scholarly journals Effects of lift-assist device on trunk and shoulder kinematics

2017 ◽  
Vol 5 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Ashish D. Nimbarte ◽  
Suman Kanti Chowdhury ◽  
Christopher W. Moore
Keyword(s):  
Unintended Consequences ◽  
Shoulder Abduction ◽  
Low Back ◽  
Shoulder Injuries ◽  
Study Objective ◽  
Trunk Motion ◽  
Depth Analysis ◽  
Shoulder Motion ◽  
Lift Assist ◽  
Shoulder Kinematics

Background: Repetitive handling of heavy concrete blocks has been associated with the risk of low back and shoulder injuries among the masons. Several interventions have been proposed to reduce the risk of musculoskeletal disorders among the masons. A new intervention, a lift-assist handle, was tested in this study. Objective: The effectiveness of the lift-assist handle in masonry work was assessed using the shoulder and low back  kinematics  during  block  lifting/lowering  tasks  performed  at  two  heights. Methods: In a laboratory setting, seven male subjects performed with- and without-lift handle assisted block lifting tasks at two different heights.  Optical motion capture system and biomechanical modeling software were used to record and model each dynamic trial. Effect of lifting height and use of a lift-assist handle on range of motion of the shoulder and trunk were tested. Results: The use of lift-assist handle significantly reduced trunk motion and increased shoulder motion. Lifting height had a significant effect on shoulder kinematics only. When height was increased from 17to 29 inches, the ranges of motion of  shoulder abduction-adduction and internal rotation significantly increased. Additionally, block lifting/lowering task duration decreased by 26% when the lift-assist handle was used. Conclusions: While  potential benefits to lower back health were found with the lift-assist handle, increased shoulder motion may increase the risk of shoulder injuries. The findings of this study emphasize the need for an in-depth analysis of assistive devices prior to implementation to ensure that there are no unintended consequences of their use that could negate their benefit. 

scholarly journals The effect of hyperbaric oxygen treatment on late radiation tissue injury after breast cancer: A case-series of 67 patients

2020 ◽  
Vol 50 (3) ◽  
pp. 206-213
Author(s):  
Nicole E Spruijt ◽  
◽  
Roy van den Berg ◽  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Hyperbaric Oxygen ◽  
Tissue Injury ◽  
Case Series ◽  
Shoulder Abduction ◽  
Hyperbaric Oxygen Treatment ◽  
Normal Tissues ◽  
Oxygen Treatment ◽  
Shoulder Motion

Introduction: Late radiation tissue injury (LRTI) after breast cancer may benefit from hyperbaric oxygen treatment (HBOT). This study aimed to report the LRTI symptom scores up to 12 months after HBOT and identify risk factors for poor scores. Methods: A case-series of 67 patients who underwent a mean of 44 sessions of HBOT was analysed. LRTI symptoms were scored at four time points using the LENT-SOMA scale (Late Effects in Normal Tissues – Subjective, Objective, Management, and Analytic), a visual analog scale for pain, and the range of shoulder motion. Results: Between starting HBOT and 12 months after HBOT 57 patients (85%) reported at least one point improvement in their LENT-SOMA score. Median pain and fibrosis scores improved significantly between the start and end of HBOT (P < 0.001), and remained stable three and 12 months after HBOT. The median breast oedema score improved significantly 12 months after HBOT (P = 0.003). Median shoulder abduction increased significantly from 90 to 165 degrees (P = 0.001) and median shoulder anteflexion increased significantly from 115 to 150 degrees (P = 0.004). Various risk factors were identified for poor scores despite HBOT; the most common risk factor was a poor score at start of HBOT. Conclusions: In this case-series, patients who underwent HBOT for LRTI after breast cancer reported significant improvement in pain, fibrosis, oedema, and shoulder movement. The improvement persisted up to 12 months after HBOT. A poor score at the start of HBOT was predictive for a poor score 12 months after HBOT.

scholarly journals P086: Effectiveness of interventions to decrease imaging among emergency department low back pain presentations: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S107
Author(s):  
C. Lui ◽  
S. Desai ◽  
L. Krebs ◽  
S.W. Kirkland ◽  
D. Keto-Lambert ◽  
...  
Keyword(s):  
Emergency Department ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Grey Literature ◽  
Clinical Decision ◽  
Unintended Consequences ◽  
Relative Reduction ◽  
Significant Heterogeneity ◽  
Low Back

Introduction: Low back pain (LBP) is an extremely frequent emergency department (ED) presentation. Although LBP imaging often results in no change to the ED management, does not identify abnormalities, and has documented risks (e.g., radiation exposure), advanced imaging (i.e., computed tomography [CT], magnetic resonance imaging [MRI]) for patients with LBP has become increasingly frequent in the ED. The objective of this review was to identify and examine the effectiveness and safety of interventions aimed at reducing imaging in the ED for LBP patients. Methods: Six bibliographic databases and grey literature were searched. Comparative studies assessing interventions aimed at reducing ED imaging for adult patients with LBP were eligible for inclusion. Two reviewers independently screened study eligibility, completed data extraction, and assessed the quality of included studies. Due to a limited number of studies and significant heterogeneity, a descriptive analysis was performed. Results: The search yielded 510 unique citations of which three before-after studies were included. Quality assessment identified potential biases relating to comparability between the pre- and post-intervention groups, reliable assessment of outcomes, and an overall lack of information on the intervention (i.e., time point, description, intervention data collection). The interventions to reduce lumbar spine imaging varied considerably. Study interventions included: 1) clinical decision support (i.e., a specialized X-ray requisition form), which reported a 47.4% relative reduction of lumbar spine radiography referrals; 2) clinical decision guidelines, which reduced referrals by 43.8%; and 3) multidisciplinary protocols, which reported a reduction in the MRI referral rate by 26.1%. Despite reductions in simple imaging, CT use increased in two of the three studies. Conclusion: LBP has been identified as a key area of imaging overuse (e.g., Choosing Wisely recommendation). Yet, evidence of interventions’ effectiveness in reducing imaging for ED patients with LBP is sparse. While there is some evidence to suggest that interventions can reduce the use of simple imaging in LBP in the ED, unintended consequences have been reported and additional studies employing higher quality methods are strongly recommended.

In-depth analysis of life values and their corresponding inhibitors and facilitators in chronic low back pain patients: A mixed-method approach

2020 ◽  
pp. 1-13
Author(s):  
Linda Fischer-Grote ◽  
Kerstin Tuechler ◽  
Thomas Kienbacher ◽  
Patrick Mair ◽  
Juliane Spreitzer ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Improve Patient Care ◽  
Low Back ◽  
Psychological Inflexibility ◽  
Depth Analysis ◽  
Planning Methods ◽  
Life Values ◽  
Pain Patients

BACKGROUND: The struggle with pain often interferes with the ability of chronic low back pain (CLBP) patients to pursue important life values due to psychological inflexibility. OBJECTIVE: This research examined life values, related inhibitors and facilitators relevant to personalized therapy planning. METHODS: Two hundred and forty-four CLBP patients completed the Chronic Pain Values Inventory (CPVI). Of these, 68 patients were interviewed to assess inhibitors and facilitators related to life values. Mixed-effects models quantitatively examined differences in the values, structuring content analysis served to qualitatively analyze the interviews. RESULTS: Participants rated the value “family” as being of highest importance and success. The largest discrepancy between importance and success was found for “health”. Content analyses revealed a broad range of inhibitors and facilitators related to the examined life values with the highest number of inhibitors related to “work”. Facilitators were also found to be of relevance to all life values, but to a lower extent than inhibitors. CONCLUSIONS: The perceived importance and success of life values and their related inhibitors and facilitators may differentially affect CLBP patients. Considering such individual aspects is therefore of utmost importance to improve patient care, as they enable treatment goals and the therapeutic strategies to be adapted accordingly.

Effect of Expertise on Shoulder and Upper Limb Kinematics, Electromyography, and Estimated Muscle Forces During a Lifting Task

2020 ◽  
pp. 001872082096502
Author(s):  
Etienne Goubault ◽  
Romain Martinez ◽  
Najoua Assila ◽  
Élodie Monga-Dubreuil ◽  
Jennifer Dowling-Medley ◽  
...  
Keyword(s):  
Upper Limb ◽  
Glenohumeral Joint ◽  
Contact Forces ◽  
Muscle Forces ◽  
Shoulder Injuries ◽  
Effective Work ◽  
Limb Kinematics ◽  
Manual Handling ◽  
Shoulder Kinematics ◽  
Lifting Task

Objective To highlight the working strategies used by expert manual handlers compared with novice manual handlers, based on recordings of shoulder and upper limb kinematics, electromyography (EMG), and estimated muscle forces during a lifting task. Background Novice workers involved in assembly, manual handling, and personal assistance tasks are at a higher risk of upper limb musculoskeletal disorders (MSDs). However, few studies have investigated the effect of expertise on upper limb exposure during workplace tasks. Method Sixteen experts in manual handling and sixteen novices were equipped with 10 electromyographic electrodes to record shoulder muscle activity during a manual handling task consisting of lifting a box (8 or 12 kg), instrumented with three six-axis force sensors, from hip to eye level. Three-dimensional trunk and upper limb kinematics, hand-to-box contact forces, and EMG were recorded. Then, joint contributions, activation levels, and muscle forces were calculated and compared between groups. Results Sternoclavicular–acromioclavicular joint contributions were higher in experts at the beginning of the movement, and in novices at the end, whereas the opposite was observed for the glenohumeral joint. EMG activation levels were 37% higher for novices but predicted muscle forces were higher in experts. Conclusion This study highlights significant differences between experts and novices in shoulder kinematics, EMG, and muscle forces; hence, providing effective work guidelines to ensure the development of a safe handling strategy is important. Application Shoulder kinematics, EMG, and muscle forces could be used as ergonomic tools to identify inappropriate techniques that could increase the prevalence of shoulder injuries.

Three-Dimensional in Vivo Kinematics of the Shoulder during Humeral Elevation

1998 ◽  
Vol 14 (3) ◽  
pp. 312-326 ◽  
Author(s):  
Timothy J. Koh ◽  
Mark D. Grabiner ◽  
John J. Brems
Keyword(s):  
Video Analysis ◽  
Three Dimensional ◽  
Movement Pattern ◽  
Helical Axis ◽  
Euler Angles ◽  
In Vivo Kinematics ◽  
Shoulder Complex ◽  
Shoulder Motion ◽  
Shoulder Kinematics

Shoulder kinematics, including scapular rotation relative to the trunk and humeral rotation relative to the scapula, were examined during humeral elevation in three vertical planes via video analysis of intracortical pins. Helical axis parameters provided an easily interpretable description of shoulder motion not subject to the limitations associated with Cardan/Euler angles. Between 30 and 150° of elevation in each plane, the scapula rotated almost solely about an axis perpendicular to the scapula. Additional scapular rotation appeared to support the notion that the scapula moves “toward” the plane of elevation. Humeral rotation took place mainly in the plane of the scapula independent of the plane of elevation. Many parameters of shoulder complex kinematics were quite similar across all planes of elevation, suggesting a consistent movement pattern with subtle differences associated with the plane of elevation.

Rotator Cuff Training for Pitchers

1998 ◽  
Vol 7 (4) ◽  
pp. 285-299 ◽  
Author(s):  
Michael E. Powers
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
High Speed ◽  
External Rotation ◽  
Shoulder Abduction ◽  
Muscular Endurance ◽  
Shoulder Injuries ◽  
Three Stages ◽  
Two Stages

This paper reviews the role of the rotator cuff during two key phases of the pitching sequence and presents a training program for these muscles. The program uses a periodization design consisting of three stages, beginning with a high-resistance/low-repetition eccentric strengthening stage. This is followed by a low-resistance/high-repetition stage for training muscular endurance. The core exercises for these two stages are prone external rotation in the 90/90 position, prone horizontal abduction, side-lying D2 flexion pattern, supine internal rotation in the 90/90 position, prone elevation with 100° of shoulder abduction and external rotation, and standing scapular plane elevation. The final stage of the program uses high-speed functional exercises: 90/90 external rotation, 90/90 internal rotation, D2 PNF flexion pattern, D2 PNF extension pattern, supine plyometric 90/90 internal rotation with a medicine ball, and the “arm whip” through the D2 PNF flexion pattern. The goal of this program is to prepare the muscles for the stresses of pitching and prevent shoulder injuries.

scholarly journals Non-Dominant Groups in Kosovo: A Marginalised View on (De)Securitisation of Minorities After Conflict

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Marius-Ionut Calu
Keyword(s):  
Ethnic Minorities ◽  
Social Economic ◽  
Physical Violence ◽  
Minority Rights ◽  
Unintended Consequences ◽  
Power Sharing ◽  
Minority Communities ◽  
Key Stakeholders ◽  
Depth Analysis

Drawing on case studies and in-depth analysis of ethnic minorities in Kosovo against the backdrop of statebuilding since 1999, this article discusses how the securitisation and desecuritisation of minorities after conflict is particularly problematic when seen from the marginalised perspective of non-dominant groups. I therefore argue that the adoption of a multi-ethnic statebuilding model of governance, including consociational power-sharing arrangements, has triggered unintended consequences for the (de)securitisation of minorities in Kosovo. Among such consequences is the risk of perceiving all minorities as potential threats and approaching minority issues merely through the lenses of security. By exploring various social, economic, legal, political, and identity characteristics of non-dominant communities in Kosovo and drawing on personal interviews with key stakeholders, representatives, and members of minority communities, this article shows the need for a more inclusive understanding of security which stretches beyond the threat of physical violence. This would permit, among other things, a more effective approach to dealing with the different layers of securitisation of minorities identified here. Otherwise, minority rights and concerns cannot escape the straitjacket of emergency politics. In conclusion, the long-term risk of managing multi-ethnicity through one-size-fits-all approaches is that statebuilding in plural societies will always struggle to desecuritise minority rights and develop ‘normal’ politics of diversity.

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