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At least 1,261 records · Page 70Linked to original sources
PubMed1992

Influences of a hand positioning device on upper-extremity control of children with cerebral palsy.

The aim of this study was to investigate the effects of a hand positioning device on aspects of upper-extremity movement control and muscular activity during a reaching task, and on visual-motor performance in a group of ten children with cerebral palsy. A three-dimensional (3D) motion analysis tracking system was used to monitor hand movement. The 3D path length, movement latency, movement time, average velocity, and the number of accelerations and decelerations (movement units) were measured. Muscle onset latencies of the anterior deltoid, triceps, brachioradialis, extensor carpi radialis, and flexor carpi ulnaris muscles were recorded by electromyography (EMG). A pencil-paper test specifically designed for this study was used to evaluate visual-motor function. Each subject was tested under two conditions (device on and device off). No significant results were found by comparing any parameter between conditions for all subjects combined, however, individual subject data revealed a trend towards an increased number of movement units, slower movement times, and decreased average velocity during the 'on' condition as compared to the 'off' condition. The average onset latencies for the EMG activity of the arm muscles showed differences between the on and off conditions, showing a more normalized muscle activation pattern for the 'on' condition. Furthermore, individual data inspection showed improved performance in the test of visual-motor function during the 'on' as compared to 'off' condition for most subjects. The potential clinical impact of the use of the device for some children with cerebral palsy, as well as directions for future research, are discussed.

Arm↗
PubMed1991

Upper-extremity musculoskeletal disorders of occupational origin.

Sufficient evidence is available at this time to conclude that several well-defined soft-tissue disorders of the upper extremities are etiologically related to occupational factors. These disorders include tendinitis of the hand and wrist, CTS, and hand-arm vibration syndrome. Force, repetition, and vibration have been established as risk factors in the etiology of these disorders. Evidence exists that other, poorly understood factors also may contribute to etiology. At this time no firm guidelines can be established regarding maximum no-effect exposure levels. We agree, however, with Armstrong (3): "Although there are no standards for excessively repetitive or forceful work, common sense dictates that these tasks be minimized to the extent possible." Tool and job redesign may be required in many situations to accomplish these goals. In addition to appropriate reductions in risk factors, medical surveillance is required and will allow greater appreciation of the extent of this growing problem, as well as ongoing assessment of the efficacy of preventive intervention.

Arm↗
PubMedDate not supplied

Occupation-related vascular disorders of the upper extremity--two case reports.

Hypothenar hammer (HH) syndrome and vibration-induced white finger (VWF) syndrome are the main occupation-related vascular diseases of the upper extremity. The clinical presentation is similar to that of Raynaud's phenomenon. The characteristic history will lead to the appropriate diagnosis being confirmed by angiographic features in HH and by functional tests in VWF. While in HH the underlying cause, which is mostly thought to be an aneurysm of the ulnar artery, might be cured surgically, in VWF only medical treatment offers relief from the symptoms. The knowledge of these entities is necessary to suspect such disorders so that further exposure to risk factors like repetitive hypothenar trauma or work with vibrating hand-held tools can be avoided, which is of great importance for the overall prognosis of these patients.

Adult↗
PubMed1986

The free scapular flap. An alternative to conventional flaps on the upper extremity.

The free scapular flap was used as an alternative to a conventional pedicle flap in resurfacing scarred areas and padding major nerve trunks on the upper extremities in a series of 8 patients. The free flap proved to be rather reliable (one failure), convenient to the patients and cheaper for the Health Service than a conventional flap.

Adult↗
PubMed1975

[Results of thoracoscopic sympathectomy in hyperhidrosis of the upper extremities (author's transl)].

Thoracoscopic sympathectomy bei Kux's method was undertaken on 256 occasions for the treatment of 168 patients suffering from hyperhidrosis of the upper extremities. There were no operative fatalities. Thoracotomy was required in only 2 cases, the indication being intraoperative bleeding. 2 further patients developed a tension pneumothorax postoperatively necessitating drainage. The operation was successful in all but 2 cases. Division of the sympathetic chain between T1 and T2 suffices to achieve dryness of the hands; if underarm perspiration is to equally influenced then division of the sympathetic trunk must be extended caudally to the level of T5. On follow-up examination of 104 patients 2 and 10 years after the operation, a successful result was noted in 94% of cases. Unwanted side effects were vicarious and gustatory perspiration, which arose in 39% and 56% of cases respectively, but did not affect the successful outcome of the operation.

Adult↗
PubMed1976

The upper-extremity amputee. Early and immediate post-surgical prosthetic fitting.

The results of immediate and early post-surgical prosthetic fitting in eighty-seven upper-extremity amputees as well as the results in nine patients with shoulder dislocation who were fitted with temporary devices were reviewed. No local wound complications occurred and the rate of prosthetic acceptance was high. A practice prosthesis, with a filler insert formed from liquid Silastic foam allowed to set between the walls of the practice prosthesis and the amputation stump, was used extensively in this series. With the Silastic insert and practice prosthesis, prosthetic training could be instituted during healing of the amputation wounds, proximal wounds, or fractures.

Amputation, Surgical↗
PubMed1992

[Pathogenesis of juvenile muscular atrophy of unilateral upper extremity in reference to venous congestion of epidural space].

MRI and dynamic CT studies were performed in a young male with juvenile muscular atrophy of unilateral upper extremity (JM) with onset at age 15 and clinical course of 2 years. The mechanism of development of congestion in vertebral venous plexus was considered. Dynamic CT of the head in the neck flexion showed rapid reflux of blood from the intervertebral veins into the posterior internal vertebral venous plexus at the C5-C6 level and consequent congestion. It is speculated that in this patient some mechanism associated with head anteflexion led to a reflux into the valveless posterior internal vertebral venous plexus and congestion as well. Furthermore, it could be considered that anterior shift of the dural sac at the time of head anteflexion plays an important role in the development of this internal vertebral venous plexus congestion in JM.

Adolescent↗
PubMed1987

Compression neuropathies in the upper extremity.

Electrodiagnostic studies, including electromyography (EMG) and nerve conduction velocity testing (NCV), can be either useful or misleading in the diagnosis of compression neuropathies in the upper extremity. The author contends it depends on whether the clinician knows how to employ these diagnostic techniques in a group of disorders with varying exact etiologies. Making a decision between nonoperative care and surgical release in the management of these patients is also discussed.

Arm↗
PubMed1987

Traumatic segmental bone defects in the upper extremity. Treatment with exposed grafts of corticocancellous bone.

We treated twenty-two consecutive patients for an open fracture and segmental loss of bone in the upper extremity by delayed insertion of a graft of iliac corticocancellous bone. All of the wounds were left open and healed by secondary intention. Sixteen patients (nineteen grafts) had long-term follow-up. Ten injuries were secondary to a gunshot wound. The ten patients (twelve grafts) who had an injury to the hand were followed for an average of 24.1 months. No patient in this group had an infection, and all had primary union after an average of 13.3 weeks. Nine had a satisfactory result. The other six patients (seven grafts) had an injury to the arm or forearm and were followed for an average of 30.2 months. There were four non-unions, one refracture, and no persistent infections. The final result was satisfactory in five and unsatisfactory in one patient. Fourteen of the nineteen grafts were inserted within seventeen days after the initial injury. All nine of the grafts in the hand that were inserted early did well, but three of the other five (in the arm or forearm) became infected. The method that was used in the patients who had an open injury of the hand allowed early active motion and quick rehabilitation. The exposed cortical bone was not prone to infection. The technique has limited application in patients who have an open injury of the arm or forearm because of a high incidence of complications.

Adult↗
PubMedDate not supplied

Lack of serum neutralizing antibody against poliovirus in patients with juvenile distal spinal muscular atrophy of upper extremities.

Serum neutralizing antibodies for type 1, 2 and 3 poliovirus were studied in 15 Chinese patients in Taiwan with juvenile distal spinal muscular atrophy of the upper extremities and 15 age-matched normal subjects. Significantly lower serum antibody titers were found in the study group, suggesting that patients with this chronic focal form of acquired motor neuron disease are, to some degree, immunologically unresponsive to the neutralizing epitope of poliovirus.

Adolescent↗
PubMed1985

Primary malignant tumors of the upper extremity: retrospective analysis of one hundred twenty-six cases.

We retrospectively evaluated 126 patients with primary sarcomas of bone (45) and soft tissue (61) in the upper extremity principally to evaluate the effectiveness of the Musculoskeletal Tumor Society staging system in predicting treatment outcome and to note differences between bone and soft tissue sarcomas. Patients were followed 2 to 11 years from diagnosis. The mean survival from treatment onset was 49 months (4 to 144 months). A strong statistical relationship (p less than 0.05) between anatomic location (above/below elbow) and surgical stage (stage I/II, A/B) was demonstrated. The type of primary operation and subsequent incidence in local tumor recurrence were found to be statistically different. Seventy percent of soft tissue tumors that metastasized first recurred locally, but such a strong association was not evident for bone. Development of metastases significantly shortened survival. Radical primary excision of soft tissue malignancies sharply reduced local recurrence and thereby diminished metastatic risk; similar findings were not present for bone malignancies. This study suggests that the Musculoskeletal Tumor Society staging system is valid and should be applied to these infrequent malignancies, permitting future statistical comparisons.

Adolescent↗
PubMed2001

[The Freehand System: an implantable neuroprosthesis for functional electrostimulation of the upper extremity].

We report on the first experience with the Freehand system in German-speaking countries, an implantable neuroprosthesis developed for the functional electrical stimulation of the upper extremity. Indications for its use are neurological deficits of the cervical spinal cord with active mobility of the shoulder and elbow flexion in tetraplegics, ideally in C5/6 tetraplegics. A further precondition for the implantation of this system is an intact reflex arc of the muscles that are to be stimulated, i.e. of the forearm and hand. Central defects such as hemiparesis, cerebral palsies or athetoid disorders or peripheral nerve palsies (e.g. brachial plexus lesions) are no good indications for the implantation of the Freehand system. We report on patient selection criteria, preoperative percutaneous electrical stimulation, the surgical procedure itself with optional active tendon transpositions, the intensive postoperative rehabilitation program until the patient is able to use the system independently and the life-long after-care.

Arm↗
PubMed1996

Multiple new-onset subcutaneous nodules of the upper extremity digits: giant cell tumor of tendon sheath and lipoma.

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's "razor" suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.

Adult↗
PubMedDate not supplied

Upper extremity range of motion and isokinetic strength of the internal and external shoulder rotators in major league baseball players.

Forty-one professional baseball players volunteered for upper extremity range of motion measurements and isokinetic testing for internal and external shoulder rotation. Pitchers demonstrated 9 degrees more external shoulder rotation with the arm abducted, 5 degrees more forearm pronation, and 9 degrees less shoulder extension on the dominant side compared with the dominant side of position players. Pitchers also demonstrated 9 degrees more external rotation in abduction, 5 degrees less shoulder flexion, 11 degrees less horizontal extension, 15 degrees less internal rotation in abduction, 6 degrees less elbow extension, 4 degrees less elbow flexion, and 5 degrees less forearm supination on the dominant side compared with their nondominant side. Position players demonstrated 8 degrees more external rotation in abduction, 14 degrees less horizontal extension, and 8 degrees less elbow extension on the dominant side compared with their nondominant side. Greater torque was produced by pitchers compared with position players for the dominant and nondominant arm at all test speeds for both mean peak and mean average torque. Greater torque was produced by the dominant arm compared with the nondominant arm also at all test speeds for both of these measurements. No difference was found between the rotation ratios for either arm, for either group, for all speeds.

Adaptation, Physiological↗
PubMed1987

Retraining of functional gait through the reduction of upper extremity weight-bearing in chronic cerebellar ataxia.

Patients with chronic ataxia resulting from traumatic central nervous system (CNS) damage frequently attain a gait pattern dependent upon upper extremity weight-bearing (UEWB). Traditional attempts to train these patients may perpetuate UEWB dependency, by not allowing optimal facilitation of balance and associated movement control required for independent ambulation. In the present study an ambulation retraining approach designed to facilitate coordination and balance while minimizing UEWB was used. This approach can allow the patient to train outside of the clinic; only about 5% of the actual therapy hours involved a therapist.

Adult↗
PubMed1990

Malignant tumors of the upper extremity in children.

Of the 422 primary malignant tumors of bone and soft tissue treated at one institution between 1968 and 1988, the 29 found in the upper extremity in children are reviewed. In the latter group, there were 13 patients with osteosarcoma; one was lost to follow-up shortly after diagnosis, one was alive and disease free four years after surgery, two are currently being followed, and nine are dead. All of the four patients with Ewing's sarcoma died. Three patients had chondrosarcoma; one was lost to follow-up after surgery, and the other two were disease free at four and 14 years' follow-up. Two of the nine patients with soft-tissue sarcomas died as a result of their tumors.

Adolescent↗