Appropriate sampling strategies for estimation of exposure to physical risk factors require knowledge of exposure variability over time. Limited information is available about the variability of exposure to physical risk factors for upper extremity musculoskeletal disorders, especially during non-cyclic work activities. We investigated the magnitude and relative contributions of several sources of variance to the total exposure variance among office, custodial, or maintenance workers (N = 5 per group). In addition, we examined the homogeneity of exposure within each group of workers and exposure contrast between groups of workers. Activation of the flexor carpi radialis and upper trapezius muscle groups was assessed with surface electromyography (EMG) and wrist motion was assessed with electrogoniometry. Exposure information was collected continuously over a complete work shift on two occasions. We observed a substantial contribution of the within-day-within-subject variance component to the total exposure variance for all EMG and electrogoniometer summary measures. We also observed limited exposure contrast between the occupational groups in summary measures of upper trapezius EMG and most electrogoniometry summary measures. The large within-day-within-subject variance suggests the need for prolonged measurement durations (e.g., more than 1 hr) in future epidemiologic investigations of associations between exposure to physical risk factors and upper extremity musculoskeletal disorders.

Title: Analysis of the motion of dominant upper extremity during offensive stroke in badminton performed by elite female players Objectives: Objective of my master thesis is to analyse movement of a dominant upper extremity during offensive stroke in badminton and to point out possible risk factors for injuries and soft tissue overload problems in the region of the upper limb. Methods: The theoretical part deals with anatomical and kinesiological description of upper extremities. Then there is a description of the motion on the court and upper strokes in badminton and movements of upper extremity during the strokes. The practical part deals with measuring of rotations in shlouder joints and with analysis of motion of upper extremity during offensive stroke in badminton. It is focused on measuring the range of motion, angular velocity and angular acceleration in joints of dominant upper extremity. The Xsens MVN was used to record motion. Results: The results showed that the internal rotation in the shoulder joint on the dominant upper limb during active movement examination is reduced in elite female badminton players. When an offensive strike is played, the players come to the extreme inner rotation in the shoulder joint. Next we found out that the risky movement during the offensive stroke is...

No description available.

Inledning: Den optimala intensiteten för styrkeökning vid styrketräning anses vara 60–70% av 1RM (repetitions maximum). Ocklusionsträning innebär träning i samband med delvis strypning av det arteriella blodflödet via ett yttre tryck proximalt på extremiteten. Vid ocklusionsträning används oftast en yttre belastning som endast motsvarar 20–40% av 1RM. Syftet med den här litteraturöversikten var att undersöka effekten av lågintensiv ocklusionsträning i övre extremitet avseende styrka och hypertrofi i muskler proximalt och distalt om ocklusionen jämfört med hög- och/eller lågintensiv styrketräning. Metod: En systematisk litteratursökning genomfördes 2023-03-01. Databaserna som söktes var PubMed, SPORTDiscus och CINAHL. Sökningen kompletterades genom granskning av inkluderade studiers referenslistor. En kvalitetsgranskning av det sammanvägda resultatet utfördes enligt the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Resultat: Sökningen genererade 151 enskilda artiklar varav 15 artiklar inkluderades i studien. Kvalitetsgranskningen av underlaget visade på låg (⨁⨁◯◯) evidensgrad enligt GRADE. Två studier visade något större styrkeökning för ocklusionsträning jämfört med lågintensiv styrketräning på distal muskulatur, en visade ingen skillnad. Två studier visade större hypertrofi i ocklusionsgruppen jämfört med lågintensiv styrketräning på distal muskulatur, en visade ingen skillnad. Jämfört med högintensiv styrketräning på distal muskulatur var resultaten motsägelsefulla gällande styrka och hypertrofi. För proximal muskulatur gav ocklusionsträning större styrkeökningoch hypertrofi jämfört med lågintensiv styrketräning enligt majoriteten av studierna men verkade ge lägre styrkeökning och hypertrofi än högintensiv styrketräning. Konklusion: Ocklusionsträning i övre extremitet hos friska vuxna ger med låg säkerhet större styrkeökning och hypertrofi i muskulatur distalt och proximalt om ocklusionen jämfört med lågintensiv styrketräning. Jämfört med högintensiv styrketräning verkar ocklusionsträning ge relativt likvärdiga resultat för muskulatur distalt om ocklusionen men lägre styrkeökning och hypertrofi för proximal muskulatur. Dock bör dessa resultat tolkas med försiktighet på grund av de stora diskrepanserna mellan studierna när det kommer till träningsprotokoll, ocklusionsprotokoll och utvärderingsmetoder. / Introduction: The optimal intensity for strength gain during resistance training is thought to be 60-70% of 1RM (repetition maximum). Blood flow restriction training (BFRT) is when the arterial blood flow is partially occluded by a cuff placed proximally on the extremity during training. Usually during BFRT an external load equal to only 20-40% of 1RM is used. The aim of this study was to examine the effect of low intensity BFRT in the upper extremity regarding strength and hypertrophy in muscles proximally and distally to the occlusion site compared to high intensity resistance training (HI-RT) and/or low intensity resistance training (LI-RT). Method: A systematic search was conducted 2023-03-01. The databases that were searched wasPubMed, SPORTDiscus and CINAHL. The original search was supplemented by exploring the reference lists from the included studies. A quality assessment of the overall result was conducted according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Of 151 identified articles, 15 were included in the study. The quality assessment showed low (⨁⨁◯◯) quality evidence according to GRADE. Two studies showed slightly higher strength gain after BFRT compared to LI-RT in distal muscles, one study showed no difference between groups. Two studies showed higher hypertrophy after BFRT compared to LI-RT in distal muscles, one study showed no difference between groups. Compared to HI-RT on distal muscles the results were contradictory regarding strength and hypertrophy. BFRT on proximal muscles produced higherstrength gain and hypertrophy than LI-RT according to most studies but seemed to provide lower strength gain and hypertrophy than HI-RT. Conclusion: BFRT in the upper extremity generates, with low certainty, higher strength andhypertrophy in muscles distally and proximally to the occlusion site compared to LI-RT. Compared to HI-RT, BFRT produces equivalent results in distal muscles but lower strength gain and hypertrophy in muscles proximally to the occlusion site. These results should be interpreted with caution due to the large discrepancy between the included studies regarding training protocols, occlusion protocols and assessment methods.

No description available.

If unaccounted for, differences in human anatomy can lead to adverse clinical outcomes for patients. The literature describes numerous variations of branches of the brachial artery; the most common anomaly is found as high as 25% of the time, in which the brachial artery passes over the median nerve, splitting the brachial artery into superficial and deep branches. Another common variation of the forearm arterial supply includes branching of the radial artery from the brachial artery proximal to the antecubital fossa (12.5%). Herein, we report a unique variation found in a 96-year-old white whole-body formalin-fixed male donor, dissected with typical dissection techniques. Although predictably bifurcating at the cubital fossa, the relative calibers and distribution of the ulnar and radial arteries in the forearm were notably atypical. The common interosseous artery branched from the radial artery rather than the ulnar artery, and distally branched into the anterior and posterior interosseous arteries. This morphology resulted in the deep anterior forearm and entirety of the posterior forearm relying on the radial artery for perfusion. There was also a notable size difference between the ulnar and radial arteries in which the radial artery was much larger. A review of the literature revealed two articles reporting this unique anomaly. It is important clinically to understand this abnormal branching pattern, as various medical procedures involve the radial artery. The radial artery is commonly used to gain access to circulation for cardiac catheterization and stent placement and can also be accessed for cannulation for a variety of medical procedures. Awareness of radial artery dominance reduces the possibility of iatrogenic injury and increases positive clinical outcomes. This protocol was reviewed by the VCOM IRB (#2022-050).

No description available.

Interscalene nerve blocks are common procedures performed before upper extremity surgeries in order to provide post-op pain relief and improve recovery time. Here we present two cases of patients who underwent a unilateral supraclavicular and bilateral interscalene nerve block, respectively. The first patient had no risk factors but the second presented with a body mass index of 45.5 and a history of symptoms consistent with obstructive sleep apnea but never diagnosed. Both patients experienced some form of respiratory distress diagnosed via changes in chest x-ray and clinical presentation. The mechanism of injury that occurs in these procedures is typically from inadvertent damage to the phrenic nerve. Mild adverse effects in interscalene nerve block are relatively common. However, there is minimal data in regards to performing bilateral interscalene nerve blocks. The purpose of this study is to highlight that severe complication in both high and low-risk patients can occur but may be reduced with a safer approach and more effective communication among multidisciplinary team members.

Due the fear of Sudden Infant Death Syndrome (SIDS), parents have been putting infants on their backs. The American Academy of Pediatrics (AAP) started to recommend balancing sleeping in supine with prone play - also called Tummy Time-to encourage optimal, healthy infant development (Zachry & Kitzman, 2011). Due to various reasons, parents avoid putting the infants in the prone position even when awake. Evidence-based literature has shown that infants sleeping in supine without spending time in prone can lead to motor delay in their first year of life (Barlett & Fanning Kneale, 2003; Dudek-Shriber & Zelazny, 2007). Evidence also shows that weight bearing in prone is associated with motor development (Salls et al. 2002). This doctoral project attempts to identify the links between prone activities, postural control and fine motor development through research on evidence-based literature. It also provides a theoretical foundation, investigates the evidence and best practice in designing an educational package on prone play for typically developing and high risks infants. It also advocates best practice in occupational therapy by addressing a lack of evidenced based literature and attempts to add to the knowledge base in regards to tummy time and its effect on fine motor development. The target audiences are parents and caregivers of infants; the health care professionals that work with them; the funding agencies and policy makers. The qualitative and quantitative benefits of the parent education program will align with health promotion and wellness initiatives of the Ontario government. The project will describes a detailed evaluation plan and dissemination of results with estimated budgets. This will include presentation to the community and the ministries in the government. The project will contribute to these areas of occupational therapy: (1) addressing evidence-based practice in tummy time with typically developing and high risks infants; (2) providing best practice for implementing a Prone to Play program to foster upper extremity motor development; and (3) promoting health and wellness initiatives in occupational therapy.

Aim and research questions: The aim of this master thesis was to test for test-retest reliability for a newly developed force instrument (FI) and determine if a combined effect of trial, speed and resistance exist on the variable fraction effective force (FEF) for a group of athletes with cerebral palsy (CP-group) and a reference group (AB-group).  1. What is the intraclass correlation coefficient on maximum velocity measured on two occasions with the FI for a CP-group and an AB-group? 2. What is the intraclass correlation coefficient on FEF for a flexion movement measured on two occasions for an AB-group? 3. Is there an interaction effect of; a) trial and group, b) trial, speed and group, c) trial, resistance and group and d) trial, speed, resistance and group, on the variable FEF for a flexion movement for a CP-group and an AB-group?   Method: This master thesis was an experimental cross-sectional study with a test-retest design. Data collection took place in Stockholm and in Elche (Spain), 2022. Participants visited the BMC laboratory at two occasions. Participants completed tasks with their least impaired arm (CP-group) or dominant arm (AB-group) in a horizonal movement at different resistances and speeds on the FI. Maximum velocity together with force in 3 directions was registered. FEF was calculated from the three forces. ICC on Vmax for both groups and FEF for the AB-group was conducted together with a mixed-design ANOVA on de independent variables trial, group, speed and resistance on the dependent variable FEF.    Results: 18 participants in the CP-group and 20 participants in the AB-group was included for statistical analysis. The ICC on Vmax was .944 for the CP-group and .804 for the AB-group. The mean ICC for FEF was .644 for the AB-group. Using a mixed-design ANOVA concluded that there was no significant interaction effect on trial, group, speed and resistance, F(4) =2.069, p=.088, nor in any of the other combinations.    Conclusion: The newly developed FI shows good test-retest reliability for both groups and could be used for measurements of arm coordination. Further studies are needed to further evaluate reliability of the instrument. / Syfte och frågeställningar: Syftet med detta examensarbete var att testa för test-retest reliabilitet för ett nyutvecklat kraftinstrument (FI) och avgöra om det finns en kombinerad effekt av testtillfälle, hastighet och motstånd på variabeln fraction effective force (FEF) för en grupp idrottare med cerebral pares (CP-grupp) och en referensgrupp (AB-grupp). 1. Vad är intraclass correlation coefficient för maximal hastighet mätt vid två tillfällen med för en CP-grupp och AB-grupp? 2. Vad är intraclass correlation coefficient för FEF för en flexionsrörelse mätt vid två tillfällen för en AB-grupp? 3. Finns det en interaktionseffekt mellan; a) testtillfälle och grupp, b) testtillfälle, hastighet och grupp, c) testtillfälle, motstånd och grupp och d) testtillfälle, hastighet, motstånd och grupp, på variabeln FEF för en flexionsrörelse för en grupp med CP och AB-grupp?   Metod: Denna masteruppsats en experimentell tvärsnittsstudie med test-retest design. Datainsamlingen genomfördes i Stockholm och Elche (Spanien), 2022. Deltagarna besökte BMC laboratoriet vid två tillfällen och genomförde rörelser i horisontalplan i olika hastigheter, mot olika motstånd med sin minst funktionsnedsatta arm (CP-gruppen) eller dominanta arm (AB-gruppen) på FI. Den maximala hastigheten tillsammans med kraft i tre riktningar samlades in. FEF beräknades utifrån de tre krafterna. Den statistiska analysen innehöll ICC som genomfördes för Vmax för båda grupperna samt för FEF för AB-gruppen. En mixed-design ANOVA genomfördes med de oberoende variablerna testtillfälle, grupp, motstånd och hastighet på den beroende variabeln FEF.   Resultat: 18 deltagare i CP-gruppen och 20 deltagare i AB-gruppen inkluderades i den statistiska analysen. ICC på Vmax för CP-gruppen var .944 och .804 för AB-gruppen. Ett medelvärde på ICC för FEF i en flexionsrörelse var .644 för AB-gruppen. Det fanns ingen signifikant interaktionseffekt på testtillfälle, grupp, hastighet och motstånd, F (4) = 2.069, p = .088, och inte heller för de andra kombinationerna.    Konklusion: Den nyutvecklade instrumentet visar på god reliabilitet vid upprepade mätningar för båda grupperna och kan användas i framtida för mätningar av arm-koordination hos de två grupperna. Men fortsatta studier behövs för att vidare utvärdera reliabilitet för instrumentet.