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Background

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies.

Methods

Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity.

Results

Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001).

Conclusions

Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.  相似文献   

3.
The purpose of this study was to examine how the limb segment inertial parameters vary across the decades from the 1920s to the 1970s. Sixty-six males participated in this study, ranging in age from 20 to 79 years. Pre-screening ensured that all subjects were healthy. The inertial properties of the segments were determined by modeling each segment as series of geometric solids. A multivariate analysis of variance (ANOVA) revealed statistically significant differences between decade age groups for the upper arm, forearm, shank, and thigh (p<0.01). Subsequent ANOVAs revealed statistically significant differences for all the inertial properties for the upper arm, the center of mass location for the forearm, and segment mass for the thigh. Linear regression lines were fit to the data so that each inertial parameter for each segment could be predicted by subject's age, with the slope of this regression line indicating the trend in the data. These trends were statistically significant for all forearm inertial parameters, thigh mass and longitudinal moment of inertia, and forearm center of mass location. The changes for the thigh, upper arm, and forearm were consistent with the changes, which would accompany a change in muscle mass with aging. Resultant joint moments were computed for a set of gait data using inertial properties reflective of the subjects from the age extremes in the study. The resulting differences in the knee and hip moments, young versus old, were all less than 4.5%.  相似文献   

4.
目的:研究128 层螺旋CT 在透析患者上肢CT 血管成像中的临床应用价值。方法:回顾性分析30 例患者的64 层CT 图像 (64 层组)与39 例患者128 层CT 图像(128 层组),对扫描数据进行三维重建后比较两组患者的动脉分支级别、血管边缘、静脉干 扰评分及瘘口显示情况的差异。结果:128 层组前臂与手部动脉分支级别显示评分高于64 层组,差异有统计学意义(P<0.05);128 层组肩部、上臂及前臂的血管边缘光滑度显示评分高于64 层组,差异有统计学意义(P<0.05)。结论:128 层螺旋CT 在透析患者上 肢血管成像中血管、内瘘口以及流入流出道等细节方面显示效果更理想。  相似文献   

5.
张霞  李跃华  谢添智  汪璇  朱莉莉 《生物磁学》2014,(18):3476-3478
目的:研究128层螺旋CT在透析患者上肢CT血管成像中的临床应用价值。方法:回顾性分析30例患者的64层CT图像(64层组)与39例患者128层CT图像(128层组),对扫描数据进行三维重建后比较两组患者的动脉分支级别、血管边缘、静脉干扰评分及瘘口显示情况的差异。结果:128层组前臂与手部动脉分支级别显示评分高于64层组,差异有统计学意义(P〈0.05);128层组肩部、上臂及前臂的血管边缘光滑度显示评分高于64层组,差异有统计学意义(P〈0.05)。结论:128层螺旋CT在透析患者上肢血管成像中血管、内瘘口以及流入流出道等细节方面显示效果更理想。  相似文献   

6.
This investigation examined the effects of a protease supplement on selected markers of muscle damage and delayed-onset muscle soreness (DOMS). The study used a double-blinded, placebo-controlled, crossover design. Twenty men (mean +/- SD age = 21.0 +/- 3.1 years) were randomly assigned to either a supplement group (SUPP) or a placebo group (PLAC). All subjects were tested for unilateral isometric forearm flexion strength, hanging joint angle, relaxed arm circumference, subjective pain rating, and plasma creatine kinase activity and myoglobin concentration. The testing occurred before (TIME1), immediately after (TIME2), and 24 (TIME3), 48 (TIME4), and 72 (TIME5) hours after a bout of eccentric exercise. During these tests, the subjects in the SUPP group ingested a protease supplement. The subjects in the PLAC group took microcrystalline cellulose. After testing at TIME5 and 2 weeks of rest, the subjects were crossed over into the opposite group and performed the same tests as during visits 1-5, but with the opposite limb. Overall, isometric forearm flexion strength was greater (7.6%) for the SUPP group than for the PLAC group, despite nearly identical (difference = 0.14 N.m, p = 0.940) mean strength values before (TIME1) the eccentric exercise protocol. There were no between-group differences for hanging joint angle, relaxed arm circumference, subjective pain ratings, and plasma creatine kinase activity and myoglobin concentration from TIME1 to TIME5. These findings provided initial evidence that the protease supplement may be useful for reducing strength loss immediately after eccentric exercise and for aiding in short-term strength recovery. The protease supplement had no effect, however, on the perception of pain associated with DOMS or the blood markers of muscle damage.  相似文献   

7.
This study examined the effects of 12 weeks of wrist and forearm training on linear bat-end velocity (BV), center of percussion velocity (CV), hand velocity (HV), and time to ball contact of high school baseball players. Forty-three baseball players were randomly assigned by a stratified sampling technique to 1 of 2 training groups. Group 1 (n = 23) and group 2 (n = 20) performed the same full-body resistance exercises while training 3 days a week for 12 weeks according to a stepwise periodized model. Group 2 also performed wrist and forearm exercises 3 days a week for 12 weeks. Wrist and forearm strength were measured pre- and posttraining. Linear BV, CV, HV, and time to ball contact were recorded pre- and posttraining by a motion-capture system. A 3 repetition maximum (RM) parallel squat and bench press were measured at baseline and after 4, 8, and 12 weeks of training. Both groups showed statistically significant increases (p < or = 0.01) in linear BV, CV, and HV (m.s(-1) +/- SD) after 12 weeks of training; however, there were no differences between the 2 groups. Both groups statistically increased wrist and forearm strength (p < or = 0.05). Group 2 had statistically greater increases (p < or = 0.05) in 10 of 12 wrist and forearm strength measures than did group 1. Both groups made statistically significant increases in predicted 1RM parallel squat and bench press after 4, 8, and 12 weeks of training; however, there were no differences between groups. These data indicate that a 12-week stepwise periodized training program can significantly increase wrist and forearm strength, linear BV, CV, and HV among high school baseball players. However, increased wrist and forearm strength did not contribute to further increases in linear BV, CV, or HV.  相似文献   

8.
Most reports regarding unplanned extubation (UE) are case-control studies with matching age and disease severity. To avoid diminishing differences in matched factors, this study with only matching duration of mechanical ventilation aimed to re-examine the risk factors and the factors governing outcomes of UE in intensive care units (ICUs). This case-control study was conducted on 1,775 subjects intubated for mechanical ventilation. Thirty-seven (2.1%) subjects with UE were identified, and 156 non-UE subjects were randomly selected as the control group. Demographic data, acute Physiological and Chronic Health Evaluation II (APACHE II) scores, and outcomes of UE were compared between the two groups. Logistic regression analysis was used to identify the risk factors of UE. Milder disease, younger age, and higher Glasgow Coma Scale (GCS) scores with more frequently being physically restrained (all p<0.05) were related to UE. Logistic regression revealed that APACHE II score (odds ratio (OR) 0.91, p<0.01), respiratory infection (OR 0.24, p<0.01), physical restraint (OR 5.36, p<0.001), and certain specific diseases (OR 3.79–5.62, p<0.05) were related to UE. The UE patients had a lower ICU mortality rate (p<0.01) and a trend of lower in-hospital mortality rate (p = 0.08). Cox regression analysis revealed that in-hospital mortality was associated with APACHE II score, age, shock, and oxygen used, all of which were co-linear, but not UE. The results showed that milder disease with higher GCS scores thereby requiring a higher use of physical restraints were related to UE. Disease severity but not UE was associated with in-hospital mortality.  相似文献   

9.
Healthy walking is characterized by pronounced arm swing and axial rotation. Aging effects on gait speed, stride length and stride time variability have been previously reported, however, less is known about aging effects on arm swing and axial rotation and their relationship to age-associated gait changes during usual walking and during more challenging conditions like dual tasking. Sixty healthy adults between the ages of 30–77 were included in this study designed to address this gap. Lightweight body fixed sensors were placed on each wrist and lower back. Participants walked under 3 walking conditions each of 1 minute: 1) comfortable speed, 2) walking while serially subtracting 3’s (Dual Task), 3) walking at fast speed. Aging effects on arm swing amplitude, range, symmetry, jerk and axial rotation amplitude and jerk were compared between decades of age (30–40; 41–50; 51–60; 61–77 years). As expected, older adults walked slower (p = 0.03) and with increased stride variability (p = 0.02). Arm swing amplitude decreased with age under all conditions (p = 0.04). In the oldest group, arm swing decreased during dual task and increased during the fast walking condition (p<0.0001). Similarly, arm swing asymmetry increased during the dual task in the older groups (p<0.004), but not in the younger groups (p = 0.67). Significant differences between groups and within conditions were observed in arm swing jerk (p<0.02), axial rotation amplitude (p<0.02) and axial jerk (p<0.001). Gait speed, arm swing amplitude of the dominant arm, arm swing asymmetry and axial rotation jerk were all independent predictors of age in a multivariate model. These findings suggest that the effects of gait speed and dual tasking on arm swing and axial rotation during walking are altered among healthy older adults. Follow-up work is needed to examine if these effects contribute to reduced stability in aging.  相似文献   

10.
Atopic eczema (AE) is associated with Staphylococcus aureus (S. aureus) colonization and skin barrier dysfunction, often measured by increased transepidermal water loss (TEWL). In the present study, the primary aim was to see whether S. aureus colonization in the vestibulum nasi and/or fauces was associated with increased TEWL in infants with healthy skin and infants with eczema. Secondarily, we aimed to investigate whether TEWL measurements on non-lesional skin on the lateral upper arm is equivalent to volar forearm in infants. In 167 of 240 infants, recruited from the general population, TEWL measurements on the lateral upper arm and volar forearm, using a DermaLab USB, fulfilled our environmental requirements. The mean of three TEWL measurements from each site was used for analysis. The infants were diagnosed with no eczema (n = 110), possible AE (n = 28) or AE (n = 29). DNA samples were analysed for mutations in the filaggrin gene (FLG). Bacterial cultures were reported positive with the identification of at least one culture with S. aureus from vestibulum nasi and/or fauces. S. aureus colonization, found in 89 infants (53%), was not associated with increased TEWL (i.e. TEWL in the upper quartile), neither on the lateral upper arm or volar forearm (p = 0.08 and p = 0.98, respectively), nor with AE (p = 0.10) or FLG mutation (p = 0.17). TEWL was significantly higher on both measuring sites in infants with AE compared to infants with possible AE and no eczema. FLG mutation was significantly associated with increased TEWL, with a 47% difference in TEWL. We conclude that S. aureus in vestibulum nasi and/or fauces was not associated with TEWL, whereas TEWL measurements on the lateral upper arm and volar forearm appear equally appropriate in infants.  相似文献   

11.
Studies of directional asymmetry in the human upper limb have extensively examined bones of the arm, forearm, and hand, but have rarely considered the clavicle. Physiologically, the clavicle is an integrated element of the upper limb, transmitting loads to the axial skeleton and supporting the distal bones. However, clavicles develop in a manner that is unique among the bones of the upper limb. Previous studies have indicated that the clavicle has a right-biased asymmetry in diaphyseal breadth, as in humeri, radii, ulnae, and metacarpals, but unlike these other elements, a left-biased length asymmetry. Few studies have assessed how clavicular asymmetry relates to these other bones of the upper limb. Bilateral directional asymmetry of the clavicle is examined in relation to the humerus in a large, geographically diverse human sample, comparing lengths and diaphyseal breadths. Dimensions were converted into percentage directional (%DA) and absolute (%AA) asymmetries. Results indicate that humans have same-side %DA bias in the clavicles and humeri, and contralateral length %DA between these elements. Diaphyseal breadths in both clavicles and humeri are more asymmetric-both in direction and amount-than lengths. Differences in diaphyseal asymmetry are shown to relate to variation in physical activities among groups, but a relationship between activity and length asymmetry is not supported. This further supports previous research, which suggests different degrees of sensitivity to loading between diaphyseal breadths and maximum lengths of long bones. Differences in lateralized behavior and the potential effects of different bone development are examined as possible influences on the patterns observed among human groups.  相似文献   

12.
ObjectivesThis laboratory study examined gender differences in upper extremity postures, applied forces, and muscle activity when a computer workstation was adjusted to individual anthropometry according to current guidelines.MethodsFifteen men and 15 women completed five standardized computer tasks: touch-typing, completing a form, editing text, sorting and resizing graphical objects and navigating intranet pages. Subjects worked at a height-adjustable workstation with the keyboard on top of the work surface and the mouse to the right. Subjects repeated the text editing task with the mouse in two other locations: a “high” mouse position, which simulated using a keyboard drawer with the mouse on the primary work surface, and “center” mouse position with the mouse between the keyboard and the body, centered with the body’s center line. Surface electromyography measured muscle activity; electrogoniometric and magnetic motion analysis system measured wrist, forearm and upper arm postures; load-cells measured typing forces; and a force-sensing mouse measured applied forces.ResultsRelative forces applied to the keyboard, normalized muscle activity of two forearm muscles, range of motion for the wrist and shoulder joints and external rotation of the shoulder were higher for women (p < 0.05). When subjects were dichotomized instead by anthropometry (either large/small shoulder width or arm length), the differences in forces, muscle activity of the shoulder and wrist posture and shoulder posture became more pronounced with smaller subjects having higher values. Postural differences between the genders increased in the high mouse position and decreased in the center mouse location.ConclusionsWhen a workstation is adjusted per current guidelines differences in upper extremity force, muscle activity and postural factors still exist between genders. However, these were often stronger when subjects were grouped by anthropometry suggesting that perhaps the computer input devices themselves should be scaled to be more in proportion with the anthropometry and strength of the user.  相似文献   

13.
The purpose of this study was to examine the effects of 2 days of isokinetic training of the forearm flexors and extensors on strength and electromyographic (EMG) amplitude for the agonist and antagonist muscles. Seventeen men (mean +/- SD age = 21.9 +/- 2.8 years) were randomly assigned to 1 of 2 groups: (a) a training group (TRN; n = 8), or (b) a control group (CTL; n = 9). The subjects in the TRN group were tested for maximal isometric and concentric isokinetic (randomly ordered velocities of 60, 180, and 300 degrees x s(-1)) torque of the dominant forearm flexors and extensors before (pretest) and after (posttest) 2 days of isokinetic strength training. Each training session involved 6 sets of 10 maximal concentric isokinetic muscle actions of the forearm flexors and extensors at a velocity of 180 degrees x s(-1). The subjects in the CTL group were also tested for strength but did not perform any training. Surface EMG signals were detected from the biceps brachii and triceps brachii muscles during the strength testing. The results indicated that there were no significant (p > 0.05) pre- to post-test changes in forearm flexion and extension torque or EMG amplitude for the agonist and antagonist muscles. Thus, unlike previous studies of the quadriceps femoris muscles, these findings for the forearm flexors and extensors suggested that 2 days of isokinetic training may not be sufficient to elicit significant increases in strength. These results may have implications for the number of visits that are required for rehabilitation after injury, surgery, or both.  相似文献   

14.
An EEL reflectance spectrophotometer was used to measure the skin color of the inner upper arm and the forearm of 913 Karkar Islanders (Madang District) and 684 Lufa villagers (Eastern Highlands District). The samples were subdivided to study sex, age, and population variation against a background of ecological observations, including sunlight exposure, clothing, and erythemally effective wavelengths of ultraviolet light (Robertson, unpublished Ph.D. thesis, 1974). Population differences in sex and age variation in upper arm skin color may largely be attributable to the effects of culturally associated clothing differences. Not only do the Lufa villagers wear substantially less clothing than the Karkars, but also their arms are exposed more frequently to ultraviolet light during heavy manual work in unshaded gardens. For the melanin content of the forearm skin there are similar patterns of age variation in both populations; however, the populations differ in mean percentage of reflectance throughout most of the age span. These between-population differences are interpreted as a consequence of greater average daily exposure to sunlight and the higher intensity of ultraviolet light in the highland environment. On the forearm the percentage of reflectance at 685 nm decreases more rapidly with age in the prepubertal and adult age groups, a result attributed to endocrine changes superimposed on cumulative changes in the melanin pigmentary mechanism.  相似文献   

15.
目的:利用肌电指标分析拳击运动员上肢和腰部肌肉力量训练效果。方法:用Mega公司的ME6000肌电图仪记录分析10名女子拳击运动员上臂肱二头肌(主动肌)与肱三头肌(拮抗肌)、前臂屈肌(主动肌)与伸肌(拮抗肌)和腰部肌群的运动诱发肌电,规定运动为手持2.5 kg的哑铃负荷进行直拳空击运动直至局部肌肉力竭。结果:直拳空击运动至局部肌肉力竭过程中,上肢拮抗肌的中位频率(MF)下降幅度和速度大于相对应的主动肌,且从肌群作功来看,主动肌作功百分比较拮抗肌大。其中9名普通运动员腰肌的肌电频率(MF)均值较1名指定样本世界冠军的下降缓慢,而且其作功百分比都较小。结论:通过对普通女子拳击运动员上肢和腰部肌群肌电指标测试与世界冠军的比较分析,提示本研究中所测普通拳击运动员拮抗肌和腰部肌肉力量训练不足,有待加强该部肌肉的力量训练。  相似文献   

16.
Quantification of rehabilitation progress is necessary for accurately assessing clinical treatments. A three-dimension (3D) upper extremity (UE) kinematic model was developed to obtain joint angles of the trunk, shoulder and elbow using a Vicon motion analysis system. Strict evaluation confirmed the system's accuracy and precision. As an example of application, the model was used to evaluate the upper extremity movement of eight hemiparetic stroke patients with spasticity, while completing a set of reaching tasks. Main outcome measures include kinematic variables of movement time, range of motion, peak angular velocity, and percentage of reach where peak velocity occurs. The model computed motion patterns in the affected and unaffected arms. The unaffected arm showed a larger range of motion and higher angular velocity than the affected arm. Frequency analysis (power spectrum) demonstrated lower frequency content for elbow angle and angular velocity in the affected limb when compared to the unaffected limb. The model can accurately quantify UE arm motion, which may aid in the assessment and planning of stroke rehabilitation, and help to shorten recovery time.  相似文献   

17.
This study was conducted to test whether glenohumeral geometry, as measured through MRI scans, is correlated with upper arm strength. The isometric shoulder strength of 12 subjects during one-handed arm abduction in the coronal plane, in a range from 5 degrees to 30 degrees , was correlated with the geometries of their glenoid fossas. Seven parameters describing the glenohumeral joint geometry in the coronal plane were identified as having expected influence on shoulder strength. In addition to these, a new geometric parameter, named the area of glenoid asymmetry (AGA), was considered to reflect the concavity-compression mechanism as well as the inclination of the glenoid surface. As a result of the high correlation between the AGA and mean force and mean moment (0.80, p0.01 and 0.69, p 相似文献   

18.
Injuries stemming from shoulder instability are very common among athletes participating in contact sports, such as football. Previous research has shown that increased laxity negatively affects the function of the sensorimotor system potentially leading to a pathological cycle of shoulder dysfunction. Currently, there are no data detailing such effects among football players. Therefore, the purpose of this study was to examine the differences in upper extremity sensorimotor control among football players compared with that of a control group. Forty-five collegiate football players and 70 male control subjects with no previous experience in contact sports participated. All the subjects had no recent history of upper extremity injury. Each subject performed three 30-second upper extremity balance trials on each arm. The balance trials were conducted in a single-arm push-up position with the test arm in the center of a force platform and the subjects' feet on a labile device. The trials were averaged, and the differences in radial area deviation between groups were analyzed using separate 1-way analyses of variance (p < 0.05). The football players showed significantly more radial area deviation of the dominant (0.41 ± 1.23 cm2, p = 0.02) and nondominant arms (0.47 ± 1.63 cm2, p = 0.03) when compared with the control group. These results suggest that football players may have decreased sensorimotor control of the upper extremity compared with individuals with no contact sport experience. The decreased upper extremity sensorimotor control among the football players may be because of the frequent impacts accumulated during football participation. Football players may benefit from exercises that target the sensorimotor system. These findings may also be beneficial in the evaluation and treatment of various upper extremity injuries among football players.  相似文献   

19.
The complex mechanical properties of skin have been the subject of much study in recent years. Several experimental methods developed to measure the mechanical properties of skin in vivo, such as suction or torsion, are unable to measure skin’s anisotropic characteristics. An experiment characterising the mechanical properties of in vivo human skin using a novel force-sensitive micro-robot is presented. The micro-robot applied in-plane deformations to the anterior forearm and the posterior upper arm. The behaviour of the skin in each area is highly nonlinear, anisotropic, and viscoelastic. The response of the upper arm skin is very dependent on the orientation of the arm. A finite element model consisting of an Ogden strain energy function and quasi-linear viscoelasticity was developed to simulate the experiments. An orthogonal initial stress field, representing the in vivo skin tension, was used as an additional model parameter. The model simulated the experiments accurately with an error-of-fit of 17.5% for the anterior lower forearm area, 6.5% for the anterior upper forearm and 9.3% for the posterior upper arm. The maximum in vivo tension in each area determined by the model was 6.2 Nm−1 in the anterior lower forearm, 11.4 Nm−1 in anterior upper forearm and 5.6 Nm−1 in the posterior upper arm. The results also show that a finite element model with a neo-Hookean strain energy function cannot simulate the experiments with the same accuracy.  相似文献   

20.
The shoulder complex (SC) consists of joints with little congruence and its active and passive structures ensure its stability. Stability of the SC rotation centre during upper arm movements can be estimated through the analysis of Helical Axes (HAs) dispersion.The aim of this study was to describe shoulder HAs dispersion during upper limb movements performed with dominant and non-dominant arms by young and elderly subjects. Forty subjects participated in the study (20 young: age 24.8 ± 2.8 years and 20 elderly: age 71.7 ± 6.3 years). Subjects were asked to perform four cycles of 15 rotations, flexions, elevations and abductions with one arm at a time at constant speed. Reflective markers were placed on participants’ arms and trunk in order to detect movements and the HAs dispersion with an optoelectronic system. Mean Distance (MD) from the HAs barycenter and Mean Angle (MA) were used as HAs dispersion indexes. Young subjects showed significant lower MD compared to the elderly during all motion ranges of rotation, flexion and elevation (p < 0.001). Moreover, the MD was lower in the dominant arm compared to the contralateral for rotation (p = 0.049) and flexion (p = 0.019). The results may be due to joint degeneration described in elderly subjects and differences in neuromuscular control of SC stability.  相似文献   

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