Arm Support Research Articles

To Solve Mechanical Working Space by Applying Graphic Integration in ADAMS

This paper mainly focuses on applying graphical method to figure out the working space of the new five joint folding arm supported pumper based on ADAMS. Firstly, discrete the included angle α between the third and the forth arm support, pick out several special points, work out the changing curve of the included angle β in the region of [0,180°] between the forth and the fifth arm support, and then get the plane track of the motion of spray gun by superposition of those curves and finally take the effect of turn angles of rotary tables into consideration, figure out the three-dimensional working space track of the spray gun by the superposition of plane track curves in the region of [0,360°].

Changes in muscle activation after reach training with gravity compensation in chronic stroke patients

The objective of this study is to examine the effect of gravity compensation training on reaching and underlying changes in muscle activation. In this clinical trial, eight chronic stroke patients with limited arm function received 18 sessions (30 min) of gravity-compensated reach training (during 6 weeks) in combination with a rehabilitation game. Before and after training, unsupported reach (assessing maximal distance, joint angles and muscle activity of eight shoulder and elbow muscles) and the Fugl-Meyer assessment were compared. After training, the maximal reach distance improved significantly by 3.5% of arm length, together with increased elbow extension (+9.2°) and increased elbow extensor activity (+68%). In some patients, a reduced cocontraction of biceps and anterior deltoid was also involved, although this was not significant on group level. Improvements in unsupported reach after gravity compensation training in chronic stroke patients with mild to severe hemiparesis were mainly accompanied by increased activation of prime movers at the elbow, although in some patients, improved selective joint control may also have been involved. Gravity compensation seems to be a suitable way to provide active, task-specific treatment, without the need for high-tech devices. Further research on a larger scale, including control groups and combinations of arm support with functional hand training, is essential to enhance the potential of arm support to complement poststroke arm rehabilitation.

S.P.14 Exploring arm function in persons with LGMD by means of questionnaires

Abstract Limb-Girdle Muscular Dystrophies (LGMD) mainly involve the pelvic and/or shoulder girdle muscles. One of the major problems is limitations in performing daily activities. The natural course of the disease has been described before, and research is done to investigate functional ability of walking. However, little is known about functional abilities of the arms, which is even more important in performing many daily activities. Clear understanding is essential to improve rehabilitation therapies and for development of new arm supports. The aim of this study is to investigate arm function of people with LGMD on activity level, by using questionnaires. A web-based questionnaire to assess arm function was developed. We used questions from the Brooke scale (grading scale, 1–6), the Capabilities of Upper Extremity questionnaire (CUE) (basic arm functions, 30 items, max score 210, higher score means better function) and Abilhand questionnaire (22 ADL items, max score 44, higher score means lower function). Also questions about disease duration, age, gender were asked. The Dutch patient organization (VSN) distributed the questionnaire. Fifty-one people (age 6–72 y) participated in the period August 2011 till February 2012. Preliminary results show that in this group, 33% has Brooke scale 1 and 51% Brooke 2–4. The CUE total median score was 159 (range 60–210), corresponding with 75.7% of the maximum score. The total Abilhand median score was 39 (range 8–44) corresponding with a 88.6% of the maximum score. Especially activities above shoulder level are problematic. Patterns of limitations in arm function are further analyzed as are correlations with disease course, age, and gender. The project McArm is a national Dutch ‘Pieken in de Delta’ project. It is partially funded by: Agentschap.nl, an agency of the Dutch Ministry of Economic Affairs, Agriculture and Innovation, the Province of Noord Brabant and the Province of Limburg.

S.P.13 Exploring arm function in FSHD by means of questionnaires

<h2>Abstract</h2> Facioscapulohumeral muscular dystrophy (FSHD) is a progressive muscular dystrophy. One of the major problems is limitations in performing daily activities. The natural course of the disease has been described before, and research is done to investigate functional ability of walking. However, little is known about functional abilities of the arms, which are even more important in performing many daily activities. Clear understanding is essential to improve rehabilitation therapies and for development of new arm supports. The aim of this study is to investigate arm function of people with FSHD on activity level, by using questionnaires. A web-based questionnaire to assess arm function was developed. We used questions from the Brooke scale (grading scale, 1–6), the Capabilities of Upper Extremity questionnaire (CUE) (basic arm functions, 30 items, max score 210, higher score means better function) and Abilhand questionnaire (22 ADL items, max score 44, higher score meaning lower function). Also questions about disease duration, age, gender were asked. The Dutch patient organization (VSN) supported with distribution of the questionnaire. Seventy-six people participated (age 13–74y) in the period August 2011 till February 2012. Preliminary results show that from this group, 88% have Brooke 2–4. The CUE total median score was 155 (range 53–210), corresponding with 73.8% of the maximum score. The total Abilhand median score was 38 (range 13–44) corresponding with a 86.4% of the maximum score. Especially activities above shoulder level are problematic. Patterns of limitations in arm function are further analyzed as are correlations with disease course, age, and gender. The project McArm is a national Dutch ‘Pieken in de Delta' project. It is partially funded by: Agentschap.nl, an agency of the Dutch Ministry of Economic Affairs, Agriculture and Innovation, the Province of Noord Brabant and the Province of Limburg.

Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.

Consistency and variation in phenotypic selection exerted by a community of seed predators.

Phenotypic selection that is sustained over time underlies both anagenesis and cladogenesis, but the conditions that lead to such selection and what causes variation in selection are not well known. We measured the selection exerted by three species of predispersal seed predators of lodgepole pine (Pinus contorta latifolia) in the South Hills, Idaho, and found that net selection on different cone and seed traits exerted by red crossbills (Loxia curvirostra) and cone borer moths (Eucosma recissoriana) over 10 years of seed crops was similar to that measured in another mountain range. We also found that the strength of selection increased as seed predation increased, which provides a mechanism for the correlation between the escalation of seed defenses and the density of seed predators. Red crossbills consume the most seeds and selection they exert accounts for much of the selection experienced by lodgepole pine, providing additional support for a coevolutionary arms race between crossbills and lodgepole pine in the South Hills. The third seed predator, hairy woodpeckers (Picoides villosus), consumed less than one-sixth as many seeds as crossbills. Across the northern Rocky Mountains, woodpecker abundance and therefore selective impact appears limited by the elevated seed defenses of lodgepole pine.

Adapting a dermatological multi‐laser fluorescent confocal microscope for ophthalmology applications

AbstractPurpose To adapt for ophthalmology the only multi‐laser fluorescent confocal microscope available on the market and initially developed for dermatology (Vivascope 1500, MAVIG, GmbH). The arm that maintains the microscope in contact with the skin was too rigid and imprecise, and the disposable plastic window placed at the interface between the tissue and the microscope objective was too large. Both were not convenient for high quality corneal and ocular adnexa imagingMethods We designed specific stands to create a take‐down interface between the confocal microscope, his dermatological arm support and an ophthalmology examination table comprising a 5 degrees of freedom stand (Zeiss, Germany). A male guide rail was machined in polyoxymethylene and permanently fixed on the confocal microscope to avoid repetition of assembly and disassembly. Two females guide rails machined in aluminium 7075 were fixed on the dermatological arm support on the one hand and on an ophthalmological stand on the other hand. Rails were blocked with simple screws. We also designed a new adapter to receive disposable caps already available for corneal confocal microscopy. A lateral camera allowed live visualization of the objective/eye contactResults These new interfaces allowed easy and solid fastening of the confocal microscope on each arms of the two specialties providing optimal conditions for clinical examination. The new ophthalmology arm allowed a precise positioning of the contact objective on the patient eyeConclusion Thanks to theses adaptations, the first multilaser fluorescent confocal microscope is now usable by ophthalmologists, and opens a completely innovative field of exploration

Rotator cuff muscles perform different functional roles during shoulder external rotation exercises

The aim of this study was to compare activity in shoulder muscles during an external rotation task under conditions of increasing arm support to investigate whether changing support requirements would influence muscle recruitment levels, particularly in the rotator cuff (RC) muscles. Electromyographic recordings were collected from seven shoulder muscles using surface and indwelling electrodes. The dominant shoulder of 14 healthy participants were examined during dynamic shoulder external rotation performed at 90° abduction with the arm fully supported, partially supported, and unsupported. Linear regressions between arm support load and the averaged muscle activity across participants for each muscle showed infraspinatus predominantly contributing to rotating the shoulder whilst supraspinatus, deltoid, upper trapezius, and serratus anterior were predominantly functioning in support/stabilization roles. During dynamic shoulder external rotation in mid-range abduction, the RC muscles perform different functional roles. Infraspinatus is responsible for producing external rotation torque, supraspinatus is playing a larger joint stabilizer role, and subscapularis is contributing minimally to joint stability. The results also indicate that increasing support load requirements during an external rotation task may be a functionally specific way to retrain the stabilization function of axioscapular muscles. Manipulating joint stabilization requirements while maintaining constant rotational load is a novel method of investigating the differential contribution of muscles to joint movement and stabilization during a given task.

Effects of breathing maneuver and sitting posture on muscle activity in inspiratory accessory muscles in patients with chronic obstructive pulmonary disease

Background: To determine the influence of breathing maneuver and sitting posture on tidal volume (TV), respiratory rate (RR), and muscle activity of the inspiratory accessory muscles in patients with chronic obstructive pulmonary disease (COPD). Methods: Twelve men with COPD participated in the study. Inductive respiratory plethysmography and surface electromyography were used to simultaneously measure TV, RR, and muscle activity of the inspiratory accessory muscles [the scalenus (SM), sternocleidomastoid (SCM), and pectoralis major (PM) muscles] during quiet natural breathing (QB) and pursed-lips breathing (PLB) in three sitting postures: neutral position (NP), with armm support (WAS), and with arm and head support (WAHS). Results: Two-way repeated-measures analysis of variance was employed. In a comparison of breathing patterns, PLB significantly increased TV and decreased RR compared to QB. Muscle activity in the SM and SCM increased significantly in PLB compared to QB. In a comparison of sitting postures, the muscle activity of the SM, SCM, and PM increased in the forward-leaning position. Conclusions: The results suggest that in COPD, PLB induced a favorable breathing pattern (increased TV and reduced RR) compared to QB. Additionally, WAS and WAHS positions increased muscle activity of the inspiratory accessory muscles during inspiration versus NP. Differential involvement of accessory respiratory muscles can be readily studied in COPD patients, allowing monitoring of respiratory load during pulmonary rehabilitation.

Development of a smart arm support for daily-life activities and entertainment

Development of a smart arm support for daily-life activities and entertainment

User experience guiding the development of a new robotic motion controlled arm support

User experience guiding the development of a new robotic motion controlled arm support

Design concept for a mobile arm support

Design concept for a mobile arm support

Weight Bearing Through Lower Limbs in a Standing Frame with and Without Arm Support and Low-Magnitude Whole-Body Vibration in Men and Women with Complete Motor Paraplegia

The aim of the study was to determine the proportion of body weight borne through the lower limbs in persons with complete motor paraplegia using a standing frame, with and without the support of their arms. We also examined the effect of low-magnitude whole-body vibration on loads borne by the lower limbs. Vertical ground reaction forces (GRFs) were measured in 11 participants (six men and five women) with paraplegia of traumatic origin (injury level T3-T12) standing on a low-magnitude vibrating plate using a standing frame. GRFs were measured in four conditions: (1) no vibration with arms on standing frame tray, (2) no vibration with arms at side, (3) vibration with arms on tray, and (4) vibration with arms at side. GRF with arms on tray, without vibration, was 0.76 ± 0.07 body weight. With arms at the side, GRF increased to 0.85 ± 0.12 body weight. With vibration, mean GRF did not significantly differ from no-vibration conditions for either arm positions. Oscillation of GRF with vibration was significantly different from no-vibration conditions (P < 0.001) but similar in both arm positions. Men and women with paraplegia using a standing frame bear most of their weight through their lower limbs. Supporting their arms on the tray reduces the GRF by approximately 10% body weight. Low-magnitude vibration provided additional oscillation of the load-bearing forces and was proportionally similar regardless of arm position.

Support of the upper limbs of office workers during a daily work journey

Generally, the studies assess the upper limbs postures during the work with Visual Display Terminal - VDT through the measurement of the angles formed by the segments or through the relation with the pre-defined anatomical postures (e.g., flexion, extension, abduction). However, few studies were found in the literature which had focused in the measurement of the upper limbs support during a real situation of work with VDT and in the definition of analysis categories for this kind of behavior. The main objective of this study was to measure, in a real situation and using a systematic observation method through video analysis, the main kinds of support for the upper limbs. The analysis was done considering 480 work hours of 30 office workers. Data were collected using a methodology proposed by Rebelo, Filgueiras & Soares [1] and related with the work organization and workspace conditions, the participants had: a) minimum of eight hours daily of work; b) similar activities, characterized as office work; c) same furniture and equipment; and, d) computers with the same hardware, software and peripherals. Results were analyzed 46554 dynamic events, considering only the fourteen Interaction Categories - ICs, for upper limps support. In this way, percentage was computed, considering the total number of occurrence, for the Right arm is: arm support (0.06%); forearm support (31,8%); elbow support (31,92%); hand support (7,41%); multiple supports (12,32%) and without support 16,41%- For the Left arm the results is: forearm support (0,11%); arm support (53,69%); elbow support (8,70%); hand support (7,97%); multiple supports (8,43%) e without support (21,11%). This systemic and ecological approach was obtained through a method which enables experimental Biomechanics and Physiology methods to develop more efficient functional requirements and recommendations for the work with VDTs.

The use of a vertical arm support device to reduce upper extremity muscle firing in sonographers

Work-related musculoskeletal disorders (WRMSD) in sonographers have increased over the past 20 years with shoulder injuries being the most prevalent. Advancing ultrasound technologies have reduced a sonographer's need to move when performing exams and increased prolonged arm abduction, resulting in static work postures and decreased joint perfusion. Work modifications in other industries have demonstrated that reducing arm abduction to 30° reduces muscle firing and fatigue. Although this is the ideal work posture for sonographers, there are many instances in which excessive arm abduction and static postures cannot be avoided. These positions are further complicated by the fact that the scanning arm is also supporting the weight of the ultrasound transducer. This observational case study evaluated the use of a moveable arm support system as a means to provide support for the scanning arm and reduce muscle firing during ultrasound exams in the scanning lab of a university diagnostic ultrasound educational program.

Computer use and ulnar neuropathy: results from a case-referent study

We aimed to evaluate associations between vocational computer use and 1) ulnar neuropathy, and 2) ulnar neuropathy- like symptoms as distinguished by electroneurography. We identified all patients aged 18-65 years, examined at the Department of Neurophysiology on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms, and three community referents per case, matched on sex, age, and primary care centre. From a Job Exposure Matrix we extracted estimates of daily hours of computer use. The analysis was performed by conditional logistic regression.There were a negative association between daily hours of computer use and the two outcomes of interest. Participants who reported their elbow to be in contact with their working table for 2 hours or more during the workday had an elevated risk for ulnar neuropathy (OR=2.16, 95 % CI; 1.06-4.44).The two outcomes were not associated with daily hours of computer use. Findings suggested specific effects of pressure on the elbow, and might be an explanation for the overweight of left-sided outcomes in this primarily right-handed group. Preventive efforts would then be straightforward by providing appropriate arm support for the left arm and elbow.

Effects of breathing maneuver and sitting posture on muscle activity in inspiratory accessory muscles in patients with chronic obstructive pulmonary disease

BackgroundTo determine the influence of breathing maneuver and sitting posture on tidal volume (TV), respiratory rate (RR), and muscle activity of the inspiratory accessory muscles in patients with chronic obstructive pulmonary disease (COPD).MethodsTwelve men with COPD participated in the study. Inductive respiratory plethysmography and surface electromyography were used to simultaneously measure TV, RR, and muscle activity of the inspiratory accessory muscles [the scalenus (SM), sternocleidomastoid (SCM), and pectoralis major (PM) muscles] during quiet natural breathing (QB) and pursed-lips breathing (PLB) in three sitting postures: neutral position (NP), with armm support (WAS), and with arm and head support (WAHS).ResultsTwo-way repeated-measures analysis of variance was employed. In a comparison of breathing patterns, PLB significantly increased TV and decreased RR compared to QB. Muscle activity in the SM and SCM increased significantly in PLB compared to QB. In a comparison of sitting postures, the muscle activity of the SM, SCM, and PM increased in the forward-leaning position.ConclusionsThe results suggest that in COPD, PLB induced a favorable breathing pattern (increased TV and reduced RR) compared to QB. Additionally, WAS and WAHS positions increased muscle activity of the inspiratory accessory muscles during inspiration versus NP. Differential involvement of accessory respiratory muscles can be readily studied in COPD patients, allowing monitoring of respiratory load during pulmonary rehabilitation.

127 ジャイロ・加速度センサを利用した腕動作支援装置の評価(北東北の産業技術と技術史(II))

Japan is said to have an aging society. Assistive devices are therefore necessary to support the independence of elderly people. This study evaluated an Arm-Balancer arm support system developed for use by elderly or handicapped people without free arm motion. Measurements of rotational arm movement using a gyro sensor and an acceleration sensor revealed the possibility of evaluating arm movement using the Arm-Balancer.

Positioning of the patient during shoulder surgery: an inexpensive, safe and easy technique

The knowledge of shoulder pathology has improved tremendously in the last decades, and shoulder surgery is increasingly performed because of new treatment options and better operative results. Nowadays most surgical shoulder procedures are performed in the sitting or semi-sitting (beach chair) position. Stability of the patient and the ability to flex, extend and rotate the shoulder during surgery are crucial to improve exposure of the surgical field and lower the risk of perioperative complications. We developed an easy, safe and inexpensive surgical set-up providing a very good posterior, superior and anterior access to the shoulder in the sitting or semi-sitting position. In this technique, the patient is placed supine with the head at the foot end of the table and the body positioned slightly eccentrically with the back being supported by the leg plate contralateral to the operative side, avoiding any contact with the scapula of the operative side. A neck support is attached on an extra bar at the contralateral side and accommodated to the patient's lordosis. Next, the leg plate on the operative side is removed, and the head and the body are secured to the table with adhesive dressing. This way a stable positioning of the patient is obtained during the whole procedure, and the shoulder girdle is completely free. The set-up can accommodate patients of different stature and weight without the need to adapt the technique. This position also gives the possibility to provide an excellent radiographic view of the shoulder during operative fracture treatment. Our technique further allows a significant reduction in costs. A surgical table, extra bar, additional arm support and neck support are usually available and can be used in different settings, without the need for a specific shoulder table.

Integrative rehabilitation of elderly stroke survivors: The design and evaluation of the BrightArm™

Purpose: To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. Method: The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Results: Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Conclusions: Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations.Implications for RehabilitationIt is possible to improve arm function in older hemiplegic patients many years after stroke.Integrative rehabilitation through games combining cognitive (memory, focusing, executive function) and physical (arm movement, hand-eye coordination, grasping, dual-tasking) elements is enjoyable for this population.The severity of depression in the elderly can be reduced through virtual reality games, as long as games adapt to the patient, are winnable and provide rewards for success.