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PubMedDate not supplied

A comparison of triceps skinfold and upper arm circumference measurements taken in standard and supine positions.

Because hospitalized patients are often unable to assume the upright position recommended for anthropometric measurements, the effect of patient position on accuracy of triceps skinfold and arm circumference measurements was investigated. Three measurements of triceps skinfold and arm circumference were taken on the right arm of 74 patients by trained technicians with extensive experience in anthropometric evaluation using a Lange caliper and Inser-tape. Measurements were repeated in the supine position 5 hours later on the same day by the same observer. Mean triceps skinfold, arm circumference, and calculated arm muscle circumference values obtained in the upright position correlated highly with those obtained in the supine position. Differences were less than one measurement unit and not significant when compared using parametric (Student t-test) and non parametric (Wilcoxon Matched-Pairs Signed-Ranks Test) statistically analysis. This study indicates that triceps skinfold and arm circumference can be measured accurately, reproducibly, and comparably in the supine position when the patient is unable to assume the recommended upright stance.

Adult↗
PubMedDate not supplied

Arm length measurement as an alternative to height in nutritional assessment of the elderly.

The use of long bone measurements as an alternative to height in nutritional assessment of the elderly was investigated in 100 young and 63 aged individuals. Highly significant correlations between height and total arm length, humerus length, forearm length, and proximal phalanx length were found. Compared to young subjects, values for the elderly were shifted significantly, demonstrating a reduction in height not paralleled by decreases in arm length measurements. In subsequent studies, lean body mass was evaluated by creatinine excretion in groups of young and elderly male and female volunteers. In both males and females, when creatinine excretion was related to height, ideal body weight, or total arm length, significantly lower values were found in the elderly as compared to the young. In all groups highly significant correlations between the use of arm length and the other two methods of expressing creatinine excretion were found. This validates the use of arm length measurement as an alternative to height for nutritional assessment. Since arm length is less affected than height by the aging process and more easily obtained in the bedfast patient, it should provide a more accurate reflection of stature when performing nutritional assessments of the elderly. These preliminary data emphasize the need for appropriate standards for subjects of different ages when evaluating lean body mass.

Adult↗
PubMed2002

Is self-reported height or arm span a more accurate alternative measure of height?

The purpose of this study was to determine whether self-reported height or arm span is the more accurate alternative measure of height. A sample of 409 people between the ages of 19 and 67 (M = 35.0) participated in this anthropometric study. Height, self-reported height, and arm span were measured by 82 nursing research students. Mean differences from criterion measures were 0.17 cm for the measuring rules, 0.47 cm for arm span, and 0.85 cm and 0.87 cm for heights. Test-retest reliability was r = .997 for both height and arm span. The relationships of height to self-reported height and arm span were r = .97 and .90, respectively. Mean absolute differences were 1.80 cm and 4.29 cm, respectively. These findings support the practice of using self-reported height as an alternative measure of measured height in clinical settings, but arm span is an accurate alternative when neither measured height nor self-reported height is obtainable.

Adolescent↗
PubMed2003

Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap.

OBJECTIVES: (1) To examine the relationships between measures of impairment and disability for the arm and leg with a measure of handicap and (2) to identify the impairment or disability most strongly related to handicap situations. DESIGN: Prospective cohort study. SETTING: Intensive functional rehabilitation unit and community. PATIENTS: One hundred and two persons who had a stroke. MAIN OUTCOME MEASURES: Arm and leg impairments and disabilities were evaluated with reliable and valid tests at discharge from rehabilitation. Six months later, handicap situations were evaluated with the Assessments of Life Habits (LIFE-H). RESULTS: Arm and leg impairments and disabilities are correlated with handicap situations. Disability of the leg is more strongly associated with handicap than arm disability. Arm and leg disabilities are not statistically more strongly related to handicap than arm and leg impairments. CONCLUSIONS: The high correlations found between handicap situations and the impairment and disability measures of the leg provide new information that support the importance of mobility to promote integration after stroke.

Aged↗
PubMed1988

Metabolic, thermoregulatory, and psychophysiological responses during arm and leg exercise.

The present investigation compares metabolic, thermoregulatory, and psychophysiological responses during upper and lower body exercise in different environmental conditions. Eight males performed four, 60-min exercise bouts using either arm or leg ergometry in ambient temperatures of 23 degrees C (relative humidity = 75%) and 33 degrees C (relative humidity = 57%). Power output was 75 W for all experiments. Oxygen consumption, rectal and skin temperatures, heart rate (HR), and rating of perceived exertion were measured during exercise. Exercise oxygen consumption averaged 1.54 l.min-1 across all experiments and was equivalent to 60% of arm and 37% of leg peak values. Rectal temperature increased (P less than 0.001) an average of 0.43 degrees C and did not differ due to experimental conditions. Exercise performed in the heat resulted in higher skin temperature (P less than 0.001), regardless of whether the arms or legs were used. HR and rating of perceived exertion were greater (P less than 0.001) in arm (132.9 b.min-1, 14.4 units) than leg (108.9 b.min-1, 10.9 units) experiments. When arm exercise was performed in the heat, HR was 6 b.min-1 greater than when performed in the cool. Greater relative exercise intensity in arm work resulted in higher HR and rating of perceived exertion at the given power output. Similar rectal temperature increases in all experiments indicate that core temperature is controlled by absolute heat production, regardless of mode of exercise and ambient temperature.

Adult↗
PubMed1990

The effects of arms and countermovement on vertical jumping.

Countermovement and arm-swing characterize most jumping. For determination of their effects and interaction, 18 males jumped for maximal height from a force platform in all four combinations of arm-swing/no-arm-swing and countermovement/no-countermovement. For all jumps, vertical velocity peaked 0.03 s before and dropped 6-7% by takeoff. Peak positive power averaged over 3,000 W, and occurred about 0.07 s before takeoff, shortly after peak vertical ground reaction force (VGRF) and just before peak vertical velocity. Both countermovement and arm-swing significantly (P less than 0.05) improved jump height, but arm-swing's effect was greater, enhancing peak total body center of mass (TBCM) rise both pre and posttakeoff. Countermovement only affected the post-takeoff rise. The arm-swing resulted in higher peak VGRF and peak positive power. During countermovement, the use of arms resulted in less unweighting, slower and less extensive TBCM drop, and less negative power. Countermovement increased pretakeoff jump duration by 71-76%, increased average positive power, and yielded large positive and negative impulses. High test-retest reliability was shown for jump descriptive variables. Body weight together with peak posttakeoff TBCM rise effectively predicted peak power (multiple R2 = 0.89, standard error of estimate = 243 W). The results lend insight into which jumping techniques are most appropriate for given sports situations and indicate that a jump test can effectively be used to estimate peak power output.

Adult↗
PubMed2004

Long-term arm morbidity after radial artery harvesting for coronary bypass operation.

BACKGROUND: The use of the radial artery (RA) in coronary bypass operations has become increasingly popular in recent years, but there is almost no documentation regarding the midterm and long-term arm complications. METHODS: Between January 1 and December 31, 1998, 109 patients underwent operations for myocardial revascularization employing a pedicled RA as 1 of the coronary grafts. The patients were surveyed for subjective arm morbidities at 2 times during their follow-up: short term (mean, 7 months postoperatively; range, 0.3-14 months) and long term (mean, 49 months postoperatively; range, 46-57 months). RESULTS: At the short-term follow-up, 33 (33.3%) of the patients had some complaints regarding the arm that was operated on, with 4 (4%) of the patients reporting arm disability with complaints that focused on pain (11, 11%), numbness (15, 15%), and parasthesias (12, 12%). At the longterm follow-up, only 9 patients (10.5%) still experienced some sort of inconvenience with the arm that was operated on, with 1 case of functional disability, 4 complaints (4.6%) of residual parasthesias, and 1 report (2.3%) each of pain or numbness. All but 2 of the patients with complaints at the short-term follow-up reported amelioration of symptoms at the long-term follow-up. CONCLUSION: It appears that severe arm disability early after RA harvesting is likely to dissolve with time. Our favorable late follow-up results support the continuation of the employment of the RA as a conduit for coronary artery bypass grafting operations.

Aged↗
PubMed1991

Cardiorespiratory responses to standing arm ergometry in patients with ischemic heart disease. Comparison with the results of treadmill exercise.

To compare cardiorespiratory responses to standing arm ergometry and treadmill exercise, two graded exercise stress tests were performed in 30 patients with ischemic heart disease (IHD). Cardiac catheterization and expired gas analyses were also done. Standing arm ergometry was discontinued because of arm fatigue in 15 (50%) patients, whereas treadmill exercise was stopped due to leg fatigue in 8 (27%) patients. Maximal increase in rate-pressure product and oxygen uptake, and magnitude of ST-segment depression during standing arm ergometry were significantly smaller (p less than 0.01, p less than 0.01 and p less than 0.05, respectively) than those during treadmill exercise. Furthermore correlations of maximal change in rate-pressure product, oxygen uptake and extent of ST-segment depression were not close between the two exercise tests (r = 0.76, r = 0.67 and r = 0.54, respectively). Our results indicate that the ability to detect IHD with standing arm ergometry is lower than that with treadmill exercise and that it is not possible to predict accurately one's capacity for arm exercise from the treadmill exercise test.

Adult↗
PubMed2002

Ventilatory and gas exchange responses under spontaneous and fixed breathing modes during arm exercise.

To evaluate the difference of ventilatory and gas exchange response differences between arm and leg exercise, six healthy young men underwent ramp exercise testing at a rate of 15 W.min-1 on a cycle ergometer separately under either spontaneous (SPNT) or fixed (FIX) breathing modes, respectively. Controlled breathing was defined as a breathing frequency (fb; 30 breaths.min-1) which was neither equal to, nor a multiple of, cranking frequency (50 rev.min-1) to prevent coupling of locomotion and respiratory movement, i.e., so-called locomotor-respiratory coupling (LRC). Breath-by-breath oxygen uptake (VO2), ventilation (VE), CO2 output (VCO2), tidal volume (VT), fb and end-tidal PCO2 (PETCO2) were determined using a computerized metabolic cart. Arm exercise engendered a higher level of VO2 at each work rate than leg exercise under both FIX and SPNT conditions. However, FIX did not notably affect the VO2 response during either arm or leg exercise at each work rate compared to SPNT. During SPNT a significantly higher fb and lower PETCO2 during arm exercise was found compared with leg exercise up to a fb of 30 breaths.min-1 while VE and VT were nearly the same. During fixed breathing when fb was fixed at a higher rate than during SPNT, a significantly lower PETCO2 was observed during both exercise modes. These results suggest that: 1) FIX breathing does not affect the VO2 response during either arm or leg exercise even when non-synchronization between limb locomotion movement and breathing rate was adopted; 2) at a fb of 30 breaths.min-1 FIX breathing induced a hyperventilation resulting in a lower PETCO2 which was not associated with the metabolic rate during either arm or leg exercise, showing that VE during only leg exercise under the FIX condition was significantly higher than under the SPNT condition.

Adult↗
PubMed2000

Differentiated ratings of perceived exertion and physiological responses during aerobic dance steps by impact/type of arm movement.

Overall ratings of perceived exertion, i.e., undifferentiated RPE, are often used as indicators of exercise intensity during walking, jogging, and cycling; however, conflicting results concerning RPE during aerobic dance exercise have been reported, and the use of differentiated RPE, i.e., local RPE and central RPE, has not been investigated. The purposes of this study were to assess local, central, and over-all RPE, and physiological responses [heart rate (HR); % HRmax; absolute and relative VO2;% VO2 max, ventilation (VE), ventilatory equivalent (VE.VO2(-1); and oxygen pulse] during aerobic dance exercise varied by Arm Movement (Static Arm vs Dynamic Arm) and Impact (High vs Low). Trained women (N = 25; max VO2 = 50.4 +/- 7.5 ml.kg-1.min.-1) completed four aerobic dance steps. No RPE were significantly correlated with heart rate or VO2; however, for all steps all RPE were significantly (r = .40-.62) correlated with VE.VO2(-1) or VE. No interactions were present for RPE or physiological variables, and main effects were noted for Impact and Arm Movement. All RPE were greater for High Impact and for Static Arm Movement. Because VE and VE.VO2(-1) were correlated with Overall RPE for all steps, this may suggest that participants "attended to" perceived changes in respiratory phenomena during aerobic dance exercise. It appears that during combined arm-and-leg aerobic dance exercise the use of Overall RPE is sufficient to assess perceptual sensations associated with the intensity of the exercise. Changes in Overall RPE were proportionate to objective measures of exercise intensity, i.e., HR and VO2; however, it is recommended that both HR and Overall RPE be used to assess fully a participant's objective and subjective responses during aerobic dance exercise.

Adult↗
PubMed2002

Ventilatory thresholds in arm and leg exercises with spontaneously chosen crank and pedal rates.

The present study assessed whether the first and the second ventilatory thresholds (VT1 and VT2) were dependent on the muscle groups solicited when spontaneously chosen crank and pedal rates are used. 20 physical education male students (22 +/- 2.2 yr.) performed two maximal incremental tests randomly assigned using an increment of 15 and 30 W every minute for arm and leg exercises, respectively. These tests were used to measure the maximal oxygen uptake (VO2 max) and to identify VT1 and VT2. The absolute oxygen uptake (VO2) values measured at VT1, VT2, and at maximal workload were significantly (p < .05) lower during arm and leg exercises. However, VT1 and VT2 expressed in percent of VO2 max were not significantly different between arm and leg exercises (54.1 +/- 8.2 vs 57.2 +/- 11.4%; and 82.5 +/- 6.4 vs 84.6 +/- 5.1% at VT1 and VT2, respectively). In addition, at the two thresholds, none of the variables measured during arm and leg exercises were significantly correlated with the exception of spontaneously chosen crank and pedal rates (p < .01; r = .75 and r = .69 for VT1 and VT2, respectively). Probably due to the different training status and skill level, no extrapolation can be made to specify the arm thresholds from the leg. These results underline the need to specify the ventilatory thresholds from specific arm ergometer measures obtained from tests performed with spontaneously chosen crank and pedal rates and, thus, close to sport and recreational activities, when they are used for training and rehabilitation programs.

Adult↗
PubMedDate not supplied

Hybrid-powered wheelchair: a combination of arm force and electrical power for propelling a wheelchair.

Many of the handicapped who could use a hand-driven wheelchair do not have sufficient arm force, arm movement and/or endurance for proper propulsion. Furthermore, there are users of electric wheelchairs who still have some arm functions and strength. In some cases a hand-driven chair, which can be propelled with reduced arm power, could be a better solution. By means of simulation, a study has been carried out to investigate the possibility of propelling a wheelchair by means of hybrid powering. Hybrid powering can be defined as a combination of arm force and electrical power. Using this hybrid principle, the necessary arm force can be decreased.

Arm↗
PubMed2000

Statistical estimation of height from arm span in north Indian subjects.

We measured height and arm span of 400 males and 231 female subjects between 16-83 years of age. Arm span exceeded height in 82.6% subjects. Mean height to arm span ratio was 0.9711 and 0.9816 in males and females respectively, and was not significantly correlated with age. Linear regression equations were generated for both sexes for prediction of height from arm span and age. The use of height to arm span ratio was found to be a less suitable method than the use of regression equations in estimating height from arm span.

Adolescent↗
PubMed2000

Role of increased arterial inflow in arm edema after modified radical mastectomy.

Chronic arm edema is a common finding after modified radical mastectomy and its pathophysiology is unclear. In a prospective study the value of increased arterial inflow and venous abnormalities after mastectomy was evaluated. Arterial and venous blood flow in axillary vessels of 39 patients with arm swelling and 16 patients without swelling were investigated by Doppler ultrasound. In patients with arm edema the arterial flow on the surgical treated side was 689.73+/-44.6 (mean+/-sem) ml/min and 427.73+/-30.8 ml/min on the contralateral side (p<0.05). In those without swelling the flow was 447.75+/-37.8 ml/min on the treated side and 354.95+/-28.7 ml/min on the contralateral side (p>0.05). The difference between arterial flow measurements on the treated sides of the patients with and without arm swelling was statistically significant. There was no significant difference between the measurements on the contralateral sides of both groups. Venous abnormalities were not detected in both groups of patients. We, therefore, conclude that modified radical mastectomy causes increased inflow in ipsilateral arm and it may play an important role in the etiology of arm swelling in breast cancer patients.

Adult↗
PubMed2001

Differences in lymph drainage between swollen and non-swollen regions in arms with breast-cancer-related lymphoedema.

Recent research indicates that the pathophysiology of breast-cancer-related lymphoedema (BCRL) is more complex than simple axillary lymphatic obstruction as a result of the cancer treatment. Uneven distribution of swelling (involvement of the mid-arm region is common, but the hand is often spared) is puzzling. Our aim was to test the hypothesis that local differences in lymphatic drainage contribute to the regionality of the oedema. Using lymphoscintigraphy, we measured the removal rate constant, k (representing local lymph flow per unit distribution volume, VD), for 99mTc-labelled human immunoglobulin G in the oedematous proximal forearm, and in the hand (finger web) in women in whom the hand was unaffected. Tracer was injected subcutaneously, and the depot plus the rest of the arm was monitored with a gamma-radiation camera for up to 6 h. VD was assessed from image width. Contralateral arms served as controls. k was 25% lower in oedematous forearm tissue than in the control arm (BCRL, -0.070+/-0.026% x min(-1); control, -0.093+/-0.028% x min(-1); mean+/-S.D.; P=0.012) and VD was greater. In the non-oedematous hand of the BCRL arm, k was 18% higher than in the control hand (BCRL, -0.110+/-0.027% x min(-1); control, -0.095+/-0.028% x min(-1); P=0.057) and 59% higher than forearm k on the BCRL side (P=0.0014). VD did not differ between the hands. Images of the BCRL arm following hand injection showed diffuse activity in the superficial tissues, sometimes extending almost to the shoulder. A possible interpretation is that the hand is spared in some patients because local lymph flow is increased and diverted along collateral dermal routes. The results support the hypothesis that regional differences in surviving lymphatic function contribute to the distribution of swelling.

Aged↗
PubMed2001

Relationship between pulmonary function and unsupported arm exercise in patients with COPD.

UNLABELLED: In patients with chronic obstructive pulmonary disease (COPD) the limitation on unsupported arm exercise (UAE) is predominantly respiratory muscle function-dependent. It is characterized by neuromechanical dysfunction (thoracoabdominal dyssynchrony) of the inspiratory muscles (diaphragm, accessory), superimposed by lung mechanics dysfunction. The undergoing mechanism is probably multifactorial. To study the relationship of resting pulmonary function and UAE performance in patients with COPD. Twenty-one patients, mean age 63 +/- 7 years, with COPD [forced expiratory volume in the first second (FEV1) 42 +/- 12% of predicted] underwent assessment of resting lung function (inspiratory capacity 57 +/- 17%; functional residual capacity 204 +/- 38% of predicted), maximal inspiratory pressure (67 +/- 14 cmH2O), upper arm circumference (30 +/- 2 cm), and symptom-limited cardiopulmonary UAE assessments. UAE consisted of bilateral anterior arm elevation to shoulder level at a rate of 40 arm strokes.minute-1. A series of stepwise multiple regression models were fitted to the data to predict exercise time from resting pulmonary function indices. RESULTS: Statistically significant correlations (r) were found between exercise time and inspiratory capacity (% of predicted) (r = 0.67, p = 0.0008), maximal inspiratory pressure (cmH2O) (r = 0.47, p = 0.03), upper arm circumference (r = 0.74, p = 0.0001), FEV1 (% of predicted) (r = 0.62, p = 0.0026), oxygen uptake (r = 0.56, p = 0.0085) and functional residual capacity (% of predicted) (r = -0.41, p = 0.06, borderline). Inspiratory capacity (% of predicted), functional residual capacity (% of predicted), upper arm circumference (cm) and FEV1 (% of predicted) explained 77% of the variance in exercise time. Therapeutic strategies that aim to increase inspiratory capacity or decrease functional residual capacity, or increase inspiratory muscle strength and upper arm/torso muscle endurance are likely to alleviate symptoms and improve UAE performance in patients with COPD.

Aged↗
PubMed2000

Arm elevation enhances muscle sympathetic nerve activity during static exercise.

The purpose of the present study was to evaluate the effect of hypoperfusion to the static-exercised-muscle induced by arm elevation on muscle sympathetic nerve activity (MSNA) recorded from the right tibial nerve (n= 10) by microneurography. Subjects performed static handgrip exercises (SHG) at 30% of maximal voluntary contraction (MVC) for 2 min, followed by 2 min of posthandgrip muscle ischemia (PHGMI) at the heart level (control) and with the arm elevated (50 cm above heart level). Basal heart rate, mean blood pressure and MSNA responses expressed as burst rate (bursts/min) and total MSNA (%) were unaffected by the arm-position. Heart rate response during SHG was not influenced by the arm elevation, while mean blood pressure and MSNA responses were increased by it (P<0.05). MSNA responses were increased during the second minute of the SHG period (P<0.05) and the PHGMI period (P<0.05) in the elevated arm position. In conclusion, arm elevation increased MSNA responses to SHG and PHGMI, suggesting an increased magnitude of muscle metaboreflex.

Adrenergic Fibers↗
PubMed1992

An electromyographic analysis of the shoulder during cones and planes of arm motion.

Shoulder motion has traditionally been described in reference to arbitrarily defined planes of motion (e.g., sagittal/flexion, coronal/abduction). This study examined shoulder muscle recruitment during conical arm movements, which include all planes of motion. Electromyographic (EMG) data was collected with intramuscular wire electrodes from ten muscles in five normal volunteers. Each muscle showed peak EMG activity in association with a direction of action consistent with its anatomic alignment. These findings were similar for movements in both the sagittal and coronal planes, calling into question conventionally held designations of shoulder muscles as flexors and abductors. Muscle recruitment was as follows: Clavicular pectoralis major, to move the arm medially along the horizontal; anterior deltoid, to move the arm obliquely upward inclined toward the midline; middle deltoid, to move the arm obliquely upward inclined away from the midline; posterior deltoid, to move the arm laterally along the horizontal; and teres major and latissimus dorsi, to move the arm obliquely downward away from the midline. Rotator cuff muscles were maximally active during elevation, consistent with the concept of a force couple.

Adult↗