901 resultados para TENNIS ELBOW


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INTRODUCTION Micro- or macroreplantation is classified depending on the level of amputation, distal or proximal to the wrist. This study was performed to review our experience in macroreplantation of the upper extremity with special attention to technical considerations and outcomes. MATERIALS AND METHODS Between January 1990 and December 2010, 11 patients with a complete amputation of the upper extremity proximal to the wrist were referred for replantations to our department. The patients, one woman and ten men, had a mean age of 43.4 ± 18.2 years (range 19-76 years). There were two elbow, two proximal forearm, four mid-forearm, and three distal forearm amputations. The mechanism of injury was crush in four, crush-avulsion in five and guillotine amputation in two patients. The Chen classification was used to assess the postoperative outcomes. The mean follow-up after macroreplantation was 7.5 ± 6.3 years (range 2-21 years). RESULTS All but one were successfully replanted and regained limb function: Chen I in four cases (36 %), Chen II in three cases (27 %), Chen III in two cases (18 %), and Chen IV in one patient (9 %). We discuss the steps of the macroreplantation technique, the need to minimize ischemic time and the risk of ischemia reperfusion injuries. CONCLUSION Thanks to improvements in technique, the indications for limb preservation after amputation can be expanded. However, because of their rarity, replantations should be performed at specialist replantation centers. LEVEL OF EVIDENCE Level IV.

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HYPOTHESIS We hypothesized that arthroscopic rotator cuff repairs using leukocyte- and platelet-rich fibrin (L-PRF) in a standardized, modified protocol is technically feasible and results in a higher vascularization response and watertight healing rate during early healing. METHODS Twenty patients with chronic rotator cuff tears were randomly assigned to 2 treatment groups. In the test group (N = 10), L-PRF was added in between the tendon and the bone during arthroscopic rotator cuff repair. The second group served as control (N = 10). They received the same arthroscopic treatment without the use of L-PRF. We used a double-row tension band technique. Clinical examinations including subjective shoulder value, visual analog scale, Constant, and Simple Shoulder Test scores and measurement of the vascularization with power Doppler ultrasonography were made at 6 and 12 weeks. RESULTS There have been no postoperative complications. At 6 and 12 weeks, there was no significant difference in the clinical scores between the test and the control groups. The mean vascularization index of the surgical tendon-to-bone insertions was always significantly higher in the L-PRF group than in the contralateral healthy shoulders at 6 and 12 weeks (P = .0001). Whereas the L-PRF group showed a higher vascularization compared with the control group at 6 weeks (P = .001), there was no difference after 12 weeks of follow-up (P = .889). Watertight healing was obtained in 89% of the repaired cuffs. DISCUSSION/CONCLUSIONS Arthroscopic rotator cuff repair with the application of L-PRF is technically feasible and yields higher early vascularization. Increased vascularization may potentially predispose to an increased and earlier cellular response and an increased healing rate.

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Robotic exoskeletons can be used to study and treat patients with neurological impairments. They can guide and support the human limb over a large range of motion, which requires that the movement trajectory of the exoskeleton coincide with the one of the human arm. This is straightforward to achieve for rather simple joints like the elbow, but very challenging for complex joints like the human shoulder, which is comprised by several bones and can exhibit a movement with multiple rotational and translational degrees of freedom. Thus, several research groups have developed different shoulder actuation mechanism. However, there are no experimental studies that directly compare the comfort of two different shoulder actuation mechanisms. In this study, the comfort and the naturalness of the new shoulder actuation mechanism of the ARMin III exoskeleton are compared to a ball-and-socket-type shoulder actuation. The study was conducted in 20 healthy subjects using questionnaires and 3D-motion records to assess comfort and naturalness. The results indicate that the new shoulder actuation is slightly better than a ball-and-socket-type actuation. However, the differences are small, and under the tested conditions, the comfort and the naturalness of the two tested shoulder actuations do not differ a lot.

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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.

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BACKGROUND: Several clinical studies on chronic stroke conducted with end-effector-based robots showed improvement of the motor function in the affected arm. Compared to end-effector-based robots, exoskeleton robots provide improved guidance of the human limb and are better suited to train task-oriented movements with a large range of motions. OBJECTIVE: To test whether intensive arm training with the arm exoskeleton ARMin I is feasible with chronic-stroke patients and whether it improves motor function in the paretic arm. METHODS: Three single cases with chronic hemiparesis resulting from unilateral stroke (at least 14 months after stroke). A-B design with 2 weeks of multiple baseline measurements (A), 8 weeks of training (B) with repetitive measurements and a follow-up measurement 8 weeks after training. The training included shoulder and elbow movements with the robotic rehabilitation device ARMin I. Two subjects had three 1-hour sessions per week and 1 subject received five 1-hour sessions per week. The main outcome measurement was the upper-limb part of the Fugl-Meyer Assessment (FMA). RESULTS: The ARMin training was well tolerated by the patients, and the FMA showed moderate, but significant improvements for all 3 subjects (p < 0.05). Most improvements were maintained 8 weeks after discharge. CONCLUSIONS: This study indicates that intensive training with an arm exoskeleton is feasible with chronic-stroke patients. Moderate improvements were found in all 3 subjects, thus further clinical investigations are justified.

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BACKGROUND: Robot-assisted therapy offers a promising approach to neurorehabilitation, particularly for severely to moderately impaired stroke patients. The objective of this study was to investigate the effects of intensive arm training on motor performance in four chronic stroke patients using the robot ARMin II. METHODS: ARMin II is an exoskeleton robot with six degrees of freedom (DOF) moving shoulder, elbow and wrist joints. Four volunteers with chronic (>or= 12 months post-stroke) left side hemi-paresis and different levels of motor severity were enrolled in the study. They received robot-assisted therapy over a period of eight weeks, three to four therapy sessions per week, each session of one hour.Patients 1 and 4 had four one-hour training sessions per week and patients 2 and 3 had three one-hour training sessions per week. Primary outcome variable was the Fugl-Meyer Score of the upper extremity Assessment (FMA), secondary outcomes were the Wolf Motor Function Test (WMFT), the Catherine Bergego Scale (CBS), the Maximal Voluntary Torques (MVTs) and a questionnaire about ADL-tasks, progress, changes, motivation etc. RESULTS: Three out of four patients showed significant improvements (p < 0.05) in the main outcome. The improvements in the FMA scores were aligned with the objective results of MVTs. Most improvements were maintained or even increased from discharge to the six-month follow-up. CONCLUSION: Data clearly indicate that intensive arm therapy with the robot ARMin II can significantly improve motor function of the paretic arm in some stroke patients, even those in a chronic state. The findings of the study provide a basis for a subsequent controlled randomized clinical trial.

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The match time spent on court in racquet sports can be perceived as dependent on the effort an athlete is willing to exert in a competition. Achievement motivation is defined as the effort a person spends on a difficult task with the completion of which she wants to meet a personal standard of excellence, wants to improve herself, or outperform others (McClelland, Atkinson, Clark, & Lowell, 1953). Fifty-two professionals of three racquet sports (tennis, table tennis, and badminton) filled in a questionnaire on their explicit achievement motive, a scale on general life stress, and a measure of the implicit achievement motive. Results indicate that the implicit but not the explicit achievement motive was able to predict the athletes' time spent on court (effort). Additionally the general life stress scale was negatively related to time spent on court. Findings are in line with theoretical assumptions that actual behavior is linked to the implicit achievement motive and that higher levels of general life stress lead to impaired performance in sports.

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Einleitung und Fragestellung In der Forschung zum Selbstgespräch im Sport dominiert die Frage nach dessen Wir-kung auf die Leistung. Der Einfluss des während der Leistungserbringung geäußerten Selbstgesprächs auf (un-)beteiligte Personen (z.B. Zuschauer, Gegenspieler oder Dop-pelpartner) wurde bislang kaum untersucht. Van Raalte, Brewer, Cornelius und Petitpas (2006) konnten immerhin zeigen, dass Zuschauer einen Tennisspieler als kompetenter einschätzen, wenn er in einem Laborexperiment mit positivem statt mit negativem Selbst-gespräch gezeigt wurde. In unserer Studie stehen Dyaden im Zentrum, in der eine Person eine andere beobach-tet, die mit sich selbst spricht. Untersucht wird, ob bei einer additiven Teamaufgabe sol-che Beobachtungen einen Effekt auf die Kompetenzeinschätzung und die Anstren-gungsbereitschaft haben. Es wird vermutet, dass die beobachtende Person dann eine höhere Anstrengungsbereitschaft (AV) zeigt, wenn sie einen Teampartner mit positivem Selbstgespräch (UV) beobachtet, da sie ihren Partner als kompetenter einschätzt und diese Einschätzung als Mediator wirkt. Methode Es wurde ein randomisierter Zweigruppen-Versuchsplan mit zwei Experimentalgruppen (je n=20) durchgeführt. Das Treatment bestand aus einem Video, das den (jeweils identi-schen) Teampartner bei der Bewältigung der zu absolvierenden visuomotorisch-koordinativen Testaufgabe zeigt (Test 2HAND des Wiener Testsystems). Das Video wur-de abhängig von der Gruppenzugehörigkeit mit negativen respektive positiven Selbstge-sprächsaussagen unterlegt. Die Mediatorvariable wahrgenommene Kompetenz wurde mittels eines Fragebogens erhoben, der in Anlehnung an Van Raalte et al. (2006) entwi-ckelt wurde. Das Vorgehen zur Erhebung der abhängigen Variable Anstrengungsbereit-schaft wurde von Ohlert (2009) übernommen: Die Probanden erhielten die Möglichkeit, sich auf die spätere Testphase vorzubereiten. Erfasst wurde dabei die Zeit, die sie für die Vorbereitung in Anspruch nahmen, und die Genauigkeit, mit der sie eine Reihe von Aufwärmaufgaben absolvierten. Ergebnisse Die Datenerhebung wurde soeben abgeschlossen. Die Ergebnisse der noch ausstehen-den regressionsanalytischen Auswertung werden auf der Tagung präsentiert. Literatur Ohlert, J. (2009). Teamleistung. Social Loafing in der Vorbereitung auf eine Gruppenaufgabe. Hamburg: Dr. Kovac. Van Raalte, J. L., Brewer, B. W., Cornelius, A. E. & Petitpas, A. J. (2006). Self-presentational effects of self-talk on perceptions of tennis players. Hellenic Journal of Psychology, 3, 134-149.

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Ausgangslage und Fragestellung In der Forschung zum Selbstgespräch im Sport dominiert die Frage nach dessen Auswir-kungen auf die sprechende Person selber. Gemäss Diaz (1992) besitzt das offene Selbstgespräch aber neben der individuell-regulatorischen auch eine sozial-kommunikative Funktion. Diese sozial-kommunikative Funktion und der damit verbunde-ne Einfluss des Selbstgesprächs auf Beobachter wurden in der Sportwissenschaft bisher nur marginal untersucht (z.B. Gould & Weiss, 1981; Van Raalte, Brewer, Cornelius & Pe-titpas, 2006). Im angestrebten Forschungsvorhaben sollen zwei Fragen geklärt werden: Steht das of-fene, während dem Wettkampf geäusserte Selbstgespräch eines Athleten in Zusammen-hang mit dessen Selbstdarstellung? Beeinflusst das offene Selbstgespräch eines Athle-ten den Dyadenpartner und wie sie sich gegenseitig wahrnehmen? Methode Es werden Doppelpartien im Badminton per Videokamera aufgezeichnet. Mittels einer Korrelationsanalyse soll überprüft werden, ob die so erhobenen Selbstgesprächsaussa-gen mit dem Persönlichkeitsmerkmal „Selbstdarstellung“ der Probanden zusammenhän-gen. Nach Spielschluss werden die Probanden entsprechend eines video-stimulierten Fremdkonfrontationsinterviews mit Spielausschnitten konfrontiert, die offenes Selbstge-spräch ihres Dyadenpartners enthalten. Sie werden dabei nach ihren Kognitionen sowie Emotionen gefragt, die sie während der entsprechenden Spielsituation erlebten. Aktuelle Fragen Welcher Fragebogen zur Erhebung des Persönlichkeitsmerkmals „Selbstdarstellung“ soll Verwendung finden? Zur Auswahl steht ein noch zu übersetzender, validierter, engli-scher und sportspezifischer Fragebogen und die Verwendung eines deutschen Frage-bogens, der habituelle Selbstdarstellungstechniken im Allgemeinen erhebt. Wie soll beim video-stimulierten Fremdkonfrontationsinterview vorgegangen werden? Werden den Probanden z.B. das ganze Spiel oder nur ausgewählte Ausschnitte gezeigt, in denen offenes Selbstgespräch vorkommt? Wie zeitnah muss das Interview durchge-führt werden? Literatur Diaz, R. M. (1992). Methodological Concerns in the Study of Private Speech. In R. M. Diaz & L. E. Berk (Eds.), Private speech. From social interaction to self-regulation (pp. 55-81). Hillsdale, NJ: Lawrence Erlbaum. Gould, D. & Weiss, M. (1981). The effects of model similarity and model talk on self-efficacy and muscular endurance. Journal of Sport Psychology, 3, 17-29. Van Raalte, J. L., Brewer, B. W., Cornelius, A. E. & Petitpas, A. J. (2006). Self-presentational effects of self-talk on perceptions of tennis players. Hellenic Journal of Psychology, 3, 134-149.

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Introduction According to Lent and Lopez’ (2002) tripartite view of efficacy beliefs, members of a team form beliefs about the efficacy of their team partners. This other-efficacy belief can influence individual performance as shown by Dunlop, Beatty, and Beauchamp (2011) in their experimental study using manipulated performance feedback to alter other-efficacy beliefs. Participants holding favorable other-efficacy beliefs outperformed those with lower other--‐efficacy beliefs. Antecedents of such other-efficacy beliefs are amongst others perceptions regarding motivation and psychological factors of the partner (Jackson, Knapp, & Beauchamp, 2008). Overt self-talk could be interpreted as the manifestation of such motivational or psychological factors. In line with this assumption, in an experimental study using dubbed videos of the same segment of a tennis match, Van Raalte, Brewer, Cornelius, and Petitpas (2006) found that players were perceived more favorably (e.g., more concentrated, and of higher ability levels) when shown with dubbed positive self-talk as compared to dubbed negative or no dubbed self--‐talk. Objectives The aim of the study was to examine the possible effects of a confederate’s overt self-talk on participants’ other-efficacy beliefs and performance in a team setting. Method In a laboratory experiment (between-subjects, pre-post-test design, matched by pretest performance) 89 undergraduate students (female = 35, M = 20.81 years, SD = 2.34) participated in a golf putting task together with a confederate (same gender groups). Depending on the experimental condition (positive, negative, or no self-talk), the confederate commented his or her putts according to a self-talk script. Bogus performance feedback assured that the performance of the confederate was held constant. Performance was measured as the distance to the center of the target, other-efficacy by a questionnaire. Results The data collection has just finished and the results of repeated measures analyses of variance will be presented and discussed at the congress. We expect to find higher other-efficacy beliefs and better individual performance in the positive self-talk condition. References Dunlop, W.L., Beatty, D.J., & Beauchamp, M.R. (2011). Examining the influence of other-efficacy and self-efficacy on personal performance. Journal of Sport & Exercise Psychology, 33, 586-593. Jackson, B., Knapp, P., & Beauchamp, M.R. (2008). Origins and consequences of tripartite efficacy beliefs within elite athlete dyads. Journal of Sport and Exercise Psychology, 30, 512-540. Lent, R.W., & Lopez, F.G. (2002). Cognitive ties that bind: A tripartite view of efficacy beliefs in growth--‐promoting relationships. Journal of Social and Clinical Psychology, 21, 256-286. Van Raalte, J.L., Brewer, B.W, Cornelius, A.E., & Petitpas, A.J. (2006). Self-presentational effects of self-talk on perceptions of tennis players. Hellenic Journal of Psychology, 3, 134-149.

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BACKGROUND The etiology of rotator cuff disease is age related, as documented by prevalence data. Despite conflicting results, growing evidence suggests that distinct scapular morphologies may accelerate the underlying degenerative process. The purpose of the present study was to evaluate the predictive power of 5 commonly used radiologic parameters of scapular morphology to discriminate between patients with intact rotator cuff tendons and those with torn rotator cuff tendons. METHODS A pre hoc power analysis was performed to determine the sample size. Two independent readers measured the acromion index, lateral acromion angle, and critical shoulder angle on standardized anteroposterior radiographs. In addition, the acromial morphology according to Bigliani and the acromial slope were determined on true outlet views. Measurements were performed in 51 consecutive patients with documented degenerative rotator cuff tears and in an age- and sex-matched control group of 51 patients with intact rotator cuff tendons. Receiver operating characteristic analyses were performed to determine cutoff values and to assess the sensitivity and specificity of each parameter. RESULTS Patients with degenerative rotator cuff tears demonstrated significantly higher acromion indices, smaller lateral acromion angles, and larger critical shoulder angles than patients with intact rotator cuffs. However, no difference was found between the acromial morphology according to Bigliani and the acromial slope. With an area under the receiver operating characteristic curve of 0.855 and an odds ratio of 10.8, the critical shoulder angle represented the strongest predictor for the presence of a rotator cuff tear. CONCLUSION The acromion index, lateral acromion angle, and critical shoulder angle accurately predict the presence of degenerative rotator cuff tears.

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Nach Krug und Kuhl (2006) sollten die Motivprofile von Leistungssportlern eine Passung zu den Anforderungen der jeweiligen Sportart aufweisen. Diesen Annahmen zufolge sollten bei Leistungssporttreibenden insbesondere das Leistungs- und Machtmotiv dominant sein. Im Rahmen zweier Studien wurde die Stärke des Macht-, Leistungs- und Anschlussmotivs von Leistungssporttreibenden mit denen von Freizeitsporttreibenden verglichen. In Studie 1 wurden die Motivprofile von 29 Leistungssporttreibenden mit denen von 34 Freizeitsportreibenden aus technik- und ausdauerorientierten Sportarten verglichen. An Studie 2 nahmen 86 Tennis-, Tischtennis- und Badmintonspieler als Hochleistungssportler teil deren Motivprofile mit denen von 57 Freizeitsporttreibenden aus interaktiven Sportarten verglichen wurden. Die impliziten Motive wurden mit Bildgeschichtenübungen (Picture Story Exercise, Operanter Motive Test) erhoben, die expliziten Motive mit Fragebögen (Zielsetzungsinventar, Personality Research Form). Die Ergebnisse bestätigen die Annahmen, dass Leistungssporttreibende höhere implizite und explizite Leistungsmotive als Freizeitsporttreibende zeigen. Die Unterschiede in den Anschlussmotiven und impliziten Machtmotiv wurden nur bei Hochleistungssportlern aus interaktiven Sportarten (Studie 2) gefunden.

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Research on performance and participation in (elite) sports has predominantly focused on variables relating to the achievement motive. However, some authors describe that athletes in interactive sports (e.g. tennis) are assumed to exhibit a strong power motive in order to win competitive matches, usually resulting in the demonstration of dominance or the experience of inferiority. The affiliation motive, by contrast, is not functional in elite sports due to their competitive rather than social character. In the present chapter we discuss how the three basic implicit motives of power, affiliation, and achievement relate to the sports field and describe how they can affect athletes’ performance. We present empirical evidence for the existence of different strengths of the three basic motives in three studies with elite athletes (Study 1), non-elite athletes (sport students, Study 2), and non-sport students infrequently involved in sports (Study 3). Our results suggest that elite athletes show higher levels of the implicit power motive compared to sport students, who in turn have higher power motives than non-sport students. Surprisingly, elite athletes do not differ from non-sport students regarding their implicit achievement motive. Moreover, non-sport students exhibit higher implicit affiliation motive scores than sport students and elite athletes. We propose that research on motivational processes of highly competitive athletes should – in addition to the achievement motive – focus more on motive themes like the implicit motives of power and affiliation.

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OBJECTIVE Precise adaptable fixation of a supracondylar humerus osteotomy with a radial/lateral external fixator to correct posttraumatic cubitus varus. INDICATIONS Acquired, posttraumatic cubitus varus as a result of a malhealed and unsatisfactorily treated supracondylar humerus fracture. Idiopathic, congenital cubitus varus (very seldom) if the child (independent of age and after complete healing) is cosmetically impaired; stability of the elbow is reduced due to malalignment (hyperextension); secondary problems and pain (e. g., irritation of the ulnar nerve) are expected or already exist; or there is an explicit wish of the child/parents (relative indication). CONTRAINDICATIONS In principle there are no contraindications provided that the indication criteria are filled. The common argument of age does not represent a contraindication in our opinion, since angular remodeling at the distal end of the humerus is practically nonexistent. SURGICAL TECHNIQUE Basically, the surgical technique of the radial external fixator is used as previously described for stabilization of complex supracondylar humeral fractures. With the patient in supine position, the arm is placed freely on an arm table. Using a 4-5 cm long skin incision along the radial, supracondylar, the extracapsular part of the distal humerus is prepared, whereby great caution regarding the radial nerve is advised. In contrast to the procedure used in radial external fixation for supracondylar humeral fracture treatment, two Schanz screws are always fixed in each fragment at a distance of 1.5-2 cm. The osteotomy must allow the fragment to freely move in all directions. The proximal and distal two Schanz screws are then connected with short 4 mm carbon or stainless steel rods. These two rods are connected with each other over another rod using the tub-to-tub technique. Now the preliminary correction according the clinical situation can be performed and the clamps are tightened. Anatomical axis and function are checked. If these are radiologically and clinically perfect, all clamps are definitively tightened; if the alignment or the function is not perfect, then further adjustments can be made. POSTOPERATIVE MANAGEMENT Due to the excellent stability, further immobilization not necessary. Immediate functional follow-up treatment performed according to pain. RESULTS Adequate healing is usually expected within 6 weeks. At this time the external fixator can be removed in the fracture clinic. Because the whole operation is performed in an extraarticular manner and the mobility of the elbow is not affected, deterioration of function has never been observed. Also regarding the cosmetic/anatomical situation, good results are expected because they were already achieved intraoperatively.

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Objective In the pediatric population traumatic injuries of the upper extremity are common. After therapy a decision has to be made if the mobility of the joint lies within a normal range. The purpose of this study was to give an introduction to normative data. We investigate if there is a significant difference in the range of motion (ROM) between male and female probands and furthermore, if an effect of the age can be detected. Methods We performed an institutional review board-approved study of healthy girls and boys aged between 2 and 16 years without any medical history of an upper extremity fracture. We investigated the active ROM of the elbow, wrist, metacarpophalangeal, and interphalangeal joints. Furthermore, age, handedness, weight, and height were recorded. A total of 171 adolescents with a mean age of 10.6 years were included and separated into four cohorts by age: 2 to 5, 6 to 10, 11 to 13, and 14 to 16 years. Results We found significant differences between the genders in the age group from 11 to 13 years for the flexion of the elbow, the pronation, the flexion of the interphalangeal joint of the thumb, as well as the flexion of the metacarpophalangeal joints of digitus II to V. Furthermore, a significant difference in the same joints except from the elbow flexion could be demonstrated between the genders. Conclusion Our study contributes normative data for upper extremity ROM in the pediatric population and presents a gender-related difference in certain joints. Clinical Relevance Normative data for the ROM of upper extremity joints in children is helpful for the evaluation of pediatric orthopedic patients and provides the framework for therapeutic resolution. Since a great number of traumatic injuries in children affect the upper extremity, this information may help the physician to estimate the impact of the injury and decide on the therapeutic management.