Arm Usage Research Articles

Longitudinal Retrospective Study of a Wearable NMES System to Determine the Effects on Arm Usage in Hemiparetic and Hemiplegic Patients

ABSTRACT Introduction Brain disorders such as traumatic brain injury (TBI), stroke, cerebral palsy (CP), and surgical interventions can result in aberrant motor function in the contralateral limbs, resulting in paralysis, weakness, and/or spasticity. It is known that, in the short term, neuromuscular electrical stimulation (NMES), the application of low-level electrical currents to motor nerves to induce muscle contractions in paralyzed muscles, can stimulate affected muscle groups and increase arm mobility. However, there remains a paucity of longitudinal evidence examining NMES-mediated improvements of arm usage. Objective The aim of this study was to determine the effectiveness of a long-term BioSleeve intervention on the recovery of arm mobility in hemiparetic patients. Study Design The design of this study is a retrospective cohort study. Methods We examined self-reported arm usage in patients with 1) TBI, 2) stroke, 3) hemispherectomy, or 4) CP who wore Axiobionics’ BioSleeve NMES device and compared this to arm usage achieved from years of conventional therapy. Results The device was well-tolerated. Patients reported an average increase in arm usage from 9.9% to 43.5%, with the TBI subcohort reporting a consistent increase in arm usage of 5.7% per year over the treatment period. Conclusions This study supports the literature suggesting that longitudinal NMES can be used to increase arm usage in hemiplegic patients. Clinical Relevance Statement This study supports the use of wearable NMES intervention in the treatment of arm hemiparesis.

GenArchBench: A genomics benchmark suite for arm HPC processors

Arm usage has substantially grown in the High-Performance Computing (HPC) community. Japanese supercomputer Fugaku, powered by Arm-based A64FX processors, held the top position on the Top500 list between June 2020 and June 2022, currently sitting in the fourth position. The recently released 7th generation of Amazon EC2 instances for compute-intensive workloads (C7 g) is also powered by Arm Graviton3 processors. Projects like European Mont-Blanc and U.S. DOE/NNSA Astra are further examples of Arm irruption in HPC. In parallel, over the last decade, the rapid improvement of genomic sequencing technologies and the exponential growth of sequencing data has placed a significant bottleneck on the computational side. While most genomics applications have been thoroughly tested and optimized for x86 systems, just a few are prepared to perform efficiently on Arm machines. Moreover, these applications do not exploit the newly introduced Scalable Vector Extensions (SVE).This paper presents GenArchBench, the first genome analysis benchmark suite targeting Arm architectures. We have selected computationally demanding kernels from the most widely used tools in genome data analysis and ported them to Arm-based A64FX and Graviton3 processors. Overall, the GenArch benchmark suite comprises 13 multi-core kernels from critical stages of widely-used genome analysis pipelines, including base-calling, read mapping, variant calling, and genome assembly. Our benchmark suite includes different input data sets per kernel (small and large), each with a corresponding regression test to verify the correctness of each execution automatically. Moreover, the porting features the usage of the novel Arm SVE instructions, algorithmic and code optimizations, and the exploitation of Arm-optimized libraries. We present the optimizations implemented in each kernel and a detailed performance evaluation and comparison of their performance on four different HPC machines (i.e., A64FX, Graviton3, Intel Xeon Skylake Platinum, and AMD EPYC Rome). Overall, the experimental evaluation shows that Graviton3 outperforms other machines on average. Moreover, we observed that the performance of the A64FX is significantly constrained by its small memory hierarchy and latencies. Additionally, as proof of concept, we study the performance of a production-ready tool that exploits two of the ported and optimized genomic kernels.

Development and evaluation of the ARM algorithm: A novel approach to quantify musculoskeletal disorder risk factors in manual wheelchair users in the real world.

This study aimed to develop and evaluate the ARM (arm repetitive movement) algorithm using inertial measurement unit (IMU) data to assess repetitive arm motion in manual wheelchair (MWC) users in real-world settings. The algorithm was tested on community data from four MWC users with spinal cord injury and compared with video-based analysis. Additionally, the algorithm was applied to in-home and free-living environment data from two and sixteen MWC users, respectively, to assess its utility in quantifying differences across activities of daily living and between dominant and non-dominant arms. The ARM algorithm accurately estimated active and resting times (>98%) in the community and confirmed asymmetries between dominant and non-dominant arm usage in in-home and free-living environment data. Analysis of free-living environment data revealed that the total resting bout time was significantly longer (P = 0.049) and total active bout time was significantly shorter (P = 0.011) for the non-dominant arm. Analysis of active bouts longer than 10 seconds showed higher total time (P = 0.015), average duration (P = 0.026), and number of movement cycles per bout (P = 0.020) for the dominant side. These findings support the feasibility of using the IMU-based ARM algorithm to assess repetitive arm motion and monitor shoulder disorder risk factors in MWC users during daily activities.

MicroRNA Transcriptomes Reveal Prevalence of Rare and Species-Specific Arm Switching Events During Zebrafish Ontogenesis.

In metazoans, microRNAs (miRNAs) are essential regulators of gene expression, affecting critical cellular processes from differentiation and proliferation, to homeostasis. During miRNA biogenesis, the miRNA strand that loads onto the RNA-induced Silencing Complex (RISC) can vary, leading to changes in gene targeting and modulation of biological pathways. To investigate the impact of these "arm switching" events on gene regulation, we analyzed a diverse range of tissues and developmental stages in zebrafish by comparing 5p and 3p arms accumulation dynamics between embryonic developmental stages, adult tissues, and sexes. We also compared variable arm usage patterns observed in zebrafish to other vertebrates including arm switching data from fish, birds, and mammals. Our comprehensive analysis revealed that variable arm usage events predominantly take place during embryonic development. It is also noteworthy that isomiR occurrence correlates to changes in arm selection evidencing an important role of microRNA distinct isoforms in reinforcing and modifying gene regulation by promoting dynamics switches on miRNA 5p and 3p arms accumulation. Our results shed new light on the emergence and coordination of gene expression regulation and pave the way for future investigations in this field.

Single-port insufflation endoscopic nipple-sparing mastectomy in early breast cancer: a retrospective cohort study.

Breast cancer is the most common malignancy in female patients. In recent years, more and more studies have focused on how to improve the appearance and the quality of life for patients. This study aimed to compare the oncologic safety, aesthetic results, and upper extremity function between single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) and conventional open mastectomy (C-OM) in early-stage breast cancer treatment. In our retrospective cohort, 285 patients with stage I and II breast cancer were categorized into the SIE-NSM group (n=71) and the C-OM group (n=214). We assessed local recurrence, distant metastasis, and upper extremity function across the two groups. The BREAST-Q scale was employed to analyze differences in aesthetic results, psychosocial well-being, and sexual health. The risk of local recurrence was evaluated using multivariable binary logistic regression, while a multivariable linear regression model gauged upper extremity function and aesthetic outcomes. Local recurrence rates between the two groups were statistically similar (1/71, 1.4% for SIE-NSM vs. 2/214, 0.9% for C-OM, P=0.735), as confirmed by the multivariable binary logistic regression analysis. Neither group exhibited distant metastases. The SIE-NSM group demonstrated higher scores in satisfaction with breasts, chest wellness, psychosocial health, and sexual well-being (P<0.001). The SIE-NSM group also exhibited superior outcomes regarding chest wall/breast pain, shoulder mobility, and daily arm usage (P<0.001). No subcutaneous effusion was reported in the SIE-NSM group, whereas the C-OM group had a 10.7% incidence rate (P=0.004). SIE-NSM offers comparable oncologic safety to C-OM but provides enhanced satisfaction regarding breast appearance, physical comfort, psychosocial health, sexual health, and improved upper extremity functionality. Consequently, this innovative approach is a suitable surgical alternative for treating early-stage breast cancer.

Effects of Regular Exercise, Arts (Origami), and Group Psychotherapy on the Quality of Life, Anxiety, Depression, Patient Satisfaction, and Hope in Cancer Patients in Remission: A Prospective Study

Background: Cancer is a critical public health problem worldwide. Some studies found that group psychotherapy, when applied to cancer patients as a psychiatric approach, also decreases the existing psychopathological symptoms. Objectives: This study aimed to determine the effects of a Quality-of-Life Support Program (QOLSP) for cancer patients in remission. Methods: Twenty-six cancer patients who were monitored while in remission were included in this study. During the eight-week prospective study, a QOLSP was implemented weekly. The patients’ hope, anxiety, depression, and quality of life (QoL) were assessed using different scales. Additional questionnaires assessed the status of program satisfaction and the arm utilization angle of the breast cancer patients (n=20). Results: The total mean score on the hope scale was initially 25.6±3.9 and increased to 29.7±1.9 post-QOLSP (P˂0.001). Additionally, the total mean score on the EORTC QLQ-C30 scale was initially 68.9±4.9 and increased to 92.6±2.2 post-QOLSP (P˂0.001). Moreover, the total mean anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS) decreased (P&lt;0.001) post-QOLSP. Factors affecting the hope score differences, including the hope pre-score and the sap score (Loss of Appetite), in the EORTC QLQ-C30 symptom scale were significant (P&lt;0.001 and P=0.01, respectively). Factors affecting the anxiety and depression score differences were the HADS anxiety (P=0.001) and depression (P&lt;0.001) pre-scores, in descending order. Moreover, the factor affecting the sql2 score, evaluating General Health Status on the EORTC QLQ-C30, was the sql2 pre-score (P&lt;0.001). All 26 patients were “very satisfied” with the program, and the arm usage angle of the 20 operated breast cancer patients improved. Conclusion: Facilities that can provide a multidisciplinary QOLSP throughout treatment and follow-up will favorably affect QoL, anxiety, depression, hope, and satisfaction among cancer patients.

Reproducing Human Arm Strategy and Its Contribution to Balance Recovery Through Model Predictive Control.

The study of human balance recovery strategies is important for human balance rehabilitation and humanoid robot balance control. To date, many efforts have been made to improve balance during quiet standing and walking motions. Arm usage (arm strategy) has been proposed to control the balance during walking motion in the literature. However, limited research exists on the contributions of the arm strategy for balance recovery during quiet standing along with ankle and hip strategy. Therefore, in this study, we built a simplified model with arms and proposed a controller based on nonlinear model predictive control to achieve human-like balance control. Three arm states of the model, namely, active arms, passive arms, and fixed arms, were considered to discuss the contributions of arm usage to human balance recovery during quiet standing. Furthermore, various indexes such as root mean square deviation of joint angles and recovery energy consumption were verified to reveal the mechanism behind arm strategy employment. In this study, we demonstrate to computationally reproduce human-like balance recovery with and without arm rotation during quiet standing while applying different magnitudes of perturbing forces on the upper body. In addition, the conducted human balance experiments are presented as supplementary information in this paper to demonstrate the concept on a typical example of arm strategy.

Balance Stability Augmentation for Wheel-Legged Biped Robot Through Arm Acceleration Control

A self-balancing wheel-legged robot provides higher maneuverability and mobility than legged biped robots. For this reason, wheel-legged systems have attracted enormous interest from academia and commercial sectors in recent years. Most of the past works in this field mainly focused on lower body stabilization. Motivated by the human ability to maintain balance in laborious activities by articulating the arm actively, we explore and analyze the active arm control on top of the wheel-legged system to assist in its balance recovery during external pushes and disturbances. This paper presents a control framework to improve the stability and robustness of an underactuated self-balancing wheel-legged robot using its upper limb arm. Furthermore, we use the centroidal moment pivot (CMP) as a key metric to quantitatively evaluate the effect of the active arm usage on the balance stability improvement of the robot in the ROS-Gazebo environment. The difference from the case of nonusage of arm is verified to clarify the impact of the active arm quantitatively. This concept would lead to the wheel-legged biped robot with an active arm for dual purposes, one is for carrying objects, another is for increasing the balance stability. This point is important for future application in a real-world environment with human-robot interactions.

MiRTil: An Extensive Repository for Nile Tilapia microRNA Next Generation Sequencing Data.

Nile tilapia is the third most cultivated fish worldwide and a novel model species for evolutionary studies. Aiming to improve productivity and contribute to the selection of traits of economic impact, biotechnological approaches have been intensively applied to species enhancement. In this sense, recent studies have focused on the multiple roles played by microRNAs (miRNAs) in the post-transcriptional regulation of protein-coding genes involved in the emergence of phenotypes with relevance for aquaculture. However, there is still a growing demand for a reference resource dedicated to integrating Nile Tilapia miRNA information, obtained from both experimental and in silico approaches, and facilitating the analysis and interpretation of RNA sequencing data. Here, we present an open repository dedicated to Nile Tilapia miRNAs: the “miRTil database”. The database stores data on 734 mature miRNAs identified in 11 distinct tissues and five key developmental stages. The database provides detailed information about miRNA structure, genomic context, predicted targets, expression profiles, and relative 5p/3p arm usage. Additionally, miRTil also includes a comprehensive pre-computed miRNA-target interaction network containing 4936 targets and 19,580 interactions.

Abstract TMP45: Constrained-Induced Movement Therapy Transfer the Function Gained by Upper Arm Robotic Therapy Into Daily Activities

Introduction: Robotic Therapy (RT) is shown to improve upper extremity (UE) function, but not the use of affected arm in daily activities. Constraint-Induced Movement Therapy (CIMT), on the other hand, is the most well-established intervention for improving the use of the affected arm. Hypothesis: (1) RT as self-training would improve UE function better than usual self-training. (2) Combination of RT and modified CIMT would improve daily use of affected arm as compared to the combination of RT with usual therapy. Methods: This study was a prospective, single-blinded, randomized, multicenter clinical trial conducted at 24 rehabilitation clinics in Japan. Participants were 129 individuals with hemiplegia (FM&lt;44) at least over 6 months post stroke. They were randomized to one of three interventions for ten weeks (3 days a week): (a) 40 minutes RT as self-training(ReoGo®-J, Teijin Pharma, Japan) with usual therapy (RT group), (b) 40 minutes RT as self-training with 20 minutes modified CIMT (Combination group), and (c) 40 minutes usual self-training with 20 minutes usual therapy (Control group). UE function (Fugl-Meyer Assessment: FM), and arm usage (Motor Activity Log: MAL) was measured. Sub-analysis was conducted divided by the onset period (14 months) and age (65 year). Results: Proximal FM improved significantly in RT group than Control group (p=0.04), especially for age under 65. MAL significantly improved in Combination group than Control group (p=0.05), especially for age over 65. RT group significantly improved on Proximal FM than Combination (p=0.05) and Control (p=0.03) groups, for patients less than 14 months onset. For over 14 months onset, Combination group improved Wrist/Finger FM (p=0.06) and arm usage (p=0.09) than RT group. Conclusions: This study indicate robotic self-training improve UE function of chronic stroke patients than usual self-training. In addition, arm usage only exceeded MCID by the combination therapy of robotic self-training with modified CIMT, and more effective for older patients (age over 65) at chronic stage (over 14 months onset).

Upper extremity function in the free living environment of adults with traumatic brachial plexus injuries

Transition of data acquisition out of the laboratory, into the real world offers a previously inaccessible perspective of physical function. This proves to be beneficial when assessing surgical intervention, especially after a traumatic brachial plexus injury (BPI) causing loss of motor function in an upper extremity (UE). Moving towards the use of real world data in clinical practice as an outcome measure, this study developed a method to report bilateral UE activity in patients with BPI. Three groups of ten subjects each participated in this study—healthy controls, subjects with traumatic BPI prior to surgical treatment (pre-), and subjects who had surgical reconstruction to treat BPI (post-). Subjects wore four activity monitors on bilateral forearms and upper arms for four days. Tri-axial acceleration data were used to calculate asymmetry indices for forearm and upper arm usage. Analysis revealed a bimodal distribution in the post- group, prompting division of this group into two subgroups based on injury type: pan-plexus and upper trunk. While median asymmetry indices at the forearm and upper arm were decreased in the post- group when compared to the pre- group, these differences were not significant. Compared to controls, the pre-surgery group (p < 0.0001, p < 0.0001) and post-surgery group with pan-plexus injuries (p = 0.0074, p = 0.0242) both exhibited statistically significant differences in forearm and upper arm asymmetry, respectively. Further investigation to establish clinically significant differences in asymmetry index is warranted. Importantly, analyzing the activity of UEs following treatment of a BPI provides objective real world evidence of function.

Characterization and comparative analysis of microRNAs in the rice pest Sogatella furcifera

MicroRNAs (miRNAs) are a class of endogenous regulatory RNA molecules 21-24 nucleotides in length that act as functional regulators of post-transcriptional repression of messenger RNA. We report the identification and characterization of a conserved miRNA and 171 novel miRNAs in the migratory rice pest Sogatella furcifera by deep sequencing, which were observed to be biased towards female adults of the insect, modulating the functionality and targets of the miRNAs in sex differentiation. A switch in arm usage was also observed in 9 miRNA when compared to the insect ancestor during insect evolution. The miRNA loci showed high 5’ fidelity in both miRNA and star species and about 93.4% of WBPH miRNAs conserved within non-planthopper species were homologous with planthopper species. The novel miRNAs identified in this study provide a better understanding of the sRNA and the regulatory role of miRNA in sexual dimorphism and alteration in the expression or function of miRNAs in the rice pest.

Genome-wide microRNA screening in Nile tilapia reveals pervasive isomiRs\u2019 transcription, sex-biased arm switching and increasing complexity of expression throughout development

MicroRNAs (miRNAs) are key regulators of gene expression in multicellular organisms. The elucidation of miRNA function and evolution depends on the identification and characterization of miRNA repertoire of strategic organisms, as the fast-evolving cichlid fishes. Using RNA-seq and comparative genomics we carried out an in-depth report of miRNAs in Nile tilapia (Oreochromis niloticus), an emergent model organism to investigate evo-devo mechanisms. Five hundred known miRNAs and almost one hundred putative novel vertebrate miRNAs have been identified, many of which seem to be teleost-specific, cichlid-specific or tilapia-specific. Abundant miRNA isoforms (isomiRs) were identified with modifications in both 5p and 3p miRNA transcripts. Changes in arm usage (arm switching) of nine miRNAs were detected in early development, adult stage and even between male and female samples. We found an increasing complexity of miRNA expression during ontogenetic development, revealing a remarkable synchronism between the rate of new miRNAs recruitment and morphological changes. Overall, our results enlarge vertebrate miRNA collection and reveal a notable differential ratio of miRNA arms and isoforms influenced by sex and developmental life stage, providing a better picture of the evolutionary and spatiotemporal dynamics of miRNAs.

Does the DEKA Arm substitute for or supplement conventional prostheses.

Research on home use of advanced upper limb prostheses is needed. To describe and compare DEKA Arm usage patterns during the last 4 weeks of a home trial for participants with a personal prosthesis and those without. To compare usage patterns during home trial to those of the personal prosthesis prior to home trial. To evaluate user activity preferences for the DEKA Arm and personal prosthesis after a trial of home use. Quasi-experimental, time-series design. Data from 17 participants were analyzed. At baseline, prosthesis users reported days and hours they wore and used personal device(s). Home trial diaries documented days and hours of wear and use for the DEKA Arm and personal device(s), if applicable. Questionnaires asked prosthesis users to list activities they could do with the DEKA Arm but not with their current prosthesis and vice versa and activities they preferred doing with either devices. The DEKA Arm was worn 81% and used 73% of functioning days, averaging 4.2 h worn and 2.4 h used on days worn. During home trial, prosthesis users used personal devices and any prosthesis for fewer hours/day than at baseline. The DEKA supplemented but did not substitute for the personal prosthesis. Clinical relevance Findings strongly suggest that given the limitations of the DEKA Arm and conventional prosthesis, persons with upper limb amputation would be best served and would be able to perform the widest range of activities if they had several types of devices.

Representation of Multiple Body Parts in the Missing-Hand Territory of Congenital One-Handers

SummaryIndividuals born without one hand (congenital one-handers) provide a unique model for understanding the relationship between focal reorganization in the sensorimotor cortex and everyday behavior. We previously reported that the missing hand’s territory of one-handers becomes utilized by its cortical neighbor (residual arm representation), depending on residual arm usage in daily life to substitute for the missing hand’s function [1, 2]. However, the repertoire of compensatory behaviors may involve utilization of other body parts that do not cortically neighbor the hand territory. Accordingly, the pattern of brain reorganization may be more extensive [3]. Here we studied unconstrained compensatory strategies under ecological conditions in one-handers, as well as changes in activation, connectivity, and neurochemical profile in their missing hand’s cortical territory. We found that compensatory behaviors in one-handers involved multiple body parts (residual arm, lips, and feet). This diversified compensatory profile was associated with large-scale cortical reorganization, regardless of cortical proximity to the hand territory. Representations of those body parts used to substitute hand function all mapped onto the cortical territory of the missing hand, as evidenced by task-based and resting-state fMRI. The missing-hand territory also exhibited reduced GABA levels, suggesting a reduction in connectional selectivity to enable the expression of diverse cortical inputs. Because the same body parts used for compensatory purposes are those showing increased representation in the missing hand’s territory, we suggest that the typical hand territory may not necessarily represent the hand per se, but rather any other body part that shares the functionality of the missing hand [4].

Usability Evaluation of a VibroTactile Feedback System in Stroke Subjects.

To increase the functional capabilities of stroke subjects during activities of daily living, patients receive rehabilitative training to recover adequate motor control. With the goal to motivate self-training by use of the arm in daily life tasks, a sensor system (Arm Usage Coach, AUC) was developed that provides VibroTactile (VT) feedback if the patient does not move the affected arm above a certain threshold level. The objective of this study is to investigate the usability of this system in stroke subjects. The study was designed as a usability and user acceptance study of feedback modalities. Stroke subjects with mild to moderate arm impairments were enrolled. The subjects wore two AUC devices one on each wrist. VT feedback was given by the device on the affected arm. A semi-structured interview was performed before and after a measurement session with the AUC. In addition, the System Usability Scale (SUS) questionnaire was given. Ten ischemic chronic stroke patients (39 ± 38 months after stroke) were recruited. Four out of 10 subjects have worn the VT feedback on their dominant, affected arm. In the pre-measurement interview, eight participants indicated a preference for acoustic or visual over VT feedback. In the post evaluation interview, nine of 10 participants preferred VT over visual and acoustic feedback. On average, the AUC gave VT feedback six times during the measurement session. All participants, with the exception of one, used their dominant arm more then the non-dominant. For the SUS, eight participants responded above 80%, one between 70 and 80%, and one participant responded below 50%. More patients accepted and valued VT feedback after the test period, hence VT is a feasible feedback modality. The AUC can be used as a telerehabilitation device to train and maintain upper extremity use in daily life tasks.

Does Usage of an eHealth Intervention Reduce the Risk of Excessive Gestational Weight Gain? Secondary Analysis From a Randomized Controlled Trial.

BackgroundExcessive gestational weight gain (GWG) contributes to the development of obesity in mother and child. Internet-based interventions have the potential for delivering innovative and interactive options for prevention of excessive GWG to large numbers of people.ObjectiveThe objective of this study was to create a novel measure of Internet-based intervention usage patterns and examine whether usage of an Internet-based intervention is associated with reduced risk of excessive GWG.MethodsThe website featured blogs, local resources, articles, frequently asked questions (FAQs), and events that were available to women in both the intervention and control arm. Weekly reminders to use the website and to highlight new content were emailed to participants in both arms. Only intervention arm participants had access to the weight gain tracker and diet and physical activity goal-setting tools. A total of 1335 (898 intervention and 437 control) relatively diverse and healthy pregnant women were randomly assigned to the intervention arm or control arm. Usage patterns were examined for both intervention and control arm participants using latent class analysis. Regression analyses were used to estimate the association between usage patterns and three GWG outcomes: excessive total GWG, excessive GWG rate, and GWG.ResultsFive usage patterns best characterized the usage of the intervention by intervention arm participants. Three usage patterns best characterized control arm participants’ usage. Control arm usage patterns were not associated with excessive GWG, whereas intervention arm usage patterns were associated with excessive GWG.ConclusionsThe control and intervention arm usage pattern characterization is a unique methodological contribution to process evaluations for self-directed Internet-based interventions. In the intervention arm some usage patterns were associated with GWG outcomes.ClinicalTrialClinicalTrials.gov; Clinical Trials Number: NCT01331564; https://clinicaltrials.gov/ct2/show/NCT01331564 (Archived by WebCite at http://www.webcitation/6nI9LuX9w)

National Traumas – Local Memories Villages Southeast and Southwest from Kolozsvár (Cluj-Napoca) during WW2 – General Research Overview

Abstract The presentation summarizes the results of two years of oral history research. The aim of the research was to record the recollections of the still living eyewitnesses of the events in the fall of 1944 in Cluj and its surroundings, in settlements that belonged to the southern part of Transylvania during World War II. Several hours of interviews were made in the villages of the regions of Ţara Călatei (Kalotaszeg) and the Transylvanian Plain (Mezőség), and the lecture presents a synthesis of these interviews. They address issues like deportation, atrocities, fleeing, arm usage, Soviet and Romanian detention camps, adventurous escapes, etc.

Alteration and recovery of arm usage in daily activities after rotator cuff surgery

The objective measurement of dominant/nondominant arm use proportion in daily life may provide relevant information on healthy and pathologic arm behavior. This prospective case-control study explored the potential of such measurements as indicators of upper limb functional recovery after rotator cuff surgery. Data on dominant/nondominant arm usage were acquired with body-worn sensors for 7 hours. The postsurgical arm usage of 21 patients was collected at 3, 6, and 12months after rotator cuff surgery in the sitting, walking, and standing postures and compared with a reference established with 41 healthy subjects. The results were calculated for the dominant and nondominant surgical side subgroups at all stages. The correlations with clinical scores were calculated. Healthy right-handed and left-handed dominant arm usage was 60.2% (±6.3%) and 53.4% (±6.6%), respectively. Differences in use of the dominant side were significant between the right- and left-handed subgroups for sitting (P=.014) and standing (P=.009) but not for walking (P=.328). The patient group showed a significant underuse of 10.7% (±8.9%) at 3months after surgery (P<.001). The patients recovered normal arm usage within 12months, regardless of surgical side. The arm underuse measurement was weakly related to function and pain scores. This study provided new information on arm recovery after rotator cuff surgery using an innovative measurement method. It highlighted that objective arm underuse measurement is a valuable indicator of upper limb postsurgical outcome that captures a complementary feature to clinical scores.

Assessment of Accelerometers for Measuring Upper-Extremity Physical Activity.

The overarching goal of this study was to examine the use of triaxial accelerometers in measuring upper-extremity motions to monitor upper-extremity-exercise compliance. There were multiple questions investigated, but the primary objective was to investigate the correlation between visually observed arm motions and triaxial accelerometer activity counts to establish fundamental activity counts for the upper extremity. Cross-sectional, basic research. Clinical laboratory. Thirty healthy individuals age 26 ± 6 y, body mass 24 ± 3 kg, and height 1.68 ± 0.09 m volunteered. Participants performed 3 series of tasks: activities of daily living (ADLs), rehabilitation exercises, and passive shoulder range of motion at 5 specific velocities on an isokinetic dynamometer while wearing an accelerometer on each wrist. Participants performed exercises with their dominant arm to examine differences between sides. A researcher visually counted all arm motions to correlate counts with physical activity counts provided by the accelerometer. Physical activity counts derived from the accelerometer and visually observed activity counts recorded from a single investigator. There was a strong positive correlation (r = .93, P < .01) between accelerometer physical activity counts and visual activity counts for all ADLs. Accelerometers activity counts demonstrated side-to-side difference for all ADLs (P < .001) and 5 of the 7 rehabilitation activities (P < .003). All velocities tested on the isokinetic dynamometer were shown to be significantly different from each other (P < .001). There is a linear relationship between arm motions counted visually and the physical activity counts generated by an accelerometer, indicating that arm motions could be potentially accounted for if monitoring arm usage. The accelerometers can detect differences in relatively slow arm-movement velocities, which is critical if attempting to evaluate exercise compliance during early phases of shoulder rehabilitation. These results provide fundamental information that indicates that triaxial accelerometers have the potential to objectively monitor and measure arm activities during rehabilitation and ADLs.