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At least 1,153 records · Page 64Linked to original sources
PubMed1999

Practice effects on the less-affected upper extremity after stroke.

OBJECTIVE: To test the hypotheses that (1) adults who have had a stroke, using the less affected upper extremity (UE), improve performance of an aiming task with practice, and (2) compared with control subjects, stroke patients show less improvement in a complex condition. DESIGN: Movement time (MT) and kinematic data were collected over practice. Comparisons were made between the less-affected UE of stroke patients and the same hand of controls. SETTING: A human performance laboratory. PARTICIPANTS: A matched sample of right-handed adults, 10 with unilateral stroke and 10 nondisabled controls. INTERVENTION: Practice of an aiming task in an easy and complex condition as defined by target width and distance between two targets. MAIN OUTCOME MEASURES: MT, peak velocity, and temporal phases of the trajectory. RESULTS: Adults who had experienced a stroke had persistently longer MTs than control subjects; however, all participants achieved faster MTs with practice in both conditions. The absolute amount of time in each temporal phase decreased without a change in the relative times. Peak velocity increased only in the easy condition. CONCLUSIONS: Adults with stroke damage can improve motor performance of the less-affected UE with practice. Further study is needed to see if practice effects are permanent and generalizable.

Cerebrovascular Disorders↗
PubMed1995

Subjective outcome following surgical management of upper extremity neuromas.

Our study used a telephone survey to evaluate long-term subjective outcome of 70 patients with 112 upper extremity neuromas treated surgically. The mean postinjury time before surgery was 9 years. The mean postsurgical followup was 5 years. Fifty-one of the patients were involved with workers' compensation (WC). Forty-five patients reported good relief of pain. Preoperatively, 46 patients were unemployed because of pain; following surgery 18 of these patients returned to work. Of the 54 patients taking analgesic medication preoperatively, 19 reported less and 10 reported no postoperative analgesic use. No significant difference was found in gender, postinjury time, postsurgical followup time, number of previous surgeries for pain relief, or site of nerve injury between patients who reported improvement versus no symptomatic improvement. Poor subjective outcome occurred in patients (p < .03), with 16 out of 19 of those not involved with WC reporting good pain relief as compared to 29 out of 51 of WC patients.

Adult↗
PubMed1998

Length of disability and cost of work-related musculoskeletal disorders of the upper extremity.

There is little information on the length of disability (LOD) reported for work-related musculoskeletal disorders of the upper extremity (WMSDUE). For this study, LOD, cost, and the relationship between LOD and cost were derived from a large workers' compensation company's claims data for 1994 WMSDUE (n = 21,338). The average LOD was 87 days, with a median of zero days. For those claims with at least one day of compensable disability (25.2%), the average and median LOD were 294 and 99 days, respectively. The distribution of cost was skewed, with the average cost of a claim being 13 times higher than its median. Approximately 60% of the claims cost $1000 or less. Additionally, the 6.8% of the claims with an LOD greater than one year accounted for 59.9% of the cost and 75% of the total disability days. The majority of WMSDUE claimants did not lose sufficient time to qualify for indemnity. For those who did receive lost time wages, a disability duration of more than three months was typical.

Adult↗
PubMed1993

Sonography of the upper extremity and jugular veins.

Color Doppler sonography is a useful technique for rapid, noninvasive evaluation of venous disease in the upper extremity. It has been used successfully to evaluate thrombosis related to indwelling central catheters. In addition, Doppler sonography shows promise for monitoring thrombolytic therapy after "effort thrombosis" and detecting intermittent venous compression related to thoracic outlet syndrome.

Arm↗
PubMed1999

[The results of the treatment of post-traumatic reflex sympathetic dystrophy within upper extremity].

Results of a retrospective study of the treatment of 146 patients with post-traumatic reflex sympathetic dystrophy within upper extremity in various stages were presented. Treatment included the following methods: regional intravenous steroid blocks, mannitol, mannitol combined with dexamethasone, physical therapy, calcitonin and surgery. Uniform, clearly defined criteria of diagnosis of the condition and criteria of assessment of the results were used in the study. Final assessment was carried out 6-15 months after ending of the treatment (mean 11 months). Good result (no pain and full finger flexion) was obtained in 94 patients (64%), moderate (pain only after load or loss of flexion less than 3 cm) in 31 (21%) and poor (pain at rest or reduction of flexion more than 3 cm) in 21 (15%). There was found that method of treatment had not significant effect on the result, except surgical treatment after which the worst results were obtained. Significant effect of duration of the disease on the results of the treatment was noted: the earlier treatment the better results. In spite of satisfactory withdrawal of other signs and symptoms, considerable reduction of grip strength after treatment persisted (mean grip strength ratio 28% of the other side) suggesting functional impairment of the hand. The critical approach to evaluation of the results of the treatment of early reflex sympathetic dystrophy was suggested with regard to spontaneous recovery of the condition in many cases.

Adult↗
PubMed2002

Prevalence of carpal tunnel syndrome and upper extremity tendinitis among dental hygienists.

PURPOSE: This study was undertaken to determine the prevalence of carpal tunnel syndrome (CTS) and upper extremity (UE) tendinitis among dental hygienists. METHODS: In a cross-sectional study dental hygienists (n = 305) were screened using sensory nerve conduction, a focused physical examination of the UE, and a symptom questionnaire. CTS was diagnosed if the subject had slowing of the median nerve at the wrist and symptoms of numbness, tingling of pain in the median distribution. Localized tendinitis of the UE was diagnosed if the subject had focal symptoms and associated findings on physical examination. RESULTS: Three percent of the participating dental hygienists were diagnosed with CTS. Thirteen were diagnosed with shoulder tendinitis, while 6% had a tendinitis of the elbow and 7% had tendinitis of the hand or wrist. Twenty-eight percent had a diagnosis of some UE tendinitis or CTS. CONCLUSIONS: The prevalence of hand and finger symptoms in the dominant hand among dental hygienists in this study was high, but the prevalence for CTS was nearly the same as the general population. There was a high rate of UE tendinitis noted within this population.

Adult↗
PubMed2001

Non-work factors associated with musculoskeletal upper extremity disorders in women: Beyond the work environment.

It is women who are predominantly affected by musculoskeletal disorders of the upper extremities (MSD/UE), especially those disorders attributed to repetitive strain or cumulative trauma. This study focuses on a female sample of supermarket employees and the effects of stress acquired from their non-work environments on the reporting of musculoskeletal symptoms. Stress and life events were shown to be positively associated with the presence of UE disorders and measures of intensity, duration, and frequency of pain. A multifactorial model for explaining the development of MSD/UE in female workers is proferred, while the significance of understanding the inter-relational nature of women's lives is underscored. Additionally, the study lends credence to the physiological underpinning of stress.

Journal Article↗
PubMed2006

[Rehabilitation of patients with upper extremities burns at the stage of skin restoration].

Results of surgical treatment of 479 patients with deep burns of the upper extremities on the area from 0.5 to 60% of body surface with the lesion of shoulder (398), elbow (407), radiocarpal (371) joints and hand (423) area. Early or delayed necrectomy (28.6%) with following skin grafting was performed at hospitalization of patients in early period. At IV-degree burns plastic reconstruction with skin-subcutaneous flaps was used: local (22), combined (16), pedicle flap and Filatov's graft (29), flaps with axial circulation (8) and on microsurgical anastomoses. Active surgical policy resulted in recovery of the function of the shoulder joints in 73.7%, elbow joints--in 75.15%, radiocarpal joints--in 83.4% and of hand in 50.2% cases.

Adolescent↗
PubMed1992

Upper extremity pain in the postrehabilitation spinal cord injured patient.

The purpose of this study was to determine the prevalence of upper extremity (UE) pain in outpatients with chronic spinal cord injury (SCI). A total of 239 SCI outpatients (136 with quadriplegia and 103 with paraplegia) were interviewed for the presence of UE pain at the shoulder, elbow, wrist, and hand. The average age of the subjects at the time of interview was 37.4 years, and the average time since onset was 12.1 years. Subjects who reported pain were referred to SCI clinics to determine the etiology. Fifty-five percent of the patients with quadriplegia reported UE pain, most commonly at the shoulder. Prevalence of reported pain was highest for subjects in the first five years postinjury. Sixty-four percent of patients with paraplegia reported UE pain. Complaints related to carpal tunnel syndrome were the most common, followed by those related to shoulder pain. This study documents the prevalence and nature of UE pain in chronic SCI patients and emphasizes the need for further research to develop strategies for prevention and treatment of pain syndromes.

Activities of Daily Living↗
PubMed1989

[Late results of replantation of the upper extremity].

The authors present the long-term results observed in 82 patients after replantations of various segments of the upper extremity which were performed at centres of microsurgery of in Italy. A number of tests of prac- four towns tical importance aimed at the evaluation of the recovery of the extremity and the fingers sensitivity has been used during the examination. The authors have come to the conclusion that the success of the operations of replantation of various moments of the extremities is determined not only by the technical aspect of the surgery, but to a greater degree by correct implementation of the system of rehabilitation treatment aimed at the extremity sensitivity recovery.

Adolescent↗
PubMed1983

[Deep venous thrombosis of the upper extremities: occurrence, etiology and prognosis].

Incidence, clinical findings, etiology and evolution of 25 cases of deep venous thrombosis of the upper extremity are evaluated in a group of 23 in- and outpatients. The incidence of the disease represents less than 6% of all deep venous thromboses. The most frequent etiology among outpatients was "primary" deep venous thrombosis. The percentage of pulmonary embolism was 8%. The prognosis is favourable in 90% of cases.

Arm↗
PubMed2006

Simultaneous two-color spectral fluorescence lymphangiography with near infrared quantum dots to map two lymphatic flows from the breast and the upper extremity.

Due to their small size and poor access, the lymphatic function has been difficult to study in vivo. Especially difficult is the mapping of lymphatic drainage from two basins into the same node. Quantum dots can be used to perform multicolor images with high fluorescent intensity and are of a nano-size size suitable for lymphatic imaging via direct interstitial injection. Here we show simultaneous two-color in vivo wavelength-resolved spectral fluorescence lymphangiography using two near infrared quantum dots with different emission spectra, which allow non-invasive and simultaneous visualization of two separate lymphatic flows draining the breast and the upper extremity and variations in the drainage patterns and the water sheds within the axillary node. Two-color spectral fluorescence lymphangiography can provide insight into mechanisms of drainage from different lymphatic basins that may lead to sentinel lymph nodes detection of the breast cancer as well as prevention of complications such as lymphedema of the arm.

Animals↗
PubMed2002

Scaling of peak moment arms of elbow muscles with upper extremity bone dimensions.

It is often assumed that moment arms scale with size and can be normalized by body segment lengths or limb circumferences. However, quantitative scaling relationships between moment arms and anthropometric dimensions are generally not available. We hypothesized that peak moment arms of the elbow flexor and extensor muscles scale with the shorter distance (D(s)) between the elbow flexion axis and a muscle's origin and insertion. To test this hypothesis, we estimated moment arms of six muscles that cross the elbow, digitized muscle attachment sites and bone surface geometry, and estimated the location of the elbow flexion axis in 10 upper extremity cadaveric specimens which ranged in size from a 5'0" female to a 6'4" male. D(s) accurately reflected the differences in peak moment arms across different muscles, explaining 93-99% of the variation in peaks between muscles in the same specimen. D(s) also explained between 55% and 88% of the interspecimen variation in peak moment arms for brachioradialis, biceps, and ECRL. Triceps peak moment arm was significantly correlated to the anterior-posterior dimension of the ulna measured at the olecranon (r(2)=0.61, p=0.008). Radius length provides a good measure of the interspecimen variation in peaks for brachioradialis, biceps, and ECRL. However, bone lengths were not significantly correlated to triceps moment arm or anterior-posterior bone dimensions. This work advances our understanding of the variability and scaling dimensions for elbow muscle moment arms across subjects of different sizes.

Arm↗
PubMed2004

Upper-extremity deep venous thrombosis complicating whole-blood donation.

BACKGROUND: Up to 36 percent of blood donors may experience a donation-related complication. Fatigue, bruises, hematomas, and vasovagal reactions comprise the great majority of donor reactions and injuries. Serious complications are rare. CASE REPORT: A 20-year-old female taking the third-generation oral contraceptive desogestrel/ethinyl estradiol and ethinyl estradiol (Mircette) developed bruising and increased pain and swelling of her right arm over a 5-day period after whole-blood donation. She was a first-time donor and the venipuncture was reported as being mildly traumatic. There was no personal or family history of thrombosis. RESULTS: Ultrasound examination of her upper extremity revealed the presence of a deep venous thrombosis that required treatment with enoxaparin sodium for 5 days and warfarin for 6 months. Evaluation for thrombophilia was negative. The only risk factor for thrombosis was use of oral contraceptives. CONCLUSION: Although serious complications from whole-blood donation are rare, they may occur. Deep venous thrombosis should be considered in a donor presenting with increasing pain and swelling after blood donation.

Adult↗
PubMed2004

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study.

The aim of the study was to present the prevalence of clinical signs and symptoms among female computer users above 45 years, both in a group with self-reported neck/shoulder trouble (NS cases) and in a group without such trouble (NS controls). The hypothesis was that computer users with self-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower in subjects with self-reported trouble as well as in the subgroup of NS cases with clinical diagnoses. In conclusion, the present clinical diagnoses and physical function tests differed between NS cases and NS controls, and are therefore recommended to be included as quantitative objective measures in assessing musculoskeletal health. Physical function tests should be further developed in order to be able to detect pre-stages of work-related disorders for preventive strategies.

Case-Control Studies↗
PubMedDate not supplied

[Work-related musculoskeletal disorders of the upper extremity in spinning: lack of risk or of adequate methods for assessing risk?].

The existence of a risk of musculoskeletal disorders work-related of the upper extremity (UEWMSDs) in the textile industry, specifically in particular working phases as spinning, appears today controversial. The upper limb disorders, sometimes described, have not a location ever plausible with the level of the biomechanical overload, as when carpal tunnel syndromes are signalled during activities in which the shoulder is the only segment eventually interested. Moreover these findings are shown in workers appointed at tasks or actions not clearly identified at risk. For example the spinning activity, that requires the movement of shuttles of modest weight, sometimes on levels above the shoulder line, is organized with cyclical cadences sometimes as repetitive tasks concentrated in a short period, sometimes in longer during the entire shift. Distribution and number of the actions, would however allow a sufficient biomechanical recovery. The identification of the single technical action may result difficult, due to interindividual variability of actions, of their speed and complexity. Furthermore the other possible activities, alternate with specific spinning activities, can require strength or not correct posture even if they may have short duration. In this paper we present and discuss the results of the ergonomic survey for risk assessment of musculoskeletal disorders work-related of the upper limb. These analysis have been carried out in two textile plants, in which some cases of disorders of the upper limb in workers employed in spinning activities have been described by occupational health physicians. In addition to assessment of possible risk for UEWMSDs in spinning activities, we founded the capability of usual methods for ergonomic analysis to adequately examine work situations like spinning, in which the hazardous actions are diluted over the entire shift or concentrate in a short period and in which there is a specific biomechanically overloaded segment i.e. the shoulder. Finally attention was paid to evaluate psychosocial factors which appear to be important when biomechanical factors are low-lying.

Arm↗
PubMed2006

Interfering effects of multitasking on muscle activity in the upper extremity.

Multitasking, where workers are required to perform multiple physical tasks with various levels of cognitive load is common in today's workplace. Simultaneous physical and mental demands are thought to cause task interference and likely increase muscle activity. To test the interfering effects of multitasking, 16 healthy participants performed hand and shoulder exertions with combinations of four grip conditions (no grip, 30% grip with low precision, 30% grip with high precision, and maximal grip) and three shoulder conditions at 90 degrees abduction (maintaining posture, 40% force-controlled moment, 40% posture-controlled moment), with and without the Stroop test while surface EMG was recorded from eight upper extremity muscles. Both 40% MVC shoulder moments increased extrinsic forearm muscle activity by 2-4% MVE (p<0.01). Grip exertion at 30% MVC reduced anterior and middle deltoid activity by 2% MVE (p<0.01). Exerting a constant force against the transducer (force-controlled) required 3-4% MVE greater middle and posterior deltoid activity (p<0.001) compared to supporting an equivalent inertial load at the same shoulder angle (posture-controlled). Performing the mental task (Stroop test) concurrently with either 40% MVC shoulder moments significantly increased trapezius activity by nearly 2% MVE (p<0.05). Interestingly, the Stroop test also reduced all deltoid activity by 1% MVE (p<0.05). The addition of both the Stroop test and force-control shoulder exertion independently reduced maximal grip force by 7% and 10% MVC, respectively. These results suggest that more complex workplace tasks may act to increase muscle load or interfere with task performance. These small but significant findings may play a role in the development of long-term musculoskeletal disorders in the workplace.

Adult↗
PubMed2004

Gas gangrene and necrotizing fasciitis in the upper extremity.

Necrotizing soft tissue infections encompass a wide variety of clinical syndromes resulting from introduction of various pathogens into injured or devitalized tissue. The extent of microbial involvement in such tissue may range from simple contamination to overt and progressive local tissue necrosis, which, if untreated, may lead to septicemia and death. Early differentiation among these infections is not always possible, as there are overlapping classification criteria. These infections exist along a continuum of clinical severity with different etiological agents and associated medical conditions. The often subtle clues heralding the presence of a necrotizing soft tissue infection must be sought so that expeditious surgical debridement and broad-spectrum antibiotic management are initiated. Although experience enables the clinician to make a specific diagnosis based on early findings, aggressive and proper treatment of suspected infections remains the priority. The purpose of the article is to provide an overview of necrotizing soft tissue infections in the upper extremity, focusing on gas gangrene, or clostridial myonecrosis, and necrotizing fasciitis, to facilitate early diagnosis and optimal management of these lethal diseases.

Cellulitis↗