New horizons in the compression of functional decline.

Population ageing, which has come about through the combination of increases in life expectancy, larger post-war cohorts reaching older age and reductions in fertility, is challenging societies and particularly health and care providers, worldwide. In Europe, the USA and Japan, there have been increases in years spent with disability and dependency. The majority of such research, as well as professional health and social care practice, measures loss of functional capability or need for social care, by aggregate disability scores, based around activities of daily living and instrumental activities of daily living.

A novel four-caster manual vehicle manoeuvring investigation: Higher loading-weights require larger turning spaces.

Patient-hoists, goods-trolleys and other omni-directional manually operated vehicles are ubiquitous. Yet no substantive, empirically based dynamic analysis has been made of these four-caster vehicles despite manual handling concerns. A relationship between loading-weight and turning space is indicated by theoretical analysis which further shows that this effect is represented by only 11 different manoeuvres.

Musculoskeletal shoulder models: a technical review and proposals for research foci.

Musculoskeletal shoulder models allow non-invasive prediction of parameters that cannot be measured, particularly the loading applied to morphological structures and neurological control. This insight improves treatment and avoidance of pathology and performance evaluation and optimisation. A lack of appropriate validation and knowledge of model parameters' accuracy may cause reduced clinical success for these models.

Sensitivity of a biomechanical model of the finger to errors in experimental input.

Biomechanical models of the fingers are used to gain a greater understanding of internal loading. This can help guide the treatment of injuries and pathologies. However, to be valid these models require accurate measurement of body kinematics, external reaction forces and soft tissue architecture.

Comparison of range of motion and function of subjects with reverse anatomy Bayley-Walker shoulder replacement with those of normal subjects.

Patients with rotator cuff tear and degenerative shoulder joint disease commonly experience severe pain and reduced performance during activities of daily living. A popular way to treat these patients is by means of reverse anatomy shoulder prosthesis. Studying the kinematics of subjects with reverse anatomy implant would be useful in order to gain knowledge about functionality of different designs.

Glenohumeral contact forces in reversed anatomy shoulder replacement.

A major requirement to design an implant is to develop our understanding of the applied internal forces during everyday activities. In the absence of any basic apparatus for measuring forces directly, it is essential to rely on modelling. The major aim of this study was therefore to understand the biomechanical function of subjects with the reversed anatomy Bayley-Walker prosthesis, using an inverse dynamic shoulder model.

Adaptation of scapula lateral rotation after reverse anatomy shoulder replacement.

Scapula motion is significant for support of the arm and stability of the shoulder. The effect of the humeral elevation on scapular kinematics has been well investigated for normal subjects, but there are limited published studies investigating adaptations after shoulder arthroplasty. Scapula kinematics was measured on 10 shoulders (eight subjects) with a reverse total joint replacement.

Multivariate analysis of the Fugl-Meyer outcome measures assessing the effectiveness of GENTLE/S robot-mediated stroke therapy.

Background: Robot-mediated therapies offer entirely new approaches to neurorehabilitation. In this paper we present the results obtained from trialling the GENTLE/S neurorehabilitation system assessed using the upper limb section of the Fugl-Meyer (FM) outcome measure.

Methods: We demonstrate the design of our clinical trial and its results analysed using a novel statistical approach based on a multivariate analytical model.

The construct validity of a spasticity measurement device for clinical practice: an alternative to the Ashworth scales.

Introduction: Spasticity is a significant cause of disability in people with an upper motor neurone lesion, but there is a paucity of appropriate outcome measures to evaluate this phenomenon. The aim was to test the construct validity of a clinically relevant, non-invasive measure of spasticity.

Methods: A cross-section study design in which participants with elbow flexor spasticity and capable of providing written informed consent were recruited.

Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study.

Objectives: To establish: (1) inter-rater and test-retest reliability of standardized guidelines for the Fugl-Meyer upper limb section, Action Research Arm Test and Box and Block Test in patients with paresis secondary to stroke, multiple sclerosis or traumatic brain injury and (2) correlation between these arm motor scales and more general measures of impairment and activity limitation.

Design: Multicentre cohort study.

Setting: Three European referral centres for neurorehabilitation.

Distal ligamentous restraints of the first metatarsal. An in vitro biomechanical study.

Background: Hypermobility or instability of the first metatarsal is associated with increased hallux valgus deformity and greater risk of recurrence after surgery. The objective of this in vitro study was to determine the ranges of movement, under directional loading, of the normal first metatarsal and the effect of the longitudinal plantar aponeurosis and the transverse tie-bar ligamentous system.

Methods: A model has been developed to quantify the influence of the first intermetatarsal ligament and plantar aponeurosis on movements of the first metatarsal.

Long-term health-related quality of life outcomes following Jefferson-type burst fractures of the atlas.

Object: The primary goal of this study was to describe the long-term health-related quality of life (HRQOL) outcomes in patients who have suffered Jefferson-type fractures. These outcomes were compared with matched normative HRQOL data and with the patient's perceptions of their HRQOL prior to the injury. Variables that potentially influence these HRQOL outcomes were analyzed.

The activity in the three regions of the trapezius under controlled loading conditions--an experimental and modelling study.

Background: There is a degree of conflict in the literature regarding the biomechanical role of the three regions of trapezius. It is suggested that some of this may result from a lack of experiments using a well defined loading regime.

Objectives: To study the activity of the three regions of trapezius under controlled load in order to gain further insight into its role in shoulder biomechanics.

A study of the external forces and moments at the shoulder and elbow while performing every day tasks.

Objectives: To establish a database of upper limb kinematics and kinetics to support the development of a biomechanical model of the shoulder and elbow.

Design: Ten unimpaired subjects were studied when performing 10 different tasks of every day living.

Background: The development of biomechanical models of the upper limb to support the design of total joint replacements requires data on the commonly performed activities.

A biomechanical investigation into the validity of the modified Ashworth Scale as a measure of elbow spasticity.

Objective: To investigate the criterion validity of the modified Ashworth Scale.

Population: Volunteers from a stroke population admitted to a district general hospital stroke unit diagnosed with a first ever stroke less than 26 weeks previously.

Outcome Measures: Resistance to passive movement about the elbow was simultaneously quantified (biomechanically) and graded (modified Ashworth Scale).

Are we underestimating the clinical efficacy of botulinum toxin (type A)? Quantifying changes in spasticity, strength and upper limb function after injections of Botox to the elbow flexors in a unilateral stroke population.

Objective: To quantify the clinical efficacy of botulinum toxin type A in treating elbow flexor spasticity in a unilateral stroke population.

Location: A spasticity clinic at a regional neurological rehabilitation centre.

Study Design: A convenience sample longitudinal study.

The morphology and biomechanics of latissimus dorsi.

OBJECTIVE: To determine the morphology of the latissimus dorsi in order to assess its actions on the shoulder, the lumbar spine and the sacroiliac joint. DESIGN: A dissection study accompanied by an analysis of the force vectors of the muscle and its parts. BACKGROUND: Although recognised as a muscle of the shoulder, latissimus dorsi has been accorded a role as an extensor of the lumbar spine, and is said to brace the sacroiliac joint.