The design of rehabilitation devices for patients experiencing musculoskeletal disorders (MSDs) requires a great deal of attention. This article aims to develop a comprehensive model of the upper-limb complex to guide the design of robotic rehabilitation devices that prioritize patient safety, while targeting effective rehabilitative treatment. A 9 degree-of-freedom kinematic model of the upper-limb complex is derived to assess the workspace of a constrained arm as an evaluation method of such devices. Through a novel differential inverse kinematic method accounting for constraints on all joints1820, the model determines the workspaces in which a patient is able to perform rehabilitative tasks and those regions where the patient needs assistance due to joint range limitations resulting from an MSD. Constraints are imposed on each joint by mapping the joint angles to saturation functions, whose joint-space derivative near the physical limitation angles approaches zero. The model Jacobian is reevaluated based on the nonlinearly mapped joint angles, providing a means of compensating for redundancy while guaranteeing feasible inverse kinematic solutions. The method is validated in three scenarios with different constraints on the elbow and palm orientations. By measuring the lengths of arm segments and the range of motion for each joint, the total workspace of a patient experiencing an upper-limb MSD can be compared to a preinjured state. This method determines the locations in which a rehabilitation device must provide assistance to facilitate movement within reachable space that is limited by any joint restrictions resulting from MSDs.
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http://dx.doi.org/10.1115/1.4048573 | DOI Listing |
Int J Surg Case Rep
December 2024
Upper extremity trauma and Microsurgery Department, 108 Military Central Hospital, 1 Tran Hung Dao Street, Hanoi, Viet Nam.
Introduction: Reconstruction for open multiple transmetacarpal amputation secondary to a crushing injury is really challenging. Some treatment approaches could be proposed. To avoid the drawbacks of a prosthesis and hand transplantation such as the high cost, and long-term side effects of anti-rejection drugs, toe transfers were chosen.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Hand & Reconstructive Microsurgery Surgery, Rashid Hospital, Dubai, United Arab Emirates.
Background: Open and crushed forearm injury is a complex and rare injury affecting the upper extremity. It results in damage to various structures, including bones, soft tissues, and neurovascular bundles, ultimately leading to functional impairment. Typically, these injuries occur owing to high-energy trauma.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Congenital radioulnar synostosis (CRUS) presents a complex forearm deformity, requiring precise osteotomy planning for anatomical restoration. This study proposes an automatic osteotomy preoperative planning method for forearms with CRUS. Proximal forearm bones are first aligned with the template forearm and then a dual dimensional optimization (DDO) strategy is used to optimize the spatial transformation parameters of the distal fragment.
View Article and Find Full Text PDFAm J Otolaryngol
December 2024
Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA. Electronic address:
Objective: This retrospective cohort study aims to compare donor site morbidity of three commonly used upper extremity flaps used in head and neck reconstructive surgery: scapular tip free flap (STFF), radial forearm free flap (RFFF), and pectoralis major pedicled flap (PMPF).
Methods: The billing database of an urban, academic, tertiary otolaryngology practice was queried to identify patients who underwent STFF, RFFF, and PMPF from 2020 to 2023. The primary outcome was identification of donor site pain and need for physical therapy (PT) referral after undergoing reconstruction.
Radiol Case Rep
February 2025
Department of Endovascular Surgery, State Budgetary Healthcare Institution "City Clinical Hospital named after M.E. Zhadkevich", Mozhaiskoe Highway, 14 121374, Moscow, Russia.
This case report presents a clinical case of management of a patient with concomitant ischemic stroke and acute arterial ischemia of the right upper limb. Emergency thrombaspiration from the middle cerebral artery improved the patient's neurological status. A hybrid intervention was carried out to restore blood flow in the right upper limb: brachial artery arteriotomy with thrombectomy through an open approach combined with endovascular recanalisation and balloon angioplasty of the forearm arteries.
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