• Title/Summary/Keyword: Upper Extremity

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Learners' Responses to a Virtual Cadaver Dissection Nerve Course in the COVID Era: A Survey Study

  • Lisiecki, Jeffrey L.;Johnson, Shepard Peir;Grant, David;Chung, Kevin C.
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.676-682
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    • 2022
  • Background Virtual education is an evolving method for teaching medical learners. During the coronavirus disease 2019 pandemic, remote learning has provided a replacement for conferences, lectures, and meetings, but has not been described as a method for conducting a cadaver dissection. We aim to demonstrate how learners perceive a virtual cadaver dissection as an alternative to live dissection. Methods A virtual cadaver dissection was performed to demonstrate several upper extremity nerve procedures. These procedures were livestreamed as part of an educational event with multimedia and interactive audience questions. Participants were queried both during and after the session regarding their perceptions of this teaching modality. Results Attendance of a virtual dissection held for three plastic surgery training institutions began at 100 and finished with 70 participants. Intrasession response rates from the audience varied between 68 and 75%, of which 75% strongly agreed that they were satisfied with the virtual environment. The audience strongly agreed or agreed that the addition of multimedia captions (88%), magnified video loupe views (82%), and split-screen multicast view (64%) was beneficial. Postsession response rate was 27%, and generally reflected a positive perspective about the content of the session. Conclusions Virtual cadaver dissection is an effective modality for teaching surgical procedures and can be enhanced through technologies such as video loupes and multiple camera perspectives. The audience viewed the virtual cadaver dissection as a beneficial adjunct to surgical education. This format may also make in-person cadaver courses more effective by improving visualization and allowing for anatomic references to be displayed synchronously.

Effect of Forearm Dynamic Taping on Muscle Activity of Extensor Carpi Radialis Brevis During Wrist Isometric and Isotonic Contraction (아래팔 다이나믹 테이핑 적용에 의한 손목 등척성과 등장성 수축 시 짧은 노쪽손목폄근 근활성도의 변화)

  • Huang, Tian-zong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.28 no.2
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    • pp.93-100
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    • 2021
  • Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal

  • Hilaire, Cameron St.;Johnson, Arianne;Loseth, Caitlin;Alipour, Hamid;Faunce, Nick;Kaminski, Stephen;Sharma, Rohit
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.22.1-22.6
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    • 2020
  • Introduction: Facial fractures (FFs) occur after high- and low-energy trauma; differences in associated injuries and outcomes have not been well articulated. Objective: To compare the epidemiology, management, and outcomes of patients suffering FFs from high-energy and low-energy mechanisms. Methods: We conducted a 6-year retrospective local trauma registry analysis of adults aged 18-55 years old that suffered a FF treated at the Santa Barbara Cottage Hospital. Fracture patterns, concomitant injuries, procedures, and outcomes were compared between patients that suffered a high-energy mechanism (HEM: motor vehicle crash, bicycle crash, auto versus pedestrian, falls from height > 20 feet) and those that suffered a low-energy mechanism (LEM: assault, ground-level falls) of injury. Results: FFs occurred in 123 patients, 25 from an HEM and 98 from an LEM. Rates of Le Fort (HEM 12% vs. LEM 3%, P = 0.10), mandible (HEM 20% vs. LEM 38%, P = 0.11), midface (HEM 84% vs. LEM 67%, P = 0.14), and upper face (HEM 24% vs. LEM 13%, P = 0.217) fractures did not significantly differ between the HEM and LEM groups, nor did facial operative rates (HEM 28% vs. LEM 40%, P = 0.36). FFs after an HEM event were associated with increased Injury Severity Scores (HEM 16.8 vs. LEM 7.5, P <0.001), ICU admittance (HEM 60% vs. LEM 13.3%, P <0.001), intracranial hemorrhage (ICH) (HEM 52% vs. LEM 15%, P <0.001), cervical spine fractures (HEM 12% vs. LEM 0%, P = 0.008), truncal/lower extremity injuries (HEM 60% vs. LEM 6%, P <0.001), neurosurgical procedures for the management of ICH (HEM 54% vs. LEM 36%, P = 0.003), and decreased Glasgow Coma Score on arrival (HEM 11.7 vs. LEM 14.2, P <0.001). Conclusion: FFs after HEM events were associated with severe and multifocal injuries. FFs after LEM events were associated with ICH, concussions, and cervical spine fractures. Mechanism-based screening strategies will allow for the appropriate detection and management of injuries that occur concomitant to FFs. Type of study: Retrospective cohort study. Level of evidence: Level III.

Scholarly Assessment of Aruco Marker-Driven Worker Localization Techniques within Construction Environments (Aruco marker 기반 건설 현장 작업자 위치 파악 적용성 분석)

  • Choi, Tae-Hun;Kim, Do-Kuen;Jang, Se-Jun
    • Journal of the Korea Institute of Building Construction
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    • v.23 no.5
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    • pp.629-638
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    • 2023
  • This study introduces an innovative approach to monitor the whereabouts of workers within indoor construction settings. While traditional modalities such as GPS and NTRIP have demonstrated efficacy for outdoor localizations, their precision dwindles in indoor environments. In response, this research advocates for the adoption of Aruco markers. Leveraging computer vision technology, these markers facilitate the quantification of the distance between a worker and the marker, subsequently pinpointing the worker's instantaneous location with heightened accuracy. The methodology's efficacy was rigorously evaluated in a real-world construction scenario. Parameters including system stability, the influence of lighting conditions, the extremity of measurable distances, and the breadth of recognition angles were methodically appraised. System stability was ascertained by maneuvering the camera at a uniform velocity, gauging its marker recognition prowess. The impact of varying luminosity on marker discernibility was scrutinized by modulating the ambient lighting. Furthermore, the camera's spatial movement ascertained both the upper threshold of distance until marker recognition waned and the maximal angle at which markers remained discernible.

Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program

  • David Momtaz;Farhan Ahmad;Aaron Singh;Emilie Song;Dean Slocum;Abdullah Ghali;Adham Abdelfattah
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.351-356
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    • 2023
  • Background: Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting. Methods: Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days. Results: A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037). Conclusions: Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence: III.

Utility of H-reflex in the Diagnosis of Cervical Radiculopathy (경수 신경근병증 진단에서의 H-reflex의 유용성)

  • Lee, Jun;Park, Gun-Ju;Doo, Hyun-Cheol;Park, Sung-Geon;Jeong, Yun-Seog;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.111-122
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    • 1997
  • H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were $16.16{\pm}1.65$ msec in FCR; $15.99{\pm}1.25$ msec in ECR; $16.47{\pm}1.59$ msec in BR; $24.46{\pm}1.42$ msec in ADM. And the mean values of side to side difference of H-reflex latency were $0.47{\pm}0.48$ msec in FCR; $0.68{\pm}0.72$ msec in ECR; $0.63{\pm}0.43$ msec in BR; $22.31{\pm}1.24$ msec in ADM. Mean values of side to side differences of interlatency time were $0.49{\pm}0.47$ msec in FCR; $0.73{\pm}0.62$ msec in ECR; $0.79{\pm}0.71$ msec in BR; $0.69{\pm}0.44$ msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

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The Effects of PNF Upper Extremity Pattern Based Vibration Exercise Equipment on Stability and Balance of the Elderly (PNF 상지패턴에 기초한 진동운동기구 훈련이 노인의 체간 안정성과 균형에 미치는 영향)

  • Lee, Hyoungsoo;Im, Jungdae;Lee, Gihun;Lee, Jiseong;Lee, Jinwuk;Seo, Yeonju;Son, Jiyoon;An, Hyojoeng;Oh, Hyunjeong;Youn, Haneul;Lee, Seoyeon;Kim, Jangsun
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.3
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    • pp.59-71
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    • 2015
  • Purpose : This study examines the effect of vibration exercise grafting PNF patterns for 6 weeks on upper body stability and equilibrium for seniors having fifteen or over of MMSE-K. Method : A total of 10 senior citizens participated in this study. Each participant performed PNF patterned exercises using vibration sports equipment for 30 minutes, once static a week, for six weeks. We measured trunk stability and balance degree before and after the six-week exercise program. Motor Assessment Scale (MAS) was used to measure trunk stability, while Functional Reach Test (FRT) and Timed Up and Go (TUG) was used to measure balance degree. The collected data was processed using paired t-test to confirm the difference between pre-program conditions and post-program conditions. Results: The results of our study show that post-program trunk stability measurements increased when compared to pre-program data; however, this increase was not statistically significant. pre and post-measurements for satatic balance and dynamic balance were statistically unchanged. Conclusion: Due to limitations in the number of participants, the procedural design of this experiment, and the limited amount of time participants actually controlled, this study failed to produce statistically significant results. However, further study should be conducted using a systematically implemented exercise program to show support for exercising with flexi-bar as an effective program for the elderly.

The Changes of Sweating Area, Temperature and Blood Flow in the Upper and Lower Extremity after Hyperhidrosis Operations (다한증수술후 발한분포 및 상하지의 온도변화와 혈류량변화)

  • 김용환;장윤희;문석환;조건현;왕영필;김세화;곽문섭;김학희;장혜숙
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.456-460
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    • 1999
  • Background: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. Material and Method: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. Result: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1$^{\circ}C$ on the right hand side and 1.9$^{\circ}C$ on the left hand side(P<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. Conclusion: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.

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A Systematic Review of Constraint Induced Movement Therapy about Upper Extremity in Stroke (뇌졸중 환자의 상지 강제유도운동치료에 관한 체계적 고찰)

  • Park, Su-Hyang;Baek, Soon-Hyung;Shin, Joong-il
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.149-161
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    • 2016
  • The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

A Survey on the Prevalence of Musculoskeletal Symptom according to Work Task (작업유형별 근골격계 증상 호소율에 관한 조사연구)

  • Oh, Hae-Ju;Lee, Duk-Hee;Park, In-Guen;Jang, She-Han
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.230-241
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    • 1994
  • Though people occupationally exposed to machineries and automation in the industrialized society desire work involving decreased strength, due to the continuous and repetitive activities, a new industrial stress is present. Studies on prevalence of musculoskeletal disease and their related risk factors have evolved. In this study in relation to work tasks, we investigated the differences in musculoskeletal symptoms occurring In each body region. The results of the survey were as follows. 1. When comparing age, level of education, work duration, job satisfaction and leisure time activities according to work task, age in control group was $38.83{\pm}5.5$, in comparison to the other 2 groups was smaller(p<0.05), and level of education in control group was higher (p<0.05). Work duration in the cutting department was $8.04{\pm}4.99$ years longer than the other 2 groups (p<0.05), but there was no difference in the job satisfaction and leisure time activities. 2. The mean of symptom scores of each work task was 1.54 in the cutting department, 1.57 in the press department and 1.59 in the control group, and there was no significant differnce in the 3 groups. The mean of symptom scores for upper extremities in the control group was low but no statistically significant diffrence was shown. 3. When comparing the mean of symptom score according to work task in the each body region, in the shoulder region, the symptom score in the press department which desired strength was higher than the other 2 groups but no significant difference was shown. In the wrist region the cutting department scored 1.01 and in comparison to the other 2 groups was significantly increased (p<0.05). 4. The results of the univariate regression analysis on the major individual risk factors associated with musculoskeletal symptom relating work showed that previous symptom complaints in the same body region was significant risk factor(p<0.001) in the whole body Besides wrist, hip, and knee, psychological problem was shown to be a significant factor(p<0.05). And the body regions which work task was significant risk factor were wrist and neck region (p<0.05). 5. The results of the multiple regression analysis involving significant factors of each body region from the univariate regression analysis showed that previous symptom complaint in whole body region(p<0.001) and psychological problem in the shoulder, elbow and lumbar region (p<0.05) were significant factors, and work task was significant factor in the wrist (p<0.05).

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