جستجوی مقالات مرتبط با کلیدواژه « Upper limb » در نشریات گروه « پزشکی »

Nowadays, one of the purposes of ergonomics is to identify the risk factors of musculoskeletal disorders and provide solutions to reduce them. The aim of this study was to investigate the effect of using Kinesio tape and doing exercise during working hours for 8 weeks on the reduction of risk and pain and improvement of hand function during daily activities.

This clinical trial study was carried out on 40 female workers employed in the manufacturing industry. The subjects were divided into three groups, including exercise-taping, exercise, and control, and performed an 8-week rehabilitation program twice a week. To assess the upper limb function, the cognitive demand of the assigned task, and hand strength, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Borg Scale, and a dynamometer were used, respectively.

The results of this study indicated a decrease in upper limb disability and increased grip strength in the tape plus exercise group compared to the control group (P<0.05). However, no significant change in the Borg scale was found in any of the three groups (P>0.05).

It can be concluded that attending at least 2 or 3 exercise sessions per week and using Kinesio tape can be effective in reducing pain in the upper limb.

We assessed the effect of change in core isometric strength and endurance on upper limb isometric strength in female athletes.

In this experimental study, 32 female athletes aged 18-25 years were recruited based on the inclusion criteria. (17 cases in the experimental group and 15 cases in the control group). Before and after the core stabilization knockdown protocol, participants were assessed for isometric core strength (abdomen/back rehab 5310; rehab line), core endurance (curl-up test), and upper limb isometric strength (push up/pull down rehab 5120; rehab line). 

The results showed a significant reduction in abdomen, back, push-up, pull-down isometric strength, and curl-up test scores in the experimental group and no significant differences in these parameters in the control group after the protocol. The experimental and control groups showed significant differences in the aforementioned parameters after the protocol.

This research suggests that performing extensive and exclusive core exercises to relieve fatigue prior to upper limb training can decrease the potential for core activation. This can ultimately lead to reduced effectiveness of upper extremity exercises or rehabilitation sessions, which can lead to upper body injuries. These exercises can be useful to enhance the knowledge regarding the sequencing of core and upper limb exercises in an athlete’s training protocols.

Understanding the relationships between exercise and performance tests is crucial for the sports rehabilitation expert.

To comprehensively review functional tests and their reliability for return to sport (RTS) after shoulder injuries.

During this research, a comprehensive review of the functional tests for RTS after shoulder injuries was performed by searching the Web of Science, PEDro, Google Scholar, PubMed, ScienceDirect, SCOPUS, and CINAHL databases with the keywords shoulder RTS, return to play, upper limb and shoulder functional tests from 2000 to June 2021. English was used in this search. After gathering the research results, first, the titles and then the summary of the research papers were studied. If the research papers meet the inclusion and exclusion criteria, their results will be utilized in the study of review otherwise they will be excluded.

When searching the texts, 123 research papers were found, after deleting 11 identical titles, 112 abstracts were chosen for review. After analyzing the abstracts, 79 research papers were removed and 33 research papers were selected for full study. After reviewing the full-text research papers, 21 research papers were removed and 12 research papers were selected from among the research papers that were very closely related to the subject under study. Many functional tests exist, but few have been studied to evaluate the RTS after a shoulder injury. 

Functional tests can assist in estimating when an athlete will RTS or exercise without restrictions. Therefore, according to the results of the current research, functional tests can be an effective tool to assess RTS after shoulder injuries, but due to the limitations and lack of information in this area, further studies are required to be conducted. Therefore, caution should be taken and a general rule should not be drawn for all shoulder injuries.

Anatomy embraces various fields and is regarded as the foundation of medical sciences due to its broad clinical applications, particularly in surgery. However, teaching this subject, particularly in practical units, poses challenges, and insufficient anatomical knowledge and errors in anatomy-related decisions by physicians can lead to avoidable deaths and medical errors. This study aimed to design and develop an electronic moulage (EM) for teaching upper limb anatomy, specifically focusing on the muscles and brachial plexus (BP).

This was a quasi-experimental study with a pre-test-post-test design. Electronic moulage has been implemented in a manner that allows independent structures within a compartment to be taught without the presence of a teacher or anatomical atlases and enables learners to comprehend the anatomical features and relationships of structures in both combined and isolated modes, even without prior knowledge of anatomical theory specific to that compartment. The EM incorporates a skeletal compartment system and a BP component, utilizing audio and visual systems to deliver a comprehensive educational experience. The effectiveness of the EM was evaluated by experts in anatomy and medical science students, comparing it to other teaching methods. Four groups of undergraduate medical radiology students with no prior instruction in upper limb anatomy participated in the study. Each group was assigned to a different training method, including lecture-based education, digital-based education with a simulator, cadaver-based education, and EM-based education.

After assessing the results using educational and motivational indicators, it was determined that the EM demonstrated innovative potential and could enhance motivation and the quality of anatomy education. Comparing the post-test scores of the EM-based education group to the other groups revealed significantly higher scores in the EM-based group. This finding indicates that the EM has the potential to improve the effectiveness and efficiency of anatomy education, addressing the limitations of other teaching methods.

The developed EM presents a promising solution for enhancing anatomy education, particularly in the context of upper limb anatomy. The innovative features of EM and its ability to improve motivation and learning outcomes make it a valuable tool for teaching this subject matter.

In recent years, the increasing popularity of cycling for commuting and leisure has led to acorresponding increase in bicycle-related injuries. However, there is a lack of extensive analysis of bicycle-relatedinjuries to the upper limb in the literature. A retrospective review of all patients with conventional bicycle-related injuries of the upper limb wasperformed. Data on demographics, mechanisms of injury, region of injury, fracture type, management type, andlength of hospital stay were extracted and analyzed. A total of 177 of 733(24%) patients with bicycle-related upper limb injuries were identified. The most commonmechanism of injury was a collision with another vehicle (60%). Frequently affected regions were the shoulder(48%), hand (19%), and wrist (19%). Eighty-eight (50%) patients sustained bony injuries, while the remainder (50%)had isolated soft tissue injuries. Fifty-three (30%) patients required a mean of 3.9 days of hospitalization, whereas13 (25%) patients required high dependency or intensive care unit treatment. Surgical interventions were requiredin 47 (27%) patients. Bicycle-related injuries to the upper limb are common and result in significant morbidity. The mostcommon regions affected are the shoulder, wrist, and hand. Most of the injuries were caused by collisions with othervehicles. A third of affected patients required hospitalization, and a quar ter required surgical intervention.Level of evidence: III

Median Nerve (MN) originated from medial and lateral cords of Brachial Plexus and can be affected by anatomical variations, which may lead to several diagnostic and therapeutic mistakes. This paper aimed to study MN variations investigated by cadaveric studies.

This study is based on research in electronic databases. The full text of all relevant papers has been studied to extend our data.

variation of MN distribution in the palm, variation of MN innervation patterns, communication between MN and (Ulnar Nerve) UN and their branches in the forearm, communication between MN and UN and their components in the palm, variation in the course of MN are main MN variation categories containing several subgroups. However, communication between the third common digital nerve of MN and the fourth common digital nerve of UN is the most common MN variation at the distal of upper limbs.

decompression of MN entrapped in the carpal tunnel can be considered the essential clinical challenge resulting from MN variations, especially variations including the third common digital nerve.

Physical exercise is a promising intervention to improve cognitive function and reduce the risk of dementia and other related neurodegenerative disorders. The present study aimed to investigate the effectiveness of an upper limb-focused physical exercise intervention on cognitive function and daily living activities in older adults. 

Forty older residents of a nursing home participated in this clinical trial and were randomly assigned to the experimental (n=20) or the control (n=20) groups. Participants in the experimental group received a physical exercise intervention for six weeks. This intervention included resistance training of the upper limbs using free weights. Evaluations were performed at baseline and after three and six weeks of the resistance training. Stroop test and Barthel index were used to evaluate cognitive function and daily living activities, respectively.

Upper limb resistance training significantly improved cognitive function in the experimental group, but there was no significant difference between the groups in the ability to perform daily activities.

The present study revealed that resistance training of the upper limb can yield cognitive improvement in older adults. Upper limb strengthening seems to have the potential to improve cognitive performance in the elderly and can be recommended as a regular exercise activity. However, further studies with more comprehensive outcome measures are needed.

COVID-19 infection can cause a wide range of complications, from respiratory infection to skin rashes.

Here, we report a case of a 73-year-old woman with left brachial artery thrombosis 2 weeks after the onset of COVID-19 infection, leading to left upper limb ischemia.

Given the life-changing nature of limb ischemia that can lead to amputation, it is crucial to consider it from the beginning of COVID-19 infection and think of preventive measures in this pandemic.

Although MATLAB is a powerful math program, its virtual reality (VR) toolbox is limited for those who engage in the modelling of human body systems. The integration of Poser software with MATLAB is provided in this study for designing and developing human bodies in VR.

First, a human entire body model was created in the Poser environment. The prototype is then loaded into MATLAB Simulink.

Two-Link Arm powered by Six Muscles (TLASM), a well-known model of human arm movements in the horizontal plane, is simulated to test the efficiency of the virtual model. TLASM was presented in this team's prior work.

Despite the fact that only one limb of the human virtual platform body has been tested, it can easily be applied to other limbs.

Stature and sex estimation according to surface anatomical landmarks is applicable for personal identification in forensic medicine.

The present study aimed to prepare a comprehensive reference of four main upper limb anthropometric dimensions in Iranian adults and make a formula for predicting sex and stature according to them.

In this cross-sectional study, four main anthropometric dimensions of the upper limb, including arm length, forearm length, hand length, and hand width of 280 Iranian adults aged 20 - 24 years, were measured according to surface anatomical landmarks. To determine sex differences, we divided the collected measures into two groups: (1) study (120 males and 120 females); and (2) test (20 males and 20 females) groups. Sexual dimorphism indicator and discriminant functions were conducted on the study group and were validated according to the test group. The relativity of stature with measured dimensions was done by a simple linear regression test in the male and female groups.

All upper limb measurements were potent to determine gender, but forearm length displayed the highest accuracy of 94.2 - 95% and 95 - 100% for the study and test groups, respectively. Regression analysis revealed that arm length had the highest correlation with stature (22.2% for males and 18.41% for females).

We prepared a sex and stature estimation formula based on four upper limb anthropometric dimensions in Iranian adults that can be used in the forensic and clinical fields.

This study assessed the impact of the COVID-19 pandemic on acute upper limb referrals and operative case-mix at the beginning and ease of British lockdown. A longitudinal multicentre observational cohort study was conducted for both upper limb trauma referrals and operative case-mix over a 12-week period (6 weeks from the beginning and 6 weeks from the ease of the national lockdown). Statistical analysis included median (± median absolute deviation), risk and odds ratios, and Fisher’s exact test to calculate the statistical significance, set at p ≤ 0.05. There was a 158% (n = 456 vs. 177) increase in upper limb referrals and 133% (n = 91 vs. 39) increase in the operative trauma caseload at the ease of lockdown compared with its commencement. An increase in sporting injuries was demonstrated (p=0.02), specifically cycling (p=0.004, OR=2.58). A significant increase in COVID-19 testing was demonstrated during the ease of lockdown (p=0.0001) with more patients having their management changed during the early pandemic (9.6% vs. 0.7%, p=0.0001). Of these patients, 47% went on to have delayed surgery within 6 months. No patients who underwent surgery tested positive for COVID-19 infection within 14 days post-operatively and no mortalities were recorded at 30 days. The ease of lockdown has seen upper limb referrals and operations more than double compared to early lockdown. With no patients testing positive for COVID-19 within 14 days of the procedure, this demonstrates that having upper limb surgery during the current pandemic is safe. Level of evidence: III

Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient.

A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases.

Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis.

Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.

The shoulder joint is one of the most commonly injured joints in sports and may lead to disability, especially in the upper extremities of overhead players (handball, volleyball, softball, and swimming).

This research is a causal-comparative study. After the approval of the Ethics Committee of the Medical University of Tehran, this study was conducted on 120 overhead athletes (Mean±SD height: 1.69±0.07 m, Mean±SD weight: 63.54±7.79 kg, Mean±SD age: 21.96±2.94 years, Mean±SD body mass index: 22.11±2.32 kg/m2). The inclusion criteria were elite female players in overhead sports with at least three years of experience in one of these sports (handball, volleyball, softball, and swimming). Samples with a history of surgery or cervical nerve problems, fractures in the shoulder area, and inflammatory joint disease were excluded from the study. The demographic information was obtained through a researcher-made questionnaire, and the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire was used to measure the degree of upper limb disability in daily activities.

In comparison between the study groups, a significant difference was observed between the dependent variable (DASH) and the research groups (F=6.067, df=3, P=0.002, Eta=0.342). Using the Bonferroni post hoc tests, the difference between volleyball and softball (P=0.44), volleyball and swimming (P=0.009), and handball and swimming players (P=0.022) were reported. In the next step, BMI characteristics, weekly training hours, and the number of training sessions per week were entered into the data analysis process as covariate variables (F=8.099, df=0.3, P=0.000, Eta=0.432). The Bonferroni post hoc test indicates the difference between volleyball and swimming athletes (P=0.001) and handball and swimming (P=0.002).

The present study results indicate a high rate of upper limb disability in elite women athletes. The present study results showed no difference between volleyball and handball due to the nature of these two disciplines and handball, softball, and swimming.

The central nervous system (CNS) is optimizing arm movements to reduce some kind of cost function. Simulating parts of the nervous system is one way of obtaining accurate information about the neurological and treatment of neuromuscular diseases. The main purpose of this paper is to model and control the human arm in a reaching movement based on reinforcement learning theory (RL).

First, Zajac’s muscle model is improved by a fuzzy system. Second, the proposed muscle model applied to the six muscles which are responsible for a two-link arm that move in the horizontal plane. Third, the model parameters are approximated based on genetic algorithm (GA). Experimental data recorded from normal subjects for assessing the approach. At last, reinforcement learning algorithm is utilized to guide the arm for reaching task.

The results show that: 1) The proposed system is temporally similar to a real arm movement.  2) The reinforcement learning algorithm has the ability to generate the motor commands which are obtained from EMGs. 3) The similarity of obtained activation function from the system is compared with the real data activation function which may prove the possibility of reinforcement learning in the central nervous system (Basal Ganglia). Finally, in order to have a graphical and effective representation of the arm model, virtual reality environment of MATLAB has been used.

  Since reinforcement learning method is a representative of the brain's control function, it has some features, such as better settling time, not having any peek overshoot and robustness.