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Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
Central post-stroke pain is a form of neuropathic pain occurring in the affected side of the body. It should be treated in a similar way to other neuropathic pains (see page 81). Shoulder pain is also seen following stroke. Shoulder–hand syndrome is autonomically mediated (reflex sympathetic dystrophy). Here the pain may be associated with swelling and changes in colour or temperature of the affected arm. An alternative cause is shoulder subluxation related to motor weakness. This can largely be prevented by appropriate patient positioning/support and careful use of handling techniques to avoid strain on the shoulder joint. Paracetamol, topical NSAIDs or transcutaneous electrical nerve stimulation may be tried.6
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The shoulder joint is supported by a number of ligaments and a group of muscles, known as the rotator cuff. The rotator cuff is formed by the supraspinatus superiorly, the subscapularis anteriorly, the infraspinatus posteriorly and the teres minor inferiorly (see Figure 7.58). The main function of the rotator cuff is to draw the head of the humerus into the glenoid, stabilizing the shoulder. Dysfunction of the rotator cuff following overuse or overload is a common cause of shoulder dysfunction.
Shoulder and elbow
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
From each observation point, look for scars, swelling, redness and deformity of the joint when compared to the other side. Standing in front of the patient, look for: deformity of the clavicleswasting of the deltoid muscles.Standing to the side of the patient, look for: swelling of the lateral aspect of the shoulder joint.Standing behind the patient, look for: wasting of the trapezius musclesnormal position, size and shape of the scapulae. Ask the patient to press their hands against a wall, and look for winging – this indicates damage to the long thoracic nerve supplying serratus anterior.
Convolutional LSTM: a deep learning approach to predict shoulder joint reaction forces
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
According to the Global Burden of Diseases (GBD) 2010 study, the musculoskeletal disorders (MSDs) are the second most common cause of disability globally (Vos et al. 2012). The GBD 2010 study also listed occupational risk factors to be one of the top three major contributors to MSD-caused years-lived-with-disability (Vos et al. 2012). Among work-related MSDs, the shoulder MSDs (accounted for 16.6% of all MSD cases) are the costliest— $28,288 per claim—and severe type of days-away-from-work (DAFW) injury in the United States, requiring 28.3 median days to recover before returning to work (Bureau of Labor Statistics 2019). The vulnerability of the shoulder complex to injuries is because the main joint in the shoulder complex, the glenohumeral joint, is highly unstable (Andrews et al. 2008), which arises due to the loose-fitting of the humeral head into the glenoid cavity—only 30% of humeral head is in contact with the glenoid cavity—at any given shoulder position (Soslowsky et al. 1992). The stability of the glenohumeral joint, also known as the shoulder joint, is primarily ensured by the coordinated action of the surrounding shoulder muscles to produce net internal joint reaction forces to counteract translational (shear) forces produced by the external loading (Lippitt and Matsen 1993). Therefore, an efficient and feasible estimation method of the shoulder joint reaction forces can contribute to identifying exertions that lead to injury and disability, aiding rehabilitation planning, and improving the product design (e.g., implant, exoskeleton, and soft robotics).
The effects of pistol grip power tools on median nerve pressure and tendon strains
Published in International Journal of Occupational Safety and Ergonomics, 2022
Ryan Bakker, Mayank Kalra, Sebastian S. Tomescu, Robert Bahensky, Naveen Chandrashekar
The prepared specimen was then secured to the custom-built hand simulator (Figure 2). The shoulder joint was connected with a bearing to allow for shoulder abduction and screwed into the humerus with a 9.52-mm threaded rod. The length of the system from the bearing (point of rotation) to the elbow was measured to be 30 cm. The cables that were sutured to the exposed tendons were passed through a series of pullies posterior to the elbow and the weights were suspended from each cable to simulate muscle forces. The muscle forces applied to these tendons through weights are presented in Table 1 and were calculated using linear interpolation to find the muscle forces at 20% of the maximum gripping task forces for an elliptical handle, equivalent to 156 N of grip force [17].
Predictors of the effect of an arm sling on gait efficiency in stroke patients with shoulder subluxation: a pre-post design clinical trial
Published in Physiotherapy Theory and Practice, 2022
Yeon-Gyu Jeong, Yeon-Jae Jeong, Hyun-Sook Kim, Kyu Hoon Lee
On the same day, each subject completed gait trials with and without a vest-type shoulder forearm support (Kang’s multi-support sling; Jeong Lib O & P, Hangang-ro 1 ga, Korea) on their hemiplegic side. The vest-type shoulder forearm support has been found to prevent glenohumeral subluxation by stabilizing the shoulder joint (Kang, Seo, Yu, and Ha, 1996). A computer-generated 1:1 blocked randomization procedure was applied to secure an even number of participants for the pre-post design of our study: subjects assigned odd numbers walked with the arm sling first and those assigned even numbers walked without the arm sling first. An individual with no involvement in the study prepared 57 numbers concealed in opaque, sealed envelopes, which were opened after completion of the baseline evaluation. All sessions were led by two physical therapists with more than 5 years of experience in rehabilitation medicine who were trained in the intervention protocols to minimize the risk of contamination. All outcome assessments were evaluated by two blinded assessors who were located offsite.