Limb Disability Research Articles

Pyrrolidine Dithiocarbamate-loaded Electrospun Membranes for Peritendinous Anti-adhesion through Inhibition of the Nuclear Factor-κB Pathway

Peritendinous adhesion is a major cause of limb dysfunction and disability in clinical practice. Numerous studies suggest that activation of nuclear factor-κB (NF-κB) pathway in macrophages could be the pivotal figure in excessive collagen synthesis and thus peritendinous adhesion formation. In this study, we assumed this pathological process could be suppressed by inhibiting NF-κB phosphorylation and nuclear translocation using pyrrolidine dithiocarbamate (PDTC), a specific NF-κB inhibitor with the ability to penetrate cell membranes, in macrophages. Then, we conducted electrospinning process to incorporate PDTC into poly(L-lactic) acid (PLA) electrospinning membranes, that is, the PDTC-PLA membranes. Further, with integral film quality and stable drug release property, the PDTC-PLA membranes were subsequently analyzed in the capability and mechanism of preventing adhesion formation both in vitro and in vivo. Our results showed inhibition of macrophage proliferation as well as NF-κB pathway activation from in vitro assays and outstanding promotion in inhibiting NF-κB p65 phosphorylation and reducing adhesion formation from in vivo assays of PDTC-PLA compared to PLA membranes. In conclusion, our findings suggested that PDTC-PLA as an alternative therapeutic approach alleviated inflammation and peritendinous adhesion formation through NF-κB signaling pathway. Statement of significancePyrrolidine dithiocarbamate (PDTC) can be blended into poly-L-lactic acid (PLA) fibrous membranes by electrospinning process. This incorporation of PDTC into PLA is an effective way to inhibit proinflammatory activation of macrophages and to achieve advanced anti-adhesion outcome after tendon repair.

Quality of life and upper limb disability in Charcot-Marie-Tooth disease: A pilot study.

Charcot-Marie-Tooth (CMT) patients present mainly lower limbs disability, with slowly progressive distal muscle weakness and atrophy, but hands impairment is a relevant problem affecting the quality of life (QoL). The evaluation of the upper limb is of primary importance. Often these patients present subclinical disorders or report difficulties in manipulating objects, with little evidence in the most used outcome measures. We aim to investigate the impact of hand impairment in the perceived QoL of CMT persons and secondly whether the Disability of Arm, Shoulder and Hand (DASH) scale can be useful in assessing upper limb abilities in CMT. We recruited 23 patients with confirmed genetic diagnosis of CMT. We performed a clinical evaluation with Sollerman Hand Function Test (SHFT), Thumb Opposition Test (TOT) and CMT examination score (CMTES). We completed the clinical assessment with DASH scale and the Short form 36 (SF36) questionnaire for a subjective evaluation of upper limb disability and quality of life. All patients also underwent an instrumental evaluation with a hand-held dynamometer measuring hand grip and tripod pinch and a sensor-engineered glove test (SEGT) to evaluate finger opposition movements in a quantitative spatial-temporal way. As expected, we found significant differences between CMT and control group performances in both clinical and instrumental assessment. Concerning QoL, we found that total score of SF36 and the SF36 Physical Composite Score (PCS) correlate with all clinical and instrumental Outcome Measures (OMs), particularly with Tripod pinch strength and TOT, which are considered major determinants of manual dexterity in CMT. DASH scale correlates with most clinical and instrumental OMs. Not surprisingly, we also found a correlation with DASH work, because CMT affects young patients engaged in work activities. However, we found a low correlation with the TOT and the dynamometer suggesting that DASH may not be the best scale for remote monitoring of upper limb disorders in CMT patients. Nevertheless, the results of our study confirm the usefulness of SF36 in recognizing the impact of upper limb disability in these subjects suggesting its use even in the remote monitoring of physical functioning.

Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study.

BackgroundAfter breast cancer, some patients report residual pain-related upper limb disability without physical impairment. Although pain and altered proprioception are known to affect the working body schema (WBS), there is little available evidence investigating the WBS of breast cancer survivors (BrCS). WBS—body representations in the brain—affect the “neuromatrix” that modulates pain sensitivity and the threshold for threatening stimuli. The aim of this study was to investigate whether WBS was disrupted after mastectomy with immediate breast reconstruction (IBR) for breast cancer and whether pain and proprioceptive changes affected WBS.MethodsThirty-five BrCS participated in the 4-month follow-up study. They were observed at 1 and 4 months postoperatively. The main outcome measures were the left right judgement test (LRJT) results, absolute angle error, pectoralis minor length index (PMI), pain, and Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. They were measured at each observation, and parametric tests were performed to identify the nature of WBS.ResultsBoth the reaction time and accuracy of the hand LRJT were poorer than those of the foot and back LRJT (p < 0.001). The hand LRJT reaction time and accuracy were unchanged over the total follow-up period (p = 0.77 and p = 0.47, respectively). There was a weak correlation between the LRJT reaction time and PMI (r = −0.26, p = 0.07), pain severity (r = 0.37, p = 0.02), and Q-DASH score (r = 0.37, p = 0.02). There was also a weak correlation between LRJT accuracy and Q-DASH score (r = −0.31, p = 0.04). The LRJT accuracy of BrCS who underwent surgery on their dominant side was higher than that of BrCS who underwent surgery on their non-dominant side (p = 0.002). Regression analysis found a weak but significant relationship between the early hand LRJT results and late pain severity (adjusted R2 = 0.179, p = 0.007). A similar relationship was found between early hand LRJT results and Q-DASH score (adjusted R2 = 0.099, p = 0.039).ConclusionTo the best of our knowledge, this is the first study providing the nature of WBS after mastectomy with IBR. In this population, it is necessary to postoperatively preserve WBS integrity for pain and upper limb disability.

An Intention Prediction Based Shared Control System for Point-to-Point Navigation of a Robotic Wheelchair

Shared control approaches for robotic wheelchairs aim to provide navigation assistance to humans by utilizing robot’s intelligence in environment perception and motion planning. They can be broadly classified into two categories based on human intention prediction. Without human intention prediction, control authority lies with humans and assistance is provided only to avoid collisions. This can cause difficulty in cases where fine motor control is required, such as when entering narrow doorways, especially for users with severe upper limb disability. Intention prediction based approaches are able to better assist with such tasks but do not give enough control authority to the user as possible user intentions are pre-defined. In this work, we present an intention prediction based shared control system for point-to-point navigation of wheelchair which gives control authority to the user and also assists in fine motor control tasks. We compute various possible user intentions online using generalized Voronoi diagram, link them across time steps using their <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">homotopy class</i> and thus are able to calculate their probability given user input history. A shared local path planner then steers user towards the most likely path. This allows the user to follow any path. Our simulation experiments with 18 healthy subjects and both simulation and real wheelchair experiments, with 2 Cerebral Palsy (CP) subjects, show that our system can improve navigation outcome for people with disability and in general leads to around 10% faster completion of the task for even healthy people as compared to a local obstacle avoidance system while allowing users to follow their desired path with similar accuracy.

Sensorimotor network dynamics predict decline in upper and lower limb function in people with multiple sclerosis

Background: Upper and lower limb disabilities are hypothesized to have partially independent underlying (network) disturbances in multiple sclerosis (MS). Objective: This study investigated functional network predictors and longitudinal network changes related to upper and lower limb progression in MS. Methods: Two-hundred fourteen MS patients and 58 controls underwent functional magnetic resonance imaging (fMRI), dexterity (9-Hole Peg Test) and mobility (Timed 25-Foot Walk) measurements (baseline and 5 years). Patients were stratified into progressors (>20% decline) or non-progressors. Functional network efficiency was calculated using static (over entire scan) and dynamic (fluctuations during scan) approaches. Baseline measurements were used to predict progression; significant predictors were explored over time. Results: In both limbs, progression was related to supplementary motor area and caudate efficiency (dynamic and static, respectively). Upper limb progression showed additional specific predictors; cortical grey matter volume, putamen static efficiency and posterior associative sensory (PAS) cortex, putamen, primary somatosensory cortex and thalamus dynamic efficiency. Additional lower limb predictors included motor network grey matter volume, caudate (dynamic) and PAS (static). Only the caudate showed a decline in efficiency over time in one group (non-progressors). Conclusion: Disability progression can be predicted using sensorimotor network measures. Upper and lower limb progression showed unique predictors, possibly indicating different network disturbances underlying these types of progression in MS.

Research on Upper Limb Action Intention Recognition Method Based on Fusion of Posture Information and Visual Information

A prosthetic hand is one of the main ways to help patients with upper limb disabilities regain their daily living abilities. Prosthetic hand manipulation must be coordinated with the user’s action intention. Therefore, the key to the control of the prosthetic hand is to recognize the action intention of the upper limb. At present, there are still problems such as difficulty in decoding information and a low recognition rate of identifying action intention with EMG signals and EEG signals. While inertial sensors have the advantages of low cost and high accuracy and posture information can characterize the upper limb motion state, visual information has the advantages of high information and being able to detect the type of target objects, which can be complementarily fused with inertial sensors to further grasp the human motion requirements. Therefore, this paper proposes an upper limb action intention recognition method based on the fusion of posture information and visual information. The inertial sensor is used to collect the attitude angle data during the movement of the upper limb, and according to the similarity of the human upper limb structure to the linkage mechanism, a model of the upper limb of the human body is established using the positive kinematics theory of a mechanical arm to solve the upper limb end positions. The upper limb end positions were classified into three categories: torso front, upper body nearby, and the initial position, and a multilayer perceptron model was trained to learn the classification relationships. In addition, a miniature camera was installed on the hand to obtain visual image information during upper limb movement. The target objects are detected using the YOLOv5 deep learning method, and then, the target objects are classified into two categories: wearable items and non-wearable items. Finally, the upper limb intention is jointly decided by the upper limb motion state, target object type, and upper limb end position to achieve the control of the prosthetic hand. We applied the upper limb intention recognition method to the experimental system of a mechanical prosthetic hand and invited several volunteers to test it. The experimental results showed that the intention recognition success rate reached 92.4%, which verifies the feasibility and practicality of the upper limb action intention recognition method based on the fusion of posture information and visual information.

Physical fitness assessment for lower limb disability: rationale and design to develop a new formula

Introduction: Injuries are a major medical problem in military populations. The physical fitness assessment is a series of tests that measure and monitor physical fitness levels. The existing physical fitness assessment and formula used by the Indonesian Military requires a running test that only applies to healthy soldiers. This study attempted to construct a formula for assessing physical fitness using tests that soldiers may perform with lower limb injury/disability. Method: The design of the study was an internal cross-sectional comparison. This study included 104 healthy, well-trained male normal soldiers (NS) and 50 injured or disabled soldiers (DS) who matched the inclusion criteria. The NS was required to perform a 12-minute running and wheeling test, a ball-throwing test, push-ups, and lunges. The DS was also required to perform the same tests except for the 12-minute running test and lunges. The analysis of the data consisted of four steps: constructing a conceptual framework, describing the characteristics of each group, identifying significant indicators using Partial Least Square-Structural Equation Modeling (PLS-SEM) to develop a physical fitness formula, and determining whether the formula is appropriate for assessing physical fitness in running and wheeling tests. Result: There is no significant difference in the characteristics of NS and DS (p&gt;0.05); thus, the subjects in both groups are comparable. Physical fitness test has several major contributing factors: distance, test method, muscle strength, and age. There is no significant difference in the number of NS in each category between the running and wheeling tests (p&gt;0.05). Conclusion: Physical fitness formula= {1.1 × (0.98 × distance*) + (0.97 × method value**)} – (0.093 × age) – (0.17 × muscle strength***) Note: *) Distance traveled during running or wheeling test (meter). **) The running test method value is entered as 1, and the wheeling test method value is entered as 2. ***) The value of wheeling muscle strength is obtained from the ball-throwing test. In contrast, the value of running muscle strength can be determined by multiplying the result of the ball-throwing test by 2. These findings may be used for assessing the physical fitness of normal soldiers or those with lower limb injury/disability.

Development of an End-Effector Type Therapeutic Robot with Sliding Mode Control for Upper-Limb Rehabilitation

Geriatric disorders, strokes, spinal cord injuries, trauma, and workplace injuries are all prominent causes of upper limb disability. A two-degrees-of-freedom (DoFs) end-effector type robot, iTbot (intelligent therapeutic robot) was designed to provide upper limb rehabilitation therapy. The non-linear control of iTbot utilizing modified sliding mode control (SMC) is presented in this paper. The chattering produced by a conventional SMC is undesirable for this type of robotic application because it damages the mechanical structure and causes discomfort to the robot user. In contrast to conventional SMC, our proposed method reduces chattering and provides excellent dynamic tracking performance, allowing rapid convergence of the system trajectory to its equilibrium point. The performance of the developed robot and controller was evaluated by tracking trajectories corresponding to conventional passive arm movement exercises, including several joints. According to the results of experiment, the iTbot demonstrated the ability to follow the desired trajectories effectively.

The Effect of Kinesio Tape and Exercise on Maximum Key Pinch Endurance on Assembly Workers

Background: Work-related musculoskeletal pain is generally caused by poor physical conditions and repetitive movement. The aim of this research is to investigate the effect of 8 weeks of kinesio tape and exercise on maximum key pinch endurance and pain reduction regarding the assembly workers.&#x0D; Method: This clinical trial study was conducted on 40 female workers employed in the assembly part of an electrical company. The subjects were categorized into three groups: exercise-taping, exercise and control, and performing an 8-week rehabilitation plan twice a week. To assess the upper limb disability and key pinch endurance before and after the intervention, authors used DASH questionnaire and pinch gauge, respectively. Data were evaluated with SPSS 20 and one-way ANOVA, Chi-Square and paired t-test tests. In this study, pinch gauge was used to measure pinch strength. Studies show that pinch gauge has high calibration accuracy and precision.&#x0D; Results: The results of this study demonstrated a decrease in upper limb disability in the two groups of exercise and taping-exercise compared to the control group. Chi-square test indicated a statistically significant difference between the history of hand pain in the three groups. Moreover, paired t-test showed that the two hand's key pinch endurance was significantly increased in the two intervention groups compared to the control group.&#x0D; Conclusion: Using a kinesio tape can be effective in reducing pain and physical damage in hands. Therefore, at least 2 or 3 exercise sessions can be done per week during working hours.

Topology optimization of a rowing terminal device for an upper limb prosthesis

Prostheses are as old as humans, although current conceptions have progressed far from early designs. The prosthesis world is a field in constant evolution, either aiming to replace or to duplicate parts of the human body. In the last four decades, since the inception of activity-specific prosthesis, the industry of sport prosthetic devices has developed considerably and with an increasing number of sport specific systems available. However, due to the complexity and uniqueness of applications, extensive issues remain unresolved. This work presents a new body-powered sport prosthetic mechanism that allows a person with an unilateral upper limb disability to row. A complete computational analysis of the mechanical properties of the device has been performed using finite element methods. Following this, topology optimization methods were applied to obtain a substantial reduction in device weight while retaining the necessary mechanical strength. This process shows the potential of topology optimization in the design of prosthetic terminal devices, achieving lighter and, hence, cheaper and more competitive mechanisms.

Do people with multiple sclerosis perceive upper limb improvements from robotic-mediated therapy? A mixed methods study

BackgroundRobot-mediated training is increasingly considered as a rehabilitation intervention targeting upper limb disability. However, experiences of such an intervention have been rarely explored in the multiple sclerosis population. This mixed methods study sought to explore the impact of an eight week upper limb robotic intervention on experiences of people with multiple sclerosis. MethodsEleven participants (Median EDSS- score: 6.5) with moderate to severe upper limb impairment, performed eight week robot- mediated training of the most affected arm. The training involved a virtual learning platform called I-TRAVLE with duration of 30 min per training session, twice to three times per week. Two subjective questionnaires with items from the Intrinsic Motivation Inventory (IMI) and Credibility and Expectancy Questionnaire (CEQ) were collected bi-weekly during the intervention. Approximately one month after completing the training, three focus groups were conducted. Main themes were identified using thematic analysis. ResultsResults from the IMI and CEQ indicated high patient satisfaction and expectation that the intervention will be beneficial for them. Two main themes were identified: (1) Effect of the intervention on impairment and activity in that participants felt that there was a positive impact of the training on strength, endurance and during activities of daily living and that it met their expectations; (2) Experiences based on system usage from the system in that participants expressed feelings of motivation and self-improvement. The participants also perceived the training as enjoyable and concluded that the use of games instigated a competitive spirit between the participants. ConclusionsRobot-mediated training could have a motivating effect and induce a general positive experience while reducing disabilities of people with multiple sclerosis.

Electric Wheelchair Hybrid Operating System Coordinated with Working Range of a Robotic Arm

Electric wheelchair-mounted robotic arms can help patients with disabilities to perform their activities in daily living (ADL). Joysticks or keypads are commonly used as the operating interface of Wheelchair-mounted robotic arms. Under different scenarios, some patients with upper limb disabilities such as finger contracture cannot operate such interfaces smoothly. Recently, manual interfaces for different symptoms to operate the wheelchair-mounted robotic arms are being developed. However, the stop the wheelchairs in an appropriate position for the robotic arm grasping task is still not easy. To reduce the individual’s burden in operating wheelchair in narrow spaces and to ensure that the chair always stops within the working range of a robotic arm, we propose here an operating system for an electric wheelchair that can automatically drive itself to within the working range of a robotic arm by capturing the position of an AR marker via a chair-mounted camera. Meanwhile, the system includes an error correction model to correct the wheelchair’s moving error. Finally, we demonstrate the effectiveness of the proposed system by running the wheelchair and simulating the robotic arm through several courses.

Case Report: Upper limb dysfunction may be caused by chest wall mass excision: An enlightenment from a special case

Of all the thoracic surgical procedures, chest wall surgery is probably the lowest-risk type. In fact, it is not so. Clinical work also often has the trap of chest wall surgery. An operation to remove a mass in the axilla may result in upper limb disability on the affected side. Here, we report the case of a 47-year-old female patient with a left chest wall adjacent axillary mass, which was considered an abnormal structural lymph node on color ultrasound examination and chest CT. Otherwise, she felt no discomfort. The left upper limb moved freely without being affected by the mass. A routine resection of the tumor was performed after the preoperative examination was completed. After the operation, the incision recovered well. However, the day after the surgery, she developed numbness and pain in her left little finger and ring finger, pain that often kept her from sleeping. The mass was confirmed to be a schwannoma with cystic degeneration by pathology slicing after the operation. By this time, doctors were alerted to the fact that the removal of the chest wall mass had nearly disabled the left upper limb of the patient, which was a great warning to the thoracic surgeon. In this case report, we hope that all surgeons will be cautious and careful and will not trust the imaging diagnosis too much. It is also hoped that the patient understands that some procedures may lead to unexpected complications.

A new prognostic nomogram for heterotopic ossification formation after elbow trauma : the Shanghai post-Traumatic Elbow Heterotopic Ossification Prediction (STEHOP) model.

Heterotopic ossification (HO) is a common complication after elbow trauma and can cause severe upper limb disability. Although multiple prognostic factors have been reported to be associated with the development of post-traumatic HO, no model has yet been able to combine these predictors more succinctly to convey prognostic information and medical measures to patients. Therefore, this study aimed to identify prognostic factors leading to the formation of HO after surgery for elbow trauma, and to establish and validate a nomogram to predict the probability of HO formation in such particular injuries. This multicentre case-control study comprised 200 patients with post-traumatic elbow HO and 229 patients who had elbow trauma but without HO formation between July 2019 and December 2020. Features possibly associated with HO formation were obtained. The least absolute shrinkage and selection operator regression model was used to optimize feature selection. Multivariable logistic regression analysis was applied to build the new nomogram: the Shanghai post-Traumatic Elbow Heterotopic Ossification Prediction model (STEHOP). STEHOP was validated by concordance index (C-index) and calibration plot. Internal validation was conducted using bootstrapping validation. Male sex, obesity, open wound, dislocations, late definitive surgical treatment, and lack of use of non-steroidal anti-inflammatory drugs were identified as adverse predictors and incorporated to construct the STEHOP model. It displayed good discrimination with a C-index of 0.80 (95% confidence interval 0.75 to 0.84). A high C-index value of 0.77 could still be reached in the internal validation. The calibration plot showed good agreement between nomogram prediction and observed outcomes. The newly developed STEHOP model is a valid and convenient instrument to predict HO formation after surgery for elbow trauma. It could assist clinicians in counselling patients regarding treatment expectations and therapeutic choices. Cite this article: Bone Joint J2022;104-B(8):963-971.

A study of prescription pattern of drugs used in the treatment of osteoarthritis in tertiary care teaching hospitals

Background: Evaluation of drug utilization patterns need to be done consistently to facilitate obligatory modifications in prescription pattern of drug to hike the therapeutic benefit and to lessen the adverse effects. Osteoarthritis (OA) is becoming growingly acknowledged as a leading reason of chronic pain and lower limb disability amid the elderly people . There are a very few studies which assess the pattern of drug utilization in newly diagnosed osteoarthritis. So the aim &amp; objective of this research is to study &amp; analyze the recent trends in pattern of drug prescription in newly diagnosed osteoarthritis patients . Methods : It was Prospective, Observational study , newly diagnosed patients with osteoarthritis were enrolled in the study considering the inclusion and exclusion criteria. Data was recorded in a specially designed proforma . Results: NSAIDs were most common prescribed class of drugs which were used in all prescriptions. Paracetamol was used in 73% prescriptions but always in combination with NSAIDs. Tramadol was used in 6%prescriptions. Corticosteroids were used in 7% of prescriptions. SYSADOAs were used in 13.5% prescriptions. Non-pharmacological measures like physiotherapy is not advised to any patient.

EFFECTIVENESS OF PHYSIOTHERAPY TREATMENT ON FUNCTIONAL CAPACITY IN POST COVID-19 SURVIVAL SUBJECTS.

Introduction: In late December 2019, an outbreak of a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started from the city of Wuhan, China. A high proportion of individuals who recovered from the acute phase of COVID-19 including SARS and MERS reported persistence of fatigue. Rehabilitation of post-COVID-19 patients is crucial for recovering from fatigue and improving functional status. Need for the study (brief): There are currently scarcity reports on the physiotherapy of COVID-19 patients that focus on fatigue, grip strength and endurance and their overall contribution to improve functional capacity. OurStudy Methodology (brief): study design focussed on randomized controlled trial. We took sample size of 30, based on various inclusion and exclusion criteria.We included only those patients for our test who were a) non-critical and had tested positive for SARS- COV 2 virus based on RT-PCR test (Nasopharyngeal and Oropharyngeal swabs). These patients were admitted to COVID wards however not admitted in ICU. b) Recovered Patient who were referred either by physician or pulmonologist for post-covid rehabilitation (post 14/17 days of quarantine).We excluded those patients from our studies a) who refused to give their consent b) who had neurological deficits c) who were unable to ambulate/with any lower limb disability or fractures d) who were haemodynamically unstable. We segregated our subjects into two categories either experimental group or control group based on sequential envelope method. Our analysis for the data is based on statistical software R version 4.1.1 and Microsoft Excel. We have used Shapiro-Wilk's test to check the normality of variables and Paired t- test/Wilcoxon's test to compare the mean/distributions of pre-operative and post-operative parameters. The ethical clearance was obtained from SDM institutional ethical committee. We had done the CLINICAL REGISTRATION TRIAL with the CTRI reference number is REF/2021/07/045807. Finally derived from the study highlighted the roleconclusion of physiotherapy intervention in not just improving the endurance and fatigue in covid 19 patients but also helped in reducing the complications and helped the patients to carry out their ADLS much more efficiently and helped in improving their quality of life.

Association of psychological factors with limb disability in patients with cervical radiculopathy: comparison with carpal tunnel syndrome

BackgroundRegarding musculoskeletal conditions, patient’s psychological distress, are shown to be associated with higher disability. Cervical radiculopathy (CR) and carpal tunnel syndrome (CTS), are two conditions caused by entrapment of cervical nerve roots and carpal median nerve, respectively. This study aims to investigate the association of psychological factors including depression, anxiety, and pain catastrophizing, with measures of upper limb patient-reported and performance-based disability, in patients with CR, and compare the obtained results with our similar study on CTS.MethodsIn a cross-sectional study, we recruited 92 patients with CR, and investigated their disability level using patient-reported questionnaires (Quick Disabilities of the Arm, Shoulder and Hand (DASH) and pain Likert Scale) and by measuring grip and pinch strength. We also assessed their psychological status with Hospital Anxiety and Depression Scale questionnaire for depression (HADS-D) and anxiety (HADS-A) and also Pain Catastrophizing Scale (PCS) tools. We performed correlational coefficient analysis between disability and psychological scores and regression analysis of dependent variables (Pain, DASH, grip and pinch scores) and independent (psychological) variables. Finally, Z observed value was calculated to compare correlational coefficients between two diseases of CTS and CR.ResultsThe results of the correlational coefficient analysis indicate that all three HADS-A, HADS-D and PCS scores correlated with DASH score (r = 0.49, 0.37, 0.38 for HADS-A, HADS-D and PCS, respectively; p < 0.001 for all three). HADS-A also significantly correlated with VAS pain score (r = 0.41, P < 0.001) and grip strength (r = − 0.25, P = 0.016). Linear regression analysis revealed that anxiety has a notable value for DASH and VAS pain scores as well as grip strength. Fisher’s r correlation coefficient to z transformation, revealed that there was no difference between two diseases of CTS and CR in terms of the resulted r coefficients from correlational coefficient analysis between disability and psychological distress.ConclusionIt is concluded that psychological disorders are associated with disability in CR patients, with anxiety also correlating with objective disability parameter of grip strength. Finally, both CTS and CR patients’ disabilities associate with anxiety, depression, and catastrophysing thinking in a similar manner.Level of evidenceLevel IV (cross-sectional study).

Apparel needs and limitations for people with limb disabilities

The paper tries to understand the needs and wants of “disabled people” regarding apparel items of clothing. The aim of “clothing is to express” the style of an individual and to fulfil the needs of the wearer’s security, functionality, and easement. In this paper, the limitations that people with “limb disabilities” face during the selection of any apparel of their choice because of medical restrictions are presented here. The apparel is important as every need of the wearer have to be satisfied in order to fulfil the human needs and obtain the functionality of the garments. Here, the functional clothes needs of the “disabled people” and with the use of 3D “virtual scanning” for a new presentation of the clothing is further presented. In order to gather data in reference to the research topic, secondary research methodology has been used here. The data findings and interpretation are also done following that manner. Also, the conclusion and future recommendations have been provided in this paper.

Goal-directed upper limb movement patterns and hand grip forces in multiple sclerosis.

BackgroundUpper limb disability in persons with Multiple Sclerosis (pwMS) leads to increased dependence on caregivers. To better understand upper limb disability, observer-based or time-based clinical assessments have been applied. However, these only poorly capture the behavioural aspects underlying goal-directed task performance.ObjectiveWe aimed to document alterations in goal-directed upper limb movement patterns and hand grip forces in a cohort of pwMS (n = 123) with mild to moderate upper limb impairments.MethodsWe relied on the Virtual Peg Insertion Test (VPIT), a technology-aided assessment with a goal-directed pick-and-place task providing a set of validated digital health metrics.ResultsAll metrics indicated significant differences to an able-bodied reference sample (p < 0.001), with smoothness, speed, and grip force control during object manipulation being most affected in pwMS. Such abnormalities negatively influenced the time to complete the goal-directed task (p < 0.001, R2 = 0.77), thereby showing their functional relevance. Lastly, abnormalities in movement patterns and grip force control were consistently found even in pwMS with clinically normal gross dexterity and grip strength.ConclusionThis work provides a systematic documentation on goal-directed upper limb movement patterns and hand grip forces in pwMS, ultimately paving the way for an early detection of MS sign using digital health metrics.

Effect of manual lymphatic drainage combined with vacuum sealing drainage on axillary web syndrome caused by breast cancer surgery.

The aim of the study was to explore the application value of manual lymphatic drainage combined with vacuum sealing drainage in axillary web syndrome (AWS) after breast cancer surgery. From 1 April 2020 to 1 June 2020, a total of 102 patients with AWS after axillary lymph node biopsy or axillary lymph node dissection in our hospital were included in this prospective study. According to the random number table method, all patients were divided into the study group (n=51) and the control group (n=51). The study group received the treatment of manual lymphatic drainage combined with vacuum sealing drainage, and the control group received health education and the treatment of functional training. The efficacy observation indicators included duration time to the disappearance of relevant clinical symptoms, degree of pain, angle of abduction of the affected limb, degree of upper limb disability function and quality of life. The duration time to the disappearance of cord-like nodules and tightness in the study group was both significantly shorter than that in the control group (both P < .05). In the time point of 1 and 3 months after the intervention, compared with that in the control group, the study group had a significantly lighter degree of pain, a better degree of upper limb disability function and higher quality of life (all P < .05). Manual lymphatic drainage combined with vacuum sealing drainage can shorten the disappearance time of relevant clinical symptoms, relieve the degree of pain, improve the upper limb disability function and improve the quality of life in patients with AWS.