Study on the activation of the biceps brachii compartments in normal subjects

Les prothèses myoélectriques modernes peuvent être dotées de plusieurs degrés de liberté ce qui nécessite plusieurs signaux musculaires pour en exploiter pleinement les capacités. Pour obtenir plus de signaux, il nous a semblé prometteur d'expérimenter si les 6 compartiments du biceps brachial pouvaient être mis sous tension de façon volontaire et obtenir ainsi 6 signaux de contrôle au lieu d'un seul comme actuellement. Des expériences ont donc été réalisées avec 10 sujets normaux. Des matrices d'électrodes ont été placées en surface au-dessus du chef court et long du biceps pour recueillir les signaux électromyographiques (EMG) générés par le muscle lors de contractions effectuées alors que les sujets étaient soit assis, le coude droit fléchi ~ 100 ° ou debout avec le bras droit tendu à l'horizontale dans le plan coronal (sur le côté). Dans ces deux positions, la main était soit en supination, soit en position neutre, soit en pronation. L'amplitude des signaux captés au-dessus du chef court du muscle a été comparée à ceux obtenus à partir du chef long. Pour visualiser la forme du biceps sous les électrodes l'imagerie ultrasonore a été utilisée. En fonction de la tâche à accomplir, l'activité EMG a était plus importante soit dans un chef ou dans l'autre. Le fait de pouvoir activer préférentiellement l'un des 2 chefs du biceps, même si ce n'est pas encore de façon complètement indépendante, suggère que l'utilisation sélective des compartiments pourrait être une avenue possible pour faciliter le contrôle des prothèses myoélectriques du membre supérieur.

Les mouvements passifs: un traitement de choix chez la clientèle blessée médullaire?

Travail d'intégration présenté à la Faculté de médecine en vue de l’obtention du grade de maîtrise professionnelle en physiothérapie

Marker placement to describe the wrist movements during activities of daily living in cyclical tasks

Objective. To describe the wrist kinematics during movement through free range of motion and activities of daily living using a cyclical task. Design. The wrist angles were initially calculated in a calibration trial and then in two selected activities of daily living (jar opening and carton pouring). Background. Existing studies which describe the wrist movement do not address the specific application of daily activities. Moreover, the data presented from subject to subject may differ simply because of the non-cyclical nature of the upper limbs movements. Methods. The coordinates of external markers attached to bone references on the forearm and dorsal side of the hand were obtained using an optical motion capture system. The wrist angles were derived from free motion trials and successively calculated in four healthy subjects for two specific cyclical daily activities (opening a jar and pouring from a carton). Results. The free motions trial highlighted the interaction between the wrist angles. Both the jar opening and the carton pouring activity showed a repetitive pattern for the three angles within the cycle length. In the jar-opening task, the standard deviation for the whole population was 10.8degrees for flexion-extension, 5.3degrees for radial-ulnar deviation and 10.4degrees for pronation-supination. In the carton-pouring task, the standard deviation for the whole population was 16.0degrees for flexion-extension, 3.4degrees for radial-ulnar deviation and 10.7degrees for pro nation-supination. Conclusion. Wrist kinematics in healthy subjects can be successfully described by the rotations about the axes of marker-defined coordinates systems during free range of motion and daily activities using cyclical tasks.

An item response analysis of the motor and behavioral subscales of the unified Huntington's disease rating scale in huntington disease gene expansion carriers

Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features.

Participation of the deltoid (anterior portion) and pectoralis major (clavicular portion) muscles in different modalities of supine and frontal elevation exercises with different grips

The muscles deltoid-anterior portion (DA) and pectoralis major-clavicular portion (PMC) were analysed to establish the muscular behavior and intensity patterns, as well to evaluate the connected participation of these muscles during supine and frontal elevation exercises. Twenty-four male volunteers were examined using a 2-channel TECA TE4 electromyograph and Hewlett Packard surface electrodes. Our results showed low levels of activity to PMC in frontal elevation exercises, whereas to DA the levels were very high. In the supine exercise, the action potential levels developed by the PMC were always lower than those presented by DA, however, with action simultaneity. Some suggestions to the use of the tested exercises are presented.

Forças manuais e o design de produtos: uma revisão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Classification of handwriting patterns in patients with Parkinson´s disease, using a biometric sensor

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Three-dimensional joint kinematics of swimming using body-worn inertial and magnetic sensors

Wearable inertial and magnetic measurements units (IMMU) are an important tool for underwater motion analysis because they are swimmer-centric, they require only simple measurement set-up and they provide the performance results very quickly. In order to estimate 3D joint kinematics during motion, protocols were developed to transpose the IMMU orientation estimation to a biomechanical model. The aim of the thesis was to validate a protocol originally propositioned to estimate the joint angles of the upper limbs during one-degree-of-freedom movements in dry settings and herein modified to perform 3D kinematics analysis of shoulders, elbows and wrists during swimming. Eight high-level swimmers were assessed in the laboratory by means of an IMMU while simulating the front crawl and breaststroke movements. A stereo-photogrammetric system (SPS) was used as reference. The joint angles (in degrees) of the shoulders (flexion-extension, abduction-adduction and internal-external rotation), the elbows (flexion-extension and pronation-supination), and the wrists (flexion-extension and radial-ulnar deviation) were estimated with the two systems and compared by means of root mean square errors (RMSE), relative RMSE, Pearson’s product-moment coefficient correlation (R) and coefficient of multiple correlation (CMC). Subsequently, the athletes were assessed during pool swimming trials through the IMMU. Considering both swim styles and all joint degrees of freedom modeled, the comparison between the IMMU and the SPS showed median values of RMSE lower than 8°, representing 10% of overall joint range of motion, high median values of CMC (0.97) and R (0.96). These findings suggest that the protocol accurately estimated the 3D orientation of the shoulders, elbows and wrists joint during swimming with accuracy adequate for the purposes of research. In conclusion, the proposed method to evaluate the 3D joint kinematics through IMMU was revealed to be a useful tool for both sport and clinical contexts.

On-table reconstruction of comminuted fractures of the radial head

The most widely accepted treatment for comminuted fractures of the radial head is either the excision or open reduction and internal fixation. The purpose of the present study is to evaluate the value of an 'on-table' reconstruction technique in severely comminuted fractures of the radial head. In this study, two patients with a Mason type-III and four patients with a Mason type-IV radial-head fracture were treated with 'on-table' reconstruction and fixation using low-profile mini-plates. After a mean follow-up of 112 months (47-154 months), the mean elbow motion was 0-6-141 degrees extension flexion with 79 degrees of pronation and 70 degrees of supination. The mean Broberg and Morrey functional rating score was 97.0 points, the Mayo Elbow Performance Index was 99.2 points and the mean Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure score was 1.94 points. One patient had symptoms of degenerative changes, with a slight joint-space narrowing. There were no radiographic signs of devitalisation at final examination. Comminuted fractures of the radial head, which would otherwise require excision, can be successfully treated with an 'on-table' reconstruction technique.

ARMin III – arm therapy exoskeleton with an ergonomic shoulder actuation

Rehabilitation robots have become important tools in stroke rehabilitation. Compared to manual arm training, robot-supported training can be more intensive, of longer duration and more repetitive. Therefore, robots have the potential to improve the rehabilitation process in stroke patients. Whereas a majority of previous work in upper limb rehabilitation robotics has focused on end-effector-based robots, a shift towards exoskeleton robots is taking place because they offer a better guidance of the human arm, especially for movements with a large range of motion. However, the implementation of an exoskeleton device introduces the challenge of reproducing the motion of the human shoulder, which is one of the most complex joints of the body. Thus, this paper starts with describing a simplified model of the human shoulder. On the basis of that model, a new ergonomic shoulder actuation principle that provides motion of the humerus head is proposed, and its implementation in the ARMin III arm therapy robot is described. The focus lies on the mechanics and actuation principle. The ARMin III robot provides three actuated degrees of freedom for the shoulder and one for the elbow joint. An additional module provides actuated lower arm pro/supination and wrist flexion/extension. Five ARMin III devices have been manufactured and they are currently undergoing clinical evaluation in hospitals in Switzerland and in the United States.

Monteggia lesion in an Asian small-clawed otter (Aonyx cinerea).

A 10-yr-old female Asian small-clawed otter (Aonyx cinerea) presented with a history of right forelimb lameness. Antebrachial radiographs revealed a Monteggia lesion, classified by cranial radial head luxation and distal diaphyseal ulnar fracture. Open reduction with placement of an ulnar-radial positional screw was performed. The lateral collateral ligament was reconstructed using suture anchored by a condylar screw and bone tunnel in the radius. Reduction and proper implant placement was confirmed on postoperative radiographs. The ulnar-radial positional screw was removed 6 wk postoperatively to allow proper supination and pronation. Limb function was greatly improved at this time; however, a mild lameness was still observed. At 7 mo postoperatively, the otter was ambulating lameness-free. Radiographs documented proper joint reduction and stable condylar screw. At 32 mo postoperatively, the otter continued to exhibit normal ambulation.

Transfer of resistance training to enhance rapid coordinated force production by older adults

The purpose of this study was to examine the capacity of resistance training to enhance the rapid and coordinated production of force by older people. Thirty adults (greater than or equal to 60 years) completed a visually guided aiming task that required the generation of isometric torque in 2 df about the elbow prior to and following a 4-week training period. Groups of six participants were allocated to two progressive ( 40 - 100% maximal voluntary contraction (MVC)) resistance-training (PRT) groups, to two constant low-load (10% MVC) training groups (CLO) and to one no-training control group. Training movements required the generation of either combined flexion and supination (FLESUP), or combined extension and supination (EXTSUP). In response to training, target acquisition times in the aiming task decreased for all groups; however, both the nature of the training load and the training movement influenced the pattern and magnitude of improvements (EXTSUP_ CLO: 36%, FLESUP_ PRT 26%, EXTSUP_ PRT 22%, FLESUP_ CLO 20%, CONTROL 15%). For one group that trained with progressively increasing loads, there arose a subsequent decrease in performance in one condition of the transfer task. For each group, these adaptations were accompanied by systematic changes in the coordination of muscles about the elbow joint, particularly the biceps brachii.

Neuromuscular adaptation during skill acquisition on a two degree-of-freedom target-acquisition task: Isometric torque production

In this study we attempted to identify the principles that govern the changes in neural control that occur during repeated performance of a multiarticular coordination task. Eight participants produced isometric flexion/extension and pronation/supination torques at the radiohumeral joint, either in isolation (e.g., flexion) or in combination (e.g., flexion - supination), to acquire targets presented by a visual display. A cursor superimposed on the display provided feedback of the applied torques. During pre- and postpractice tests, the participants acquired targets in eight directions located either 3.6 cm (20% maximal voluntary contraction [MVC]) or 7.2 cm (40% MVC) from a neutral cursor position. On each of five consecutive days of practice the participants acquired targets located 5.4 cm (30% MVC) from the neutral position. EMG was recorded from eight muscles contributing to torque production about the radiohumeral joint during the pre- and posttests. Target-acquisition time decreased significantly with practice in most target directions and at both target torque levels. These performance improvements were primarily associated with increases in the peak rate of torque development after practice. At a muscular level, these changes were brought about by increases in the rates of recruitment of all agonist muscles. The spatiotemporal organization of muscle synergies was not significantly altered after practice. The observed adaptations appear to lead to performances that are generalizable to actions that require both greater and smaller joint torques than that practiced, and may be successfully recalled after a substantial period without practice. These results suggest that tasks in which performance is improved by increasing the rate of muscle activation, and thus the rate of joint torque development, may benefit in terms of the extent to which acquired levels of performance are maintained over time.

Neuromuscular adaptation during skill acquisition on a two degree-of-freedom target-acquisition task: Dynamic movement

In this experiment, we examined the extent to which the spatiotemporal reorganization of muscle synergies mediates skill acquisition on a two degree-of-freedom (df) target-acquisition task. Eight participants completed five practice sessions on consecutive days. During each session they practiced movements to eight target positions presented by a visual display. The movements required combinations of flexion/extension and pronation/supination of the elbow joint complex. During practice sessions, eight targets displaced 5.4 cm from the start position ( representing joint excursions of 54) were presented 16 times. During pre- and posttests, participants acquired the targets at two distances (3.6 cm [36 degrees] and 7.2 cm [72 degrees]). EMG data were recorded from eight muscles contributing to the movements during the pre- and posttests. Most targets were acquired more rapidly after the practice period. Performance improvements were, in most target directions, accompanied by increases in the smoothness of the movement trajectories. When target acquisition required movement in both dfs, there were also practice-related decreases in the extent to which the trajectories deviated from a direct path to the target. The contribution of monofunctional muscles ( those producing torque in a single df) increased with practice during movements in which they acted as agonists. The activity in bifunctional muscles ( those contributing torque in both dfs) remained at pretest levels in most movements. The results suggest that performance gains were mediated primarily by changes in the spatial organization of muscles synergies. These changes were expressed most prominently in terms of the magnitude of activation of the monofunctional muscles.

Muscle coordination during rapid force production by young and older adults

Background. Older adults typically exhibit dramatic reductions in the rate of force development and deficits in the execution of rapid coordinated movements. The purpose of the current study was to investigate the association between the reduced rate of force development exhibited by older adults and the ability to coordinate groups of muscles. Methods. The performance of a visually guided aiming task that required the generation of isometric torque about the elbow joint was compared in 10 young adults (age range, 19 to 29 years) and 10 older adults (age range, 65 to 80 years). Participants were required to exert isometric torque in flexion, extension, pronation, or supination, or in combinations of these directions, to reach a target in minimum time. Surface electromyograms were obtained from the biceps brachii, triceps brachii, brachioradialis, and flexor carpi radialis. Results. Older participants exhibited slower target acquisition times compared with young participants (p < .05), with the extent of the differences between the groups varying markedly between target locations. Conclusions. The impairment in performance, although partially attributable to a general decline in the ability to produce force rapidly, was also affected by the requirements for muscular coordination. At the neuromuscular level, differences between the young and the elderly were expressed most prominently in the bifunctional muscle biceps brachii and in certain temporal aspects of muscular coordination.