266 results match your criteria: "Limb Center[Affiliation]"

Background: This study aims to investigate the effect of a newly developed virtual reality task-oriented training (VR-TOT) video game on upper extremity fine motor function compared with conventional occupational therapy through leap motion in children with spastic hemiplegic cerebral palsy (CP).

Methods: In this double-blind randomized clinical trial, 30 children with spastic hemiplegic CP aged six to 10 years were included and randomly allocated into two groups. During six weeks, 15 patients in the intervention group received VR_TOT-based video game in addition to conventional occupational therapy, whereas 15 patients in the control group received only conventional occupational therapy.

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A Scoping Review of Interventions Aimed at Reducing Fear of Falling in Older Adults With Orthopedic Conditions.

J Geriatr Phys Ther

December 2024

Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada.

Background And Purpose: Fear of falling (FoF) is a persistent anxiety regarding the risk of falling, which can even impact individuals without a history of falls. Fear of falling has been associated with decreased physical functioning and increased risk of falls. Most interventions have focused on reducing FoF in healthy older adults.

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Objectives: To investigate the barriers and facilitators to rehabilitation experienced by individuals with cervical SCI after upper limb (UL) reconstructive surgery.

Methods: We conducted a prospective cohort study with a follow-up period of up to 24 months. Data collection occurred at two academic and two Veterans Affairs medical centers in the United States.

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Objective assessments of shoulder motion are paramount for effective rehabilitation and evaluation of surgical outcomes. Inertial Measurement Units (IMU) have demonstrated promise in providing unbiased movement data. This study is dedicated to evaluating the concurrent construct validity and accuracy of a wearable IMU-based sensor system, called 'Motion Shirt', for the assessment of humero-thoracic motion arcs in patients awaiting shoulder replacement surgery.

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Background: This study reviews and meta-analyzes the responsiveness and minimal clinically important difference (MCID) of the Western Ontario Rotator Cuff (WORC) Index for various patient populations and treatment durations.

Methods: A comprehensive search in PubMed, Embase, Web of Science, and CINAHL identified studies on the responsiveness or MCID of the WORC in shoulder conditions. Two authors independently screened articles.

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Application of Machine Learning to Osteoporosis and Osteopenia Screening Using Hand Radiographs.

J Hand Surg Am

January 2025

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA; Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA. Electronic address:

Article Synopsis
  • The study explores the use of artificial intelligence to screen for osteoporosis and osteopenia using regular hand radiographs, as current diagnostic methods like DXA scans are specialized and costly.
  • Researchers developed a deep learning algorithm trained on labeled hand images to classify them into normal, osteopenia, or osteoporosis categories, achieving high sensitivity and specificity.
  • The model showed an overall accuracy of 80.8% when detecting low bone density, suggesting it could provide a more accessible and automated diagnostic tool for these conditions in the future.
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New Technologies in the Treatment of Base of Thumb Osteoarthritis.

J Am Acad Orthop Surg

October 2024

From the Division of Orthopedic Surgery, University of Western Ontario, Roth-McFarlane Hand and Upper Limb Center, St Joseph's Health Care, London, Ontario, Canada (Dr. Rotem and Dr. Kadar), and the Department of Hand Surgery, Sheba Medical Center, Tel Aviv University School of Medicine, Tel Hashomer, Israel (Dr. Rotem).

Article Synopsis
  • Symptomatic osteoarthritis (OA) of the first carpometacarpal (CMC) joint mainly affects older adults, particularly postmenopausal women, and this review discusses recent advancements in treatment methods.
  • Traditional nonsurgical treatments include custom braces and corticosteroid injections, while newer approaches involve 3D printed braces and specialized injectables like autologous fat, which can improve patient outcomes.
  • Standard surgical options remain trapeziectomy, but newer techniques such as patient-specific instrumentation and innovative devices offer promising precision and personalization, though they have yet to prove superior to established treatments.
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Article Synopsis
  • * The study reviewed 17 articles covering 300 patients, finding significant improvements post-surgery, particularly for conditions like cubital tunnel syndrome, while noting minor complications.
  • * The conclusions emphasize the need for standardized measures, early surgical intervention, and thorough rehabilitation to enhance patient recovery and outcomes in nerve transfer surgeries.
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Despite significant advancements in flexor tendon repair techniques and rehabilitation strategies, achieving complete restoration of digital motion remains a formidable challenge. The most prevalent complications associated with tendon repair are the development of tendon adhesions and joint contractures. Left unaddressed, these complications can further lead to secondary pathomechanical changes, resulting in fixed deformities significantly affecting hand function.

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Flexor Tendon Injuries.

J Hand Surg Am

September 2024

Robert A. Chase Hand and Upper Limb Center, Stanford University Medical Center, Stanford, CA; Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA; Division of Plastic Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address:

Article Synopsis
  • - Flexor tendon injuries require careful management that considers factors like when to operate, where the injury is located, and how to handle surrounding tissues.
  • - Common complications from these injuries include adhesions, tendon rupture, infection, and a high likelihood of needing additional surgeries, especially for zone 2 repairs.
  • - Special attention is needed for chronic ruptures, fractures that happen alongside tendon injuries, and cases involving children, with the aim to improve patient outcomes through current treatment concepts.
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Article Synopsis
  • The thumb carpometacarpal (CMC) joint's unique biomechanics, influenced by ligaments like the anterior oblique ligament (AOL) and dorsoradial ligament (DRL), enable its power and precision.
  • This study examined the impact of cutting the AOL or DRL on thumb CMC joint biomechanics, including rotational and translational range-of-motion (ROM) and stiffness, using robotic simulations.
  • Results showed that cutting the DRL increased rotational ROM in flexion and internal rotation, while cutting the AOL improved ROM in extension, indicating that both ligaments provide essential stabilizing functions for the thumb joint.
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How to salvage the fractured coracoid during the Latarjet Procedure? An empirical approach.

Orthop Traumatol Surg Res

June 2024

Alps Surgery institute, Hand, Upper Limb, Peripheral Nerve, Brachial Plexus and Microsurgery Unit, Clinique Générale, Annecy, France; Hand and Upper Extremity Surgery Unit, Department of Orthopaedic Surgery, Lapeyronie Hospital, Montpellier University Medical Center, Montpellier, France; Amsterdam University Medical Center, Department of Orthopaedic Surgery, Amsterdam, The Netherlands. Electronic address:

The Latarjet procedure is a frequently used stabilization procedure in case of anterior shoulder instability with critical glenoid bone loss and/or off-track Hill Sachs lesions. Although uncommon, intra-operative graft fractures do occur. When confronted with this potentially challenging intra-operative complication, having a secondary solution is paramount to achieve a successful outcome.

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Sustainable practices in hand therapy: a global perspective.

J Hand Surg Eur Vol

September 2024

Orfit Industries, Wijnegem, Belgium.

Given its significant environmental footprint, healthcare sustainability is paramount. This study delves into the contributory role of hand therapy, assessing hand therapists' comprehension, implementation and barriers to sustainable practices, focusing on orthotic fabrication. A global survey distributed via social media and professional networks collected data on sustainability awareness, practices and educational needs from 113 respondents, primarily from North America (34%) and Europe (32%).

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Opportunistic hand radiographs to screen for low forearm bone mineral density: a prospective and retrospective cohort study.

BMC Musculoskelet Disord

February 2024

Department of Orthopaedic Surgery, Robert A. Chase Hand & Upper Limb Center, Stanford University, Stanford, CA, USA.

Background: Low bone mineral density affects 53% of women over age 65 in the US, yet many are unaware and remain untreated. Underdiagnosis of forearm osteoporosis and related fragility fractures represent missed warning signs of more deadly, future fractures. This study aimed to determine if hand radiographs could serve as early, simple screening tools for predicting low forearm bone mineral density (BMD).

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Managing the unknowns in distal radial fractures: commentary and opinion.

J Hand Surg Eur Vol

March 2024

Division of Orthopedics, Roth|McFarlane Hand and Upper Limb Center, University of Western Ontario, London, ON, Canada.

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Symptomatic varus malunion after proximal humeral fractures is associated with weakness and painful limitation of shoulder range of motion. When there is conformity of the articular surface and no avascular necrosis, a head-preserving procedure is best indicated. Arthroscopic arthrolysis, subacromial decompression, and tuberoplasty have been described for the treatment of mild deformity.

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Current Treatment Landscape for Dystrophic Epidermolysis Bullosa: From Surgical Management to Emerging Gene Therapies and Novel Skin Grafts.

J Hand Surg Am

May 2024

Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA; Robert A Chase Hand and Upper Limb Center, Stanford University School of Medicine, Palo Alto, CA. Electronic address:

Article Synopsis
  • Epidermolysis bullosa is a genetic skin disorder that leads to blister formation due to mechanical trauma, with dystrophic epidermolysis bullosa (DEB) being a severe form caused by COL7A1 gene mutations.
  • DEB presents symptoms like blisters from birth, extensive scarring, and deformities such as "mitten hand" from skin fusion.
  • Current treatments are mainly supportive, but new therapies, including gene therapy (like B-VEC) and advanced skin grafts, show promise for improving patient outcomes, especially in treating pseudosyndactyly.
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Researchers have been exploring alternative methods for bone tissue engineering, as current management of critical bone defects may be a significant challenge for both patient and surgeon with conventional surgical treatments associated with several potential complications and drawbacks. Recent studies have shown mesenchymal stem cell sheets may enhance bone regeneration in different animal models. We investigated the efficacy of implanted scaffold-free bone marrow-derived mesenchymal stem cell (BMSC) sheets on bone regeneration of a critical bone defect in a weight-bearing rat model.

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Purpose: This scoping review uniquely aims to map the current state of the literature on the applications of wearable sensors in people with or at risk of developing upper extremity musculoskeletal (UE-MSK) conditions, considering that MSK conditions or disorders have the highest rate of prevalence among other types of conditions or disorders that contribute to the need for rehabilitation services.

Materials And Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews guideline was followed in this scoping review. Two independent authors conducted a systematic search of four databases, including PubMed, Embase, Scopus, and IEEEXplore.

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Fear of Movement in People With CRPS: A Psychometric Evaluation of the Tampa Scale-11 for Kinesiophobia.

Clin J Pain

January 2024

School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

Background: People with complex regional pain syndrome (CRPS) commonly report a fear of movement that can worsen symptoms and increase disability. The Tampa Scale of Kinesiophobia (TSK) is used to evaluate fear of movement and (re)injury, but findings have been inconsistent in different populations.

Objective: To evaluate the psychometric properties of the Persian version of TSK-11 in individuals with upper limb CRPS.

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Introduction: Despite technological advancements in recent years, glenoid component loosening remains a common complication after anatomical total shoulder arthroplasty (ATSA) and is one of the main causes of revision surgery. Increasing emphasis is placed on the prevention of glenoid component failure. Previous studies have successfully predicted range of motion, patient-reported outcomes and short-term complications after ATSA using machine learning methods, but an accurate predictive model for (glenoid component) revision is currently lacking.

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Occupational Performance 1 Year After a Distal Radius Fracture From the Perspective of the International Classification of Functioning, Disability and Health.

Am J Occup Ther

September 2023

Amir Reza Farhoud, MD, is Assistant Professor, Department of Orthopedic Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Joint Reconstruction Research Center, Tehran, Iran.

Importance: Distal radius fractures (DRFs) frequently compromise independent functioning.

Objective: To analyze occupational performance post-DRF using the Canadian Occupational Performance Measure (COPM) and related interviews, guided by the International Classification of Functioning, Disability and Health (ICF). COPM score was compared with standard metrics: Patient-Reported Wrist Evaluation (PRWE) and Participation Behavior Questionnaire (PBQ).

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Do current upper limb orthotic classification systems help clinicians choose and design effective orthoses? A scoping review with expert interviews.

J Hand Ther

March 2024

Hand and Upper Limb Center, St. Joseph's Health Center, School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.

Background: Orthosis (orthotic) fabrication is an essential part of the treatment plan for many upper extremity conditions.

Purpose: We aim to comprehensively identify the current body of evidence about the purpose, structure, scope, and application of available orthotic classification systems. Our secondary aim was to know if the current classification systems can be used as a decision guide for clinicians.

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Purpose: As hand and upper extremity outreach trips increase, guidelines for assessing quality of care are being established. The Global Quality in Upper Extremity Surgery and Training investigators have published validated quality measures deemed to be essential for outreach trips to low and middle-income countries (LMICs). The purpose of this study was to assess baseline implementation of these quality measures across nine international hand surgery outreach sites to LMICs.

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The open Latarjet-Patte procedure for the treatment of anterior shoulder instability in professional handball players at a mean follow-up of 6.6 years.

J Shoulder Elbow Surg

April 2024

Shoulder, Elbow and Orthopaedic Sports Medicine, Orthopädie Sonnenhof, Bern, Switzerland; Shoulder, Elbow Unit, SportsClinic#1, Bern, Switzerland.

Article Synopsis
  • The study focuses on the Latarjet-Patte (LP) surgical procedure for treating shoulder instability in young competitive handball players, as this sport poses significant risks to the shoulder joint.
  • A total of 20 players (average age 22.9) who underwent the LP procedure were analyzed, with results showing an 85% rate of returning to play.
  • Outcomes included a mean Rowe score of 90 points and reported complications, such as a low recurrence rate of dislocations and some residual pain that was manageable.
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