Wrist Motion Research Articles

Biomechanical evaluation of the wrist after scaphotrapeziotrapezoid arthrodesis.

The main objective of the present study was to present the biomechanical properties of the wrist in patients who underwent scaphotrapeziotrapezoid arthrodesis when compared to a healthy control hand. The study group consisted of 29 consecutive patients who underwent a scaphotrapeziotrapezoid wrist arthrodesis at least 1year before the research onset. Both hands of all patients were examined in 4 main categories. Average score obtained in the VAS, before the surgery, without motion of the wrist was 5.21 (SD = 3.04), whereas with wrist motion, it was 8.10 (SD = 1.37). Nineteen (65.52%) patients exhibited weakened wrist muscle strength. After the surgery, only 5 (17.24%) patients declared pain in the wrist. Furthermore, the results obtained in the VAS statistically significant differed from the ones before (p < 0.05). Twenty-eight (96.55%) patients were able to resume their profession. Twenty-seven (93.10%) patients stated that they would opt for the operation again. The peak torque during the analysis of extension of the wrist in the isometric protocol was found to be 8.1Nm (SD = 2.9), 7.9Nm (SD = 2.3), and 7.9Nm (SD = 2.5) in the operated hands and 10.9Nm (SD = 3.2), 9.6Nm (SD = 2.9), and 9.1Nm (SD = 3.8) in non-operated hand for 30° extension, no-flexion, and 30° flexion positions, respectively (p < 0.05). The current study is the first to present the biomechanical parameters of flexor and extensor muscles of the wrist and fingers in patients after the said procedure. Biomechanical assessments with additional isometric, isotonic, and isokinetic tests provide an opportunity to objectify treatment outcomes and guide appropriate rehabilitation by monitoring its effects. III.

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

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

Enhancing piezoelectric effect of PVDF electrospun fiber through NiO nanoparticles for wearable applications

Flexible electrospun fiber-based piezoelectric nanogenerator (PENG) has attracted a lot of interest due to its ability of generating electrical energy from mechanical energy sources. The present work aims to improve the piezoelectric output of PENG devices based on electrospun polyvinylidene fluoride (PVDF) doped with nickel oxide nanoparticles (NiO NPs) in different concentrations (2, 4, 6, 8 and 10 wt.-%). Crystalline phase changes and β-crystalline content in electrospun fibers were evaluated using XRD and FTIR-ATR, respectively. Surface morphology and surface roughness of the electrospun fibers were observed using FE-SEM and AFM, respectively. The hydrophobic nature of the fibers was analyzed using a wettability test. PENG output voltage and short-circuit current performance of neat PVDF and PVDF doped with NiO (PN) composite electrospun fibers were calculated using a customized variable-pressure setup with an optimized force of 1.0 kgf and 1.0 Hz frequency. Neat PVDF-based PENG exhibited only 1.7 V and 0.7 μA, whereas, PVDF doped with 6 wt.-% NiO NP (PN-6) based PENG generated a high output voltage of 5.5 V and 1.83 μA current. The optimized PN-6 PENG device is demonstrated for use in wearable devices towards identifying certain body movements like tapping, wrist movement, walking and running.

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

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

The Complex Role of Botulinum Toxin in Enhancing Goal Achievement for Post-Stroke Patients.

The rehabilitation medical team is responsible for the therapeutic management of post-stroke patients and, therefore, for the complex therapeutic approach of spasticity. Considering the generous arsenal at our disposal in terms of both pharmacological treatment, through the possibility of administering botulinum toxin to combat spasticity, and in terms of accurate assessment through developed functional scales such as the GAS (Goal Attainment Scale), one of our purposes is to monitor the parameters that influence the achievement of functional goals set by patients together with the medical team in order to render the patients as close as possible to achieving their proposed functional goals, thus enhancing their quality of life. By assessing and establishing statistical and clinical correlations between the GAS and quantifiable parameters related to the affected post-stroke upper limb, namely degree of spasticity, motor control, pain level and evolution of pain under treatment with BoNT-A (abobotulinum toxin A), and patients' overall response to BoNT-A treatment, we aim to quantify the improvement of the therapeutic management of post-stroke patients with spasticity and develop a more personalized and effective approach to their disability and impairment. The analysis concluded that there were two independent predictors of the Achieved GAS-T score (the study's endpoint parameter) motor control at any level of the upper limb and number of prior BoNT-A injections. The number of prior BoNT-A injections was an independent predictor of Achieved GAS-T score improvement but had no significant influence over Baseline GAS-T score. Enhancement in proximal and intermediate motor control showed a GAS score improvement of 3.3 points and a 0.93-point GAS score improvement for wrist motor control progress. From a separate viewpoint, patients with motor deficit on the left side have shown significantly greater improvement in Changed GAS-T scores by 2.5 points compared to patients with deficits on the right side; however, we note as a study limitation the fact that there was no statistical analysis over the dominant cerebral hemisphere of each patient. Improvement in the Achieved GAS-T score means better achievement of patients' goals. Thus, after the BoNT- A intervention, at follow-up evaluation, GAS was found to be directly correlated with improvement in motor control of the affected upper limb. Mobility of the corresponding limb was enhanced by pain decrease during p-ROM (passive range of motion) and by amelioration of spasticity. We conducted an observational, non-randomized clinical study on 52 stroke patients, a representative sample of patients with post-stroke spasticity and disability from our neurological rehabilitation clinic, who have been treated and undergone a specific rehabilitation program in our tertiary diagnostic and treatment medical center, including BoNT-A focal treatment for spasticity in the affected upper limb. The primary objective of the study was to assess the influence of abobotulinum toxin A treatment on the Goal Attainment Scale. Secondary objectives of the study included the assessment of BoNT-A treatment efficacy on spasticity with the MAS (Modified Ashworth Scale), pain with the NRS (Numerical Rating Scale), and joint passive range of motion (p-ROM), identifying demographic, clinical, and pharmacological factors that influence the response to BoNT-A treatment, as well as to conduct a descriptive and exploratory analysis of the studied variables.

Free hemi-hamate arthroplasty: A review of donor site outcomes

IntroductionThe use of the dorsal hamate as a free osteochondral bone graft or vascularized bone flap has become the mainstay for large, comminuted middle phalanx volar lip fractures. To date, few studies have been conducted in the assessment of donor site morbidity for the hemi-hamate graft or flap, and none have discussed modes of repair or reconstruction of this donor site. MethodsA retrospective analysis of 14 hemi-hamate arthroplasty (HHA) procedures, including 6 vascularized and 8 non-vascularized grafts, from two surgeons was performed. Four hamate defect reconstruction techniques were utilized: no formal reconstruction, autologous bone grafting, gel foam, or synthetic bone substitute. The dorsal capsule was repaired with either extensor retinaculum grafting or by direct closure. Wrist range of motion, pain scores, and radiographic alignment were assessed. ResultsAt 6 months follow-up, all patients achieved full, pain-free wrist motion compared to the uninjured side, with visual analog scale pain scores of 0. Serial radiographs showed maintained carpal alignment without instability or subluxation. No differences based on the hamate defect reconstruction method or capsular repair technique was demonstrated. ConclusionSafe return to pain free, unrestricted wrist function is achievable after HHA, regardless of hamate donor site management. Adequate dorsal capsular repair appears critical to prevent instability. Further study is needed to compare techniques, but choice may be guided by surgeon preference in the absence of clear evidence.

3D‐printed intrinsically stretchable room‐temperature‐curable electrodes

Abstract3D printing technology has driven the development of flexible and stretchable electronic devices. In this field, silver‐based silicone rubber composites have emerged as promising materials due to their commendable conductivity, stretchability, and printability. However, the manufacturing of stretchable silver electrode materials at room temperature faced significant challenges, including intricate ink preparation methods, phase separation requiring high‐temperature annealing, and subpar conductivity. To address these issues, SP‐RTV ink was developed by mechanically blending room‐temperature vulcanized silicone rubber (RTV) with commercial conductive silver paste (SP). Subsequently, the 3D‐printed SP‐RTV electrodes were both stretchable and curable at room temperature, demonstrating excellent conductivity across various substrates. By optimizing the ink ratio, we achieved outstanding electrical conductivity of 5.17 × 105 S/m for the SP‐RTV electrode comprising 90 wt% silver paste. Moreover, the SP‐RTV electrodes containing 70 wt% silver paste exhibited excellent stretchability of 110% along with a gauge factor of 14.87, making them suitable for detecting finger and wrist movements. Additionally, the 80 wt% SP‐RTV maintained stable relative resistance changes during stretching, positioning it aptly for intrinsic stretchable organic electrochemical transistor applications. Overall, this study offers valuable insights into the room‐temperature manufacturing of flexible electrodes, paving the way for advancements in this burgeoning field.

Tendon ball arthroplasty and proximal carpal stabilization with tendon graft for advanced Kienbock's disease.

This study reports the surgical technique and outcomes of tendon ball arthroplasty combined with proximal carpal stabilization using the extensor carpi radialis longus tendon for treating advanced Kienbock's disease. The collapsed lunate is excised and a tendon ball inserted as a spacer. A distally based extensor carpi radials longus graft is passed through the scaphoid, tendon ball and triquetrum, reconstructing the proximal carpal row. In total, 16 patients were included and the mean follow-up was 25 months. Pain improved from 5.6 preoperatively to 1.3 postoperatively on a 10-point visual analogue scale. Mean wrist motion improved by 17.8° and grip strength compared with the non-operative side increased by 22.1% on average. Radiographic outcomes demonstrated correction of scaphoid flexion and carpal height ratio. The modified tendon ball arthroplasty may be an alternative wrist salvage procedure for the treatment of advanced Kienbock's disease.Level of evidence: IV.

O243: The effect of midcarpal fusions on dart thrower’s motion: a cadaveric study

Abstract Introduction Midcarpal osteoarthritis can be managed with several types of partial wrist fusion. Limited information is available regarding their effects on functional movement. Many daily activities require a coupled wrist movement, from radial extension to ulnar flexion, termed dart thrower’s motion (DTM). This study aimed to compare the effect of four different midcarpal fusions on DTM. Methods Twelve fresh-frozen cadaveric specimens were dissected. Sequential loading of tendons into radial extension and ulnar flexion enabled full DTM to be measured using goniometry. Specimens were tested at baseline and following each fusion, performed sequentially using Kirschner wires: (1) scaphocapitate fusion, (2) lunocapitate fusion with scaphoid excision, (3) four-corner fusion with scaphoid excision and (4) three-corner fusion with scaphoid and triquetral excision. A one-way ANOVA and Tukey test established the significance of differences in range of motion. Results Each procedure significantly decreased DTM compared with intact wrists. Scaphocapitate fusion resulted in the smallest mean reduction in movement from 78°–70° (p=0.0014). Four-corner fusion produced the greatest reduction in DTM from 78°–63° (p&amp;lt;0.0001). There was a significant difference in DTM between four-corner and scaphocapitate fusions (p=0.0338). There was no significant difference in the range of postoperative DTM between lunocapitate, three-corner, or four-corner fusions. Conclusion DTM was minimally affected by scaphocapitate fusion and maximally affected by four-corner fusion, with a significant difference seen between these two operations. However, as a 44°–87° range of DTM was maintained for four-corner fusions, this is felt to be adequate for function. These results could aid preoperative decision-making.

Prevalence of Overuse Syndrome of wrist in Food Delivery Employees

The rapid growth of online food delivery services has spotlighted the occupational hazards faced by food delivery employees, particularly the prevalence of wrist overuse syndrome. This condition, caused by repetitive movements, is exacerbated by the nature of delivery work, including continuous gripping of handlebars, smartphone use, and lifting heavy bags. Ergonomic challenges and pressure to meet delivery deadlines compound the risk. This study examines the prevalence of overuse syndrome of the wrist among food delivery employees, a population increasingly reliant on repetitive wrist movements due to the demands of their occupation.

Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study.

In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

Measurement of 3D Wrist Angles by Combining Textile Stretch Sensors and AI Algorithm.

The wrist is one of the most complex joints in our body, composed of eight bones. Therefore, measuring the angles of this intricate wrist movement can prove valuable in various fields such as sports analysis and rehabilitation. Textile stretch sensors can be easily produced by immersing an E-band in a SWCNT solution. The lightweight, cost-effective, and reproducible nature of textile stretch sensors makes them well suited for practical applications in clothing. In this paper, wrist angles were measured by attaching textile stretch sensors to an arm sleeve. Three sensors were utilized to measure all three axes of the wrist. Additionally, sensor precision was heightened through the utilization of the Multi-Layer Perceptron (MLP) technique, a subtype of deep learning. Rather than fixing the measurement values of each sensor to specific axes, we created an algorithm utilizing the coupling between sensors, allowing the measurement of wrist angles in three dimensions. Using this algorithm, the error angle of wrist angles measured with textile stretch sensors could be measured at less than 4.5°. This demonstrated higher accuracy compared to other soft sensors available for measuring wrist angles.

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

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

A Physics-Informed Low-Shot Adversarial Learning for sEMG-Based Estimation of Muscle Force and Joint Kinematics.

Muscle force and joint kinematics estimation from surface electromyography (sEMG) are essential for real-time biomechanical analysis of the dynamic interplay among neural muscle stimulation, muscle dynamics, and kinetics. Recent advances in deep neural networks (DNNs) have shown the potential to improve biomechanical analysis in a fully automated and reproducible manner. However, the small sample nature and physical interpretability of biomechanical analysis limit the applications of DNNs. This paper presents a novel physics-informed low-shot adversarial learning method for sEMG-based estimation of muscle force and joint kinematics. This method seamlessly integrates Lagrange's equation of motion and inverse dynamic muscle model into the generative adversarial network (GAN) framework for structured feature decoding and extrapolated estimation from the small sample data. Specifically, Lagrange's equation of motion is introduced into the generative model to restrain the structured decoding of the high-level features following the laws of physics. A physics-informed policy gradient is designed to improve the adversarial learning efficiency by rewarding the consistent physical representation of the extrapolated estimations and the physical references. Experimental validations are conducted on two scenarios (i.e. the walking trials and wrist motion trials). Results indicate that the estimations of the muscle forces and joint kinematics are unbiased compared to the physics-based inverse dynamics, which outperforms the selected benchmark methods, including physics-informed convolution neural network (PI-CNN), vallina generative adversarial network (GAN), and multi-layer extreme learning machine (ML-ELM).

A self-powered flexible piezoelectric sensor patch for deep learning-assisted motion identification and rehabilitation training system

Artificial intelligence-assisted wearable devices have attracted great interest in medical treatment and healthcare. However, wearable electronic devices are expensive to manufacture and usually depend on external power supply. Herein, a flexible self-powered piezoelectric sensor patch (SPP) using Polyvinylidene fluoride (PVDF) fibrous film as the functional layer is demonstrated for the assessment and motion identification of wrist joint rehabilitation training. PVDF fibrous film is prepared by a triboelectric nanogenerator (TENG)-driven near-field electrospinning system with a special designed synchronous mechanical switch. The results show that this flexible SPP has a high sensitivity of 0.2768 V KPa−1 at pressures from 1 to 75 kPa. Such excellent flexibility allows us to attach the SPP to the finger as a tactile sensor for rehabilitation assessment of wrist joint flexibility. In addition, long short-term memory network model is used to process the collected data from the SPP for motion identification. The test accuracy of the SPP wrist motion identification reaches 92.6%, which afford a potential way to understand the progress of the rehabilitation training of patients' wrists. Generally, this flexible SPP shows great promise for applications in the fields of motion monitoring, medical diagnosis and rehabilitation training based on artificial intelligence.

A rare case of solitary exostosis of capitate

Exostosis arising from carpal bones is rare and only a few cases have been reported till date. A 29 years old female came to the outpatient department with a localized swelling present on the dorsum of her right wrist since the past three years. On examining the patient clinically, a well-defined protuberance was observed over the dorsal aspect of the right wrist. CT report showed bony outgrowth over the dorsum of the capitate extending beyond the carpometacarpal joint. In surgical intervention, the mass was removed from the base, which grossly had an appearance of chondral origin. The biopsy report confirmed the diagnosis of exostosis (osteochondroma). Hence, excising the exostosis surgically led to achievement of adequate motion of the patient's wrist along with the additional cosmetic correction benefit.

Alginate-PVDF piezoelectric hydrogel containing calcium copper titanate- hydroxyapatite as a self-powered scaffold for bone tissue engineering and energy harvesting

We have developed a piezoelectric hydrogel composite comprising cross-linked polyvinylidene fluoride-sodium alginate (PVDF-SA) and calcium copper titanate nanowires (CCTO) as the piezoelectric filler, and hydroxyapatite nanoparticles (HA) as the mineral filler. A freeze-drying method was used to prepare piezoelectric hydrogel scaffold. The PVDF/SA-CCTOs-HA hydrogel composite with 0.5% CCTO and 0.4% HA content demonstrated significantly improved piezoelectric performance. Specifically, it exhibited the highest piezoelectric performance among all samples, with VOC of 7 V and ISC of 3.5 μA. These values were 5.5 and 4.9 times higher, than those of the pure PVDF-SA hydrogel scaffold. The rheology studies explored the viscoelastic properties of hydrogel and found that the hydrogel's solid characteristics led to a higher elastic modulus in comparison to the viscous modulus. The composite exhibited higher compressive and tensile strengths at 8.2 and 0.8 MPa, respectively, compared to the pure hydrogel, which has strengths of 6.3 and 0.4 MPa. In vitro studies revealed the good cytocompatibility, cell proliferation of MC3T3-E1 cells on piezoelectric composite. The PVDF-SA/CCTO-HA demonstrated significant antibacterial properties, offering further advantages for its practical applications. The hydrogel composite can identify various human activities, such as wrist and elbow movements, finger pressing and releasing, and heel pressure. Furthermore, it demonstrated its energy storage capability by charging a 1 μF capacitor. This work offers a practical approach to fabricate hydrogel scaffolds possessing favorable piezoelectric characteristics, biocompatibility, robust mechanical properties, and enhanced proliferation, thereby enabling their extensive utilization in bone tissue engineering applications, human movement detection, and energy harvesting.

Outcome of Transfer Flexor Carpi Ulnaris And Plmaris Longus Tendons for Hand Deformity in Persistance Radial Nerve Palsy

Objective; the aim of our study is to evaluate the functional outcome of transfer flexor carpi ulnaris and palmaris longus for patients with persistence radial nerve palsy by minimal tendon transfer technique.&#x0D; Methods; The study included 10 patients 8 male and two female, mean age 25 years, range from 20 to 30 years. They underwent transfer of flexor carpi ulnaris (FCU) and palmaris longus (PL) tendon for patient with persistence radial nerve palsy, the duration of outcome of tendon transfer after radial nerve injury evaluated after one year. Clinical evaluation include wrist joint range of movement by Geniometry and compared with the contralateral normal side.&#x0D; Results; The average ranges of wrist movements were as the follows: the mean wrist flexion was 52⁰(range 46⁰–56⁰), the mean wrist extension was 34⁰(range 30–38), radial deviation 18⁰(range 16⁰–20⁰) and ulnar deviation 21⁰ (range 18–23). The mean extension of the fingers in wrist extension was 7⁰(range 5⁰–10⁰) and in wrist neutral position was 12⁰(range 9⁰–16⁰). The mean abduction of the thumb was 38⁰(range 35⁰–44⁰). In comparison to the measure of joints in the contralateral normal hand, the final extension of the wrist was less, but extension of the fingers and MCP joints was similar to that of the normal hand. All of the patients in our study were able to extend their fingers with the wrist in the neutral position. Thumb abduction and extension was sufficient to deal with daily activities and, even, heavy jobs in most of the patients. Postoperative follow up of the patients was ranged (12–24) months. After 45 days, 8o% of the patients were able to do the normal non heavy daily work. In 20% of cases recovery was not progressing satisfactorily at 5 weeks. These were referred to physiotherapy for a planned exercise program, which the two patients improved their movements.&#x0D; Conclusion; The purpose of this study was to evaluate function of the hand after transfer of the FCU to EDC and PL to EPL, with persistence high nerve injuries. The FCU &amp; PL tendons transfer has some advantages over the other techniques, short duration of operation time, no morbidity, improve range of motion of hand and less surgical scares. It is a viable option to restore hand function and strength following radial nerve injuries.

Novel near E-Field Topography Sensor for Human-Machine Interfacing in Robotic Applications.

This work investigates a new sensing technology for use in robotic human-machine interface (HMI) applications. The proposed method uses near E-field sensing to measure small changes in the limb surface topography due to muscle actuation over time. The sensors introduced in this work provide a non-contact, low-computational-cost, and low-noise method for sensing muscle activity. By evaluating the key sensor characteristics, such as accuracy, hysteresis, and resolution, the performance of this sensor is validated. Then, to understand the potential performance in intention detection, the unmodified digital output of the sensor is analysed against movements of the hand and fingers. This is done to demonstrate the worst-case scenario and to show that the sensor provides highly targeted and relevant data on muscle activation before any further processing. Finally, a convolutional neural network is used to perform joint angle prediction over nine degrees of freedom, achieving high-level regression performance with an RMSE value of less than six degrees for thumb and wrist movements and 11 degrees for finger movements. This work demonstrates the promising performance of this novel approach to sensing for use in human-machine interfaces.

A PRISMA-IPD systematic review and meta-analysis: does age and follow-up improve active range of motion of the wrist and forearm following pediatric upper extremity cerebral palsy surgery?

Surgical treatments such as tendon transfers and muscle lengthening play a significant role in cerebral palsy management,but timing of upper extremity cerebral palsy surgery remains controversial. This study systematically reviews the current literature and investigates the correlation between age at surgery and follow-up time with surgical outcomes in pediatric upper extremity cerebral palsy patients. A comprehensive search of PubMed, Cochrane, Web of Science, and CINAHL databases was performed from inception to July 2020 and articles were screened using PRISMA guidelines to include full-text, English papers. Data analysis was performed using itemized data points for age at surgery, follow-up length, and surgery outcomes, reported as changes in active forearm and wrist motion. A 3D linear model was performed, to analyze the relationship between age, follow-up length, and surgery outcomes. A total of 3,855 papers were identified using the search terms and a total of 8 studies with itemized patient data (n=126) were included in the study. The studies overall possessed moderate bias according to the ROBINS-I scale. Regression analysis showed that age is a significant predictor of change (|t| > 2) in active forearm supination (Estimate = -2.3465, Std. Error = 1.0938, t-value= -2.145) and wrist flexion (Estimate = -2.8474, Std. Error = 1.0771, t-value = -2.643) post-intervention, with older individuals showing lesser improvements. The duration of follow-up is a significant predictor of improvement in forearm supination (Estimate = 0.3664, Std. Error = 0.1797, t-value = 2.039) and wrist extension (Estimate = 0.7747, Std. Error = 0.2750, t-value = 2.817). In contrast, forearm pronation (Estimate = -0.23756, Std. Error = 0.09648, t-value = -2.462) and wrist flexion (Estimate = -0.4243, Std. Error=0.1859, t-value = -2.282) have a significant negative association with follow-up time. These results suggest that there is significant correlation between the age and follow up after surgery with range of motion gains. Most notably, increased age at surgery had a significant negative correlation with select active range of motion postoperative outcomes. Future research should focus on identifying other factors that could affect results of surgical treatment in upper extremity.