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Ergonomics Dec 2017The objective of this study was to determine how simulated manual wheelchair pushing influences biomechanical loading to the lumbar spine and shoulders. Sixty-two...
The objective of this study was to determine how simulated manual wheelchair pushing influences biomechanical loading to the lumbar spine and shoulders. Sixty-two subjects performed simulated wheelchair pushing and turning in a laboratory. An electromyography-assisted biomechanical model was used to estimate spinal loads. Moments at the shoulder joint, external hand forces and net turning torque were also assessed. Multiple linear regression techniques were employed to develop biomechanically based wheelchair pushing guidelines relating resultant hand force or net torque to spinal load. Male subjects experienced significantly greater spinal loading (p < 0.01), and spine loads were also increased for wheelchair turning compared to straight wheelchair pushing (p < 0.001). Biomechanically determined maximum acceptable resultant hand forces were 17-18% lower than psychophysically determined limits. We conclude that manual wheelchair pushing and turning can pose biomechanical risk to the lumbar spine and shoulders. Psychophysically determined maximum acceptable push forces do not appear to be protective enough of this biomechanical risk. Practitioner Summary: This laboratory study investigated biomechanical risk to the low back and shoulders during simulated wheelchair pushing. Manual wheelchair pushing posed biomechanical risk to the lumbar spine (in compression and A/P shear) and to the shoulders. Biomechanically determined wheelchair pushing thresholds are presented and are more protective than the closest psychophysically determined equivalents.
Topics: Adult; Biomechanical Phenomena; Electromyography; Ergonomics; Female; Hand; Humans; Lumbar Vertebrae; Lumbosacral Region; Male; Middle Aged; Muscle, Skeletal; Shoulder; Shoulder Joint; Torque; Wheelchairs; Young Adult
PubMed: 28627334
DOI: 10.1080/00140139.2017.1344445 -
European Journal of Applied Physiology Feb 2015Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly... (Review)
Review
Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly emphasizes an incomplete understanding of the nature of shoulder pain. Indeed, the effective diagnosis and treatment of shoulder pain should not only rely upon a detailed knowledge of the peripheral pathologies that may be present in the shoulder, but also on current knowledge of pain neurophysiology. To assess and treat shoulder pain, a comprehensive understanding of the way in which pain is processed is essential. This review reflects modern pain neurophysiology to the shoulder and aims to answer the following questions: why does my shoulder hurt? What is the impact of shoulder pain on muscle function? What are the implications for the clinical examination of the shoulder? And finally, what are the clinical implications for therapy? Despite the increasing amount of research in this area, an in-depth understanding of the bidirectional nociception-motor interaction is still far from being achieved. Many questions remain, especially related to the treatment of nociception-motor interactions.
Topics: Exercise Therapy; Humans; Muscle, Skeletal; Shoulder; Shoulder Pain
PubMed: 25431129
DOI: 10.1007/s00421-014-3059-7 -
Biomechanics and Modeling in... Oct 2022Joint motion calculated using multi-body models and inverse kinematics presents many advantages over direct marker-based calculations. However, the sensitivity of the...
Joint motion calculated using multi-body models and inverse kinematics presents many advantages over direct marker-based calculations. However, the sensitivity of the computed kinematics is known to be partly caused by the model and could also be influenced by the participants' anthropometry and sex. This study aimed to compare kinematics computed from an anatomical shoulder model based on medical images against a scaled-generic model and quantify the effects of anatomical errors and participants' anthropometry on the calculated joint angles. Twelve participants have had planar shoulder movements experimentally captured in a motion lab, and their shoulder anatomy imaged using an MRI scanner. A shoulder multi-body dynamics model was developed for each participant, using both an image-based approach and a scaled-generic approach. Inverse kinematics have been performed using the two different modelling procedures and the three different experimental motions. Results have been compared using Bland-Altman analysis of agreement and further analysed using multi-linear regressions. Kinematics computed via an anatomical and a scaled-generic shoulder models differed in average from 3.2 to 5.4 degrees depending on the task. The MRI-based model presented smaller limits of agreement to direct kinematics than the scaled-generic model. Finally, the regression model predictors, including anatomical errors, sex, and BMI of the participant, explained from 41 to 80% of the kinematic variability between model types with respect to the task. This study highlighted the consequences of modelling precision, quantified the effects of anatomical errors on the shoulder kinematics, and showed that participants' anthropometry and sex could indirectly affect kinematic outcomes.
Topics: Humans; Biomechanical Phenomena; Shoulder; Models, Anatomic; Magnetic Resonance Imaging; Shoulder Joint
PubMed: 35867281
DOI: 10.1007/s10237-022-01606-0 -
Arthroscopy : the Journal of... Jan 2021To determine whether change in shoulder position between internal rotation (IR) and external rotation (ER) during magnetic resonance arthrography (MRA) affects... (Comparative Study)
Comparative Study
PURPOSE
To determine whether change in shoulder position between internal rotation (IR) and external rotation (ER) during magnetic resonance arthrography (MRA) affects previously defined capsular measurements and to determine the utility of rotation in the diagnosis of instability.
METHODS
A retrospective study was conducted of patients who received a shoulder MRA with humeral IR and ER views. Patients with an arthroscopically confirmed diagnosis of instability and those with clinically stable shoulders, no history of instability, and no MRA findings of instability were identified and compared. Humeral rotation, glenoid retroversion, humeral head subluxation, capsular length, and capsular area using axial sequences of IR and ER views were recorded. Analysis compared IR, ER, and Δ capsular measurements between groups using independent t tests and univariate and multivariate regression.
RESULTS
Thirty-one subjects who were diagnosed with instability were included, along with 28 control subjects. Capsular length, capsular area, and humeral subluxations were significantly greater with ER compared with IR views (P < .001, P < .001, P < .001). Patients with instability displayed greater ER capsular length (P = .0006) and ER capsular area (P = .005) relative to controls. Multivariate logistic regression identified age, weight, sex, ER capsular length, and retroversion to be significant predictors of instability. ER capsular length independently predicts instability with 86% sensitivity and 84% specificity. Interobserver reliability using the intraclass correlation coefficient was rated good or excellent on all measurements.
CONCLUSION
Variance in humeral rotation during shoulder MRA significantly affects capsular measurements. Rotational views increase the utility of capsular measurements when assessing for instability, particularly capsular length and capsular area. The implementation of ER positioning enhances the ability to examine capsular changes of the shoulder joint and can assist in the diagnosis of instability.
LEVEL OF EVIDENCE
III, retrospective comparative study.
Topics: Adolescent; Adult; Arthrography; Female; Humans; Humeral Head; Joint Dislocations; Joint Instability; Magnetic Resonance Imaging; Male; Middle Aged; Multivariate Analysis; Patient Positioning; Reproducibility of Results; Retrospective Studies; Rotation; Scapula; Shoulder; Shoulder Joint; Young Adult
PubMed: 32956802
DOI: 10.1016/j.arthro.2020.09.014 -
Acta Oto-laryngologica Sep 2023Shoulder syndrome can be reduced by preserving the spinal accessory nerve (SAN). However, it is unclear whether performing level IIb preservation will decrease the risk... (Observational Study)
Observational Study
BACKGROUND
Shoulder syndrome can be reduced by preserving the spinal accessory nerve (SAN). However, it is unclear whether performing level IIb preservation will decrease the risk of SAN injury and shoulder syndrome.
AIMS/OBJECTIVES
We investigated whether neck dissection with level IIb preservation can reduce shoulder dysfunction and postoperative quality of life (QOL) in head and neck cancer patients.
MATERIAL AND METHODS
This prospective observational study enrolled patients who underwent neck dissection from 2011 to 2014. Patients were divided into three groups (level IIb preservation group [group 1], IIb dissection group [group 2], and IIb and V dissection group [group 3]). Postoperative shoulder function and QOL were evaluated among the three groups.
RESULTS
There were a total of 35 neck sides in three groups, with nine neck sides in group 1, 16 neck sides in group 2, and 10 neck sides in group 3. Although the results showed less shoulder dysfunction in group 1 at early postoperative period. The QOL in group 1 was preserved in the early postoperative period.
CONCLUSIONS AND SIGNIFICANCE
Neck dissection with level IIb preservation may help reduce shoulder syndrome and maintain QOL in the early postoperative period.
Topics: Humans; Shoulder; Quality of Life; Neck Dissection; Head and Neck Neoplasms; Accessory Nerve
PubMed: 37772758
DOI: 10.1080/00016489.2023.2261985 -
Annual International Conference of the... Jul 2023The assessment of a frozen shoulder (FS) is critical for evaluating outcomes and medical treatment. Analysis of functional shoulder sub-tasks provides more crucial...
The assessment of a frozen shoulder (FS) is critical for evaluating outcomes and medical treatment. Analysis of functional shoulder sub-tasks provides more crucial information, but current manual labeling methods are time-consuming and prone to errors. To address this challenge, we propose a deep multi-task learning (MTL) U-Net to provide an automatic and reliable functional shoulder sub-task segmentation (STS) tool for clinical evaluation in FS. The proposed approach contains the main task of STS and the auxiliary task of transition point detection (TPD). For the main STS task, a U-Net architecture including an encoder-decoder with skip connection is presented to perform shoulder sub-task classification for each time point. The auxiliary TPD task uses lightweight convolutional neural networks architecture to detect the boundary between shoulder sub-tasks. A shared structure is implemented between two tasks and their objective functions of them are optimized jointly. The fine-grained transition-related information from the auxiliary TPD task is expected to help the main STS task better detect boundaries between functional shoulder sub-tasks. We conduct the experiments using wearable inertial measurement units to record 815 shoulder task sequences collected from 20 healthy subjects and 43 patients with FS. The experimental results present that the deep MTL U-Net can achieve superior performance compared to using single-task models. It shows the effectiveness of the proposed method for functional shoulder STS. The code has been made publicly available at https://github.com/RobinChu9890/MTL-U-Net-for-Functional-Shoulder-STS.Clinical Relevance- This work provides an automatic and reliable functional shoulder sub-task segmentation tool for clinical evaluation in frozen shoulder.
Topics: Humans; Shoulder; Learning; Bursitis; Healthy Volunteers; Neural Networks, Computer
PubMed: 38083530
DOI: 10.1109/EMBC40787.2023.10341137 -
Veterinary Surgery : VS Feb 2021To evaluate the use of the Leipzig distractor during canine shoulder arthroscopy.
OBJECTIVE
To evaluate the use of the Leipzig distractor during canine shoulder arthroscopy.
STUDY DESIGN
Experimental, ex vivo.
SAMPLE POPULATION
Paired shoulder joints from 15 large breed canine cadavers.
METHODS
Standard lateral shoulder arthroscopy was performed with or without the use of the Leipzig distractor (n = 15 each). Joint space width, procedure time, and visibility and palpability of the intra-articular structures were assessed during the arthroscopy. After the arthroscopic evaluation, each shoulder joint was disarticulated to assess the area and number of iatrogenic articular cartilage injury (IACI) lesions. Sites around the distraction device were assessed for the presence of iatrogenic injury.
RESULTS
With shoulder distraction, median joint space width was 4 mm larger (P = .01), IACI area was 9.5 mm lower (P = .003), and there were two fewer total number of IACI lesions (P = .004) compared with nondistracted shoulders. The mean total surgery time was 93 seconds shorter (P = .01) in distracted shoulders. Although distraction was associated with increased visibility of the supraglenoid tubercle (P = .015), no significant differences were found for other intra-articular structures for their visibility and palpability. Unexpected lesions at the sites around the distraction device were not encountered.
CONCLUSION
Use of the distraction device decreased the area and incidence of IACI lesions and shortened the arthroscopy time. However, no improvement was found in the visibility or palpability of the intra-articular structures.
CLINICAL SIGNIFICANCE
Although additional clinical studies are required to evaluate the effect of the distraction device on pathologic articular conditions and intraoperative manipulation, the use of a shoulder distraction device might improve the outcomes of shoulder arthroscopy by decreasing IACI and arthroscopy time.
Topics: Animals; Arthroscopy; Cadaver; Dog Diseases; Dogs; Joint Diseases; Shoulder; Shoulder Joint
PubMed: 33400311
DOI: 10.1111/vsu.13562 -
Gait & Posture Sep 2017This review investigates current protocols using Inertial Measurement Units (IMUs) in shoulder research, and outlines future paths regarding IMU use for shoulder... (Review)
Review
This review investigates current protocols using Inertial Measurement Units (IMUs) in shoulder research, and outlines future paths regarding IMU use for shoulder research. Different databases were searched for relevant articles. Criteria for study selection were (1) research in healthy persons or persons with shoulder problems, (2) IMUs applied as assessment tool for the shoulder (in healthy subjects and shoulder patients) or upper limb (in shoulder patients), (3) peer-reviewed, full-text papers in English or Dutch. Studies with less than five participants and without ethical approval were excluded. Data extraction included (1) study design, (2) participant characteristics, (3) type/brand of IMU, (4) tasks included in the assessment protocol, and (5) outcomes. Risk of bias was assessed using the Downs and Black checklist. Scapulothoracic/glenohumeral and humerothoracic kinematics were reported in respectively 10 and 27 of the 37 included papers. Only one paper in healthy persons assessed, next to scapulothoracic/glenohumeral kinematics, other upper limb joints. IMUs' validity and reliability to capture shoulder function was limited. Considering applied protocols, 39% of the protocols was located on the International-Classification-of-Functioning (ICF) function level, while 38% and 23% were on the 'capacity' and 'actual performance'-sublevel, of the ICF-activity level. Most available IMU-research regarding the shoulder is clinically less relevant, given the widely reported humerothoracic kinematics which do not add to clinical-decision-making, and the absence of protocols assessing the complete upper limb chain. Apart from knowledge on methodological pitfalls and opportunities regarding the use of IMUs, this review provides future research paths.
Topics: Accelerometry; Biomechanical Phenomena; Humans; Physical Examination; Reproducibility of Results; Shoulder; Shoulder Joint; Vocabulary, Controlled
PubMed: 28683420
DOI: 10.1016/j.gaitpost.2017.06.025 -
Indian Pediatrics Jun 2017
Topics: Calcinosis; Female; Hip; Humans; Hyperphosphatemia; Infant; Scalp; Shoulder
PubMed: 28667736
DOI: 10.1007/s13312-017-1062-x -
The Veterinary Clinics of North... Mar 2021Advanced imaging (ultrasound, computed tomography, MRI) is a key component in defining and localizing the underlying cause of forelimb lameness. Given the propensity of... (Review)
Review
Advanced imaging (ultrasound, computed tomography, MRI) is a key component in defining and localizing the underlying cause of forelimb lameness. Given the propensity of soft tissue injury/disease of the shoulder and brachial plexus, ultrasound and MRI are of particular utility in defining tendinous, muscular, and nerve lesions. An advanced knowledge of shoulder and brachial plexus anatomy is necessary for both image acquisition and interpretation. To determine clinical significance, interpretation of both normal anatomy and suspected pathology must be correlated with clinical signs and orthopedic examination findings.
Topics: Animals; Brachial Plexus; Dog Diseases; Dogs; Forelimb; Magnetic Resonance Imaging; Shoulder
PubMed: 33446361
DOI: 10.1016/j.cvsm.2020.11.005