Robot-assisted upper limb therapy improves shoulder joint proprioception after stroke / 中华物理医学与康复杂志

Objective To explore the effect of robot-assisted therapy on the shoulder joint proprioception of convalescent stroke survivors.Methods Forty stroke survivors were enrolled and randomized into an experimental group (n =20) and a control group (n =20).Both groups received routine drug treatment and rehabilitation,including the traditional kinesitherapy,occupational therapy and physical therapy,but the experimental group was additionally provided with 20 minutes of robot-assisted upper limb therapy 6 times a week for 8 weeks.Before the intervention and at 4 and 8 weeks the multi-joint system (MJS) upper limb proprioception test system was used to evaluate the average trace error and test execution time of the upper limb.Shoulder joint proprioception was measured at 30° and 60° in intorsion and extorsion using an isokinetic dynamometer.Results Before the training there were no significant differences between the two groups in terms of any of the assessments.After 4 and 8 weeks of training,significant improvement was observed in the measurements,and those of the experimental group were significantly better than those of the control group at the same time points.Conclusion Robot-assisted therapy can facilitate the recovery of shoulder joint proprioception after a stroke.It is worthy of application in clinical practice.

THE WEIGHT OF SCHOOLBAGS AND MUSCULOSKELETAL SYMPTOMS IN SCHOOL STUDENTS, ULAANBAATAR, MONGOLIA / Шинэ санаа Шинэ нээлт

There is a little information about weight excess of school materials in Ulaanbaatar, Mongolia. The aim of this study was to study of the weight of backback and the ergonomic effects of backpack carriage on school students in Ulaanbaatar. This cross-sectional study was performed in the city of Ulaanbaatar in 2015. Two hundred fourteen school students participated in study. Nordic Musculoskeletal Questionnaire was used, asking about complaints of neck, shoulders, upper and lower back. Length and weight of the children were determined. Backpacks were weighed and the relative weight of the backpack was calculated.In this study, first and second grades students carried proportionately heavier backpacks than older students and more than 10% of their weight. Musculoskeletal complaints were reported by about 79% of school students. The (relative) weight of backpacks was not related to complaints of neck, shoulders, upper and lower back.

Relations of Stiff Shoulders with Deep Hemodynamics Values / 日本温泉気候物理医学会雑誌

Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry.<br>The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO₂, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO₂. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO₂ and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.

Scapulohumeral Rhythm of Hemiplegic Patients by Plain X-ray Examination

OBJECTIVE: 1. To determine the difference of scapulohumeral rhythm (SHR) between the affected and unaffected side in hemiplegic patients. 2. To discover the influencing factors on altered scapulohumeral rhythm of affected side in hemiplegic patients. METHOD: Fifteen hemiplegic subjects, 18 to 54 years of age, participated in this study. Subjects were divided into two groups according to muscle tone on the basis of modified Ashworth scale (MAS). Plain X-ray of the shoulders were taken in neutral, 90 degree abduction, and full elevation of the arm in both affected and unaffected side. The arm angle, scapula angle, and glenohumeral angle were recorded for each individual in each of the three positions. RESULT: In the unaffected shoulders of hemiplegic patients, the mean values of SHRs from neutral to the 90o and from neutral to the 180o were 1 : 1.82 and 1 : 2.12, respectively. In the affected shoulders, the mean values of SHRs between 0~90o abduction and 0 to full abduction were 1 : 2.35 and 1 : 2.25, respectively. The mean value of SHRs from neutral to 90 degree of affected side was significantly decreased than unaffected side in the low tone group and increased in the high tone group (p<0.05). In addition, the SHRs of hemiplegic shoulders were significantly increased in the high tone group than the low tone group (p<0.05). CONCLUSION: Spasticity tends to result in decreased motion of scapula, which alters the SHR. A glenohumeral-to-scapulothoracic ratio of hemiplegic shoulder could be affected by spasticity and presence of subluxation.