Quantifying the effectiveness of silver ring splints to correct swan-neck deformity

Swan-neck deformity is a common symptom of rheumatoid arthritis affecting the fingers. It can be classified by hyperextension of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal joint [1]. Methods to correct hyperextension of the PIP joint range from surgery to splinting techniques [2]. Silver ring splints (SRSs) were recently identified as a possible alternative to surgery and traditional thermoplastic splints because patient adherence was improved by their appearance [3]. The objective of this study was to investigate whether the SRSs restrict PIP joint hyperextension during a fine dexterity task

Post-operative rehabilitation after PIP joint arthroplasty with early active motion: A retrospective review of outcomes

We present a retrospectively review of outcomes of the first fifteen patients who underwent proximal interphalangeal (PIP) joint arthroplasty and were treated using the same early active motion rehabilitation regime introduced by the therapy department at Mount Vernon Hospital. The regime utilises early motion of the PIP joint while protecting the arthroplasty with a small static splint and digit strapping to reduce lateral forces on the joint. The notes of fifteen patients were reviewed and their outcomes presented. To evaluate the outcomes in more detail the patients were divided into three groups according to their diagnostic reason for the procedure (rheumatoid arthritis, osteoarthritis and trauma). The overall mean arc of motion at the PIP joint on discharge from therapy was 54 improved from 28 pre operatively. The patients with the osteoarthritic PIP joints gained the largest improvement in the PIP joint arc of motion and required the least rehabilitation intervention. Patients with rheumatoid arthritis required intense rehabilitation to gain less overall PIP joint motion but still reported satisfaction with their outcome. All 15 patients experienced an improvement in their pain level and subjectively reported increased function in their affected hand. Following this retrospective review of cases the team continue to use this regime for metal and silastic prosthesis but now routinely provide additional written information pre operatively to assist patients’ understanding of the procedure and the extent of the rehabilitation required

Quantitative sensory testing in painful hand osteoarthritis demonstrates features of peripheral sensitisation.

Hand osteoarthritis (HOA) is a prevalent condition for which treatments are based on analgesia and physical therapies. Our primary objective was to evaluate pain perception in participants with HOA by assessing the characteristics of nodal involvement, pain threshold in each hand joint, and radiological severity. We hypothesised that inflammation in hand osteoarthritis joints enhances sensitivity and firing of peripheral nociceptors, thereby causing chronic pain. Participants with proximal and distal interphalangeal (PIP and DIP) joint HOA and non-OA controls were recruited. Clinical parameters of joint involvement were measured including clinical nodes, VAS (visual analogue score) for pain (0-100 mm scale), HAQ (health assessment questionnaire), and Kellgren-Lawrence scores for radiological severity and pain threshold measurement were performed. The mean VAS in HOA participants was 59.3 mm ± 8.19 compared with 4.0 mm ± 1.89 in the control group (P < 0.0001). Quantitative sensory testing (QST) demonstrated lower pain thresholds in DIP/PIP joints and other subgroups in the OA group including the thumb, metacarpophalangeal (MCPs), joints, and wrists (P < 0.008) but not in controls (P = 0.348). Our data demonstrate that HOA subjects are sensitised to pain due to increased firing of peripheral nociceptors. Future work to evaluate mechanisms of peripheral sensitisation warrants further investigation

Evolutionary Inference via the Poisson Indel Process

We address the problem of the joint statistical inference of phylogenetic trees and multiple sequence alignments from unaligned molecular sequences. This problem is generally formulated in terms of string-valued evolutionary processes along the branches of a phylogenetic tree. The classical evolutionary process, the TKF91 model, is a continuous-time Markov chain model comprised of insertion, deletion and substitution events. Unfortunately this model gives rise to an intractable computational problem---the computation of the marginal likelihood under the TKF91 model is exponential in the number of taxa. In this work, we present a new stochastic process, the Poisson Indel Process (PIP), in which the complexity of this computation is reduced to linear. The new model is closely related to the TKF91 model, differing only in its treatment of insertions, but the new model has a global characterization as a Poisson process on the phylogeny. Standard results for Poisson processes allow key computations to be decoupled, which yields the favorable computational profile of inference under the PIP model. We present illustrative experiments in which Bayesian inference under the PIP model is compared to separate inference of phylogenies and alignments.Comment: 33 pages, 6 figure

A preliminary case study of the effect of shoe-wearing on the biomechanics of a horse’s foot

Horse racing is a multi-billion-dollar industry that has raised welfare concerns due to injured and euthanized animals. Whilst the cause of musculoskeletal injuries that lead to horse morbidity and mortality is multifactorial, pre-existing pathologies, increased speeds and substrate of the racecourse are likely contributors to foot disease. Horse hooves have the ability to naturally deform during locomotion and dissipate locomotor stresses, yet farriery approaches are utilised to increase performance and protect hooves from wear. Previous studies have assessed the effect of different shoe designs on locomotor performance; however, no biomechanical study has hitherto measured the effect of horseshoes on the stresses of the foot skeleton in vivo. This preliminary study introduces a novel methodology combining three-dimensional data from biplanar radiography with inverse dynamics methods and finite element analysis (FEA) to evaluate the effect of a stainless steel shoe on the function of a Thoroughbred horse's forefoot during walking. Our preliminary results suggest that the stainless steel shoe shifts craniocaudal, mediolateral and vertical GRFs at mid-stance. We document a similar pattern of flexion-extension in the PIP (pastern) and DIP (coffin) joints between the unshod and shod conditions, with slight variation in rotation angles throughout the stance phase. For both conditions, the PIP and DIP joints begin in a flexed posture and extend over the entire stance phase. At mid-stance, small differences in joint angle are observed in the PIP joint, with the shod condition being more extended than the unshod horse, whereas the DIP joint is extended more in the unshod than the shod condition. We also document that the DIP joint extends more than the PIP after midstance and until the end of the stance in both conditions. Our FEA analysis, conducted solely on the bones, shows increased von Mises and Maximum principal stresses on the forefoot phalanges in the shod condition at mid-stance, consistent with the tentative conclusion that a steel shoe might increase mechanical loading. However, because of our limited sample size none of these apparent differences have been tested for statistical significance. Our preliminary study illustrates how the shoe may influence the dynamics and mechanics of a Thoroughbred horse's forefoot during slow walking, but more research is needed to quantify the effect of the shoe on the equine forefoot during the whole stance phase, at faster speeds/gaits and with more individuals as well as with a similar focus on the hind feet. We anticipate that our preliminary analysis using advanced methodological approaches will pave the way for new directions in research on the form/function relationship of the equine foot, with the ultimate goal to minimise foot injuries and improve animal health and welfare

Proportional-Integral-Plus Control Strategy of an Intelligent Excavator

This article considers the application of Proportional-Integral-Plus (PIP) control to the Lancaster University Computerised Intelligent Excavator (LUCIE), which is being developed to dig foundation trenches on a building site. Previous work using LUCIE was based on the ubiquitous PI/PID control algorithm, tuned on-line, and implemented in a rather ad hoc manner. By contrast, the present research utilizes new hardware and advanced model-based control system design methods to improve the joint control and so provide smoother, more accurate movement of the excavator arm. In this article, a novel nonlinear simulation model of the system is developed for MATLAB/SIMULINK, allowing for straightforward refinement of the control algorithm and initial evaluation. The PIP controller is compared with a conventionally tuned PID algorithm, with the final designs implemented on-line for the control of dipper angle. The simulated responses and preliminary implementation results demonstrate the feasibility of the approach

A new smart dynamic external fixator in the treatment of complex fractures of the proximal interphalangeal joint of the long fingers.

Treatment of articular fractures of the proximal interphalangeal (PIP) joint of the hand can be a hard challenge. Ideal treatment should include an anatomic reduction, stable fixation and the possibility of early finger mobilization to prevent joint stiffness. We propose for the treatment of these fractures a new smart dynamic external fixator (SDEF), derived from the device described by Suzuki and based on the concept of the capsuloligamentotaxis described by Vidal

Dataglove Measurement of Joint Angles in Sign Language Handshapes

In sign language research, we understand little about articulatory factors involved in shaping phonemic boundaries or the amount (and articulatory nature) of acceptable phonetic variation between handshapes. To date, there exists no comprehensive analysis of handshape based on the quantitative measurement of joint angles during sign production. The purpose of our work is to develop a methodology for collecting and visualizing quantitative handshape data in an attempt to better understand how handshapes are produced at a phonetic level. In this pursuit, we seek to quantify the flexion and abduction angles of the finger joints using a commercial data glove (CyberGlove; Immersion Inc.). We present calibration procedures used to convert raw glove signals into joint angles. We then implement those procedures and evaluate their ability to accurately predict joint angle. Finally, we provide examples of how our recording techniques might inform current research questions

Proportional-integral-plus control applications of state-dependent parameter models

This paper considers proportional-integral-plus (PIP) control of non-linear systems defined by state-dependent parameter models, with particular emphasis on three practical demonstrators: a microclimate test chamber, a 1/5th-scale laboratory representation of an intelligent excavator, and a full-scale (commercial) vibrolance system used for ground improvement on a construction site. In each case, the system is represented using a quasi-linear state-dependent parameter (SDP) model structure, in which the parameters are functionally dependent on other variables in the system. The approach yields novel SDP-PIP control algorithms with improved performance and robustness in comparison with conventional linear PIP control. In particular, the new approach better handles the large disturbances and other non-linearities typical in the application areas considered