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At least 19 recordsLinked to original sources
PubMed2026

The Impact of Upper Extremity Rehabilitation on Fatigue in Individuals With Multiple Sclerosis: A Systematic Review.

BACKGROUND: Although numerous interventions have been investigated to alleviate fatigue in people with multiple sclerosis (PwMS), evidence regarding the effects of upper extremity rehabilitation on fatigue remains limited. OBJECTIVE: The objective of this review was to evaluate and synthesize the available evidence on the effects of upper extremity rehabilitation interventions on fatigue in PwMS. METHODS: This review was conducted in accordance with the PRISMA guidelines and was prospectively registered in the PROSPERO database. A systematic search of PubMed, Web of Science, and Scopus was performed up to August 2026. Studies were eligible if they investigated the effects of upper extremity rehabilitation interventions on fatigue in PwMS. The risk of bias of randomized controlled trials was assessed using the Risk of Bias 2 (RoB 2), and the certainty of the evidence was appraised using the GRADE methodology. RESULTS: Nine studies including 250 participants (136 intervention, 114 control) met the inclusion criteria. The included studies evaluated a range of technology-assisted, exercise-based, home-based, and task-oriented upper extremity rehabilitation approaches, with some interventions incorporating more than one therapeutic or technological component. Fatigue outcomes were measured using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS). Risk of bias was low in three randomized controlled trials, with some concerns in two and high in two; among the two crossover studies, one was rated as low risk and one as high risk. GRADE assessment showed low certainty of evidence for studies using the FSS and very low certainty for those using the MFIS, indicating an overall low certainty of the available evidence. CONCLUSIONS: The available evidence is insufficient to draw definitive conclusions regarding the effects of upper extremity rehabilitation on fatigue in PwMS. Further high-quality randomized controlled trials are required.

Humans↗
PubMed1976

Neuropathy in the upper extremity after open-heart surgery.

Eleven patients with upper-extremity neurological abnormalities underwent open-heart surgery performed through a median sternotomy incision. Seven of the 11 patients were referred in the routine manner to evaluate and treat the neurological problem. The remaining four were part of a consecutively studied group of 11 patients examined prospectively to determine the possible presence of abnormalities. Two of these four patients were asymptomatic. All lesions could be postulated to occur within the brachial plexus, the most common area being the median cord, but lesions were also noted in the posterior and lateral cords and upper trunk. The etiology of the problem appears to be stretching injury of the brachial plexus from retraction of the sternum, which in turn causes retroclavicular displacement of the clavicle. However, it is possible that an ischemic neuropathy could result from intraarterial procedures in some of our patients. The possibility that neurologic deficit may occur in the upper extremity should be considered by physicians who may have the opportunity to evaluate patients who undergo open-heart surgery.

Adult↗
PubMed1978

Upper extremity deformities associated with the orofacial clefts.

A material of 89 cases of upper extremity deformities, among the 3225 cleft patients born during the period 1950-75, and treated in the Finnish Red Cross Cleft Centre is presented. About two-thirds of the patients had an isolated cleft palate--half of the male and nearly all of the female patients. The percentage of upper extremity deformities appearing with the different types of the orofacial clefts was, for clefts of the primary palate 2.0: specifically for cleft lip 0.8, cleft lip--palate 2.6, and cleft lip and palate 3.6; and for clefts of the secondary palate 3.5: specifically for cleft palate 3.7, submucous cleft palate 1.6; and for the branchial arch syndrome (lateral cleft) 5.2; the total average being 2.8 percent. About one-third of the patients were dwarfs, most of them diastrophic dwarfs. Syndactyly was somewhat more common among cleft patients, 0.3%, than in the average population. Polydactyly, 0.1% was about as common as the average. Ectrodactyly was more common among cleft patients, 0.4%, than either syndactyly or polydactyly that are considered the most common hand deformities among the general population. The syndactyly cases were more complicated than the average, among them 4 cases of Apert syndrome were noted. About three-fourths of the 89 patients had multiple deformities.

Abnormalities, Multiple↗
PubMed1979

[Disorders of the arterial blood supply in the upper extremities].

Arteriopathies of the upper half of the body may lead to considerable functional disturbances of the arm and severe deficits on the part of the central nervous system. Due to good comparison they scarcely cause or do not cause any complaints in a no unconsiderable part. The clinical material consisting of 4,162 patients from five annual courses had in 9.2% occlusion and stenoses localized in the supraaortic and brachial region. The in most cases systemic angiopathy here explains the frequently combined appearance with arterial processes in the pelvic and the leg region. According to the height of the occlusion we clinically differ types of carotis, shoulder girdle, upper arm and peripheral-acral obliteration, which in each case show differences concerning frequency, age of manifestation, etiology, distribution of sex and clinical degree of severity. The angiological basic diagnostics is based on the inspection, palpation of the arteries, auscultation of the vessels, bilateral measuring of the blood pressure after Riva-Rocci and functional examinations, such as fist closure test and Allen test, as well as clinical proofs or exclusions of neurovascular syndromes of the shoulder girdle. The special apparative angiological methods comprise the oscillo-, rheo- and vein occlusion plethysmography, the Doppler ultrasound technique, estimations of the ophthalmic pressure, isotopic methods and angiographic exploration. --The individual angiological examination methods are of different importance according to the height localisation of the angioorganopathy. --The incomplete syndrome of the aortic arch is taken into consideration. In short the author adopts a definite attitude to the demands of therapy.

Adult↗
PubMed1978

Chronic upper extremity arterial insufficiency. Etiology, manifestations, and operative management.

Forty-eight arterial reconstructions were performed for chronic upper extremity ischemia in 43 patients, aged 31 to 81 years. Diagnostic arterial catheterization was the most frequent cause of symptomatic occlusion, followed by proximal arteriosclerotic lesions and noniatrogenic trauma. Doppler ultrasound evaluation provided important diagnostic and prognostic data that complemented information derived from arteriography. Indications for operation included disabling claudication (39 cases) or digital gangrene (four cases). Restoration of normal extremity function can be anticipated except in instances where poor forearm runoff exists. Autogenous saphenous and basilic interposition vein grafts have proved excellent for axillary-brachial revascularizations. Axillary-axillary bypass procedures for innominate-subclavian artery occlusions appear hemodynamically sound and technically simple. Follow-up, averaging 48 months, extended to 144 months. Late vein graft failure or progressive distal occlusive disease was not encountered.

Adult↗
PubMed1976

Chemical injuries of the upper extremity.

The prompt recognition and management (Tables 8-1 and 8-2) of chemical burns of the upper extremity may prevent injury to the deep structures of the hand and may make the difference between satisfactory rehabilitation and crippling deformities. Immediate irrigation with water is the single most important treatment that can be carried out, and should be continued for at least an hour and often for several hours, depending on the severity of the injury. Precious time should not be wasted hunting for a specific neutralizing agent. Hydrofluoric acid injuries and phosphorus injuries are the two exceptions to this principle. After copious irrigation and débridement, small superficial burns may be treated without dressings or topical therapy. Large partial-thickness burns are best treated with Sulfamylon burn cream and then with with biologic dressings until healing is achieved. Full-thickness injuries of limited extent should be excised and skin-grafted to regain maximum function, and more extensive burns treated in a nonexicisional regimen.

Acids↗
PubMed1977

[Acupuncture as after care following injuries of the upper extremities].

Acupuncture is able to improve restriction of motion in general and in the smaller joints of the upper extremity, disturbances in circulation, posttraumatic swelling, reversible nerve lesions and ulcers following burns or pressure of a plaster. Localisation of the points for acupuncture in the different conditions and the possibilities of their combinations are described. Acupuncture is performed bilaterally at symmetrical points, unilaterally in pareses, contralaterally in amputees and in cases with dressings. During ear acupuncture the analgesic effect occurs more quickly, but has a shorter duration of action; in paralyses it was without success. The course of the treatment was controlled by clinical examination and measurement of the range of motion.

Acupuncture Therapy↗
PubMed2026

The Effect of Game-Based Virtual Reality Rehabilitation and Its Impact on Upper Extremity Function After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.

BACKGROUND: Arthroscopic rotator cuff repair (ARCR) often results in prolonged recovery and limited shoulder function. Conventional physical therapy rehabilitation programs require sustained patient engagement; however, adherence is frequently low. Game-based virtual reality (VR) offers an interactive and engaging environment that may enhance rehabilitation outcomes. OBJECTIVE: To evaluate the effect of a game-based VR program on the function of the upper limb in patients following ARCR. METHODS: A randomized controlled trial was conducted with patients who underwent ARCR. Participants were randomized into two groups: game-based VR or conventional rehabilitation. Outcomes were evaluated using the Disabilities of the Arm, Shoulder and Hand score, pain severity by the Numerical Pain Rating Scale, range of motion measures, and muscle strength testing. Assessments were performed at baseline and at 6 weeks and 12 weeks post surgery. RESULTS: Results have shown significant within-group improvements in pain, function, range of motion, and isometric muscle strength across all time points (P < 0.05). Between-group analysis revealed greater improvements in pain, function, flexion range, and abduction and external rotation strength in the experimental group at both time points (P < 0.05). Abduction range improved significantly only at 12 weeks (P = 0.02), whereas external rotation range showed no significant difference between groups at either time point (P > 0.05). CONCLUSION: The findings indicate that integrating game-based VR rehabilitation provides additional benefits over conventional therapy in improving pain and upper extremity function following ARCR. These findings support the use of VR as an effective alternative to the conventional rehabilitation for postoperative rehabilitation.

Humans↗
PubMed1979

Free vascularized bone grafts in surgery of the upper extremity.

Free vascularized fibular grafts were employed in five patients with segmental bone defects following trauma or resection of tumors of the upper extremity with excellent results in three patients and satisfactory results in two. No donor site morbidity was experienced. A comparison with rib and iliac crest grafts indicates that the fibula is more suitable for reconstruction of long bone defects. The advantages of this technique are stability without sacrificing viability and a shorter immobilization period with more rapid incorporation and hypertrophy of the graft. The disadvantages are prolonged operating time, difficulty in assessing patency of anastamoses in the immediate postoperative period, and sacrifice of a major vessel in the lower extremity.

Adult↗
PubMed1978

Upper extremity total joint replacement.

Current techniques of total joint replacement surgically correct badly destroyed joints by the insertion of plastic and metal components, which are secured to the skeleton by methylmethacrylate cement. This approach began in England in 1962 and in the United States in 1967. Recent development in the field of upper extremity joint replacement allow implementation of refined total shoulder, elbow, and wrist prostheses. Although less experience has been gained with these prostheses than with total hip and knee replacements, preliminary results are encouraging.

Arm↗
PubMedDate not supplied

[Peripheral nerve damage in upper extremities in glass cutters].

A group of glass cutters working with flint-glass was analysed in view of their susceptibility to ulnar nerve crush injury. The group comprised 429 cutters from Eastern Bohemia working in the Bohemia manufacture. The type of work done by cutters is described with particular reference to the way in which they rest their upper extremities during work and to the duration of work. Subjective symptoms were present in 44.7% of workers. The following neurological abnormalities were found during examination: hypaesthesia in 36.8%, motor activity impairment in 21.9%, muscular atrophy in 8.1%. Autonomic abnormalities involved hands in 29.1% of workers. Slight electromyographic abnormalities were demonstrated not only in the innervation area of the ulnar nerve but also in that of the median nerve. The authors discuss their views on the aetiology of the disease and criteria used in medical evaluation of ability to work in these workers.

Electromyography↗
PubMed1979

Free groin flap transfer to the upper extremity.

Seven patients underwent free groin flap transfer to the first web space, palm, wrist or elbow. Six of the seven were successful. The seventh developed acute venous occlusion and superficial necrosis of part of the flap, receiving split thickness skin grafts to salvage the dermal portion. Transfer is offered as an alternative to more conventional flaps for coverage of defects of the upper extremity.

Adolescent↗
PubMed1979

Movements in the lumbar spine during exercises of the upper extremities. A roentgenologic study in para- and tetraplegic patients.

Strengthening exercises during treatment of patients with unstable lumbar fractures produce a kyphotic or lordotic sagittal movement in the lumbar spine. These movements have been measured roentgenologically. Forward flexion exercises in the shoulder joints to 45 degrees produced a kyphotic movement, while forward flexion to 110 degrees and abduction exercises to 90 degrees produced a lordotic movement. Flexion of hips and knees to 45 degrees produced a kyphotic movement adding to the movements caused by the shoulder exercises. Increasing the load on the upper extremities produced an increase of all movements.

Adult↗
PubMed1976

[The fibrolipomatous hypertrophy of the main nerves of the upper extremity].

10 cases of lipofibromatous hypertrophy of the main nerves in the upper limb in 7 female and 3 male patients are described. In 1 case at the level of the middle third of the upper arm and in 6 cases at the level of the wrist and neighboring areas. In 2 patients these pathological changes were found in the ulnar nerve, in 1 case the hypertrophy was limited to the upper arm, in the other it extended all along the extremity from below the axilla to the wrist. Finally, in 1 case a 20 cm long hypertrophy was found at the level of the deep branch of the radial nerve (posterior interosseus nerve) in the lower arm below the elbow. The fibrous and lipomatous tissue snugly surrounds the fascicles and cannot be separated from them without damaging them, even if the finest microsurgical techniques are used. As the disease has been diagnosed in children as young as five years a congenital etiology has to be considered. The condition is distinct though from the disease of DEJERINE-SOTTAS or from that of von RECKLINGHAUSEN. The hypertrophic nerve is progressively submitted to a chronic compression in the naturally narrow passages (carpal tunnel, ulnar grove at the elbow, arcade of FROHSE) or it becomes painful and paretic after even minor trauma which leads probably to local oedema, intraneural bleeding and epineural compression. An external and internal decompression has to be carried out. Resection or defatting of the hypertrophic fascicles, however, should be avoided. In 2 of our cases the disease was anamnestically present for 45-50 years and clinically followed in another case for 18 years. The disease does not seem progressive. These cases show, that this disorder, which first appeared in the medical literature in 1964 and have been described by several authors in the median nerve, exists as well in the two other main nerves of the upper extremity.

Adult↗
PubMed1979

Procedures for EMG biofeedback training in involved upper extremities of hemiplegic patients.

This article presents practical information about using electromyographic biofeedback to train specific muscle groups in the involved upper extermity of hemiplegic patients. Our approach is first to reduce hyperactivity in spastic musculature and then to increase activity levels in weak muscles. Electrode placements and a sequence of training procedures for muscles whose functions are most commonly impaired following stroke are described.

Arm↗
PubMed1978

Swelling of the upper extremity, function and muscle strength of shoulder joint following mastectomy combined with radiotherapy.

Swelling of the arm, mobility of the shoulder joint and muscle strength were examined in 76 patients with breast cancer 4.5 to 14 years (mean 8 years) after primary therapy. Marked arm swelling was found on the operated side in 31% of the patients operated by radical mastectomy and in 18% of those having undergone total mastectomy. The swelling was more marked in the upper arm than in the forearm. Patients irradiated postoperatively with a megavoltage technique showed more often and more oedema than those treated with a kilovoltage technique. Obese patients had more swelling than patients of normal weight. Of the various movements of the shoulder joint, abduction, adduction, flexion, extension, horizontal extension and internal rotation were significantly reduced on the operated side in comparison with the non-operated side, but the differences were not great. Neither swelling of the arm nor the patient's weight had any effect on the function of the shoulder joint, as expressed in terms of abduction. Of the muscle groups in the shoulder joint adductors, flexors and extensors were significantly weaker on the operated than on the non-operated side. The muscle strength of the operated side averaged 25% weaker than that of the control side. Swelling of the arm did not reduce the muscle strength of the shoulder joint.

Adult↗