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Limb Function (limb + function)

Distribution by Scientific Domains

Medical Sciences	90%
Life Sciences	10%

Kinds of Limb Function

upper limb function

Selected Abstracts

The relationship between unimanual capacity and bimanual performance in children with congenital hemiplegia

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2010
LEANNE SAKZEWSKI
Aim, This study explores the relationship between unimanual capacity and bimanual performance for children with congenital hemiplegia aged 5 to 16 years. It also examines the relationship between impairments and unimanual capacity and bimanual performance. Method, Participants in this cross-sectional study attended a screening assessment before participating in a large, randomized trial. They comprised 70 children with congenital hemiplegia (39 males, 31 females; mean age 10y 6mo, SD 3y); 18 were classified in the Manual Ability Classification System level I, 51 in level II, and one in level III. Eighteen were in Gross Motor Function Classification System, level I and 52 in level II. Sixty-five participants had spasticity and five had dystonia and spasticity. Fifteen typically developing children (7 males, 8 females; mean age 8y 8mo, SD 2y 7mo), matched to study participants for age and sex, were recruited as a comparison group for measures of sensation, grip strength, and movement efficiency. Outcome measures for unimanual capacity were the Melbourne Assessment of Unilateral Upper Limb Function (MUUL), and the Jebsen,Taylor Hand Function Test (JTHFT). The Assisting Hand Assessment (AHA) evaluated bimanual performance. Upper limb impairments were measured using assessments of stereognosis, moving two-point discrimination, spasticity, and grip strength. Results, There was a strong relationship between unimanual capacity (MUUL) and bimanual performance (AHA; r=0.83). Linear regression indicated MUUL and stereognosis accounted for 75% of the variance in AHA logit scores. Sensory measures were moderately correlated with unimanual capacity and bimanual performance. Age, sex, and grip strength did not significantly influence bimanual performance. There was no difference between children with right- and left-sided hemiplegia for motor performance. Interpretation, Findings of our study confirm a strong relationship between unimanual capacity and bimanual performance in a cohort of children with congenital hemiplegia. However, the directionality of the relationship is unknown and therapists cannot assume improvements in unimanual capacity will lead to gains in bimanual performance. [source]

Comparison of the Melbourne Assessment of Unilateral Upper Limb Function and the Quality of Upper Extremity Skills Test in hemiplegic CP

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2008
K Klingels MSc
This study investigated interrater reliability and measurement error of the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment) and the Quality of Upper Extremity Skills Test (QUEST), and assessed the relationship between both scales in 21 children (15 females, six males; mean age 6y 4mo [SD 1y 3mo], range 5,8y) with hemiplegic CP. Two raters scored the videotapes of the assessments independently in a randomized order. According to the House Classification, three participants were classified as level 1, one participant as level 3, eight as level 4, three as level 5, one participant as level 6, and five as level 7. The Melbourne Assessment and the QUEST showed high interrater reliability (intraclass correlation 0.97 for Melbourne Assessment; 0.96 for QUEST total score; 0.96 for QUEST hemiplegic side). The standard error of measurement and the smallest detectable difference was 3.2% and 8.9% for the Melbourne Assessment and 5.0% and 13.8% for the QUEST score on the hemiplegic side. Correlation analysis indicated that different dimensions of upper limb function are addressed in both scales. [source]

A new limb salvage surgery in cases of high-grade soft tissue sarcoma using photodynamic surgery, followed by photo- and radiodynamic therapy with acridine orange

JOURNAL OF SURGICAL ONCOLOGY, Issue 6 2008
Tomoki Nakamura MD
Abstract Background To maintain excellent limb function after tumor resection in patients with high-grade malignant sarcomas, we developed and established a new surgical adjuvant therapy using acridine orange (AO) after intra-lesional or marginal resection while sparing normal tissues of major nerves, vessels or bones adjacent to the tumor. Method Our AO therapy procedure was combined with photodynamic surgery (PDS), photodynamic therapy (PDT) and radiodynamic therapy (RDT). In this study, 26 patients with primary high-grade soft tissue sarcomas were treated with AO therapy. Result Results showed a low local recurrence rate (7.7%) and good local recurrence-free rate (88%) after AO therapy. Limb function of all patients was maintained at 100% of ISOLS criteria. Conclusion Based on these results, we concluded that AO therapy is useful for local control after margin-positive tumor resection and for preserving excellent limb function in patients with high-grade soft tissue sarcomas. J. Surg. Oncol. 2008;97:523,528. © 2008 Wiley-Liss, Inc. [source]

Motor function in 5-year-old children with cerebral palsy in the South Australian population

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2009
JAMES RICE
The aim of this study was to describe the motor function of a population of children at age 5 years enrolled on the South Australian Cerebral Palsy Register. Among children born between 1993 and 1998, there were 333 with confirmed cerebral palsy (prevalence rate 2.2 per 1000 live births), in whom 247 assessments (56.7% males, 43.3% females) were completed. The distribution by Gross Motor Function Classification System (GMFCS) level was: level I, 50.6%; level II, 18.2%; level III, 9.3%; level IV, 9.7%; level V, 12.1%. The most common topographical classification was spastic diplegia (38.5%), followed by spastic hemiplegia (34.8%) and spastic quadriplegia (14.6%). Abnormal movements occurred at rest or with intention in 19.4% of children. A high proportion of the population with relatively mild gross motor impairments have difficulty with everyday bimanual tasks, reinforcing the need to assess upper limb function independently of gross motor function. The use of ankle,foot orthoses was common, particularly across GMFCS levels II to IV. Further refinement is indicated for this population's motor dataset, to include more recently described classification measures as well as future novel measures to better describe the presence of both spasticity and dystonia. [source]

Comparison of the Melbourne Assessment of Unilateral Upper Limb Function and the Quality of Upper Extremity Skills Test in hemiplegic CP

Functional anatomy and muscle moment arms of the thoracic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris)

JOURNAL OF ANATOMY, Issue 4 2008
S. B. Williams
Abstract We provide quantitative muscle,tendon architecture and geometry data for the racing greyhound thoracic limb. Muscle mass, belly length, fascicle lengths, pennation angles and moment arms were measured, as were tendon masses and lengths. Maximum isometric force and maximum power were estimated for muscles, and maximum stress and strain were estimated for tendons. Results are compared with other fast quadrupedal runners, and to previously published data in mixed-breed dogs. The implications of the functional adaptations of the greyhound thoracic limb for sprinting performance are discussed. The thoracic limb was found to benefit from a similar proportion of locomotor muscle mass to the pelvic limb, suggesting that it may be used to some extent in propulsion, or alternatively that stabilisation is very important in this animal. Extrinsic muscles, especially latissimus dorsi and pectoralis profundus, were predicted to be powerful and important for generating net positive work during accelerations. Proximal biarticular muscles show specialisation toward preventing collapse of the shoulder and elbow joints to enable strut-like limb function, or some form of dynamic control. Distal muscles did not appear specialised for elastic energy storage, a functional difference to pelvic limb muscles, and the equivalents in horse thoracic limbs. The greyhound thoracic limb appears to possess substantial differences from both that of more ,sub-maximal specialist' quadrupeds, and from the greyhound pelvic limb. [source]

Simultaneous use of bilateral caudal superficial epigastric axial pattern flaps for wound closure in a dog

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 12 2003
P. D. Mayhew
A neutered male German shorthaired pointer sustained severe bite wounds to the left caudal flank and thigh area. Thorough wound lavage and debrldement was performed immediately and also three days after presentation. Daily wound dressing resulted in the production of a mature granulation tissue bed. Prior to wound closure, colour flow Doppler ultrasonography was used to confirm blood flow through the right and left caudal superficial epigastric arteries and veins. Sixteen days after presentation, right and left caudal superficial epigastric axial pattern flaps were simultaneously elevated to cover the defect. The right flap was elevated as an island flap, rotated 120° and used to cover the caudodorsal aspect of the defect. The left flap was elevated and rotated dorsally to cover the cranioventral aspect of the defect. Ninety per cent wound coverage was achieved and flap survival was total. The donor site defect was closed primarily and no dehiscence occurred. Three months postsurgery, the entire defect was closed and limb function was normal. [source]

Transposition of the sacrotuberous ligament for the treatment of coxofemoral luxation in dogs

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 8 2002
E. Kiliç
A surgical technique is described for transposition of the sacrotuberous ligament to replace the teres ligament in the treatment of coxofemoral luxation in dogs. Ten dogs with coxofemoral luxation were treated using this technique and all animals regained full limb function within two months of surgery. It is suggested that the technique could be employed in dogs suffering from all types of hip luxations. [source]

A new limb salvage surgery in cases of high-grade soft tissue sarcoma using photodynamic surgery, followed by photo- and radiodynamic therapy with acridine orange

Outcomes of re-excision after unplanned excisions of soft-tissue sarcomas

JOURNAL OF SURGICAL ONCOLOGY, Issue 3 2005
Mark W. Manoso MD
Abstract Background and Objectives Unplanned excisions of soft-tissue sarcomas of the extremities occur commonly. Our goal was to evaluate the presence of residual disease, the treatment outcomes as they relate to local and distant recurrence and 5-year survival, and the limb functional outcomes in patients with unplanned sarcoma excision who were treated with re-excision and adjuvant therapy. Methods Between 1993 and 1999, 42 patients presented to our institution after unplanned excision of soft-tissue sarcomas. Of those 42 patients, 38 without gross residual disease or metastatic lesions formed the basis of this review. All 38 patients underwent revision wide excision; most (31) also received adjuvant therapy (radiation and/or chemotherapy). Clinical data were obtained from analysis of patient records and radiographic studies. Univariate analysis was performed with logistical regression, and multivariate analysis was performed with Cox modeling. Results The overall 5-year survival rate was 91.3% and the disease-free 5-year survival rate was 82.2%. Univariate analysis showed that stage-III disease (American Joint Committee on Cancer classification of soft-tissue sarcomas), lesions below the fascia, a histologic high-grade, and the development of organ metastasis were statistically significant factors for mortality. Stage-III disease also was significant for mortality on multivariate analysis. Only stage-III disease was significant for the development of local recurrence. Eighty-four percent of the patients had good to excellent functional outcomes. Conclusions Re-excision with adjuvant therapy proved to be a safe and effective method for treating the disease and preserving limb function. J. Surg. Oncol. 2005;91:153,158. © 2005 Wiley-Liss, Inc. [source]

Ultrasound-guided photodynamic therapy for deep seated pathologies: prospective study

LASERS IN SURGERY AND MEDICINE, Issue 9 2009
Waseem Jerjes MSc (OMFS)
Abstract Introduction Interstitial photodynamic therapy remains an attractive remedial option in minimally invasive surgery. Our aim in this prospective study was to evaluate the outcome following ultrasound-guided iPDT of deep-seated pathologies. Patients' reports on quality of life with clinical and radiological evaluation were the main end point parameters used to assess the outcome. Materials and Methods Sixty-eight patients were referred to the UCLH Head and Neck Centre for treatment of various deep-seated pathologies involving the head and neck region, upper and lower limbs. All patients underwent interstitial photodynamic therapy under general anaesthesia, using 0.15,mg/kg mTHPC as the photosensitising agent. Following treatment, patients were followed-up for a mean of 7 months. Results All three patients who presented with visual problems reported improvement after treatment. Also, 14/17 patients reported improvement of breathing. Improvement of swallowing was reported by 25/30 patients; while speaking improvement was evident in 16/22 patients and 33/40 reported reduction in the disfigurement caused by their pathology. All five patients with impeded limb function reported some degree of improvement. Clinical assessment showed that half of the patients had ,good response' to the treatment and a third reported ,moderate response' with two patients being free of disease. Radiological assessment comparing imaging 6-week post-PDT to the baseline showed stable pathology with no change in size in 13 patients, minimal response in 18 patients, moderate response in 23 patients and significant response in 11 patients. Conclusion This study on 68 patients with deep-seated pathologies undergoing interstitial photodynamic therapy provided evidence that PDT can be the fourth modality in the management of tissue disease. Lasers Surg. Med. 41:612,621, 2009. © 2009 Wiley-Liss, Inc. [source]

A review of clinical upper limb assessments within the framework of the WHO ICF

MUSCULOSKELETAL CARE, Issue 3 2007
Cheryl Metcalf BA (Hons) MSc
Abstract This paper is intended to provide a practical overview for clinicians and researchers involved in assessing upper limb function. It considers 25 upper limb assessments used in musculoskeletal care and presents a simple, straightforward comparative review of each. The World Health Organization International Classification on Functioning, Disability and Health (WHO ICF) is used to provide a relative summary of purpose between each assessment. Measurement properties of each assessment are provided, considering the type of data generated, availability of reliability estimates and normative data for the assessment. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Bilateral asymmetry in the limb bones of the chimpanzee (Pan troglodytes),

AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 4 2005
L.A. Sarringhaus
Abstract There is much debate in behavioral primatology on the existence of population-level handedness in chimpanzees. The presence or absence of functional laterality in great apes may shed light on the origins of human handedness and on the evolution of cerebral asymmetry. The plasticity of long bone diaphyses in response to mechanical loading allows the functional interpretation of differences in cross-sectional geometric. While left-right asymmetry in upper limb diaphyseal morphology is a known property in human populations, it remains relatively unexplored in apes. We studied bilateral asymmetry in 64 skeletons of wild-caught chimpanzee using the humerus, second metacarpal, and femur. The total subperiosteal area (TA) of the diaphyses was measured at 40% of maximum humeral length and at the midshaft of the metacarpals and femora using external silicone molds. Overall, the TA values of the left humeri were significantly greater than the right, indicating directional asymmetry. This effect was even greater when the magnitude of difference in TA between each pair of humeri was compared. The right second metacarpals showed a tendency toward greater area than did the left, but this did not reach statistical significance. The lack of asymmetry in the femur serves as a lower limb control, and suggests that the upper limb results are not a product of fluctuating asymmetry. These findings imply behavioral laterality in upper limb function in chimpanzees, and suggest a complementary relationship between precision and power. Am J Phys Anthropol 2005., © 2005 Wiley-Liss, Inc. [source]

Pretreatment With Portal Venous Ultraviolet B Irradiated Donor Alloantigen Promotes Donor-Specific Tolerance to Rat Nerve Allografts,

THE LARYNGOSCOPE, Issue 3 2001
Eric M. Genden MD
Abstract Objective To determine if a single intraportal inoculation of ultraviolet B-irradiated (UVB) donor splenocytes can prevent nerve allograft rejection and confer donor-specific immunotolerance to rat nerve allograft segments. Methods Age-matched, class I and class II major histocompatibility complex (MHC) mismatched Buffalo (RT1b) rats were transplanted with a syngeneic nerve isograft, a Lewis (RT1l) nerve allograft, or a Brown-Norway (RT1n) rat nerve allograft segment. Control Buffalo rats in group I received a 3.0-cm Lewis (RT11) sciatic-posterior tibial interposition nerve allograft without pretreatment;group II Buffalo rats received a syngeneic Buffalo nerve isograft without pretreatment. Group III Buffalo recipients were inoculated with 2.5 × 107 UVB-irradiated Lewis donor splenocyte cells by portal venous administration 7 days before transplantation with a 3.0-cm sciatic-posterior tibial nerve allograft from a Lewis (RT11) or a third party Brown-Norway rat (RT1n) donor (group IV). Nerve graft regeneration was assessed with walking track analysis, nerve conduction studies, retrograde neural tracing, nerve graft histology, and morphometry. Recipient immune tolerance was assessed through in vitro immunological assessment. Results Pretreatment with UVB-irradiated donor splenocytes 7 days before transplantation prevented nerve allograft rejection. Pretreated animals receiving a nerve allograft recovered limb function, and demonstrated morphological, histological, and electrophysiologic parameters of nerve regeneration similar to that measured in rats receiving a nerve isograft. In vitro immunological assessment by mixed lymphocyte culture (MLC), cytotoxic T lymphocyte (CTL) assay, limiting dilution analysis (LDA) of helper (pTH) and cytotoxic (pCTL) precursor frequencies, and IL-2 production demonstrated a marked donor-specific suppression in allografted animals pretreated with intraportal UVB-irradiated donor splenocytes. These assessments correlated with indefinite acceptance of donor nerve allografts. Conclusions A single pretreatment with a single intraportal dose of UVB-modified donor antigen specifically induces tolerance to peripheral nerve allografts in rats. [source]

Use of a night-time hand positioning splint reduced pain, improved grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2009
Sally Bennett
No abstract is available for this article. [source]

Femoral component failure in canine cemented total hip replacement: a report of two cases

AUSTRALIAN VETERINARY JOURNAL, Issue 6 2010
GD Yates
Femoral stem fracture is reported as an uncommon late complication of cemented total hip replacement in two dogs. In each case surgical salvage was achieved by extirpation of the proximal unstable component of the femoral stem, resulting in acceptable limb function. To the authors' knowledge, intramedullary femoral stem failure has not been previously reported after cemented total hip replacement in the dog. Factors believed to have contributed to implant failure in these dogs are discussed and compared with the same complication in humans. [source]

Extensive venous/lymphatic malformations causing life-threatening haematological complications

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007
J. Mazereeuw-Hautier
Summary Background, Large venous/lymphatic slow-flow malformations (SFM) can be associated with a coagulopathy resulting in thrombosis and haemorrhage. Such potentially life-threatening complications of SFM have been reported only rarely. Objectives, To better define the clinical characteristics of haematological complications associated with SFM, to highlight the importance of recognition and to discuss the management of these difficult-to-treat patients. Patients and methods, A cohort of six children who presented with massive SFM associated with serious haematological complications was seen between January 1980 and June 2005 in the Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K. (tertiary referral centre for vascular anomalies). Clinical and haematological characteristics were recorded. Results, Patients were aged 1,20 years. All suffered with recurrent episodes of pain, localized skin necrosis and bleeding. All had intravascular coagulopathy and life-threatening complications. These included brain haemorrhage, massive bleeding from the uterus and colon, large and extensive thromboses of the deep vessels in the abdomen and pelvis and severe haemoptysis. One patient died suddenly at the age of 20 years from pulmonary thromboembolism and thrombosis within the deep vessels of the vascular malformation. The youngest patient underwent a leg amputation to remove the huge vascular malformation due to the major risk of complications and lack of limb function. Three of the patients underwent anticoagulation treatment and showed improvement in their coagulopathy. Conclusions, It is essential that patients with extensive SFM have their coagulation screened regularly to detect intravascular coagulopathy. This may progress to disseminated vascular coagulopathy and a serious risk of thrombosis and haemorrhage. Such patients require early anticoagulation in an attempt to prevent these secondary complications. [source]

Effects of zileuton and montelukast in mouse experimental spinal cord injury

BRITISH JOURNAL OF PHARMACOLOGY, Issue 3 2008
T Genovese
Background and purpose: 5-lipoxygenase (5-LO) is the key enzyme in leukotriene (LT) biosynthesis from arachidonic acid (AA). Here, we examined the role of the 5-LO- product, cysteinyl-LT (Cys-LT), with a 5-LO inhibitor (zileuton) and a Cys-LT, receptor antagonist (montelukast), in the inflammatory response and tissue injury associated with spinal cord injury (SCI). Experimental approach: SCI was induced in mice by the application of vascular clips to the dura via a two-level T6 to T7 laminectomy for 1 min. Cord inflammation was assessed histologically and by measuring inflammatory mediators (ELISA) and apoptosis by annexin V, TUNEL, Fas ligand staining and Bax and Bcl-2 expression (immunohistochemistry and western blots). Motor function in hindlimbs was assessed by a locomotor rating scale, for 10 days after cord injury. Key results: SCI in mice resulted in tissue damage, oedema, neutrophil infiltration, apoptosis, tumour necrosis-, (TNF-,) and cyclooxygenase-2 (COX-2) expression, prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) production, and extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation in injured tissue. Treatment of the mice with zileuton or montelukast reduced the spinal cord inflammation and tissue injury, neutrophil infiltration, TNF-,, COX-2 and pERK1/2 expression, PGE2 and LTB4 production, and apoptosis. In separate experiments, zileuton or montelukast significantly improved the recovery of limb function over 10 days. Conclusions and implications: Zileuton and montelukast produced a substantial reduction of inflammatory events associated with experimental SCI. Our data underline the important role of 5-LO and Cys-LT in neurotrauma. British Journal of Pharmacology (2008) 153, 568,582; doi:10.1038/sj.bjp.0707577; published online 3 December 2007 [source]

Study of the Different Types of Actuators and Mechanisms for Upper Limb Prostheses

ARTIFICIAL ORGANS, Issue 6 2003
Vanderlei O. Del Cura
Abstract: Research in the area of actuators and mechanisms has shown steadily growing technological advances in externally activated upper limb prostheses. From among the actuators, advances include the use of piezoelectric materials, special metal alloys, polymers, and new motor applications, while the advances in mechanisms include mechanical designs based on the anatomy of the human hand and improvements in the way these components are combined. These efforts are aimed at meeting the need for anthropomorphic and functional prosthetic devices that enable patients to carry out basic daily tasks more easily and reduce the rejection rate of prostheses. This article technically discusses the several types of actuators and mechanisms, listing their main characteristics, applications, and advantages and disadvantages, and the current state of research in the area of rehabilitation of upper limb functions through the use of active prostheses. Comparisons of these devices are made with regard to the main criteria of construction and operation required to achieve optimal prosthetic performance. [source]