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Separating Professional from Lay Ethics
Published in Howard Winet, Ethics for Bioengineering Scientists, 2021
Often, there are alternative ways of solving the problem available. A person with shoulder pain may be helped by exercise, cortisone injection, or rotator cuff surgery to ease the pain. A professional is familiar with or knows how to research alternative approaches to the problem. Some alternatives solve the client’s problem better than others. The patient may find that shoulder exercises takes more time and energy than does a cortisone injection, but has fewer pharmacological side effects. Usually, benefits and harm of each alternative treatment must be considered. Because the professional has expert knowledge, she has some basis for offering the lay person client some advice about these alternatives, too. In any case, the professional owes her client comprehensive consideration of alternative responses to the client’s need.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Following initial investigation by projectional radiography, MDCT is used to assess bone displacement, rotation and integrity of the articular surfaces of the shoulder joint and for quantifying degenerative diseases [28; 29]. MRI and ultrasound are commonly used to examine the rotator cuff [30] and MRI is used to examine joint instability and traumatic joint injury [31]. MDCT arthrography may also be used to assess joint instability [32].
Acromiohumeral distance quantification during a variety of shoulder external and internal rotational exercises in recreationally overhead athletes
Published in Research in Sports Medicine, 2022
Leyla Eraslan, Ann Cools, Ozan Yar, Selcuk Akkaya, Irem Duzgun
Shoulder problems are common among overhead athletes, and rotator cuff pathology is thought to be a principal cause of shoulder pain (Niederbracht et al., 2008; Sakata et al., 2019). The shoulder complex is highly loaded during practice and competition among overhead athletes due to repetitive high-demand throwing activities (Sakata et al., 2019). The nature of overhead sports demands a dynamic shoulder stabilization provided by the rotator cuff and scapular muscles (Bdaiwi et al., 2015; Niederbracht et al., 2008). Scapular upward rotation and posterior tilt are essential for elevating the acromion, thereby maintaining the subacromial space (Atalar et al., 2009; Bdaiwi et al., 2015). Decreased serratus anterior activity and the lack of coordination between the different parts of the trapezius may adversely affect the scapular orientation and decrease the subacromial space (Bdaiwi et al., 2015). The role of the rotator cuff muscles during shoulder elevation is to limit the superior migration of the humeral head and, therefore, increase the subacromial space (Leong et al., 2016; Mayerhoefer et al., 2009; Michener et al., 2003). Decreased infraspinatus and subscapularis activity, as well as inadequate coactivation of rotator cuff against the deltoid, is reported to be associated with superior humeral head translation, which leads to subacromial space narrowing (Myers et al., 2009; Neer, 2005; Reddy et al., 2000).
Starting and stopping kinetics of a rear mounted power assist for manual wheelchairs
Published in Assistive Technology, 2019
Stephanie Wong, Ben Mortenson, Bonita Sawatzky
Although manual wheelchairs are prescribed to increase mobility and improve independence (Cooper et al., 2006), almost half of wheelchair users need assistance (Shields, 2004). Furthermore, their use of wheelchairs may lead to upper limb injuries. Common injuries include rotator cuff tendonitis, which may cause negative long-term consequences including pain, decreased arm strength, and deconditioning (Cooper, Fitzgerald, et al., 2006; Cooper, Quatrano, et al., 1999; Kloosterman, Snoek, van der Woude, Buurke, & Rietman, 2013). Alternatives such as pushrim-activated power-assist wheels (PAPAWs), powered wheelchairs, and scooters (Kloosterman et al., 2013) were developed to overcome some of the issues associated with wheelchair use.
Acute postoperative pain management with percutaneous peripheral nerve stimulation: the SPRINT neuromodulation system
Published in Expert Review of Medical Devices, 2021
Rodney A. Gabriel, Brian M. Ilfeld
Rotator Cuff Repair. One feasibility study has been published on the use of PNS to manage acute postoperative pain following arthroscopic rotator cuff repair[14]. Fourteen patients were recruited and received either implanted lead placement to the suprascapular nerve or the brachial plexus roots/trunks via ultrasound-guidance. Two patients received the suprascapular nerve lead; however, neither received any appreciable analgesia. Thus, the subsequent patients received the leads placed immediately posterior to the brachial plexus roots/trunks. In these patients during the first two postoperative weeks, the median pain score on the numeric rating scale was 1, and patients averaged less than 5 mg oxycodone per day.