PURPOSE: The Upper Limb Physician's Rating Scale (ULPRS) is a tool that assesses movement quality of the upper limbs. It is used as an outcome measure after botulinum toxin type A injection in children with cerebral palsy (CP). This study aimed to investigate the reliability and validity of the ULPRS in children with spastic CP. MATERIALS AND METHODS: Thirty children with spastic CP (M:F=17:13) aged 5 to 13 years old were recruited. The ULPRS was scored based on recorded videotapes by four physicians on two separate occasions. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL) was scored by an occupational therapist. Intraclass correlation coefficients (ICCs), 95% confidence intervals and weighted kappa statistics were calculated for the scores of ULPRS to obtain interrater and intrarater reliability. The relationship between ULPRS and MUUL was assessed using Pearson correlation coefficients. RESULTS: The ICCs for the total ULPRS scores were 0.94 between raters and 0.99 to 1.00 within raters. The weighted kappa statistics for subitem scores for the ULPRS ranged from 0.67 to 1.00 within raters and from 0.46 to 0.86 between raters. The relationship between ULPRS and MUUL was strong (Pearson correlation coefficient=0.751; p<0.05). CONCLUSION: The results demonstrated the high reliability of the total ULPRS score within and between raters. A significant concurrent validity between ULPRS and MUUL also supports the clinical utility of the ULPRS as an outcome measure of spastic upper limb in children with CP.
Adolescent ; Arm/*physiopathology ; Cerebral Palsy/*physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Male ; *Physicians ; Reproducibility of Results

Harlequin syndrome is characterized by unilateral hyperhidrosis and flushing, which are predominantly induced by heat or exercise. Usually, the sympathetic deficits confine to the face. Rarely, the autonomic deficits involve the arm or the parasympathetic neurons in the ciliary ganglia. We report a 43-yr-old woman who presented with facial flushing and sweating in the right side, which were mainly induced by exercise. The facial flushing accompanied relative coldness in the right arm. Valsalva maneuver, cold pressure and 0.125% pilocarpine test, and computed tomography of the chest were normal. The crossed sympathetic deficit in the left face and right arm suggested that the lesions were multifocal. The sympathetic impairment in our patient may lie on a spectrum of pre- and postganglionic autonomic dysfunction, which was observed in Holmes-Adie, Ross, and Guillain-Barre syndrome.
Adult ; Arm/innervation/*physiopathology ; Autonomic Nervous System Diseases/*physiopathology ; Face/innervation/*physiopathology ; Female ; Flushing/*physiopathology ; Humans ; Research Support, Non-U.S. Gov't ; Sweating/*physiology ; Syndrome

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

PURPOSE: The purpose of this study was to determine the effect of EPMLM(educational program of manual lymph massage) on the arm functioning and QOL(quality of life) in breast cancer patients with lymphedema. METHOD: Subjects in the experimental group(n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2weeks, and 6weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group(n=20). The collected data was analyzed by using SPSS 10.0 statistical program. RESULT: The arm functioning of experimental group was increased from 2 weeks after(W=.224, p=.011) and statistically differenced with control group at 2 weeks(Z=-2.241, p=.024) and 6 weeks(Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group(Z=-1.162, p=.050), also statistically differenced with control group(Z=-2.182, p= .030) at 6weeks. CONCLUSION: The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.
*Self Care ; *Quality of Life ; Movement ; Middle Aged ; *Massage ; Lymphedema/etiology/*therapy ; Humans ; Female ; Breast Neoplasms/*complications/therapy ; *Arm/physiopathology ; Adult

The effect of combined low-frequency repetitive transcranial magnetic stimulation (LF rTMS) and virtual reality (VR) training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups: experimental and control. In experimental group, the patients received LF rTMS and VR training treatment, and those in control group received sham rTMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment (U-FMA) and wolf motor function test (WMFT), and the secondary endpoint including modified Barthel index (MBI) and 36-item Short Form Health Survey Questionnaire (SF-36) were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study (55 in experimental group and 53 in control group respectively). After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval (CI) 3.6 to 22.7, P<0.01], WMFT scores (mean difference of 2.9, 95% CI 2.7 to 12.3, P<0.01), and MBI scores (mean difference 16.1, 95% CI 3.8 to 9.4, P<0.05) were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF rTMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.
Aged ; Arm ; physiopathology ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stroke ; physiopathology ; therapy ; Transcranial Magnetic Stimulation ; Virtual Reality Exposure Therapy

OBJECTIVE: To analyze and compare different methods for assessment of the limbs joints function and to discuss the rationality of the methods. METHODS: Eight hundred and six cases were collected from the Fujian Minzhong Forensic Appraisal Center from 2007 to 2010. These cases included injuries of large limbs joints with or without peripheral nerve injury. The loss of joint function was calculated according to the simple joint mobility method or the table method introduced in the book "Forensic Clinical Judicial Authentication Practice". The results of disability evaluation with different methods were analyzed and compared between different joints and injury patterns. RESULTS: In 642 cases of simple joint injuries without peripheral nerve injury, the results of disability evaluation based on simple joint mobility were the same as that based on the table. In 118 cases of joint injuries with peripheral nerve injury, all of them could be classified as disability, 33 cases (28.00%) had higher degree based on the table method than based on the simple joint mobility method. While 21 cases (17.80%) did not be evaluated as disabled based on the simple joint mobility method. CONCLUSION The evaluation for loss of limb function would be easier, more scientific and reasonable by the direct table method than the simple joint mobility method.
Accidents, Traffic ; Adult ; Arm Injuries/physiopathology* ; Disability Evaluation ; Extremities ; Female ; Forensic Medicine/methods* ; Humans ; Joints/physiopathology* ; Leg Injuries/physiopathology* ; Male ; Peripheral Nerve Injuries/physiopathology* ; Range of Motion, Articular/physiology* ; Trauma Severity Indices

OBJECTIVETo explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy.

METHODSFrom March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment.

RESULTSAll patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01).

CONCLUSIONSelective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

Adolescent ; Arm ; physiopathology ; Cerebral Palsy ; complications ; Cervical Vertebrae ; surgery ; Exercise Therapy ; Female ; Humans ; Male ; Muscle Spasticity ; etiology ; physiopathology ; surgery ; therapy ; Paralysis ; etiology ; physiopathology ; surgery ; therapy ; Spinal Nerve Roots ; surgery ; Young Adult

Aiming at three kinds of tremor, including essential tremor (ET), Parkinsonian disease (PD) tremor and physiological tremor (PT), which are subjected to frequent clinical misdiagnosis, a new method based on singular value decomposition (SVD) of empirical mode decomposition (EMD) and support vector machine (SVM) for the recognition of tremor is proposed in this paper. First, the hand acceleration signals of three different types of 40 tremor voluntary subjects were collected on the basis of informed consent, and the EMD method was used to decompose the signals into a number of stationary intrinsic mode functions (IMFs). Then the preceding four IMFs which could describe signals were selected, and the initial feature vector matrixes were formed. After the application of SVD technique to the initial feature vector matrixes, the singular values were obtained and used as the feature vectors of tremor types to be put in the support vector machine classifier as well as in the identification of tremor types. The results of experiment have shown that the proposed diagnosis method based on SVD of EMD and SVM can extract tremor features effectively and identify tremor types accurately. It also provides a new assistant approach for clinical diagnosis of tremor.
Algorithms ; Arm ; physiopathology ; Diagnosis, Computer-Assisted ; Diagnosis, Differential ; Electromyography ; methods ; Humans ; Muscle, Skeletal ; physiology ; Parkinson Disease ; diagnosis ; Signal Processing, Computer-Assisted ; Software ; Support Vector Machine ; Tremor ; diagnosis

AIMTo investigate the effects of RLI on plasma nitric oxide (NO) and NO synthase (NOS) isoforms of healthy humans.

METHODS30 healthy human subjects (aged from 40 - 70 years old) were recruited. RLI was induced by five 5 min cycles of ischemia of non dominant arm (200 mmHg, 5 min interval). Blood pressure, heart rate, and the feelings of ischemic arm were continuously monitored. Venous plasma was collected in contralateral arm at Pre, Post-0 h, Post-4 h, and Post-24 h. Plasma level of NO was measured by Griess reaction, and NOS was measured by chemical method.

RESULTSBlood pressure and heart rate varied in normal range. The uncomfortable feeling was decreased with the increasing numbers of ischemic cycles. Plasma level of NO, and iNOS in plasma were significantly increased at Post-0 h, Post-4 h, and Post-24 h compared to Pre (P < 0.05). tNOS was also significantly increased at Post-0 h and Post-4 h compared to Pre (P < 0.05). No significant change in plasma cNOS was shown at following three time points than Pre.

CONCLUSIONThese findings suggest that RLI can elevate plasma level of NO, tNOS, and iNOS in healthy humans. RLI might be a safe method as a rIPC, and it would have important possibility to be performed in clinic.

Adult ; Aged ; Arm ; blood supply ; Female ; Humans ; Ischemia ; blood ; physiopathology ; Ischemic Preconditioning ; methods ; Male ; Middle Aged ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; metabolism ; Reperfusion Injury ; physiopathology ; prevention & control