Development of an EMG-based muscle health model for elbow trauma patients

Wearable robotic braces have the potential to improve rehabilitative therapies for patients suffering from musculoskeletal (MSK) conditions. Ideally, a quantitative assessment of health would be incorporated into rehabilitative devices to monitor patient recovery. The purpose of this work is to develop a model to distinguish between the healthy and injured arms of elbow trauma patients based on electromyography (EMG) data. Surface EMG recordings were collected from the healthy and injured limbs of 30 elbow trauma patients while performing 10 upper-limb motions. Forty-two features and five feature sets were extracted from the data. Feature selection was performed to improve the class separation and to reduce the computational complexity of the feature sets. The following classifiers were tested: linear discriminant analysis (LDA), support vector machine (SVM), and random forest (RF). The classifiers were used to distinguish between two levels of health: healthy and injured (50% baseline accuracy rate). Maximum fractal length (MFL), myopulse percentage rate (MYOP), power spectrum ratio (PSR) and spike shape analysis features were identified as the best features for classifying elbow muscle health. A majority vote of the LDA classification models provided a cross-validation accuracy of 82.1%. The work described in this paper indicates that it is possible to discern between healthy and injured limbs of patients with MSK elbow injuries. Further assessment and optimization could improve the consistency and accuracy of the classification models. This work is the first of its kind to identify EMG metrics for muscle health assessment by wearable rehabilitative devices

The Effect of Wrist Position on Finger Tendon Loads Following Pulley Sectioning and Operative Reconstruction

© 2019 The Authors Purpose: Postoperative rehabilitation is important for maximizing patient outcomes after surgical pulley reconstruction. The purpose of this study was to identify the optimal wrist position in which rehabilitation should be undertaken to decrease the load on surgically reconstructed pulleys. Methods: We tested 14 digits composed of the index, middle, and ring fingers from 5 cadaveric specimens in a novel in vitro finger motion simulator designed to achieve full finger flexion and extension actively. Servo-motors were used to generate motion through tendons under load or position control while measuring tendon forces, joint range of motion, and tendon excursion. Flexor digitorum profundus (FDP) and flexor digitorum superficialis loads were measured sequentially with native intact pulleys and A2 and A4 pulleys sectioned, and with reconstructed A2 and A4 pulleys. Each condition was tested with the wrist neutral and with 30° wrist flexion or extension. The effect of wrist position on FDP and flexor digitorum superficialis loads under each condition was analyzed using repeated-measures analysis of variance. Results: With pulleys reconstructed, the wrist position had a significant effect on tendon load. The flexed wrist position resulted in a 31% reduction of FDP load compared with the neutral wrist position. Wrist extension also produced an apparent reduction of 14%, although not statistically significant. Conclusions: After pulley repair, placing the wrist in 30° flexion decreased tension in the FDP tendon compared with a neutral wrist. Clinical relevance: This study suggests that rehabilitation should be carried out with the wrist flexed to reduce the load on pulley reconstructions

Static Progressive versus Three-point Elbow Extension Splinting: A Mathematical Analysis

Elbow joint contractures are often treated by using static progressive, dynamic, turnbuckle, or serial static splinting. These splint designs are effective in regaining functional elbow range of motion due to the high forces applied to the contracted tissues; however, regaining terminal elbow extension remains a challenge. Static progressive splints are commonly used to initiate treatment, however, are considered less effective in regaining terminal extension. Recently, the concept of converting a static progressive splint into a three-point static progressive splint (TPSPS) to regain terminal extension has been introduced. This paper mathematically analyzes the compressive and rotational forces in static progressive and TPSPSs. Our hypothesis was that three-point static progressive splinting was superior to the standard static progressive elbow extension splint in applying rotational forces to the elbow at terminal extension. © 2009 Hanley & Belfus

Static progressive orthosis for patients with limited radial and/or ulnar deviation: an innovative orthotic design.

After injury to the wrist and forearm, therapists and patients frequently work to regain the motions of wrist flexion/extension and forearm pronation/supination. Although these motions play a vital role in everyday functioning, for some, limitations in wrist radial/ulnar deviation can also present functional challenges. These authors describe the creation and utilization of a static progressive orthosis to assist a patient in regaining wrist radioulnar deviatio

Zone III flexor tendon injuries - A proposed modification to rehabilitation

© 2015 Hanley & Belfus. In this manuscript, these authors have utilized years of clinical experience to suggest rehabilitation modifications for Zone III flexor tendon injuries. - Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor