Study Design: Single group pretest-posttest. Background: There is a lack of consensus concerning the preferred assessment and treatment for radial epicondylalgia. Objectives: Determine whether deficiencies in muscle force, joint range of motion, or painful force threshold are detected when measurements from the involved upper extremity are normalized to values from the uninvolved extremity. Methods and Measures: Ten patients (70% men) 42 ± 7 years in age with unilateral radial epicondylalgia participated. The visual analog pain scale and 6 measurements involving either muscle force, joint range of motion, or painful force threshold were examined. Results: When comparing the initial assessments to final assessments, a significant improvement was found for the visual analog pain scale (5 ± 3 vs 1 ± 3) and for the following normalized scores: grip (78 ± 26% vs 101 ± 20%) and isometric wrist extension forces (68 ± 24% vs 95 ± 35%), painful force threshold over the lateral epicondyle (49 ± 22% vs 94 ± 14%), and active wrist extension range of motion (83 ± 13% vs 96 ± 10%). Conclusions: Normalized force and range of motion measurements following treatment for unilateral radial epicondylalgia are sensitive assessments of patient progress. In comparison with measurements of force and range of motion that are not adjusted to a baseline score, normalized measurements detect changes in patient responses when baseline scores vary.

The primary objective of this research was the design of an easy to use C++ Graphical User Interface (GUI) which helps the user to choose the task that he/she wants to perform. This C++ application provides a platform intended for upper arm rehabilitation applications. The user can choose from different tasks such as: Assistive Function in 3D Space to Traverse a Linear Trajectory, User Controlled Velocity Based Scaling, Fitts' Task in X, Y, Z Directions. According to a study conducted by the scientific journal of the American Academy of Neurology, stroke patients aided by robotic rehabilitation devices gain significant improvement in movement. They also indicate that both initial and long term recovery are greater for patients assisted by robots during rehabilitation. This research aims to provide a haptic interface C++ platform for clinicians and therapists to study human arm motion and also to provide assistance to the user. The user would get to choose andperform repetitive tasks aimed at improving his/her muscle memory. About eight healthy volunteers were chosen to perform a set of preliminary experiments on this haptic integrated C++ platform. These experiments were performed to get an indication of the effectiveness of the assistance functions provided in this C++ application. The eight volunteers performed the Fitts' Task in X, Y and Z directions. The subjects were divided into two groups, where one of the groups was given training without assistance and the other was given training with assistance. The execution time for both the groups was compared and analyzed. The experiments performed were preliminary, however some trends were observed: the people who received training with assistive force feedback took less execution time compared to those who were given training without any assistance. The path following error was also analyzed. These preliminary tests were performed to demonstrate the haptic platform's use as a therapeutic assessment application, a rehabilitation tool and a data collection system for clinicians and researchers.

The National Occupational Research Agenda stresses the importance of identifying work-related musculoskeletal disorder (WMSD) risk factors, understanding their exposure dependent nature, and identifying strategies to reduce their incidence and severity. We first examined behavioral changes after exposure to a low repetition low force (LRLF) reaching task for 12 weeks in young rats. We observed increased movement reversals in LRLF - week 8, indicative of a decline in fine motor control, and a small decrease in voluntary task participation in LRLF - week 12, compared to controls. This decline was associated temporally with a low-grade increase of macrophages in peripheral nerve and distal forelimb bones that correlated with nociceptive neurochemical increases in the spinal cord. We next examined motor behavior changes in young rats exposed to either a food retrieval high repetition negligible force (HRNF) task or a lever pulling high repetition low force (HRLF) reaching task. We found that both tasks led to motor declines, with more marked declines in fine motor control in the HRNF group. Thus, repetition, rather than the difference in force magnitude between the 2 tasks, appears to be the key factor in the induction of motor declines associated with repetitive motion injuries (RMIs). Also, these findings indicate that activities involving negligible force do not necessarily pose a lower risk than activities involving low force. Factors such as fine motor coordination requirements may even pose greater risks. Also, compared to the LRLF task, the high repetition tasks resulted in more motor performance declines, thus confirming exposure-dependency in the context of RMI. We also explored the effects of HRNF and HRLF tasks on supraspinatus tendon of young adult rats in 6 and 12 weeks. We found a small but non-significant elevation of ED1+ macrophages in 6 weeks. The supraspinatus tendon does not appear to develop as many pathological changes as forelimb flexor tendons (Barbe, et al., 2003) with task performance. Lastly, we examined the effects of performing HRLF tasks in aged rats. We found that aged rats demonstrate both declines in motor performance and pathological tissue changes over the course of 12 weeks of exposure to the HRLF lever pulling task. The observed declines in grip strength in aged trained control and HRLF rats over time suggest that both age and cumulative exposure to the repetitive task are factors in the development of WMSDs. Our findings suggest that additional study of exposure-dependency and risk factors is warranted. Deeper understanding of the relative contributions of various risk factors can help inform prophylactic programs and/or interventions for individuals who are at risk for, or suffer from, WMSDs. / Physical Therapy