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PloS One 2017This study aimed to identify and qualify grasp-types used by patients with stroke and determine the clinical parameters that could explain the use of each grasp....
This study aimed to identify and qualify grasp-types used by patients with stroke and determine the clinical parameters that could explain the use of each grasp. Thirty-eight patients with chronic stroke-related hemiparesis and a range of motor and functional capacities (17 females and 21 males, aged 25-78), and 10 healthy subjects were included. Four objects were used (tissue packet, teaspoon, bottle and tennis ball). Participants were instructed to "grasp the object as if you are going to use it". Three trials were video-recorded for each object. A total of 456 grasps were analysed and rated using a custom-designed Functional Grasp Scale. Eight grasp-types were identified from the analysis: healthy subjects used Multi-pulpar, Pluri-digital, Lateral-pinch and Palmar grasps (Standard Grasps). Patients used the same grasps with in addition Digito-palmar, Raking, Ulnar and Interdigital grasps (Alternative Grasps). Only patients with a moderate or relatively good functional ability used Standard grasps. The correlation and regression analyses showed this was conditioned by sufficient finger and elbow extensor strength (Pluri-digital grasp); thumb extensor and wrist flexor strength (Lateral pinch) or in forearm supinator strength (Palmar grasp). By contrast, the patients who had severe impairment used Alternative grasps that did not involve the thumb. These strategies likely compensate specific impairments. Regression and correlation analyses suggested that weakness had a greater influence over grasp strategy than spasticity. This would imply that treatment should focus on improving hand strength and control although reducing spasticity may be useful in some cases.
Topics: Adult; Aged; Female; Hand Strength; Hemiplegia; Humans; Male; Middle Aged
PubMed: 29125855
DOI: 10.1371/journal.pone.0187608 -
Journal of Taibah University Medical... Dec 2019Grip strength is important for independent self-care and is a predictor of functional decline. This study aimed to determine if healthy individuals would demonstrate...
OBJECTIVE
Grip strength is important for independent self-care and is a predictor of functional decline. This study aimed to determine if healthy individuals would demonstrate different hand-grip and key-pinch strengths at three different arm positions and in comparisons between dominant and non-dominant hands.
METHODS
A total of 61 right-hand-dominant male college students aged 19-23 years were consecutively recruited from the College of Medical Rehabilitation Sciences. Three researchers performed the measurements. All tests were performed with the JAMAR® hand-grip dynamometer handle set in its second position. Participants were instructed to squeeze the handle of the hand-grip dynamometer in the 90° elbow flexion, 90° shoulder flexion, and arm dangled positions. For assessment of key-pinch strength, every participant had to squeeze the thumb pad against the lateral aspect of the middle phalanx of the index finger. Key-pinch strength was measured in the same positions used for assessment of hand-grip strength. Participants were blinded for the outcome measurements. The significance level was set at < 0.05.
RESULTS
The hand-grip and key-pinch strengths did not show significant effects. Comparison of right and left hand-grip strengths also showed insignificant differences. However, the key-pinch strength showed a significant increase in favour of the dominant hand.
CONCLUSIONS
Clinicians can choose any upper-extremity position to measure hand-grip and key-pinch strength. Furthermore, clinicians should aim to maintain and restore almost equal scores for hand-grip and pinch strength of the dominant and non-dominant hands to ensure better hand function.
PubMed: 31908646
DOI: 10.1016/j.jtumed.2019.10.001 -
Journal of Hand Surgery Global Online May 2021The objective of this study was to describe an original method of bone-preserving arthroplasty with abductor pollicis longus (APL) tenodesis and determine its safety and...
PURPOSE
The objective of this study was to describe an original method of bone-preserving arthroplasty with abductor pollicis longus (APL) tenodesis and determine its safety and effectiveness as a treatment for early-stage osteoarthritis of the trapeziometacarpal joint.
METHODS
Eleven patients underwent a trapezium-preserving arthroplasty with APL tenodesis for stage 1 and 2 osteoarthritis were retrospectively reviewed. This arthroplasty consisted of a distally-based APL tendon being passed through the trapeziometacarpal joint. The proximal end of the tendon was then pulled and passed through a drill hole made at the neck of the second metacarpal and sutured to itself. Thus, distraction of the first metacarpal and interposition of the tendon were created. Postoperative radiologic and clinical follow-up visits were performed at 4, 8, and 12 weeks. Range of motion and strength were assessed after surgery. Patient satisfaction and outcome were assessed, and the disabilities of the arm, shoulder, and hand (DASH) score was used.
RESULTS
After a mean follow-up of 29.5 months (range, 16-43 months), the mean patient visual analog scale pain score improved from 7.1 to 2.3. The average DASH score of all patients at the follow-up examination was 18.3 ± 19.8. Patients' mean grip strength was 25.3 kg, which represented 102% of the value on the contralateral side. The key-pinch strength was 6.2 kg on the operated hand compared with 6.5 kg on the contralateral side. The mean thumb opposition Kapandji index was 9.4, which was similar to that of the contralateral side. Three patients were very satisfied with the postoperative outcome and 3 patients were satisfied. Two patients were lost to follow-up, 1 patient did not consent to share her data, and 2 patients had to undergo trapeziectomy.
CONCLUSIONS
Although a larger study population and a longer follow-up period are needed to draw conclusions, bone-preserving arthroplasty with APL tenodesis showed satisfying results in patients presenting with early-stage osteoarthritis. This method is technically simple and time-efficient, does not reduce the range of motion, and leaves open all other surgical options.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV, Case Series.
PubMed: 35415545
DOI: 10.1016/j.jhsg.2021.03.003 -
Journal of Orthopaedic Surgery and... Apr 2023This study was designed to investigate whether intraoperative electrical nerve stimulation has effects on the short-term recovery of cubital tunnel syndrome patients... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study was designed to investigate whether intraoperative electrical nerve stimulation has effects on the short-term recovery of cubital tunnel syndrome patients after ulnar nerve release.
METHODS
Patients diagnosed as cubital tunnel syndrome were selected. At the same time, they received conventional surgery treatment. The patients were divided by a randomized digits table into two groups. The control group underwent conventional surgery, and the electrical stimulation (ES) group underwent intraoperative electrical stimulation. All the patients were tested for sensory and motor functions, grip strength, key pinch strength, motor conductivity velocity (MCV), and maximum compound muscle action potential (CMAP) before operation and 1 month and 6 months after operation.
RESULTS
In patients treated with intraoperative ES, the sensory and motor functions and the strength of muscle were significantly improved after 1-month and 6-month follow-up than the control group. After the follow-up, the patients in the ES group had significantly higher grip strength and key pinch strength than the control group. After the follow-up, the patients in the ES group had significantly higher MCV and CMAP than the control group.
CONCLUSION
Intraoperative electrical stimulation of nerve muscle can significantly promote the short-term recovery of nerve and muscle functions after the surgery in cubital tunnel syndrome patients.
Topics: Humans; Cubital Tunnel Syndrome; Ulnar Nerve; Hand Strength; Neurosurgical Procedures; Decompression, Surgical
PubMed: 37013614
DOI: 10.1186/s13018-023-03668-x -
International Journal of Environmental... Sep 2021Information regarding the relationship between the degree of hand function among the elderly as measured by traditional assessments and the ability to manipulate...
Information regarding the relationship between the degree of hand function among the elderly as measured by traditional assessments and the ability to manipulate touchscreens is lacking. This study aimed to examine the correlation between the ability to manipulate a touchscreen device, as assessed using the touchscreen assessment tool (TATOO) (University of Haifa, Israel & Universetiy of Bologna, Italy), and hand strength and manual dexterity among independent community-living older individuals. Thirty-four community-living older adults (average age 79.4 ± 6.7 years) participated in single-session assessments lasting 45 min each. The assessment included hand strength measurement using the manual hand dynamometry and hydraulic pinch gauge, a functional dexterity test (FDT), and TATOO. No significant correlations were observed between most of the TATOO items (22 out of 26) and handgrip strength, pinch strength, and FDT results. Moderately significant correlations were demonstrated between the number of drag attempts in the "Drag to different directions" task and handgrip strength and manual dexterity ( value: -0.39, value: 0.02; value: 0.36, value: 0.04, respectively). In addition, a moderately significant correlation was noted between the number of double taps and manual dexterity ( value: 0.32, value: 0.07). These results indicate that more complex gestures that require greater accuracy (dragging task) or rapid movements (double tapping) are related to hand strength and manual dexterity. These results suggest that the manual gestures necessary for touchscreen operation entail unique and specific capabilities that are generally not captured by traditional tools. The clinical implication is that the hand function assessment toolbox should be expanded. Tools such as the TATOO should be used to capture skills required for touchscreen manipulation in the context of the modern digital milieu.
Topics: Aged; Aged, 80 and over; Hand; Hand Strength; Humans; Independent Living; Israel; Italy; Motor Skills
PubMed: 34501994
DOI: 10.3390/ijerph18179408 -
Frontiers in Neurology 2022Patients with neurogenic thoracic outlet syndrome report pain and upper-limb weakness. They complain about weakness occurring on the entire upper-limb, especially at the...
Patients with neurogenic thoracic outlet syndrome report pain and upper-limb weakness. They complain about weakness occurring on the entire upper-limb, especially at the hand and the shoulder levels. Hydraulic dynamometers can reliably assess the strength of the hand, and isokinetic shoulder testing can provide accurate and reliable evaluations of the rotators strength. Yet, isokinetic proximal assessment needs expensive tools, whereas hydraulic hand dynamometers are cheap and easy to use. We aimed to assess the correlation between the isokinetic shoulder strength and the hand grip and the key pinch strength. The grip strength was evaluated with a hydraulic hand dynamometer and the key pinch with a pinch gauge. Isokinetic rotators strength tests were performed using a Humac Norm® dynamometer at 60 and 180°/s. One-hundred and thirty patients had been included, 72% of women, mean age of 39.8 ± 9.5. Symptomatic hands presented a strength deficit of 12.2% on the grip ( < 0.0001) and 10% on the key pinch ( = 0.01). Isokinetic strength was lower on the symptomatic shoulders at 60 and 180°/s concerning medial rotators [-10.3 and -8.8%, respectively ( = 0.02)] and lateral rotators [-10.8 and -10%, respectively ( = 0.04 and = 0.03)]. There was a moderate correlation between the grip strength of the symptomatic upper-limbs and the isokinetic rotators strength ( < 0.001). The key pinch strength was moderately correlated to the isokinetic medial and lateral rotators strength at 60°/s ( < 0.001). Hand dynamometers could prove useful during medical consultations or in outpatient management to assess upper-limb overall weakness, but isokinetic measurement remains the gold standard for a precise evaluation.
PubMed: 36046630
DOI: 10.3389/fneur.2022.919312 -
BMJ Neurology Open 2022A number of clinical trials targeting GNE myopathy patients have been conducted. However, useful clinical parameters for postmarketing surveillance and long-term...
BACKGROUND
A number of clinical trials targeting GNE myopathy patients have been conducted. However, useful clinical parameters for postmarketing surveillance and long-term clinical observation have not yet been established.
OBJECTIVE
We conducted a 5-year observational follow-up natural history study to identify evaluation parameters, which may be useful for the long-term observation of GNE myopathy patients.
METHODS
Thirty-three genetically confirmed GNE myopathy patients were recruited and evaluated at study entry (baseline) and yearly in a 5-year follow-up. Hand-held dynamometer measurements of knee extension strength, grip power and pinch power, summed Manual Muscle Testing (MMT) score of 17 muscles, Gross Motor Function Measure (GMFM), 6 min walk test, percent vital capacity and percent forced vital capacity (%FVC), lean body mass (whole body, arms and legs), creatine kinase, Barthel Index, modified Rankin Scale and 36-item Short Form Survey national standard scores were examined.
RESULTS
Of the 33 patients, 22 (66%) completed evaluations for the entire 5-year follow-up period. These patients had a significant reduction in summed MMT score (p=0.005), GMFM (p=0.005), pinch power (p<0.001) and %FVC (p<0.001) at the fifth year evaluation relative to baseline. Among these parameters, summed MMT score, GMFM, pinch power and %FVC showed significant changes even in non-ambulant patients.
CONCLUSIONS
MMT, GMFM, pinch power and %FVC are useful parameters for the long-term evaluation of GNE myopathy patients.
PubMed: 36483092
DOI: 10.1136/bmjno-2022-000362 -
Archives of Plastic Surgery Jul 2019Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus...
BACKGROUND
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS.
METHODS
A total of 72 patients (53 female and 19 male patients; mean age, 57.8±15.3 years; range, 24-94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes- Weinstein monofilaments) was assessed and pinch and grip strengths were measured.
RESULTS
Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50-53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, 80.9±26.0; range, 0-100).
CONCLUSIONS
This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.
PubMed: 31336424
DOI: 10.5999/aps.2018.00535 -
Plastic and Reconstructive Surgery.... May 2023Arthroscopic partial trapeziectomy with suture-button suspensionplasty was developed for the surgical treatment of thumb carpometacarpal arthritis. However, the...
UNLABELLED
Arthroscopic partial trapeziectomy with suture-button suspensionplasty was developed for the surgical treatment of thumb carpometacarpal arthritis. However, the relationship between clinical results and radiographic evidence is unclear.
METHODS
The authors retrospectively reviewed 33 consecutive patients who underwent arthroscopic partial trapeziectomy with suture-button suspensionplasty for thumb carpometacarpal arthritis between 2016 and 2021. Clinical and radiographic outcomes were recorded, and the correlations between them were evaluated.
RESULTS
The average patient age at surgery was 69 years. Patient radiologic evidence was Eaton stage Ⅱ in three thumbs, Ⅲ in 25 thumbs, and Ⅳ in five thumbs. The average trapezial space ratio (TSR) was 0.36 immediately after the operation but declined to 0.32 after 6 months. In contrast, the average joint subluxation was reduced to 0.005 immediately after the operation compared with 0.28 before, and was maintained at 0.04 at final follow-up. A statically significant correlation was detected between grip strength and TSR ( = 0.03), and between pinch strength and TSR ( = 0.02). A significant correlation was detected between TSR and trapezium height ( = 0.0215), which remained after partial trapeziectomy. No correlation was detected between rope position and other clinical or radiographic scores.
CONCLUSIONS
Suture-button can have an effect on the medialization of the first metacarpal base. Excessive trapeziectomy can result in functional deficiency of the thumb through metacarpal subsidence, which potentially causes loss of grip and pinch strength.
PubMed: 37180981
DOI: 10.1097/GOX.0000000000004983 -
The Journal of International Medical... Nov 2018The study aim was to examine the hand function (hand strength and dexterity) and intervention effects of training in adults with Prader-Willi syndrome (PWS).
OBJECTIVE
The study aim was to examine the hand function (hand strength and dexterity) and intervention effects of training in adults with Prader-Willi syndrome (PWS).
METHODS
Six adults with PWS (two females; mean age 26.14 years) underwent hand muscle strength and dexterity training for 3 months (2 hours per week). The following hand function tests were performed pre- and post-intervention: (1) hand grip, lateral pinch, and tip pinch hand strength tests, (2) the Box and Block test (BBT) for gross manual dexterity and (3) the Purdue Pegboard test for finger dexterity.
RESULTS
Before treatment, all subjects showed lower hand grip, lateral pinch, tip pinch strength, and poorer manual/finger dexterity relative to healthy adults. After training, hand function scores improved on many test items, but only the left hand tip pinch and the right hand BBT performance showed significant improvements.
CONCLUSIONS
All subjects showed lower hand strength and poorer manual/finger dexterity compared with healthy adults; this should be considered during physical training programs. Owing to limitations in the intervention intensity and possible subject behavioral deficits, further research is needed to clarify the effects of this intervention on hand function in PWS patients.
Topics: Adult; Female; Functional Laterality; Hand Strength; Humans; Male; Pilot Projects; Prader-Willi Syndrome; Young Adult
PubMed: 30213215
DOI: 10.1177/0300060518788243