Responses: Overuse of U/L
jcumbo
Description
Collection
Title:
Responses: Overuse of U/L
Creator:
jcumbo
Date:
5/8/2001
Text:
Hi All
These are the responses I have received so far in and to my query.
Thanks again.
A colleague of mine is collecting info on the Overuse in the intact
arm in upper limb amputees can anyone out there assist?
This was a major motivation for my doctoral thesis study which focussed
on Mechanical energy measurement during activities of daily living,
comparing UL prosthesis users and normally-limbed similar adults. The
two references I found during my research are:
Jones, L.E. and Davidson, J.H. 1999. Save that arm: a study of problems
in the remaining arm of unilateral upper limb amputees. Prosthetics and
Orthotics International, vol. 23, pp. 55-58.
Stocker, D. and Neufeld, G. 1999. A pilot study examining repetitive
strain injuries in people with limb loss. Conference proceedings of MEC
'99: Narrowing the Gap, Fredericton, NB, p. 27-30.
When one takes into account the research of :
Muggleton, J.M., Allen, R., Chappell, P.H. 1999. Hand and arm injuries
associated with repetitive manual work in industry: a review of
disorders, risk factors and preventive measures. Ergonomics, vol. 42,
no. 5, pp. 714-739.
and Hartelt, C. 1999. Ouch! Credit Union Management, Madison. vol.
22, no. 3. pp. 18-21.
Quoting from the first chapter of my Ph.D. thesis:
The need for co-ordinated functional studies is emphasised by the
survey of Jones and Davidson (1999) which found 50% of unilateral upper
limb amputees suffered long term problems in their remaining arm.
Furthermore, 53%
of those using a prosthesis had pain in their remaining arm, most of
which was associated with cumulative trauma disorders (Jones and
Davidson 1999). In comparison, the incidence of upper limb
musculo-skeletal disorders in
the general population, while increasing, remains second to back
complaints in Britain
(Muggleton et al. 1999), and accounts for only approximately one-third
of the occupational injuries
in the United States (Hartelt 1999). Considering that the annual
occupational injury rate in 2000 was expected to reach 50% of the
American workforce (Muggleton et al. 1999), one-sixth of the general
population may
experience an upper limb cumulative trauma disorder annually.
Extrapolating from the studies of
Jones and Davidson (1999) and Muggleton et al. (1999), unilateral upper
limb amputees are roughly three times as likely to suffer repetitive
motion or overexertion type injuries as the general workforce. The
challenge to avoid overuse
injuries among amputees is augmented by the fact that many tasks can be
performed with one arm and hand (Day 1998) and that a prosthesis cannot
be expected to take on more than 30% of the function of a bi-manual task
(Atkins 1989).
Notably, neither Jones & Davidson (1999) nor Stocker and Neufeld (1999)
of these tried to trace the source of the increased stress on the
remaining limb, but my Ph.D. thesis work found that there is a greater
difference in
mechanical energy of the upper limb between dominant and non-dominant
arm (or arm with prothesis,
for myoelectric prosthesis users) when studying 6 brief, goal oriented
upper limb working tasks. Inter-task and arm dominance were both
significant in determining total mechanical energy measured using a
VICON 140 (3-camera) system. I want to extend this work further with a
6-camera VICON 512 system, but
I think this greater asymetry might be important to higher incidence of
CTD symptom development
My PhD thesis is recently submitted and accepted and being bound...
Nancy Black, 2001, MECHANICAL ENERGY MEASUREMENT APPLIED TO UPPER LIMB
POWERED PROSTHESES, Doctoral Thesis, Fredercton, NB:
University of New Brunswick
Best of luck
Nancy
Nancy Black, Ph.D.
------------------------------------------------------------------
John,
I have anecdotal experience with four long time UE amputees. One pt. is
Vietnam AE amputee. He has been in a standard conventional TH
prosthesis. He reports some sside affected tingling but not too bad.
Onset unknown but gradually increasing symptom severity.
One is Vietnam BE amputee. He had severe Radial and ulnar nerve
problems resulting in his ability to get approved for a myoelectric arm
which took care of the problem.
One pt. is WWII TH amputee. From his first arm, he refused the axilla
loop and went with a shoulder saddle design. He has no problems with
his sound side.
Last pt. is an amputee from MVC in 1969. He has always had
conventionals and experiences problems with his sound side to the point
that he only wears his prosthesis when he has to.
Problems are Carpal tunnel, tingling and slight neuropathy.
Hope this helps,
Rob
John:
I have several patients, all upper limb amputees at the trans-humeral
level that have developed chronic elbow tendonitis. I think you will
find more prevalence in the higher level patients because of the loss of
the affected side elbow.
Jim Rogers, CPO
---------------------------------------------------
The literature search finding my colleague refered to is:
Jones, L.E. and Davidson, J.H. 1999. Save that arm: a study of problems
in the remaining arm of unilateral upper limb amputees. Prosthetics and
Orthotics International, vol. 23, pp. 55-58. This is also mentioned
above in
the responses.
These are the responses I have received so far in and to my query.
Thanks again.
A colleague of mine is collecting info on the Overuse in the intact
arm in upper limb amputees can anyone out there assist?
This was a major motivation for my doctoral thesis study which focussed
on Mechanical energy measurement during activities of daily living,
comparing UL prosthesis users and normally-limbed similar adults. The
two references I found during my research are:
Jones, L.E. and Davidson, J.H. 1999. Save that arm: a study of problems
in the remaining arm of unilateral upper limb amputees. Prosthetics and
Orthotics International, vol. 23, pp. 55-58.
Stocker, D. and Neufeld, G. 1999. A pilot study examining repetitive
strain injuries in people with limb loss. Conference proceedings of MEC
'99: Narrowing the Gap, Fredericton, NB, p. 27-30.
When one takes into account the research of :
Muggleton, J.M., Allen, R., Chappell, P.H. 1999. Hand and arm injuries
associated with repetitive manual work in industry: a review of
disorders, risk factors and preventive measures. Ergonomics, vol. 42,
no. 5, pp. 714-739.
and Hartelt, C. 1999. Ouch! Credit Union Management, Madison. vol.
22, no. 3. pp. 18-21.
Quoting from the first chapter of my Ph.D. thesis:
The need for co-ordinated functional studies is emphasised by the
survey of Jones and Davidson (1999) which found 50% of unilateral upper
limb amputees suffered long term problems in their remaining arm.
Furthermore, 53%
of those using a prosthesis had pain in their remaining arm, most of
which was associated with cumulative trauma disorders (Jones and
Davidson 1999). In comparison, the incidence of upper limb
musculo-skeletal disorders in
the general population, while increasing, remains second to back
complaints in Britain
(Muggleton et al. 1999), and accounts for only approximately one-third
of the occupational injuries
in the United States (Hartelt 1999). Considering that the annual
occupational injury rate in 2000 was expected to reach 50% of the
American workforce (Muggleton et al. 1999), one-sixth of the general
population may
experience an upper limb cumulative trauma disorder annually.
Extrapolating from the studies of
Jones and Davidson (1999) and Muggleton et al. (1999), unilateral upper
limb amputees are roughly three times as likely to suffer repetitive
motion or overexertion type injuries as the general workforce. The
challenge to avoid overuse
injuries among amputees is augmented by the fact that many tasks can be
performed with one arm and hand (Day 1998) and that a prosthesis cannot
be expected to take on more than 30% of the function of a bi-manual task
(Atkins 1989).
Notably, neither Jones & Davidson (1999) nor Stocker and Neufeld (1999)
of these tried to trace the source of the increased stress on the
remaining limb, but my Ph.D. thesis work found that there is a greater
difference in
mechanical energy of the upper limb between dominant and non-dominant
arm (or arm with prothesis,
for myoelectric prosthesis users) when studying 6 brief, goal oriented
upper limb working tasks. Inter-task and arm dominance were both
significant in determining total mechanical energy measured using a
VICON 140 (3-camera) system. I want to extend this work further with a
6-camera VICON 512 system, but
I think this greater asymetry might be important to higher incidence of
CTD symptom development
My PhD thesis is recently submitted and accepted and being bound...
Nancy Black, 2001, MECHANICAL ENERGY MEASUREMENT APPLIED TO UPPER LIMB
POWERED PROSTHESES, Doctoral Thesis, Fredercton, NB:
University of New Brunswick
Best of luck
Nancy
Nancy Black, Ph.D.
------------------------------------------------------------------
John,
I have anecdotal experience with four long time UE amputees. One pt. is
Vietnam AE amputee. He has been in a standard conventional TH
prosthesis. He reports some sside affected tingling but not too bad.
Onset unknown but gradually increasing symptom severity.
One is Vietnam BE amputee. He had severe Radial and ulnar nerve
problems resulting in his ability to get approved for a myoelectric arm
which took care of the problem.
One pt. is WWII TH amputee. From his first arm, he refused the axilla
loop and went with a shoulder saddle design. He has no problems with
his sound side.
Last pt. is an amputee from MVC in 1969. He has always had
conventionals and experiences problems with his sound side to the point
that he only wears his prosthesis when he has to.
Problems are Carpal tunnel, tingling and slight neuropathy.
Hope this helps,
Rob
John:
I have several patients, all upper limb amputees at the trans-humeral
level that have developed chronic elbow tendonitis. I think you will
find more prevalence in the higher level patients because of the loss of
the affected side elbow.
Jim Rogers, CPO
---------------------------------------------------
The literature search finding my colleague refered to is:
Jones, L.E. and Davidson, J.H. 1999. Save that arm: a study of problems
in the remaining arm of unilateral upper limb amputees. Prosthetics and
Orthotics International, vol. 23, pp. 55-58. This is also mentioned
above in
the responses.
Citation
jcumbo, “Responses: Overuse of U/L,” Digital Resource Foundation for Orthotics and Prosthetics, accessed May 17, 2024, https://library.drfop.org/items/show/216607.
