The typical control of myoelectric interfaces, whether in laboratory settings or real-life prosthetic applications, largely relies on visual feedback because proprioceptive signals from the controlling muscles are either not available or very noisy. We conducted a set of experiments to test whether artificial proprioceptive feedback, delivered noninvasively to another limb, can improve control of a two-dimensional myoelectrically-controlled computer interface. In these experiments, participants were required to reach a target with a visual cursor that was controlled by electromyogram signals recorded from muscles of the left hand, while they were provided with an additional proprioceptive feedback on their right arm by moving it with a robotic manipulandum. Provision of additional artificial proprioceptive feedback improved the angular accuracy of their movements when compared to using visual feedback alone but did not increase the overall accuracy quantified with the average distance between the cursor and the target. The advantages conferred by proprioception were present only when the proprioceptive feedback had similar orientation to the visual feedback in the task space and not when it was mirrored, demonstrating the importance of congruency in feedback modalities for multi-sensory integration. Our results reveal the ability of the human motor system to learn new inter-limb sensory-motor associations; the motor system can utilize task-related sensory feedback, even when it is available on a limb distinct from the one being actuated. In addition, the proposed task structure provides a flexible test paradigm by which the effectiveness of various sensory feedback and multi-sensory integration for myoelectric prosthesis control can be evaluated.
Arthroscopic fixation using the TightRope device for acute AC joint dislocation achieves satisfactory outcome.
Unreamed interlocking tibial nailing can be safely used for type-I and type-II open injuries even with delayed presentation. Use of unreamed nailing in those type-III fractures with delayed presentation was not recommended, because of high incidence of complications.
purpose. To compare the outcome in patients who underwent surgery for unstable intertrochanteric femoral fractures using the proximal femoral locking plate versus the dynamic hip screw (DHS). Methods. 15 men and 5 women aged 32 to 78 (mean, 55) years were randomised to the proximal femoral locking plate group, whereas 14 men and 6 women aged 38 to 75 (mean, 59) years were randomised to the conventional 135º DHS group. The time to union, medialisation of the shaft, neck-shaft angle, limb shortening, varus collapse, and functional outcome (using the Hospital for Special Surgery Hip Rating System) were assessed. results. Respectively in the locking plate and DHS groups, the mean times to union were 14.6 and 16.5 weeks (p=0.067) and the mean limb shortenings were 0.3 and 1.4 cm (p<0.001). Medialisation of the shaft occurred in 0 and 15 patients (p<0.0001); varus collapse occurred in 2 and 5 patients (p=0.408); the functional hip score was good-to-excellent in 18 and Proximal femoral locking plate versus dynamic hip screw for unstable intertrochanteric femoral fractures Address correspondence and reprint requests to: Dr Anoop C Dhamangaonkar, 2/28, Madhavi Soc., Mogal Lane, Matunga (W), Mumbai, 400016, India. Email: anoopd_7@yahoo.com Journal of Orthopaedic Surgery 2013;21(3):317-22 11 patients (p=0.031); deep wound infection occurred in 3 and 2 patients; and implant cut-out occurred in one patient each group. conclusion. A non-collapsing locking plate achieved bone union in unstable intertrochanteric fractures with lower risks of limb shortening and medialisation of the shaft.
BackgroundHaemarthrosis and pain adversely affects the functional outcome of ACL reconstruction, especially in case of DB ACL reconstruction due to more extensive procedure. The purpose of the study was to evaluate the effect of haemarthrosis on the rehabilitation of DB ACL reconstruction versus SB ACL reconstruction.Methods100 patients were divided into two groups, of SB ACL and DB ACL reconstruction consisting of 50 patients each. An intra-articular drain was put in every patient. The pain was evaluated till week 8 using VAS (Visual Analog Scale). The Functional outcomes were evaluated using the Isokinetic Dynamometer at 3 and 6 months in both the groups. Muscle bulk and Range of motion were also noted in each group.ResultsThe results showed that there was statistically significant difference between the drain amount (n = 60.3 ml in SB ACL group vs. n = 94.2 ml in the DB ACL group) and haemarthrosis (n = 0.7 in SB ACL vs n = 1.5 in DB ACL) at week 1 post-operatively. Also the pain outcome improved on SB ACL after day 3 (VAS, n = 1.8) as compared to the DB ACL group (VAS, n = 3.7). The isokinetic muscle strength was found to be statistically significantly (p value < 0.05) better in the SB ACL group in the quadriceps muscle (both concentric and eccentric) at the end of the 3rd month. In the SB ACL group the Quadriceps Concentric strength deficit was 22.32% as compared to 34.12% in the DB ACL group. Both the groups had comparable flexor muscle strength at end of 3rd month. Both the groups had comparable muscle strength after 6 months of post-operative rehabilitation in both quadriceps and Hamstring muscle group.ConclusionWe noted that rehabilitation of DB ACL reconstruction group lags behind that of SB ACL reconstruction during the first 3 months due to post-operative haemarthrosis & its effects, but show comparable results after 6 months. The muscle strength measured isokinetically and the muscle bulk were found to be greater in the SB ACL group initially after 3 months but was found to be similar after 6 months.
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