PubMed · 4065990
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R M Joshi, B A Bharucha, N B Kumta. 1985. Congenital limb defects.. https://pubmed.ncbi.nlm.nih.gov/4065990/
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A new method for analyzing kinematic patterns during smooth movements is proposed. Subjects are asked to move the end of a two-joint manipulandum to copy a smooth initial target path. On subsequent trials the target path is the subject's actual movement from the preceding trial. Using Principal Components Analysis, it is shown that the trajectories have very low dimension and that they converge toward a linear superposition of the first few principal components. We show similar results for handwriting on an electronic pen tablet. We hypothesize that the low dimensionality and convergence are attributable to combined properties of the internal controller and the musculoskeletal system. The low dimensionality may allow for efficient descriptions of a large class of arm movements.
PURPOSE: To evaluate the best position of the arms in mantle field for Hodgkin's disease. METHODS AND MATERIALS: In 12 patients, with surgical clips placed at the time of an axillary dissection for breast cancer, the radiological projection of the clips according to three arm positions was prospectively evaluated: akimbo (A), extended (E), and up over the head (U). The surgical clips were arbitrarily separated into two groups: lower and upper. In each patient, the distance between the surgical clips and chest wall was measured, and the possibility of shielding the lungs and humeral heads was evaluated. RESULTS: The mean displacement of the lower clips away from the chest wall when the patients were in A, E, and U positions was 2.5, 3.0, and 4.6 cm, respectively. The upper group clips showed a lower difference in distance from chest wall. In the U position, there was always a clip of the lower group that projected over the humeral head, making it impossible to block this structure. CONCLUSION: In the A position, there is the possibility of blocking the humeral head, but it is necessary to irradiate more lung parenchyma. Type E treatment setup allows the shielding of both lung and humeral head, while maintaining adequate margins around the axillary nodes. In the U position, there is a greater possibility of shielding the lung parenchyma, but it is impossible to block the humeral heads.
This clinical review will describe the epidemiology, clinical presentation, and management of the following work-related musculoskeletal disorders (WMSDs) of the distal upper extremity: deQuervain's disease, extensor and flexor forearm tendinitis/tendinosis, lateral and medial epicondylitis, cubital tunnel syndrome, and hand-arm vibration syndrome (HAVS). These conditions were selected for review either because they were among the most common WMSDs among patients attending the New York State Occupational Health Clinics (NYSOHC) network, or because there is strong evidence for work-relatedness in the clinical literature. Work-related carpal tunnel syndrome is discussed in an accompanying paper. In an attempt to provide evidence-based treatment recommendations, literature searches on the treatment of each condition were conducted via Medline for the years 1985-1999. There was a dearth of studies evaluating the efficacy of specific clinical treatments and ergonomic interventions for WMSDs. Therefore, many of the treatment recommendations presented here are based on a consensus of experienced public health-oriented occupational medicine physicians from the NYSOHC network after review of the pertinent literature. A summary table of the clinical features of the disorders is presented as a reference resource.