Database : MEDLINE
Search on : Upper and Extremity [Words]
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[PMID]: 29524797
[Au] Autor:Peeters LHC; de Groot IJM; Geurts ACH
[Ad] Address:Radboud University Medical Center, Donders Centre for Neuroscience, Department of Rehabilitation, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: laura.hc.peeters@radboudumc.nl.
[Ti] Title:Trunk involvement in performing upper extremity activities while seated in neurological patients with a flaccid trunk - A review.
[So] Source:Gait Posture;62:46-55, 2018 Mar 06.
[Is] ISSN:1879-2219
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Trunk control is essential during seated activities. The trunk interacts with the upper extremities (UE) and head by being part of a kinematic chain and by providing a stable basis. When trunk control becomes impaired, it may have consequences for the execution of UE tasks. AIM: To review trunk involvement in body movement and stability when performing seated activities and its relation with UE and head movements in neurological patients with a flaccid trunk, with a focus on childhood and development with age. METHODS AND PROCEDURES: A search using PubMed was conducted and 32 out of 188 potentially eligible articles were included. OUTCOMES AND RESULTS: Patients with a flaccid trunk (e.g. with spinal cord injury or cerebral palsy) tend to involve the trunk earlier while reaching than healthy persons. Different balance strategies are observed in different types of patients, like using the contralateral arm as counterweight, eliminating degrees of freedom, or reducing movement speed. CONCLUSIONS AND IMPLICATIONS: The key role of the trunk in performing activities should be kept in mind when developing interventions to improve seated task performance in neurological patients with a flaccid trunk.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 37150 MEDLINE  
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[PMID]: 29476978
[Au] Autor:Barbe MF; Massicotte VS; Assari S; Monroy MA; Frara N; Harris MY; Amin M; King T; Cruz GE; Popoff SN
[Ad] Address:Lewis Katz School of Medicine at Temple University, Department of Anatomy and Cell Biology, Philadelphia, PA 19140, United States. Electronic address: mary.barbe@temple.edu.
[Ti] Title:Prolonged high force high repetition pulling induces osteocyte apoptosis and trabecular bone loss in distal radius, while low force high repetition pulling induces bone anabolism.
[So] Source:Bone;110:267-283, 2018 Feb 22.
[Is] ISSN:1873-2763
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We have an operant rat model of upper extremity reaching and grasping in which we examined the impact of performing a high force high repetition (High-ForceHR) versus a low force low repetition (Low-ForceHR) task for 18weeks on the radius and ulna, compared to age-matched controls. High-ForceHR rats performed at 4 reaches/min and 50% of their maximum voluntary pulling force for 2h/day, 3days/week. Low-ForceHR rats performed at 6% maximum voluntary pulling force. High-ForceHR rats showed decreased trabecular bone volume in the distal metaphyseal radius, decreased anabolic indices in this same bone region (e.g., decreased osteoblasts and bone formation rate), and increased catabolic indices (e.g., microcracks, increased osteocyte apoptosis, secreted sclerostin, RANKL, and osteoclast numbers), compared to controls. Distal metaphyseal trabeculae in the ulna of High-ForceHR rats showed a non-significant decrease in bone volume, some catabolic indices (e.g., decreased trabecular numbers) yet also some anabolic indices (e.g., increased osteoblasts and trabecular thickness). In contrast, the mid-diaphyseal region of High-ForceHR rats' radial and ulnar bones showed few to no microarchitecture differences and no changes in apoptosis, sclerostin or RANKL levels, compared to controls. In further contrast, Low-ForceHR rats showed increased trabecular bone volume in the radius in the distal metaphysis and increased cortical bone area its mid-diaphysis. These changes were accompanied by increased anabolic indices, no microcracks or osteocyte apoptosis, and decreased RANKL in each region, compared to controls. Ulnar bones of Low-ForceHR rats also showed increased anabolic indices, although fewer than in the adjacent radius. Thus, prolonged performance of an upper extremity reaching and grasping task is loading-, region-, and bone-dependent, with high force loads at high repetition rates inducing region-specific increases in bone degradative changes that were most prominent in distal radial trabeculae, while low force task loads at high repetition rates induced adaptive bone responses.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 37150 MEDLINE  
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[PMID]: 29378284
[Au] Autor:Shaw EP; Rietschel JC; Hendershot BD; Pruziner AL; Miller MW; Hatfield BD; Gentili RJ
[Ad] Address:Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA; Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.
[Ti] Title:Measurement of attentional reserve and mental effort for cognitive workload assessment under various task demands during dual-task walking.
[So] Source:Biol Psychol;134:39-51, 2018 Jan 31.
[Is] ISSN:1873-6246
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Previous work focused on cognitive workload assessment suggests EEG spectral content and component amplitudes of the event-related potential (ERP) waveform may index mental effort and attentional reserve, respectively. Although few studies have assessed attentional reserve and mental effort during upper-extremity performance, none have employed a combined approach to measure cognitive workload during locomotion. Therefore, by systematically considering ERPs, spectral content and importantly their combination, this study aimed to examine whether concurrent changes in spectral content and ERPs could collectively serve as an index of cognitive workload during locomotion. Specifically, ERP and EEG biomarkers were assessed as participants performed a cognitive task under two levels of difficulty (easy or hard) and two conditions (seated or walking). Changes in attentional reserve and mental effort appeared to collectively index cognitive workload under varying demands due to changes in task difficulty or performance conditions. This work can inform cognitive workload assessment in patient populations with gait deficiencies for future applications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  4 / 37150 MEDLINE  
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[PMID]: 29523349
[Au] Autor:Whittaker RL; Park W; Dickerson CR
[Ad] Address:Department of Kinesiology, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada.
[Ti] Title:Application of a symbolic motion structure representation algorithm to identify upper extremity kinematic changes during a repetitive task.
[So] Source:J Biomech;, 2018 Feb 24.
[Is] ISSN:1873-2380
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Efficient and holistic identification of fatigue-induced movement strategies can be limited by large between-subject variability in descriptors of joint angle data. One promising alternative to traditional, or computationally intensive methods is the symbolic motion structure representation algorithm (SMSR), which identifies the basic spatial-temporal structure of joint angle data using string descriptors of temporal joint angle trajectories. This study attempted to use the SMSR to identify changes in upper extremity time series joint angle data during a repetitive goal directed task causing muscle fatigue. Twenty-eight participants (15 M, 13 F) performed a seated repetitive task until fatigued. Upper extremity joint angles were extracted from motion capture for representative task cycles. SMSRs, averages and ranges of several joint angles were compared at the start and end of the repetitive task to identify kinematic changes with fatigue. At the group level, significant increases in the range of all joint angle data existed with large between-subject variability that posed a challenge to the interpretation of these fatigue-related changes. However, changes in the SMSRs across participants effectively summarized the adoption of adaptive movement strategies. This establishes SMSR as a viable, logical, and sensitive method of fatigue identification via kinematic changes, with novel application and pragmatism for visual assessment of fatigue development.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  5 / 37150 MEDLINE  
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[PMID]: 29522873
[Au] Autor:Mahmoud O; Vikatmaa P; Räsänen J; Peltola E; Sihvo E; Vikatmaa L; Lappalainen K; Venermo M
[Ad] Address:Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland; Department of Vascular Surgery, Assiut University Hospital, Faculty of Medicine, Assiut University, Egypt.
[Ti] Title:Catheter-Directed Thrombolysis vs. Pharmacomechanical Thrombectomy for Upper Extremity Deep Venous Thrombosis: Cost-Effectiveness Analysis.
[So] Source:Ann Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: We compared the immediate and one-year results as well as total hospital costs between catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of symptomatic upper extremity deep venous thrombosis (UEDVT). MATERIAL AND METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital. Of them, 43 underwent thoracoscopic rib resection later in order to relieve phlebography-confirmed vein compression. This patient cohort was prospectively followed up with repeated phlebographies. CDT was performed to 24 patients and 19 had PMT with a Trellis™ device. Clinical evaluation and vein patency assessment were performed with either phlebography or ultrasound one year after the thrombolysis. Primary outcomes were immediate technical success, one-year vein patency, and costs of the initial treatment. RESULTS: The immediate overall technical success rate, defined as recanalization of the occluded vein and removal of the fresh thrombus, was 91.7% in the CDT group, and 100% in the PMT group (n.s.). The median thrombolytic time was significantly longer in CDT patients than PMT patients (21.1 hours vs. 0.33 hours, P<0.00001). There were no procedure-related complications. The one-year primary assisted patency rate was similar in both groups (91.7% and 94.7%, respectively). There were no recurrences of clinical DVT. The hospital costs for the acute period were significantly lower in the PMT group than the CDT group (medians 11,476 € and 5,975 € in the in the CDT and PMT group, respectively (P<0.00001)). CONCLUSIONS: The clinical results of the treatment of UEDVT with CDT or PMT were similar. However, PMT required shorter hospital stay and less intensive surveillance, leading to lower total costs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 37150 MEDLINE  
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[PMID]: 29522781
[Au] Autor:Feldman SJ; Boyd LA; Neva JL; Peters S; Hayward KS
[Ad] Address:Graduate Program in Neuroscience, Faculty of Medicine, University of British Columbia, Vancouver BC, V6T 1Z3, Canada.
[Ti] Title:Extraction of corticospinal tract microstructural properties in chronic stroke.
[So] Source:J Neurosci Methods;, 2018 Mar 06.
[Is] ISSN:1872-678X
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Information about the structural integrity of the corticospinal tract (CST) from diffusion-weighted imaging can improve our ability to understand motor outcomes in people with upper limb impairment after stroke, especially those with severe impairment. Yet, there is no consensus on which method of CST generation most accurately represents function and impairment in individuals with chronic stroke. NEW METHOD: The aim of the study was to compare different methods of CST reconstruction and resulting microstructural properties, as well as the relationship between these properties and motor function and impairment. Fifteen individuals with mild-moderate impairment and 15 with severe impairment who were in the chronic phase post-stroke underwent a diffusion-weighted imaging scan and motor function and impairment assessments. RESULTS: Different relationships existed between reconstruction methods, microstructural properties, and impairment and function. In severe stroke, fractional anisotropy (FA) emerged over and above apparent diffusion coefficient (ADC) and tract number to index CST integrity; FA correlated with impairment and function, whereas ADC and tract number did not correlate. No significant differences between methods or microstructural properties were found in mild-moderate stroke. COMPARISON WITH EXISTING METHODS: Our study demonstrates that CST reconstruction method influences the extraction of microstructural integrity in individuals with chronic severe stroke, with FA appearing to be the most representative method. A similar line of investigation is warranted earlier post-stroke. CONCLUSION: Differences in this data set highlight the need to establish a common methodology for CST reconstruction and analysis which may eliminate discrepancies in interpreting DWI and enhance biomarker use post-stroke for motor function.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  7 / 37150 MEDLINE  
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[PMID]: 29522405
[Au] Autor:Xu K; Liu H; Zhang Z; Zhu X
[Ti] Title:Wrist-Powered Partial Hand Prosthesis Using a Continuum Whiffle Tree Mechanism: A Case Study.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;26(3):609-618, 2018 Mar.
[Is] ISSN:1558-0210
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Among the advances in upper extremity prostheses in the past decades, only a small portion of the results were obtained for partial hand prostheses, possibly due to the highly diverse partial hand presentations and limited space for component integration. In an attempt to address these challenges, this paper presents the design, construction, installation, and experimental characterization of a wrist-powered partial hand prosthesis developed in Shanghai Jiao Tong University (hereafter referred to as the JTP hand), customized for a specific amputee. The JTP hand possesses: 1) a continuum whiffle tree mechanism to allow adaptive grasping; 2) a force-magnifying partial gear pair to enhance the power of the grip; and 3) a phalange-embedded disengageable ratchet to enable or disable backdrivability. Various grasps and gestures were formed using the JTP hand. The obtained results suggest that the proposed design might be a viable option for patients with transmetacarpal amputation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1109/TNSRE.2018.2800162

  8 / 37150 MEDLINE  
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[PMID]: 29522355
[Au] Autor:Kruse NT; Ueda K; Hughes WE; Casey DP
[Ad] Address:Department of Physical Therapy and Rehabilitation Science, University of Iowa, United States.
[Ti] Title:Eight weeks of nitrate supplementation improves blood flow and reduces the exaggerated pressor response during forearm exercise in peripheral arterial disease.
[So] Source:Am J Physiol Heart Circ Physiol;, 2018 Mar 09.
[Is] ISSN:1522-1539
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Peripheral arterial disease (PAD) is characterized by a reduced blood flow (BF) and elevated blood pressure (pressor) response during lower extremity exercise. Although PAD is evident in the upper extremities no studies have determined BF and pressor responses during upper extremity exercise in PAD. Emerging evidence suggests that inorganic nitrate (NO ) supplementation may serve as an alternative dietary strategy to boost nitric oxide bioavailability, improving exercising BF and pressor responses during exercise. The present study investigated 1) BF and pressor responses to forearm exercise in PAD (n=21) relative to healthy age-matched controls (n=16) and 2) whether eight weeks of sodium NO (NaNO ) supplementation influenced the BF and pressor responses to forearm exercise in PAD. Moderate-to-severe PAD patients were randomly assigned to NaNO (1g/day; n=13) or placebo (microcrystalline cellulose; n=8) groups. Brachial artery forearm BF (FBF; via Doppler) and blood pressure (via finger plethysmography) were measured during hand-gripping exercise at a mild (~3.5kg) and moderate (~7kg) intensity exercise. The absolute change (Δ from baseline) in FBF was reduced (except 3.5kg condition) and BP responses increased in PAD versus healthy controls in both 3.5kg and 7kg conditions (all P<0.05). Eight weeks of NaNO supplementation elevated plasma nitrate and nitrite, and improved exercising (7kg) ΔFBF (141{plus minus}17 to 172{plus minus}20 mL/min) and reduced the Δ mean arterial pressure response (13{plus minus}1 to 9{plus minus}1 mmHg) (P<0.05) in PAD relative to placebo. These results suggest that the BF limitation and exaggerated pressor response to moderate intensity forearm exercise in PAD is improved with eight weeks of NaNO supplementation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1152/ajpheart.00015.2018

  9 / 37150 MEDLINE  
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[PMID]: 29521686
[Au] Autor:Teo T; Schaeffer E; Cooper A; Mulpuri K
[Ad] Address:Department of Orthopaedic Surgery, British Columbia Children's Hospital.
[Ti] Title:Do immediate postoperative radiographs change patient management after fracture fixation? A systematic review.
[So] Source:J Orthop Trauma;, 2018 Feb 20.
[Is] ISSN:1531-2291
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To evaluate whether immediate (0-3 day) postoperative radiography leads to alterations in management for patients post-fracture fixation. DATA SOURCES: Systematic review of English-language articles in the MEDLINE (1946-2016), EMBASE (1974-2016), CDSR (2005-2016), CENTRAL (1948-2016) and Google Scholar databases using PRISMA guidelines. STUDY SELECTION: Randomized or non-randomized controlled trials and prospective or retrospective cohort studies that addressed surgical management of upper extremity, lower extremity or hip fractures were eligible for review. All included studies needed to have performed radiography within 0-3 days of surgery and reported any directly resulting management changes. DATA EXTRACTION: Data were independently extracted by two reviewers using a standardized data collection form with predefined data fields for demographics, interventions, study methods, complications and management outcomes. DATA SYNTHESIS: A random-effects model was applied and pooled effects for absolute benefit increase (ABI) and number needed to treat (NNT) were calculated. CONCLUSIONS: Combining the 11/12 articles that reported by patient numbers, the absolute benefit increase (ABI) of immediate postoperative radiography for management change was 0.13% (95% CI: 0.00078-0.60%; NNT = 753). The ABI for identification of complications was 0.22% (95% CI: 0.0015-1.24%; NNT = 453). Current literature suggests that immediate postoperative radiography does not lead to management change in the majority of patients post-fracture fixation. More comprehensive reporting, along with further prospective comparative research, is encouraged. LEVEL OF EVIDENCE: Diagnostic Level III.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/BOT.0000000000001152

  10 / 37150 MEDLINE  
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[PMID]: 29518219
[Au] Autor:Oushy S; Carlstrom LP; Krauss WE
[Ad] Address:Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
[Ti] Title:Spontaneous Regression of a Retroodontoid Transverse Ligament Cyst: A Case Report.
[So] Source:Neurosurgery;, 2018 Mar 05.
[Is] ISSN:1524-4040
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness. Magnetic resonance imaging (MRI) demonstrated a well-circumscribed 5.8 mm cystic mass at the atlantoaxial junction, posterior to the odontoid process, most consistent with a TLC. She presented to our institution 1 yr later with symptoms of progressive occipital neuralgia seeking surgical treatment. No evidence of cervical myelopathy was identified on clinical examination. Repeat MRI showed near doubling of the cyst, with no brainstem edema. The patient elected for surveillance of the cyst with a transforaminal steroid injection at C1-C2 for her occipital neuralgia. One year later, symptoms of occipital neuralgia had resolved and she remained neurologically intact; MRI of the cervical spine showed near complete involution of the cyst. CONCLUSION: Symptomatic TLCs are often managed with surgical decompression and, in selected cases, fusion with good functional outcome. However, these interventions carry high risk of postoperative morbidity, particularly in the elderly. Conservative surveillance is rarely reported as a viable option. We present the first case of spontaneous TLC regression in the absence surgery or neck bracing. In select patients without acute myelopathy, clinical and radiographic surveillance may be considered for the management of TLCs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/neuros/nyy036


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