Reliability of the Ulnar Collateral Ligament of the Elbow Assessed Using Musculoskeletal Ultrasound

Background : Ulnar collateral ligament（ UCL） injury to the elbow is common in athletic populations.The anterior bundle of the UCL is the main stabilizer against valgus stress on elbow flexion; it provides thegreatest degree of joint stabilization and is therefore the most clinically important component for judo therapy.Recently, musculoskeletal ultrasound（ MUS） has been used as a new technique in the field of judo therapy.Because only a few studies have measured the reliability of the UCL using ultrasound, the reliability ofeach angle of elbow flexion remains unclear. The purpose of this study was to investigate the measurementreliability of the UCL thickness and length at each elbow flexion angle（ 30°, 60°, and 90°） using MUS.Methods : MUS was conducted to evaluate the anterior bundle of the UCL of 10 elbows of 10 healthyasymptomatic volunteers. The intra- and inter-rater reliabilities were tested using the interclass correlationcoefficients（ ICCs）.Results : The inter-rater reliability was good to excellent（ ICCs : 0.877–0.951） for the UCL thickness at 60°and 90° of elbow flexion. At 30° of elbow flexion, the ICCs was good （0.872 and 0.761 for the right and leftarms, respectively）. The inter-rater reliability was excellent（ ICCs : 0.945–0.998） for the UCL length at thethree angles of elbow flexion. The intra-rater reliability was good to excellent （ICCs : 0.804–0.975） for theUCL thickness at the three angles of elbow flexion in the individual examiners. Similarly, the intra-raterreliability was excellent（ ICCs : 0.978–0.996） for the UCL length at the three angles of elbow flexion.Conclusion : The results of this study suggest that the reliability of the UCL thickness and length does notdiffer among each angle of elbow flexion using MUS

Changes in circle area after gravity compensation training in chronic stroke patients

After a stroke, many people experience difficulties to selectively activate muscles. As a result many patients move the affected arm in stereotypical patterns. Shoulder abduction is often accompanied by elbow flexion, reducing the ability to extend the elbow. This involuntary coupling reduces the patient's active range of motion. Gravity compensation reduces the activation level of shoulder abductors which limits the amount of coupled elbow flexion. As a result, stroke patients can instantaneously increase their active range of motion [1]. The objective of the present study is to examine whether training in a gravity compensated environment can also lead to an increased range of motion in an unsupported environment. Parts of this work have been presented at EMBC2009, Minneapolis, USA

Comparison between partial ulnar and intercostal nerve transfers for reconstructing elbow flexion in patients with upper brachial plexus injuries

<p>Abstract</p> <p>Background</p> <p>There have been several reports that partial ulnar transfer (PUNT) is preferable for reconstructing elbow flexion in patients with upper brachial plexus injuries (BPIs) compared with intercostal nerve transfer (ICNT). The purpose of this study was to compare the recovery of elbow flexion between patients subjected to PUNT and patients subjected to ICNT.</p> <p>Methods</p> <p>Sixteen patients (13 men and three women) with BPIs for whom PUNT (eight patients) or ICNT (eight patients) had been performed to restore elbow flexion function were studied. The time required in obtaining M1, M3 (Medical Research Council scale grades recovery) for elbow flexion and a full range of elbow joint movement against gravity with the wrist and fingers extended maximally and the outcomes of a manual muscle test (MMT) for elbow flexion were examined in both groups.</p> <p>Results</p> <p>There were no significant differences between the PUNT and ICNT groups in terms of the age of patients at the time of surgery or the interval between injury and surgery. There were significantly more injured nerve roots in the ICNT group (mean 3.6) than in the PUNT group (mean 2.1) (<it>P </it>= 0.0006). The times required to obtain grades M1 and M3 in elbow flexion were significantly shorter in the PUNT group than in the ICNT group (<it>P </it>= 0.04 for M1 and <it>P </it>= 0.002 for M3). However, there was no significant difference between the two groups in the time required to obtain full flexion of the elbow joint with maximally extended fingers and wrist or in the final MMT scores for elbow flexion.</p> <p>Conclusions</p> <p>PUNT is technically easy, not associated with significant complications, and provides rapid recovery of the elbow flexion. However, separation of elbow flexion from finger and wrist motions needed more time in the PUNT group than in the ICNT group. Although the final mean MMT score for elbow flexion in the PUNT group was greater than in the ICNT group, no statistically significant difference was found between the two groups.</p

Effects of Hand Position During a Push-Up on Scapular Kinematics

The purpose of this study was to investigate the effect of hand position and elbow flexion angle on scapular kinematics in a traditional push up exercise. Sixteen healthy subjects (11 males, 5 females, age 20.50 ± 5.25 yrs.) participated in the study. Following a standardized warm-up subjects were instrumented. Kinematic data was collected via the Polhemus Fastrak magnetic tracking system. Following digitization, subjects assumed a push-up position. A 10-cm wood block was positioned on the floor to control for push-up depth. Subjects performed push-ups with their hands in a standard position, wide, and narrow. Subjects performed three repetitions of each condition to a 4-second count. During the concentric phase in each condition, mean scapular orientations were measured during an elbow extension range of motion (ROM) of 90º - 30º. There was no significant interaction between elbow flexion and hand position for scapular upward rotation (UR) (p = .938) and no main effect of elbow flexion for UR (p = .232). There was a main effect of hand position on UR (p \u3c .001). Pairwise comparisons indicated that standard and narrow conditions showed greater UR than wide (p = .001 and p = .002, respectively). However, no significant difference was seen between standard and narrow conditions (p = .091). There was no significant interaction between elbow flexion and hand position for posterior tilt (PT) (p = .821). There was a main effect of hand position of on PT (p = .001). There was no significant main effect of elbow angle (p = .218). Narrow hand position and significantly higher PT than wide (p = .004). There was no interaction between elbow flexion and hand position on external rotation (ER) (p = .073). There were main effects of both hand position (p = .021) and elbow flexion (p \u3c .001) on ER. ER decreased linearly with elbow extension (p \u3c .001)

COMPARATIVE ANALYSIS ON MUSCLE STRENGTH AMONG PATIENTS WHO UNDERWENT ARTHROSCOPIC TENOTOMY OF THE LONG HEAD OF THE BICEPS IN RELATION TO ESTHETIC DEFORMITY

ABSTRACTObjective: To determine whether there was any discrepancy in elbow flexion strength among patients with and without evident clinical deformity resulting from arthroscopic tenotomy on the long head of the biceps. Method: A group of 120 patients who underwent this procedure were evaluated. After applying the exclusion criteria, 89 patients remained in the analysis. Eighteen months after the operation (median), the elbow flexion strength was measured in newtons using a digital dynamometer. Three consecutive measurements were made and the average was used. The dominant and non-dominant sides were compared. Sex, age and mean elbow flexion strength in the operated and contralateral arms of patients with and without apparent clinical deformity were evaluated. Results: The median elbow flexion strength among the patients with evident clinical deformity was 17.78 N for the dominant arm and 20.87 N for the non-dominant arm. The difference was 2.51 N. In the group without evident clinical deformity, the difference was 2.14 N. The median muscle strength in the operated arm was 17.26 N, while the median was 20.06 N in the non-operated arm, thus suggesting that there was a significant loss of muscle strength (p = 0.005). The difference in muscle strength loss between the patients with and without evident deformity was not considered statistically significant (p = 0.977). Conclusion: The patients who underwent arthroscopic tenotomy on the long head of the biceps with or without apparent clinical deformity from distal migration presented similar elbow flexion muscle strength

ADVANCES IN UPPER LIMB MODELLING: IMPLICATIONS FOR TESTING CRICKET BOWLING ACTIONS

This study investigates the effect of glenohumeral joint centre (GHJ) mislocation on elbow flexion-extension kinematics and outlines the development and validation of functionally based 2DoF upper-limb model that is proposed to more accurately measure elbow flexion-extension angles. The findings suggest that a new regression equation be adopted to calculate the GHJ centre used in the definition of the upper arm anatomical coordinate system. The research also proposes that a 2DoF mean finite helical axis model (HAM) be used to describe upper limb motion as it more accurately measures flexion-extension angles when compared with traditional anatomically based models as validated against a mechanical arm moving through known ranges and angles. The HAM model also eliminated cross-talk on elbow flexion-extension kinematics

Monitoring muscle fatigue following continuous load changes

Department of Human Factors EngineeringPrevious studies related to monitoring muscle fatigue during dynamic motion have focused on detecting the accumulation of muscle fatigue. However, it is necessary to detect both accumulation and recovery of muscle fatigue in dynamic muscle contraction while muscle load changes continuously. This study aims to investigate the development and recovery of muscle fatigue in dynamic muscle contraction conditions following continuous load changes. Twenty healthy males conducted repetitive elbow flexion and extension using 2kg and 1kg dumbbell, by turns. They performed the two tasks of different intensity (2kg intensity task, 1kg intensity task) alternately until they felt they could no longer achieve the required movement range or until they experienced unacceptable biceps muscle discomfort. Meanwhile, using EMG signal of biceps brachii muscle, fatigue detections were performed from both dynamic measurements during each dynamic muscle contraction task and isometric measurements during isometric muscle contraction right before and after each task. In each of 2kg and 1kg intensity tasks, pre, post and change value of EMG amplitude (AEMG) and center frequency were computed respectively. They were compared to check the validity of the muscle fatigue monitoring method using Wavelet transform with EMG signal from dynamic measurements. As a result, a decrease of center frequency in 2kg intensity tasks and an increase of center frequency in 1kg intensity tasks were detected. It shows that development and recovery of muscle fatigue were detected in 2kg and 1kg intensity tasks, respectively. Also, the tendency of change value of center frequency from dynamic measurements were corresponded with that from isometric measurements. It suggests that monitoring muscle fatigue in dynamic muscle contraction conditions using wavelet transform was valid to detect the development and recovery of muscle fatigue continuously. The result also shows the possibility of monitoring muscle fatigue in real-time in industry and it could propose a guideline in designing a human-robot interaction system based on monitoring user's muscle fatigue.clos

Downhill running impairs peripheral but not central neuromuscular indices in elbow flexor muscles

The purpose of this study was to examine the effects of a 1-h downhill running exercise on the elbow flexor muscles’ neuromuscular functions. Seventeen adults (Control [CON]: n = 9; Experimental [EXP]: n = 8) completed this study. The CON rested for 30 min while the EXP performed the downhill running. Before, 10 min, 24 h, and 48 h after the interventions, dependent variables (knee extensor muscle soreness, elbow flexion and knee extension isometric strength, elbow flexion resting twitch and voluntary activation [VA], and the biceps surface electromyography [EMG] amplitude) were measured. Knee extensor muscle soreness was significantly greater in the EXP than the CON group following the intervention throughout the entire 48 h. This was accompanied by the greater decline in the knee extension strength in the EXP than the CON (mean ± SD: -6.9 ± 3.4% vs. 1.0 ± 3.2%, p = 0.044). The elbow flexion strength, VA, and EMG amplitude were not affected by the exercise. However, the decline of the elbow flexion resting twitch was greater in the EXP than the CON (−19.6 ± 6.3% vs. 8.7 ± 5.9%, p = 0.003). Therefore, the downhill running impaired the remote elbow flexor muscles at a peripheral level

Characteristics of counter-movements in sport climbing: A comparison between experienced climbers and beginners

学位記番号：保博甲12