Elbow joint restriction: Effect on functional upper limb motion during performance of three feeding activities

Cooper, Juliette; Shwedyk, E.; Quanbury, Arthur O.; Miller, Janice E.; Hildebrand, Diane

doi:10.1016/0003-9993(93)90005-u

Cited by 61 publications

(41 citation statements)

References 13 publications

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“…Patients with contractures are likely to have pain [10,26,37], pressure ulcers [8], and cognitive impairment [26]. Contractures also can contribute to impaired function and activity limitations [5,12,14,16,19,26]. Notably, the proportion of patients who have contractures develop in major joints 1 year after spinal cord injury ranges from 11% to 43%, and it is difficult to accurately predict those susceptible to contracture soon after injury [7].…”

Section: Introductionmentioning

confidence: 99%

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

Iwasawa

Nomura

Sakitani

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Contractures are a prevalent and potentially severe complication in patients with neurologic disorders. Although heat, cold, and stretching are commonly used for treatment of contractures and/or spasticity (the cause of many contractures), the sequential effects of these modalities remain unclear. Questions/purposes Using an established rat model with spinal cord injury with knee flexion contracture, we sought to determine what combination of heat or cold before stretching is the most effective for treatment of contractures derived from spastic paralyses and investigated which treatment leads to the best (1) improvement in the loss of ROM; (2) restoration of deterioration in the muscular and articular factors responsible for contractures; and (3) amelioration of histopathologic features such as muscular fibrosis in biceps femoris and shortening of the joint capsule. Methods Forty-two adolescent male Wistar rats were used. After spasticity developed at 2 weeks postinjury, each animal with spinal cord injury underwent the treatment protocol daily for 1 week. Knee extension ROM was measured with a goniometer by two examiners blinded to each other's scores. The muscular and articular factors contributing to contractures were calculated by measuring ROM before and after the myotomies. We quantitatively measured the muscular fibrosis and the synovial intima length, and observed the distribution of collagen of skeletal muscle. The results were confirmed by a blinded observer. Results The ROM of heat alone (34°± 1°) and cold alone (34°± 2°) rats were not different with the numbers available from that of rats with spinal cord injury (35°± 2°) (p = 0.92 and 0.89, respectively). Stretching after heat (24°± 1°) was more effective than stretching alone (27°± 3°) at increasing ROM (p \ 0.001). Contrastingly, there was no difference between stretching after cold (25°± 1°) and stretching alone (p = 0.352). Stretching after heat was the most effective for percentage improvement of muscular (29%) and articular (50%) factors of contractures. Although quantification of muscular fibrosis in the rats with spinal cord injury (11% ± 1%) was higher than that of controls (9% ± 0.4%) (p = 0.01), no difference was found between spinal cord injury and each treatment protocol. The total synovial intima length of rats with spinal cord injury (5.9 ± 0.2 mm) became shorter than those of the controls (7.6 ± 0.2 mm) (p \ 0.001), and those of stretching alone (6.9 ± 0.4 mm), stretching after heat (7.1 ± 0.3 mm), and stretching after cold (6.7 ± 0.4 mm)

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Section: Introductionmentioning

confidence: 99%

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

Iwasawa

Nomura

Sakitani

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Hand function is defined as the ability to use the hand and fingers for activities of daily living or occupation, and includes the ability to move the upper limb in all dimensions to position and orient the hand in the environment (Kapandji, 1981;Cooper et al, 1993). We chose to use active range of motion (AROM) as our measure of the ability to move each segment because AROM was the variable that was most strongly related to hand function in our previous sample (Lang and Beebe, 2007), and because it can easily be measured clinically.…”

Section: Introductionmentioning

confidence: 99%

Absence of a proximal to distal gradient of motor deficits in the upper extremity early after stroke

Beebe¹,

Lang²

2008

Clinical Neurophysiology

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Objective-Our first purpose was to determine whether there was a proximal to distal gradient in motor deficits in nine segments of the affected upper extremity (shoulder, elbow, forearm, wrist, and 5 fingers) post stroke. Our second purpose was to determine which upper extremity segments made the greatest contributions to hand function.Methods-33 subjects were tested on average 18.6 (± 5.6) days after stroke. The ability to move each segment was measured by active range of motion (AROM). Hand function was measured by a battery of standardized clinical tests which were synthesized into a single, sensitive score for hand function using principal components analysis.Results-AROM at all nine segments of the upper extremity was reduced and there was no evidence of a proximal to distal gradient in AROM values. Strength of each segment was reduced and there was also no evidence of a gradient in strength values. AROM at each segment was strongly correlated with hand function scores (range 0.76 -0.94). General multiple regression analysis showed that AROM explained 82% of the variance in hand function, with most of the variance shared across proximal, middle, and distal segments. Hierarchical regression analysis showed that shoulder AROM alone could explain 88% of the variance in hand function.Conclusion-Early after stroke a proximal to distal gradient of motor deficits was not present, and loss of hand function was due to a loss of ability to move many segments of the upper extremity and not just the distal ones.Significance-These results suggest that a change in the clinical perception of motor deficits post stroke is needed. Our finding that shoulder AROM predicted almost all the variance in hand function opens up the possibility that this quick, simple measure may be predictive of future hand function. This would be of high economic and clinical utility compared to other ongoing efforts attempting to predict outcomes post stroke (e.g. fMRI, MEG).

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“…Previous studies have reported joint angles during eating with a spoon for men and women 10,16,20,21) and during eating with chopsticks for women, 22) but gender differences were not investigated. Our findings identified that upper limb joint angles and RoMs of joints during eating differ between genders, which contrasts with the findings of previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…19) Therefore, gender differences in joint angles during eating may exist. Joint angles during eating have been reported for men and for women 10,16,[20][21][22] ; however, no study has investigated gender differences. Therefore, the present study aimed to examine the upper limb joint angles separately in young, healthy Japanese men and women and to investigate gender differences during eating with a spoon and with chopsticks.…”

Section: Introductionmentioning

confidence: 99%

Influence of Gender Differences on Range of Motion and Joint Angles During Eating in Young, Healthy Japanese Adults

Nakatake

Totoribe

Chosa

et al. 2017

PRM

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Objective: Eating is important in rehabilitation and is evaluated using joint angles that serve as kinematic information. Joint angles of the upper extremities during eating have been reported for men and for women; however, no study has investigated these joint angles in terms of gender differences. At present, no information is available on gender differences as individual factors of upper extremity joint angles during eating. Therefore, the present study investigated gender differences in upper limb joint angles during eating tasks involving a spoon or chopsticks. Methods: We examined eating motions in 12 healthy Japanese men and 13 healthy Japanese women (aged 20-39 years) and compared the two groups. Motions were assessed using inertial sensors and three-dimensional motion analysis. Results: We established, separately for men and women, the maximum angle and the range of motion (RoM) for each upper limb joint. Women generally had greater RoMs for all upper limb joints than men did. When subjects used a spoon, statistically significant differences and large effect sizes were observed for the maximum elbow joint flexion angle and the RoMs of the shoulder joint in abduction, flexion, and internal rotation. When subjects used chopsticks, statistically significant differences and large effect sizes were observed for maximum angles of shoulder joint internal rotation, elbow joint flexion, and wrist joint radial flexion and for the RoM of shoulder joint abduction. Conclusions: We concluded that there are significant gender differences in upper limb joint angles during eating, and that these differences are influenced by numerous factors.

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Elbow joint restriction: Effect on functional upper limb motion during performance of three feeding activities

Cited by 61 publications

References 13 publications

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

Absence of a proximal to distal gradient of motor deficits in the upper extremity early after stroke

Influence of Gender Differences on Range of Motion and Joint Angles During Eating in Young, Healthy Japanese Adults

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