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PubMed1984

Reference values and age-related trends for arm muscle area, arm fat area, and sum of skinfolds for United States adults.

Age- and sex-specific percentile distributions for mid-upper arm muscle area (AMA), mid-upper arm fat area (AFA), subscapular skinfold thickness, and sum of triceps and subscapular skinfold thickness for United States adults (18-74 yr) were developed from cross-sectional data collected by the National Center for Health Statistics (NCHS) during the Health and Nutrition Examination Survey, 1971-1974 (NHANES I). Sample weighting factors were applied to the data to assure the production of the identical data set used to calculate weight-for-height percentiles by NCHS. Smoothed curves developed from the percentile distributions for AMA and AFA are also presented. Arm muscle area and AFA were calculated from the Health Examination Survey of 1960-1962 (HES) which made possible an age-cohort analysis for age-related changes and secular trends. Secular differences were found for arm muscle area for both men and women, while men differed little in fat-related anthropometric parameters. The secular change in arm fat area for women could be explained by the greater amount of fat that surrounded a larger arm, since the ratio of AFA to AMA did not change between the two surveys. Age-cohort analysis revealed increases in AMA with age rather than the apparent decrease observed for the older age groups in the cross-sectional data. Reference values developed from the most recent cross-sectional data are the most appropriate for the nutritional assessment of United States adults, because each age cohort can be seen to display different anthropometric characteristics as well as age-related changes in these parameters.

Adipose Tissue↗
PubMed1992

The influence of arm position and cardiac output on bolus clearance from the arm.

The importance of arm position and cardiac output on the clearance of a bolus injection from the arm was assessed in 63 patients using technetium-99m. Injections were made in the left arm which was either adducted, abducted or adducted with the forearm flexed over the lower chest. The clearance of isotope was assessed by measuring the amount of radioactivity remaining in the arm at 10 s intervals and calculating it as a fraction of the injected dose. The clearance of Tc-99m was significantly faster and more complete from the abducted arm than from the adducted arm. There was no correlation between clearance and cardiac output.

Arm↗
PubMedDate not supplied

Reference values for arm muscle area, arm fat area, subscapular skinfold thickness, and sum of skinfold thicknesses for American adults.

Reference values for the mid-upper arm muscle area, mid-upper arm fat area, subscapular skinfold thickness, and sum of triceps and subscapular skinfold thicknesses of American adults were developed from data collected by the National Center for Health Statistics during the first National Health and Nutrition Examination Survey, 1971 to 1974. The reference values were compared to other reference values derived from a similarly conducted cross-sectional survey of the American population, the Health Examination Survey of 1960 to 1962. These comparisons revealed that arm muscle area and subscapular skinfold thickness of men and arm muscle area of women continuously increase with aging from 18 to 74 yr; arm fat area and sum of skinfold thicknesses of men increase with aging from 18 to 34 yr but stabilize or decrease with further aging; and arm fat area, subscapular skinfold thickness, and sum of skinfold thicknesses of women increase with aging from 18 to 64 yr but decrease thereafter. As these parameters frequently change more than 20% over the period of a single decade, it is important that age be considered in nutritional evaluations based on anthropometric measurements. Changes in these four parameters with successive generations are also frequently large. Consequently, it is imperative that the reference values used in nutritional assessment protocols be updated at regular intervals.

Adipose Tissue↗
PubMed2002

Brain activation pattern as assessed with multi-modal EEG analysis predict motor recovery among stroke patients with mild arm paresis who receive the Arm Ability Training.

PURPOSE: Receiving the Arm Ability Training for three weeks improves motor function among stroke patients with mild arm paresis. There is, however, a considerable variability in recovery among patients receiving the Arm Ability Training. The study investigated whether intersubject differences in movement-related electric brain activity explain the variability in motor recovery. METHODS: In a sample of 9 patients receiving the Arm Ability Training both motor performance using a standardised arm function test (TEMPA) and movement-related electric brain activity, i.e. slow cortical potentials (DC) as well as event-related desynchronisation of alpha (alpha-ERD) and beta activity (beta-ERD), were assessed before the Arm Ability Training was started. Stepwise multiple regression was used to establish the best predictive model for motor improvement scores (TEMPA difference from pre to post test three weeks later). RESULTS: Stepwise multiple regression indicated that electric brain activity during movement preparation explained the variance of motor improvement scores completely. Further, electric brain activity during movement as well as baseline motor performance accounted each for 50% of the variance of motor improvement scores. CONCLUSIONS: Activation of sensorimotor areas during movement preparation and deactivation of other cortical areas during movement execution seem to be factors that predict a favourable outcome after training.

Aged↗
PubMed1997

Arm arterial occlusion cuffs as a means of alleviating high +Gz-associated arm pain.

In an aircraft used under sustained high +Gz conditions, if the stick and throttle are positioned such that the pilot's hands are 20 cm or more below heart level, the consequent rise in forearm venous pressure (FVP) may give rise to arm pain, which is exacerbated by positive pressure breathing for G protection (PBG). This study examined the use of arm arterial occlusion cuffs (AAOC) as a means of pain alleviation. Six subjects were exposed on a human centrifuge to a simple acceleration profile of +7 Gz for 15 s, (onset rate 1 G.s-1), and to a complex profile of +4.8 Gz for 10 s followed by +7 Gz for 10 s, repeated 3 times. Subjects wore full coverage anti-G trousers, used PBG (+2 Gz out-in and 10 mm Hg/G), and performed runs with and without inflation of AAOC, during which invasive measurement of FVP was made. During the simple acceleration profile without AAOC, FVP rose to a mean peak of 209 mm Hg and arm pain was severe. With inflation of the AAOC, FVP rise was curtailed at a mean peak of 158 mm Hg and pain was absent. However, during sequential +7 Gz plateaus of the complex profile, AAOC inflation was associated with serially increasing FVP, which was significantly higher than that without AAOC inflation (p < 0.05 and p < 0.001 for second and third plateaus, respectively), giving rise to immediate and severe arm pain. Therefore, the use of arm arterial occlusion as a means of alleviating arm pain is unsuccessful.

Acceleration↗
PubMed2003

Selective exclusion of treatment arms in multi-arm randomized clinical trials.

In this paper we discuss a design for multi-arm randomized clinical trials (RCTs) in which clinicians and their patients can selectively exclude one of the randomized treatment arms. This approach has the advantage that it should expedite protocol development, and allow easier and faster recruitment of patients into the trial. However, to preserve the randomized nature of treatment comparisons, not all recruited patients can be included in all treatment comparisons. This dictates that treatment arms are compared in a pairwise fashion, and that the numbers of patients included in different treatment comparisons may not be equal. The total trial size of a multi-arm RCT that allowed selective exclusion of arms would be greater than the size of an equivalent standard multi-arm RCT. However, the duration of time taken to recruit the study would be reduced. The implications for the design, monitoring and analysis of such RCTs are discussed.

Data Interpretation, Statistical↗
PubMed2001

Internal/external rotation moment arms of muscles at the knee: moment arms for the normal knee and the ACL-deficient knee.

Knowledge of the three-dimensional balance of loads at the knee joint is required to adequately assess the treatment and rehabilitation of the malfunctioning knee. This report focuses upon the moment arms for the knee in internal/external (IE) rotation motion. It augments prior work that defined flexion/extension moment arms. Muscle excursions and angular motion of the lower leg during IE rotation were measured in 17 fresh-frozen hemi-pelvis specimens. Moment arms were calculated as the derivatives of excursion with respect to the angle. Rotational motion was performed for the normal and anterior cruciate ligament (ACL)-deficient knee. Of the 13 muscles measured at the knee, seven were significant contributors to IE rotation: the biceps femoris long and short head externally rotate opposite the gracilis, sartorious, semimembranosis, semitendonosus and popliteus, functioning as internal rotators. Moment arm magnitudes were greatest with the knee in a flexed position (internal [external] rotators peaked at 70 degrees [90 degrees] flexion). At 30 degrees flexion, the IE rotation moment arm minima and maxima were 10.1-11.6, 6.8-9.0, 6.0-15.7, 8.2-14.1 and 0.0-10.4 mm for the semimembranosis, semitendonosus, gracilis, sartorius and popliteus, and 14.7-27.9 and 18.5-31.5 mm for the biceps femoris short and long, respectively. Moment arms for the ACL-deficient condition were significantly changed only at extremes of flexion-extension.

Adult↗
PubMed1997

The effects of electrolytic lesion to the shell subterritory of the nucleus accumbens on delayed non-matching-to-sample and four-arm baited eight-arm radial-maze tasks.

The effects of bilateral electrolytic lesions of the "shell" subterritory of the nucleus accumbens in the rat were examined on 2 tasks known to be sensitive to hippocampal damage. Experiment 1 tested the effects of shell lesion on delayed non-matching-to-sample (DNMS) task in a T-maze. The maze was rotated 180 degrees after the end of acquisition. Experiment 2 used a 4-arm baited, 4-arm unbaited, 8-arm radial-maze task and its reversal. Shell lesion led to impaired acquisition of DNMS in a T-maze and of 4-arm baited, 4-arm unbaited, 8-arm radial maze tasks, suggestive of mnemonic deficits. Following analysis of animals' choice pattern in both tasks, the deficit was interpreted as being largely due to an extensive use of response strategy. The results suggest that the inappropriate use of response strategy by shell animals was a result of their inability to switch from initial response strategy to a later, more appropriate, memory-dependent strategy.

Animals↗
PubMed1999

The relative accuracy of sequential same-arm and simultaneous opposite-arm measurements for the intra-arterial validation of blood pressure monitors.

OBJECTIVE: To compare the results of simultaneous opposite-arm and sequential same-arm intra-arterial validation of automated blood pressure monitors. DESIGN: Intra-arterial blood pressure measurements were compared with blood pressure measurements obtained using conventional sphygmomanometry and two automated blood pressure monitors (the Dinamap XL and the SpaceLabs Scout) using a methodology based on the protocol published by the Association for the Advancement of Medical Instrumentation (AAMI) for the intra-arterial validation of automated monitors. METHODS: Thirteen women with radial arterial lines were recruited from the obstetric intensive care unit at Groote Schuur Hospital, Cape Town. For each woman, intra-arterial blood pressure measurements were compared with those obtained by mercury sphygmomanometry and by using the two automated blood pressure monitors with both a sequential same-arm protocol and a simultaneous opposite-arm protocol. The mean and SD of the differences was calculated for each protocol and the results were compared using Student s t test. RESULTS: The differences between the 'means of the differences' for these two protocols never differed by more than 2 mmHg. For individuals the differences between data obtained using the two methodologies were up to 32 mmHg for mercury sphygmomanometry and 18 mmHg for the automated monitors. The differences between the SD of the differences were all less than 3 mmHg except for that of systolic blood pressure obtained by mercury sphygmomanometry, which was 7 mmHg CONCLUSIONS: The results of this study show that a sequential same-arm and a simultaneous opposite-arm comparison of intra-arterial and indirect blood pressure measurements yield similar results.

Arteries↗
PubMed2006

Voluntary changes in leg cadence modulate arm cadence during simultaneous arm and leg cycling.

Although there is some evidence showing that neural coupling plays an important role in regulating coordination between the upper and lower limbs during walking, it is unclear how tightly the upper and lower limbs are linked during rhythmic movements in humans. The present study was conducted to investigate how coupling of both limbs is coordinated during independent rhythmic movement of the upper and lower limbs. Ten subjects performed simultaneous arm and leg cycling (AL cycling) at their preferred cadences without feedback for 10 s, and then were asked to voluntarily change the cadence (increase, decrease, or stop) of arm or leg cycling. Leg cycling cadence was not affected by voluntary changes in arm cadence. By contrast, arm cycling cadence was significantly altered when leg cycling cadence was changed. These results suggest the existence of a predominant lumbocervical influence of leg cycling on arm cycling during AL cycling.

Adult↗
PubMed1997

Shoulder-arm muscle load and performance during control operation in forestry machines. Effects of changing to a new arm rest, lever and boom control system.

Three work station design studies in forestry machines were carried out with regard to shoulder/arm muscle load. (1) In an arm rest study, a movable (in the sagittal plane) arm rest was compared with a fixed one; (2) in a lever study, a mini lever with a small deflection was compared with an ordinary hand lever; (3) in a boom control study, a computer controlled boom system was compared with an ordinary boom system. In the arm rest study eight male subjects carried out lever operations in the laboratory. In the lever and boom studies, 15 male forestry students operated forwarders. Muscle load, cycle time, skill, perceived exertion, heart rate and preferred set up were recorded. The muscle loads on the upper trapezius, infraspinatus, extensor carpi ulnaris and flexor carpi radialis were recorded by electromyography. With mini lever and movable arm rest the upper trapezius load was reduced with preserved or decreased cycle time, although the grand mean of the 'static' load level was only about 2% of maximal voluntary contraction (MVC) and the effects of the new designs were small (about 0.7% MVC). The subjects preferred the lever/arm rest also giving the lowest muscle load. No differences between levers or arm rests were found in skill, perceived exertion or heart rate. It was not possible to draw any definitive conclusions regarding effects of the boom control system, due to technical problems. According to the literature, the duration of lever operation has increased considerably in forestry during recent years as part of a rationalization process. Partly due to this, it is suggested that the investigated work station improvements may not be sufficient to eliminate the risk for shoulder-neck disorders.

Arm↗
PubMed2001

Radial nerve entrapment in the upper arm as a cause of lateral arm pain: a report of four cases.

Four patients with no history of trauma presented with lateral arm pain, local tenderness, and a tingling sensation at the distal end of the arm when the radial nerve was percussed in the mid-third of the upper arm (Tinel's sign), but no clinical or subjective signs of muscular weakness. They were treated by decompression of the radial nerve in the fibrous canal proximal to the lateral intermuscular septum. Three of the patients had a complete or pronounced reduction in pain, while the fourth had only a slight improvement. Non-traumatic radial nerve entrapment in the upper arm may be the cause of lateral arm pain without clinical signs of muscular weakness.

Adult↗
PubMed2005

The effect of a whole body exercise programme and dragon boat training on arm volume and arm circumference in women treated for breast cancer.

The purpose of this study was to examine the effect of a whole body exercise programme and dragon boat training on changes in arm volume in breast cancer survivors. A total of 16 female breast cancer survivors with no clinical history of lymphoedema volunteered. The 20-week exercise programme consisted of resistance and aerobic exercise with the addition of dragon boat training at week 8. Arm circumference at two sites (CIRC10, CIRC15), arm volume (VOL), and upper body strength (1-RM) were measured at baseline (T1), week 8 (T2), and week 20 (T3). All statistical tests were two-sided (alpha < or = 0.05). No significant differences between the ipsilateral and contralateral upper extremities at any of the three time points were found. All variables significantly increased from T1 to T3 (CIRC10: difference, d = 0.49 cm, 95% confidence interval, CI = 0.25-0.73, P = 0.000; CIRC15: d = 1.33 cm, CI = 0.78-1.88, P = 0.000; VOL: d = 100 mL, CI = 69-130, P = 0.000). As well, 1-RM significantly increased from T1 to T3 (d = 10.8 kg, CI = 5.6-16.1; P = 0.000). In summary, participation in a whole body exercise programme and dragon boat training resulted in a significant increase in upper extremity volume over time. However, the changes were consistent for both arms and the significant gain in upper body muscular strength likely accounted for the increase in arm volume.

Adult↗
PubMed2002

Initial arm muscle activation in a planar ballistic arm movement with varying external force directions: a simulation study.

It has been shown in previous research that the initial phase of EMG for a punching movement remained almost unchanged regardless of whether an external force was applied to the arm. The purpose of the present study was to explain this finding with the help of simulations. A two-dimensional model of the arm actuated by 6 Hill-type muscles was used to simulate a punching movement in the horizontal plane from a prescribed starting position with 90 elbow flexion. Input to the model was the stimulation of the muscles, and output were, among others, muscle forces and segmental accelerations. A genetic algorithm was used to determine the muscle onset times that minimized movement duration and targeting error. In a subsequent forward simulation, the optimized muscle onset times for an unloaded punching movement were superimposed on the isometric stimulation necessary to hold the arm in the starting position while an external force was applied to the arm. The resulting movement was only slightly different from the unloaded movement. It appeared that because of the low level of isometric muscle force prior to the movement, and the high level of stimulation during the movement, muscle force was increased at a rate that was almost independent of the prior force level. These results confirmed the suggestion that the initial phase of EMG in ballistic movements is more related to the rate of change of force than to the absolute force level. It is hypothesized that this may simplify the task of the nervous system in the choice of initial muscle activity in ballistic arm movements because no adjustments to varying external forces are required

Arm↗
PubMed2003

Arm-cranking muscle power and arm isometric muscle strength are independent predictors of all-cause mortality in men.

Poor muscle strength is associated with mortality, presumably due to low muscle mass. Notably, muscle power declines more rapidly than muscle strength with increasing age, which may be related to more complex central nervous system movement control. We examined arm-cranking power against four workloads and isometric strength measured in the upper extremities of 993 men longitudinally tested over a 25-yr period. Muscle mass was estimated by using 24-h creatinine excretion; physical activity was assessed by self-reported questionnaire. Muscle power and strength were modeled by time by using mixed-effects models, which developed regression equations for each individual. The first derivative of these equations estimated rate of change in strength or power at each evaluation. Survival analyses, using the counting method, examined the impact of strength, power, and their rates of change on all-cause mortality while adjusting for age. Arm-cranking power [relative risk (rr) = 0.984 per 100 kg.m.min(-1), P < 0.001] was a stronger predictor of mortality than was arm strength (rr = 0.986 per 10 kg, P = not significant), whereas rate of power change (rr = 0.989 per 100 kg.min(-1).yr(-1)) and rate of arm strength change (rr = 0.888 per 10 kg/yr) were risks independent of the power or strength levels. The impacts of power and strength were partially independent of muscle mass and physical activity. The risk of mortality was similar across the four power workloads (rr = 0.93-0.96 per 100 kg.m.min(-1)), whereas the lowest load generated less than one-half the power as the higher loads. Arm-cranking power is a risk factor for mortality, independent of muscle strength, physical activity, and muscle mass. The impact is found with loads that do not generate maximal power, suggesting an important role for motor coordination and speed of movement.

Adult↗
PubMed2005

Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study.

OBJECTIVES: To establish: (1) inter-rater and test-retest reliability of standardized guidelines for the Fugl-Meyer upper limb section, Action Research Arm Test and Box and Block Test in patients with paresis secondary to stroke, multiple sclerosis or traumatic brain injury and (2) correlation between these arm motor scales and more general measures of impairment and activity limitation. DESIGN: Multicentre cohort study. SETTING: Three European referral centres for neurorehabilitation. SUBJECTS: Thirty-seven stroke, 14 multiple sclerosis and five traumatic brain injury patients. MAIN MEASURES: Scores of the Fugl-Meyer Test (arm section), Action Research Arm Test, and Box and Block Test derived from video information. RESULTS: All three motor tests showed very high inter-rater and test-retest reliability (ICC and rho for main variables > 0.95). Correlation between the motor scales was very high (rho > 0.92). Motor scales correlated moderately highly with the Hemispheric Stroke Scale, a measure of impairment (rho = 0.660-0.689), but not with the Modified Barthel Index, a measure of the ability to cope with basic activities of daily living (rho = 0.044-0.086). CONCLUSIONS: The standardized guidelines assured comparability of test administration and scoring across clinical facilities. The arm motor scales provided information that was not identical to information from the Hemispheric Stroke Scale or the Modified Barthel Index.

Adolescent↗
PubMed1991

Automatic algebraic computation of basic kinematic equations of tree structure robot arms: application to human arms.

Tree structure robot arms have been very little studied due to the complexity of their topological structure compared with those of the simple chain type. This paper presents a symbolic computation of the basic kinematic equations of these tree structure robot arms. This leads to the calculation of the homogeneous transformation matrices (HTMs) of the tree branches. These computations are arranged to need the smallest possible number of arithmetic operations. A computer program MGLAT is developed in Pascal to generate such equations in symbolic form. The human arm which consists of the forearm, a wrist and fingers is a very good example of such a structure. A simplified model of 25 degrees of mobility of such an arm is presented. Its basic kinematic equations need 358 multiplications, 214 additions and 252 equations. These equations are useful for improving the existing designs of the artificial arms for handicapped persons and for designing new robot hands for delicate tasks.

Arm↗