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At least 1,117 records · Page 62Linked to original sources
PubMed2005

[Effects of educational program of manual lymph massage on the arm functioning and the quality of life in breast cancer patients].

PURPOSE: The purpose of this study was to determine the effect of EPMLM (educational program of manual lymph massage) on the arm functioning and QOL (quality of life) in breast cancer patients with lymphedema. METHOD: Subjects in the experimental group (n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2 weeks, and 6 weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group (n=20). The collected data was analyzed by using SPSS 10.0 statistical program. RESULT: The arm functioning of experimental group was increased from 2 weeks after (W=.224, p=.011) and statistically differenced with control group at 2 weeks (Z=-2.241, p=.024) and 6 weeks (Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group (Z=-1.162, p=.050), also statistically differenced with control group (Z=-2.182, p= .030) at 6 weeks. CONCLUSION: The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.

Adult↗
PubMed1999

[Post-therapeutic lymphedema of the arm--possibilities and limits of diagnosis and therapy].

The post-therapeutical secondary arm lymphedema is the most frequent complication after a curatively treated cancer of mamma. For the diagnosis and therapy the knowledge of physiology and pathophysiology of lymphedema and of specific anatomy are necessary. The diagnosis facilities are essentially limited to a basic diagnosis (anamnesis, inspection, palpation, sonography, functional-diagnosis). Specific apparative diagnostics like lab, sonography, CT, MRI and PTE have to be applied especially at an early stage of the secondary arm lymphedema for the differential diagnosis between the secondary malign and secondary benign arm lymphedema. Specific apparative examinations like lymphscintigraphy and lymphography are limited and solely indicated for special questions. As a therapy possibility of the secondary arm-lymph edema, a conservative therapy, that is, the complex two-stage-decongestive physiotherapy (CDP) is recommended as first choice. Surgical therapies such as autologous lympho-lymphostatic anastomoses and lymphovenous anastomoses are only recommended in selected individual cases. The secondary malignant arm lymphedema must be primarily treated oncologically; lymphological therapy measures have to be postponed. Diagnosis and therapy are limited through lymphological incompetence and insufficient patient compliance. In this respect the provision of financial resources through National Health policy ist regarded as utterly important.

Arm↗
PubMed1999

Upper arm arteriovenous fistulas as a reliable access alternative for patients requiring chronic hemodialysis.

The wrist fistula is the access procedure of choice in the hemodialysis patient. However, unavailable or unusable anatomy in this aging population has made them difficult to establish. This study retrospectively compares patency, occlusion, and complication rates of upper arm arteriovenous fistulas (AVFs) as a reliable alternative. Fifty-eight upper arm AVFs were created in 52 patients between February 1995 and August 1997 at Hermann Hospital, affiliated with the University of Texas Health Science Center in Houston, Texas. Fistulas were constructed using the brachial artery (BA) side-to-end (n = 56) or side-to-side (n = 1) with either the cephalic vein (CV; n = 39), transposed basilic vein (TBV; n = 16), or other vein [basilic vein (BV; n = 1), transposed cephalic vein (TCV; n = 1), median cubital vein (MCV; n = 1)]. One-year primary patency rates for upper arm AVFs were 66 per cent, and secondary patency rates were 22 per cent. Flow rates averaged 354.6 mL/minute. Primary and secondary patency rates for fistulas created are: BA-CV (67% and 20%), BA-TBV (63% and 25%), and other upper arm AVFs 66 per cent without revisions. Primary patencies for both BA-CV and BA-TBV fistulas were similar to previously reported studies. Secondary patencies proved to be less effective. Upper arm AVFs should be considered before graft placement when wrist and forearm anatomy does not lend itself to fistula creation.

Adult↗
PubMed1999

Longitudinal growth of arm circumference in Punjabi infants.

OBJECTIVE: To study distance and velocity growth pattern of mid-upper-arm-circumference in Punjabi infants. DESIGN: Longitudinal, monthly follow up. SETTING: Growth clinic and homes of subjects. SAMPLE: One hundred and fifty four (Male 86, Female 68) Punjabi infants weighing more than 2.5 kg at birth with gestation over 37 weeks. METHODS: Every subject was measured for mid-upper-arm circumference between 1 to 12 months of age at one monthly intervals by the same investigator with a time tolerance of 3 days on the day of measurement. RESULTS: Mid upper arm circumference showed rapid increase between 1 to 6 months whereafter, gain became slower during second half of infancy. It had grown by 34.9% in male and 40.2% in female infants between 1 to 12 months. Sex differences favoring male infants were statistically significant between 1 to 4 months. Monthly growth rates for arm-circumference depicted vascillatory pattern. CONCLUSION: The values presented for arm circumference may be used as reference base to monitor growth of children during infancy.

Age Factors↗
PubMed2002

Substrate utilization during arm and leg exercise relative to the ventilatory threshold in men.

BACKGROUND: The purpose of this study was to determine variations in substrate utilization in men during arm and leg exercise at 70 and 90% of mode specific ventilatory threshold (Tvent). METHODS: Ten males served as subjects. Limb total and muscle volumes were estimated in the right arm and leg with anthropometry. Ventilatory equivalence, excess CO2, and modified V-slope methods were used to determine Tvent. Subjects performed 15 min of exercise at 70 and 90%Tvent arm cranking (AC) exercise, and 70 and 90%Tvent leg cycling (LC) exercise. RESULTS: VO2, VE, and HR were higher during LC exercise at both intensities. However, arm and leg RPE were not different at 70 and 90%Tvent. There were no significant differences between modes at 70%Tvent in relative carbohydrate use (54.5+/-9.5 and 57.8+/-8.2% for AC and LC, respectively) and relative fat oxidation (45.5+/-9.5 and 42.2+/-8.2% for AC and LC, respectively). However, at 90%Tvent, relative carbohydrate oxidation was significantly higher during AC versus LC exercise (75.4+/-10.6 versus 68.6+/-9.0%, p<0.05). Energy expenditure (total kJ x min(-1) was significantly lower during AC exercise (14.5+/-2.9 and 18.4+/-3.4 for the 70 and 90%Tvent, respectively) versus LC exercise (27.1+/-3.3 and 34.8+/-4.1 for the 70 and 90%Tvent, respectively; p<0.05). CONCLUSIONS: These results indicate that substrate use during AC exercise is similar to LC exercise at 70%Tvent. However, as the exercise intensity increases, the smaller arm musculature becomes more dependent on carbohydrate utilization compared to the legs.

Adult↗
PubMed1976

[Arm and hand prosthesis--today and in the future (author's transl)].

The hand must be taken in a required working position (necessary for eating, drinking, dressing and writing) in order it can touch and grasp. For that purpose a combined motion of all arm-joints is necessary. Hand-surgical procedures are of little value when the hand cannot be taken in such a working position. The problem of the upper arm prosthesis is the driving of the elbow because both the Hood-arm and the myoelectrically driven elbow joint bring no satisfactory functional results. The Tobelbader Hand is a self-powered prosthesis for patients who have a wrist stump. By means of this Tobelbader Hand the prehension can be dosed muscularly. The substitute of the amputated wrist by implantation of an endoprosthesis is discussed theoretically. For the first time to an amputee (with upper arm amputation on both sides) an endoprosthesis was implanted into the stump of the upper arm in order to drive the prosthetic elbow. By means of this artificial, however movable elbow joint the electrical artificial hand can be reliable taken into any wanted position for working.

Arm↗
PubMed2000

Normative growth standard for upper arm measurements for exclusively breastfed infants.

OBJECTIVE: To develop a normogram for upper arm measurements for the evaluation of exclusively breastfed infants and to evaluate the clinical usefulness of the normogram. DESIGN: A prospective study involving the evaluation of infants discharged from the Newborn Unit and follow-up for the first six months of life while being exclusively breastfed. SETTING: Neonatal follow up Clinic, University Teaching Hospital, Benin City, Nigeria from 1st June, 1995 to 31st May, 1997. SUBJECTS: A total of 219 exclusively breastfed infants were recruited and analysed for the development of the normogram. A second group of 100 normal exclusively breastfed infants were evaluated to determine the clinical usefulness of the normogram. INTERVENTIONS: Determination of the upper arm measurement of the infants and development of the normogram using the statistics of the regression analysis of these measurements on postnatal age. MAIN OUTCOME MEASURES: Upper arm measurements, mean measurements at each completed month, regression statistics (MAC on postnatal age). RESULTS: Mean MAC measurements increased progressively from the first to the sixth completed months. There was a significant difference between the mean measurements at the 4th and 6th completed months. Upper arm measurements showed a highly significant correlation with postnatal age and the regression line and the 95% confidence limits were used to develop the normogram. Of the 100 infants in the second group, 92% had normal infant growth using the normogram. CONCLUSION: The developed normogram of upper arm measurements was evaluated to be clinically useful in exclusively breastfed infants.

Anthropometry↗
PubMedDate not supplied

Arm area measurements as indices of nutritional reserves and body water in African newborns.

Although application of non-invasive techniques for early evaluation of body water, calorie and protein reserves has been available for more than two decades, there is a dearth of information on the evaluation of extracellular water, protein and calorie reserves in the African newborn. A cross-sectional study of arm area measurements was undertaken in 510 term new-born infants consisting of 318 infants who were normal weight term infants (NWTI) with a mean birth weight of 2898.5 +/- 287.7 g and 192 low birth weight term infants (LBWTI) with a mean birth weight of 2176.5 +/- 194.7 g. The triceps skin fold thickness (TSF), the arm fat area (AFA), percentage of arm area (AFA%) and arm water area (AWA) were significantly greater in females than males weighing > 2500 g at birth (P < 0.05), though the mean birth weight and mid-upper arm circumference (MUAC) were similar (P > 0.05). With the exception of AFA%, all measured and calculated indices were significantly lower in LBWTI than in the NWTI irrespective of sex (P < 0.05). The measurements may aid detection of newborns at risk of developing malnutrition in an area of the world where childhood undernutrition is common.

Adipose Tissue↗
PubMed2003

The extended lateral arm flap in head and neck reconstruction.

BACKGROUND: The lateral arm flap has been proven to be a reliable and versatile flap for the coverage of small to moderated-sized defects, especially in the head and neck and in the extremities. This flap has been modified by either extending the vascular pedicle or the flap territory. METHODS: From September 1997 to October 2000, we performed 17 free lateral arm flaps with extension of the flap size, including 1 osteofasciocutaneous flap for the coverage of head and neck defects. The reconstructions included a partial circumference defect of the esophagus, extensive intraoral defects, through-and-through bucco-cheek defect, etc. Follow-up was from three months to 12 months, with an average of 8 months. RESULTS: All but one flaps survived completely. Necrosis of the distal part occurred in one flap. Follow-up of donor sites revealed minimal morbidity when the flaps were extended to the below-elbow level. CONCLUSIONS: The cutaneous territory of the lateral arm flap, based on the posterior radial collateral artery, can be extended distally onto the forearm up to 10 cm. The center point of the flap design could be located more distally toward the lateral epicondyle in order to increase the size of the flap and the length of the vascular pedicle. The lateral arm flap provides a considerable amount of thin, pliable fasciocutaneous tissue. The advantages of the flap are constant anatomy, very easy and fast dissection, and the donor site being easier to camouflage than that of the radial forearm flap. The lateral arm flap is an excellent choice of fasciocutaneous flap for the reconstruction of head and neck defects.

Adult↗
PubMed2005

Effect of arm cranking on oxygenation of vastus lateralis and lateral gastrocnemius muscles during leg cycling.

AIM: The purpose of this study was to compare the changes in oxygenation in exercising vastus lateralis muscle (VL) and lateral gastrocnemius muscle (LG) when arm cranking is added to on-going leg cycling. METHODS: Change in oxygenation (difference between concentrations of oxygenated hemoglobin and deoxygenated hemoglobin, HbD) was determined using near-infrared spectrometry. Before the combined exercise, each subject (n=8) rested for 5 min and then performed 10-min constant-work-rate leg cycling. The intensities of leg cycling were 20% and 40% of peak oxygen uptake (VO2peak) during incremental leg cycling (LC20 and LC40). Arm cranking at an intensity of 60% of VO2peak recorded during incremental arm cranking (AC60) was added to the on-going leg cycling (both AC60LC20 and AC60LC40 in two separate sessions) for 6 min. RESULTS: During AC60LC20, HbD in both the VL and LG showed significant decreases compared to the control value (1 min before combined exercise: LC20). During AC60LC40, a significant decrease in HbD compared to the control value (1 min before combined exercise: LC40) was observed only in the LG. In the VL, the integrated electromyogram (iEMG) during AC60LC40 was significantly larger than that during AC60LC20, whereas in the LG, no significant difference was found between the iEMG during AC60LC40 and that during AC60LC20. These results suggest that the decrease in HbD in the exercising leg muscles is related to the level of its muscle activity after the addition of arm cranking. CONCLUSION: The results suggest that HbD shows different changes in exercising leg muscles due to the difference in its activity level when arm cranking is added to on-going leg cycling.

Adult↗
PubMedDate not supplied

High venous urea concentrations in the opposite arm. A consequence of hemodialysis-induced compartment disequilibrium.

Resistance to urea diffusion among body fluid compartments diminishes the therapeutic effectiveness of hemodialysis. Cell membrane or capillary wall resistance is thought to be responsible for hemodialysis-induced urea disequilibrium. The authors examined the possibility that reduced blood flow might contribute to urea disequilibrium in the arm opposite the blood access site. Blood samples were taken simultaneously from a vein in the arm opposite the access site and from the arterial port after occluding the access graft between the needle sites for 1 min. Venous urea nitrogen levels from the opposite arm averaged 10% higher after 5 min, 26% higher after 60 min, and 36% higher after 120 min of dialysis. A three-compartment model of urea kinetics that includes a blood flow term accurately predicted all measured urea nitrogen concentrations in both arms. These data suggest that the opposite arm often behaves as a compartment with high resistance to urea diffusion. Slow diffusion from this compartment is partially due to reduced blood flow/compartment volume, and results in a delayed fall in venous blood urea nitrogen (BUN).

Arm↗
PubMed1991

Temporal patterns of muscle activation for arm movements in three-dimensional space.

Little is known about the patterns of muscle activation that subserve arm movement in three-dimensional space. In this study, activation patterns of seven arm muscles were related to the spatial direction of human arm movement. Twenty movement directions defined two orthogonal vertical planes in space. The arm movements were moderately paced; each movement lasted approximately 500 msec. New techniques of EMG analysis were developed to describe the temporal pattern of muscle activation. For each muscle, a principal component analysis revealed a common phasic and tonic waveform for all directions of movement, within one plane. A temporal shifting procedure based on best covariance values revealed activation delays associated with different movement directions. The results show a consistent pattern of temporal shifting of the common waveform for movements in different directions. Coupled with past results showing that activation amplitude is a function of the cosine angle of movement or force direction, the present results suggest a relatively simple control strategy for mechanically complex arm movements: neural circuits produce a common phasic and tonic activation waveform that is scaled in amplitude and delayed in time, depending on the desired movement direction.

Arm↗
PubMed1990

Different tissue plasminogen activator release in the arm and leg during venous occlusion is equalized after DDAVP infusion.

The mechanism of tissue plasminogen activator (t-PA) release during arm and leg venous occlusions and DDAVP (1-desamino-8-D-arginine vasopressin) infusion was studied in 10 healthy males. The following determinations were carried out on venous blood: t-PA antigen (ELISA), t-PA activity, and t-PA inhibitor (PAI) activity (amidolytic assays). Before DDAVP, there was a 270% t-PA antigen increase in the arm at the end of occlusion as opposed to only a 40% increase in the leg. After DDAVP, t-PA antigen at the end of arm and leg occlusion reached an equal level which was significantly higher than in the arm before DDAVP. The study produced no evidence of PAI release during venous occlusion of a limb. It is concluded that DDAVP is able to elicit t-PA release from arm as well as from leg vessels. The poor fibrinolytic response of leg vessels to venous occlusion is not due to a high PAI release or t-PA stores depletion in leg vessels, but rather to low basal t-PA release in leg vessels.

Adult↗
PubMed1990

Making arm movements within different parts of space: dynamic aspects in the primate motor cortex.

The activity of 176 individual cells in the arm area of motor cortex (areas 4 and 6) was studied while monkeys made arm movements of similar direction within different parts of extrapersonal space. The behavioral paradigm used was a 3-dimensional reaction-time task aimed at dissociating the direction of movement, which remained similar across the work space, from the patterns of muscular activity and the angular joint excursions necessary to perform these movements. In agreement with other studies (Georgopoulos et al., 1982; Schwartz et al., 1988), we found that, within a given part of space, the activity of 169 (96.0%) cells studied increased most for a given preferred direction and less for other directions of movement. This change was graded in an orderly fashion. We further analyzed the orientation in space of the cells' preferred directions under the differing conditions of the task. We found that, as movements with similar trajectories were made within different parts of space, the cells' preferred directions changed spatial orientation. This change was of different magnitudes for different cells, but at the level of the population, it followed closely the changes in orientation of the arm necessary to perform the movements required by the task. Movement population vectors (Georgopoulos et al., 1983, 1986, 1988) computed from cell activity proved to be good predictors of movement direction regardless of where in space the movements were performed. These results indicate that motor cortical cells can code direction of movement in a way which is dependent on the position of the arm in space. The data are discussed in relation to the existence of mechanisms which facilitate the transformation between extrinsic and intrinsic coordinates. These transformations are necessary to perform arm movements to visual targets in space.

Animals↗
PubMed1989

Arm exercise training for wheelchair users.

Although individuals with lower-limb paralysis typically use their arms for wheelchair locomotion and exercise training, several factors including the relatively small muscle mass available, as well as deficient cardiovascular reflex responses and inactivity of the venous muscle pump (resulting in hypokinetic circulation), can cause the early onset of fatigue during arm activity. Thus, cardiopulmonary (aerobic) fitness is difficult to develop and maintain; this situation can often be exacerbated by a sedentary lifestyle. The purpose of this paper is to present research related to exercise capability of wheelchair users, arm exercise modes, physical fitness training programs using arm exercise, and newly developed exercise techniques which incorporate combinations of voluntary arm exercise and functional neuromuscular stimulation-induced exercise of paralyzed leg muscles. It is evident that exercise training programs utilizing appropriate techniques can markedly improve the physical fitness, functional independence, and rehabilitation outcome of wheelchair users.

Arm↗
PubMed1989

Normative arm and calf blood pressure values in the newborn.

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (+/- SD) of the neonate less than 36 hours of age were 62.6 +/- 6.9/38.9 +/- 5.7 mm Hg (48.0 +/- 6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P less than .05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P less than .05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1 +/- 7.7 mm Hg systolic, -0.01 +/- 6.2 mm Hg diastolic, and 0.9 +/- 6.9 mm Hg mean pressures. Mean heart rate (+/- SD) of neonates less than 36 hours of age was 129.4 +/- 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4 +/- 14.1 beats per minute.(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗
PubMed1988

[Arm rotation during abduction of the shoulder in the scapular plane].

The arm rotation during abduction of the shoulder in the scapular plane was investigated in 11 volunteers. The degree and direction of the arm rotation were measured using five potentiometers, and were analysed by a computer system. In eight volunteers, the arm always rotated externally (1.5 degrees-4.9 degrees of rotation for each 10 degrees of abduction); in one volunteer it rotated internally (0.9 degree of rotation for each 10 degrees of abduction); and in the two remaining volunteers it rotated without showing a constant tendency during the abduction. The degree of arm rotation was correlated to the tilting angle of the acromial articular surface which was measured radiographically. A tendency of external rotation of the arm is suggested to occur during abduction in the scapular plane along with the decrease of the tilting angle of the acromial articular surface.

Adult↗
PubMed1988

Cardiorespiratory and subjective responses to incremental and constant load ergometry with arms and legs.

Aerobic exercises in which both arm and legs are used are becoming more popular for conditioning and rehabilitation. In order to clarify our understanding of physiologic and subjective responses to work of this type, two experiments were conducted using legs and/or arms. In the first, incremental cycle ergometry was done with the arms (A), legs (L), and combined, in which either 10% (A-10) or 25% (A-25) of the power output (PO) was done by the arms. Peak rate of oxygen consumption (VO2) and heart rate (HR) were significantly lower for A, but the other three conditions did not differ significantly. Ventilatory breakpoint (VB) was significantly higher for A-10 than for L. The second study used 60 minutes of constant-load work at a PO of approximately 115% of the PO at which the VB occurred in the L incremental test, to stimulate an aerobic training session. During the 60 minutes, VO2 and cardiac output were significantly higher, and systolic blood pressure (SBP) significantly lower for A-25 than for L, with A-10 values generally failing between the two. The HR-SBP products and ratings of perceived exertion were quite similar for the three modes. Thus, assigning some of the PO to the arms allowed a greater metabolic load to be maintained with no greater cardiovascular or subjective strain, suggesting that this type of exercise might be valuable for aerobic conditioning, cardiorespiratory rehabilitation, and weight control.

Adult↗