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Musculoskeletal system
Published in David A Lisle, Imaging for Students, 2012
For suspected rotator cuff disease, radiographs of the shoulder are used to diagnose calcific tendonosis (Fig. 8.53) and to exclude underlying bony pathology as a cause of shoulder pain. US is the investigation of choice for suspected rotator cuff tear (Fig. 8.54). MRI is used as a problem-solving tool for difficult or equivocal cases.
Development of a more biofidelic musculoskeletal model with humeral head translation and glenohumeral ligaments
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Sujata Khandare, Meghan E. Vidt
Computational musculoskeletal modeling is a useful tool for understanding the biomechanics of the upper extremity, especially when in vivo tests are not feasible. In this study, we developed and validated a model of the upper extremity with increased biofidelity by including HHT and ligament representations at the glenohumeral joint. Results of computational analyses closely matched results of previous studies investigating function of individual ligaments and the effect of shoulder elevation on HHT. Inclusion of ligaments and HHT in the model facilitate prediction of conditions like subacromial impingement that could be followed by clinical conditions, like rotator cuff tear. Evaluating HHT and its effect on joint loading during upper limb tasks can provide a better understanding of GH joint stability and help predict upper extremity movements and joint mechanics.
Forward dynamic optimization of handle path and muscle activity for handle based isokinetic wheelchair propulsion: A simulation study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Nithin Babu Rajendra Kurup, Markus Puchinger, Margit Gföhler
van der Woude, Dallmeijer et al. (2001) reported that the hand-rim was the most favoured mode of propulsion by a large percentage of wheelchair users even though it follows the least efficient pattern of propulsion. The use of the hand-rim may lead to severe upper limb injuries mainly in the shoulder joint such as rotator cuff tear and injuries in the wrist region caused by the discontinuous and complex upper limb movements during propulsion (Arnet et al. 2012). Studies focused on the kinematic aspects of push rim propulsion, have shown that the joints of the upper limb exhibit large ranges of motion and at certain extreme joint limits, the muscles may need to produce relatively large forces to maintain the propulsion cycle. In such situations the muscles operate in unfavourable regions of their force–length curves, resulting in limited force production and subsequently leading to musculoskeletal injury and pain (Rao et al. 1996; Wei et al. 2003).
Shoulder muscular activity in individuals with low back pain and spinal cord injury during seated manual load transfer tasks*
Published in Ergonomics, 2018
Clark R. Dickerson, Talia Alenabi, Bernard J. Martin, Don B. Chaffin
This study had some limitations. There was a heterogeneity in the level of spinal cord injuries and hence, the trunk control (Mulroy et al. 2004), however, all of the paraplegic individuals had normal innervation of the upper-extremity muscles. Although there was some variation in our participant pool, the differences in shoulder demands were substantial enough to be detected. Chronic LBP is also an inclusive term and is insensitive to discriminating causality. Future studies could study a narrower population, though this may be pragmatically difficult to ensure and would limit the scope of application of findings. The individuals in control group were younger than the participants in LBP and SCI groups. We have acknowledged that this may complicate direct inferences regarding the exact relative personal contributors to the responses. However, the younger controls had less risk of asymptomatic rotator cuff tear in their shoulders. Although higher muscular demands were observed for these load transfer tasks, accumulation and association with potential muscular fatigue over the course of a workday or workweek was not specifically evaluated. Finally, monitoring additional muscles would provide a more holistic characterisation of shoulder function in these tasks but was precluded by experimental expediency and equipment.