Evaluation of the Chinese version of the disability of the arm, shoulder and hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study

Abstract
The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives
This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method
Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results
Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion
The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Construct validity of the Chinese version of the disability of the arm, shoulder and hand questionnaire (DASH-HKPWH)

The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages

Correlation between shoulder flow zone quality and material flow quantity during friction stir welding of thick aluminum section using scroll shoulder tool

The so-called scroll shoulder tool is widely used particularly for thick section friction stir welding (FSW). However, the correlation between its shoulder flow zone weld quality and material flow quantity remains unclear. This information is important for tool design. In the present study, a scroll shoulder tool was used to FSW 20mm thick 6061 aluminum (Al) plates at a range of welding parameters. The pick-up material (PUM) by the scroll was quantified, and the effect of welding parameters and PUM on the shoulder flow zone formation and weld quality was studied. It was found that there is a positive linear relationship between the PUM and weld quality. In order to obtain a defect-free FSW weld produced by the scroll shoulder tool, scroll groove needs to be fully filled by PUM.

Material flow forming the shoulder flow zone using scroll shoulder tool during friction stir welding of thick section aluminum alloys

Scroll shoulder tools are widely used and they do not need to be tilted during friction stir welding (FSW). However, the detailed material flow, which is important for proper scroll shoulder tool design and subsequently for forming the defect-free shoulder flow zone, has not been fully explained. In the present study, features of material flow in shoulder flow zone, during FSW of thick 6061 aluminium (Al) plates using a scroll shoulder tool were investigated. It was observed that there is a simple layer-to-layer banded structure which appears in the bottom portion of shoulder flow zone, but disappears in the top portion of this weld zone. When the scroll shoulder tool is plunged into the workpiece to a determined depth, the workpiece material is extruded by the tool pin, and pushed up into the scroll groove beneath the shoulder forming the pick-up material. During the forward movement of the tool, the central portion of pick-up material was driven downward by the root portion of pin and then it detaches from the tip portion of pin in a layer-to-layer manner to form the weld.

Impaction bone grafting of the glenoid in revision shoulder arthroplasty : classification, technical description and early results

Background Glenoid component fixation remains an issue in the long-term survival of total shoulder arthroplasty. As a consequence revision of the glenoid component is becoming increasingly more common and reconstructive techniques to preserve and restore bone stock are becoming more important.

Methods In this article we describe the combined technique of impaction grafting and glenoid component exchange together with a classification of the glenoid defect with a report on four sequential cases in patients with rheumatoid arthritis with an average age of 56 years. The minimum follow-up was 34 months (range 34 months to 62 months).

Results Patients reported excellent pain relief and some improvement in motion and function. The complication rate remains low. Radiological assessment using tomograms showed good incorporation of the bone graft and minimal signs of glenoid loosening.

Conclusion The results of this study confirm that at least in the short term impaction grafting techniques used to reconstitute the glenoid in revision surgery can be successful.

Greater auricular nerve neuropraxia with beach chair positioning during shoulder surgery

Neuropraxia of the greater auricular nerve is an uncommon complication of shoulder surgery, with the patient in the beach chair position. The greater auricular nerve, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. In this case series, we present three cases of neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. We outline the risk of using devices of this nature and discourage the use of similar headrest devices due to the potential complications in headrest devices that exert pressure on the posterior auricular area to maintain head position during surgery.

Understanding in-vivo abrasion fatigue or common suture materials used in arthroscopic and open shoulder surgery

In orthopaedic surgery the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow healing at the tendon-bone interface. Failure rates of this type of surgery can be as high as 25%. While the tissue suture interface is a weak link, proportions of these failures are caused by in-vivo abrasion of the suture with bone and suture anchor materials. Abrasion of the suture material results from the movement of the suture through the eyelet by the surgeon during surgery, or with limb movement after surgery as the suture is not rigidly restrained within the eyelet. During movement the suture is subjected to bending and frictional forces that can lead to fatigue induced failure. This paper investigates the mechanism of bending abrasion fatigue induced failure of number two grade braided sheath only and braided sheath/multifilament core sutures. Sutures were oscillated over a stainless steel wire at low frequency under load in a dry state to simulate the bending and frictional forces between suture and eyelet. Failure mechanism was determined by video microscopy of the suture during abrasion combined with optical microscopy analysis of partially and fully abraded sutures. Braided only structures had high friction loading on the small number of fibres at the abrasion interface. This caused rapid single fibre breakages that accumulate to cause suture failure. The addition of ultra-high molecular weight polyethylene core fibres to a braided suture distributed the applied load across multiple fibres at the abrasion interface. This improved abrasion resistance by 15-20 times that of braided sheath alone.

Combating shoulder-surfing: a hidden button gesture based scheme

This project describes an authentication technique that is shoulder-surfing resistant. Shoulder surfing is an attack in which an attacker can get access to private information by observing the user’s interaction with a terminal, or by using recording tools to record the user interaction and study the obtained data, with the objective of obtaining unauthorized access to a target user’s personal information. The technique described here relies on gestural analysis coupled with a secondary channel of authentication that uses button pressing. The thesis presents and evaluates multiple alternative algorithms for gesture analysis, and furthermore assesses the effectiveness of the technique.

Electromyographic activity of shoulder muscles during exercises performed with oscillatory and non-oscillatory poles

CONTEXTUALIZAÇÃO: A dor e a disfunção no complexo articular do ombro é comumente encontrada na prática fisioterapêutica. Essas anormalidades musculoesqueléticas estão relacionadas à instabilidade e inadequado funcionamento cinemático, que dependem da integridade dos tecidos musculares. Assim, no sentido de prevenir e reabilitar esses sintomas, o uso da haste oscilatória vem sendo implantado para melhorar os resultados de técnicas cinesioterapêuticas. OBJETIVOS: Analisar a atividade eletromiográfica (EMG) dos músculos que estabilizam a articulação do ombro durante a realização de exercícios com haste oscilatória e haste não-oscilatória. MÉTODOS: Participaram do estudo 12 voluntárias com idade de 20,4±1,9 anos. Os dados EMG foram coletados nos músculos trapézio superior (TrS), trapézio inferior (TrI) e deltoide médio (DM) durante três diferentes exercícios realizados com haste oscilatória e haste não-oscilatória. O sinal EMG foi analisado no domínio do tempo pelo cálculo do Root Mean Square (RMS). Os valores de RMS foram normalizados pelo valor de pico obtido em todas as tentativas por cada músculo. A análise estatística foi feita com os testes ANOVA para medidas repetidas e post-hoc de Bonferroni. RESULTADOS: A atividade EMG dos músculos TrS, TrI e DM foi significativamente maior nos exercícios com haste oscilatória do que com haste não-oscilatória (todos p<0,001). Não foram significativas as diferenças na ativação desses músculos entre os exercícios. CONCLUSÃO: Os resultados do presente estudo indicaram que a haste oscilatória requisitou maior atividade EMG dos músculos do ombro e, assim, pode ser um instrumento útil no treinamento desses músculos.

Electromyographic study of levator scapulae and rhomboideus major muscles in movements of the shoulder and arm

In 21 normal adult male subjects, the muscular activity of the levator scapulae and rhomboideus major muscles was studied electromyographically during the movements of the shoulder and arm. Two single coaxial needle electrodes were used for registering the action potentials. Concerning shoulder movement, it was shown that the levator scapulae was active in elevation and rhomboideus major was active in retraction. Both muscles were inactive during protrusion, in most events. Concerning free movements of the arm, both muscles were active in abduction, elevation, adduction, flexion and circumduction, but inactive in extension. During the same movements, performed with a load, we observed greater intensity in the activity of these muscles in comparison to their activity during free movements.

Electromyographic study of the trapezius muscle in free movements of the shoulder

The objective of this study is to analyze the simultaneity of the actions of the three portions of the trapezius (superior portion = TS; middle portion = TM and inferior portion = TI) in elevation, lowering, retraction and protraction of the shoulders. The electromyographic tests were carried out in 20 volunteers using a 4-channel TECA TE 2-7 electromyograph and surface and single coaxial needle electrodes. The electromyographs, obtained with the two types of electrodes, show that in elevation and lowering of the shoulders, TS and TM present increasing and decreasing activity, respectively, from the beginning until the end of these movements. In retraction of the shoulders, TM and TI present increasing activity from the beginning to the end of the movement. In protraction, TS, TM and TI do not show any activity.