Upper-limb Disability Research Articles

Development and Production of a Children's Upper-Limb Cycling Adapter Using 3D Printing.

The research described in this study focuses on the development of an innovative upper-limb adapter for young children aged 1-3 years who have congenital upper-limb defects. The objective was to create a functional and affordable solution that allows children to engage more safely and actively in physical activities such as cycling. The adapter was designed within the DESIGN+ project at the University of West Bohemia in Pilsen in collaboration with the German company Ottobock. The development included a detailed analysis of hand movements during cycling, modelling using CAD software (NX 1888), prototype manufacturing through 3D printing, and subsequent testing. The result is an adapter that allows 360° rotation around the arm axis, provides natural hand movement while turning, and is made of soft material to enhance safety. Despite initial challenges and necessary prototype adjustments, a functional and reliable design was achieved. This adapter will contribute to improving the quality of life for children with upper-limb disabilities, supporting their coordination, strength, and confidence in daily activities.

Effectiveness of Two Models of Telerehabilitation in Improving Recovery from Subacute Upper Limb Disability after Stroke: Robotic vs. Non-Robotic.

Finding innovative digital solutions is fundamental to ensure prompt and continuous care for patients with chronic neurological disorders, whose demand for rehabilitation also in home-based settings is steadily increasing. The aim is to verify the safety and the effectiveness of two telerehabilitation (TR) models in improving recovery from subacute upper limb (UL) disability after stroke, with and without a robotic device. One hundred nineteen subjects with subacute post-stroke UL disability were assessed for eligibility. Of them, 30 patients were enrolled in the study and randomly assigned to either the Robotic Group (RG), undergoing a 20-session TR program, using a robotic device, or the Non-Robotic Group (NRG), undergoing a 20-session TR program without robotics. Clinical evaluations were measured at baseline (T0) and post-intervention (T1, 5 weeks after baseline), and included assessments of quality of life, motor skills, and clinical/functional status. The primary outcome measure was the World Health Organization Disability Assessment Schedule 2.0, evaluating the change in perceived disability. Statistical analysis shows that patients of both groups improved significantly over time in all domains analyzed (mean decrease from baseline in the WHODAS 2.0 of 6.09 ± 2.62% for the NRG, and of 0.76 ± 2.21% for the RG), with a greater improvement of patients in the NRG in motor (Fugl-Meyer Assessment Upper Extremity-motor function, Box and Block Test) and cognitive skills (Trail Making Test-A). This study highlights the potential of TR programs to transform stroke rehabilitation by enhancing accessibility and patient-centered care, promoting autonomy, improving adherence, and leading to better outcomes and quality of life for stroke survivors.

Movement-Based Prosthesis Control with Angular Trajectory Is Getting Closer to Natural Arm Coordination.

Traditional myoelectric controls of trans-humeral prostheses fail to provide intuitive coordination of the necessary degrees of freedom. We previously showed that by using artificial neural network predictions to reconstruct distal joints, based on the shoulder posture and movement goals (i.e., position and orientation of the targeted object), participants were able to position and orient an avatar hand to grasp objects with natural arm performances. However, this control involved rapid and unintended prosthesis movements at each modification of the movement goal, impractical for real-life scenarios. Here, we eliminate this abrupt change using novel methods based on an angular trajectory, determined from the speed of stump movement and the gap between the current and the 'goal' distal configurations. These new controls are tested offline and online (i.e., involving participants-in-the-loop) and compared to performances obtained with a natural control. Despite a slight increase in movement time, the new controls allowed twelve valid participants and six participants with trans-humeral limb loss to reach objects at various positions and orientations without prior training. Furthermore, no usability or workload degradation was perceived by participants with upper limb disabilities. The good performances achieved highlight the potential acceptability and effectiveness of those controls for our target population.

The association between dexterity and upper limb impairment during stroke recovery.

Stroke-induced upper limb disabilities can be characterized by both motor impairments and activity limitations, commonly assessed using Fugl-Meyer Motor Assessment for Upper Extremity (FMMA-UE) and Action Research Arm Test (ARAT), respectively. The relationship between the two assessments during recovery is largely unstudied. Expectedly they diverge over time when recovery of impairment (restitution) plateaus, but compensation-driven improvements still occur. The objective of this study is to evaluate the alignment between FMMA-UE and ARAT in defining upper limb functional recovery categories by ARAT scores. We aimed to establish cut-off scores for both measures from the acute/early subacute, subacute and chronic stages of stroke recovery. Secondary analysis of four prospective cohort studies (acute/early subacute: n = 133, subacute: n = 113, chronic: n = 92) stages post-stroke. Receiver operating characteristic curves calculated the area under the curve (AUC) to establish optimal FMMA-UE cut-offs based on predefined ARAT thresholds distinguishing five activity levels from no activity to full activity. Weighted kappa was used to determine agreement between the two assessments. We used minimally clinically important difference (MCID) and minimal detectable change (MDC95) for comparison. FMMA-UE and ARAT scores showed no relevant divergence across all recovery stages. Results indicated similar cut-off scores in all recovery stages with variability below MCID and MDC95 levels. Cut-off scores demonstrated robust AUC values from 0.77 to 0.86 at every recovery stage. Only in highly functional patients at the chronic stage, we found a reduced specificity of 0.55. At all other times sensitivity ranged between 0.68 and 0.99 and specificity between 0.71 and 0.99. Weighted kappa at the acute/early subacute, subacute and chronic stages was 0.76, 0.83, and 0.81, respectively. Our research shows a strong alignment between FMMA-UE and ARAT cut-off scores throughout stroke recovery, except among the subgroup of highly recovered patients at the chronic stage. Discrepancies in specificity potentially stem from fine motor deficits affecting dexterity outcomes that are not captured by FMMA-UE. Additionally, the high congruence of both measures suggests they are not suited to distinguish between restitution and compensation. Calling for more comprehensive assessment methods to better understand upper limb functionality in rehabilitation.

Upper Limb Function in People With Upper and Lower Limb Loss 8Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study.

Upper limb (UL) disability in people with UL loss is well reported in the literature, less so for people with lower limb loss. This study aimed to compare UL disability in injured (major trauma) and uninjured UK military personnel, with particular focus on people with upper and lower limb loss. A volunteer sample of injured (n= 579) and uninjured (n= 566) UK military personnel who served in a combat role in the Afghanistan war were frequency matched on age, sex, service, rank, regiment, role, and deployment period and recruited to the Armed Services Trauma Rehabilitation Outcome (ADVANCE) longitudinal cohort study. Participants completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, scored from 0 (no disability) to 100 (maximum disability) 8years postinjury. Mann-Whitney U and Kruskal-Wallis tests were used to compared DASH scores between groups. An ordinal model was used to assess the effect of injury and amputation on DASH scores. DASH scores were higher in the Injured group compared to the Uninjured group (3.33 vs 0.00) and higher in people with lower limb loss compared to the Uninjured group (0.83 vs 0.00), although this was not statistically significant. In the adjusted ordinal model, the odds of having a higher DASH score was 1.70 (95% CI = 1.18-2.47) times higher for people with lower limb loss compared to the Uninjured group. DASH score was not significantly different between people with major and partial UL loss (15.42 vs 12.92). The odds of having a higher DASH score was 8.30 (95% CI = 5.07-13.60) times higher for people with UL loss compared to the Uninjured group. People with lower limb loss have increased odds of having more UL disability than the Uninjured population 8years postinjury. People with major and partial UL loss have similar UL disability. The ADVANCE study will continue to follow this population for the next 20years. For the first time, potential for greater long-term UL disability has been shown in people with lower limb loss, likely resulting from daily biomechanical compensations such as weight-bearing, balance, and power generation. This population may benefit from prophylactic upper limb rehabilitation, strength, and technique.

Upper Limbs Muscle Co-Contraction Changes Correlate With The Physical Motor Impairments in CMT.

Subjects with Charcot-Marie-Tooth (CMT) disease show hands impairment which is a relevant problem affecting the quality of life. This symptom is related to muscle weakness and reduced motor coordination of the upper limb. However, most studies focus on lower limb impairment, therefore the investigation of upper limb disability is necessary to identify biomarkers able to monitor disease-specific features and to tailor rehabilitation. This study aimed at characterizing upper limb muscle co-contraction using the co-contraction index (CCI) in CMT population. Upper limb kinematic and electromyography (EMG) data were collected from fourteen CMT subjects (6-CMT1A and 8-CMT1X) during motor tasks typical of daily living activities. Rudolph's CCI was used to quantify muscle co-contraction of four muscle pairs acting on shoulder, elbow and wrist. All CMT subjects underwent clinical examination. Thirteen healthy subjects served as the normative reference (HC). CMT1X and CMT1A showed a significant reduction in CCI for distal and proximal muscle pairs compared to HC. Furthermore, CMT1A showed greater values of CCI compared to CMT1X mainly for the axial and axial-to-proximal muscle pairs. Movement speed and smoothness were not altered compared to HC. In addition, EMG metrics showed moderate-to-strong significant correlations with clinical outcomes. CCI was able to quantify disease-specific deficits with respect to the normative reference, highlighting motor control alterations even before motor output impairment. CCI was also sensitive in detecting CMT subtypes-based differences and adopted compensatory strategies. Our findings suggest that CCI can be an outcome measure for CMT disease monitoring and interventional studies.

Musculoskeletal Disorders Related to Upper Limb Disability after One-Year Lung Cancer Resection.

Lung resection represents the main curative treatment in lung cancer; however, this surgical process leads to several disorders in tissues and organs. Previous studies have reported cardiovascular, pulmonary, and muscular disturbances that affect the functional capacity of these patients in the short, mid, and long term. However, upper limb impairment has been scarcely explored in the long term, despite the relevance in the independence of the patients. The aim of this study was to characterize the upper limb impairment in survivors of lung cancer one year after pulmonary resection. In this observational trial, patients who underwent lung cancer surgery were compared to control, healthy subjects matched by age and gender. Upper limb musculoskeletal disorders (shoulder range of motion, pain pressure threshold, nerve-related symptoms) and functional capacity (upper limb exercise capacity) were evaluated one-year post-surgery. A total of 76 survivors of lung cancer and 74 healthy subjects were included in the study. Significant differences between groups were found for active shoulder mobility (p < 0.05), widespread hypersensitivity to mechanical pain (p < 0.001), mechanosensitivity of the neural tissue (p < 0.001), and upper limb exercise capacity (p < 0.001). Patients who undergo lung cancer surgery show upper limb musculoskeletal disorders and upper limb functional impairment after a one-year lung resection. This clinical condition could limit the functionality and quality of life of patients with lung cancer.

Upper-Limb Movement Quality before and after Surgery in Women with Breast Cancer: An Exploratory Study.

(1) Background: This study aimed to describe upper-limb (UL) movement quality parameters in women after breast cancer surgery and to explore their clinical relevance in relation to post-surgical pain and disability. (2) Methods: UL movement quality was assessed in 30 women before and 3 weeks after surgery for breast cancer. Via accelerometer data captured from a sensor located at the distal end of the forearm on the operated side, various movement quality parameters (local dynamic stability, movement predictability, movement smoothness, movement symmetry, and movement variability) were investigated while women performed a cyclic, weighted reaching task. At both test moments, the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire was filled out to assess UL disability and pain severity. (3) Results: No significant differences in movement quality parameters were found between the pre-surgical and post-surgical time points. No significant correlations between post-operative UL disability or pain severity and movement quality were found. (4) Conclusions: From this study sample, no apparent clinically relevant movement quality parameters could be derived for a cyclic, weighted reaching task. This suggests that the search for an easy-to-use, quantitative analysis tool for UL qualitative functioning to be used in research and clinical practice should continue.

Prevalence of Upper Extremity Injuries in Military Personnel and the Assessment of Disability Conditions according to Military Regulations

Objective: Musculoskeletal injuries have an essential place among the injuries of military personnel. Depending on the severity of these injuries and the degree of functional loss, return to work is delayed, and sequela leads to job loss and disability as well. This study has aimed to assess the distributions of current injuries and make recommendations to reduce these injuries and evaluate the conditions causing disability. Material and Method: Upper limb injury distribution and disability status of injured contracted soldiers/NCOs, who applied to a tertiary trauma center between January 2019 and January 2020, were evaluated according to Turkish Armed Forces Health Ability Regulation No. 6405. Results: The number of patients included in the study was 31. Their mean age was 21.45. A significant relationship was found when the relationship between injured areas and disability occurrence was evaluated (p=0.036). In this relationship, it was observed that the possibility of especially hand (excluding finger), forearm, and upper arm injuries to cause disability was high and that although the number of finger injuries was high, their possibility to cause disability was at 60%. There was no significant difference between combat and noncombat occupational accidents in terms of the injured areas (p=0.305). Conclusion: Although injuries in military personnel require long rest periods and finger loss poses a major obstacle to serving, there are loss of rights due to the limited disability conditions and insufficient details of the regulations. It is recommended that military guidelines be made more functional, reviewed by a board that includes a hand surgeon, increased training, and the development of double-stage security systems and protective equipment

Novel Extension Control Instrument for Power Wheelchair Based on Kalman Filter Head Motion Detection

People with upper limb disabilities or high quadriplegia have extremely high requirements for the maneuverability and functionality of power wheelchairs. Normal wheelchairs cannot meet travel tasks, while smart customized wheelchairs are expensive and cannot be popularized. Therefore, a novel extension control instrument for power wheelchairs with low cost, strong scalability, and convenient usage is proposed, which can realize the control of the wheelchair by sensing a change of head posture. The device is divided into a head motion sensing unit (HMSU) and a wheelchair assistance control unit (WACU). The mapping relationship between the head attitude and the subject’s motion intention is established. The inertial measurement module in the HMSU collects the head attitude data and uses the Kalman filtering method to obtain the accurate Euler angle. The WACU is fixed on the original controller of the wheelchair. The joystick is inserted into the extended control mechanism and controlled, instead of the hand, through a 2-degree-of-freedom servo system combined with the pinion and rack push rod structure, thus controlling the movement of the wheelchair. In proceeding, the system can also detect the distance of objects in the environment in real time through the three-direction (front, left, right) ultrasonic ranging sensors installed on the WACU, with a certain obstacle avoidance function. The prototype experiments prove that the extension control instrument developed in this paper based on the Kalman filter can quickly and accurately identify head motion and accurately control the movement of the wheelchair. It is easy to operate and has strong universality, which presents a new low-cost solution for the travel of patients with disabilities.

СПОСОБ ЛЕЧЕНИЯ ЛОЖНЫХ СУСТАВОВ ЛАДЬЕВИДНОЙ КОСТИ ПУТЕМ ПРИМЕНЕНИЯ НАДКОСТНИЧНЫХ ЛОСКУТОВ НА МЕТАКАРПАЛЬНЫХ АРТЕРИЯХ

The purpose of the study: to improve the method of surgical treatment of patients with scaphoid nonunion. Material and methods: the results of treatment of 30 patients operated on for scaphoid nonunion of the hand, which arose after conservative treatment (not treatment) of fractures, surgical treatment for 2018-2021 were analyzed. The patients were divided into two groups: 15 patients with scaphoid nonunion who underwent free bone autoplasty as a surgical aid, fixation of bone fragments with a headless screw – a control group; 15 patients with fscaphoid nonunion, who underwent free bone autoplasty as surgical treatment, supplemented with non-free plastic surgery with a periosteal flap on the metacarpal artery – the main (experimental) group of patients. The possibility of using periosteal flaps isolated from the first and second metacarpal bones was evaluated. To assess the results of treatment, X-ray monitoring of scaphoid nonunion consolidation was used at 8, 12 weeks and 6 months after surgery; computed tomography of wrist joints was performed at 4 months after surgery in order to assess the degree of bone graft reconstruction. Hand function was assessed before and after surgery using the DASH Upper Limb Disability Questionnaire and the Visual Analog Pain Scale (VAS). Results of the study: in the experimental group, scaphoid nonunion consolidation was achieved in 13 out of 15 patients (86.6%) compared with the control group (10 out of 15 patients – 66.7%). According to the severity of the pain syndrome and the final functional result, comparable indicators were obtained in both groups. Discussion: given the small sample of patients who participated in the work, the study has moderate reliability. However, the data obtained allow us to hope for the effectiveness of the proposed method of surgical treatment used in patients of the main study group.

Design and Analysis of VARONE a Novel Passive Upper-Limb Exercising Device

Robots have been widely investigated for active and passive rehabilitation therapy of patients with upper limb disabilities. Nevertheless, the rehabilitation assessment process is often ignored or just qualitatively performed by the physiotherapist implementing chart-based ordinal scales or observation-based measures, which tend to rely on professional experience and lack quantitative analysis. In order to objectively quantify the upper limb rehabilitation progress, this paper presents a noVel pAssive wRist motiOn assessmeNt dEvice (VARONE) having three degrees of freedom (DoFs) based on the gimbal mechanical design. VARONE implements a mechanism of three revolute passive joints with controllable passive resistance. An inertial measurement unit (IMU) sensor is used to quantify the wrist orientation and position, and an encoder module is implemented to obtain the arm positions. The proposed VARONE device can also be used in combination with the previously designed two-DoFs device NURSE (cassiNo-qUeretaro uppeR limb aSsistive dEvice) to perform multiple concurrent assessments and rehabilitation tasks. Analyses and experimental tests have been carried out to demonstrate the engineering feasibility of the intended applications of VARONE. The maximum value registered for the IMU sensor is 36.8 degrees, the minimum value registered is −32.3 degrees, and the torque range registered is around −80 and 80 Nmm. The implemented models include kinematics, statics (F.E.M.), and dynamics. Thirty healthy patients participated in an experimental validation. The experimental tests were developed with different goal-defined exercising paths that the participant had to follow.

Retracted: Intelligent Writing System for Patients with Upper Limb Disabilities

Retracted: Intelligent Writing System for Patients with Upper Limb Disabilities

Analysis of Hand Function, Upper Limb Disability, and Its Relationship with Peripheral Vascular Alterations in Raynaud's Phenomenon.

This study aimed to compare vascular involvement, hand functionality, and upper limb disability between Raynaud's phenomenon participants and controls. Also, we analyzed the relationships between vascular impairment, mobility, and strength with disability in this Raynaud population. We conducted a case-control study with fifty-seven participants. We registered sociodemographic and clinical data; vascular variables (temperature, cold test, blood flow, and oxygen saturation); functional variables (pinch strength, range of motion), and disability (Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire) (Q-DASH). Raynaud participants present more disability in all Q-DASH subscales, lower hands' temperature pre and post cold test, decreased blood flow on radial artery, decreased ranges of motions at passive extension of index finger, and active flexion and extension of thumb than the healthy controls. The multivariate regression analysis showed that extension of the index finger, lateral pinch strength, and oxygen saturation were significantly associated with disability in RP, almost the 55% of the total variance on the upper limb, 27% at sports/arts, and 42% at work. Our findings suggest that RP has a disabling effect on the upper extremities and a practice of activities in people who suffer it. Also, disability in Raynaud seems to be more related with hand mobility and strength impairment than vascular injury.

Classifying Hand Dexterity Impairment in Degenerative Cervical Myelopathy With 10-Second Grip and Release Test.

Diagnostic accuracy study with prospectively collected data. This study aimed to establish optimal cutoff values for the 10-second grip and release (10s-G&R) Test to distinguish between mild, moderate, and severe levels of hand dexterity impairment in patients with degenerative cervical myelopathy (DCM). The 10s-G&R test is widely utilized to assess hand function in DCM patients. However, whether this test can effectively distinguish between varying severities of hand dexterity impairment, along with the relevant cutoff values, remains unknown. The authors analyzed hand motion data from 551 consecutively enrolled DCM patients using an artificial intelligent system. In addition, the authors conducted evaluations of functional status, quality of life, and outcome measures. Receiver operating curve analysis was performed to determine cutoff values that differentiate mild, moderate, and severe hand dexterity impairments based on the ability to fasten buttons, as assessed by the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire Q2-1. The validity of these cutoffs was assessed by comparing G&R parameters, upper limb disability, overall disease severity, and quality of life among patients in different severity groups. The authors identified 16 G&R cycles as the cutoff for moderate hand dexterity impairment and 13 G&R cycles as the cutoff for severe impairment. Patients with severe impairment exhibited significantly worse G&R parameters, more severe upper limb symptoms, greater overall disease severity, and reduced quality of life. Patients completing fewer than 13 G&R cycles within 10 seconds were more likely to have moderate-to-severe DCM, indicating the need for potential surgical intervention. The authors propose classifying mild hand dexterity impairment as 17 to 20 cycles on the 10s-G&R test, moderate as 14 to 16 cycles, and severe as 13 cycles or less. Our study underscores that the 10s-G&R test can serve as an effective supplementary tool within the context of other currently available measurement tools.

Shoulder and scapulothoracic impairments in women with breast cancer-related lymphedema in the upper limb: A cross-sectional study shoulder and breast cancer-related lymphedema

IntroductionLymphedema in the upper limb as a complication of breast cancer may lead to shoulder pain and dysfunctions. Objective: To compare the scapular positioning, the shoulder range of motion, and muscle strength among women undergoing treatment for breast cancer with and without lymphedema and a control group. MethodsThis cross-sectional study evaluated women undergoing treatment for breast cancer (N = 25) and without lymphedema (N = 25), and a control group (N = 25). Static scapular positions and shoulder range of motion were measured by using an inclinometer. The shoulder and periscapular muscle strength were measured by using a hand-held dynamometer and the Disabilities of the Arm, Shoulder, and Hand Questionnaire was applied. Linear regression of the mixed effects model was used to compare the groups. ResultsBoth groups of mastectomized women had reduced shoulder range of motion, scapular upward rotation, and muscle strength for shoulder and periscapular muscles compared to the control group. Also, women undergoing treatment for breast cancer with lymphedema had reduced shoulder range of motion, scapular upward rotation, increased anterior tilt, reduced muscle strength of the upper trapezius, and greater upper limb disability compared to women without lymphedema. ConclusionWomen undergoing treatment for breast cancer with lymphedema had even greater shoulder and scapulothoracic impairments when compared to the control group and women without lymphedema.

Efficacy and safety of vagus nerve stimulation on upper extremity motor function in patients with stroke: A meta-analysis of randomized controlled trials.

In 2021, the U.S. Food and Drug Administration (FDA) approved paired vagus nerve stimulation (VNS) for patients with moderate-to-severe upper extremity motor impairments following chronic ischemic stroke. Previous meta-analyses have shown that VNS may impact stroke rehabilitation, but each has some limitations. PubMed, Ovid, Cochrane Library, ScienceDirect, Web of Science and WHO ICTRP databases were searched until July 14, 2022 for randomized controlled trials (RCTs). We defined primary outcomes as Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Wolf Motor Function Test (WMFT). Subgroup analyses included types of VNS, time since onset and long-term effects. Secondary outcomes included adverse events of VNS. Eight RCTs involving 266 patients were analyzed, of which five used direct VNS and three transcutaneous auricular VNS. The results revealed that VNS enhanced upper extremity function via FMA-UE (SMD = 0.73; 95% CI: 0.48 to 0.99; P < 0.00001) and WMFT (SMD = 0.82; 95% CI:0.52 to 1.13; P < 0.00001) in comparison to the control group, but showed no significant change on long-term effects of FMA-UE (SMD = 0.69; 95% CI: - 0.06 to 1.44; P = 0.07). There was no difference in adverse events between the VNS and control groups (RR = 1.16; 95% CI: 0.46 to 2.92; P = 0.74). For stroke victims with upper limb disabilities, VNS paired with rehabilitation was significantly safe and effective. More high-quality multicentric RCTs are needed to validate this conclusion.

The combined effect of Kinesio tape and exercise on risk reduction, pain relief, and hand function improvement in assembly workers of a manufacturing industry

Background and aims: Nowadays, one of the purposes of ergonomics is to identify the risk factors of musculoskeletal disorders and provide solutions to reduce them. The aim of this study was to investigate the effect of using Kinesio tape and doing exercise during working hours for 8 weeks on the reduction of risk and pain and improvement of hand function during daily activities. Methods: This clinical trial study was carried out on 40 female workers employed in the manufacturing industry. The subjects were divided into three groups, including exercise-taping, exercise, and control, and performed an 8-week rehabilitation program twice a week. To assess the upper limb function, the cognitive demand of the assigned task, and hand strength, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Borg Scale, and a dynamometer were used, respectively. Results: The results of this study indicated a decrease in upper limb disability and increased grip strength in the tape plus exercise group compared to the control group (P&lt;0.05). However, no significant change in the Borg scale was found in any of the three groups (P&gt;0.05). Conclusion: It can be concluded that attending at least 2 or 3 exercise sessions per week and using Kinesio tape can be effective in reducing pain in the upper limb.

Musculoskeletal complaints and disability in a group of young adults with major congenital upper limb differences in The Netherlands

Purpose To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. Materials and methods Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. Results Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. Conclusions MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitation The year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs. Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands. Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD. Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability.

Study on Elevator Recognition Techniques for Upper-Limb-Disabled Wheelchair Users

This study proposes a LiDAR-sensor-based elevator recognition technique to prevent collisions caused by poor operation and the cognitive decline of wheelchair users with upper limb disabilities. Existing elevator recognition studies show high performance for elevator door recognition, but this can only be recognized at a position where the elevator can be viewed directly due to the angle of view range of the sensor. This is not appropriate for wheelchair users who are inexperienced in operation because alignment must be performed directly based on the elevator. Therefore, this study presents a LiDAR-sensor-based elevator recognition technique that can detect elevators from the side to the position and at an angle to the front in order to solve this problem. In addition, this study proposes a technique for recognizing elevator gates finished with low- and high-reflective materials in order to enable recognition in various elevator environments. In order to quantitatively verify the elevator recognition technique proposed in this study, experiments were conducted in an elevator environment consisting of low and high reflections. The results of the experiments confirmed that there was no problem in applying the wheelchair active driving technique.