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Neural Plasticity 2021Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, leading to disability and decreased quality of life. In past research...
OBJECTIVE
Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, leading to disability and decreased quality of life. In past research and clinical studies, the lower limb function of DPN patients was often the principal subject of research, with little attention given to the upper limb and hand. Our goal was to assess and compare hand function between elderly diabetic patients with DPN and without DPN.
METHODS
A total of 52 diabetic patients were registered and underwent hand function assessments and electrodiagnostic tests. Dynamometer, pinch meter, Semmes Weinstein monofilaments, and the Purdue Pegboard Test (PPT) were used to assess the patients' grip strength, pinch strength, tactile sensory threshold, and hand dexterity.
RESULTS
Compared with the non-DPN group, the elderly DPN group showed worse thumb-middle fingertip pinch strength and thumb-little fingertip pinch strength in the dominant hand (3.50 (2.50, 4.25) vs. 4.50 (3.00, 5.00), = 0.019; 1.50 (1.00, 2.00) vs. 2.50 (2.00, 3.00), < 0.001); the elderly DPN group displayed worse thumb-middle fingertip pinch strength, thumb-ring fingertip pinch strength, and thumb-little fingertip pinch strength in the nondominant hand (3.50 (2.00, 4.50) vs. 4.00 (3.00, 5.00), = 0.013; 2.50 (1.25, 3.00) vs. 3.00 (2.50, 3.50), = 0.033; 1.00 (0.75, 2.25) vs. 2.50 (2.00, 2.50), < 0.001). The elderly DPN group scored lower than the non-DPN group on the PPT test of assembly (13.96 ± 5.18 vs. 16.96 ± 4.61, = 2.212, = 0.032).
CONCLUSION
Motor function limitation is the principal hand dysfunction in elderly patients with DPN, which is mainly manifested as a decline in fingertip pinch strength and a decrease in hand dexterity. This trial is registered with Clinical Trial Registry no. ChiCTR1900025358.
Topics: Aged; Aged, 80 and over; Diabetic Neuropathies; Female; Hand; Humans; Male; Muscle Strength; Muscle Strength Dynamometer; Neural Conduction; Pinch Strength
PubMed: 34335735
DOI: 10.1155/2021/9959103 -
The Journal of Hand Surgery Jan 2023Patients with severe ulnar neuropathy at the elbow frequently experience suboptimal surgical outcomes. Clinical symptoms alone may not accurately represent the severity...
PURPOSE
Patients with severe ulnar neuropathy at the elbow frequently experience suboptimal surgical outcomes. Clinical symptoms alone may not accurately represent the severity of underlying nerve injury, calling for objective assessment tools, such as electrodiagnostic studies. The goal of our study was to determine whether specific electrodiagnostic parameters can be used to predict the outcomes after in situ decompression of the ulnar nerve.
METHODS
This prospective study enrolled consecutive patients aged ≥18 years diagnosed with ulnar neuropathy at the elbow. Patients completed a baseline battery of motor, sensory, functional, and electrodiagnostic tests before undergoing in situ decompression of the ulnar nerve. They were reassessed at 6 weeks, 3 months, 6 months, and 12 months after surgery. Forty-two patients completed at least 2 follow-up assessments and were included in the study.
RESULTS
When controlling for other electrodiagnostic measurements and demographic factors, none of the electrodiagnostic parameters were predictive of outcomes at 12 months after surgery. Patients with decreased compound muscle action potential amplitudes demonstrated slower trends of recovery in grip strength, pinch strength, and overall scores on the Michigan Hand Outcomes Questionnaire as well as its function, work, and activities of daily living subscales, Disabilities of the Arm, Shoulder, and Hand questionnaire, and the Carpal Tunnel Questionnaire. Decreased motor nerve conduction velocity was predictive of slower recovery of 2-point discrimination and pinch strength.
CONCLUSIONS
Compound muscle action potential amplitude, but not other conventional electrodiagnostic parameters, was predictive of functional outcomes after in situ decompression of the ulnar nerve. This parameter should play a role in determining the timing and prognosis of treatment for ulnar neuropathy at the elbow.
TYPE OF STUDY/LEVEL OF EVIDENCE
Prognostic II.
Topics: Humans; Adolescent; Adult; Ulnar Nerve; Activities of Daily Living; Prospective Studies; Ulnar Neuropathies; Decompression, Surgical
PubMed: 36371353
DOI: 10.1016/j.jhsa.2022.10.008 -
Hand Clinics May 2022Trapezium resection with or without tendon suspension arthroplasty has been considered the gold standard surgical treatment for thumb carpometacarpal joint... (Review)
Review
Trapezium resection with or without tendon suspension arthroplasty has been considered the gold standard surgical treatment for thumb carpometacarpal joint osteoarthritis (CMCJ OA). However, the removal of the trapezium may result in subsidence or shortening of the first metacarpal axis. Resection may also lead to reduced pinch strength and thumb instability. Joint preservation techniques may be used in early stages of CMCJ OA to promote pain relief, return to function, and delay more invasive procedures such as a trapezium resection.
Topics: Arthroplasty; Carpometacarpal Joints; Humans; Osteoarthritis; Thumb; Trapezium Bone
PubMed: 35465935
DOI: 10.1016/j.hcl.2022.01.002 -
International Journal of Dental Hygiene Aug 2023The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals. (Review)
Review
OBJECTIVE
The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals.
METHODS
Three databases were utilized from September 2019 to November 2021 in addition to hand-searching specific journals and reference lists. Research articles that examined pinch force generation in dental professionals during scaling with manual instruments only were included. Bias was assessed in the individual articles.
RESULTS
Six research articles were included with sample populations that varied from 12 to 24 participants. Four articles evaluated instrument designs in relation to pinch force generation during scaling by dental professionals. Two articles evaluated the clinicians' experience levels and the impact on pinch force generation. Results of three articles revealed instruments with large diameters and low weights produced the least amount of pinch force (p < 0.05). Additionally, two articles found instruments with a round, tapered shape produced less pinch force and instrument handles made of silicone produced higher pinch strength post-scaling (p < 0.05). One study indicated instrument designs associated with modified scaling techniques may reduce thumb and index finger pinch force (p < 0.05).
CONCLUSION
The findings from this review indicate weak evidence for instrument choices to reduce pinch force during scaling. Dental professionals should consider lightweight and large diameter instruments for manual scaling. Clinicians may also want to consider round, tapered handles and instrument designs with modified scaling techniques. This systematic review further identified the need for clinical research studies with rigorous research designs that examine the ergonomic impacts of instrument designs.
Topics: Humans; Research Design; Dental Scaling; Hand; Ergonomics; Dentists
PubMed: 36524311
DOI: 10.1111/idh.12649 -
Journal of Hand and Microsurgery Apr 2023There has been an increasing utilization of end-to-end (ETE) and reverse "supercharged" end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers... (Review)
Review
There has been an increasing utilization of end-to-end (ETE) and reverse "supercharged" end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers (NTs) for treatment of high ulnar nerve injury. This study aimed to review the potential indications for, and outcomes of, ETE and SETS AIN-ulnar NT. A literature review was performed, and 10 articles with 156 patients who had sufficient follow-up to evaluate functional outcomes were included. English studies were included if they reported the outcome of patients with ulnar nerve injuries treated with AIN to ulnar motor NT. Outcomes were analyzed based on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores, grip and key pinch strength, and interosseous Medical Research Council-graded motor strength. Comparisons were made using the independent -test and the chi-square test. No nerve graft control group was required for eligibility. Ulnar nerve injury types varied. NT resulted in 77% of patients achieving M3+ recovery, 53.7 ± 19.8 lb grip strength recovery, 61 ± 21% key pinch recovery, and a mean DASH score of 33.4 ± 16. In this diverse group, NT resulted in significantly greater M3+ recovery and grip strength recovery measured in pounds than in the nerve graft/conventional treatment group, and ETE repairs had significantly better outcomes compared with SETS repairs for grip strength, key pinch strength, and DASH scores, but heterogeneity limits interpretation. ETE and SETS AIN-ulnar NTs produce significant restoration of ulnar nerve motor function for high ulnar nerve injuries. For ulnar nerve transection injuries at or above the elbow, ETE NT results in superior motor recovery compared with nerve grafting/conventional repair. However, further research is needed to determine the best treatment for other types of ulnar nerve injury and the role of SETS NT.
PubMed: 37020610
DOI: 10.1055/s-0041-1734399 -
Muscle & Nerve Jan 2021The split-hand concept has highlighted the preferential wasting of the thenar side of the hand in amyotrophic lateral sclerosis (ALS). Our objective is to re-explore...
BACKGROUND
The split-hand concept has highlighted the preferential wasting of the thenar side of the hand in amyotrophic lateral sclerosis (ALS). Our objective is to re-explore pinch grip strength to assess whether it has the potential to be a practical biomarker of ALS.
METHODS
We measured different pinch grip strengths (thumb, index, and fifth) using a pinch gauge from both hands of 54 ALS patients and correlated this with the Medical Research Council (MRC) score, the upper-limb component of the revised ALS Functional Rating Scale - Revised (ALSFRS-R) score, and compound muscle action potentials (CMAPs) that comprise the split-hand index.
RESULTS
Pinch grip strength using any of the three fingers showed a positive correlation with its corresponding CMAP, MRC grading, and upper-limb ALSFRS-R score. The thumb pinch showed the strongest correlation with the split-hand index and MRC grading.
CONCLUSIONS
Pinch grip strength test using a simple gauge deserves further study as a potentially practical biomarker of ALS.
Topics: Adult; Aged; Amyotrophic Lateral Sclerosis; Female; Hand; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Pinch Strength
PubMed: 33118631
DOI: 10.1002/mus.27111 -
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 -
JPMA. the Journal of the Pakistan... Feb 2022The objective of the study was to observe the change in Pinch Strength (PS) of arteriovenous fistula (AVF) arm and non-AVF arm before and after haemodialysis (HD). A...
The objective of the study was to observe the change in Pinch Strength (PS) of arteriovenous fistula (AVF) arm and non-AVF arm before and after haemodialysis (HD). A total of 31 patients (21 Male and 10 Female) undergoing HD during January and February 2020 at a trust hospital were selected through purposive sampling. Mean PS was calculated from the measurements taken using the Jamar digital pinch gauge with an interval of five seconds between each measurement. Paired sample T-test was applied using SPSS 20. The mean PS values for AVF arm when compared before and after the session were 3.64 ±1.01 and 2.87 ±1.20 kgs (p<0.01), whereas for non AVF arm PS values were 3.96 ±1.50 and 3.69 ±1.37 kgs (p=0.09). It was concluded that PS of AVF arm decreased more significantly after HD as compared to the non AVF arm.
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Female; Humans; Kidney Failure, Chronic; Male; Pinch Strength; Renal Dialysis
PubMed: 35320205
DOI: 10.47391/JPMA.1406 -
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 -
Mymensingh Medical Journal : MMJ Oct 2021The three jaw chuck pinch is a variety of pinch technique where thumb opposes both middle and index fingers. Pinch strength is generally influenced by the health status...
The three jaw chuck pinch is a variety of pinch technique where thumb opposes both middle and index fingers. Pinch strength is generally influenced by the health status and level of physical activity of a person. The present study was conducted to measure the correlation of three-jaw chuck pinch strength with hand depth in electronics technicians working in Dhaka Metropolitan City. The data obtained from the study may be used as a base line for other professions as well as for research in our country. This cross sectional, analytical study was carried out in the department of Anatomy, Dhaka Medical College, Dhaka, Bangladesh from July 2015 to June 2016 on 100 adults male electronics technicians and 100 adult sedentary workers. Electronics technicians were considered as case group and sedentary workers were considered as control group. Case group was further subdivided according to their working experiences. Study subjects were selected by convenient purposive sampling technique. Hand depth was measured by digital slide calipers and pinch gauge was used to measure the three-jaw chuck pinch strength. The mean three-jaw chuck pinch strength was significantly higher (p<0.05) in case group than in the control group. Significant difference were also observed between case group and control group in the mean hand depth (p<0.05). Mean hand depth was greater in case group than that of control group. Three-jaw chuck pinch strength showed significant positive correlation with hand depth in case group. Case group was further subdivided according to their working experiences, the mean three-jaw chuck pinch strength and hand depth was significantly higher (p<0.05) in more working experience group than in less working experience group. Three-jaw chuck pinch strength showed significant positive correlation with hand depth.
Topics: Adult; Bangladesh; Cross-Sectional Studies; Electronics; Hand Strength; Humans; Male; Pinch Strength
PubMed: 34605470
DOI: No ID Found