Free Arm Research Articles

Sex Differences Exist in the Relationship Between Vertical Jump Performance Biomechanical Parameters and Hamstring/Quadriceps Ratio in Adolescent U18 Track and Field Athletes

Isokinetic metrics are suggested to be related to vertical jump performance, but little is known about the possible sex differences in this relationship in adolescent track and field athletes. The aim of the study was to examine the possible sex differences in the strength of the relationship between the kinetic parameters of the vertical squat jump with arms akimbo, the countermovement jump with arms akimbo, and the countermovement jump with free arm swing with the isokinetic parameters of the knee extensor and flexor muscles (angular velocities: 60°/s and 300°/s). In total, 35 (males: 21, females: 14) U18 track and field athletes were examined. The results revealed that the Men U18 group had higher vertical jump performance, higher values in the kinetic parameters of the vertical jump tests, higher knee extensor torque, and higher knee flexor torque in the non-dominant leg compared to the Women U18 group. Significant (p < 0.05) sex differences were observed in the relationship between the isokinetic parameters and the vertical jump performance metrics, as the Women U18 athletes relied more on the knee flexor torque than Men U18 athletes, and demonstrated a stronger negative relationship between selected isokinetic metrics and the pre-stretch gain in the vertical jump tests. In conclusion, it is recommended that young female track and field athletes minimize interlimb asymmetry and improve the convention ratio in their non-dominant leg to optimize vertical jump performance.

Leveraging Tendon Vibration to Enhance Pseudo-Haptic Perceptions in VR.

Pseudo-haptic techniques are used to modify haptic perception by appropriately changing visual feedback to body movements. Based on the knowledge that tendon vibration can affect our somatosensory perception, this article proposes a method for leveraging tendon vibration to enhance pseudo-haptics during free arm motion. Three experiments were performed to examine the impact of tendon vibration on the range and resolution of pseudo-haptics. The first experiment investigated the effect of tendon vibration on the detection threshold of the discrepancy between visual and physical motion. The results indicated that vibrations applied to the inner tendons of the wrist and elbow increased the threshold, suggesting that tendon vibration can augment the applicable visual motion gain by approximately 13% without users detecting the visual/physical discrepancy. Furthermore, the results demonstrate that tendon vibration acts as noise on haptic motion cues. The second experiment assessed the impact of tendon vibration on the resolution of pseudo-haptics by determining the just noticeable difference in pseudo-weight perception. The results suggested that the tendon vibration does not largely compromise the resolution of pseudo-haptics. The third experiment evaluated the equivalence between the weight perception triggered by tendon vibration and that by visual motion gain, that is, the point of subjective equality. The results revealed that vibration amplifies the weight perception and its effect was equivalent to that obtained using a gain of 0.64 without vibration, implying that the tendon vibration also functions as an additional haptic cue. Our results provide design guidelines and future work for enhancing pseudo-haptics with tendon vibration.

Reliability and validity of "My Jump 2" application for countermovement jump free arm and interlimb jump symmetry in different sports of professional athletes.

Vertical jumping is an important evaluation tool to measure muscle strength and power as well as lower limb symmetry. It is of practical importance and value to develop and utilize a portable and low-cost mobile application (APP) to evaluate jumping. The "My Jump 2" app is an iPhone camera-based application for measuring jumping movements, which is applied to the countermovement jump (CMJ) vertical jumps of the lower limbs of athletes in different sports. The validity of this application and previous versions applied to different forms of vertical jump tests has been preliminarily demonstrated in different population, which has an obvious progress in research. Therefore, the reliability and validity of the jump height, time of flight parameters and symmetry of the CMJ vertical jump of athletes in different sports are needed to be verified by more experiments. The purpose of this study is to verify whether "My Jump 2" can effectively and reliably assess jump height, flight practice and lower limb symmetry in CMJAM (countermovement jump free arm) tests in fencing, swimming and diving athletes. Seventy-nine fencers, swimmers and divers with training experience participated in this study. They completed a total of three CMJAM vertical jump and lower limb symmetry tests in 1 day, while being assessed by using the "My Jump 2" application and a force platform. The intra-group correlation coefficient (ICC) was used to verify reliability, while the Cronbach's alpha and coefficient of variation (CV%) was used to analyze the stability of the CMJAM vertical jump test over three jumps. The Pearson correlation coefficient was used to verify the strength of the relationship between methods (i.e., concurrent validity), and the Bland-Altman plot was used to represent consistency, meanwhile, the t-test was used to determine the systematic bias between methods. Compared with the force platform, the cumulative height values of the total number of jumps (r = 0.999; p = 0.000), the cumulative time to vacate (r = 0.999; p = 0.000) for the CMJAM test obtained by the "My Jump 2" application, the height (ICC = 0.999-1, p = 0.000), the time to vacate flight (ICC = 0.999-1, p = 0.000), contact time symmetry (ICC = 0.976-0.994, p = 0.000), and flight time symmetry (ICC = 0.921-0.982, p = 0.000), respectively. Showed high correlation between the results of "my jump 2" app and the force platform. The "My Jump 2" application is a valid tool to assess CMJAM vertical jump and lower limb symmetry in fencing, swimming and diving athletes with training experience.

Exploring how arm movement moderates the effect of lower limb muscle fatigue on dynamic balance in healthy youth

BackgroundIn young adults, there is evidence that free arm movements do not help to compensate muscle fatigue-induced deteriorations in dynamic balance performance. However, the postural control system in youth is immature, and as a result, the use of arm movements may provide a compensatory “upper body strategy” to correct fatigue-related balance impairments. Thus, the purpose of the present study was to compare the effects of free vs. restricted arm movement on dynamic balance performance prior and following exercise-induced muscle fatigue.MethodsForty-three healthy youth (19 females; mean age: 12.8 ± 1.9 years) performed the Y Balance Test–Lower Quarter before and immediately after a fatiguing exercise (i.e., repetitive vertical bipedal box jumps until failure) using two different arm positions: free (move the arms freely) and restricted (keep the arms akimbo) arm movement.ResultsMuscle fatigue (p ≤ 0.033; 0.10 ≤ ηp2 ≤ 0.33) and restriction of arm movement (p ≤ 0.005; 0.17 ≤ ηp2 ≤ 0.46) resulted in significantly deteriorated dynamic balance performance. However, the interactions between the two did not reach the level of significance (p ≥ 0.091; 0.01 ≤ ηp2 ≤ 0.07).ConclusionOur findings indicate that the use of an “upper body strategy” (i.e., free arm position) has no compensatory effect on muscle fatigue-induced dynamic balance deteriorations in healthy youth.

The Erector Spinae Muscle, a Determining Factor in the Pathological Biomechanics of the Spine

Pathological biomechanics of adolescent idiopathic scoliosis is dominated by unilateral erector spinae stiffness. This leads to morpho pathological vertebral changes that aggravate the condition. Manual therapies can be used to correct the asymmetry of the stretch reflexes, and massage techniques can be used to improve the range of motion. Pain is an aggravating factor for biomechanical disorders and can be combated by myofascial techniques. To prevent scoliosis in adults, it is possible to tone the erector spinae muscles (deadlifts and their variations, exercises with free weights, arm and leg ergometer exercises, some aquatic exercises, Pilates isometric exercises performed on a stable surface). Keywords: spinal erector muscles, scoliosis prophylaxis

Comparison of sEMG Onset Detection Methods for Occupational Exoskeletons on Extensive Close-to-Application Data.

The design of human-machine interfaces of occupational exoskeletons is essential for their successful application, but at the same time demanding. In terms of information gain, biosensoric methods such as surface electromyography (sEMG) can help to achieve intuitive control of the device, for example by reduction of the inherent time latencies of a conventional, non-biosensoric, control scheme. To assess the reliability of sEMG onset detection under close to real-life circumstances, shoulder sEMG of 55 healthy test subjects was recorded during seated free arm lifting movements based on assembly tasks. Known algorithms for sEMG onset detection are reviewed and evaluated regarding application demands. A constant false alarm rate (CFAR) double-threshold detection algorithm was implemented and tested with different features. Feature selection was done by evaluation of signal-to-noise-ratio (SNR), onset sensitivity and precision, as well as timing error and deviation. Results of visual signal inspection by sEMG experts and kinematic signals were used as references. Overall, a CFAR algorithm with Teager-Kaiser-Energy-Operator (TKEO) as feature showed the best results with feature SNR = 14.48 dB, 91% sensitivity, 93% precision. In average, sEMG analysis hinted towards impending movements 215 ms before measurable kinematic changes.

Effect of Lower Limb Muscle Fatigue on Dynamic Balance Performance in Healthy Young Adults: Role of Arm Movement.

There is evidence that balance performance deteriorates due to exercise-induced muscle fatigue. However, it is unknown if free arm movement during balance testing can compensate for, or restricted arm movement can amplify these performance degradations. Thus, the objective of this study was to compare the effects of free versus restricted arm movement on balance performance under non-fatigued and fatigued conditions. Fifty-two healthy participants (men=31, women=21; age=22.6±1.6 years) were assessed for their dynamic balance (reach distances for the Y Balance Test - Lower Quarter) under non-fatigued and fatigued (repetitive vertical bipedal box jumps until failure) conditions using two different arm positions: free (move the arms freely) and restricted (keep the arms akimbo) arm movement. Restriction of arm movement (all p< 0.001; 0.48≤ η p 2 ≤0.79) and application of fatigue ( p≤ 0.003; 0.16≤ η p 2 ≤0.28) independently, but not the interaction between the two (except for the posteromedial reach direction: p= 0.046; η p 2 =0.08) , resulted in significantly deteriorated lower limb reach distances. These findings suggest that free arm movement and thus the use of an 'upper body strategy' has no compensatory effect on muscle fatigue-induced balance deteriorations.

Scalp reconstruction with locoregional and free flaps - a retrospective cohort study.

Scalp defect reconstruction requires interdisciplinary cooperation to restore soft tissue and osseous defects. While wound closure and form restoration, often a short-term treatment goal, ensures patient survival, the long-term preservation of the head and neck's integrity and aesthetics is crucial for maintaining quality of life. This study aims to compare, quantify, and establish a safe and reproducible approach to various reconstruction options and the postoperative complication profile for individual scalp defect areas. We retrospectively evaluated patients who underwent scalp reconstruction at our institution between March 2017 and April 2022. The inclusion criterion was the presence of a soft tissue defect at the cranium level. We included 31 patients in the study (17 males, 14 females), with an average age of 61 years (range 17-92 years). Eight patients had received radiotherapy in the affected region. The mean defect size was 72.5±116 cm2 (range 20-441 cm2), and an average of 3±2 surgeries had been performed before the plastic surgical treatment was initiated. Eleven patients had only a soft tissue defect, while 20 patients had an associated bone defect. Fifteen of these patients received a cranioplasty. The rotation flap was the most frequently used (n=23), with or without split-thickness skin grafting, followed by the free latissimus dorsi muscle flap with split-thickness skin grafting (n=5), and the free lateral arm flap (n=2). Revision surgeries were necessary in 38.7% of cases due to wound healing disorders (n=9), bleeding (n=2), and cerebrospinal fluid leaks (n=1). Eventually, all wounds were successfully closed. Complex scalp defects can be closed using local flaps, thereby restoring aesthetics and tissue integrity. Free flaps remain a reliable solution for extensive defects. Moreover, in cases requiring cranioplasty, careful preoperative planning and an uncontaminated wound are essential for successful treatment.

Effects of free versus restricted arm movements on postural control in normal and modified sensory conditions in young and older adults

The purpose of this study was to explore the effects of arm movements on postural control when standing under different sensory conditions in healthy young and older adults. Fifteen young (mean ± SD age; 21.3 ± 4.2 years) and 15 older (mean ± SD age; 73.3 ± 5.0 years) adults completed the modified Romberg test, which uses four task manipulations (i.e. eyes open and eyes closed on a firm and foam surface) to compromise the fidelity of sensory feedback mechanisms. Each participant completed the tasks under two arm movement conditions: restricted and free arm movements. Centre of pressure (COP) range and frequency were calculated to characterise postural performance and strategy, respectively. Older adults showed greater COP range with restricted compared to free arm movements during all modified sensory conditions, with these effects most prominent in the medio-lateral (ML) plane (all p < .05, Cohen's d = 0.69–1.61). Compared to the free arm movement condition, there was an increase in ML displacement and frequency when arm movements were restricted during only the most challenging (i.e. vestibular dominant) task in young adults (all p < .05, d = 0.645–0.83). Finally, main age effects for the arm restriction cost (p < .05) indicates a greater reliance on an upper body strategy in older compared to young adults, independent of sensory availability/accuracy. These findings indicate that older adults compensate for the loss of accuracy in sensory input by increasing reliance on upper body movement strategies.

Effectiveness of a community health worker-led low-sodium salt intervention to reduce blood pressure in rural Bangladesh: protocol for a cluster randomized controlled trial

BackgroundHigh blood pressure is a major public health problem in low- and middle-income countries. Low-sodium salt substitute (LSSS) is a promising population-level blood pressure-lowering intervention requiring minimal behavioral change. The optimal method of delivering LSSS to individuals, however, is currently unknown. Community health workers (CHWs) have successfully been used to implement health interventions in Bangladesh and may provide a venue for the dissemination of LSSS.MethodsWe aim to conduct a cluster-randomized controlled trial involving 309 households in rural Bangladesh previously identified and characterized by the BRAC James P Grant School of Public Health, BRAC University (BRAC JPGSPH). These households will be randomly assigned to three arms: (1) control, i.e., no intervention; (2) information only, i.e., community health workers will provide basic information on high blood pressure, the health consequences of excessive salt consumption, and feedback to the participant on the likely quantity of salt s/he consumes (estimated using a questionnaire); (3) free LSSS arm: the same information as in arm 2 will be provided, but participants will receive 6 months of free low-sodium salt along with education on the benefits of LSSS. One male and one female adult (age ≥ 18 years) in each household will be invited to participate, the exclusion criteria being households with members known to have high serum potassium levels, are taking medications known to elevate potassium levels (e.g., ACE inhibitors, ARBs, potassium-sparing diuretics), are already taking potassium supplements, or those who have known kidney disease or abnormal serum creatinine at baseline. The primary endpoint will be blood pressure at 6 months post-intervention.DiscussionRecent large clinical trials of LSSS in China and India have shown not only blood pressure improvements, but also stroke, major cardiac event, and all-cause mortality reductions. Nevertheless, how to best translate this intervention to population-level effectiveness remains unclear. Our study would test whether a community health worker-based program could be effectively used to disseminate LSSS and achieve measurable blood pressure benefits.Trial registrationClinicalTrials.gov NCT05425030. Registered on June 21, 2022.

Effects of arm movement strategies on emotional state and balance control during height-induced postural threat in young adults

BackgroundIt is firmly established that postural threat seems to lead to an increased reliance on an ankle control (‘stiffening’) strategy. However, little is known about how postural threat affects performance in challenging tasks that require the use of upper body postural control strategies for stability. It is logical to assume that in such conditions, being able to utilise an upper body strategy may reduce the reliance on such ankle stiffening strategy. Research questionThe objective of this study was to determine how arm movement influences balance control during a challenging balance task performed under conditions of postural threat. MethodsThirty young adults (mean ± SD age; 22.0 ± 4.0 years) balanced in tandem stance whilst standing at both ground-level (no threat) and 0.8 m above ground (threat). In both conditions, participants performed the task under two different arm positions: restricted arm movements and free arm movements. Postural sway amplitude and frequency were calculated to infer postural stiffening response. Self-reported emotional responses were quantified by assessing balance confidence, fear of falling, perceived stability, and conscious balance processing. ResultsIndependent of arm movements, postural threat evoked an increase in fear of falling and conscious balance processing, and reductions in balance confidence and perceived stability. These threat-related changes in emotional state were further amplified when arm movements were restricted. Whilst significant increases in sway frequency during threat were observed in both arm conditions, reductions in sway amplitude were only observed during the restricted arm movement condition. SignificanceWe propose that these responses likely reflect a fear-related cautious strategy intended to reduce the postural destabilisation associated with individuals being unable to use their arms to counter any destabilisation, as would normally be the case in daily life.

Exploring how arm movement moderates the effect of task difficulty on balance performance in young and older adults

Emerging evidence highlights that arm movements exert a substantial and functionally relevant contribution on quiet standing balance control in young adults. Ageing is associated with “non-functional” compensatory postural control strategies (i.e., lower limb co-contraction), which in turn, may increase the reliance on an upper body strategy to control upright stance. Thus, the primary purpose of this study was to compare the effects of free versus restricted arm movements on balance performance in young and older adults, during tasks of different difficulty. Fifteen young (mean ± SD age; 21.3 ± 4.2 years) and fifteen older (mean ± SD age; 73.3 ± 5.0 years) adults performed bipedal, semi-tandem and tandem balance tasks under two arm position conditions: restricted arm movements and free arm movements. Centre of pressure (COP) amplitude and frequency were calculated as indices of postural performance and strategy, respectively. Especially in older adults, restriction of arm movement resulted in increased sway amplitude and frequency, which was primarily observed for the mediolateral direction. Further, increasing balance task difficulty raised the arm restriction cost (ARC; a new measure to quantify free vs. restricted arm movement differences in postural control) that was more prominent in older adults. These findings indicate the ARC provides a measure of reliance on the upper body for balance control and that arm movement is important for postural control in older adults, especially during tasks of greater difficulty.

Cascade Genetic Risk Education and Testing in Families With Hereditary Cancer Syndromes: A Pilot Study.

Cascade genetic risk evaluation in families with hereditary cancer can reduce the burden of disease but the rate of germline genetic testing in relatives of patients at risk is low. We identified all 277 women diagnosed with breast cancer in Georgia in 2017 who linked to a clinically actionable germline pathogenic variant through a Surveillance, Epidemiology, and End Results registry-variant linkage initiative. We surveyed them, and then invited eligible respondents to an online platform hosted by a navigator that offered cancer genetic risk education and germline genetic testing to untested relatives. We randomly assigned patient-family clusters at the time of the patient enrollment offer to free versus $50 (USD) test cost. Patients invited relatives to join the study through personalized e-mail. Enrolled relatives received online cancer genetic education and the opportunity to order clinical germline genetic testing through the platform. The primary outcome was the number of relatives who ordered genetic testing. One hundred twenty-five of 277 patients completed surveys (45.2%). Most respondents were eligible for the trial offer (113 of 125; 90.4%). In the free testing arm, 20 of 56 eligible patients participated (35.7% of eligible respondents) and they invited 28 relatives: 12 relatives enrolled and 10 ordered testing. In the $50 (USD) arm, 16 of 57 eligible patients participated (28.1%) and they invited 38 relatives: 18 relatives enrolled and 17 ordered testing. Cascade genetic testing in families with hereditary cancer syndromes accrued through a population-based cancer registry can be achieved through an online platform that offers genetic risk education and low-cost testing to relatives. A modest charge did not appear to influence the percentage of participating patients, numbers of participating relatives, and numbers of relatives who received genetic testing.

Intraseason Changes in Vertical Jumps of Male Professional Basketball Players

This study aimed to analyze basketball players' jumping bhavior in the Squat Jump (SJ), Countermovement Jump (CMJ), and Free Arm Swing CMJ (CMJ Free) during a professional basketball season and check if it is modulated by the players' specific playing position, the time played on court, and the different leagues. Fifty-three male professional basketball players were assessed in three different moments of the season through SJ, CMJ, and CMJ Free. Between the beginning of pre-season (1st assessment) and the second round of the season (3rd assessment), there was a strong increase in performance in the three jumps (SJ Height: 5.6%, η2P = 0.234, p = 0.007; CMJ Height: 5.1%, η2P = 0.177, p = 0.007; CMJ Free height: 4.11%, η2P = 0.142, p = 0.01). There was also a significantly large increase in SJ and CMJ between the 2nd and 3rd assessments and in the CMJ Free between the 1st and 2nd assessments. No significant interactions were found between jumping performance and the group factors (players' specific playing position, time played on court, and league). In conclusion, SJ, CMJ, and CMJ Free performance strongly increases between 1st and 3rd assessment, without being influenced by the specific playing position or the minutes played per game.

Abstract P4-06-01: Platinum-based chemotherapy for early triple-negative breast cancer: A Cochrane systematic review and meta-analysis

Abstract In early triple-negative breast cancer (eTNBC), platinum-based chemotherapy has been shown to improve pathological complete response, but recommendations to include platinum chemotherapy are not consistent in international guidelines. We performed a systematic review of published randomized control trials to assess to assess survival outcomes and quality of life for people with early TNBC. The results presented in this abstract have not yet been peer-reviewed by Cochrane. If the final version of the review meets the necessary standards, the review is expected to be published in the Cochrane Database of Systematic Reviews. Methods: Randomized controlled trials examining neoadjuvant or adjuvant platinum chemotherapy for eTNBC were included. We searched for published and unpublished data using standard Cochrane search strategies. The primary outcomes assessed were disease free survival (DFS) and overall survival (OS). Secondary outcomes included rate of pathological complete response (pCR), dose intensity and completion of regimens, grade III or IV toxicity related to chemotherapy, and quality of life. Prespecified subgroups included BRCA mutation status, HRD status, lymph node status, frequency of chemotherapy, type of platinum agent used, and the presence or absence of anthracycline chemotherapy. Results: From 3972 records, 19 published studies were eligible. Twenty six ongoing studies were identified. Risk of bias was judged low for most trials. There were 14 neoadjuvant chemotherapy trials, 4 adjuvant chemotherapy trials, and one trial of neoadjuvant and adjuvant therapy. Most trials used carboplatin (16 trials) followed by cisplatin (2), and lobaplatin (1). Eight trials had an anthracycline free intervention arm, 5 of which had a carboplatin-taxane intervention compared to an anthracycline-taxane control. All studies reporting DFS and OS used carboplatin. Twelve of 19 studies with a total of 3347 participants reported DFS data. Inclusion of platinum chemotherapy improved DFS in neoadjuvant and adjuvant setting (HR 0.63, 95% confidence interval (CI) 0.53-0.75; HR 0.69, 95% CI 0.54-0.88 respectively)). Eleven studies collected OS data, with a total of 3229 participants and 460 deaths reported. Inclusion of platinum chemotherapy in the regimen improved OS (neoadjuvant: HR 0.69, 95% CI 0.69, 0.55-0.86; adjuvant: 0.70, 95% CI 0.50 to 0.96). Median follow up for survival outcomes ranged from 36 – 97.6 months. Our analysis confirmed platinum chemotherapy increased pCR rates (RR 1.46 [1.33-1.61], p&amp;lt; 0.00001). Subgroup analysis revealed that survival outcome benefits were seen regardless of BRCA mutation status, HRD status, lymph node status, or whether the intervention arm contained anthracycline chemotherapy or not. Platinum chemotherapy was associated with reduced dose intensity, with participants more likely to require chemotherapy delays (RR 2.23 [1.70-2.94], 4 studies), dose reductions (RR 1.77 [1.56-2.02], 6 studies) and early cessation of treatment (RR 1.20 [1.04-1.38], 16 studies). Increased hematological toxicity occurred in the platinum group who were more likely to experience grade III/IV neutropenia (RR 1.55 [1.45-1.66]), anemia (RR 10.12 [6.61-15.50]) and thrombocytopenia (RR 7.59 [5.10-11.29]). There was no increase in febrile neutropenia (RR 1.16 [0.89-1.49]). Treatment-related death was very rare (7 events in 3094 patients) and similar across treatment groups (RR 0.58 [0.14-2.33]). Five studies collected quality of life data but did not report it. Conclusion: Platinum-based chemotherapy using carboplatin in the adjuvant or neoadjuvant setting improves long-term outcomes in eTNBC, regardless of the examined subgroups. This was at the cost of more frequent chemotherapy delays and dose reductions, and greater haematological toxicity. Benefit from platinum was seen both when platinum agents were added to anthracycline containing regimens, as well as in anthracycline-free regimens. Citation Format: Sofia Mason, Melina Willson, Annabel Goodwin, Jane Beith, Sam J. Egger, Rachel F. Dear. Platinum-based chemotherapy for early triple-negative breast cancer: A Cochrane systematic review and meta-analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-06-01.

Securing perforator flap perfusion by using dynamic infrared thermography (DIRT) in complex traumatic hand surgery – A case report

A complex traumatic hand injury may pose a challenge for the reconstructive surgeon. Perforator flaps provide the surgeon with an option in managing such injuries. Securing perfusion of the perforator flap is essential, as partial, or total flap loss yield poor functional and cosmetic outcome, often requiring reoperation. We report a case of a 28-year -old male suffering a mutilating hand injury after a car accident. Reconstruction was performed with a free microvascular lateral arm flap, and perfusion of the flap was monitored pre-, intra-, and postoperatively with dynamic infrared thermography (DIRT).The purpose of this report is to highlight the usefulness of DIRT as a novel perfusion imaging modality in the management of complex traumatic hand injury. • Dynamic infrared thermography (DIRT) can be used in complex traumatic hand surgery for perforator mapping. • DIRT can be used to evaluate flap perfusion intra- and postoperatively. • DIRT can be used to evaluate patency of the microvascular anastomose. • DIRT is a non-invasive, non-contact imaging modality that provides reliable information on skin perfusion.

Hand Injuries at Work: Causes, Spectrum and Management

Background: Hand injuries are common and an increased surge has been seen secondary to the use of machines.The spectrum of injuries is wide ranging from injuries requiring few stitches to requiring specific reconstructive procedures such as skin grafting, pedicled flaps to free flaps or amputations depending on severity and pattern of injury. Methods: This was a hospital-based single-arm prospective study conducted in the Department of Plastic and Reconstructive Surgery for 3 years. 46 patients were included.Each record was analyzed as per the etiology, the treatment received, the reconstructive procedures done, and the functional and aesthetic outcomes. Results: Most of the affected individuals were young, the mean age of the patients was found to be 23 years. Among the injured 85% were males. The dominant hand (right hand) was more frequently injured in 74% of cases. In total 18 patients had some of the affected areas amputated; this included formalization of traumatic amputations. It is also significant that twelve patients underwent revascularization and four reimplantations. Twelve patients underwent groin flaps as a primary or delayed primary in the same admission. Ten patients required split skin grafting and three. Two patients were managed with FDMA flap for thumb defect, one patient was managed with reverse radial forearm flap for compound defect dorsum of thumb, and another with free lateral arm flap for compound defect of thumb. Conclusion: The management of machine injuries of the upper limb and hand requires specific and unique methods of treatment. A "reconstructive ladder" of techniques was utilized, ranging from "simple" (e.g., direct closure, skin grafts, and local flaps) to "complex" (free flaps, toe-to-thumb transfer) procedures. The individual procedure selected is the most straightforward, consistent with expediency and early return of a functional hand. The return of these hands to function has been facilitated by recent advances in tissue assessment, free tissue transfer, and skilled hand therapy. Keywords: Dominant hand, machine injury, band saw, brush cutter, rotator drill.

Retracted: Clinical Effectiveness of Free Upper Arm Medial Flap in Repairing Skin and Soft Tissue Defects of the Dorsum of the Hand.

[This retracts the article DOI: 10.1155/2022/7144037.].

Effect of arm movement and task difficulty level on balance performance in healthy children: are there sex differences?

In children, studies have shown that balance performance is worse in boys compared to girls and further studies revealed inferior performance when arm movement was restricted during balance assessment. However, it remains unclear whether restriction of arm movement during balance testing differentially affects children's balance performance (i.e., boys more than girls). Thus, we compared the influence of arm movement on balance performance in healthy boys versus girls (mean age: ~11.5 years) while performing balance tasks with various difficulty level. In nearly all tests, balance performance (i.e., timed one-legged stance, 3-m beam walking backward step number, Lower Quarter Y-Balance test reach distance) was significantly worse during restricted compared to free arm movement but without any differences between sexes or varying levels of task difficulty. These findings indicated that balance performance is negatively affected by restriction of arm movement, but this does not seem to be additionally influenced by children's sex and the level of task difficulty.

Effect of arm movement on balance performance in children: role of expertise in gymnastics

Studies have shown that balance performance is better in gymnasts compared to age-/sex-matched controls and further studies revealed superior performance when arms were free to move during assessment of balance. However, it is unknown whether free arm movement during balance testing differentially affects balance performance with respect to sports expertise (i.e., gymnasts areless affected than age-/sex-matched controls). Therefore, we investigated the effect of arm movement on balance performance in young female gymnasts compared to age-/sex-matched controls while performing balance tasks with various difficulty levels. In both samples, balance performance (except for the timed one-legged stance) was significantly better during free compared to restricted arm movement conditions and this was especially observed in the highest task difficulty condition of the 3-m beam walking backward test. These findings revealed that balance performance is positively affected by free arm movements, but this does not seem to be additionally influenced by the achieved expertise level in young gymnasts.