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The loss of range of motion (ROM) in the upper extremities can interfere with activities of daily living (ADL) and, therefore, many interventions focus on improving impaired ROM. The question, however, is what joint angles are needed to naturally perform ADL. The present review aimed to compile and synthesize data from literature on shoulder and elbow angles that unimpaired participants used when performing ADL tasks. A search was conducted in PubMed, Cochrane, Scopus, CINAHL, and PEDro. Studies were eligible when shoulder (flexion, extension, abduction, adduction) and/or elbow (flexion, extension) angles were measured in unimpaired participants who were naturally performing ADL tasks, and angles were provided per task. Thirty-six studies involving a total of 66 ADL tasks were included. Results demonstrated that unimpaired participants used up to full elbow flexion (150°) in personal care, eating, and drinking tasks. For shoulder flexion and abduction approximately 130° was necessary. Specific ADL tasks were measured often, however, almost never for tasks such as dressing. The synthesized information can be used to interpret impairments on the individual level and to establish rehabilitation goals in terms of function and prevention of secondary conditions due to excessive use of compensatory movements.

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The pontine micturition center (PMC) or Barrington's nucleus controls micturition by way of its descending projections to the sacral spinal cord. However, little is known about the afferents to the PMC that control its function and may be responsible for dysfunction in patients with urge-incontinence and overactive bladder. In five female cats, wheatgerm agglutinin-conjugated horseradish peroxidase (WGA-HRP) injections were made in the PMC and adjoining dorsolateral pontine tegmentum. Retrogradely labeled neurons were found in a large area, including the medullary and pontine medial and lateral tegmental field; dorsomedial, lateral, and ventrolateral periaqueductal gray matter (PAG); posterior hypothalamus; medial preoptic area (MPO); bed nucleus of the stria terminalis; central nucleus of the amygdala; and infralimbic, prelimbic, and insular cortices. To verify whether these areas indeed project specifically to the PMC or perhaps only to adjacent structures in the pontine tegmentum, in 67 cats (3)H-leucine or WGA-HRP injections were made in each of these regions. Five cell groups appeared to have direct connections to the PMC, the ventromedial pontomedullary tegmental field, the ventrolateral and dorsomedial PAG, the MPO, and the posterior hypothalamus. The possible functions of these projections are discussed. These results indicate that all other parts of the brain that influence micturition have no direct connection with the PMC.

The periaqueductal gray (PAG) is involved in aggressive and defensive behavior, micturition, and lordosis. Especially for the latter two functions, PAG afferents from the lumbosacral cord are of vital importance because, in addition to information regarding homeostasis and thermoregulation, they convey information from the pelvic viscera and sex organs. In the present retro- and antero-grade tracing study, the projection patterns of different lumbosacral cell groups in the PAG were determined. In the retrograde study, wheatgerm agglutinin-horseradish peroxidase (WGA-HRP) injections were made in the PAG and/or adjacent tegmentum, and in the anterograde study, WGA-HRP was injected in different lumbosacral segments. The results revealed that lumbosacral-PAG neurons could be divided into three groups. The first and largest group was present in lumbar 7-sacral 3 segments (L7-S3) and consisted of small, oval, and fusiform neurons. It extended from the dorsolateral part of lamina I in L7, along the lateral part of the dorsal horn in S1, and into lamina V of S2. In the lateral part of S2, some of its neurons formed clusters with intervals of +/- 230 microns. The location of the first group overlapped extensively with the termination area of pelvic and pudendal afferents. The main midbrain target of the first group was the medial part of the lateral PAG. The second group consisted of small to large multipolar neurons in laminae VIII and medial VII of caudal L6, L7, and rostral S1. This group projected strongly to a distinct region in the lateral part of the lateral PAG and the laterally adjacent tegmentum. About 10% of the labeled neurons did not fit in the two groups. They were evenly distributed throughout lumbar 4-coccygeal 3 segments (L4-Co3) and consisted of large multipolar lamina V neurons and small lamina I neurons that projected diffusely to the lateral and dorsal PAG. The large lamina V neurons also targeted the laterally adjacent tegmentum. The possible involvement of the lumbosacral-PAG projections in micturition, lordosis, and defensive and aggressive behavior is discussed.

The periaqueductal gray (PAG) plays an important role in analgesia as well as in motor activities, such as vocalization, cardiovascular changes, and movements of the neck, back, and hind limbs. Although the anatomical pathways for vocalization and cardiovascular control are rather well understood, this is not the case for the pathways controlling the neck, back, and hind limb movements. This led us to study the direct projections from the PAG to the spinal cord in the cat. In a retrograde tracing study horseradish peroxidase (HRP) was injected into different spinal levels, which resulted in large HRP-labeled neurons in the lateral and ventrolateral PAG and the adjacent mesencephalic tegmentum. Even after an injection in the S2 spinal segment a few of these large neurons were found in the PAG. Wheat germ agglutinin-conjugated HRP injections in the ventrolateral and lateral PAG resulted in anterogradely labeled fibers descending through the ventromedial, ventral, and lateral funiculi. These fibers terminated in lamina VIII and the medial part of lamina VII of the caudal cervical, thoracic, lumbar, and sacral spinal cord. Interneurons in these laminae have been demonstrated to project to axial and proximal muscle motoneurons. The strongest PAG-spinal projections were to the upper cervical cord, where the fibers terminated in the lateral parts of the intermediate zone (laminae V, VII, and the dorsal part of lamina VIII). These laminae contain the premotor interneurons of the neck muscles. This distribution pattern suggests that the PAG-spinal pathway is involved in the control of neck and back movements. Comparing the location of the PAG-spinal neurons with the results of stimulation experiments leads to the supposition that the PAG-spinal neurons play a role in the control of the axial musculature during threat display.

The present retrograde tracing study in the cat describes the spinal cord projections to the periaqueductal gray (PAG), taking into account different regions of the PAG and all spinal segments. Results show that injecting different parts of the PAG leads to different laminar and segmental distributions of labeled spinal neurons. The impression was gained that at least five separate clusters of spinal neurons exist. Cluster I neurons are found in laminae I and V throughout the length of the cord and are probably involved in relaying nociceptive information to the PAG. Cluster II neurons lie in the ventrolateral part of laminae VI-VII of the C1-C4 spinal cord and were labeled by injecting the ventrolateral or lateral part of the rostrocaudal PAG or the deep tectum. Cluster III neurons are located in lamina X of the thoracic and upper lumbar cord and seem to target the PAG and the deep tectum. Cluster IV neurons are located in the medial part of laminae VI-VII of the lumbosacral cord and seem to project predominantly to the lateral and ventrolateral caudal PAG. These neurons may play a role in conveying tactile stimuli to the PAG during mating behavior. Neurons of cluster V are located in the lateral part of lamina I of L6-S2 and in laminae V-VII and X of S1-S3. They are labeled only after injections into the central portion of the lateral and ventrolateral caudal PAG and probably relay information concerning micturition and mating behavior.