Short-duration, high-intensity bouts of physical therapy to increase self-efficacy, confidence, and function in an individual with incomplete spinal cord injury: A case report.

High intensity and frequency of task-specific practice is required to produce functional change in individuals with neurologic conditions. Self-efficacy is an important predictor of engagement in physical activity in individuals with spinal cord injury. Combining these two rehabilitation concepts has the potential for lasting functional improvement.

Coccolithophore calcification response to past ocean acidification and climate change.

Anthropogenic carbon dioxide emissions are forcing rapid ocean chemistry changes and causing ocean acidification (OA), which is of particular significance for calcifying organisms, including planktonic coccolithophores. Detailed analysis of coccolithophore skeletons enables comparison of calcite production in modern and fossil cells in order to investigate biomineralization response of ancient coccolithophores to climate change. Here we show that the two dominant coccolithophore taxa across the Paleocene-Eocene Thermal Maximum (PETM) OA global warming event (~56 million years ago) exhibited morphological response to environmental change and both showed reduced calcification rates.

Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial.

Background: Shoulder pain is a common problem after spinal cord injury (SCI), with negative effects on daily activities and quality of life (QOL).

Objective: The purpose of this study was to determine the effect of an exercise program and instruction to optimize performance of upper-extremity tasks on shoulder pain in people with paraplegia from SCI.

Methods: Design Eighty individuals with paraplegia from SCI and shoulder pain were randomly assigned to receive either an exercise/movement optimization intervention or an attention control intervention.

Effect of AFO design on walking after stroke: impact of ankle plantar flexion contracture.

This study was conducted to compare the effects of three ankle-foot orthosis (AFO) designs on walking after stroke and determine whether an ankle plantar flexion contracture impacts response to the AFOs. A total of 30 individuals, ranging from 6-215 months post-stroke, were tested in four conditions: shoes only (SH), dorsi-assist/dorsi-stop AFO (DA-DS), plantar stop/free dorsiflexion AFO (PS), and rigid AFO (Rigid). Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace.

Comparison of shoulder muscle electromyographic activity during standard manual wheelchair and push-rim activated power assisted wheelchair propulsion in persons with complete tetraplegia.

Objectives: To compare spatio-temporal propulsion characteristics and shoulder muscle electromyographic activity in persons with cervical spinal cord injury propelling a standard pushrim wheelchair (WC) and a commercially available pushrim-activated power assisted wheelchair (PAPAW) design on a stationary ergometer.

Design: Repeated measures.

Setting: Motion analysis laboratory within a rehabilitation hospital.

A comparison of shoulder joint forces during ambulation with crutches versus a walker in persons with incomplete spinal cord injury.

Objective: To compare 3-dimensional (3D) shoulder joint reaction forces and stride characteristics during bilateral forearm crutches and front-wheeled walker ambulation in persons with incomplete spinal cord injury (SCI).

Design: Cross-sectional cohort study.

Setting: Biomechanics laboratory.

Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 2. An electromyographic analysis.

Background/objectives: Shoulder pain is common in persons with complete spinal cord injury. Adjustment of the wheelchair-user interface has been thought to reduce shoulder demands. The purpose of this study was to quantify the effect of seat fore-aft position on shoulder muscle activity during wheelchair propulsion.

Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 1. A kinetic analysis.

Background/objective: The highly repetitive and weight-bearing nature of wheelchair (WC) propulsion has been associated with shoulder pain among persons with spinal cord injury (SCI). Manipulation of WC seat position is believed to reduce the overall demand of WC propulsion. The objective of this investigation was to document the effect of fore-aft seat position on shoulder joint kinetics.

Effect of an electric stimulation facilitation program on quadriceps motor unit recruitment after stroke.

Objective: To compare maximum voluntary isometric torque (MVIT) and motor unit recruitment of the quadriceps after an electric stimulation facilitation program in persons affected by cerebrovascular accident (CVA).

Design: Three-week, randomized controlled trial with an electric stimulation facilitation program added to standard care.

Setting: Inpatient rehabilitation center.

Upper extremity kinetics during Lofstrand crutch-assisted gait.

A three-dimensional (3D) biomechanical model was developed to determine upper extremity kinematics and kinetics of persons walking with forearm crutches. Six-component load cells and strain gauges were installed in the crutches to determine crutch forces. A six-camera VICON motion system was used to acquire coordinate data from 24 reflective markers attached to the upper extremities and crutches.

Energy expenditure and gait characteristics of a bilateral amputee walking with C-leg prostheses compared with stubby and conventional articulating prostheses.

Objective: To compare energy cost and stride characteristics during walking with 3 different types of prostheses in a person with bilateral knee disarticulations.

Design: Single-case study. Setting Pathokinesiology laboratory.

Effects of spinal cord injury level on the activity of shoulder muscles during wheelchair propulsion: an electromyographic study.

Objective: To determine the influence of spinal cord injury (SCI) level on shoulder muscle function during wheelchair propulsion.

Design: Fine-wire electromyographic activity of 11 muscles was recorded during wheelchair propulsion.

Setting: Biomechanics research laboratory.

Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following stroke.

The mixture of gait deviations seen in patients following a stroke is remarkably variable. An objective system for classification of gait patterns for this population could be used to guide treatment planning. Quantitated gait analysis was conducted for 47 individuals at admission to in-patient rehabilitation and again at 6 months post-stroke for 42 subjects.

Shoulder EMG during depression raise in men with spinal cord injury: the influence of lesion level.

Background & Objective: The depression-style raise maneuver is commonly performed by persons with spinal cord injury (SCI) to relieve skin pressures and avoid skin ulceration. The demands of this critical activity, however, are not fully documented for individuals with higher spinal cord lesions. The purpose of this investigation was to determine the influence of SCI lesion level on shoulder muscle activity during a depression raise maneuver.

The effect of level of spinal cord injury on shoulder joint kinetics during manual wheelchair propulsion.

Objective: The effects of spinal cord injury level on shoulder kinetics during manual wheelchair propulsion were studied.

Design: Single session data collection in a laboratory environment.

Methods: Male subjects were divided into four groups: low level paraplegia (n=17), high level paraplegia (n=19), C7 tetraplegia (C7, n=16) and C6 tetraplegia (C6, n=17).

Electromyographic and kinematic analysis of the shoulder during four activities of daily living in men with C6 tetraplegia.

The pattern of motor paralysis that commonly follows C6 tetraplegia creates an increased demand on upper limb function. The present investigation documented shoulder motion and muscular activity during planar motions and four activities of daily living (ADLs) in 15 men with spinal cord injuries (SCI) resulting in C6 tetraplegia. Three-dimensional (3-D) shoulder motion was recorded using a VICON motion system, and intramuscular electrodes recorded electromyographic (EMG) activity of 12 shoulder muscles.

Three dimensional upper extremity motion during manual wheelchair propulsion in men with different levels of spinal cord injury.

This investigation compared three dimensional upper extremity motion during wheelchair propulsion in persons with 4 levels of spinal cord injury: low paraplegia (n=17), high paraplegia (n=19), C7 tetraplegia (n=16), and C6 tetraplegia (n=17). Upper extremity motion was recorded as subjects manually propelled a wheelchair mounted on a stationary ergometer. For all motions measured, subjects with paraplegia had similar patterns suggesting that the wheelchair backrest adequately stabilizes the trunk in the absence of abdominal musculature.

Shoulder joint kinetics during the push phase of wheelchair propulsion.

The purpose of this investigation was to quantify the forces and moments at the shoulder joint during free, level wheelchair propulsion and to document changes imposed by increased speed, inclined terrain, and 15 minutes of continuous propulsion. Data were collected using a six-camera VICON motion analysis system, a strain gauge instrumented wheel, and a wheelchair ergometer. Seventeen men with low level paraplegia participated in this study.

Three-dimensional kinematics of wheelchair propulsion.

A three-dimensional (3-D) biomechanical model was used to determine upper extremity kinematics of 16 male subjects with low-level paraplegia while performing wheelchair propulsion (WCP). A six-camera VICON motion analysis system was used to acquire the coordinate data of ten anatomic markers. Joint axes for the wrist and elbow were defined along with the planes of motion for the upper arm (humerus) and trunk.

Temporal-spatial characteristics of wheelchair propulsion. Effects of level of spinal cord injury, terrain, and propulsion rate.

The purpose of this investigation was to compare the temporal-spatial characteristics of wheelchair propulsion (velocity, cycle distance, and cadence) of customary wheelchair users in conditions designed to simulate community settings. Seventy adult males with spinal cord injuries (SCI) were grouped by their level of SCI: low paraplegia (n = 17); high paraplegia (n = 19); C-7 tetraplegia (n = 17); C-6 tetraplegia (n = 17). Testing was performed in a wheelchair that had the right pushrim instrumented with force transducers.

Electromyographic analysis of the shoulder muscles during depression transfers in subjects with low-level paraplegia.

Objective: To document and compare the intensity of selected shoulder muscle activity during depression transfers.

Design: Intramuscular electrodes were used to record the activity of 12 shoulder muscles while transferring to and from a wheelchair.

Participants: Twelve adult men with spinal cord injuries resulting in low paraplegia.

Electromyographic activity of shoulder muscles during wheelchair propulsion by paraplegic persons.

Objective: Phasing and intensity of shoulder muscle activity during wheelchair propulsion were documented to identify muscles at risk for fatigue and overuse.

Design And Participants: Electromyographic (EMG) activity of 12 muscles was recorded with wire electrodes in 17 paraplegic men during propulsion on a stationary ergometer.

Main Outcome Measures: Push and recovery phases of the propulsion cycle were determined with an instrumented pushrim.

Electromyographic analysis of shoulder muscles of men with low-level paraplegia during a weight relief raise.

The purpose of this study was to define the demand on the shoulder musculature during performance of a weight relief raise. Intramuscular electromyographic activity of 12 shoulder muscles was recorded in 13 pain-free subjects with paraplegia while elevating the trunk from a sitting position. Upper extremity motion was determined by elbow electrogoniometry and video recordings.

Electromyograph analysis of the popliteus muscle in level and downhill walking.

It has been proposed that the popliteus muscle is a source of lateral knee pain, typically after downhill activities. Electromyography of the popliteus muscle was recorded in 9 normal subjects during level walking, downhill walking, and walking downhill wearing a 40-lb backpack (to simulate hiking). Popliteal muscle intensity during the midstance phase of walking downhill with weights increased significantly over that of level walking (30% versus 13%, respectively) (p < 0.

Isometric shoulder torque in subjects with spinal cord injury.

The etiology of shoulder pain in spinal cord injured (SCI) patients has been attributed to overuse, with dysfunction being more prevalent as the time since injury increases. Impingement syndrome, the most common diagnosis in this population, may be related to weakness of the rotator cuff and shoulder girdle musculature. Shoulder dysfunction is greater in subjects with SCI than in able-bodied patients; consequently, this study compares isometric strength of quadriplegic and paraplegic subjects to able-bodied controls.