Forearm Support Research Articles

Designing a Nasal Lining-Framework Complex for Reconstructing Total Nasal Defects.

To validate the feasibility of an innovative nasal lining-framework complex (NLFC) for reconstructing total nasal defects. Retrospective cohort study. This NLFC is composed of forearm flap and support framework. Twenty-four patients were followed up for a minimum of 17 months in 5 centers. Patients' medical history data were retrospectively analyzed. Visual Analog Scale (VAS) of surgeons and patients was used to evaluate the aesthetic effects and self-satisfaction. The Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and Rhinoplasty Outcome Evaluation (ROE) questionnaire were used for functional assessment. Reconstruction surgeries were all successfully completed. The flaps healed well in all patients, and there were no signs of ischemic necrosis. The healing time of the wound was 10 to 14 days, except for 1 case with infection. The nasal lining was reconstructed and no significant contracture was observed. The average VAS of surgeons was 4.29 ± 0.69 (range 3-5). The mean VAS score of patients was 3.75 ± 0.79 (range 2-5). There was a significant positive correlation between patients' and surgeons' VAS scores (P = .007, r = .5355). The results of the NOSE questionnaire showed that all patients had no obvious ventilation restriction, and only 3 patients mildly felt that the nasal inspirations were slightly insufficient during exercise or exertion. The mean ROE of the patients was 21 ± 1.96 (range 18-25). This NLFC is suitable for total nasal reconstruction, which can provide effective support to prevent flap collapse and retraction and ensure good nasal ventilation. Level IV, therapeutic study.

Development of Assistance Level Adjustment Function for Variable Load on a Forearm-Supported Robotic Walker.

With the progression of an aging society, the importance of walking assistance technology has been increasing. The research and development of robotic walkers for individuals requiring walking support are advancing. However, there was a problem that the conventional constant support amount did not satisfy the propulsion force required for the walking speed that users wanted. In this study, in order to solve this problem, we propose an algorithm for determining the support amount to maintain the walking speed when the average walking speed of each user is set as the target speed. A robotic walker was developed by attaching BLDC motors to an actual walker, along with a control algorithm for assistance based on sampling-type PID control. The effectiveness of the assistance determination algorithm and the usefulness of the parameters were demonstrated through experiments using weights loaded on the forearm support and target speeds. Subsequently, subject experiments were conducted to verify the ability to maintain target speeds, and a questionnaire survey confirmed that the assistance did not interfere with actual walking. The proposed algorithm for determining the assistance levels demonstrated the ability to maintain target speeds and allowed for adjustments in the necessary level of assistance.

Comparison of Development of Upper Trapezius Trigger Point in Computer Operators with or without Fore arm support

Background:Computer work often involves both physical and mental demands. The physical demands are characterizedby low-force exertions and static postures that are sustained for long durations. Elevated shoulder postures,prolonged static contractions and the task duration have been identified as computer-related risk factorsfor neck and shoulderproblems, so this is responsible for development of trigger points particularly in the uppertrapezius muscles in forearm-unsupported computer operators as compared to forearm-supported.The uppertrapezius (UT)is designated as a postural muscle and is highly suspected ofoveruse because it works constantlyagainst gravity to maintain an erect head and neck position. This studyaims to identify upper trapezius triggerpoints (TrPs) developed with or without forearm support (FS) in computer operators.Materials and Methods: The study took place in the worksite of computer operators in Nagpur,Maharashtra for1.5 year. With a power of 90 and significance error of 1%, a total of 40 patients were taken according to the convenientsampling and divided into two categories computer operators Group A: with FS and Group B: without FS,following signs and symptoms like Trigger point, posterolateral neck and upper back pain most common in which group assessed by using, VAS (Visual Analogue Scale) for measuring pain intensity, Trigger Point Rating Scale is used for myofascial screening. Neck Disability Index for assessing the neck-related disability due to pain taken.Result: The study was conducted on 40 people, in which 20 people with forearm support and 20 people withforearm unsupported. The result is that forearm support reduces the load on the UTand also reduces the risk ofdevelopment of upper trapezius TrPs as compared to the forearm unsupported.Conclusion: Based on the results of these studies, it has been concluded that the development of UT TrPsincomputer operators without FS is more common as compared to FS.

Total forearm support during a typing task may reduce the risk of Trapezius' Myalgia development

ObjectiveEvaluate the influence of alternating the position of the upper limbs, between fully supported and unsupported forearms, in the Upper Trapezius (UT) activity during a typing task on a straight-edged desk. BackgroundErgonomic barriers, such as reduced desk area, is one of the reasons that force computer users to work without supporting their forearms. Unsupported forearms may lead to increased UT muscle fatigue, increasing the potential for lesions, with Trapezius Myalgia (TM) being a possible outcome. Method15 healthy volunteers were assessed (6 females, average age of 3,7 ± 9,5 years old). The protocol included an alternated position of forearms every 5 min between fully supported and unsupported forearms, with a 20-min total duration of a typing task. Surface electromyography readings were collected from both UTs. ResultsSignificant differences were found in the variation of the EMG signal between the two positions for the non-dominant arm after 10 min (p < .05) of typing. The non-dominant UT registered higher levels of activity than the dominant UT. Supported forearms reduced the electrical activity in both UTs, with a greater difference in the non-dominant. ConclusionThis study consolidates the current knowledge that unsupported upper limb during typing tasks significantly increases UT's electrical activity. By fully supporting the forearm, that activity is reduced. Females and the non-dominant UT showed higher electrical activity, potentially increasing the risk of developing TM. ApplicationHealthcare providers, safety and health professionals, and ergonomists should be mindful of the forearm position when advising computer users to prevent TM.

Research on a compact and lightweight forearm pronosupination support device using an elastic strip

Research on a compact and lightweight forearm pronosupination support device using an elastic strip

Mechanism design of elbow joint rehabilitation robot

Aiming at the problems of low mechanism precision, large motion inertia, and ease of secondary patient damage in the elbow joint rehabilitation robot, an exoskeleton parallel robot that can realize two degrees of freedom (2-PRR-S) motion of the elbow joint is designed. First, use Solidworks to complete the design and modeling of each component, and use ANSYS to perform finite element analysis on some important components to check the strength of the components. Finally, Adams is used to performing kinematic analysis in order to verify the kinematic properties of the forearm support, and the check analysis of the whole mechanism’s kinematic properties is completed. The simulation results show that the designed elbow joint rehabilitation robot meets the design requirements.

Autologous Stem Cell Transplantation (ASCT) for Refractory Juvenile-Onset Systemic Sclerosis (jSSc) Is Safe and Well Tolerated and Improves Clinical and Patient-Reported Outcomes

Introduction: jSSc is a rare autoimmune disease that leads to inflammation, fibrosis, and dysfunction of multiple organ systems which can cause skin sclerosis, interstitial lung disease (ILD), myositis, fasciitis, gastrointestinal and vascular disease. Severe SSc is often refractory to immunomodulatory medications including newer targeted agents. ASCT has demonstrated success in adults with SSc, but experience and data in pediatric patients is limited. Methods: We report our first four consecutive adolescent and young adult ASCT patients. All patients were referred to our scleroderma center at UPMC Children's Hospital of Pittsburgh where they were evaluated by our multidisciplinary team. Baseline patient characteristics are summarized in Table 1. Patients met criteria for ASCT by severity of lung or skin disease, or both. The first 3 patients had severe ILD or musculoskeletal chest wall weakness resulting in pulmonary function tests (PFTs) below traditional cut offs for adult SSc ASCT trials. All four patients had refractory disease and had previously received 3-8 immunomodulatory medications. Autologous stem cells were mobilized with cyclophosphamide and filgrastim and collected via pheresis. Following this, conditioning chemoradiation was administered per an IRB-approved individual treatment plan (Patients 1-3) or on our clinical trial NCT03630211 (Patient 4) with rituximab, anti-thymocyte globulin (ATG), TBI 600 cGy with lung and kidney shielding, and cyclophosphamide or thiotepa +/- alemtuzumab. A CD34+ selected cryopreserved autologous peripheral blood stem cell graft was infused on day 0. Antimicrobial prophylaxis was given per institutional standard and PCRs for EBV, CMV and adenovirus were closely monitored. Steroids were weaned off by 5 weeks post-ASCT. Results: The median cell dose was 5.9 e6 CD34/kg. All patients engrafted, with median neutrophil engraftment on day 11 (range 11-15), and median platelet engraftment (>50K) on day 18.5 (range 16-20). There were infusion-related side effects with equine ATG, but none with rabbit ATG. There were no cases of sinusoidal obstructive syndrome, thrombotic microangiopathy or clinically significant bleeding. No patients required a PCA for pain and received minimal (median=3) doses of narcotics. Patients were discharged from the hospital a median of 19 days after transplant (range 17-21). Only one patient was readmitted, and had a negative 48 hour infectious rule out. Two patients acquired COVID-19 infections at 5 and 19.5 months post-ASCT; both remained outpatient with quick improvement after treatment with best available therapy. There were no viral reactivations, bacterial or fungal infections. There has been no evidence of organ toxicity and there are objective improvements in clinical parameters as well as patient reported outcomes (PROs) over the follow-up visits (Table 2). All patients demonstrated an improvement in their skin involvement, as measured by the modified Rodnan Skin Score (mRSS). There was an improvement in clinical symptoms and exam findings of Raynaud's. The lower esophageal sphincter became less hypotensive; objective measures and symptoms of gastroesophageal reflux were much improved. Despite severely reduced values of forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) prior to ASCT, all subjects regained pre-ASCT values. All patients demonstrated an improvement in their PROs and report improvement in fatigue, pain, and the ability to participate in activities of daily living. All patients are off immunomodulatory medications. Tandem serial skin biopsies of the forearm support decreased collagen burden and disappearance of a myofibroblasts population with single cell RNA sequencing (n=3, timepoints 0, 6, 12 mos; data not shown), which correlates with an improvement in the skin score. Conclusions: In refractory jSSc patients, ASCT is well tolerated, even in patients with severe disease who would otherwise not be eligible for clinical trials based on exclusion criteria that were developed for adults with SSc. ASCT can serve as a hard reset to the immune system for patients with this refractory autoimmune disease, with improvements in clinical parameters that reflect disease modification involving the skin, musculoskeletal, vascular, and gastrointestinal systems. Further clinical research treating patients with this rare disease is of great need. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Riscos ergonômicos e sintomas musculoesqueléticos em técnicos administrativos do Instituto Federal Catarinense durante o teletrabalho na pandemia da COVID-19

ABSTRACT This study aimed to evaluate musculoskeletal symptoms and ergonomic risks in telework environments of administrative technicians at the Instituto Federal Catarinense. In total, 142 administrative technicians who answered an online questionnaire about sociodemographic information, task performance, work environment, and musculoskeletal pain participated in the study. Data were analyzed by binary logistic regression separately for each outcome, using pain in the neck, right shoulder and low back pain as dependent variables. The prevalence of pain among administrative technicians was 92.7% and the most frequent regions were the neck, lumbar spine, and right shoulder. Mental overload (stress), inadequate worktable, monitor and work chair, lack of guidance on ergonomic risks and adaptations in the work environment were the main ergonomic risks. An association was observed between neck pain and administrative technicians who were mentally overloaded, did not practice any physical activity, did not have the table at elbow level, had neither forearms support nor used a mouse (but a touchpad instead); and right shoulder pain in administrative technicians who had no forearm support and used a touchpad. Also, low back pain was associated with mentally overloaded women who did not have footrest, table at the elbow level, or a chair with lumbar support and upholstery. The institution should provide adequate equipment and furniture and training the employees on the ergonomic risks at work.

Impact of measurement timing on reproducibility of testing among haemodialysis patients

Accurate evaluation of physical function in patients undergoing haemodialysis is crucial in the analysis of the impact of exercise programs in this population. The aim of this study was to evaluate the reproducibility of several physical functional tests, depending on the timing of their implementation (before the HD session vs. non-HD days). This is a prospective, non-experimental, descriptive study. Thirty patients in haemodialysis were evaluated twice, 1 week apart. The test session was performed before the haemodialysis session started and a retest was performed in non-dialysis day. The testing battery included the short physical performance battery, sit-to-stand tests, 6 min walk test, one-leg stand test, timed up and go, and handgrip strength with and without forearm support. The intra-rater reproducibility was determined by the intraclass correlation coefficients and the agreement was assessed by Bland–Altman analysis. The intraclass correlation coefficients values ranged from 0.86 to 0.96, so that all tests showed good to very good relative reliability. The mean differences between trials of sit to stand 10 and 60, timed up and go and all the handgrip tests were close to zero, indicating no systematic differences between trials. Large range of values between trials was observed for the 6 min walk test, gait speed, one-leg stand test and short physical performance battery, indicating a systematic bias for these four tests. In conclusion, the sit to stand 10 and 60, timed up and go and handgrip tests had good to excellent test–retest reliability in measuring physical function in different dialysis days of patients undertaking haemodialysis. The minimal detectable change values are provided for this population. Bias were found for the 6 min walk test, gait speed, Short physical performance battery or one-leg stand test when the testing day changed.

Effect of ergonomic Armrest® forearm support on wrist posture related to carpal tunnel pressure during computer mouse work

ObjectiveWe validated the effect of moveable arm support (Armrest®) on wrist posture during three standardized tasks. BackgroundThe use of the computer mouse has been increasing over the years and it has been identified as one of the occupational activities related to carpal tunnel syndrome (CTS). The main mechanism for CTS is carpal tunnel pressure (CTP) that could be estimated from the wrist posture. MethodUsing an electronic goniometer, we assessed wrist extension/flexion and ulnar-radial flexion in 15 participants (age: 34.8 [8.7] years) and calculated the time the wrist posture was outside the threshold values previously related to CTP. Specifically, we estimated time when wrist posture yielded >25 mmHg of CTP: wrist extension >32.7°; wrist flexion < −48.6°; wrist ulnar flexion >14.5°; and wrist radial flexion < −21.8°. ResultsAverage wrist extension/flexion tends to be 13.4° lower (p = 0.063), while radial-ulnar flexion was 13.2° lower (p = 0.025) when Armrest® forearm support was used in comparison to fixed forearm support. Furthermore, the time spent outside the threshold wrist extension was 25.8% (p = 0.018) lower and ulnar flexion was 37.2% (p = 0.017) lower when using Armrest® compared to a fixed forearm support. Results were independent from tasks. ConclusionArmrest® diminished the time spent outside the threshold values related to 25 mmHg of CTP indicative of CTS. ApplicationA moveable arm support is a simple and effective way to increase occupational health during computer mouse work.

Developmental delay in congenital hypothyroidism.

We report the case of a 5-month-old male, born out of a nonconsanguineous marriage, who presented with an inability to hold neck. As per the parents, he had diminished spontaneous movements since birth and described him as lethargic. He was clinically diagnosed with cretinism by a pediatric neurologist. He was referred by to the department of physiotherapy for evaluation and advice for the associated motor delay. On observation, the infant displayed peculiar clinical features of sparse hair, periorbital edema and macroglossia (A). Irritability, hoarse cry, abdominal distension and frog leg position was observed in supine lying position (B). Examination revealed generalized hypotonia, wide fontanelles, feeding difficulties and global developmental delay. He was neither able to roll over from supine to prone nor was he able to hold neck adequately. He had head lag during pull to sit test. Due to financial constraints, they were not willing to attend physiotherapy sessions on a regular basis. Thus, parents were educated about the home exercise program that included active assisted rolling, neck extensor muscles facilitation against gravity while lying prone on forearm, active assisted reaching out for objects while lying, neck flexor muscles facilitation in gravity minimized plane and active neck rotations to look at objects of interest while side lying on forearm support. Congenital hypothyroidism is still a common cause of developmental delay in newborns of the developing countries. Awareness, universal newborn screening, prompt recognition and medical treatment along with physiotherapy can minimize adverse effect on the physical and neurocognitive development.

Risk factors associated to musculoskeletal disorder perception in college students, Bogota, 2016

ObjetivoAnalisar fatores de risco (pausas activos e posto de trabalho) associados à percepção de distúrbios músculo-esqueléticos (MSD) em estudantes de pós-graduação de uma universidade, Bogotá 2016. Métodosrealizou-se um estudo transversal; um questionário de auto-relato (variáveis sociodemográficas, conteúdo de trabalho e questionário nórdico) por e-mail enviado; uma amostra aleatória de 304 estudantes de pós-graduação da universidade e a análise estatística em SPSS Versión 24 foram feitas. Resultados89,5% (272) algum tipo de desconforto ocular e/ou DME nos últimos 7 dias; diferença significativa entre não ter pausas e sintomas (S) na χ2 do pescoço = 7.227 (P = 0,007); não executa alongamentos vs (S) no pescoço O = 2.4048 (1.0133–5.707); uso de laptop versus olhos (S) OR = 2.7132 (1.457–5.0526), (S) ombros OR = 10.6364 (4.9905–22.6697), (S) cotovelos χ2 = 6.407 (P = 0,04); não usa o mouse externo vs (S) cotovelos (χ2 = 4849 P = 0,028, (S) mão pulso χ2 = 4095 (P = 0,043), não suporte do antebraço na tabela vs. (S) parte inferior das costas: χ2 = 6894 (P = 0,009), houve alteração na (S) do ombro, cotovelo, pulso, costas altas, joelho e tornozelo (P < 0,05) (teste de Mcnemar). Conclusõesos resultados correm em associação entre não realizar pausas ativas, alongamento e (S.) Pescoço; uso de laptop e (S) nos olhos, ombros (S) e cotovelo esquerdo, sem uso de mouse externo e (S) no cotovelo e mão/pulso direito, sem suporte do antebraço na mesa e (S) na parte inferior das costas; A mudança em (S) nos membros superiores e inferiores foi apresentada.

Лечение пронаторной деформации предплечья у детей с церебральным параличом в дошкольном возрасте

Cerebral palsy (CP) remains one of the main neurological diseases leading to disability of children. One of the leading causes is pronator deformity of the forearms, in which the development of voluntary hand movements is not only slowed down, but qualitatively impaired. In 75–90% of children, the manipulative activity of the upper extremities remains defective, and in 30–45% of cases it is sharply limited throughout life, especially in hemiparetic form and spastic diplegia. With a severe form of spastic diplegia, by the age of 3, flexion contractures of the elbow joints, pronator contractures of the forearm, with elbow deviation of the hand, with violation of all types of grips, make self-service difficult. Lack of attention to these deformities of the upper limbs on the part of neurologists and orthopedists leads to an incorrect treatment plan, primarily surgical, to eliminate pronator deformities of the forearm. In the literature, there are few publications on upper limb deformities in cerebral palsy, although the positive results of surgical correction of pronator deformities are recognized in 85%. However, the indications for surgical treatment are not clearly defined, especially regarding the choice of the method of surgical correction in a particular case. The analysis of preoperative treatment of 54 children with spastic diplegia at the age of 3–4 years showed a low efficiency of conservative therapy with pronator settings of the forearms and a complete lack of effect in case of contractures. This led to the understanding that in case of pronator contractures and deformities of the forearm by 3–4 years of age, with spastic diplegia, surgical treatment is indicated, aimed either at restoring active movements or at eliminating a cosmetic defect. The main reason for the formation of pronator deformity of the forearms was the contraction of the round pronator of the forearm. The observed patients were divided into 3 groups. In children of the first group (27 patients), contracture was 30-70º, due to contraction of the m.pronator teres, while maintaining the manipulative function of the hand. In the second group (6 patients), hand function was also not impaired, but there was a decrease in the strength of the forearm instep support (up to 3 points) with pronator contracture of the forearm at 40–90º. The third group (6 children) lacked the function of the instep support while maintaining the function of m.pronator teres and a decrease in manipulative activity. The dysfunction was accompanied by the absence of one or two main grips, with manifestations of afunctionality. In this group, MRI studies revealed porencephalic and arachnoid cysts of the contralateral hemispheres. The indications for surgical treatment are cosmetic only. 39 children of 3–7 years old with cerebral palsy with pronatonator deformity of the forearm were operated. Before surgery, pronator contractures were 40–90° with no convincing age correlation. With surgical treatment at 3–4 years of age, pronator deformity of the forearm up to 50° was completely eliminated, and with initial values of 70–90° — to a residual of 15–30°, with a decrease to 10–15° after a year. With surgery at the age of 6–7 years, a residual contracture of 10–30° was observed in more than half of the patients, due to the torsion of the forearm bones and disturbed relationships in the distal and proximal radioulnar joints at this age. Complete restoration of forearm supination and elimination of deformity (good result) was achieved in 21 (53,8%) children. An increase in supination of the forearm with residual deformity and an improvement in the manipulative function of the hand, or the desired cosmetic effect (satisfactory result) was observed in 18 (46,2%) patients. In three children of the first and second groups, despite a pronounced clinical improvement, the expected effect on the complete restoration of the manipulative function of the forearm and hand was not obtained, due to gross organic changes in the 4 and 6 fields of the brain, revealed by MRI. In the postoperative period after aponeurotic lengthening of the round pronator or its myotomy, we applied a method developed by us for the functional treatment of early kinesitherapy of the operated forearm. In children of the first and second groups, an improvement in the vegetative state on the part of the forearm and hand was revealed (symptoms of «cold hands» and hyperhidrosis disappeared), associated with the elimination of the «tunnel» state of the median nerve in the zone of its passage at the circular pronator in the upper third of the forearm and improving microcirculation of the forearm and hand. Thus, a differentiated approach to surgical correction of deformities made it possible to obtain a good result in 21 (53,8%) children, and a satisfactory one in 18 (46,2%) children.

Forearm Support Band Versus Wrist Splint in Treatment of Lateral Epicondylitis

Forearm Support Band Versus Wrist Splint in Treatment of Lateral Epicondylitis

Effects of holding postures on user-defined touch gestures for tablet interaction

Multi-touch tablets afford various support positions and can accommodate interaction with the thumbs and multiple fingers from both hands. However, today’s touch gesture design for tablets generally does not consider the effects of such a diversity of interactions. Therefore, we conducted a user-elicited study by asking participants to create touch gestures to perform interactive tasks in three common tablet-holding postures respectively (i.e. two-handed palm support, one-handed palm support and one-handed forearm support). In all, 1323 gestures for 30 common tasks were logged and analyzed. Our main findings are: (1) In general, user-designed gestures were quite alike for one-handed palm support and forearm support; (2) for commands such as target-position-related ones (e.g. “select single or group (center area of the screen)”) and target-movement-related ones (e.g. “move a lot (left to right) / (right to left)” and “move a little (center area of the screen)”), two-handed support and one-handed supports led to different user-defined gesture performances; (3) the effects of tablet holding postures on users’ mental models varied in referents being executed by defined gestures. We also present a complete user-defined gesture set, quantitative agreement rates and practical implications for gesture design on tablets.

Reconstruction of forearm support with ulnar translocation after resection of chondrosarcoma in the proximal radius.

This is areport of the reconstructive surgery of apatient with chondrosarcoma in the proximal radius. After extensive resection of the proximal radius that contained the tumor, the skeleton of the forearm was reconstructed by ulnar translocation. This patient was followed for 2years, no recurrence of the tumor was found and the function of the forearm was nearly normal. This case is reported and discussed and aliterature review is presented.

Mouse with your arm™: Facilitating forearm support using the chair armrest to prevent and mitigate musculoskeletal disorders.

Musculoskeletal disorders (MSDs) can be prevented by avoiding trauma caused by poor posture, compression, force, and repetition. Neutral postures are recommended to avoid MSDs. This study introduces Mouse With Your Arm™ (MWYA) methodology which promotes sitting back in a chair, using the chair's armrest for forearm support at relaxed elbow height, matching surface and armrest height, and keeping the mouse on the surface edge. This position allows optimal task chair use, facilitates movement and neutral postures, avoids compression and contact stress, and is effective in mitigating MSDs. MWYA was applied and measured in the field for more 23 years providing over 3,500 individualized assessments to integrate a participant's unique characteristics, reported health concerns, tasks, tools, and environment to achieve and sustain whole-body neutral and comfortable working postures. Previous research has consistently recommended use of forearm support by a desk, apparatus, or wrist rest, and resulted in non-neutral, static postures and measured health consequences. By using armrests for support, MWYA avoids the potential of MSDs as can be caused by these previously endorsed postures. By applying the five MWYA principles, computer users comprehend neutral posture and put forth the effort essential to creating healthy human computer relationships.

Robotic Surgery Is Less Physically Demanding Than Laparoscopic Surgery: Paired Cross Sectional Study.

To study musculoskeletal workload in experienced surgeons during laparoscopic surgery (LS) compared with robotic assisted laparoscopy (RALS). 70-90% of surgeons who regularly perform LS report musculoskeletal symptoms, mainly in neck and shoulders. Data regarding the potential ergonomic benefits of RALS in a clinical setting is very limited. Twelve surgeons with advanced experience in both LS and RALS each performed 2 hysterectomies on the same day. LS was performed standing, RALS sitting, the latter allowing forearm and head support. Bipolar surface electromyogram (EMG) was recorded from several muscles and was expressed relative to EMG during maximum contractions (%EMGmax). Gaps per minute plus static (p0.1), mean (p0.5), and peak (p0.9) muscle activation were calculated. Perceived exertion was rated before and just after each surgery. Neck muscle activity (p0.1 4.7 vs. 3.0%EMGmax, p0.5 7.4 vs. 5.3%EMGmax, p0.9 11.6 vs. 8.2%EMGmax, all P < 0.05) and static shoulder muscle activity (p0.1 5.7 vs. 2.8%EMGmax, P < 0.05) were higher for LS than for RALS. Both a higher level of gaps during RALS and a lower rating of perceived exertion, also for the legs, after RALS supported these observations. However, low back muscle activity was higher for RALS. RALS is significantly less physically demanding than LS, and also feels less strenuous for the surgeons. However, for both types of surgeries, there still is room for improvement of working conditions. To further optimize these, we suggest a scheme to regularly observe and advise the surgeons.

A case report: Reconstruction of the forearm support and function after resection of rare proximal radius malignant chondrosarcoma (grade III) bone tumor

A case report: Reconstruction of the forearm support and function after resection of rare proximal radius malignant chondrosarcoma (grade III) bone tumor

A patient with compressive myelopathy who gained the ability to perform meal movements using right forearm support

A patient with compressive myelopathy who gained the ability to perform meal movements using right forearm support