Quality and usability of clinical assessments of static standing and sitting posture: A systematic review.

Background: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available.

Objective: The objective of this study was to provide such an overview and to interpret the results for clinical practice.

Reliability of an instrument for screening hand profiles: The Practical Hand Evaluation.

Study Design: Psychometric study with 2-week interval.

Introduction: Musculoskeletal hand complaints are common among manual workers. Mismatch between anthropometric hand features and tasks can affect the ability to perform hand activities, with an increased risk of complaints.

Early Shortening of Wrist Flexor Muscles Coincides With Poor Recovery After Stroke.

Background: The mechanism and time course of increased wrist joint stiffness poststroke and clinically observed wrist flexion deformity is still not well understood. The components contributing to increased joint stiffness are of neural reflexive and peripheral tissue origin and quantified by reflexive torque and muscle slack length and stiffness coefficient parameters.

Objective: To investigate the time course of the components contributing to wrist joint stiffness during the first 26 weeks poststroke in a group of patients, stratified by prognosis and functional recovery of the upper extremity.

Perturbation velocity affects linearly estimated neuromechanical wrist joint properties.

The dynamic behavior of the wrist joint is governed by nonlinear properties, yet applied mathematical models, used to describe the measured input-output (perturbation-response) relationship, are commonly linear. Consequently, the linearly estimated model parameters will depend on properties of the applied perturbation properties (such perturbation amplitude and velocity). We aimed to systematically address the effects of perturbation velocity on linearly estimated neuromechanical parameters.

Variation in occupational exposure associated with musculoskeletal complaints: a cross-sectional study among professional bassists.

Background: Variation in occupational exposure is assumed to have a protective effect against the development of musculoskeletal complaints (MSC), but this common assumption is not strongly supported by the literature. Among musicians, who have a high prevalence of MSC, many play more than one type of instrument (multi-instrumentalism) for many hours a day. Since multi-instrumentalism implies greater variation in ergonomic load of specific musculoskeletal areas than mono-instrumentalism, musicians are a suitable study population to test whether the above assumption is true.

Estimation of tissue stiffness, reflex activity, optimal muscle length and slack length in stroke patients using an electromyography driven antagonistic wrist model.

Background: About half of all chronic stroke patients experience loss of arm function coinciding with increased stiffness, reduced range of motion and a flexed wrist due to a change in neural and/or structural tissue properties. Quantitative assessment of these changes is of clinical importance, yet not trivial. The goal of this study was to quantify the neural and structural properties contributing to wrist joint stiffness and to compare these properties between healthy subjects and stroke patients.

Effects of Unilateral Upper Limb Training in Two Distinct Prognostic Groups Early After Stroke: The EXPLICIT-Stroke Randomized Clinical Trial.

Background and Objective Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10° of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only.

No association between posture and musculoskeletal complaints in a professional bassist sample.

Background: Professional musicians receive little attention in pain medicine despite reports of high prevalence of musculoskeletal complaints. This study aims to investigate the association between work-related postures and musculoskeletal complaints of professional bass players.

Method: Participants were 141 professional and professional student double bassists and bass guitarists.

Comprehensive neuromechanical assessment in stroke patients: reliability and responsiveness of a protocol to measure neural and non-neural wrist properties.

Background: Understanding movement disorder after stroke and providing targeted treatment for post stroke patients requires valid and reliable identification of biomechanical (passive) and neural (active and reflexive) contributors. Aim of this study was to assess test-retest reliability of passive, active and reflexive parameters and to determine clinical responsiveness in a cohort of stroke patients with upper extremity impairments and healthy volunteers.

Methods: Thirty-two community-residing chronic stroke patients with an impairment of an upper limb and fourteen healthy volunteers were assessed with a comprehensive neuromechanical assessment protocol consisting of active and passive tasks and different stretch reflex-eliciting measuring velocities, using a haptic manipulator and surface electromyography of wrist flexor and extensor muscles (Netherlands Trial Registry number NTR1424).

Age-related differences in quality of standing balance using a composite score.

Background: Age-related differences in standing balance are not detected by testing the ability to maintain balance. Quality of standing balance might be more sensitive to detect age-related differences.

Objective: To study age-related differences in quality of standing balance, center of pressure (CoP) movement was evaluated using a wide range of CoP parameters in several standing conditions in healthy young and old participants.

Perturbation amplitude affects linearly estimated neuromechanical wrist joint properties.

System identification techniques have been used to separate intrinsic muscular and reflexive contributions to joint impedance, which is an essential step in the proper choice of patient specific treatment. These techniques are, however, only well developed for linear systems. Assuming linearity prescribes the neuromuscular system to be perturbed only around predefined operating points.

Differentiation between non-neural and neural contributors to ankle joint stiffness in cerebral palsy.

Background: Spastic paresis in cerebral palsy (CP) is characterized by increased joint stiffness that may be of neural origin, i.e. improper muscle activation caused by e.

Reduction of the linear reflex gain explained from the M1-M2 refractory period.

Linear system identification methods combined with neuromechanical modeling enable the quantification of reflex gains from recorded joint angular perturbation, torque, and/or electromyography (EMG). However, the stretch reflex response as recorded by EMG consists of multiple consecutive activation volleys (M1 and M2 responses) separated by a period of reduced activity and is nonlinearly related to joint perturbation. The goal of this study is to assess to what extent linear assumptions hold when quantifying these reflexive responses.

Force control in the absence of visual and tactile feedback.

Motor control tasks like stance or object handling require sensory feedback from proprioception, vision and touch. The distinction between tactile and proprioceptive sensors is not frequently made in dynamic motor control tasks, and if so, mostly based on signal latency. We previously found that force control tasks entail more compliant behavior than a passive, relaxed condition and by neuromuscular modeling we were able to attribute this to adaptations in proprioceptive force feedback from Golgi tendon organs.

The gap between clinical gaze and systematic assessment of movement disorders after stroke.

Background: Movement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different measurement conditions (tasks) and standardized input signals (force, position and velocity).

Spinal reflex properties in the long term after stroke.

In the long term after stroke, secondary functional deterioration may be observed while patients also get older. Possible underlying mechanisms are largely unknown. We aimed to assess neuromuscular degeneration represented by alterations in peripheral reflex loop characteristics as a function of follow-up time after stroke, controlled for age.

Reduced elbow mobility affects the flexion or extension domain in activities of daily living.

Background: Rehabilitation of patients with joint affecting diseases makes an appeal to available compensating motions. Objective information about compensatory motions is required for clinical decision-making. Our objective was to quantify resulting shoulder and arm motions from limited elbow mobility during activities of daily living in healthy controls and patients.

The relation between neuromechanical parameters and Ashworth score in stroke patients.

Background: Quantifying increased joint resistance into its contributing factors i.e. stiffness and viscosity ("hypertonia") and stretch reflexes ("hyperreflexia") is important in stroke rehabilitation.

Tizanidine does not affect the linear relation of stretch duration to the long latency M2 response of m. flexor carpi radialis.

The long latency M2 electromyographic response of a suddenly stretched active muscle is stretch duration dependent of which the nature is unclear. We investigated the influence of the group II afferent blocker tizanidine on M2 response characteristics of the m. flexor carpi radialis (FCR).

Inactive lifestyle in adults with bilateral spastic cerebral palsy.

Objective: To quantify the level of everyday physical activity in adults with bilateral spastic cerebral palsy, and to study associations with personal and cerebral palsy-related characteristics.

Participants And Methods: Fifty-six adults with bilateral spastic cerebral palsy (mean age 36.4 (standard deviation (SD) 5.

Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.

Background: Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity.

Responsiveness of the Michigan Hand Outcomes Questionnaire--Dutch language version in patients with rheumatoid arthritis.

Objective: To investigate the responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) in patients with rheumatoid arthritis (RA) who were treated in a multidisciplinary hand clinic.

Design: Observational study comparing the responsiveness of the MHQ with that of various other outcome measures for hand function.

Setting: Multidisciplinary hand clinic within a tertiary referral center for rheumatologic care.

Shoulder pain and external rotation in spastic hemiplegia do not improve by injection of botulinum toxin A into the subscapular muscle.

Objective: To study the effect of botulinum toxin A in the subscapular muscle on shoulder pain and humerus external rotation.

Methods: 22 stroke patients with spastic hemiplegia, substantial shoulder pain and reduced external rotation of the humerus participated in a randomised, double blind, placebo controlled effect study. Injections of either botulinum toxin A (Botox, 2x50 units) or placebo were applied to the subscapular muscle at two locations.