Dynamic scapular movement analysis: is it feasible and reliable in stroke patients during arm elevation?
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ABSTRACT:
SUBMITTER: De Baets L
PROVIDER: S-EPMC3823991 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Optimal scapular position and movement are necessary for normal function of the shoulder joint and it is essential to focus on scapula in the rehabilitation for shoulder disorders. The aim of this study was to discover the relationship between the scapular initial position and scapular movement during dynamic motions in healthy young men. Thirty-four men participated in this study. The scapular angles at initial position and in elevation and lowering during flexion and abduction were measured using an electromagnetic tracking device. The scapular movements from 30° to 120° during flexion and abduction were calculated. Spearman's rank correlation coefficients were used to analyze the relationship between the scapular initial position and scapular movements. For upward rotation and posterior tilt of the scapula, there were significant positive correlations between the scapular initial position and scapular movement during flexion and abduction. For internal rotation, there were significant positive correlations, except 90° in lowering phase and 120° in both phases. While the humeral elevation increased, the correlation coefficients tended to decrease. Except for the internal rotation our results clarified the interactions between the scapular initial position and scapular movement during dynamic motions in healthy young men. The tendency of the decrease in correlation coefficient with elevation angle was shown.
| S-EPMC6936830 | biostudies-literature
Project description:We study the mechanism of human arm-posture control by means of nonlinear dynamics and quantitative time series analysis methods. Utilizing linear and nonlinear measures in combination, we find that pathological tremors emerge in patient dynamics and serve as a main feature discriminating between normal and patient groups. The deterministic structure accompanied with loss of complexity inherent in the tremor dynamics is also revealed. To probe the underlying mechanism of the arm-posture dynamics, we further analyze the coupling patterns between joints and components, and discuss their roles in breaking of the organization structure. As a result, we elucidate the mechanisms in the arm-posture dynamics of normal subjects responding to the gravitational force and for the reduction of the dynamic degrees of freedom in the patient dynamics. This study provides an integrated framework for the origin of the loss of complexity in the dynamics of patients as well as the coupling structure in the arm-posture dynamics.
| S-EPMC4633101 | biostudies-literature
Project description:BackgroundInterpretation of shoulder motion across studies has been complicated due to the use of numerous scapular coordinate systems in the literature. Currently, there are no simple means by which to compare scapular kinematics between coordinate system definitions when data from only one coordinate system is known.Research questionHow do scapular kinematics vary based on the choice of coordinate system and can average rotation matrices be used to accurately convert kinematics between scapular local coordinate systems?MethodsAverage rotation matrices derived from anatomic landmarks of 51 cadaver scapulae (29 M/22 F; 59 ± 13 yrs; 26R/25 L; 171 ± 11 cm; 70 ± 19 kg; 23.7 ± 5.5 kg/m2) were generated between three common scapular coordinate systems. Absolute angle of rotation was used to determine if anatomical variability within the cadaver population influenced the matrices. To quantify the predictive capability to convert kinematics between the three coordinate systems, the average rotation matrices were applied to scapulothoracic motion data collected from 19 human subjects (10 M/9 F; 43 ± 17 yrs; 19R; 173 ± 9 cm; 71 ± 16 kg; 23.6 ± 4.5 kg/m2) using biplane fluoroscopy. Root mean squared error (RMSE) was used to compare kinematics from an original coordinate system to the kinematics expressed in each alternative coordinate system.ResultsThe choice of scapular coordinate system resulted in mean differences in scapulothoracic rotation of up to 23°, with overall different shapes and/or magnitudes of the curves. A single average rotation matrix between any two coordinate systems achieved accurate conversion of scapulothoracic kinematics to within 4° of RMSE of the known solution. The average rotation matrices were independent of sex, side, decomposition sequence, and motion.SignificanceScapulothoracic kinematic representations vary in shape and magnitude based solely on the choice of local coordinate system. The results of this study enhance interpretability and reproducibility in expressing scapulothoracic motion data between laboratories by providing a simple means to convert data between common coordinate systems. This is necessitated by the variety of available motion analysis techniques and their respective scapular landmark definitions.
| S-EPMC7484087 | biostudies-literature
Project description:BackgroundExamine the ability of a dynamic scapular recognition exercise to improve scapular upward rotation and decrease shoulder pain and disability in patients with adhesive capsulitis of the shoulder.MethodsA test-retest randomized controlled study design was used. A total of sixty-six patients with unilateral adhesive capsulitis were equally divided into two groups. The study group received a dynamic scapular recognition exercise using a wireless biofeedback system, while the control group received placebo treatment in the form of active range-of-motion (ROM) exercises of the sound upper limb. A digital inclinometer was used to measure the scapular upward rotation and ROM of the shoulder joint, and the Shoulder Pain and Disability Index (SPADI) was used to measure the shoulder pain and disability.ResultsStudy results showed that after two weeks, there were statistically significant differences between the study and control groups in scapular upward rotation and shoulder flexion and abduction (P < .05) and nonsignificant differences in shoulder external rotation and SPADI (P > .05). After two and six months, there were statistically significant differences between study and control groups in scapular upward rotation; shoulder flexion, abduction and external rotation; and SPADI scores (P < .05).ConclusionThis study showed that a dynamic scapular recognition exercise significantly improves scapular upward rotation and the ROM of shoulder flexion and abduction after two weeks. At two and six months, this exercise improves scapular upward rotation; ROM of shoulder flexion, abduction, and external rotation; and SPADI scores. These improvements persisted for six months after the performance of this exercise.
| S-EPMC7480516 | biostudies-literature
Project description:BackgroundArm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated.MethodThis single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge.ResultsEighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation.ConclusionsA majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.
| S-EPMC5470733 | biostudies-literature
Project description:BackgroundThe key for successful stroke upper-limb rehabilitation includes the personalization of therapeutic interventions based on patients' functional ability and performance level. However, therapists often encounter challenges in supporting personalized rehabilitation due to the lack of information about how stroke survivors use their stroke-affected arm outside the clinic. Wearable technologies have been considered as an effective, objective solution to monitor patients' arm use patterns in their naturalistic environments. However, these technologies have remained a proof of concept and have not been adopted as mainstream therapeutic products, and we lack understanding of how key stakeholders perceive the use of wearable technologies in their practice.ObjectiveWe aim to understand how stroke survivors and therapists perceive and envision the use of wearable sensors and arm activity data in practical settings and how we could design a wearable-based performance monitoring system to better support the needs of the stakeholders.MethodsWe conducted semi-structured interviews with four stroke survivors and 15 occupational therapists (OTs) based on real-world arm use data that we collected for contextualization. To situate our participants, we leveraged a pair of finger-worn accelerometers to collect stroke survivors' arm use data in real-world settings, which we used to create study probes for stroke survivors and OTs, respectively. The interview data was analyzed using the thematic approach.ResultsOur study unveiled a detailed account of (1) the receptiveness of stroke survivors and OTs for using wearable sensors in clinical practice, (2) OTs' envisioned strategies to utilize patient-generated sensor data in the light of providing patients with personalized therapy programs, and (3) practical challenges and design considerations to address for the accelerated integration of wearable systems into their practice.ConclusionsThese findings offer promising directions for the design of a wearable solution that supports OTs to develop individually-tailored therapy programs for stroke survivors to improve their affected arm use.
| S-EPMC9584451 | biostudies-literature
Project description:Arm movement recovery after stroke can improve with sufficient exercise. However, rehabilitation therapy sessions are typically not enough. To address the need for effective methods of increasing arm exercise outside therapy sessions we developed a novel armrest, called Boost. It easily attaches to a standard manual wheelchair just like a conventional armrest and enables users to exercise their arm in a linear forward-back motion. This paper provides a detailed design description of Boost, the biomechanical analysis method to evaluate the joint torques required to operate it, and the results of pilot testing with five stroke patients. Biomechanics results show the required shoulder flexion and elbow extension torques range from -25% to +36% of the torques required to propel a standard pushrim wheelchair, depending on the direction of applied force. In pilot testing, all five participants were able to exercise the arm with Boost in stationary mode (with lower physical demand). Three achieved overground ambulation (with higher physical demand) exceeding 2 m/s after 2-5 practice trials; two of these could not propel their wheelchair with the pushrim. This simple to use, dynamic armrest provides people with hemiparesis a way to access repetitive arm exercise outside of therapy sessions, independently right in their wheelchair. Significantly, Boost removes the requirements to reach, grip, and release the pushrim to propel a wheelchair, an action many individuals with stroke cannot complete.
| S-EPMC9354471 | biostudies-literature
Project description:BackgroundBased on Euler/Cardan analysis, prior investigations have reported up to 80° of glenohumeral (GH) external rotation during arm elevation, dependent on the plane of elevation (PoE). However, the subtraction of Euler/Cardan angles does not compute the rotation around the humerus' longitudinal axis (i.e. axial rotation). Clinicians want to understand the true rotation around the humerus' longitudinal axis and rely on laboratories to inform their understanding of underlying shoulder biomechanics, especially for the GH joint since its motion cannot be visually ascertained. True GH axial rotation has not been previously measured in vivo, and its difference from Euler/Cardan (apparent) axial rotation is unknown.Research questionWhat is the true GH axial rotation during arm elevation and external rotation, and does it vary from apparent axial rotation and by PoE?MethodsTwenty healthy subjects (10 M/10 F, ages 22-66) were recorded using biplane fluoroscopy while performing arm elevation in the coronal, scapular and sagittal planes, and external rotation in 0° and 90° of abduction. Apparent GH axial rotation was computed using the xz'y'' and yx'y'' sequences. True GH axial rotation was computed by integrating the projection of GH angular velocity onto the humerus' longitudinal axis. One-dimensional statistical parametric mapping was utilized to compare apparent versus true axial rotation, axial rotation versus 0°, and detect differences in axial rotation by PoE.ResultsIn contrast to apparent axial rotation, true GH axial rotation does not differ by PoE and is not different than 0° during arm elevation at higher elevation angles. The spherical area between the sequence-specific and actual humeral trajectory explains the difference between apparent and true axial rotation.SignificanceProper quantification of axial rotation is important because biomechanics literature informs clinical understanding of shoulder biomechanics. Clinicians care about true axial rotation, which should be reported in future studies of shoulder kinematics.
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Project description:Intra-sarcoplasmic reticulum (SR) free [Ca] ([Ca](SR)) provides the driving force for SR Ca release and is a key regulator of SR Ca release channel gating during normal SR Ca release or arrhythmogenic spontaneous Ca release events. However, little is known about [Ca](SR) spatiotemporal dynamics.To directly measure local [Ca](SR) with subsarcomeric spatiotemporal resolution during both normal global SR Ca release and spontaneous Ca sparks and to evaluate the quantitative implications of spatial [Ca](SR) gradients.Intact and permeabilized rabbit ventricular myocytes were subjected to direct simultaneous measurement of cytosolic [Ca] and [Ca](SR) and FRAP (fluorescence recovery after photobleach). We found no detectable [Ca](SR) gradients between SR release sites (junctional SR) and Ca uptake sites (free SR) during normal global Ca release, clear spatiotemporal [Ca](SR) gradients during isolated Ca blinks, faster intra-SR diffusion in the longitudinal versus transverse direction, 3- to 4-fold slower diffusion of fluorophores in the SR than in cytosol, and that intra-SR Ca diffusion varies locally, dependent on local SR connectivity. A computational model clarified why spatiotemporal gradients are more detectable in isolated local releases versus global releases and provides a quantitative framework for understanding intra-SR Ca diffusion.Intra-SR Ca diffusion is rapid, limiting spatial [Ca](SR) gradients during excitation-contraction coupling. Spatiotemporal [Ca](SR) gradients are apparent during Ca sparks, and these observations constrain models of dynamic Ca movement inside the SR. This has important implications for myocyte SR Ca handling, synchrony, and potentially arrhythmogenic spontaneous contraction.
| S-EPMC3084972 | biostudies-literature
Project description:Systematic social observation (SSO) methods traditionally measure neighborhoods at street level and have been performed reliably using virtual applications to increase feasibility. Research indicates that collection at even higher spatial resolution may better elucidate the health impact of neighborhood factors, but whether virtual applications can reliably capture social determinants of health at the smallest geographic resolution (parcel level) remains uncertain. This paper presents a novel, parcel-level SSO methodology and assesses whether this new method can be collected reliably using Google Street View and is feasible.Multiple raters (N=5) observed 42 neighborhoods. In 2016, inter-rater reliability (observed agreement and kappa coefficient) was compared for four SSO methods: (1) street-level in person; (2) street-level virtual; (3) parcel-level in person; and (4) parcel-level virtual. Intra-rater reliability (observed agreement and kappa coefficient) was calculated to determine whether parcel-level methods produce results comparable to traditional street-level observation.Substantial levels of inter-rater agreement were documented across all four methods; all methods had >70% of items with at least substantial agreement. Only physical decay showed higher levels of agreement (83% of items with >75% agreement) for direct versus virtual rating source. Intra-rater agreement comparing street- versus parcel-level methods resulted in observed agreement >75% for all but one item (90%).Results support the use of Google Street View as a reliable, feasible tool for performing SSO at the smallest geographic resolution. Validation of a new parcel-level method collected virtually may improve the assessment of social determinants contributing to disparities in health behaviors and outcomes.
| S-EPMC5233427 | biostudies-literature