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

Telerehabilitation is increasingly being used to meet the rehabilitation needs of situations where face-to-face therapy is not possible. Nevertheless, reports on barriers and facilitators of implementing this method from the perspective of therapists still need to be made available.

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Hand arthritis is the leading cause of disability in individuals over the age of 50, causing impairments in grip strength and range of motion. Golf is often recommended to patients with hand arthritis as a low-impact sport to maintain a healthy lifestyle. As such, numerous “arthritic” golf grips have been marketed, but lack quantitative measures to justify their use. The objective of this study was to quantify the differences in total applied grip force in golfers with/without hand arthritis using several types of golf grips. Twenty-seven participants (17 without and 10 with hand arthritis) were evaluated swinging mid-iron clubs with 12 different golf grip designs (9 standard and 3 “arthritic”). The trail hand thumb, index, middle, and ring finger applied grip forces were measured using the wireless FingerTPS system. Finger grip configuration (finger joint angles) of the thumb and index were measured using the Dartfish Movement Analysis Software paired with the newly developed Grip Configuration Model to obtain grip range of motion. Results indicated that golfers with hand arthritis had a significant deficit of 45% golf grip strength (P = 0.02). In addition, individuals with hand arthritis exhibited larger forces in 11 out of 12 golf grips tested when compared with their maximum golf grip strength. Despite how these grips are marketed, there are no “savings” in finger force or grip configuration when using the “arthritic” designed golf grips. Therefore, these grips may not be beneficial for patients with hand arthritis.

Measuring finger forces during activities of daily living and how these forces change for individuals with pathologies such as arthritis is valuable to our understanding of hand function.

Systematic review with meta-analysis.

Glenoid reaming is a technically challenging step during shoulder arthroplasty that could possibly be learned during simulation training. Creation of a realistic simulation using vibration feedback in this context is innovative. Our study focused on the development and internal validation of a novel glenoid reaming simulator for potential use as a training tool. Vibration and force profiles associated with glenoid reaming were quantified during a cadaveric experiment. Subsequently, a simulator was fabricated utilizing a haptic vibration transducer with high- and low-fidelity amplifiers; system calibration was performed matching vibration peak–peak values for both amplifiers. Eight experts performed simulated reaming trials. The experts were asked to identify isolated layer profiles produced by the simulator. Additionally, experts’ efficiency to successfully perform a simulated glenoid ream based solely on vibration feedback was recorded. Cadaveric experimental cartilage reaming produced lower vibrations compared to subchondral and cancellous bones ($$p\le 0.03$$ p≤0.03 ). Gain calibration of a lower-fidelity (3.5 $${g}_{\mathrm{pk-pk}}, 0.36\,{g}_{\mathrm{rms}})$$ gpk-pk,0.36grms) and higher-fidelity (3.4 $${g}_{\mathrm{pk-pk}}, 0.33\,{g}_{\mathrm{rms}})$$ gpk-pk,0.33grms) amplifier resulted in values similar to the cadaveric experimental benchmark (3.5 $${g}_{\mathrm{pk-pk}}, 0.30\,{g}_{\mathrm{rms}})$$ gpk-pk,0.30grms) . When identifying random tissue layer samples, experts were correct $$52\pm 9\%$$ 52±9% of the time and success rate varied with tissue type ($$p=0.003$$ p=0.003 ). During simulated reaming, the experts stopped at the targeted subchondral bone with a success rate of $$78\pm 24\%$$ 78±24% . The fidelity of the simulation did not have an effect on accuracy, applied force, or reaming time ($$p>0.05$$ p>0.05 ). However, the applied force tended to increase with trial number ($$p=0.047$$ p=0.047 ). Development of the glenoid reaming simulator, coupled with expert evaluation furthered our understanding of the role of haptic vibration feedback during glenoid reaming. This study was the first to (1) propose, develop and examine simulated glenoid reaming, and (2) explore the use of haptic vibration feedback in the realm of shoulder arthroplasty.

AbstractAccurately positioning components during radial head arthroplasty is difficult due to the complex shape of the radial head. The objective of this study was to develop a navigation system for patient-specific radial head implants using intra-operative surface-based registration techniques. Using an optical tracking system, an implant stem was navigated using real-time visualisation of the implant position and orientation (n = 8). Absolute positioning errors in the ML and AP directions were 0.8 ± 0.5 mm (and 1.1 ± 0.9°) and 0.8 ± 0.6 mm (and 1.2 ± 1.7°), respectively. Registration error was less than 1.0 mm. The current system is an important first step in the development of a computer-assisted system for implant navigation.

The experimental quantification of the process parameters associated with bone burring represents a desirable outcome both from the perspective of an optimized surgical procedure as well as that of a future implementation into the design of closed-loop controllers used in robot-assisted bone removal operations. Along these lines, the present study presents an experimental investigation of the effects that tool type, rotational speed of the tool, depth of cut, feed rate, cutting track overlap, and tool angle (to a total of 864 total unique combinations) have on bone temperature, tool vibration, and cutting forces associated with superficial bone removal operations. The experimental apparatus developed for this purpose allowed a concurrent measurement of bone temperature, tool vibration, and cutting forces as a function of various process parameter combinations. A fully balanced experimental design involving burring trials performed on a sawbone analog was carried out to establish process trends and subsets leading to local maximums and minimums in temperature and vibration were further investigated. Among the parameters tested, a spherical burr of 6 mm turning at 15,000 r/min and advancing at 2 mm/s with a 50% overlap between adjacent tool paths was found to yield both low temperatures at the bone/tool interface and minimal vibrations. This optimal set of parameters enables a versatile engagement between tool and bone without sacrificing the optimal process outcomes.

To quantify the effects of dorsal translation deformities of the distal radius with and without dorsal angulation on volar displacement of the ulnar head during simulated active forearm rotation, both with the triangular fibrocartilage complex (TFCC) intact and sectioned conditions.

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The effect of radial head implant length on forearm biomechanics is not well understood. This study examined the influence of an increase or a decrease in radial head implant length on forearm load transfer as measured by interosseous membrane (IOM) tension and changes in radiocapitellar joint contact properties.

In vitro biomechanical research using an elbow motion simulator.

To determine the effect of two types of triceps repair techniques on elbow stability and extension strength in the setting of olecranon deficiency using a cadaveric model.

This biomechanical study compares four different techniques of fixation of middle third clavicular fractures.

Lateral collateral ligament (LCL) repair of the elbow is commonly performed in the management of unstable dislocations and fracture dislocations of the elbow. The appropriateness of clinically employed techniques of LCL repair in restoring elbow kinematics and stability has not been reported. The purpose of this in vitro study was to evaluate the effectiveness of LCL transosseous sutures repair and the influence of ligament tensioning on the initial kinematics and stability of the elbow.

To compare the mechanical performance of 3 fixation techniques for comminuted talar neck fractures.

There is presently an increasing attention to decisions and decision-making as a subject of study in the social sciences. In addition, each and every discipkline has its arbitrary interpretation of decision-making. A discussion of the political decision-making approach must be selective with respect to both the quantity and the type of literature. The decision-making approach can be described as dynamical analysis. Decision-making analysis is based on the perspectives anticipated by the general systems theory.