Elbow Motion Research Articles

Elbow Gesture Recognition with an Array of Inductive Sensors and Machine Learning.

This work presents a novel approach for elbow gesture recognition using an array of inductive sensors and a machine learning algorithm (MLA). This paper describes the design of the inductive sensor array integrated into a flexible and wearable sleeve. The sensor array consists of coils sewn onto the sleeve, which form an LC tank circuit along with the externally connected inductors and capacitors. Changes in the elbow position modulate the inductance of these coils, allowing the sensor array to capture a range of elbow movements. The signal processing and random forest MLA to recognize 10 different elbow gestures are described. Rigorous evaluation on 8 subjects and data augmentation, which leveraged the dataset to 1270 trials per gesture, enabled the system to achieve remarkable accuracy of 98.3% and 98.5% using 5-fold cross-validation and leave-one-subject-out cross-validation, respectively. The test performance was then assessed using data collected from five new subjects. The high classification accuracy of 94% demonstrates the generalizability of the designed system. The proposed solution addresses the limitations of existing elbow gesture recognition designs and offers a practical and effective approach for intuitive human-machine interaction.

Os supratrochleare anterius: a very rare clinical case and review of literature.

The accessory bones around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient's history. They are of different nature, either presenting within muscle tendons as sesamoids (brachialis and triceps brachii muscles) or presenting intra-articularly probably as separated or accessory ossification centres. The least common is the os supratrochleare anterius. We present a case of a young male, featuring chronic blocking and 20° limited flexion of his right elbow, which bothered him during his occupation as a locksmith. In history, he suffered minor trauma to the elbow 20 years ago. X-ray and CT showed a large ossicle in the coronoid fossa of the humerus. The ossicle was surgically extracted in small pieces. The patient left satisfied with no mention of complaints. The os supratrochleare anterius is a very rare accessory bone of the elbow, located in the coronoid fossa of the humerus which can mimic many pathological states, and limit movements and causing pain around the elbow.

The anconeus-triceps lateral flap approach in terrible triad of the elbow: good outcome in a series of ten cases.

Standard surgical management for the terrible triad of the elbow (TTE) has been established since 2004, yet postoperative complications are common and consensus on optimal management is absent. Different surgical algorithms for treating TTE and their efficacy have been reported worldwide, yet evidence from Vietnam remains limited. Ten cases diagnosed with TTE admitted to the Hospital of Traumatology and Orthopedics, a tertiary orthopedic center in Ho Chi Minh City, were presented to demonstrate the effectiveness and rate of postoperative complications following our stepwise surgical procedures using the anconeus-triceps lateral flap approach. The intraoperative "drop sign", quantitative assessment of pain and level of upper arm disability (via VAS and QuickDASH score) was mentioned to assess the algorithm's benefit. All patients' information was retrieved from medical records from August 2022 to January 2024. All 10 cases required repair of the lateral ligament complex and underwent surgery within 2 days of hospitalization. Immediate postoperative imaging revealed no drop sign, and none of the patients experienced elbow dislocation nor the need for repeated surgery, and a full range of elbow motion was demonstrated at 3-6 months follow-up. TTE is a challenging injury that almost always obligates surgical correction. The anconeus-triceps lateral flap approach, with its advantages of better visualization and preservation of certain essential stabilizing muscles of the elbow, was demonstrated to yield a high success rate and low postoperative complication rate.

Recovery of the Total Birth Brachial Plexus Palsy without Surgical Treatment: A Single-Center, Retrospective Study and Literature Review

Abstract Background Spontaneous recovery of a birth brachial plexus disorder is difficult to predict. Although root avulsion and total plexus injury is indicated for surgical management, early nerve surgery is still doubtful. Hand motion is obviously an important indicator for predicting the function of an affected limb. However, the timing for diagnosing a transient or true total plexus injury from hand recovery is controversial. This study aimed to report the recovery time of total birth brachial plexus palsy in patients who did not undergo surgery due to various reasons. Methods In this 15-year retrospective chart review, 45 patients of total birth brachial plexus injury with a mean follow-up time of 34.5 months, were included. Although patients met surgical indications, surgical management was abandoned for a variety of reasons. Imaging was not performed routinely and, nerve conduction study and Horner's syndrome were not consistently recorded in the past. All patients were evaluated for clinical improvement by motor power grading. The recovery time was reported as the median and interquartile range. Results Forty-five patients were diagnosed with total birth brachial plexus injury. Out of 45 patients, 36 showed clinical evidence of recovering their hand motion within a median of 3 months. The median time for the recovery of elbow flexion and shoulder abduction was 4 months. The median for achieving antigravity or full motion recovery of elbow flexion, shoulder abduction, and hand flexion were 10, 10.5, and 7 months, respectively. Conclusion In this study, spontaneous recovery of shoulder, elbow and hand motion substantially occurred in the patient diagnosed with a total birth brachial plexus palsy. True total plexus palsy can be distinguished from transient palsy by the recovery of hand motion at 3 months. Most of the patients, who had spontaneous recovery, potentially achieved antigravity or full hand movement without surgery.

Nano PDA@Tur-Modified Piezoelectric Sensors for Enhanced Sensitivity and Energy Harvesting.

Tourmaline is known for its natural negative ion effect and far-infrared radiation function, which promote human blood circulation, relieve pain, regulate the endocrine system, and enhance immunity and other functions. These functions motivate the use of this material for enhanced sensitivity of wearable sensors. In this work, taking advantage of the unique multifunctions of tourmaline nanoparticles (Tur), highly boosted piezoelectricity was achieved by incorporating polydopamine (PDA)-modified Tur in PVDF. The PDA@Tur nanofillers not only effectively increased the β-phase content of PVDF but also played a major role in significantly enhancing piezoelectricity, wettability, elasticity, air permeability, and stability of the piezoelectric sensors. Especially, the maximum output voltage of the fiber membrane with 0.5 wt % PDA@Tur reached 31.0 V, being 4 times that of the output voltage of the pure PVDF fiber membrane. Meanwhile, the sensitivity reached 0.7011 V/kPa at 1-10 N, which was 3.6 times that of pure PVDF film (0.196 V/kPa). The power intensity reached 8 μW/cm2, being 5.55 times that of the pristine PVDF PENG (1.44 μW/cm2), and the piezoelectric coefficient from d33 m/PFM is 5.5 pC/N, higher than that of pristine PVDF PENG (3.1 pC/N). Output signal graphs corresponding to flapping, finger, knee, and elbow movements were detected. The response/recovery time of the sensor device was 24/19 ms. The piezoelectric nanogenerator (PENG) was capable of charging multiple capacitors to 2 V within a short time and lighting up 15 light-emitting diodes bulbs (LEDs) simultaneously with a single beat. In addition, a 4 × 4 row-column multiplexed sensor array was made of PENGs, which showed distinct responses to different stress areas in different sensor modules. This study demonstrated high-performance PDA@Tur PVDF-based PENG being capable of energy harvesting and sensing, providing a guideline for the design and buildup of wearable self-powered devices in healthcare and human-computer interaction.

Study of Titanium Elastic Nailing in Forearm Fractures in Elderly Patients

Background: As operative techniques and the quality of implants are improving, surgical management of diaphyseal fractures of forearm bones in elderly patients is gaining widespread acceptance. Titanium elastic nailing system (TENS) provides flexural, axial, translational, and adequate rotational stability. This study aims to analyze the outcomes of the treatment of diaphyseal forearm bone fracture with TENS nail. Methods: Elderly patients with both-bone forearm (BBFA) fractures in diaphysis were evaluated clinically and radiologically and followed for an average of six months. The outcome was assessed using the Grace-Eversmann scoring system. We followed up with all 25 patients and evaluated them every two weeks until the fracture united. Results: After approval of the ethics committee, twenty-five elderly patients with AO type 22A3 and 22B3 fractures of the forearm bone who fulfilled the inclusion and exclusion criteria were taken for the study. The mean age of the participants was 65 years. The average time to bone union was 12 weeks, and the average surgery time was 35 minutes. There was a superficial infection in one case. Most patients had a full range of elbow and wrist movements after the union. Conclusion: The TENS is an acceptable and good tachnique for displaced BBFA diaphyseal fractures in elderly patients. It is easy, cheap, and convenient and gives elastic mobility, promoting a rapid union of fractures and stability, which is ideal for early mobilization. It provides a lower complication rate, shorter surgery time, good cosmetic outcome, and easy implant removal.

The feasibility, acceptability, safety, and effects of early weight bearing in humeral fractures – a scoping review

Purpose Non-weight bearing is often recommended after humeral fractures. This review aims to summarise the extent and nature of the evidence for the feasibility, acceptability, safety, and effects of early weight bearing (EWB) in people with humeral fractures, treated operatively or non-operatively. Methods Data sources identified published (PUBMED, EMBASE, CINAHL) and unpublished (ClinicalTrials.gov, CENTRAL, NIHR Open Research, OpenGrey) literature. Independent data extraction was conducted by two reviewers. Results 13 901 records were retrieved. Ten studies, involving 515 post-operative patients and 351 healthcare professionals, were included. EWB was found to be feasible in nine studies. There was limited evidence regarding adherence to EWB. Trauma and orthopaedic surgeons reported that EWB was acceptable. This depended on surgery type and whether it was a post-operative polytrauma case. No acceptability data was reported from patients’ perspectives. Only one study reported two patients who developed unsatisfactory outcomes from excessive post-operative EWB. Positive effects of EWB were reported on disability level, pain, shoulder and elbow motion, and union. Conclusion There is some evidence for the feasibility, safety, and effectiveness of post-operative EWB after humeral fractures. There was limited data on the acceptability of EWB. Heterogeneous study designs, and variations in EWB protocols limit conclusions.

Associated Factor and Long-Term Clinical Outcomes for Patients with Postoperative Rotational Malreduction in Pediatric Supracondylar Humeral Fractures.

Background and Objectives: Long-term outcomes of immediately postoperative rotational malreduction in the axial plane after operative treatment of supracondylar humeral fractures (SCHF) are unknown. This study aimed to investigate the long-term clinical outcomes and associated factors for immediately postoperative rotational malreduction of SCHF. Materials and methods: In this retrospective case-control study, 88 patients who underwent surgery for Gratland type III SCHF were enrolled between January 2012 and January 2020. Among them, 49 patients had immediately postoperative malrotational reduction (rotational malreduction group) and 39 patients had no rotational deformity (control group). To evaluate the associated factors for immediately postoperative rotational malreduction, demographic data, fracture patterns, physical examination signs, and preoperative radiological parameters were analyzed. To compare the clinical outcomes, operation time, range of motion of the elbow, time from operation to full range of motion, and Flynn criteria were evaluated. The Oxford elbow score was used to investigate long-term clinical outcomes for patients five years after operation. Results: The mean age was 5.7 ± 2.3 years and mean follow-up period was 15.7 ± 4.0 months. The rotational malreduction group had significantly more patients with oblique fracture pattern (p = 0.031) and Pucker sign (p = 0.016) and showed a significantly longer operative time (p = 0.029) than the control group. Although there was no significant difference in the range of elbow motion and the Flynn criteria, the Kaplan-Meier survival curve showed a longer time to recover the full range of elbow motion in the rotational malreduction group (p = 0.040). There were no significant differences in the long-term clinical outcomes assessed using the Oxford elbow score (p = 0.684). Conclusions: Oblique fracture pattern and Pucker sign may be associated with immediately postoperative rotational malreduction in the axial plane. Although patients with immediately postoperative rotational malreduction showed favorable results of long-term clinical outcomes, they required more weeks to recover the full range of elbow motion.

Usefulness of multiple bioabsorbable Mg screws/K‑wires for comminuted radial head fractures.

We hypothesized that multiple absorbable screws/K-wires would be effective for native head preservation in comminuted radial head fracture fixation (com-RHFs). Seventeen patients who met the inclusion criteria between 2018 and 2020 were included. Radiologic findings indicating proper union and clinical outcomes such as the range of elbow motion, visual analog scale score, and Mayo Elbow Performance Score were assessed prospectively after surgery and at least threeyears of follow-up. The mean follow-up period was 4.6years. Eleven, one, three, and two patients presented with isolated com-RHFs, type 2 (accompanied injury of medial collateral ligament), type 4 ("terrible triad") fractures, and type 5 posterior olecranon fracture-dislocations, respectively. Union was achieved after a mean of nineweeks postoperatively. The head and shaft angles did not differ significantly from the contralateral normal values (p = 0.778 and 0.872, coronal and sagittal, respectively). At the final follow-up, the mean flexion-extension/pronation-supination arcs were 126.47 ± 4.92°/135.59 ± 10.13°, and thus were significantly different from those on the contralateral side (p < 0.001, both), however the arcs were functional ranges for ordinary daily life. Also, functional status was satisfactory in all individuals. The arthritis grade and extent of heterotrophic ossification were satisfactory in all cases, and there were no serious complications requiring revision surgery. Absorbable screw/K-wire fixation for com-RHFs is an option before radial head arthroplasty associated with a low complication rate and no need for revision.

Effectiveness of the static progressive Joint Active System splint in improving upper extremity joint stiffness

PurposeInjuries to the upper extremity often result in stiffness. The joint capsule may lose its elastic properties, limiting motion. Most modalities for increasing motion are based on capsule stretching, and usually involve physical or occupational therapy. We tested the hypothesis that the Joint Active System static-progressive splint is helpful in increasing range of motion in stiff joints after failure of other treatments. MethodsCandidates for the Joint Active System splint were mostly patients with upper extremity trauma that required surgery, if they plateaued after therapy but still had stiffness. A retrospective review was performed of all patients from 2015 to 2019 that met our inclusion criteria. Etiologies of stiffness and patient demographics were documented. Range of motion was recorded before and after treatment and, when available, functional scores were calculated. ResultsForty-four patients were treated with the Joint Active System splint; 5 were excluded, leaving 39 for analysis: 15 elbow, 14 wrist and 10 proximal interphalangeal joints. All patients had received therapy before using the Joint Active System and 11 had tried a dynamic splint in addition to therapy. All joints showed significant improvement in motion after treatment: from 66.5° to 95.7° in the elbow, 63.5° to 81.1° in the wrist and 33.2° to 51.8° in the proximal interphalangeal joint. When functional scores were available before and after treatment, there was significant improvement for both elbow and wrist. Even when the Joint Active System was started many months after injury, it was effective. ConclusionsDespite reaching a plateau with therapy, the Joint Active System static-progressive splint is effective in improving range of motion in elbow, wrist and finger joints with stiffness following injury or surgery. Type of studyRetrospective case series. Level of evidenceTherapeutic, level IV.

Complex elbow fracture-dislocations- what factors are associated with a poor post-operative outcome?

Despite standardized treatment algorithms, patients with complex elbow fracture-dislocation frequently suffer from poor post-operative elbow function leading to reduced quality of life. Up to now, there is no valuable data regarding risk factors that lead to poor post-operative outcome after surgical reconstruction of complex elbow fracture-dislocations. From 06/2010 to 12/2020 134 patients (51.3 ± 15.1 years, 44% women) undergoing surgical treatment of complex elbow fracture-dislocations could be included in this study. Follow-up period was 4.4 years (SD 2.5). All patients were clinically evaluated for elbow movement, elbow stability and common elbow scores (MEPS, OES, DASH-Score). Potential risk factors for poor post-operative outcome were identified using bi- and multivariate analyses. Overall good post-operative outcome has been achieved, mean MEPS was 88.8 ± 17.6. Post-operative complications occurred in 31.3% of the cases, while 25.4% required surgical revision. Patients with transolecranon dislocation fractures showed the significantly worst functional outcomes (p = 0.01). In addition, it has been shown that a patient's age of more than 70 years (OR = 10, p = 0.003) and a BMI of more than 35kg/m2 (OR = 7.6, p = 0.004) are independent risk factors for a poor post-operative outcome. In contrast, gender and time to surgery showed no significant influence on post-operative outcome. In most cases, good post-operative functional results can be achieved using standardized treatment protocols. However, complication and revision rates remain high. Patients older than 70 years of age or with a BMI over 35kg/m2 are at risk for an inferior outcome and require close follow-up monitoring.

Enhancing Robustness of Surface Electromyography Pattern Recognition at Different Arm Positions for Transhumeral Amputees Using Deep Adversarial Inception Domain Adaptation

Pattern recognition in myoelectric control that relies on the myoelectric activity associated with arm motions is an effective control method applied to myoelectric prostheses. Individuals with transhumeral amputation face significant challenges in effectively controlling their prosthetics, as muscle activation varies with changes in arm positions, leading to a notable decrease in the accuracy of motion pattern recognition and consequently resulting in a high rejection rate of prosthetic devices. Therefore, to achieve high accuracy and arm position stability in upper-arm motion recognition, we propose a Deep Adversarial Inception Domain Adaptation (DAIDA) based on the Inception feature module to enhance the generalization ability of the model. Surface electromyography (sEMG) signals were collected from 10 healthy subjects and two transhumeral amputees while performing hand, wrist, and elbow motions at three arm positions. The recognition performance of different feature modules was compared, and ultimately, accurate recognition of upper-arm motions was achieved using the Inception C module with a recognition accuracy of 90.70% ± 9.27%. Subsequently, validation was performed using data from different arm positions as source and target domains, and the results showed that compared to the direct use of a convolutional neural network (CNN), the recognition accuracy on untrained arm positions increased by 75.71% (p &lt; 0.05), with a recognition accuracy of 91.25% ± 6.59%. Similarly, in testing scenarios involving multiple arm positions, there was a significant improvement in recognition accuracy, with recognition accuracy exceeding 90% for both healthy subjects and transhumeral amputees.

Implicit and explicit motor imagery ability after SCI: Moving the elbow makes the difference

Cervical spinal cord injury (SCI) causes dramatic sensorimotor deficits that restrict both activity and participation. Restoring activity and participation requires extensive upper limb rehabilitation focusing elbow and wrist movements, which can include motor imagery. Yet, it remains unclear whether MI ability is impaired or spared after SCI. We investigated implicit and explicit MI ability in individuals with C6 or C7 SCI (SCIC6 and SCIC7 groups), as well as in age- and gender-matched controls without SCI. Inspired by previous studies, implicit MI evaluations involved hand laterality judgments, hand orientation judgments (HOJT) and hand-object interaction judgments. Explicit MI evaluations involved mental chronometry assessments of physically possible or impossible movements due to the paralysis of upper limb muscles in both groups of participants with SCI. HOJT was the paradigm in which implicit MI ability profiles differed the most between groups, particularly in the SCIC6 group who had impaired elbow movements in the horizontal plane. MI ability profiles were similar between groups for explicit MI evaluations, but reflected task familiarity with higher durations in the case of unfamiliar movements in controls or attempt to perform movements which were no longer possible in persons with SCI. Present results, obtained from a homogeneous population of individuals with SCI, suggest that people with long-term SCI rely on embodied cognitive motor strategies, similar to controls. Differences found in behavioral response pattern during implicit MI mirrored the actual motor deficit, particularly during tasks that involved internal representations of affected body parts.

The relationship between manual ability, dystonia and choreoathetosis severity and upper limb movement patterns during reaching and grasping in children and young adults with dyskinetic cerebral palsy

IntroductionImpaired upper limb movements are a key feature in dyskinetic cerebral palsy (CP). However, information on how specific movement patterns relate to manual ability, performance and underlying movement disorders is lacking. Insight in these associations may contribute to targeted upper limb management in dyskinetic CP. This study aimed to explore associations between deviant upper limb movement patterns and (1) manual ability, (2) severity of dystonia/choreoathetosis, and (3) movement time/trajectory deviation during reaching and grasping. Participants/methodsParticipants underwent three-dimensional upper limb analysis during reaching forwards (RF), reaching sideways (RS) and reach-and-grasp vertical (RGV) as well as clinical assessment. Canonical correlation and regression analysis with statistical parametric mapping were used to explore associations between clinical/performance parameters and movement patterns (mean and variability). ResultsThirty individuals with dyskinetic CP participated (mean age 16±5 y; 20 girls). Lower manual ability was related to higher variability in wrist flexion/extension during RF and RS early in the reaching cycle (p < 0.05). Higher dystonia severity was associated with higher mean wrist flexion (40–82 % of the reaching cycle; p = 0.004) and higher variability in wrist flexion/extension (31–75 %; p < 0.001) and deviation (2–14 %; p = 0.007/60–73 %; p = 0.006) during RF. Choreoathetosis severity was associated with higher elbow pro/supination variability (12–19 %; p = 0.009) during RGV. Trajectory deviation was associated with wrist and elbow movement variability (p < 0.05). ConclusionCurrent novel analysis of upper limb movement patterns and respective timings allows to detect joint angles and periods in the movement cycle wherein associations with clinical parameters occur. These associations are not present at each joint level, nor during the full movement cycle. This knowledge should be considered for individualized treatment strategies.

Metal-doped functional zinc oxide nanosheets as flexible piezoelectric generator for self-powered mechanical sensing

The development of self-powered active mechanical sensors, which enable tactile sensing capabilities for soft robotics, has been substantially accelerated by the invention and rapid advancement of piezoelectric nanogenerators that harness mechanical energy from the environment as electricity. However, fabrication methods and sensory output expansion of nanogenerators are still challenging to meet the stability and durability requirements during prolonged use. In this work, metal-doped zinc oxide nanomaterial-polymer composites are prepared, characterized, and fully embedded in the flexible substrates to fabricate piezoelectric sensors with enhanced output performance and sensing capabilities. The flexible device can generate an open-circuit voltage up to 13.6 V when the applied force is 8 N at 3 Hz. In addition, these lead-free composite devices exhibit remarkable elbow motion detection sensitivity, providing a tremendous potential for precise human body motion sensing. Further, based on the sensors, a biomimetic soft robotic fin with mechanosensation has been developed, which can measure both the amplitude and frequency of the flapping of the fin ray. These findings not only shed new light on the development of functionl piezoelectric nanogenerators, but also lay the framework for advanced ambient sensing capacities of underwater organisms or robots.

Bridge plating is an effective adjunct treatment for complex elbow instability

Managing persistent elbow instability and chronic dislocations presents challenges despite traditional treatments. Supplementary methods like immobilization and various fixations, though common, can carry high complication rates. This study assesses the efficacy of bridge plating in treating complex elbow instability through a retrospective review of patients. Data on characteristics, treatment duration, range of motion, complications, and evaluation scores were analyzed, providing insights into outcomes complications associated with bridge plating. Eleven patients were reviewed at a mean follow-up of 80±68 weeks postoperatively. The mean age was 53±14 years and there were 5 females and 6 males. The mean body mass index was 38. Bridge plating was used for a spectrum of complex elbow injuries. The mean time from injury to bridge plating in acute cases was 29±19 days and 344±381 days in chronic cases. The mean duration of bridge plating was 121±72 days. At the time of plate removal, mean intraoperative elbow motion was extension 58°±12°, flexion 107°±14°, supination 66°±23° and pronation 60°±26°. At the latest follow-up visit, mean elbow motion was extension 37°±22°, flexion 127°±17°, supination 72°±15°, and pronation 63°±18°. There were 6 complications (55%): heterotopic ossification, ulnar neuropathy, wound failure over the plate in a thin patient, an ulnar shaft periprosthetic fracture due to a seizure-induced fall, and persistent elbow subluxation despite bridge plate fixation. Finally, 1 patient sustained a fracture of a 3.5-mm locking bridge plate. One patient required a contracture release for persistent stiffness. Four of these complications can be directly attributed to the use of the bridge plate (36%). At final follow-up, the mean patient-rated elbow evaluation score was 34, with 0 indicating no pain and disability. The mean Single Assessment Numeric Evaluation score was 66% for the 8 patients who had this available, with 100% being the best possible attainable score. Bridge plating effectively maintains joint reduction in selected complex elbow instability cases. However, patients with bridge plates often require a second surgery for removal and experience high rates of general complications because of the complexity of their condition.

Study on Motion Sensing Using Textile Electrodes-Focusing on the Application of PANI Conductive Material

Abstract This study investigates the application of textile electrodes using PANI (Polyaniline) conductive material for motion sensing, specifically aimed at motion monitoring for the elderly. By depositing a PANI conductive layer on the base of warp-knitted fabric through in-situ polymerization and plasma treatment, a PCCWKF (Polyaniline Coated Conductive Warp-Knitted Fabric) with enhanced electrical conductivity and mechanical flexibility was developed. The research optimized the electrical resistivity and durability of PCCWKF by incorporating Polyvinyl Alcohol (PVA) as a toughening agent, improving the adhesion of the PANI conductive layer to the textile substrate. The sensor’s efficacy in accurately recording and monitoring motion amplitude and frequency in real-time was demonstrated through its application in smart clothing, focusing on respiratory, elbow, and knee motion monitoring. This study holds significant implications for the advancement of wearable technology and smart textiles in the health monitoring of the elderly.

Visuomotor coordination with gaze, head and arm movements during table tennis forehand rallies.

The purpose of this study was to clarify the temporal coordination between gaze, head, and arm movements during forehand rallies in table tennis. Collegiate male table tennis players (n=7) conducted forehand rallies at a constant tempo (100, 120, and 150bpm) using a metronome. In each tempo condition, participants performed 30 strokes (a total of 90 strokes). Gaze, head, and dominant arm (shoulder, elbow, and wrist) movements were recorded with an eye-tracking device equipped with a Gyro sensor and a 3-D motion capture system. The results showed that the effect of head movements relative to gaze movements was significantly higher than that of eye movements in the three tempo conditions. Our results indicate that head movements are closely associated with gaze movements during rallies. Furthermore, cross-correlation coefficients (CCs) between head and arm movements were more than 0.96 (maximum coefficient: 0.99). In addition, head and arm movements were synchronized during rallies. Finally, CCs between gaze and arm movementswere more than 0.74 (maximum coefficient: 0.99), indicating that gaze movements are temporally coordinated with arm movements. Taken together, head movements could play important roles not only in gaze tracking but also in the temporal coordination with arm movements during table tennis forehand rallies.

Safety and effectiveness of the three-dimensional-printed guide plate-assisted rotation axis positioning of a hinged external fixator for the elbow.

We aimed to evaluate the safety and effectiveness of three-dimensional (3D)-printed guide plates for assisting in the positioning of the rotation axis of an elbow-hinged external fixator. Terrible triad (TT) patients, who were screened using the predefined inclusion and exclusion criteria, underwent installation of a hinged external fixator on the basis of internal fixation; 3D-printed guide plates, generated from the patient's imaging data, assisted in positioning the rotation axis. All patients received the same peri-operative management and were followed up at six, 12, 24, and 48 weeks postoperatively. The duration of positioning pin placement, the number of fluoroscopies, pin placement success rate, types and incidence of post-operative complications, and the Mayo elbow performance score (MEPS) of the diseased elbow and range of motion (ROM) of both elbows were assessed. In 25 patients who completed the follow-up, the average time required for positioning pin placement was 329.32 ± 42.38 s (263-443 s), the average number of fluoroscopies was 2.32 ± 0.48 times (2-3 times), and the pin placement success rate was 100%. At the last follow-up, the mean MEPS of the diseased elbow was 97.50 ± 6.92 (75-100), with an excellent and good rate of 100%, and all patients demonstrated stable concentric reduction. The average range of flexion and extension was 135.08° ± 17.10° (77-146°), while the average range of rotation was 169.21° ± 18.14° (108-180°). No significant difference was observed in the average ROM between the both elbows (P > 0.05). Eight (32%) patients developed post-operative complications, including elbow stiffness due to heterotopic ossification in three (12%) patients, all of whom did not require secondary intervention. Utilizing 3D-printed guide plates for positioning the rotation axis of an elbow-hinged external fixator significantly reduced intra-operative positioning pin placement time and the number of fluoroscopies with excellent positioning results. Satisfactory results were also obtained in terms of post-operative complications, elbow ROM, and functional scores.

Is Postoperative Splinting Advantageous After Upper Extremity Fracture Surgery? Results From the Arm Splint Pain Improvement Research Experiment.

The authors report no conflict of interest.To determine if short-term immobilization with a rigid long arm plaster elbow splint after surgery of the arm, elbow, or forearm results in superior outcomes compared with a soft dressing with early motion. Prospective Randomized Control Trial. Academic Medical Center. Patients undergoing operative treatment for a mid-diaphysis or distal humerus, elbow, or forearm fracture were consented and randomized according to the study protocol for postoperative application of a rigid elbow splint (10-14 days in a plaster Sugar Tong Splint for forearm fracture or a Long Arm plaster Splint for 10-14 for all others) or soft dressing and allowing immediate free range of elbow and wrist motion (range of motion [ROM]). Self-reported pain (visual analog score or VAS), Healthscale (0-100, 100 denoting excellent health), and physical function (EuroQol 5 Dimension or EQ-5D) surveyed on postoperative days 1-5 and 14 were compared between groups. Patient-reported pain score (0-10, 10 denoting highest satisfaction) at week 6, time to fracture union, ultimate disabilities of the arm, shoulder, and hand score, and elbow ROM were also collected for analysis. Incidence of complications were assessed. Hundred patients (38 men to 62 women with a mean age of 55.7 years) were included. Over the first 5 days and again at postop day 14, the splint cohort reported a higher "Healthscale" from 0 to 100 than the nonsplint group on all study days ( P = 0.041). There was no difference in reported pain between the 2 study groups over the same interval ( P = 0.161 and 0.338 for least and worst pain, respectively), and both groups reported similar rates of treatment satisfaction ( P = 0.30). Physical function ( P = 0.67) and rates of wound problems ( P = 0.27) were similar. Additionally, the mean time to fracture healing was similar for the splint and control groups (4.6 ± 2.8 vs. 4.0 ± 2.2 months, P = 0.34). Ultimate elbow ROM was similar between the study groups ( P = 0.48, P = 0.49, P = 0.61, and P = 0.51 for elbow extension, flexion, pronation, and supination, respectively). Free range of elbow motion without splinting produced similar results compared with elbow immobilization after surgical intervention for a fracture to the humerus, elbow, and forearm. There was no difference in patient-reported pain outcomes, wound problems, or elbow ROM. Immobilized patients reported slightly higher "healthscale" ratings than nonsplinted patients and, however, reported similar rates of satisfaction. Both treatment strategies are acceptable after upper extremity fracture surgery. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.