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Journal of Cardiology Mar 2021We aimed to examine the relationship between the difficulty of activity using the arms and mild cognitive impairment (MCI), the relationship between the difficulty of...
BACKGROUND
We aimed to examine the relationship between the difficulty of activity using the arms and mild cognitive impairment (MCI), the relationship between the difficulty of activity using the arms and manual function, and cognitive function in patients with coronary artery disease (CAD).
METHODS
We conducted a cross-sectional study of 263 non-dementia patients who met the study criteria from 2328 CAD patients. MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). The difficulty of activity using the arms was evaluated using the Disability of the Arm, Shoulder, Disability of the Arm, Shoulder and Hand and Hand (DASH) questionnaire. Manual function was evaluated by pinch strength and handgrip strength.
RESULTS
Age (odds ratio, 1.10), three-fingered pinch strength (odds ratio, 0.69), and DASH score (odds ratio, 1.03) were independently associated with MCI in the multivariable logistic regression analysis. Hemoglobin (β=-0.15), handgrip strength (β=-0.37), and MoCA-J score (β=-0.15) were independently associated with DASH score (Model 1: p<0.001, adjusted R=0.33); hemoglobin (β=-0.17), eGFR (β=-0.14), three-fingered pinch strength (β=-0.25), and MoCA-J score (β=-0.14) were independently associated with DASH score in the multivariate regression analysis (Model 2: p<0.001, adjusted R=0.31).
CONCLUSIONS
The difficulty of activity using the arms was independently associated with manual and cognitive function and MCI in CAD patients.
Topics: Arm; Cognitive Dysfunction; Coronary Artery Disease; Cross-Sectional Studies; Hand Strength; Humans; Pinch Strength
PubMed: 33121796
DOI: 10.1016/j.jjcc.2020.10.009 -
Acta Bio-medica : Atenei Parmensis Mar 2022Rhizarthrosis represents 10% of all arthritic manifestations and its prevalence increases with age and in women. The hyperextension of the metacarpophalangeal joint...
BACKGROUND AND AIM
Rhizarthrosis represents 10% of all arthritic manifestations and its prevalence increases with age and in women. The hyperextension of the metacarpophalangeal joint (MCPj) is consequent to a progressive dorsoradial subluxation of the trapeziometacarpal joint (TMj) in advanced osteoarthritis. The aim of this retrospective study is to evaluate the clinical and functional results of 32 patients affected by advanced rhizarthrosis who underwent to modified Burton-Pellegrini's trapeziectomy in absence of surgical correction of MCPj hyperextension in order to understand when this last step is really necessary.
METHODS
Patients were assessed trough DASH and PRWHE questionnaires; the functionality of the hand was assessed by carrying out specific test (grip strength, key-pinch, kapandji test, reduction of wrist flexion strength) and the degree of MCP joint hyperextension was recorded.
RESULTS
Clinical evaluation and individual satisfactory were positive in most cases (mean DASH 19 and mean PRWHE 21.8, with a reduction of 77% of VAS pain score). Kapandji test was excellent in 26 patients and grip strength and key pinch were stackable in operated and non-operated hands. Twenty-five out 32 patients presented a MCP joint hyperextension between 0° and 5°, 5 of 10° and other 2 of 15°.
CONCLUSION
Modified Burton-Pellegrini's trapeziectomy is a valid option to treat patient with TMj osteoarthritis. The absence of surgical correction of the MCPj does not affect clinical and functional results in deformities <15°.
Topics: Female; Humans; Metacarpophalangeal Joint; Osteoarthritis; Retrospective Studies; Thumb; Trapezium Bone
PubMed: 35604247
DOI: 10.23750/abm.v92iS3.12625 -
BMC Musculoskeletal Disorders Feb 2023Normative values for hand grip and pinch strength among children in Saudi Arabia has not been well established. Therefore, the main aim of this study is to establish...
BACKGROUND
Normative values for hand grip and pinch strength among children in Saudi Arabia has not been well established. Therefore, the main aim of this study is to establish normative values for hand grip and pinch strength in children aged 6 to 18 years in Saudi Arabia.
METHODS
A cross-sectional study was conducted from different 5 regions in Saudi Arabia. Participants between the age of 6 years and 18 years old were recruited through different primary and secondary schools in Saudi Arabia. Data for age, gender, Body Mass Index, and preferred hand were collected. Hand grip strength was measured using digital hand dynamometer and the tip pinch, palmar pinch, and key pinch strength were measured using the hydraulic pinch gauge.
RESULTS
A total of 616 participants included in this study (318 boys and 298 girls). Participants were stratified into 5 chronological age groups of 6-7 years, 8-9, 10-11, 12-13, 14-15, 16-17, and 18 years. The results showed an overall trend of increasing hand grip strength and pinch strength with age regardless of hand preference. Boys had significantly higher grip strength than girls in all age groups (P < 0.05).
CONCLUSION
This study established normative values for hand grip and pinch strength in the healthy Saudi pediatric and adolescent population, using boys and girls aged 6 to 18. The outcomes of this study also demonstrated that gender, age, and hand preference can all have an impact on how strong a handgrip develops.
Topics: Male; Female; Adolescent; Humans; Child; Pinch Strength; Hand Strength; Saudi Arabia; Cross-Sectional Studies; Fingers; Reference Values; Hand
PubMed: 36740670
DOI: 10.1186/s12891-023-06197-0 -
BMJ Open Nov 2023To compare the efficacy of a traditional cock-up splint, which supports the wrist only, with a modified splint that supports the wrist and the metacarpophalangeal (MCP)... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the efficacy of a traditional cock-up splint, which supports the wrist only, with a modified splint that supports the wrist and the metacarpophalangeal (MCP) joints of the medial four digits in the treatment of carpal tunnel syndrome (CTS).
DESIGN
An assessor-blind randomised controlled trial.
SETTING
Hospital-based hand therapy clinics.
PARTICIPANTS
Fifty-nine adults with mild-to-moderate CTS were randomly assigned to wear a wrist splint (control group) or an MCP splint (intervention group) for 6 weeks.
OUTCOME MEASURES
The standardised outcome measures used included grip and pinch strength, the static two-point discrimination test, Phalen's manoeuvre test, Tinel's sign and the Boston CTS Questionnaire.
RESULTS
Both groups improved significantly from splint use in some clinical features. The wrist splint and the MCP splint groups had significant improvements in lateral pinch strength (p=0.032 and p=0.002, respectively), two-point discrimination of the thumb (p=0.003 and p=0.041, respectively), two-point discrimination of the index (p=0.035 and p=0.023, respectively) and the Phalen's manoeuvre symptoms (p=0.025 and p=0.002, respectively). The MCP splint group had additional improvements over the wrist splint group in tip pinch (p=0.012) and Palmar pinch (p=0.011) strength.
CONCLUSION
Splinting is a practical and effective intervention option for improving the symptoms of CTS. A wrist splint that incorporates the MCP joints is more effective than the traditional wrist-only splint, with long-lasting improvements that remained consistent after 6 months of the splint intervention. Using the more effective MCP splint may consequently reduce disability, facilitate return to work and lower the associated costs.
TRIAL REGISTRATION NUMBER
ISRCTN13189602.
Topics: Adult; Humans; Carpal Tunnel Syndrome; Wrist; Occupational Therapy; Hand Strength; Metacarpophalangeal Joint; Treatment Outcome
PubMed: 38016794
DOI: 10.1136/bmjopen-2023-076961 -
Hand (New York, N.Y.) Jan 2020A radial incision with radial plate fixation for distal radius fracture has historically been avoided due to its risk to the superficial branch of the radial nerve...
A radial incision with radial plate fixation for distal radius fracture has historically been avoided due to its risk to the superficial branch of the radial nerve (SBRN). With careful technique, it is possible to avoid injury to the SBRN, thereby minimizing the soft tissue injury associated with other approaches. We compare subjective and objective functional outcomes of radial plate fixation surgeries that we performed with those of dorsal and volar plate fixation in current literature. Patients at a single center who underwent radial plate fixation for an AO type A or AO type B distal radius fracture between December 2006 and December 2014 were enrolled in the study. Postoperative grip strength and 3-digit pinch strength were measured systematically in the injured and uninjured wrists. Patients also completed a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire to assess subjective outcomes. Thirty-six patients met our inclusion criteria and had available medical records. Postoperative grip strength in the injured wrist was significantly lowered-68% compared with the uninjured wrist. After subgroup analysis of dominant and nondominant wrist injuries, there was no significant difference in grip strength between injured and uninjured wrists. There was no significant decrease in postoperative 3-digit pinch strength in the injured wrist-89% compared with the uninjured wrist. The mean QuickDASH score for our study participants was 20.9. Radial plate fixation is an effective approach for distal radius fractures. Objective and subjective outcomes are noninferior to those of a dorsal or volar approach.
Topics: Adult; Aged; Bone Plates; Female; Fracture Fixation, Internal; Hand Strength; Humans; Male; Middle Aged; Postoperative Period; Radius Fractures; Range of Motion, Articular; Retrospective Studies; Treatment Outcome; Wrist Injuries; Wrist Joint; Young Adult
PubMed: 30003806
DOI: 10.1177/1558944718787290 -
Journal of Wrist Surgery Dec 2020Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and...
Pyrocardan trapeziometacarpal interposition implant is a free intra-articular spacer composed of pyrocarbon. This biconcave resurfacing implant, both ligament and bone-stock sparing, is indicated for use in early-to-moderate stage trapeziometacarpal osteoarthritis. It was hypothesized that the postoperative outcome measures of the Pyrocardan implant would be comparable to those seen with ligament reconstruction and tendon interposition (LRTI) surgeries and those reported by the designer of the implant, Phillipe Bellemère, but that strength would be greater than for LRTI. In this prospective case series, 40 Pyrocardan implants were performed in 37 patients. Average age was 58 years (range: 46-71). Patients were assessed preoperatively, 3 months, 6 months, 1 year, 2 years, and beyond (long term) wherever possible. There have been no major complications or revision surgeries for the series. Average follow-up was 29 months (range: 12 months-7 years). Twenty-eight joints were assessed at over 2 years post index surgery. Outcome measure scores improved from preoperative assessment to the most recent follow-up equal or greater than 2 years. Average grip strength at 2 years was 30 kg, as compared with 19.6 kg in an age-matched cohort who underwent trapeziectomy and 25 kg in Bellemère's original series of Pyrocardan implants. Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. Patient-reported clinical outcomes were at least equivalent to LRTI and are comparable to Bellemère's original series. Grip and pinch strength appear to be better than LRTI. This is a Level III, prospective observational cohort study.
PubMed: 33282537
DOI: 10.1055/s-0040-1714685 -
Hand (New York, N.Y.) Nov 2022Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve...
BACKGROUND
Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries.
METHODS
A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups.
RESULTS
For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups.
CONCLUSIONS
The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.
Topics: Humans; Radial Neuropathy; Tendon Transfer; Nerve Transfer; Retrospective Studies; Quality of Life
PubMed: 33530787
DOI: 10.1177/1558944720988126 -
PeerJ 2023Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy resulting in hand pain, numbness and/or weakness, which significantly impairs hand function in daily... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy resulting in hand pain, numbness and/or weakness, which significantly impairs hand function in daily activities. Repetitive peripheral magnetic stimulation (rPMS) is a potential therapeutic option for focal peripheral nerve disease and may be beneficial for CTS treatment. We aimed to compare the effects of rPMS and conventional therapy in the management of CTS.
METHODS
A blinded assessor randomly assigned 24 participants with electrodiagnostically-confirmed mild or moderate CTS to either rPMS or conventional therapy. Both groups were briefed on disease progression and tendon-gliding exercises. In the intervention group, the rPMS protocol, five sessions of rPMS-with a frequency of 10 Hz, 10 pulses/train, and 100 trains/session-were performed over a period of 2 weeks, with three sessions in the first week and two sessions in the second week. At baseline and the end of the second week, the Boston Carpal Tunnel Questionnaire, pinch strength, and electrodiagnostic results were evaluated.
RESULTS
The rPMS group demonstrated significantly greater within-group improvement in symptom severity scores (2.3 . 1.6, = 0.009) and pinch strength (10.6 lbs . 13.8 lbs, < 0.001). Regarding electrodiagnostic parameters, sensory nerve action potential (SNAP) amplitude was significantly increased (8.7 µV . 14.3 µV, = 0.002) within the group treated with rPMS. With conventional therapy, there were no statistically significant within-group differences. Multiple linear regression models showed that there were no significant differences in other outcomes in between-group comparisons.
CONCLUSIONS
Five sessions of rPMS resulted in significant reduction in symptom severity, improvement in pinch strength and increase in SNAP amplitude. Future research should investigate the clinical utility of rPMS using a larger sample and longer treatment and follow-up durations.
Topics: Humans; Carpal Tunnel Syndrome; Pilot Projects; Nerve Compression Syndromes; Exercise Therapy; Magnetic Phenomena
PubMed: 37220528
DOI: 10.7717/peerj.15398 -
The Journal of Venomous Animals and... 2022Scorpions can use their pincers and/or stingers to subdue and immobilize their prey. A scorpion can thus choose between strategies involving force or venom, or both,...
BACKGROUND
Scorpions can use their pincers and/or stingers to subdue and immobilize their prey. A scorpion can thus choose between strategies involving force or venom, or both, depending on what is required to subdue its prey. Scorpions vary greatly in the size and strength of their pincers, and in the efficacy of their venom. Whether this variability is driven by their defensive or prey incapacitation functionis unknown. In this study, we test if scorpion species with different pincer morphologies and venom efficacies use these weapons differently during prey subjugation. To that end, we observed and sp. with large pincers and and sp. with slender pincers.
METHODS
The scorpion pinch force was measured, and behavioral experiments were performed with hard and soft prey ( and ). Stinger use, sting frequency and immobilization time were measured.
RESULTS
We found that scorpions with large pincers such as produce more force and use the stinger less, mostly subjugating prey by crushing them with the pincers. In and sp. we found they use their slender and relatively weak pincers for holding the prey, but seem to predominantly use the stinger to subjugate them. On the other hand, sp. uses both strategies although it has a high pinch force.
CONCLUSIONS
Our results show that scorpionspecies with massive pincers and high pinch force as use the stinger less for prey subjugation than scorpionspecies with slenderpincers.
PubMed: 35432495
DOI: 10.1590/1678-9199-JVATITD-2021-0037 -
European Journal of Trauma and... Apr 2022The primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose...
PURPOSE
The primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose of the present study was to introduce a variation of the abductor pollicis longus (APL) suspension arthroplasty using a single looping of a radial slip from the APL tendon around the flexor carpi radialis (FCR) tendon combined with RegJoint™ interposition and to determine its efficacy in the treatment of thumb CMC joint osteoarthritis.
METHODS
Between 2015 and 2017, 21 patients were included. The average age was 60.8 years (range 48-79). The mean follow-up was 27.7 months (range 8-50). Evaluation included pain, radial and palmar abduction, tip pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score.
RESULTS
Pain averaged 0.3 (range 0-4) at rest and 1.4 (range 0-4) on exertion. The radial and palmar abduction were 97% and 99% compared to the contralateral side. The tip pinch and grip strength were 4.1 kg (range 3-6.5) and 22 kg (range 13.3-40), respectively. The DASH score accounted for 18.5 (range 0.8-41.7).
CONCLUSION
The modified APL suspension interposition arthroplasty was an efficient and simplified option for the treatment of thumb CMC joint osteoarthritis, with results comparable or better than other published procedures. The APL suspension technique was easy to perform avoiding difficult bone tunneling and incision of the FCR tendon. The RegJoint™ interposition as spacer prevented impingement of the first metacarpal base on the second metacarpal base or the trapezoid bone.
Topics: Aged; Arthroplasty; Carpometacarpal Joints; Humans; Middle Aged; Osteoarthritis; Pain; Tendon Transfer; Thumb
PubMed: 33367972
DOI: 10.1007/s00068-020-01577-w