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Neurosurgery: Supratentorial tumors
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Monica S. Tandon, Kashmiri Doley, Daljit Singh
Patients may be placed in the supine, lateral, semi-sitting, park bench, or prone positions, depending on the site and the surgical approach to the lesion. These patients are more vulnerable to peripheral nerve damage and pressure injuries from malpositioning than younger patients, due to their skin atrophy and decreased skin integrity (5). Hence it is important to ensure that their extremities are placed in an anatomically neutral position, there is no overstretching of any extremity or joint, and all pressure points are adequately padded. A combination of gel pads, foam cushions, pillows, and padded armrests are used for these purposes. Eyes should also be protected well to avoid any compression on the eyeballs. The specific precautions to be taken during the positioning of the head and the neck have been described previously in the section “Surgical approaches and patient positioning”.
Fundamental Techniques Of Microvascular Anastomosis
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
Positioning of the surgeon is very important prior to starting microvascular anastomosis. The surgeon should sit at a comfortable height at right angles to the vessel to be anastomosed and his forearms should rest on the operating table to prevent tremor or shivering of the hands, because “stable hands” are of paramount importance in doing such fine work. Armrests attached to a special motorized chair are commercially available, but have some limitations in clinical use. The authors prefer to use folded drapes or towels beneath the forearms to adjust the height of the hands, depending on the level of the vessel to be anastomosed. The needle holder, scissors, and the forceps should be held like a pen and manipulated with rotational finger motions, resting on the hypothenar eminences (Figure 4).
Vehicle Modifications: Useful Considerations for Life Care Planners*
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
At that time: Norm's wheelchair armrests were replaced and adjusted so that they allowed for proper fit of his seat belt when in the driver's position.Correct Smart view mirrors and front fender mirror were installed.Vehicle armrest was replaced and adjusted appropriately.Turn signal controls and G/B controls were adjusted correctly
Investigating the impacts of working at home among office workers with neck pain on health status, depression and sleep quality during the COVID-19 pandemic
Published in International Journal of Occupational Safety and Ergonomics, 2023
Another study by Malińska et al. [30] showed that predictive factors of neck pain in workers aged 20–25 years were associated with increased physical exertion at work (odds ratio [OR] 2.63, 95% confidence interval [CI] [1.55, 4.45]), the inability to adjust armrests (OR 0.39) and a lack of chair back support (OR 0.10, 95% CI [0.01, 1.00]). The current study supports the relation between inappropriate ergonomic features and neck pain intensity with the high scores of the neck pain and disability index (NPDI) in home office workers. So, the rate of absence of back support and the rate of absence of flexible back support were higher in home office workers. Also, most home office workers used a chair without adjustable seat height and arm support. The importance of arm support was underlined in a phase III cohort study for prevention of neck pain in office workers and the research revealed that the risk of developing neck/shoulder disorders was low in workers who use chairs with armrests compared to those who use chair without armrests [31]. Another review showed evidence about low-risk neck pain and use of a chair with armrests [22]. Lack of arm support may cause stress on the upper back, and developed strain on the neck [32]. The adjustable height seat importance for office workers’ neck pain risk factor was supported by a study in which the risk of neck pain in men was increased by the absence of a chair with adjustable height of the seat plate [30].
Measurements and observations of movements at work for warehouse forklift truck operators
Published in International Journal of Occupational Safety and Ergonomics, 2022
Bo Rolander, Mikael Forsman, Bijar Ghafouri, Farhad Abtahi, Charlotte Wåhlin
Several commonly identified risk factors for work-related neck and shoulder pain, such as holding the hands above shoulder level, heavy manual handling and monotonous hand/arm work, were not pronounced for the operators in the workplace in the present study. Although they are exposed to periods of postural load, the inclinometer measurements indicated relatively few occasions with extreme head movements in rotation, flexion or extension. This finding is also in line with the video review. However, more studies are needed to further evaluate the physical impact of tasks such as driving with the body in a backward or sideways position and periodically sitting with the head highly extended and rotated in order to look at high shelves. In addition, the importance of being able to relieve the arms on an armrest must be looked at. Operators’ work tasks during a working day are fairly monotonous, and this study shows the importance of increased job task rotation. In the present study, the self-reported measures of health indicates that these operators belong to a rather healthy group. However, some results in this study and the previous study by Flodin et al. [1] show that the neck and shoulders seems to be a prevalent health problem.
Profile of upper limb recovery and development of secondary impairments in patients after stroke with a disabled upper limb: An observational study
Published in Physiotherapy Theory and Practice, 2020
Louise Ada, Elisabeth Preston, Birgitta Langhammer, Colleen G Canning
Shoulder subluxation was measured on X-ray and reported in millimeters. Participants were seated in a chair without armrests, with the arm hanging freely by the side and the elbow extended. A steel ball bearing of known size was taped halfway along the clavicle to act as a reference point. Anteroposterior plain X-rays of both shoulders were taken at a focal field distance of 1 m. Shoulder subluxation was quantified using the method described by Prévost, Arsenault, Dutil, and Drouin (1987) which measures the shortest perpendicular distance in millimeters (i.e. vertical distance) between the most superior part of the head of the humerus and the inferior portion of the glenoid fossa of the affected arm. This method has demonstrated validity and reliability (Prévost, Arsenault, Dutil, and Drouin, 1987). The amount of subluxation was determined by a radiographer subtracting the distance in the affected shoulder from that in the unaffected shoulder. Vertical distance in the intact shoulder was measured once at 2 weeks after stroke.