Wearable, mechanically passive (i.e. spring-powered) exoskeletons may be more practical and affordable than active, motorized exoskeletons for providing continuous, home-based, antigravity movement assistance for people with shoulder disability. However, the biomechanical moment due to gravity is a nonlinear function of shoulder elevation angle and, thus, challenging to counteract proportionally across the shoulder elevation range of motion with a spring alone. We designed, fabricated, and tested an integrated spring-cam-wheel system that can generate a nonlinear moment to proportionally compensate for the expected antigravity moment at the shoulder. We then incorporated the proposed system in a benchtop model and a novel wearable passive cable-driven exoskeleton that was intended to counteract half of the gravitational moment during shoulder elevation movements. The rotational moment measured from the benchtop model closely matched the theoretical moment during simulated positive shoulder elevation. However, a larger moment (up to 12.5% larger) was required during simulated negative shoulder elevation to stretch the spring to its initial length due to spring hysteresis and friction losses. The wearable exoskeleton prototype was qualitatively tested for assisting shoulder elevation movements; we identified several aspects of the prototype design that need to be improved before further testing on human participants. In future studies, we will quantitatively evaluate human kinematics and neuromuscular coordination with the exoskeleton to determine its suitability for assisting patients with shoulder disability.
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http://dx.doi.org/10.1109/EMBC44109.2020.9175633 | DOI Listing |
Background: There has been an increase in both primary anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) over the last decade, with rates peaking for patients aged 75 years and older. Despite aTSA being the mainstay of treatment for patients with glenohumeral arthritis in the absence of rotator cuff insufficiency, there has been an upward trend of rTSA utilization in the elderly due to concerns about rotator cuff integrity, regardless of deformity. The purpose of this study is to evaluate outcomes including pain, function, range of motion, satisfaction, and complications in patients 80 years or older following primary anatomic and reverse total shoulder arthroplasty for osteoarthritis without full thickness rotator cuff tears.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Melbourne Shoulder and Elbow Centre, Sandringham, VIC, Australia; Department of Surgery, School of Clinical Sciences Monash Health, Monash University, VIC, Australia.
Background: Acromial stress fractures can occur after reverse total shoulder arthroplasty (RTSA). We performed this study to assess the incidence, risk factors, characteristics, and outcome of acromial stress fractures and reactions after RTSA.
Methods: We determined the incidence of acromial stress fractures and reactions in a cohort of patients who underwent RTSA, and assessed risk factors using a case-control design.
J Cardiovasc Dev Dis
December 2024
Postgraduate Program in Physical Education, Universidade Federal do Rio de Janeiro (EEFD/UFRJ), Rio de Janeiro 21941-599, Brazil.
Background: This study aimed to investigate the acute effects of different pre-ST strategies on muscular performance and blood pressure (BP) responses in recreationally strength-trained women.
Methods: Twelve overweight women with normal BP were recruited and performed six experimental protocols in a randomized order: (1) control protocol (CC), where BP was assessed without exercises performed; (2) ST; (3) foam rolling warm-up followed by ST (FR + ST); (4) specific warm-up followed by ST (SW + ST); (5) aerobic exercise followed by ST (AE + ST); and (6) stretching exercises followed by ST (SE + ST). ST consisted of three sets at 80% of 10 repetition maximum with a self-suggested rest interval between sets for bench press, back squat, bench press 45°, front squat, lat pull-down, leg press, shoulder press, and leg extension.
J Transl Med
January 2025
Division of Adolescent and Young Adult Medicine, Departments of Pediatrics, Johns Hokins University School of Medicine, 200 N. Wolfe St., Room 2077, Baltimore, MD, 21287, USA.
Background: We have noted that some adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) report difficulty with arms-overhead activities, suggestive of brachial plexus dysfunction or thoracic outlet syndrome (TOS). In the TOS literature, diagnostic maneuvers focus on the provocation of upper limb symptoms (arm fatigue and heaviness, paresthesias, neck and upper back pain), but not on elicitation of systemic symptoms.
Objectives: To estimate the proportion of patients with fatiguing illness who experience local and systemic symptoms during a common maneuver used in evaluating TOS-the elevated arm stress test (EAST).
J Shoulder Elbow Surg
January 2025
Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Gent, Ghent, Belgium.
Background: Reversed shoulder arthroplasty (rTSA) is often used to restore functionality in patients with joint arthropathy and dysfunctional rotator cuff. As rTSA changes the biomechanical properties of the shoulder, an altered movement pattern of arm and scapula is to be expected. Previous studies focused on changes of the scapulohumeral rhythm during functional elevation tasks.
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