PubMed Health⌕ Search

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 883 records · Page 49Linked to original sources
PubMedDate not supplied

Distal upper extremity function following proximal humeral resection and reconstruction for tumors: contralateral comparison.

BACKGROUND: Most functional analyses after limb salvage operations about the shoulder have focused on proximal function with the assumption that distal function is largely unaffected. This analysis examines distal function objectively. METHODS: Objective laboratory data regarding distal upper extremity strength after reconstructive procedures for tumors near the shoulder joint was collected over a 16-year period. Thirty-two patients were able to participate fully in the data collection at an average most recent follow-up duration of > 3.5 years. RESULTS: Statistically significant reductions on the involved side compared with the uninvolved side in grip, forearm pronation, forearm supination, elbow flexion, and elbow extension strength were documented (p < 0.05). The magnitude of reduction in strength diminishes distally, with the greatest effect in this group of patients being observed in elbow extension, followed by elbow flexion, forearm supination, and forearm pronation. Grip strength consistently showed the least amount of strength reduction compared with the uninvolved side, even within resection and reconstruction groups. Subjective patient rating of dexterity was no less than 3 of 5. Ninety percent of patients rated their dexterity 4 of 5 (52%) or 5 of 5 (38%). CONCLUSIONS: Despite the insistence of "normal" function in the distal upper extremity after limb salvage procedures, complete normality is not maintained. However, the degree of maintenance of distal function appears to be high, especially for grip strength and forearm pronation strength, and patient satisfaction is acceptable.

Adolescent↗
PubMed1995

Upper extremity performance test for the elderly (TEMPA): normative data and correlates with sensorimotor parameters. Test d'Evaluation des Membres Supérieurs de Personnes Agées.

OBJECTIVES: Objectives of this study were to develop normative data for the Test d'Evaluation des Membres Supérieurs de Personnes Agées (TEMPA) and determine its relation to upper extremity sensorimotor parameters such as fine and gross dexterity, coordination, strength, endurance, range of motion, and several types of sensibility. DESIGN: Cross-sectional study. SETTING: Community-dwelling subjects. PARTICIPANTS: Three hundred sixty healthy subjects randomly recruited by age and sex strata (60 to 69, 70 to 79, and 80 or older). MAIN OUTCOME MEASURES: Length of execution of the tasks in the TEMPA. RESULTS: Normative data are reported by gender and age group. The time taken to execute the tasks increased significantly with age. The women were faster on the tasks requiring a higher degree of fine dexterity, whereas the task requiring a lesser degree of fine dexterity and sensibility and more grip strength was accomplished faster by the men. Subjects who were more active and described themselves as being in excellent or good health performed better. CONCLUSION: The norms will help clinicians differentiate better between normal and pathological aging in upper extremity performance.

Aged↗
PubMed1991

Alterations in human upper extremity motor function during acute exposure to simulated altitude.

We tested the hypothesis that mild motor dysfunction was associated with Acute Mountain Sickness (AMS) by measuring arm movement characteristics in 14 subjects at sea level and at the end of a 30-h simulated altitude exposure (4,600 m). A computerized upper extremity movement analyzer (UEMA) was used to quantitate arm movements between a "start" position and randomly-generated targets on a large digitizing tablet by measuring selected speed parameters and error indices. The UEMA results were compared with the results of the Environmental Symptoms Questionnaire (ESQ) and with neurologic examinations. When compared with sea-level values, the mean values for all the speed-related parameters measured at the end of the 30-h exposure significantly declined by 20% to 32%. The error indices were not different. The declines in the speed-related parameters were significantly correlated with the severity of AMS symptoms as measured by the ESQ (R = 0.82). The neurologic abnormalities were limited to changes in mental status items. These results demonstrate that subclinical alterations in upper extremity speed are associated with mild, reversible AMS and provide evidence that hypoxia may produce supraspinal inhibition of motor pathways.

Adult↗
PubMed2003

Takeoff forces transmitted to the upper extremity during water-skiing.

As data were unavailable, this study quantified the forces acting on the upper extremities during water-skiing takeoff in 10 male volunteers (mean age: 28 years). Body weight ranged between 141 and 195 lbs. Low, medium, and full-power takeoffs were used to propel each skier out of the water. Although low-power takeoffs produced significantly less peak force (P < or = .0004), they yielded a trend toward greater time under load (P = .097). As the data suggest that forces assume roughly one and one-half times body weight, individuals with pre-existing shoulder morbidity may risk exacerbation of their condition.

Adult↗
PubMed2003

Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume.

BACKGROUND AND PURPOSE: The volume of all limbs can be determined by water displacement methods or calculations derived from girth measurements. The purpose of this study was to determine the concurrent validity of calculated volume and water displacement volume measurements. SUBJECTS: Both upper extremities of 14 women with lymphedema were measured. METHODS: Volumetric measurements were taken with a volumeter, and circumferential measurements were taken with a tape measure. Calculated volume was determined by summing segment volumes derived from the truncated cone formula. Pearson product moment correlations, paired t tests, and linear regression tests were used to assess relative association and absolute differences between calculated and actual volumes. RESULTS: The correlation coefficient for calculated volume versus upper extremity minus fingers (UE-F) water displacement volume was.99. Paired t tests showed differences between calculated volume and UE-F water displacement volume (t=-3.88, mean difference=-95.62 mL), and the linear regression slope was 0.83 with an intercept of 255.28 mL. DISCUSSION AND CONCLUSION: Calculated volume measurements were highly associated with measurements based on water displacement; therefore, clinicians should feel confident in using either calculated volume or water displacement volume. The differences, however, indicated that the measures were not interchangeable. Thus, clinicians should not mix or substitute measurement methods with a single patient or in a single study.

Adult↗
PubMed2001

Dynamic loads on the upper extremities during two different floor cleaning methods.

BACKGROUND: Biomechanical models have been used frequently to estimate the load on the low back and the lower extremities during occupational work tasks. The shoulder region has received much less attention although this area is a common site of work-related musculoskeletal disorders. OBJECTIVE: The aim of the present study was to evaluate the mechanical loading of the upper extremities during floor cleaning performed with different techniques. DESIGN: A comparative study of six subjects performing floor cleaning with two different techniques (mopping and scrubbing) in a laboratory setting. METHODS: A "force handle" equipped with two force dynamometers was used for continuous measurement of three-dimensional forces on each hand, separately, during this two handed asymmetrical task. A link segment model of the upper extremities was used to calculate the mechanical loading of the elbows and shoulders. Electromyograms were recorded from six shoulder muscles. RESULTS: Despite differences in movement patterns between mopping and scrubbing, only small differences were found in the moments of force. In accordance similar levels of electromyograms were found. CONCLUSION: In preventive strategies, changing the cleaning tool may not be sufficient to change the load on the shoulder muscles. RELEVANCE: Combined three-dimensional video recording and force measurements on the hands during a two-handed asymmetric work tasks allow calculation of the mechanical load on the elbow and shoulder. Thus it is possible to evaluate physiologically, new equipment designed to prevent work-related musculoskeletal disorders. Before introducing such equipment in large scale interventions it may be evaluated if the changes in force requirements are sufficient to predict prevention of musculoskeletal disorders.

Adult↗
PubMed2002

Incidence and risk factors of upper extremity deep vein lesions after permanent transvenous pacemaker implant: a 6-month follow-up prospective study.

The incidence of venous lesions after permanent pacemaker insertion is around 45%. However, this incidence has been based on retrospective studies in a small series; moreover, factors predicting the development of these venous injuries have not been clearly defined. The aim of this study was to identify the risk factors for higher incidence of upper extremity deep vein thrombosis after transvenous permanent pacemaker insertion. The study included 229 patients and the criteria were age above 12 years and first permanent transvenous pacemaker implant. Exclusion criteria were pulmonary embolism, lower or upper extremity deep venous thrombosis, previous use of central venous catheters, coagulation disturbances, and malignancy. Age, race, sex, underlying cardiac disease, functional class to heart failure, LVEF, venous access, number, material and caliber of the leads, and previous use of a transvenous temporary pacemaker were considered. Six months after the pacemaker was implanted, 202 patients were submitted to digital subtraction venography ipsilateral to pacemaker implant. The venographies were normal in 73 (36%) patients and abnormal in 129 (64%) patients. Patients with previous use of transvenous temporary leads (P = 0,0001, OR = 4,260, confidence limits = 2,133-8,465) and LVEF < or = 40% (P = 0,0378, OR = 3,437, confidence limits = 1,064-12,326), had higher incidence of venous lesions. Previous use of a temporary pacemaker and LVEF < or = 0.40 were considered independent risk factors to a higher incidence of venous stenosis or thrombosis 6 months after permanent pacemaker insertion.

Angiography, Digital Subtraction↗
PubMed1994

Diagnosis of compressive and entrapment neuropathies of the upper extremity: value of MR imaging.

Compressive and entrapment neuropathies (CENs) are relatively common clinical syndromes characterized by neurologic manifestations caused by mechanical or dynamic compression of peripheral nerves. Radiologists are often required to evaluate CENs primarily to rule out soft-tissue lesions as a potential cause of the syndrome. MR imaging has become the best technique for accurate delineation of soft-tissue lesions, and it is ideally suited for the assessment of CEN. Although many CENs of the upper extremity have been described in the clinical literature, only a few of them have received attention in radiologic publications. This review focuses on the most common CENs involving the upper extremity, with special emphasis on the MR manifestations.

Arm↗
PubMed1999

Upper extremity kinematics and body roll during preferred-side breathing and breath-holding front crawl swimming.

Front crawl swimmers often restrict the number of breaths they take during a race because of the possible adverse effects of the breathing action on resistance or stroke mechanics. The aim of this study was to determine whether differences exist in the kinematics of the trunk and upper extremity used during preferred-side breathing and breath-holding front crawl swimming. Six male swimmers performed trials at their 200 m race pace under breathing and breath-holding conditions. The underwater arm stroke was filmed from the front and side using video cameras suspended over periscope systems. Video recordings were digitized at 50 Hz and the three-dimensional coordinates of the upper extremity obtained using a direct linear transformation algorithm. Body roll angles were obtained by digitizing video recordings of a balsa wood fin attached to the swimmers' backs. The swimmers performed the breathing action without any decrement in stroke length (mean +/- s: breathing 2.24 +/- 0.27 m; breath-holding 2.15 +/- 0.22 m). Stroke widths were similar in the breathing (0.28 +/- 0.07 m) and breath-holding (0.27 +/- 0.07 m) trials, despite swimmers rolling further when taking a breath (66 +/- 5 degrees) than when not (57 +/- 4 degrees). The timing of the four underwater phases of the stroke was also unaffected by the breathing action, with swimmers rolling back towards the neutral position during the insweep phase. In conclusion, the results suggest that front crawl swimmers can perform the breathing action without it interfering with their basic stroke parameters. The insweep phase of the stroke assists body roll and not vice versa as suggested in previous studies.

Adult↗
PubMed1993

Precision of dual energy x-ray absorptiometry in the upper extremities.

Dual energy x-ray absorptiometry (DEXA) has been shown to be a precise method for measuring bone mineral density (BMD) and content (BMC) in lumbar spine and proximal femur, but it has not been widely used in other skeletal sites. The in vivo day-to-day precision of DEXA (Norland XR-26) for seven anatomic sites in the upper extremities was evaluated by twice measuring both the right and left sides in ten subjects. For consistently defined regions-of-interest, the following precision values (coefficient of variation) were obtained for BMD and BMC: 0.8% and 1.0% (proximal humerus); 0.5% and 0.5% (humeral shaft); 0.7% and 0.5% (radial shaft); 1.3% and 1.1% (ulnar shaft); 0.7% and 1.0% (distal radius); 0.7% and 1.2% (distal ulna); 0.4% and 0.6% (hand). The initially observed relative side-to-side differences did not change significantly in the repeated measurements. Our results indicate that DEXA is a precise method for assessment of BMD and BMC also in the upper extremities.

Absorptiometry, Photon↗
PubMed1996

A prospective study for upper-extremity cumulative trauma disorders of workers in aircraft manufacturing.

Occupational diseases affect 15 to 20% of all Americans. Cumulative trauma disorders (CTDs) account for 56% of all occupational injuries. The recognition and control of occupational injuries has become a major concern of employees, employers, medicine, and the federal government because of health risk and related costs. Upper-extremity CTDs are identified by the National Institute for Occupational Safety and Health as one of the ten most significant occupational health problems in the United States. It is estimated by the year 2000 that 50 cents on the dollar will be spent on CTDs. Although enlightened aircraft employers have developed primary prevention strategies, primary prevention can never be expected to eliminate 100% of the cases. To evaluate several preventive activities, a CTD risk-assessment program was developed and implemented in cooperation with a major aircraft manufacturer employing over 8000 workers. This program was focused on objectively identifying the relationship of work and other activities to an individual worker experiencing CTDs. Early identification has been linked, when applicable, to intervention algorithms for medical care, job task modification, workplace accommodation, and training. A prospective study group of 212 workers who used rivet guns was placed into a four-way experimental design for ergonomic posture training, exercise training, and rivet-gun type (primary factors). A statistical model was developed for the level of CTD risk and evaluated using the SAS software program (SAS Institute, Inc, Carry, NC). Statistical analysis of the primary factors without regard to associated variables (covariates) demonstrated that only posture training had a beneficial risk reduction for the individual. The impact (beneficial or detrimental) for exercise training and for vibration-dampening rivet guns was probably obscured because of the large variability of the responses regarding the associated variables (covariates). When the covariates were analyzed in conjunction with the four experimental groups, a positive benefit from ergonomic posture training and exercise training was demonstrated for the following groups: the dominant han, time spend in an awkward position, number of standard rivets bucked, number of parts routed, number of parts ground, number of vibration-dampening rivets bucked, and newly hired individuals. A negative effect (increase in individual risk level) for current employees using a vibration-dampening rivet gun was demonstrated. This prospective study helps to identify the possible benefit of education and training for controlling CTDs and demonstrates the usefulness of being able to evaluate materials, methods, machines, and environments as they relate to the individual's risk level for the development of upper-extremity CTDs.

Adult↗
PubMed1994

Carotid brachial bypass for treating proximal upper-extremity arterial occlusive disease.

Symptomatic occlusive disease of the subclavian arteries, not associated with thoracic outlet syndrome, is an uncommon problem with a paucity of literature related to the appropriateness of bypass graft selection and long-term patency for revascularization. Between 1985 and 1993, 9 patients (3 men and 6 women) underwent 13 carotid brachial bypasses for chronic severe upper-extremity ischemia. Ages ranged from 47 to 75 years (mean 65). Three patients had documented collagen vascular disease, 1 had radiation arteritis, and 4 had bilateral disease requiring staged arterial reconstruction. Indications for operation included severe exercise-induced ischemia in two limbs (15%), rest pain in eight (62%), and gangrene or infection, or both, in three (23%). Two bypasses were performed for failed prior reconstructions. Inflow originated from the carotid artery (4 proximal and 9 bifurcation), and distal anastomoses were made to a disease-free section of brachial artery. Reinforced 6 mm thin-wall polytetrafluoroethylene (PTFE) grafts were used in all operations. No operative mortality or major upper-extremity amputation was associated with the procedure, although digital amputations were performed in four instances. Follow-up ranged from 4 to 83 months with a mean of 38 months. The 5-year primary patency rate, by life-table analysis, was 92%. Our results showed excellent long-term patency when prosthetic grafts were used for carotid brachial bypass, because of excellent runoff and the relatively short graft length required.

Aged↗
PubMed1977

Replantation of the upper extremity in children.

Since Malt and McKhann performed the first successful replantation of a traumatically amputated extremity in 1962, there has been a flurry of case reports and articles debating the pros and cons of the various technical aspects of replantation. There have been three case reports of children, under the age of 15, who have successfully undergone replantation of the upper extremity transected throught the humerus. The first case report in this article is the fourth. The factors involved in selecting replantation or amputation, and the technical aspects of the operation which are felt to be important, are briefly reviewed. Because the mechanics of limb replantation are rather straightforward, we feel that the pediatric surgeon should be familar with the preoperative and intraoperative factors to be weight, and that this alternative to stump closure be carefully considered when one is presented with an upper extremity transection.

Accidents, Occupational↗
PubMed1996

Carpal instability in the weight-bearing upper extremity.

The prevalence of carpal instability in a paraplegic population was investigated to establish an association between chronic repetitive stress on the wrist and the development of such instability. Nine of 162 paraplegic patients had static carpal instability and no history of an acute injury of the wrist. The predominant pattern of instability, found in eleven wrists (six patients), was non-dissociative volar intercalated segmental instability. The prevalence of carpal instability increased with the duration of weight-bearing on the upper extremity. Eighteen per cent of the patients in whom the spinal cord injury had occurred more than twenty years before the study had carpal instability. Carpal instability in these weight-bearing upper extremities and the increase in its prevalence with the duration of the forces across the wrist demonstrate an association between chronic repetitive stress on the wrist and carpal instability.

Adult↗
PubMedDate not supplied

[Age-related changes in large joints and long tubular bones of the upper extremity in children (echographic data)].

Two hundred and ten children at the age of 17 days up to 15 years have been examined. Echocameras, working in the grey scale regime have been used. At examination of the arm, forearm, brachial, elbow and radiocarpal joints in the children the most informative are longitudinal echographic approaches. At examination of the brachial bone head in the children older than 10 years only the anterior longitudinal approach is informative. To perform the echographic investigation of various elements of the locomotor apparatus of the upper extremities in children older than 9-10 years is difficult. The echographic reveal of additional nuclei of ossification and synostosis stages of the long tubular bones of the upper extremities in children often coincide in time with roentgenological data.

Adolescent↗
PubMed1999

Soft tissue sarcoma of the upper extremity: descriptive data and outcome in a population-based series of 108 adult patients.

We report a population-based, 29-year review of 108 adult patients with soft tissue sarcoma of the upper extremity who had a minimum follow-up period of 3 years. Fifty tumors were localized in the upper arm, 8 in the elbow, 40 in the forearm, and 10 in the hand. Thirty-four tumors were subcutaneous and 74 were deep-seated. The median tumor size was 6 cm. Malignant fibrous histiocytoma was the most common histotype (n = 43), and grade IV (on a 4-grade scale) was the most common malignancy grade (n = 54). All but 6 patients underwent surgery; limb-sparing surgery of the primary tumor was performed in 89 patients. Twenty-four patients were given adjuvant radiotherapy; 11 received adjuvant chemotherapy. Inadequate local treatment was more common in patients treated outside the tumor center. Local recurrence occurred in 15 of 28 with inadequate local treatment and in 16 of 74 patients with adequate local treatment (20 of the 39 patients treated outside the center and 11 of the 63 patients treated at the center). At the latest follow-up visit, 32 patients had developed metastases, giving a 5-year metastasis-free survival rate of 0.72. In a multivariate analysis, tumor size larger than 5 cm and vascular invasion emerged as independent prognostic factors. Patients without these 2 factors had excellent survival. When compared with soft tissue sarcoma of the lower extremity or trunk wall, tumors in the upper extremity were smaller at the time of diagnosis and had a higher 5-year metastasis-free survival rate.

Adolescent↗
PubMed1979

Prevalence of tenosynovitis and other injuries of the upper extremities in repetitive work.

The purpose of this investigation was to compare the prevalence of soft tissue disorders in the neck, arms and hands between packers doing repetitive work and shop assistants with variable tasks. One hundred and fifty-two female assembly-line packers in a food production factory and 133 female shop assistants were interviewed about their symptoms and given a clinical examination of the neck and upper extremities. The number of cases of tension neck, cervical syndrome, scalenus syndrome, and humeral epicondylitis did not differ significantly between the two groups. The prevalence of tenosynovitis and humeral tendinitis was significantly higher for the assembly-line packers. The packing work consisted of static muscle work by the arms, grasping and maximal extensions of the fingers, and lateral deviations of the wrists. The movements numbered up to 25,000/workday. A relationship between some work load factors and some disorders of the upper extremities is probable.

Acromioclavicular Joint↗