with a difference in blood pressure between the right and left arms.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2000

Plasma catecholamine and blood lactate responses to incremental arm and leg exercise.

PURPOSE AND METHODS: The present study was conducted to examine the pattern of plasma catecholamine and blood lactate responses to incremental arm and leg exercise. Seven untrained male subjects performed two incremental exercise tests on separate days in random order. One test consisted of 1-arm cranking (5W x 2 min(-1)), whereas the other exercise test was 2-leg cycling (20-25W x 2 min(-1)). Blood samples were obtained from the nonexercising arm during 1-arm cranking and from the same arm and vein during 2-leg cycling. Thresholds for blood lactate (T(La)), epinephrine (T(Epi)) and norepinephrine (T(NE)) were determined for each subject under both exercise conditions and defined as breakpoints when plotted as a function of power output. RESULTS: When the two modes of exercise were compared, T(La), T(Epi), and T(NE) were all significantly lower for 1-arm cranking than for 2-leg cycling (P < 0.01). During 1-arm cranking, T(La) (0.96 +/- 0.10 L x min(-1)), T(Epi) (1.02 +/- 0.07 L x min(-1)), and T(NE) (1.07 +/- 0.09 L x min(-1)) occurred simultaneously. During 2-leg cycling, T(La) (1.77 +/- 0.20 L x min(-1)), T(Epi) (1.74 +/- 0.17 L x min(-1)), and T(NE) (1.98 +/- 0.17 L x min(-1)) occurred at similar levels of VO2 and were not significantly different. The correlation observed between the VO2 measured at the T(La) and T(Epi) was 0.917 for arm and 0.929 for leg exercise (P < 0.001). The epinephrine concentration ([Epi]) obtained at the T(La) was not significantly different for arm (0.144 ng x mL(-1)) and leg (0.152 ng x mL(-1)) exercise. CONCLUSIONS: The breakpoint in plasma [Epi] shifted in an identical manner and occurred simultaneously with that of T(La) regardless of the mode of exercise (arm or leg). The Epi concentrations observed at the T(La) agree with those previously reported to produce a rise in blood lactate during Epi infusion at rest. These results support the hypothesis that a rise in plasma [Epi] may contribute to the breakpoint in blood lactate that occurs during incremental exercise.

Adult↗
PubMed2001

Relationship between height and arm span in women of different age groups.

OBJECTIVES: (1) To study the correlation between height and arm span in young, perimenopausal, and postmenopausal age groups, (2) To compare the height and arm span difference in each age group. METHODS: Four hundred and eighty-five women from menopause and gynaecologic clinics were included in the study. All subjects were measured for height and arm span. Correlations of height and arm span were obtained for each age group independently and the difference between the two measurements was examined. RESULTS: Correlation coefficients (r = 0.9899) indicated a clear association between height and arm span measurements in young women. This correlation, however, decreased in perimenopausal and postmenopausal age groups. The mean differences between height and arm span were 0.263 +/- 0.445, 2.105 +/- 1.885, and 2.568 +/- 2.443 cm in the 3 groups, respectively. In comparison with the young age group, the mean difference between height and arm span in the perimenopausal and postmenopausal age groups were significantly different (p < 0.05) and it was the highest in the postmenopausal age group. CONCLUSION: The height and arm span were well correlated and could be used interchangeably in young women. The correlation decreased with advancing age. Since arm span does not change with age, we can therefore conclude that there was a decrease in height among women of increasing age using arm span as the reference of the previous height.

Adult↗
PubMed2005

Why do arms extract less oxygen than legs during exercise?

To determine whether conditions for O2 utilization and O2 off-loading from the hemoglobin are different in exercising arms and legs, six cross-country skiers participated in this study. Femoral and subclavian vein blood flow and gases were determined during skiing on a treadmill at approximately 76% maximal O2 uptake (V(O2)max) and at V(O2)max with different techniques: diagonal stride (combined arm and leg exercise), double poling (predominantly arm exercise), and leg skiing (predominantly leg exercise). The percentage of O2 extraction was always higher for the legs than for the arms. At maximal exercise (diagonal stride), the corresponding mean values were 93 and 85% (n = 3; P < 0.05). During exercise, mean arm O2 extraction correlated with the P(O2) value that causes hemoglobin to be 50% saturated (P50: r = 0.93, P < 0.05), but for a given value of P50, O2 extraction was always higher in the legs than in the arms. Mean capillary muscle O2 conductance of the arm during double poling was 14.5 (SD 2.6) ml.min(-1).mmHg(-1), and mean capillary P(O2) was 47.7 (SD 2.6) mmHg. Corresponding values for the legs during maximal exercise were 48.3 (SD 13.0) ml.min(-1).mmHg(-1) and 33.8 (SD 2.6) mmHg, respectively. Because conditions for O2 off-loading from the hemoglobin are similar in leg and arm muscles, the observed differences in maximal arm and leg O2 extraction should be attributed to other factors, such as a higher heterogeneity in blood flow distribution, shorter mean transit time, smaller diffusing area, and larger diffusing distance, in arms than in legs.

Adult↗
PubMed2003

Using arm configuration to learn the effects of gyroscopes and other devices.

Previous studies have perturbed the association between motor commands and arm movements by applying forces to the arm during two-dimensional movements. These studies have revealed that, when the normal hand path is perturbed, subjects gradually adapt their motor commands to return to this path. The present study used the spin of a gyroscope to create a complex perturbation, as subjects reached to targets presented in three dimensions. Hand path did not change, but the whole-arm geometry ("arm configuration" in four dimensions) was altered. Over a series of several hundred reaches to various targets, subjects gradually returned the arm movement to its normal configuration. Furthermore, during the course of this learning, subjects used a strategy that involved manipulating arm posture. A similar strategy was observed when subjects made reaching movements with a rod attached to the upper arm to change its inertial characteristics. In both cases, the gradual return to the normal arm movement was accomplished without an increase in kinetic energy, suggesting that arm postures and movements (kinematics) and muscular forces (kinetics) may be mutually optimized. In contrast to previous studies, the present results highlight the role of arm configuration (rather than hand path) in learning and control.

Adaptation, Physiological↗
PubMed2005

Corticospinal excitability is lower during rhythmic arm movement than during tonic contraction.

Humans perform rhythmic, locomotor movements with the arms and legs every day. Studies using reflexes to probe the functional role of the CNS suggest that spinal circuits are an important part of the neural control system for rhythmic arm cycling and walking. Here, by studying motor-evoked potentials (MEPs) in response to transcranial magnetic stimulation (TMS) of the motor cortex, and H-reflexes induced by electrical stimulation of peripheral nerves, we show a reduction in corticospinal excitability during rhythmic arm movement compared with tonic, voluntary contraction. Responses were compared between arm cycling and tonic contraction at four positions, while participants generated similar levels of muscle activity. Both H-reflexes and MEPs were significantly smaller during arm cycling than during tonic contraction at the midpoint of arm flexion (F = 13.51, P = 0.006; F = 11.83, P = 0.009). Subthreshold TMS significantly facilitated the FCR H-reflex during tonic contractions, but did not significantly modulate H-reflex amplitude during arm cycling. The data indicate a reduction in the responsiveness of cells constituting the fast, monosynaptic, corticospinal pathway during arm cycling and suggest that the motor cortex may contribute less to motor drive during rhythmic arm movement than during tonic, voluntary contraction. Our results are consistent with the idea that subcortical regions contribute to the control of rhythmic arm movements despite highly developed corticospinal projections to the human upper limb.

Adaptation, Physiological↗
PubMed2006

Context-dependent modulation of interlimb cutaneous reflexes in arm muscles as a function of stability threat during walking.

Cutaneous reflexes evoked in the muscles of the arms with electrical stimulation of nerves of the foot ("interlimb reflexes") are observed during walking. These reflexes have been suggested to coordinate the actions of the legs and arms when walking is disturbed. Recently, we showed that cutaneous reflexes evoked in the leg muscles after stimulation at the foot are modulated according to the level of postural threat during walking. We hypothesized that the amplitude of interlimb cutaneous reflexes would similarly be modulated when subjects walk in unstable environments. Subjects walked on a treadmill under four walking conditions: 1) normal; 2) normal with unpredictable anterior-posterior (AP) perturbations; 3) arms crossed; and 4) arms crossed with unpredictable AP perturbations. Interlimb reflexes evoked from electrical stimulation of the right superficial peroneal or sural nerves were recorded bilaterally, at four points of the step cycle. These reflexes were compared between conditions in which the arms were moving in a similar manner: 1) normal versus AP walking and 2) arms crossed versus arms crossed with AP perturbations. Differences in reflex amplitudes between arms-crossed conditions were observed in most upper limb muscles when subjects were perturbed while walking compared with undisturbed walking. This effect was less apparent when the arms were swinging freely. The results indicate that the strength of interlimb connections is influenced by the level of postural threat (i.e., the context of the behavior), thereby suggesting that these reflexes serve a functional link between the legs and arms during locomotion.

Adult↗
PubMed1992

Constraints on arm position when pointing in three dimensions: Donders' law and the Fick gimbal strategy.

1. While making saccades between targets with the head stationary, eye positions are constrained to two of the possible three degrees of freedom. Classically this constraint has been described by Donders' and Listing's laws. The objective was to determine whether these laws also apply for the straight arm when pointing between different targets. Thus we determined whether the arm adopts only one angular position for every pointing direction (Donders' law) and whether these positions can be described by rotations from a reference position about axes that lie in a plane (Listing's law). 2. The angular positions (orientations) of the arm in three-dimensional space were studied as subjects pointed with a straight arm at different targets. Arm position was measured with the search coil technique by means of coils attached to the back of the hand. Pointing was studied over a range of +/- 45 degrees in all directions from a central target located 45 degrees to the right of the straight-ahead position. 3. The positions of the arm in space were described by quaternion vectors, i.e., a particular position was described in terms of the axis and amplitude of a rotation from a reference position to that position. Using this description, it was found that the straight arm adopted a similar orientation (standard deviations ranged from 2.8 to 4.8 degrees) when pointing at a particular target irrespective of which target from which it had moved. 4. The angular position vectors for arm positions associated with relatively small movements (e.g., less than +/- 30 degrees) lay in a flat surface with minimal torsion. At first sight, this surface appeared to be similar to Listing's plane of the eye. However, for positions associated with larger movements (e.g., +/- 45 degrees) it became apparent that, unlike the eye, the surface deviated from one obeying Listing's law, i.e., it was twisted and showed torsion like that produced by rotations around the horizontal and vertical axes of a Fick gimbal. (The characteristic of a Fick gimbal is that the vertical axis is fixed, whereas the horizontal axis moves with the gimbal.) 5. Although there were differences between subjects, all showed a twisted position vector surface. The twist was always in the same direction, and it was always less than that of a Fick gimbal. 6. This position vector surface had a similar shape whether the arm was stationary or was moving between targets, whether subjects pointed with or without vision, and whether the pointing arm had moved between targets or from a bent-elbow position on the lap.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1995

Metabolic and ventilatory response pattern to arm elevation in patients with COPD and healthy age-matched subjects.

Many patients with chronic obstructive pulmonary disease (COPD) experience problems in those activities of daily living which involve so-called unsupported arm elevations (AE). In this study, possible differences in the metabolic and ventilatory response pattern to three types of arm elevation were compared between 13 COPD patients (forced expiratory volume in one second (FEV1) (mean (SD)) 38 (13)% of predicted) and 13 age-matched healthy subjects. Each subject consecutively performed three types of arm elevation for 2 min, with 3 min rest periods in between. Breath-by-breath metabolic and ventilatory parameters and heart rate (HR) were registered during a 3 min baseline period and throughout the measurement period. Adjusted for significantly greater baseline test results in COPD patients, it was found that AE (arm elevation including recovery) tended to be more demanding with respect to metabolic and ventilatory response for patients with COPD than for the age-matched healthy subjects. Arm elevation resulted in an increase in oxygen consumption (V'O2) (COPD 12%; healthy 6%), carbon dioxide elimination V'CO2 (COPD 15%; healthy 10%), minute ventilation V'E (COPD 13%; healthy 7%) and heart rate (COPD 2%; healthy 5%). A pronounced difference was found in the pattern of metabolic and ventilatory response to arm elevation, i.e. there was an earlier but sluggish V'O2 onset in COPD patients, whereas the healthy subjects demonstrated a sudden peak approximately 30 s after arm elevations. Mutual comparison of the three different types of arm elevation demonstrated a comparable response pattern. Knowledge of the specific response to arm elevations in COPD patients seems essential for interpretation of arm elevation tests in upper extremity rehabilitation programmes.

Aged↗
PubMed2005

Effectiveness of unilateral and symmetrical bilateral task training for arm during the subacute phase after stroke: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of an arm training programme combining repetition of unilateral and symmetrical bilateral tasks for people in the subacute phase after stroke. DESIGN: Randomized controlled trial. SETTING: Inpatient functional rehabilitation unit. SUBJECTS: Forty-one people who had had a stroke, in the subacute phase, receiving conventional arm occupational and physical therapy, were randomized to an experimental group (n=20) and a control group (n=21). INTERVENTIONS: In addition to the usual arm therapy in the rehabilitation unit, the experimental group received an arm therapy programme (15-20 45-min sessions) based on repetition of unilateral and symmetrical bilateral tasks. The control group received additional usual arm therapy of a similar duration and frequency to the experimental treatment. MAIN MEASURES: The effect of the programme was judged on the basis of: (1) arm impairments (motor function, grip strength, gross and fine manual dexterity and motor co-ordination), (2) arm disabilities in tasks related to daily activities, and (3) functional independence in activities of daily living (ADL) and instrumental ADL (IADL). RESULTS: Although both experimental and control groups of participants improved similarly during the study period, the statistical analyses did not show any difference between the groups at the end of the treatment for the different dependent variables evaluated: (1) arm impairments: p = 0.43-0.79; (2) arm disabilities: p = 0.16-0.90; and (3) functional independence: p = 0.63 and 0.90. CONCLUSIONS: An arm training programme based on repetition of unilateral and symmetrical bilateral practice did not reduce impairment and disabilities nor improve functional outcomes in the subacute phase after stroke more than the usual therapy.

Activities of Daily Living↗