SEARCH · PubMed Health

Results for “upper extremity”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2006

Surgical outcome of posterior decompression for cervical spondylosis with unilateral upper extremity amyotrophy.

STUDY DESIGN: Case studies of patients with cervical spondylosis with unilateral upper extremity amyotrophy. OBJECTIVE: To clarify the surgical outcome of posterior decompression for this amyotrophy. SUMMARY OF BACKGROUND DATA: Cervical spondylosis sometimes causes a characteristic severe muscular atrophy without sensory disturbance or lower-extremity dysfunction, which is the so-called "cervical spondylotic amyotrophy." However, response to treatment, especially to posterior decompression, has not been well understood. METHOD: This study included 32 patients. All underwent posterior cervical laminoplasty, and 22 patients had an additional foraminotomy. Preoperative and postoperative muscle power and results of imaging and electrophysiologic studies were evaluated. The follow-up period averaged 78 months. Whether impingement was against the ventral nerve root (VNR) or anterior horn (AH) in the spinal cord was assessed according to these findings. These cases were divided into proximal type and distal type according to the most severely atrophic muscle and compared statistically. RESULTS: Severe preoperative muscle atrophy was observed in the deltoid and biceps muscles of 24 patients (proximal type) and in the forearm and hand muscles of 8 patients (distal type). Impingements against the VNR and AH were observed in 21 and 28 cases, respectively, and 17 cases had impingement of both the VNR and AH. Improvements in muscle atrophy after surgery were observed in 25 cases. In proximal-type patients, muscle power improved in 92% of cases but was improved in only 38% of the distal-type cases. CONCLUSIONS: Laminoplasty and foraminotomy were effective in the treatment of most patients with this syndrome, although the outcome in the distal type was inferior to that in the proximal type.

Adult↗

PubMed2006

A review of upper extremity deep vein thrombosis in pregnancy: unmasking the 'ART' behind the clot.

BACKGROUND: Upper extremity deep vein thrombosis (UEDVT) is uncommon and is associated with well-defined risk factors in the general population. Increasingly, UEDVTs are being reported during pregnancy, particularly those achieved with the use of assisted reproductive techniques (ART), and in conjunction with ovarian hyperstimulation syndrome (OHSS). AIM: We performed this review was to estimate the incidence of UEDVT associated with ART, to examine the risk factors and presentation of UEDVT in pregnancy, and to determine if differences exist between this cohort and the general population. RESULTS: There were 35 published case reports of UEDVT in pregnant women. The incidence of this condition is estimated to be 0.08-0.11% of treatment cycles in women undergoing ART. The development of UEDVT is not always be preceded by OHSS. In addition, commonly associated risk factors for UEDVT were not often reported for UEDVT that developed during pregnancy. Instead the association of UEDVT and ART was common. UEDVT in pregnancy also appears to involve the internal jugular vein more often than the subclavian vein. The reported risk of thrombus extension in this cohort, despite anticoagulation therapy, is also disconcerting. CONCLUSION: Because UEDVT may not be a rare entity during pregnancy in association with the use of ART, clinicians should be better informed of its presentation and clinical course in these women. Once UEDVT develops, appropriate therapeutic anticoagulation should be instituted and patient carefully monitored. The long-term implications and recurrence rate of this condition in pregnancy warrants further prospective studies.

Female↗

PubMed1980

Musculocutaneous neurectomy for spastic elbow flexion in non-functional upper extremities in adults.

The charts of twenty-nine patients who had undergone thirty musculocutaneous neurectomies for acquired spasticity of the elbow in a non-functional upper extremity were reviewed. The most common causes of the spasticity were cerebrovascular accident (59 per cent) and head injury (24 per cent). The aims of the operation were to increase the patient's capacity for self-care and to improve ambulation, personal hygiene, and appearance. Patients who had 30-degree flexion contractures preoperatively did not require a cast postoperatively; those who had 30 to 75-degree flexion contractures preoperatively required a cast postoperatively; and patients who had flexion contractures of more than 75 degrees preoperatively required a concomitant release of soft tissue in the elbow and application of a cast postoperatively. One patient who was operated on to improve appearance had no active elbow flexion postoperatively and was regarded as having a poor result. Musculocutaneous neurectomy is a safe, reliable procedure for treating the spastic elbow in the non-functional upper extremity.

Adult↗

PubMed1981

Effect of forced use of the upper extremity of a hemiplegic patient on changes in function. A single-case design.

This study was designed to examine the effect of forced use of the affected upper extremity of a hemiplegic patient on the quantity, quality, and efficiency of functional behaviors. The patient was a woman with right hemiplegia of 18 months' duration. The study was divided into three one-week phases: an initial base-line, and experimental, and a second base-line phase. Base-line scores of frequency, quality, and time were recorded for completion of functional tasks. During the experimental phase, the patient's intact upper extremity was restrained. The efficiency and quality of movement scores did not reflect changes related to the period of restraint; however, the frequency of purposeful behaviors and the patient's functional use of her affected extremity increased during the experimental phase. The relationship of forced use to recovery of function in hemiplegia remains uncertain.

Arm↗

PubMed2001

[Thrombosis of the upper extremity in a female patient with protein C deficiency].

The case-record describes a 23-year-old female patient hospitalized on account of phlebothrombosis of the right upper extremity, associated with protein C deficiency and the use of hormonal contraception. The patient was treated with heparin and subsequently warfarin treatment. During the check-up examination by duplex sonography one month after discharge the thrombus was fully recanalized. The authors discuss the causes, diagnosis and treatment of thromboses of the upper extremities.

Adult↗

PubMed2001

Delayed-onset muscle soreness and motor performance of the upper extremity.

The purpose of this study was to examine the effects of delayed-onset muscle soreness after a strength-training session on the motor performance of the upper extremities, including the reaction time, speed of movement, tapping speed and coordination. In addition, muscle strength, electromyographic (EMG) activity, creatine kinase (CK) and soreness responses were measured. The study was a randomised cross-over intervention study, where 30 subjects (divided into two groups, A and B) performed a 1-h muscle strength-training session of the upper extremities, and the responses were measured 48 h after that. All of the subjects experienced muscle soreness, which was evaluated on a visual analogue scale. The mean value of CK activity was 115 IU.l-1 before training and 1259 IU.l-1 after training (P < 0.001). There were no statistically significant differences in wrist flexion/extension muscle strength or EMG tests in either group. Isometric elbow extension strength decreased by 4% (P < 0.01) in group A, and elbow flexion strength decreased by 6% (P < 0.05) in group B. There were no statistically significant changes in simple reaction time, choice reaction time, or speed of movement or coordination in either group. However, tapping speed decreased by 2% (P < 0.05) in group A and by 6% (P < 0.001) in group B. Based on the results of this study, it seems that the feeling of incompetence to perform fast and accurate movements with sore muscles is mainly a subjective feeling, and it may be that the real effect of muscle soreness on motor performance is quite small, and presumably less than generally assumed.

Adult↗

PubMed2005

Biceps femoris perforator free flap for upper extremity reconstruction: anatomical study and clinical series.

BACKGROUND: Perforator flaps are an important development in reconstructive surgery. The description of new perforator flaps is an open field in anatomical and surgical research. METHODS: The anatomy of the musculocutaneous perforating vessels of the short head of the biceps femoris muscle was investigated as a possible source for free tissue transfer in 10 fresh specimens. A series of 10 free biceps femoris perforator flaps for upper extremity reconstruction is described. RESULTS: There were three constant sizable perforators, located at 6 cm (range, 5 to 6.5 cm), 11.6 cm (range, 10 to 14 cm), and 15.3 cm (range, 14 to 17 cm), respectively, from the knee joint line. The distalmost perforator was a branch off the superior lateral genicular artery in all anatomical specimens. The middle perforator was a direct branch off the popliteal artery in 60 percent of the cases and off the profunda femoris in the remaining 40 percent. The uppermost perforator was usually a branch off the middle perforator. The flaps of the clinical series were based on the middle perforator (11.6 cm). All 10 free flaps were used for upper extremity trauma coverage, with a 100 percent success rate, although one flap required pedicle revision because of arterial thrombosis and developed partial necrosis. Donor-site delayed wound healing occurred in two patients. CONCLUSIONS: The vascular anatomy is relatively constant. Flap dissection is straightforward under tourniquet control, donor morbidity is low provided a primary closure is possible, and pedicle size is appropriate for repair. When a moderate-size free flap with moderate thickness and a medium-sized pedicle is needed, the biceps femoris perforator flap should be considered in the first-choice group of donor areas.

Adolescent↗

PubMed1994

The effects of casting on upper extremity motor disorders after brain injury.

OBJECTIVES: This study compares casting to traditional techniques, such as passive range of motion, static stretch, and splinting, in the treatment of the hypertonic upper extremity in individuals with severe brain injury. METHOD: Fifteen subjects with brain injury were randomly assigned to one of two groups. One group received a month of casting followed by a month of traditional therapy; the second group received 1 month of traditional therapy followed by casting. The subjects' limbs were evaluated for range of motion, clinical indications of spasticity, and functional use of the extremity at three intervals--before intervention, after the first month of intervention, and after the second month of intervention. Two sample t-tests and paired t-tests were used in data analysis. RESULTS: All but one subject showed a greater improvement in range of motion with casting than with traditional treatment; 11 subjects showed a greater improvement in clinical measures of spasticity with casting. There was no apparent correlation between these measures and functional use of the extremity. CONCLUSION: These findings suggest that casting is more effective than traditional techniques in reducing contracture and in decreasing hypertonicity in some cases. The greater improvements in these motor indicators with casting did not translate into greater gains in functional use of the upper extremities.

Adolescent↗

PubMed1993

Straight-line graphs for the prediction of growth of the upper extremities.

A simple graphic method was used for the prediction of growth and the determination of when a corrective procedure should be performed to equalize the lengths of the upper extremities. Straight-line graphs, similar to those described by Moseley for the lower extremities, were constructed for the radius, ulna, and humerus. The data for the current study were derived from a multidisciplinary, longitudinal study of growth in 244 healthy children (123 boys and 121 girls)--from infancy to skeletal maturity--and from previously constructed graphs depicting remaining growth. The use of this method can simplify the planning of an equalization procedure for an upper extremity.

Adolescent↗

PubMed1986

[Congenital partial gigantism of the upper extremities in children].

Angio-and phlebography, as well as pathomorphological studies were made on epiphyseal cartilaginous plate, diaphyseal bone tissue and skin of patients with partial gigantism of upper extremities. Significant developmental anomalies were found in the formation of palmar arches and digital arteries, as well as hypoplasia and aplasia of deep brachial and antebrachial veins. Light and electron microscopy revealed epiphyseal plate dystrophy and dysplasia, tubular bone osteoporosis, subcutaneous fat hyperplasia. The data obtained suggest a pathogenetic relationship between the vascular formation and the development of some malformations and growth abnormalities of upper extremities.

Adolescent↗

PubMed1996

Reconstruction following resection of malignancies of the upper extremity.

A multidisciplinary approach using advances in diagnosis, staging, adjuvant therapy, surgical resection, and especially reconstruction has made limb salvage a viable option in the treatment of most upper extremity malignancies. Although adequate surgical resection never should be compromised by reconstructive considerations, the reconstructive surgeon's input into preoperative planning may be crucial to the best possible functional and aesthetic outcome. Emphasis should be placed on a thorough evaluation by all members of the treatment team so that the best possible result is not compromised. A broad spectrum of techniques currently available for both salvage and restoration of function includes local soft-tissue flaps, regional pedicled and vascular island flaps, free tissue transfers, bone autografts and allografts (Fig. 17), endoprostheses, skin expansion, skeletal lengthening techniques, tendon transfers, and nerve and arterial grafts. This article reviews both new and well-established reconstructive options after resection of upper extremity malignancies in children and adults and provides illustrative case examples.

Amputation, Surgical↗

PubMed2001

An ergonomic evaluation of surgeons' axial skeletal and upper extremity movements during laparoscopic and open surgery.

BACKGROUND: Many surgeons have complained of fatigue and musculoskeletal pain after laparoscopic surgery. We evaluated differences in surgeons' axial skeletal and upper extremity movements during laparoscopic and open operations. METHODS: Five surgeons were videotaped performing 16 operations (8 laparoscopic and 8 open) to record their neck, trunk, shoulder, elbow, and wrist movements during the first hour of surgery. We also compared postprocedural complaints of pain, stiffness, or numbness between the two groups. RESULTS: Compared with surgeons performing open surgery, surgeons performing laparoscopic surgery exhibited less lateral neck flexion; less trunk flexion; more internal rotation of the shoulders; more elbow flexion; more wrist supination and wrist ulnar and radial deviation. There was a trend of more shoulder stiffness after laparoscopic operations than after open operations. CONCLUSIONS: Laparoscopic surgery involves a more static posture of the neck and trunk, but more frequent awkward movements of the upper extremities than open surgery. Ergonomic changes in the operating room environment and instrument design could ease the physical stress imposed on surgeons during laparoscopic operations.

Adult↗

PubMed2000

Surgery on the affected upper extremity of patients with a history of complex regional pain syndrome: a retrospective study of 100 patients.

Surgery on the extremity affected with complex regional pain syndrome (CRPS) is generally avoided because of the risk that the symptoms will recur or worsen. Perioperative sympathectomy or stellate ganglion block has previously been recommended for CRPS patients requiring surgery of the affected upper extremity. We evaluated 100 patients with a history of upper extremity CRPS undergoing surgery on the affected extremity. All signs and symptoms of CRPS had resolved before surgery. After completion of the surgical procedure half of the patients (n = 50) underwent a stellate ganglion block; the other half received no intervention. The recurrence rate of CRPS was significantly lower in those patients receiving a postoperative stellate ganglion block (n = 5; 10%) compared with those receiving no intervention (n = 36; 72%). We conclude that performing a perioperative stellate ganglion block in patients with a history of CRPS can significantly reduce the recurrence rate of this disease process.

Anesthetics, Local↗

PubMed2005

Effect of augmented feedback on motor function of the affected upper extremity in rehabilitation patients: a systematic review of randomized controlled trials.

OBJECTIVE: Assessment of the available evidence regarding the effect of augmented feedback on motor function of the upper extremity in rehabilitation patients. METHODS: A systematic literature search was performed to identify randomized controlled trials that evaluated the effect of augmented feedback on motor function. Two reviewers systematically assessed the methodological quality of the trials. The reported effects were examined to evaluate the effect of therapeutic interventions using augmented feedback and to identify a possible relationship with patient characteristics, type of intervention, or methodological quality. RESULTS: Twenty-six randomized controlled trials were included, 9 of which reported a positive effect on arm function tests. Follow-up measurements were performed in 8 trials, 1 of which reported a positive effect. Different therapeutic interventions using augmented feedback, i.e. electromyographic biofeedback, kinetic feedback, kinematic feedback, or knowledge of results, show no difference in effectiveness. CONCLUSION: No firm evidence was found of effectiveness regarding the use of augmented feedback to improve motor function of the upper extremity in rehabilitation patients. Future studies should focus more on the content, form and timing of augmented feedback concerning the therapeutic intervention. It should be emphasized that motor learning effects can only be determined by re-examining the population after a follow-up period.

Arm↗

PubMed2000

Job stress, upper extremity pain and functional limitations in symptomatic computer users.

BACKGROUND: Research suggests that exposure to occupational stressors are related to the presence and/or exacerbation of work-related upper extremity symptoms in office workers. Also worker's response to work demands and/or job stressors (i.e., workstyle) may exacerbate symptom severity and impact function. The present study examines the association among work demands, job stress and workstyle on pain and function. METHODS: 124 symptomatic female office workers completed a questionnaire measuring demographics, medical history, work demands, perception of the work environment, workstyle, pain intensity, functional impact, and time lost from work. RESULTS: Heightened job stress and the tendency to continue to work in a way that contributes to pain to ensure high quality (dimension of workstyle) were related to pain intensity at work and decreased function. These variables, in addition to hours worked per year, were related to increased pain experienced across the work week. The model tested did not predict the occurrence of lost time. CONCLUSIONS: The present findings provide support for the association between job stress, workstyle, upper extremity pain and function. While it is not possible to determine the exact direction of the observed relationships, these results are consistent with prior research indicating the potential significance of job stress and workstyle on symptom exacerbation and functional limitations. Implications for evaluation and intervention are discussed.

Activities of Daily Living↗

PubMed1994

Heating rate modeling and measurements in phantom and in vivo of the human upper extremity in a defective 2450 MHz microwave oven.

Multiple door interlock switches in commercial microwave ovens are designed to prevent accidental exposure and injury. We report a) heating rate (degree/sec) measurements in a phantom of the human upper extremity in a 2450 MHz microwave oven having interlock switches deliberately bypassed; b) skin temperature measurements on the upper extremity of a human volunteer similarly exposed; c) perception of warmth and pain experienced by the volunteer during exposure; d) thermographic camera recordings of the volunteer's skin; and e) finite element modeling of specific absorption rate (SAR) in the volunteer's hand. Moderately severe pain was experienced at the fingertips after 5 sec of exposure, consistent with the modeled SAR, measured heating rates, and published data on the temperature threshold for pain. We estimate that an additional 9 sec of exposure would be required to produce irreversible injury, consisting of focal thermal injury in the fingertips and possibly the thenar and hypothenar eminences.

Computer Simulation↗

PubMed2006

Psychometric properties of a modified Wolf Motor Function test for people with mild and moderate upper-extremity hemiparesis.

OBJECTIVE: To test the necessity of videotaping, test-retest reliability, and item stability and validity of a modified Wolf Motor Function Test (WMFT) for people with mild and moderate chronic upper-extremity (UE) hemiparesis caused by stroke. DESIGN: Raters of videotape versus direct observation; test-retest reliability over 3 observations, item stability, and criterion validity with upper-extremity Fugl-Meyer Assessment (FMA) in the mildly and moderately impaired groups. SETTING: Academic research center. PARTICIPANTS: Sixty-six subjects with chronic UE hemiparesis who participated in a large intervention study. Subjects were classified into mild and moderate groups for additional analyses. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mean and median times of task completion, functional ability, and strength (weight to box) measures of the WMFT. FMA scores for validity assessment. RESULTS: In a subgroup of 10 subjects, the intraclass correlation coefficient (ICC) for videotape versus direct observation ranged from .96 to .99. For the whole group, test-retest reliability using ICC2,1 ranged from .97 to .99; stability of the test showed that administration 1 differed from administrations 2 and 3 but administrations 2 and 3 did not differ; item analysis showed that 4 of 17 items changed across time, and validity, using a correlation with UE FMA, ranged from .86 to .89. Separate mild- and moderate-group analyses were similar to whole-group results. CONCLUSIONS: Videotaping the modified WMFT was not necessary for accurate scoring. The modified WMFT is reliable and valid as an outcome measure for people with chronic moderate and mild UE hemiparesis and is stable, but 1 repeat testing is recommended when practical.

Adult↗

PubMed1994

Exercise-induced upper extremity rhabdomyolysis and myoglobinuria in shipboard military personnel.

During a 6-month Amphibious Task Force deployment to the Mediterranean Sea, five sailors and Marines were admitted to the ship's ward with severe upper extremity pain, elevated serum muscle enzymes, and a urinalysis dip positive for blood in the absence of microscopic hematuria-a finding highly suggestive of myoglobinuria. Each patient had begun a vigorous upper-extremity work-out program in the ship's weight room 1 to 3 days prior to development of symptoms. All responded well to vigorous intravenous hydration, mannitol diuresis, alkalinization of the urine, and skeletal muscle rest. No patient developed acute tubular necrosis. With increasing emphasis on physical fitness and body building, this condition is likely to become more frequent. The most important preventive measure is gradual conditioning. Awareness of this entity and early aggressive management are necessary to avoid the potentially severe complication of renal failure.

Adult↗