Synthesis Bullet Analysis Paper

Synthesis Bullet Analysis Paper
Lia Groulx, Synthesis Bullet Analysis #1
Langan J, DeLave K, Phillips L, Pangilinan P, Brown SH. Home–Based Telerehabilitation Shows
Improved Upper Limb Function in Adults with Chronic Stroke: A Pilot Study. Journal of
rehabilitation medicine. 2013;45(2):217–220. doi:10.2340/16501977–1115
What did the researchers study and why?
Technology–based rehabilitation for stroke patients with chronic upper–limb conditions
Testing the success of telerehabilitation training
The potential for expansion of physical therapy to more patients
More accessible system of keeping track of patients and their improvements or set backs
Who participated in the study?
Seven adult stroke patients with an upper limb handicap o 5 males ages: 50, 56, 62, 63, 63
♣ ... Show more content on Helpwriting.net ...
What are its limitations?
Contribution/s: increased accessibility to and for patients, rehabilitation program post–stroke from
home, provides a focus on motor functions, improving post–stroke patient care practices, offering
feedback to patients directly during rehabilitation
Limitation/s: most stroke patients do not continue rehabilitation treatment/exercise within a year of
their accident causing these handicaps; suggests that patients may not follow through with training
How scientifically valid is the study? How clinically useful is this study?
Scientifically Valid?
Randomized – no
All participants accounted for – yes
Blinded – no
Participants similar at start – demographically no, physically yes (upper limb
Participants treated equally – sort of (allotted different times for tasks, levels of difficulty adjusted,
time taken for rest, different home

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Nursing Case Study Musculoskeletal
Musculoskeletal The patient has right sided weakness on upper and lower extremities related to her
stroke. Right sided weakness prevalent on range of motion exercises, mobility and strength is
limited. Left sided range of motion was completed while the patient was sitting bedside, she was
able to complete range of motion by lifting left leg, bending left knee and flexing the left foot
without difficulty. The patient is unsteady, weak and is unable to stand or transfer on her own, so I
was unable to perform the Romberg test, assess gait, heel to toe walking, standing on one foot, or
shallow knee bend. I observed the patient's spine with the client touching her toes from a sitting
position at the edge of the bed, spine is straight, with ... Show more content on Helpwriting.net ...
Encourage patient to be conscious of body parts and watch feet, use of visual and tactile stimuli
assists in reintegration of affected side.
Evaluation The goal will be met when the patient retains or gains sensory motor function back to her
baseline or improvements are noted from her time of admission. Additional care and therapy may be
necessary if the patient does not meet the goal by the desired date. Long term therapy or care may be
a consideration.
Nursing Diagnosis #3 Self–care deficit R/T neuromuscular impairment AEB impaired ability to
perform or complete ADL's.
Outcome The patient will demonstrate techniques and lifestyle changes to meet self care activities
within the level of their own ability by 05/10/18.
Interventions
In order to promote recovery and maintain self–esteem, avoid doing things for the patient that she
can do for herself.
Do not rush the patient, allow the patient sufficient time to accomplish task, this shows empathy and
consistence with assistance.
Provide positive feedback on the patient's efforts and accomplishments. This will enhance the sense
of self–worth, promotes independence and

Orthopedic Physical Assessment and Physical Therapy Essay
In physical therapy, patients come to the clinic with a long list of symptoms and a specific
mechanism of injury. It is the physical therapists job to take this information and form hypotheses of
what pathology may be affecting the patient. With the patient that has been presented in this case, a
full history shows a very good description of symptoms and what the patient remembers happening
when the injury occurred. With this history, an examination plan can be created in order to make this
examination process thorough, but efficient.
A hypothesis that can be made from the patient's report is that she is suffering from cervical
radiculopathy, or a nerve root lesion. Symptoms that describe cervical radiculopathy include: arm
pain in a ... Show more content on Helpwriting.net ...
375). That is why it is still important to perform red flag testing to keep the patient as safe as
possible. Red flag tests indicate if something potentially dangerous or life threatening is going on
with the patient. This will cause a physical therapy examination to stop and that patient may be
referred to their primary care physician for further care before physical therapy can proceed. These
tests include vertebral artery testing and cervical instability testing (Dutton, 2012). The vertebral
artery test rules out any blood supply being cut off to the brain (Magee, 2008, p. 150). In terms of
cervical instability testing, the transverse ligament and alar ligament tests should be done to avoid
any bones in the cervical spine moving out of place to damage the spinal cord (Magee, 2008, p.
180). When these two red flags are tested and found to be negative, the rest of the exam can start. If
they turn out to be positive, a referral back to the patient's primary care physician should be made
before any excursion of the cervical spine occurs. Active range of motion testing with passive end
feel testing should be done next. This will allow the physical therapist to observe and feel the range
of motion the patient is able to do. Also, the therapist will be able to note motions that elicit pain and
if radiating pain occurs. Next, muscle length testing will detect any shortening due to the

Description Of An Artificial Device
By: nada kabouli Wafaa kaffas Mirna Ramadan
Amputation:
Is the absence of part of the upper or lower extremities
Causes of amputation:
1–peripheral vascular disease
2– Trauma
3–malignancy
4 congenital deficiencies
Prosthesis
Is an artificial device that provide replacement for a missing body parts of the lower or upper
extremities, is designed to replace the function or appearance of a missing limb or body part.
Purpose:
1– To provide an individual who has an amputated limb to perform functional tasks, walking which
may not be possible without the limb.
2– use during activities or sports, such as swimming, climbing, driving and dancing
3– use to activity of daily living such as eating, taking a shower
Description:
1–Be comfortable to wear
2 –removable (Easy to put and remove) 3–Lightweight,
4–permanently implanted
Considerations when choosing prosthesis:
1– Amputation level
2–cognitive function
3– Financial resources of the patient
4–contour of the limb
5–cosmetic importance of the prosthetics
6– Patient job
Problems may occur when using prosthesis are:
1–causes unequal weight load to lower limbs
2– Cause extra stress or pressure on the other (uninvolved) leg
3– The increased pressure may lead to pain and skin problems
4– Walking with prosthesis on takes extra energy.
5– Need to be adjusted several times
Prostheses are typically manufactured using the following steps:

1–Measurement of the stump.
2–Measurement of the body to determine

An Approach of Designing an Exoskeleton Arm
An approach of designing exoskeleton arm is synthesized by all dynamic forces and stress of arm .A
musculoskeletal arm model is built to simulate the injury symptom in terms of evaluating the muscle
activations, by using related commercial design software and also specific biomechanics software is
used for analyzing the exoskeleton . A stimulation platform is created by synthesizing a
biomechanical model of human body and the exoskeleton which allows and evaluates the
functioning and effects of two models. Results of design analysis and optimization are included
INTRODUCTION: An exoskeleton suit is designed to grant support, aid and defense for the human
body. Starting from these main functions researchers create robotic suits by combining several
technologies for military use to help soldiers with a bit of super–human strength, medical exosuits
are the one which augments the human strength and speed ,and exoskeleton suits that offer hope for
paralyzed persons. This is achieved by providing feedback to the various joints of the upper limb
which include the wrist, elbow and shoulder. When in use, the device itself may be grounded, in
which case it limits the human mobility. Exoskeletons can be categorized into two major groups,
passive and active exoskeletons. Several passive exoskeleton robots have been developed recently.
The first true exoskeleton in the sense of being a mobile machine integrated with human movements
was co–developed by General Electric of United

Mirror Therapy Research Paper
LOWER EXTREMITY MIRROR THEARPY IN STROKE PATIENTS WITH NEGLECT
Alli McCarthy
PT 640 Research Proposal
Spring Semester 2015
Research Question: Can mirror therapy performed on the upper and lower extremity of stroke
patients improve unilateral visual neglect more than mirror therapy exclusively performed on the
upper extremity?
Abstract
Background and Purpose. Stroke patients with visual neglect can be treated with mirror therapy to
improve neglect and function. Previous studies have shown improvement of neglect and function in
stroke patients who are given mirror therapy on the upper extremity only. This research will exam
whether mirror therapy of both the upper and lower extremity can show greater improvement than if
mirror therapy is performed ... Show more content on Helpwriting.net ...
A pilot study will be performed since no current research looking at the effect of mirror therapy
performed on stroke patients with neglect with primary outcome measures of SCT and LBT have
provided exact values of means with standard deviations between the groups. An effect size of .50
will be used based on the study performed by Pandian et al. which looked at the effect of mirror
therapy performed on stroke patients with neglect and used similar primary outcome measures as
this study (Pandian) Therefore, with an effect size of .5, a sample size of 64 participants in each
group will be needed. However, it is necessary to account for a predicted attrition rate when
recruiting participants. Based on the 12% attrition rate seen in the study performed by Pandian et al.,
this study will start with an additional 8 participants per group with the hope of maintaining 80%
power and reducing the risk of a type II error. (Pandian) Therefore, this study will begin with 72
participants in each group. An intention–to–treat analysis will be performed in order to account for
subjects who drop out of the study. A Bonferroni adjustment will be made in order to maintain an
overall α2 = 0.05 to protect against type 1

The Neurodevelopmental Treatment Approach: A Case Study
The Neurodevelopmental treatment approach was also known as Bobath treatment and is based on
normal development and movement. (Schultz–Krohn, Pope–Davis, & Mclaughlin–Gray, 2014, p.
804). The objectives of this theory is to normalize muscle tone, inhibit primitive reflexes, and
facilitate normal postural reactions (Schultz–Krohn, Pope–Davis, & Mclaughlin–Gray, 2014, p.
804). The key objectives for this theory are to improve the quality of movements and helping clients
relearn normal movements (Schultz–Krohn, Pope–Davis, & Mclaughlin–Gray, 2014, p. 804). To
achieve the key objectives therapist use techniques such as handling techniques, weight bearing over
the affected limb, use of positions that encourage the use of both sides of the body, ... Show more
content on Helpwriting.net ...
The occupational therapist use handling by using his/her body in contact with the client to promote
more efficient movement and avoid unwanted motor responses (McLaughin, 2014). The therapist
uses handling to add the sensorimotor information that the client experiences during performing
task, to make the client more aware of his body and incorporate the hemiplegic side and to assist in
coordination and timing of movements patterns (McLaughin, 2014). The client should be active in
the process (McLaughin, 2014). Handling and guiding should be graded just enough assistance and
input to give the client a feel more for a more efficient movement pattern and then be gradually
withdrawn as the client prgressess and is able to do more of the movement pattern task more
independently (McLaughin, 2014). Inetervention for limb movements is graded from closed chain
movements to open chain patterns (McLaughin, 2014). An example of a closed chain pattern for the
upper extremity would incoporaring the arm in weight bearing alignment for postural support and to
assist with balance during an activity such as standing as a counter while bearing weight on one
hand for support and reaching overhead into a cubboard for an item (McLaughin,

Origin And Development Of Hunting
"Origin and Development of Hunting in Humans" Everyday humans around the world consume
meat for nutritional value and; though it is out of mind, survival. When we plan to acquire meat
today it is typically purchased from a store where it had been processed and packaged. However the
process of acquiring this valuable protein was not always so simple. It has been proposed since the
time of Darwin and his theory of Evolution that it was our initial conversion into omnivores who
both hunted and gathered that gave us the extra nutrients to further develop as an intelligent race.
Not only did meat help enlarge brain size but it has been argued to shape our morphology which
further aided in hunting and survival on the savannah rather than in trees. Darwin's evolutionary
studies have remained unchallenged until recently. Darwin specified hominization began when our
ancestors abandoned the trees, embraced an upright bipedal gait, and began using their free hands to
create and use tools. Tools became vital for the purpose of hunting and carcass processing. Darwin
explained that meat, obtained through hunting, became the most stimulating component in hominid
adaptation to savannas. Triggering a progressive increase in brain size, meat subsequently led to
increased intelligence. Another element surrounding this theory of evolution suggests men are
superior in mental endowment to women. Hunting being primarily a male activity and gathering
primarily for females its possible gender

Mental Performance: Video Analysis
The video starts off talking about a man who had a stroke and he is cognitively functioning well, but
does not have use of his left upper extremity. They are trying to help him regain strength in his left
hand by not letting him use his right hand. The key to help regain strength in the extremity that is
not strong is to keep repeating exercises. You have to keep using the limb to help your brain revert
back to how it was before it was affected. Another topic that the video talks about is how age affects
mental performance, as you age you become slower with processing information and recalling less
information. Physical activity and the other part is genetics have a big part on how fast the brain
ages. The video also goes on to talk about parkinson's

Observation Of The Client, The Head
On observation of the client, the head is rotated a little to the left as well as a slight chin poke is
noticed. Also, more bulk is noticed on the right trapezius musculature. Range of motion examination
of the cervical spine indicates pain 2 type on active and passive extension. Similarly, pain 2 type is
reproduced on right side flexion on both active and passive movement. On passive accessory
intervertebral movement examination, Postero–anterior central pressure (PA) reproduces pain before
resistance at the 6th cervical vertebrae. Postero–anterior unilateral pressure on the right articular
processes patient experiences pain before resistance at the 6th and 7th cervical vertebrae. A
transverse pressure on the 6th and 7th cervical vertebrae produced pain before resistance as well.
Manual muscle testing indicates a weakness of the right triceps. Since the upper traps were painful
moving into position they were not tested. On palpation, the right upper trapezius was tight and
painful as well as the right scalenes. The joints above and below were tested with decrease in ROM
detected. ROM at the shoulder was examined with decrease in flexion of the glenohumeral joint and
decrease in the range of medial rotation of right shoulder.
On carrying out of special tests, Myotomes were positive for triceps weakness and dermatomes were
positive for tingling at C6 level on right. Upper limb tension tests (ULTTs) were carried out with
ULTT1 and ULTT2a positive due to pins and needle

Plantar Flexion
"Full–movement neuromuscular electrical stimulation improves plantar flexor spasticity and ankle
active dorsiflexion in stroke patients: a randomized controlled study"
This was an interesting article. It examined the use of electrical stimulation as a treatment for
spasticity in the ankle plantar muscles, specifically the tibias posterior, gastrocnemius, and soleus.
Electrodes were placed over the extensor digitorum longus muscles and the extensor hallicus
muscles of post stroke patients with plantar flexor spasticity. Various intensities were tested. The
article explains that spasticity in the ankle plantar flexors can lead to an equinovarus or
strephenopodia deformity. The article also recognizes the common use of botulinum injections
which ... Show more content on Helpwriting.net ...
The control group received only standard physical therapy treatments (stretching and strengthening
exercises). There were three experimental groups. One group received estim to the intensity of
stimulating only sensory nerves. The next group received estim with an intensity that minimally
stimulated motor neurons. The final group received "full movement neuromuscular electric
stimulation," which was an estim intensity to the maximum tolerated intensity to receive maximum
muscle movement. All three experimental groups also received standard PT interventions (stretching
and strengthening exercises). At the start of the four week trial there were no measured differences
between the groups. After the four week, all four groups had decreased spasticity, however only the
FMNES group retained a significant after a two week fallow up and there were no significant
differences among the other three groups. Also only the FMNES group retained increased
dorsiflexion strength after the two week follow up (which was significantly greater than the control).
An LSD post–hoc test revealed that all four groups had an equal significant reductions in "timed up
and go" walking time at the two week follow

My Life Of A Refugee
From 1991 over one–sixth of Bhutan's people flee their country and take a shelter in Nepal, India
and other countries around the world. The large populations of Bhutanese refugee are called
lhotshamps, an ethnic group, who were forced to leave their country in the early 1990s. Among
105,000 Bhutanese I'm one of them. I was born in a hut made of bamboo, food rations, and dirt
roads. We are hostile, unsettled, unsure of who we are and what future held for us. I often think can
we ever able to get rid out of the tag called "refugee" would my life ever changed, while ongoing
tussled between mind and outside world finally in 2008 United States open a door for us to settled in
the United States a "promised land" with full of struggle in 2009 we came here at Grand Forks. As I
was growing up in the refugee camp I have seen a countless number of violence, crimes, injuries,
and rebuff that words can't be described. Most importantly death of people from a disease that can
be a cure if, we have enough facilities such as, advanced medical training and hospitals. Although
during my early childhood I have seen so much of maltreatment and practices, I always thought of
having a career in health–related profession because I wanted to invest and improve the lives of
individuals so that their children don't have to orphans, forced to work when their parent died, nor
they have to beg for food. When I was 10 years old, my friend and I were trying to climb up the
mango tree and I step in

The Game Of Softball : An Explosive And Peak Power Of The...
Application The game of softball is very explosive and peak power of the upper extremity can
improve many different areas of the sport. In softball, it is important to have a strong quick throw in
order to get as many outs as possible. Every second counts and having a weak throw can cost a
runner to be safe by only a tenth of a second. It can also relate to hitting, being able to have quick
hands to the ball. Having power of the upper extremity is a major difference between a good and a
great athlete.
Scientific Background and Research Power is the rate at which work is performed. It has a speed
component to it, unlike strength. The explosive aspect of strength is referred to as maximal muscular
power and is the functional application of both strength and speed of movement (Kenney, Wilmore,
& Costill, 2015). The Wingate Anaerobic Test (WAnt) has been proven to be a tool that is reliable
for assessing muscular power, endurance and fatigue. A study was completed in order to determine
the relationship between upper body strength and power and on the upper body
anaerobicperformance. A bench press and bench press throw was used to determine upper body
anaerobic performance and was measured during an arm ergometry WAnt (Lovell, Mason, Eagles,
Shewring &Mclellan,2011). There were 24 men and 16 women who were physically active to
participate in the study. The participants were asked to not complete any exhaustive exercise 48
hours prior to the session. To assess strength,

Upper Limb Disorders Research Paper
According to recent reports by the health and safety executive, there are thousands of cases that are
related to upper limb disorders. These cases include a wide range of work related complaints that
include shoulder, neck, hand, elbow, wrist and fingers. Most of this is brought about by continuous
repetitive or strenuous activities. According to the law if a person is affected by a work–related
upper limb disorder an employer could be held liable especially if they failed to control and manage
the risks related to the condition effectively. Upper limb disorders can be brought forward if
symptoms such as tenderness, swelling, weakness, stiffness, cramps, aches and pains show up. An
upper limb disorder can only be diagnosed as work–related upper limb disorder if there is enough
proof that it was caused by the activities and processes that one does at work. These ... Show more
Eventually these symptoms may become so intense that the affected person might have problems
doing simple day to day tasks. Sometimes treatments like resting the affected limbs or having
physiotherapy sessions can end up not being enough so the person affected might have to stop
working in the same job because of pain. The compensation can help cover the medical bills and
treatment, as well as other monetary, social and emotional losses. In order to be able to win such
cases you will need a solicitor. To start off with a solicitor it is vital to understand the no win no fee
agreement, the no win no fee upper limb disorder claims start once the person affected agrees with
his/her solicitor a Conditional Fee Agreement. This agreement explains that the lawyer will only be
paid once they successfully win your claim. Selecting an injury specialist solicitor helps you
prioritise your recovery, and you will also be sure that there will be nothing that is required to be
paid

Pinky Finger Crush Injury Report
Reason for Visit: Right index and pinky finger crush injury S: TM works in Engine 2. According to
TM he was repairing an engine, the wrench slipped off a bolt and he smashed his right hand on the
engine pallet, injuring his right index and pinky fingers. TM rates his pain at 7/10 pulsating pain. O:
Right index; minimal bleeding, small laceration present at the dorsal DIP joint, Full ROM, tender
with palpation; erythema and edema present, clean, minimal tension, minimal bleeding, NO FB,
Surrounding intact skin Right pinky finger Subungual Hematoma present, mild edema at DIP joint.
Full ROM; A: Right index and pinky finger crush injury Right pinky finger Subungual Hematoma
P: Right index and Pinky : Clean the wound with tap water and Hibiclens,

Brain Trauma Essay
Haptic and Exoskeleton Devices, Virtual Reality, and Upper Limb Neurorehabilitation
Leah Piggott, Samantha R. Wagner, and Mounia Ziat
Abstract– Brain trauma frequently affects an individual's motor functioning and sensory feedback.
Current neurorehabilitation research explores how technology can improve a patient's quality of life.
Haptic and Exoskeleton devices assist in motor functioning, and enable sensory and haptic
feedback; virtual reality can create immersive environments or games for rehabilitation. Research is
also focused on inexpensive technologies that can be used in therapy settings or at home.. This
review highlights the most important haptic and robotic devices used in neurorehabilitation research
and their benefits, as well ... Show more content on Helpwriting.net ...
Drug prescriptions may help with pain, and occupational therapy, physical therapy, and massage
therapy are useful for the recovery of motor and sensory functions. However, there are limitations to
these therapies, such as when and where they can be performed. Additionally research has focused
on a person's overall ability or disability in performing activities of daily living (ADL) after therapy,
which doesn't distinguish between the motor function of the affected limb and compensation by
other limbs. Neurorehabilitation research contributed to changing the discussion to an individual's
level of motor and sensory function and the development of assistive haptic and robotic devices [6].
The range of technology varies from simple end–effector devices to full scale exoskeleton robots, to
be fitted to the hand or affected limb.
(talk about importance of immediate, and repetitious movement for rehabilitation) If motor
functions of the upper limbs are not addressed within the first three months and improvements are
not seen by six months, a person may not be able to regain the level of motor skills they had before a
stroke [1], [13], [17]. Not only has this research improved the lives of patients and the quality of
rehabilitation, but it has improved our understanding of how humans interact with their environment

Designing an Exoskeleton Robotic Arm
It was believed that the decisive factor for designing a robotic arm is its inexpensiveness and
friendly interfacing with the user. Teleoperated master–slave anthropomorphic robotic arm with the
single axis revolute joints having six degree of freedom was designed [13]. The master used the
human machine interface (HMI) to operate in RTOS. The master incorporated the motion capture
devices, such as vision sensors to transform the motion into analog voltages so as to actuate the
exoskeleton robotic arm. The human machine interface comprised of GUI (Graphical User
Interface) system, an Exoskeleton Robotic Arm and a Mode selector which enabled the operator to
choose among the three modes of operation (manual, autonomous and semi–autonomous).
We humans are companionable with the amorphous environment which is the principal benefit of
advancement of Exoskeleton robots in the field of teleoperation. The 6–DOF exoskeleton enables
the robot to elevate and shift items anywhere in space. A 6–DOF exoskeleton is very analogous to
homo–sapiens in regards to no. and joints position. The limitation of this model was inadequate
precision because of the non–linearity and mechanical coupling of the joints. [13]
Nakai implemented a human interface technique using force feedback mechanism attached to the
operator's hand and named it Sensor Arm System [5]. The arm served the basis of the Master–Slave
manipulator system in Teleoperation. The arm with which he experimented had 7–DOF same as that

Right Shoulder Pain Case Summary
CC
Right shoulder pain.
Tick bite.
S
The patient is a 64–year–old gentleman who tells me nine or 10 days ago he started having pain in
his right shoulder which started in the morning. He states that prior to this he has been doing
increased amount of work at his horse farm. He has had to not only bale hay, he has needed to lift 15
car batteries up onto a platform. He also tells me he caught a heavy "I beam" and felt a jerk of his
shoulder several days prior to onset of pain. He states the day after the onset of the pain, he had such
back pain, he had a difficult time sleeping. He was taking Advil every six hours, but this was not
helping the pain. At that point, the pain was gone up not only in his right shoulder but going up his
neck and down his arm. He tells me that he then switched to Aleve, two tablets twice a day and
started using ice alternating with heat. He states the ice seems to work magic for him and one week
after the pain started he woke in the morning and had no pain. He states that he still gets an
occasional twinge, but it is almost completely resolved. He does worry because he works on a horse
farm and does not want to have any sort of intervention if not needed. He does occasionally get
aches and pains in his shoulders and at this point, this is the state he is in. ... Show more content on
Helpwriting.net ...
He states two weeks prior to her shoulder pain, he got a tick bite in his right elbow. He does state it
was a Deer Tick and was embedded. He did take one dose of doxycycline and that his wife had left
over from her prescription. He did look for a rash, but did not have any other than irritation from the
tick bite. He states that he did not have any fevers, other skin rashes, body aches other than the
shoulder. He does request today a prescription for doxycycline to have on hand in case he gets more
embedded tick

Upper Limbs Experiment
To become familiar with the scientific method and know how to use the metric system of
measurement. A person who has long upper limbs tends to be tall and vice versa. The length of a
person's arm in centimeter is equal to 40% of his or her height in centimeter. Materials needed for
this experiment are the calculator, metric stick or measuring tape, and 5 students. The formula to
calculate the expected arm length is the height in centimeter times 0.4. If the experiment could be
done again, the subjects could all be boys' upper limb length and height or could all be girls' upper
limb length and height. Then, the student could see the difference between the girls and boys upper
limb length and height. An error that could have happened is that

Intermittent Numbness Case Summary
Chief Complaint Intermittent numbness, left lower extremity. History The patient is an 80–year–old
right–handed white female, who presents with her male partner for evaluation of left lower
extremity symptoms. She did present for an EMG nerve conduction study in May. At that time, she
gave a history of intermittent numbness into the anterior lateral thigh. The numbness rarely extended
below the knee at that time, and it rarely occurred on the right. There was no clear radicular
component. Her exam was normal. Her EMG of the left lower extremity was limited because she is
on Pradaxa, but it was normal and CBs were consistent with a mild motor neuropathy. The diagnosis
was possible meralgia paresthetica. The patient now states that the numbness is intermittent. It is on
the anterior thigh, but now it goes down into the calf anteriorly and ... Show more content on
Helpwriting.net ...
Allergies Niacin. Physical Examination Constitutional Weight 175. She is 5'3". Respiration 12.
Pulse 69. General She is in no obvious distress. Mental Status She is oriented x3, alert, and
cooperative. Good short–term, long–term, and intermediate memory. No aphasia. Normal fund of
knowledge, attention, and concentration. Cranial Nerves Visual fields full to confrontation.
Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation, and movement.
Tongue and uvula were midline. Decreased auditory acuity bilaterally. Normal shoulder shrug.
Motor Exam was 5/5 in the upper extremity and right lower extremity. She had 5–/5 of her left
quadriceps. Tone was normal. Sensation was intact to primary modalities. Cerebellar Revealed good
finger–to–nose, heel–to–shin, and rapid alternating motion. Gait Slightly antalgic. She did have poor
toe walking on the left. DTRs 2+ in the upper extremity, 1+ at the knees and ankles. Toes are

Skfs Essay
The Little Bison Basin
PROBLEM
8
,t
..
~
The Little Bison River flows from small glaciers in the high cirques of the Rocky Mountains east to
the Great Plains of North America, where it ultimately joins the Missouri system. The valley
through the Rockies contains a few small towns which are supported by the ski industry and
tourism. Recently, extensive natural gas deposits have been discovered in the area, and salvage
archaeology projects have been funded to assess the nature of archaeological resources prior to the
construction of pipelines, access roads, and well heads. You have been asked to summarize the
prehistory of the area for a book on the local history of the resort town of Poplar, soon to celebrate
its centennial. ... Show more content on Helpwriting.net ...
Rock suitable for the production of stone tools is fOW1don every mountain range, and in creek beds
as cobbles and pebbles. Two surveys have been conducted in the area. Horned Toad Consultants
conducted extensive judgemental surveys during initial impact assessment, concentrating on the
grasslands of the Little Bison valley, two arbitrarily chosen tributary valleys (Cripple Creek and
Silver Creek), one cirque (below Smith Peak) and the Inverness Plateau. Four site types were
defined. Camp sites contain a wide range of artifact types and fire broken rock. Kill sites contain a
restricted range of artifacts (mainly projectile points) and large quantities of bone. Lithic scatters are
small sites with no diagnostic artifacts. Quarries have large quantities of debitage, usually associated
with shallow pits dug into bedrock. The distribution of sites and diagnostic artifacts is shown in
Figure 8.1. Recently R. Bootheel undertook a survey of the area using random sampling techniques.
Although her M.A. thesis is still being written, she has commented on the previous survey as
follows:
ARCHAEOWGICAL DATA
Survey

!
~
i
I.';.
My work in the region confirms the dense distribution of sites along the Little Bison valley and all
tributary valleys. It also identifies the much lower frequency of sites in plateau areas. However, the
judgemental sampling techniques employed by Horned Toad Con– .

Interactive Visuo Motor Therapy Essay
Interactive visuo–motor therapy system for stroke rehabilitation
Abstract:
Background: Stroke can cause multiple neurological impairments which may relentlessly reduce an
individual's ability to perform normal daily activities. Approximately 30% of individual's with arm
paralysis do not regain considerable dexterity after 6 months. The most common therapies at the
moment are techniques that are readily used within occupational and physical therapy, and tend to
focus on guided limb manipulation as well as task–oriented exercises. Methods that utilize virtual
reality (VR) technology build on this methodology and are increasing the range of possible tasks,
partly automating and quantifying therapy procedures, and improving patient motivation ... Show
more content on Helpwriting.net ...
Introduction: A thorough search of existing literature was done to identify any prior studies that have
partaken in Mirror Therapy. Thus, this current journal included journal articles that were assessed
and reviewed for the overall significance. Methods: Fifty one studies were utilized and taken into
account. Furthermore, there were five different categories established. Of these, twenty four studies
paid attention to mirror therapy after stroke, thirteen studies pressed the factor of Mirror therapy
after having an amputation, three studies then focused on mirror therapy with complex regional pain
syndrome. Two studies took into account cerebral palsy, and one was based on after a fracture.
Results: Theses studies demonstrated that there was a trend among Mirror Therapy and benefited all
of those previously mentioned. Conclusion: Due to the diversity, and widespread range use within
these studies, it allowed for more insight into Mirror Therapy on a generalist scale. Comparison
studies, along with physiotherapy modalities, interventions, and outcome measures were all taken.
All demonstrated an improvement among functional movements from the healthy limb to that of the
impaired

Upper Limb Function Research Paper
What is the efficacy of Mental Practice/Mental Imagery for Upper limb Function in a Stoke
Population, both acute and Chronic?
Student Number: 400042610
Course Name: PT 711
Course Instructor: Liliana Coman
Date Submitted: Tuesday, October 11, 2016
Introduction:
Mental practice (MP) is the act of safely visualizing and repeating movements without any outward
physical movement, and requires mental imagery or internal guidelines of movements.1–6 In fact,
MP can be performed through incorporating a variety of senses, where visual is the most commonly
used, as well as from different perspectives, where first person, or kinesthetic, is the most commonly
used requiring the individual to visualize themselves doing an action.4,6,7 Historically, it was
shown that visualizing a task could result in physical success, and thus began the study of MP in the
context of sports psychology to improve athletic performance and acquisition of new skills.5,6
Eventually imaging studies began showing how MP activated brain areas similar to those activated
during physical action when engaging in motor learning.5,7 This similarity in

Essay On Robotics-Assisted Therapy
IntroductionRobotics–assisted therapy is the new advent for medical advancements, helping
patientsrehabilitate, recover, and have an overallbetter quality of life. Those who have suffered from
astroke, spinal cord injury, or neurological disorder are now able to benefit from thesetechnological
advances in ways no other physical modality can provide.Types of Robotic ProsthesesUpper
ExtremityThe need for a specific device is often based on the pathology involved. Since strokes
arethe most common case among disease and injuries for upper limb movement disorders,
ourfindings will start there.Rehabilitation hospitals likeBurkeMedical Research Institute (BMRI)are
currently implementing robotic rehab in all of their physical therapy programs ... Show more content
on Helpwriting.net ...
invented a robotic arm exoskeletonwith an integrated springmechanism and an overhead sling
suspension system for fine motor skills. The device'sobjective was based on functional task
orientation along with training in a virtual environmentand therapeutic monitoring CITATION
Lou13 l 1033 .Another rehab robot named "Luna"works with electromyography (EMG) technology
to diagnose the tonic state of muscles and thenerve conductibility of cells around them. "(Luna's)
versatile system's force sensors allow it todynamically change the resistance during therapy
sessions, offering patients a range ofpossibilities for isokinetic, isometric and isotonic exercises, and
uses automatic weightcompensation to detect as little as 0.2Nm" (Bortole, 2015).When motor
neuron cells sendelectrical signals to the muscles, the EMG electrodes detect them and determine
the strength andoverall health of the muscles. It can diagnose nerve or muscle malfunction and
anycommunication problems between nerves and musclesLower ExtremitySpeaking of innovation,
another visionary (and double amputee) is Hugh Herr, inventorand owner of BiOM,"the first lower–
leg system to use robotics to replace muscle and tendonfunction" (Shaer, 2014). Working with MITS
media lab, he has developed his own system forthe ankles, feet and knees. His vision was to
improve the mobility and feel of the prosthetic leg
Speaking of innovation, another visionary (and double amputee) is Hugh Herr, inventorand owner of
BiOM,"the

Analysis Of Physiotherapy Assessment Of A Young Boy '...
Introduction
Physiotherapy assessment involves forming hypotheses, and thus a diagnosis, by way of
questioning, observation and physical examination. It is a requirement of the Health and Care
Professions Council (HCPC) as stated in the "Standards of Proficiency: Physiotherapists" All details
and information recorded are highly confidential, so patient records must be maintained
appropriately, and confidentiality of these never breached (HCPC 2013).
In the following report, I will be discussing the hypothetical assessment of a young boy 'Miguel',
who suffered a supracondylar fracture. As he is under 16, he will be accompanied by a
parent/guardian who may possibly contribute to the assessment process. Consent should also be
given prior to assessment.
Subjective Assessment – History Taking
This subjective assessment forms a series of questions posed to the patient relating to their present
condition/problem (Farr 2014a). Important factors that must be taken into consideration prior to
treatment, such as patient preferences, contraindications, contributing factors, medication, family
medical history, other medical conditions and previous medical investigations, are ascertained
during this 'history–taking'.
The subjective assessment consists of Presenting Condition (PC), History of Presenting Condition
(HPC), Past Medical History (PMH), Social History (SH) and Drug History (DH) (Forrester–Gale
2014a).
During the PC, it is important that Miguel's pain is documented. This

Upper Limb Amputations: A Case Study
In the United States there are "1.7 million people living with limb loss (NLLIC, 2008, p.1).
According to the CDC, "each year about 1,500 babies in the united states are born with upper limb
reductions (CDC, 2014, p.1)." As systemic diseases continue to increase, so are the chances of
people having upper limb amputations. Some of the common systemic diseases that can cause upper
limb amputations are diseases of the vascular system, diabetes, and cancer (NLLIC, 2008, p.1).
Other common causes are infections, burns, and accidents (Capital Health, n.d., p.1). Although there
have been many advances in science for those that have upper limb amputations, many people may
not be able to afford these advances such as prosthetics and surgery. Assistance with self–care is a
common difficulty that is continuously faced (CDC, 2014, p.1). Observing the amount of people that
have upper limb amputations or reductions is something that I am passionate about. For my adaptive
aid, I am focusing on aiding those without upper limbs in their daily oral hygiene care. The goal is to
make the adaptive aid something, simple, affordable, adjustable, and portable. Whether the person is
in a wheel chair, standing, sitting, or traveling they are able have daily oral health care with limited
assistance. ... Show more content on Helpwriting.net ...
This however has limited placement and adaptability to fit the patient. For my adaptive aid, I am
taking a multifunctional device stand that can be clipped and adjusted to hold an electric toothbrush
on one end, and a tufted brush on the other end. This stand is adjustable and portable to meet any of
the needs they may face. The handle is able to bend and extend to adjust to any ergonomic position
required. This handle was bought online for $10 making it something affordable for the patient to

Upper Limb Case Summary
Primary Diagnosis: Fractures of upper limb. Secondary Diagnosis: Muscular dystrophies and other
myopathies. It was unclear how SSA determined the primary diagnosis "Fractures of Upper Limb"
(code 8180) in this case. No record was found indicating that the claimant had a fracture of the
upper extremities after the CPD. In addition to muscular dystrophy, the claimant had a motor vehicle
accident on 04/05/2008 and sustained the following injuries: Traumatic brain injury with
subarachnoid hemorrhage Multiple pelvic fractures involving both acetabulum and both pubic rami,
left sacral iliac crest fracture Multiple left rib fractures Cervical disc derangement (C3–C4) Spleen
laceration Urethral tear Left distal tibia/fibula fracture Left distal femur fracture Left elbow
contusion A more appropriate diagnosis would be "Other fractures of bones" code (8290). 35–year–
old male alleged muscular dystrophy, chronic spinal pain, traumatic brain injury, chronic pelvic
pain. ... Show more content on Helpwriting.net ...
Had visual and mobility problems, difficulty using hands and fingers. Ambulated with a cane and
wore a brace on the right lower extremity. Shoulders and upper and lower extremities were weak.
Problems with memory, concentration, understanding, completing tasks, and getting along with
people. Had difficulty managing money. Was able to feed himself, understood and followed
directions. A caregiver or his mother assisted him with all activities and reminded him to take his

Upper Limb Injuries
Participation in sports can affect the upper body extremity in a positive or negative way. Sport
injuries of the upper limbs can happen while playing amateur or professional sports. In the article
entitled: Sports Injuries of the Upper Limbs, provides the reader with information on the common
types of injuries and a treatment plan for each. The article evaluates the management of upper limb
tendon injuries from the physiopathology and the new methods of injury treatment that are common
in Brazil. (Silva, 2010) Even though this article looked at the Brazilian population, many of the
injuries and treatments can be applicable to athletes in the United States. The injuries of the upper
body usually happen in sport activities such as, tennis, volleyball, ... Show more content on
Helpwriting.net ...
Ruptures of the rotator cuff are more often seen in players over the age of 40 years. "This is because
of the wear and dehydration that tendon structures suffer with advancing age." (Silva, 2010) The
younger sports population usually experience tendinopathy. Treating a rotator cuff injury is usually
more successful in the older population and this is mainly due to the fact that the person is no longer
active in sports. On the other hand an active player does not feel the pain and therefore continues to
play the sport. The repair of a rotator cuff can be performed both arthroscopically and open
procedure. (Silva, 2010) Injuries can also be experienced in the elbow and the wrist. In most
instance, it the pain or injury is due to the bone or muscle overload. There are also some not so
common injuries of the shoulder and elbow. They include, nerve, stress–induced bone injuries,
tumors, muscle–tendon tears and chondral injuries. ( (Silva,

Unilateral Training Research Paper
Unilateral versus Bilateral Training in Stroke Rehabilitation of Persons with Upper Limb
Hemiparesis
Celeste James, Lindsay Konal, and Jenell Nadolski
OT 6230
March 1, 2017
Abstract
Purposeful movement of an upper limb can be difficult for many individuals with post–stroke
functional limitations such as hemiparesis. Due to the level of disability caused by stroke,
researchers have investigated rehabilitation protocols such as unilateral and bilateral training, and
the benefits of each in expediting progress towards recovery. Neurophysiological mechanisms were
studied, analyzing the effects of unilateral training, bilateral training, and a combination of the two
and their effect on the brain. Participants of the studies varied widely. However, ... Show more
Mudie & Matyas (2000) claim that long–term potentiation may result from initial bilateral
rehabilitation, which in turn established a perpetual firing pattern of the brain. Once this firing
pattern is established, simultaneous activation of both hemispheres aids the more affected limb's
hemisphere via crossed corticospinal pathways. This is suspected to occur because the strong
neuronal inputs to the less affected hemisphere are able to assist the weaker inputs to the more
affected hemisphere. Through this association, the stronger input assists the weaker input to become
potentiated, thereby increasing supply to the more affected upper extremity (Mudie & Matyas,

Case Study On Stroke
1.1. Stroke:
Stroke is a common, serious and global health care problem; it's the third most common cause of
health and first cause of adult disability (12). The rehabilitation is the major part of his care (13).
Stroke is a neurological deficit caused by an acute focal injury f the central nervous system (CNS)
by a vascular cause: a cerebral infraction appears with overt symptoms or intracerebral hemorrhage
with no symptoms (10%) and subarachnoid hemorrhage (5%) (14).
The most impairment that can be regarded as a loss or limitation of function in movement or
limitation in mobility and muscle contraction, is the most common and widely recognized
impairment caused by stroke. The movement of face, arm, and leg of one side of the body are the
structures affected by the motor impairment after stroke and affected 80% of patients. Motor
impairment can be caused by ischemic or hemorrhagic injury to the motor cortex, premotor cortex,
motor tracts, or associated pathways in the cerebrum or cerebellum (15).
One of the common undesirable ... Show more content on Helpwriting.net ...
Due to motor training, the kinesthetic, extero–ceptive, visual and attention information can be
modulated; it's useful for arm function rehabilitation when it increases. The healthy hemisphere does
not play a univocal role after a stroke. The spontaneous upper extremity neurological recovery after
a stroke can occur through contralesional motor cortex recruitment. This bi–hemispheric
reorganization allows the healthy hemisphere to efficiently contribute to a uni–manual motor task by
the paretic arm. The motor facilitation observed in the bilateral mode could be explained by the fact
that the healthy hemisphere removes its inhibition upon the lesion hemisphere. Furthermore, the
corticospinal fibers stemming from the healthy hemisphere, no decussated and aimed for proximal
motricity, could be recruited

Non-Septic Bursitis Case Study
This is a 70 year old female who denies PMHx of osteoarthritis, rheumatoid arthritis, gout and STI's
presenting with pain and edema in the posterior left elbow for 2 weeks. Physical exam revealed a
mildly tender, fluctuant mass on the posterior elbow consistent with non–septic olecranon bursitis.
There were no signs of septic bursitis such as fever, erythema, warmth or purulent drainage. The
patient had normal sensation, muscle tone, full range of motion and 5/5 strength in the elbows
bilaterally. Physical exam of the left shoulder and wrist were unremarkable. The patient initially
elected for PRICE (protection, rest, ice, elevation). Specifically, the patient was instructed to protect
the left arm from further injury, rest her left arm, ... Show more content on Helpwriting.net ...
Common signs of infection are not always accurate in distinguishing these two types but two
parameters, bursal warmth and fever are highly specific for septic bursitis.2 Moreover, bursal fluid
should be aspirated and analyzed for white cell count, fluid to serum glucose ratio,
polymorphonucleocytes, gram stain and culture and presence of crytals.2 These tests seem useful if
a specific etiology such as rheumatoid arthritis or gout is suspected. If the patient was showing signs
of infection such as fever, redness and warmth at the site and purulent bursal aspirate, a CBC with
differential should be ordered and aspirated bursa fluid should be analyzed. To help identify
rheumatoid arthritis an erythrocyte sedimentation rate, C–reactive protein and Rheumatoid factor
should be tested.1 In addition, if gout was suspected a uric acid level and the bursal aspirate should
be tested for crystals. However, there were no signs of either septic arthritis, rheumatoid arthritis, or
gout in this patient so these tests were not considered necessary. Plain X–rays of the elbow would
have been useful if there was known injury to rule out

Cerebral Palsy Upper Limb
Cerebral Palsy – Orthotic Treatment of the Upper Limb
Cerebral Palsy (CP) is an example of an upper motor neurone lesion and a general term for a group
of neurological conditions that affect movement and co–ordination. It affects around 1 in 400
people, occurring in utero or the first few years of life. Multiple parts of the brain can be affected,
resulting in different types and severities. Approximately 80% have upper limb involvement with
problems in the wrist and hand being most frequent, which affect activities of daily living (ALDs)
such as eating. Around 56% are prescribed upper limb orthoses, with only around half using them.
Upper limb orthoses cannot be concealed which may account for this low patient compliance, or
upper limb function ... Show more content on Helpwriting.net ...
Hand orthoses can abduct and extend the thumb in such a way that children can achieve grasps
(Figure 2). Thumb abduction can be treated similarly. These orthoses should be limited to the
minimal amount of skin coverage (Figure 2) to maintain sensory feedback. A global resting hand
splint can be used when the deformity involves wrist flexion, in which the wrist and fingers are
extended to the maximum comfortable

Constraint Induced Movement Therapy Essay
Occupational Therapy Interventions
Constraint–Induced Movement Therapy & Modified Constraint–Induced Movement Therapy
Constraint Induced Movement Therapy (CIMT) is a treatment approach that has been found to be
effective in unilateral (hemiplegic) spastic cerebral palsy. It involves constraint of the less impaired
upper extremity and repetitive practice of the affected arm and hand. Casts, splints, and slings are
used to restrain the unaffected arm while the individual is encouraged to use the impaired arm. The
individual performs motor activities repetitively for up to 6 hours a day for 2 to 4 weeks. In order to
perform more complex functional motor acts, the task is broken down into smaller movements and
rewarded at each step of the ... Show more content on Helpwriting.net ...
Edward Taub and his colleagues through a study on sensory and motor learning in non–human
primates. The In this study, the researchers temporarily reduced the motor function of monkeys on
one side of their bodies. They observed the behavior of the monkeys and how they would drop
objects or fall down with their affected side. However, when the monkeys recovered, they continued
to not use their affected side. This phenomenon was called "learned non–use." Based on this
research, the basic principles of CIMT were established. Through CIMT, the behaviors of "learned
non–use" are reversed by restraint of the unaffected side along with repetitive practice with the
impaired side. Children with hemiplegic cerebral palsy tend to develop motor skills that rely
primarily on the unaffected arm. Therefore, because of disuse, the impaired arm does not fully
develop. Not having bilateral upper extremity function has an effect on gross and fine motor skills
which ultimately impairs performance of functional activities such as self–care, feeding, and
playing. In order to develop motor skills, CIMT is used to gain function in the impaired

My Initial Assessment From Module 4
As discussed in Module 4, the workstation I described involved washing dishes on an industrial
scale where meals are served in high volumes, up to 2000 people per meal. This particular
workstation is not equipped with mechanical or automated processes which requires employees to
accomplish this massive undertaking. The workplace stressors related to this task includes, awkward
postures, excessive force, repetition, and compression. During my initial assessment from Module 4,
I identified significant posture issues regarding excessive bending and twisting from the trunk and
waste which could lead to disc bulges, muscle strain and lower back WMDSs. I also identified
excessive force hazards regarding relocating, lifting, pulling and ... Show more content on
Helpwriting.net ...
Step 4 (Wrist Twist) was scored as a +1 because minimal twisting action were required. For step 5,
the precious scores were plotted in Table A of the RULA guide which resulted in an overall score of
4. Step 6 and step 7 both resulted in a +1 score due to the repetitiveness of the process and the
weight of the objects handled by the employee. Step 8 consisted of adding the values of steps 5–7
(4+1+1 respectively) to indicate an overall wrist/arm score of 6. Step 9 (Neck Position) resulted in a
+2 because the employee's neck primarily stayed within the 0–20 degree range. Step 10 (Trunk
Position) in a +3 because the individual was bent forward at a 20–60 degree angle. Step 11 (Legs)
resulted in a +1 because the employee's legs were stable and supported. Using Table B (Trunk
Posture Score) resulted in a score of 4 for step 12. Steps 13 and 14 both resulted in a +1 score
because the of the weight of the objects handled and number of repetitive tasks. Step 15 indicated a
final score of 6 for the neck, trunk and legs. Plotting the final scores while using Table C of the
RULA guide resulted in a final score of 7. This result indicates that major ergonomics risk factors
were prevalent at this workstation and significant engineering and administrative controls are
needed. (Stack, Ostrom, & Wilhelmsen, 2016) Much like the RULA assessment tool the Rapid
Entire Body Assessment (REBA) method is

Principles And Methods Of Ergonomics
INTRODUCTION
Ergonomic means the understanding of the interactions among humans and other elements of a
system. This is achieved by applying theoretical principles, data and methods to design so that we
can optimise human well being and thus improving overall system performance. Ergonomists helps
in planning, designing and evaluation of tasks, jobs and products in industries. These also include
environments and systems in order to make viable to the needs, abilities and limitations of peoples.
The term Ergonomics means Greek ergo that is work and nomos means laws to denote the science
of work, ergonomics now contributes to all aspects of human activity. Physical ergonomics is
concerned with human anatomy, and some of the anthropometric, physiological ... Show more
According to International Ergonomics Association (IEA); Ergonomics is the scientific discipline
concerned with the understanding of interactions among humans and other elements of a system,
and the profession that applies theory, principles, data and methods to design in order to optimize
human well–being and overall system performance(2). In countries like India where there are many
industries, they play a vital role in employing majority of industrial workers. The majority of the
industrial workers are suffering from musculoskeletal disorder(5) that are work related specially
upper extremity work–related musculoskeletal disorders (UE–WMSDs) are the most common form
of occupational diseases. Hence to consider this factor, operator needs proper seating arrangement
such that their problems regarding the MSDs can be reduced & productivity will be increased (3).
This is dealt by ergonomics that deals with making the work place safe, comfortable, efficient, and
harmless as possible. This is achieved by proper balance between worker characteristics and task
demands. In any work setting it is important to produce high quality products and it's been a main
objective also. Labour is directly related to the productivity. Their ability, skills, productivity and
performance have a great importance towards the increased production (4). Hence proper
ergonomics enhance worker productivity, provide worker safety, physical and mental well–being
and job

Modified Edema Research Paper
Synopsis: Comparing the Effects of Modified Manual with Traditional Edema Technique Jovel
Duatin Samuel Merritt University Department of Occupational Therapy Knygsand–Roenhoej and
Maribo (2011) examined the effects of modified edema mobilization (MEM) treatment with MEM
pump points (MPP) stimulation technique and compared it with the traditional edema technique for
patients with subacute hand/arm edema. The effects were determined based on the outcome
measures that includes reduction in edema and pain, active range of motion (AROM), and activities
of daily living(ADL). It was hypothesized that modified MEM treatment will have better outcome
measures compared to the traditional edema technique. The study's design was single–blinded, ...
Show more content on Helpwriting.net ...
Subacute edema size was measured using a volumeter. The distance from the nail of the fingertip to
the proximal palmar crease was measured for AROM. The distance from the nail of the thumb to the
base of the fifth finger was used to measure thumb opposition. Moreover, pain was measured using
the visual analog scale. Patients' ADL levels was assessed through a questionnaire for bilateral
activities and perceived performance and satisfaction with ADL was assessed using the Canadian
Occupational Performance Measure. The study had 30 participants originally but only 29 completed
the treatments. There was a statistically significant decrease in edema, pain, and improvement in
AROM observed in both groups. There was a significant change in ADL observed in modified
MEM group that indicates that the group managed bilateral ADL activities quicker than the control
group. There was also a tendency for modified MEM group to receive fewer occupational therapy
session. However, there was no significant statistical difference found between the groups in terms
of pain during activity or at rest, AROM, and ADL at inclusion or after six and nine

Shortening Osteotomy Essay
Material and methods The equipment included 10 orthopedic surgeons with no experience in wrist
surgery, 1 video of distal radius shortening osteotomy technique, a shine enhancer (Orthoscan®,
Ziehm Imaging GmbH, Nuremberg, Germany), Surgical motors equipped with oscillating saws
(Stortz ™, Tuttlingen, Germany) as well as three types of procedural simulators: 5 dry radius
without any component of soft parts (radius ERP # 1018®, Sawbones ™, Washon Island, WA, USA)
3D impression simulators (Wristsim®, Biomodex ™, Paris, France), 10 forearms of fresh thawed
bodies. Wristsim®, derived from 3D printer technology (Figure 1), consisted of a silicone forearm /
wrist / hand segment with an orifice on which a cartridge consisting of a Distal radius and soft tissue
[7 Lazarus 2016]. The learning method consisted of a first step in viewing a video of a distal radius
shortening osteotomy technique performed by a senior surgeon and in a second step reproducing the
same technique on a procedural simulator. This second step was performed either on a procedural
radius ERP # 1018® simulator for 5 Interns (Group 1) or on a Wristsim® procedural simulator for 5
other Interns (Group 2). ... Show more content on Helpwriting.net ...
2a), the distal radius shortening osteotomy technique consisted of placing an anterior distal radius
plate (Initial–R®, Newclip Technics ™, Goulaine, France) upstream of the dividing line of the
anterior cortex of the distal radius, then installing all the epiphyseal screws, removing the screws
and the plate, performing a metaphyseal osteotomy of the distal radius with the oscillating saw d A
width of 2 saw blades to simulate the shortening, to replace the plate and the epiphyseal screws, and
finally to put in place all the diaphyseal screws. At all stages, learners were free to use the

Literature Review: The Notion Of Ergonomics
Literature Review
The literature review covers a wide range of theories, frameworks, models, parts of research articles,
and opinions to support the findings and analysis in the fourth chapter. Literature reviews are
important for the analysis purpose in order to explain the phenomenon under research as different
researchers have different opinions, some opinion are outdated whereas some are still applicable in
today's date.
2.1 The Notion of Ergonomics
Ergonomics is a science concern with the fit between people and their work. It puts people first
taking account of their capabilities and limitations. It aims to make sure that task, equipment,
information and the environment suit each worker in the organization.
Ergonomics is the study of their work in relation to the environment in which it is performed, i.e. the
workplace and those who perform it, i.e. workers. It is ... Show more content on Helpwriting.net ...
This was done by filling a questionnaire through participants. As results it was seen that workers
working on computers were at risks of having musculoskeletal disorders than workers who were
involved in editing. (Anon., 2003)
Another research was done by (Michele Marcys PhD, 1996) where he studied the relationship
between musculoskeletal disorderd and video display terminal and also occupational psychosocial
stress among women office workers using a self administered questionnaire. He demonstrated that
non users who used to previously work on computers experienced only upper limb musculoskeletal
disorders whereas employees who do not work on computers are less prone to these symptoms. He
then suggested that employees should reduce the usage of the visual display

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