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The Journal of Hand Surgery... Feb 2024Functional outcomes of patients who underwent arthroscopy-assisted surgery for trapeziometacarpal osteoarthritis were reported. We included 24 consecutive patients (6...
Functional outcomes of patients who underwent arthroscopy-assisted surgery for trapeziometacarpal osteoarthritis were reported. We included 24 consecutive patients (6 males and 18 females) who underwent surgery and postoperative hand therapy at our hospital between April 2012 and March 2018. For functional evaluation, we used the Purdue Pegboard Test (PPT), grip and pinch strength, range of motion of the thumb, visual analogue scale (VAS) for thumb pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Japanese version of the Patient-Rated Wrist Evaluation (PRWE-J) preoperatively and 3 months postoperatively. The mean PPT rating improved from 12.3 to 13.3, the VAS score from 51 to 16, the QuickDASH score from 48 to 30 and the PRWE-J score from 55 to 29. All the improvements were statistically significant. There was a moderate positive correlation between the magnitude of improvement in PPT and QuickDASH scores. Arthroscopic intervention and associated hand therapy were effective in achieving early postoperative relief of thumb pain and in improving hand dexterity and activities of daily living. Level IV (Therapeutic).
Topics: Male; Female; Humans; Arthroscopy; Activities of Daily Living; Carpometacarpal Joints; Osteoarthritis; Pain
PubMed: 38299245
DOI: 10.1142/S2424835524500024 -
Journal of Orthopaedics and... Jul 2022The success of digit replantation is mainly based on survival rates. The functional outcome as well as the recovery of sensibility are essential parameters for judging...
BACKGROUND
The success of digit replantation is mainly based on survival rates. The functional outcome as well as the recovery of sensibility are essential parameters for judging the outcome after digit replantation but have been poorly assessed in previous studies.
PATIENTS AND METHODS
Forty-eight patients with 56 complete traumatic digit amputations occurring between 2008 and 2013 returned for a follow-up examination, the earliest being 6 months postoperatively. Each patient's range of motion, fingertip-to-table distance, fingertip-to-palm distance, grip and pinch strengths, static two-point discrimination (2-PD), and Semmes-Weinstein monofilament (SWM) test level were assessed in order to compare functional outcome and recovery of sensibility between successful replantation (n = 19) and primary or secondary amputation (n = 37). Subjective assessments of the pain level and function of the upper extremity were performed using the numerical rating scale and the DASH score, respectively.
RESULTS
Replanted digits achieved 58% of the median total range of motion of the corresponding uninjured digits. Grip and pinch strength were not significantly different after thumb or finger replantation or amputation. Recovery of sensibility was excellent after replantation, with a median static 2-PD of 5 mm and a reduction of pressure sensibility of two levels of the SWM test compared to the contralateral side. After amputation, the median static 2-PD was also very good, with a median value of 6 mm and a reduction of pressure sensibility of only one level according to the SWM test. There was significantly less pain after replantation at rest (p = 0.012) and under strain (p = 0.012) compared to patients after amputation. No significant differences were observed in the DASH score between the two groups.
CONCLUSION
Comparable functional results and sensory recovery but significantly less pain at rest and under strain can be expected after digit replantation when compared to digit amputation.
LEVEL OF EVIDENCE
IV.
Topics: Amputation, Surgical; Amputation, Traumatic; Finger Injuries; Humans; Pain; Replantation; Retrospective Studies
PubMed: 35896899
DOI: 10.1186/s10195-022-00654-7 -
Clinical Spine Surgery Nov 2019Prospective. (Observational Study)
Observational Study
STUDY DESIGN
Prospective.
OBJECTIVE
To evaluate improvements in grip and pinch strength in patients with or without myelopathy and determine patient factors that are predictive of continued postoperative grip strength weakness.
SUMMARY OF BACKGROUND DATA
The degree to which cervical myelopathy can diminish upper extremity muscle strength has not been objectively characterized. Few studies have investigated the association between the expected improvements in patient-reported outcomes (PROs) and strength in grip and pinch after anterior cervical discectomy and fusion (ACDF).
METHODS
Patients were asked to perform grip and pinch strength tests both preoperatively and at 6-month follow-up. Patients were also administered PRO surveys, which included Neck Disability Index, Short-Form-12 physical composite score and mental composite score, and Visual Analog Scale neck and arm pain scores. Receiver operating characteristic (ROC) curve analysis was used to determine optimum cutoff values of preoperative patient factors to predict postoperative dominant handgrip weakness after ACDF.
RESULTS
Patients with radiculopathy demonstrated a significantly greater improvement in Visual Analog Scale arm pain compared with patients with myelopathy. The ROC curve analysis determined the optimum cutoff for preoperative dominant handgrip strength to be 22 kgf. This value demonstrated a sensitivity of 0.89 and a specificity of 0.62. The area under the ROC curve value was 0.71 (95% confidence interval, 0.55-0.88), indicating fair prognostic accuracy of the cutoff for postoperative dominant handgrip weakness.
CONCLUSIONS
In this prospective, observational study, postoperative increase in grip and pinch strength demonstrated an association with improvement of pain and disability of the neck and overall quality of health regardless of the presence of cervical myelopathy. Preoperative grip strength weakness was found to be predictive of postoperative grip strength deficiency after ACDF. Our investigation suggests the recovery of hand function may be correlated with improvement of PROs after ACDF.
Topics: Aged; Cervical Vertebrae; Diskectomy; Female; Hand Strength; Health Surveys; Humans; Male; Neck Pain; Pain Measurement; Patient Reported Outcome Measures; Pinch Strength; Postoperative Period; Prospective Studies; ROC Curve; Spinal Cord Diseases; Spinal Fusion
PubMed: 31567533
DOI: 10.1097/BSD.0000000000000892 -
Journal of Orthopaedic Surgery (Hong... 2020Gripping and pinching a ball is a fundamentally important part of the kinetic chain for throwing baseball pitches of various types. This study of high school pitchers...
OBJECTIVE
Gripping and pinching a ball is a fundamentally important part of the kinetic chain for throwing baseball pitches of various types. This study of high school pitchers was conducted to assess the association between grip and pinch strength, the pitch type, and the history of elbow symptoms.
METHODS
We examined 133 high school baseball pitchers, all of whom had completed a self-administered questionnaire including items related to pitch type throwing ratios, the age at starting each pitch type, and throwing-related elbow joint pain sustained during the prior 3 years. We measured grip strength and the bilateral side tip, key, and palmar pinch strengths. Comparisons were made between the participants with and without an elbow symptom history to assess the grip and each pinch strength, throwing ratio of pitch type, and the age at starting to throw each pitch type.
RESULTS
Pitchers with an elbow symptom history exhibited less difference between the grip strength on the throwing side than those with no elbow symptom history ( = 0.04). No difference was found between participants with and without an elbow symptom history in terms of pinch strength, the throwing ratios of pitch types, or the age at starting to throw pitches of each type. Positive significant association was found between pinch strength on the pitching side and the forkball and screwball throwing ratio ( = 0.27, = 0.002).
CONCLUSION
Grip strength might influence high school baseball pitcher elbow conditions. The frequency of certain pitch types might develop pinch strength in high school baseball pitchers.
Topics: Adolescent; Arthralgia; Athletic Performance; Baseball; Biomechanical Phenomena; Elbow Joint; Hand Strength; Humans; Pinch Strength; Range of Motion, Articular; Schools; Youth Sports
PubMed: 31986969
DOI: 10.1177/2309499019890743 -
JPMA. the Journal of the Pakistan... Aug 2023To evaluate immediate and long-term effect of texting or handwriting on hand-grip and key-pinch strength among healthy female students. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate immediate and long-term effect of texting or handwriting on hand-grip and key-pinch strength among healthy female students.
METHODS
The single-blind, randomised controlled trial was conducted between February and April 2021 after approval from the ethics review committee of the College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia, and comprised female Physio Therapy students aged 19-23 years who were right-hand dominant and had normal body mass index. The subjects used smartphones and electronic gadgets for >2hrs daily, writing more than 10min/day. They were randomised using sealed envelopes into five groups. Group A practised 10min texting, group B 15min texting, group C 10min writing, group D 15min writing, and group E used the phones only for talking or watching, with no texting or writing, and was taken as the control group. Hand-grip strength and key- pinch strength were assessed one minute before starting, and within one minute after having finished the assigned hand activity. All measurements were recorded in the sitting position using a single hand-grip dynamometer. Data was analysed using SPSS 23.
RESULTS
Of the 65 individuals assessed, 60(92.3%) were initially enrolled, but the study was finished by 50(83.3%) subjects with a mean age of 20.88±0.98 years and mean body mass index 20.8±2.30kg/m2. There were 12(24%) subjects in group A, 7(14%) in group B, 12(24%) in group C, 10(20%) in group D and 9(18%) in group E. The association of the time-based groups with hand-grip and key-pinch strength was not significant (p>0.05).
CONCLUSIONS
Texting and handwriting did not have any significant immediate effect on hand- grip or key-pinch strength.
CLINICAL TRIAL NUMBER
(NCT04810416).
Topics: Adult; Female; Humans; Young Adult; Body Mass Index; Hand Strength; Handwriting; Single-Blind Method; Text Messaging
PubMed: 37697745
DOI: 10.47391/JPMA.1577 -
Hand (New York, N.Y.) Mar 2021To decrease the time to reinnervation of the intrinsic motor end plates after high ulnar nerve injuries, a supercharged end-to-side (SETS) anterior interosseous to...
To decrease the time to reinnervation of the intrinsic motor end plates after high ulnar nerve injuries, a supercharged end-to-side (SETS) anterior interosseous to ulnar motor nerve transfer has been proposed. The purpose of this study was to compile and review the indications, outcomes, and complications of SETS anterior interosseous to ulnar motor nerve transfer. A literature search was performed, identifying 73 papers; 4 of which met inclusion and exclusion criteria, including 78 patients. Papers included were those that contained the results of SETS between the years 2000 and 2018. Data were pooled and analyzed focusing on the primary outcomes: intrinsic muscle recovery and complications. Four studies with 78 patients met inclusion and exclusion criteria. Most patients (33.3%) underwent SETS for an ulnar nerve lesion in continuity, the average age was 46.5 years, and the average follow-up was 10 months. The average duration of symptoms before surgery was 99 weeks, all patients had weakness and numbness, nearly all (96%) had atrophy, and half (53%) had pain. Grip and key pinch strength improved 202% and 179%, respectively, from the preoperative assessment. The vast majority (91.9%) recovered intrinsic function at an average of 3.7 months. Other than 8% of patients who did not recover intrinsic strength, no other complications were reported in any of the 78 patients. The SETS is a successful procedure with low morbidity, which may restore intrinsic function in patients with proximal nerve injuries.
Topics: Arm; Hand Strength; Humans; Middle Aged; Nerve Transfer; Ulnar Nerve; Ulnar Neuropathies
PubMed: 30924361
DOI: 10.1177/1558944719836213 -
Journal of Hand Therapy : Official... 2022Randomized controlled study. (Randomized Controlled Trial)
Randomized Controlled Trial
STUDY DESIGN
Randomized controlled study.
INTRODUCTION
Lateral epicondylitis (LE) causes pain and loss of function in the affected limb. Different exercises have been used for the treatment of LE. In recent years, the technique of neuromobilization has been frequently used to treat tendinopathy. However, there is no study that demonstrates the effects of neuromobilization techniques on patients with LE.
PURPOSE OF THE STUDY
The aim of the present study was to determine the effects of neuromobilization techniques on pain, grip strength, and functional status in LE patients and to compare them with conservative rehabilitation treatment.
METHODS
A total of 40 patients (26 females and 14 males; age: 42.80 ± 8.91 years) with a history of LE participated in the study. The patients were randomly assigned to two groups: the neuromobilization group and the control group. The neuromobilization group completed a 6-week conservative rehabilitation and radial nerve mobilization program, whereas the control group received conservative rehabilitation therapy only. Both groups underwent a 7-day weekly conservative home rehabilitation program. Pain severity, grip strength, pinch strength, joint motions, and upper extremity functional level were assessed before treatment, at the third week after treatment, and at the sixth week after treatment.
RESULTS
There was a significant decrease in all pain scores in favor of the neuromobilization group at week 6 after treatment (at rest: P = .001, effect size (ES) = 0.84; at night: P = .001, ES = 0.91 and during activity: P = .004, ES = 1.06). No significant differences were found for grip strength, pinch strength, joint motions, and functional level in the neuromobilization group, although trends toward better improvement were observed.
CONCLUSIONS
Radial nerve mobilization techniques are more effective on pain than conservative rehabilitation therapy in LE patients, and this effect continues after treatment.
Topics: Adult; Female; Hand Strength; Humans; Male; Middle Aged; Pain; Pain Measurement; Physical Therapy Modalities; Tennis Elbow; Treatment Outcome
PubMed: 33563509
DOI: 10.1016/j.jht.2020.11.003 -
International Journal of MS Care 2023Multiple sclerosis (MS) is a degenerative disease with typical onset between 20 and 50 years of age. An increase in MS cases has been found in the adolescent US...
BACKGROUND
Multiple sclerosis (MS) is a degenerative disease with typical onset between 20 and 50 years of age. An increase in MS cases has been found in the adolescent US population. Adolescents require fine motor manipulation skills for their functional and academic performance. Deficits in the major components of manipulation skills may result in insufficient function. This study examined the 2-point, 3-point, and lateral pinch strength of adolescents diagnosed as having MS.
METHODS
Seventy-four adolescents, 37 with a diagnosis of relapsing-remitting MS and a control group of 37 age-matched peers, participated in this study. Data on 2-point, 3-point, and lateral pinch strength in both hands were collected using a pinch meter. Analyses of covariance were used to describe differences across the 2 groups, and effect sizes (Cohen ) were calculated by finding the mean difference between the study groups divided by the pooled SD.
RESULTS
A significant difference was found in the 2-point pinch strength of the right hand of participants with pediatric MS compared with age- and sex-matched control participants. There were no significant differences in 2-point pinch strength of the left hand or in 3-point or lateral pinch strength of the right and left hands.
CONCLUSIONS
Pinch grasp strength was differentially affected in adolescents with MS. Pinch strength should be assessed and considered in adolescents with MS for a better understanding of their functional performance of fine motor tasks in activities of daily living and academics.
PubMed: 36711222
DOI: 10.7224/1537-2073.2021-046 -
The Journal of International Medical... Dec 2020To evaluate the development level of children's physiological hand shape indicators and their relationship with grip/pinch strength.
OBJECTIVE
To evaluate the development level of children's physiological hand shape indicators and their relationship with grip/pinch strength.
METHODS
Hand shape and grip/pinch strength in 1255 Chinese children aged 5 to 13 years were prospectively measured. Development curves of physiological hand shape indicators and grip/pinch strength were constructed.
RESULTS
The physiological hand shape indicators (full length, middle finger length, width, and wrist thickness) and grip/pinch strength of boys and girls increased with age and showed statistically significant differences at different ages. In most age groups, hand shape indicators and grip/pinch strength were larger in boys than in girls of the same age. After puberty, the physiological hand shape indicators and grip/pinch strength increased more rapidly in girls than in boys of the same age, and the differences gradually decreased thereafter. Moreover, a significant difference in pinch strength between the right and left hands was observed in most age groups. Pearson correlation analysis showed that the physiological hand shape indicators were significantly positively correlated with grip/pinch strength, height, weight, and body mass index.
CONCLUSIONS
This study revealed the relationship between physiological hand shape indicators and grip/pinch strength and provided reference ranges of physiological hand shape indicators and grip/pinch strength for children.
Topics: Adolescent; Age Factors; Anthropometry; Child; Child, Preschool; Female; Hand; Hand Strength; Humans; Male; Pinch Strength
PubMed: 33275482
DOI: 10.1177/0300060520970768 -
Topics in Spinal Cord Injury... 2021To reach agreement on standardized protocols for assessing upper limb strength and grip and pinch force for upper limb reconstructive surgery for tetraplegia.
OBJECTIVES
To reach agreement on standardized protocols for assessing upper limb strength and grip and pinch force for upper limb reconstructive surgery for tetraplegia.
METHODS
Selected members of an expert panel composed of international therapists formed at the 2018 International Congress for Upper Limb Surgery for Tetraplegia conducted a literature review of current practice that identified gaps and inconsistencies in measurement protocols and presented to workshop attendees. To resolve discrepancies, a set of questions was presented to workshop attendees who voted electronically. Consensus was set at 75% agreement.
RESULTS
For manual muscle testing, consensus was reached for using the Medical Research Council scale, without plus or minus, and the use of resistance through range when testing grade 4 and grade 5 strength. Pectoralis major and serratus anterior should be routinely tested, however there was no consensus on other shoulder muscles. Grip and pinch strength should be tested according to the American Society of Hand Therapists positioning. For grip strength, either the Jamar or Biometrics dynamometer expressed in kilograms should be used. For grip and pinch strength, three measurements should be performed at each testing. No consensus was reached on a device for pinch strength.
CONCLUSION
This work is an important step to enable comparable data in the future. Further consensus methods will work toward developing more comprehensive guidelines in this population. Building international consensus for pre- and postoperative measures of function supports objective evaluation of novel therapies and interpretation of multicenter studies.
Topics: Humans; Muscle Strength; Physical Examination; Quadriplegia; Plastic Surgery Procedures; Spinal Cord Injuries; Upper Extremity
PubMed: 34456548
DOI: 10.46292/sci20-00012