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Annals of Physical and Rehabilitation... Mar 2018People with type 2 diabetes mellitus frequently show complications in feet and hands. However, the literature has mostly focused on foot complications. The disease can... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
People with type 2 diabetes mellitus frequently show complications in feet and hands. However, the literature has mostly focused on foot complications. The disease can affect the strength and dexterity of the hands, thereby reducing function.
OBJECTIVES
This systematic review and meta-analysis focused on identifying the existing evidence on how type 2 diabetes mellitus affects hand strength, dexterity and function.
METHODS
We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane central register of controlled trials for reports of studies of grip and pinch strength as well as hand dexterity and function evaluated by questionnaires comparing patients with type 2 diabetes mellitus and healthy controls that were published between 1990 and 2017. Data are reported as standardized mean difference (SMD) or mean difference (MD) and 95% confidence intervals (CIs).
RESULTS
Among 2077 records retrieved, only 7 full-text articles were available for meta-analysis. For both the dominant and non-dominant hand, type 2 diabetes mellitus negatively affected grip strength (SMD: -1.03; 95% CI: -2.24 to 0.18 and -1.37, -3.07 to 0.33) and pinch strength (-1.09, -2.56 to 0.38 and -1.12, -2.73 to 0.49), although not significantly. Dexterity of the dominant hand did not differ between diabetes and control groups but was poorer for the non-dominant hand, although not significantly. Hand function was worse for diabetes than control groups in 2 studies (MD: -8.7; 95% CI: -16.88 to -1.52 and 4.69, 2.03 to 7.35).
CONCLUSION
This systematic review with meta-analysis suggested reduced hand function, specifically grip and pinch strength, for people with type 2 diabetes mellitus versus healthy controls. However, the sample size for all studies was low. Hence, we need studies with adequate sample size and randomized controlled trials to provide statistically significant results.
Topics: Aged; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Female; Hand Strength; Humans; Male; Middle Aged
PubMed: 29366905
DOI: 10.1016/j.rehab.2017.12.006 -
Behavioral Sciences (Basel, Switzerland) May 2023The COVID-19 lockdown restrictions affected physical performance and cognitive function in older people as they were confined to their homes. There is an association...
The COVID-19 lockdown restrictions affected physical performance and cognitive function in older people as they were confined to their homes. There is an association between physical and cognitive functions. Mild Cognitive Impairment (MCI) is a condition that risks progressing to dementia. This study aimed to identify the relationship between handgrip strength (HGS), Timed Up-and-Go (TUG), and MCI in older people during the COVID-19 pandemic restrictions. The cross-sectional study recruited 464 eligible participants for an interview and anthropometric measurement. The Montreal Cognitive Assessment-Basic (MoCA-B), HGS, and TUG were measured in addition to demographic and health characteristics. A total of 398 participants (85.8%) were found to have MCI when screened with the MoCA-B. Their mean age was 71.09 ± 5.81 years. Forward multiple regression analysis demonstrated that HGS (β = 0.032, < 0.001), education level (β = 2.801, < 0.001), TUG (β = -0.022, = 0.013), Thai Geriatric Depression Score, TGDS (β = -0.248, = 0.011), and age (β = -1.677, = 0.019) were associated with MCI. A decrease in HGS and an increased TUG might allow for the early detection of MCI and promote physical training in order to reduce the risk of MCI. Further studies can investigate multidomain indicators for MCI, for example, fine motor skills and pinch strength as components of the motor abilities.
PubMed: 37232647
DOI: 10.3390/bs13050410 -
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 -
BMC Nephrology May 2024Patients undergoing maintenance hemodialysis (MHD) experience increased mortality and cardiovascular disease (CVD) risks; however, the potential connection between pinch...
BACKGROUND AND AIMS
Patients undergoing maintenance hemodialysis (MHD) experience increased mortality and cardiovascular disease (CVD) risks; however, the potential connection between pinch strength (PS) and the prognosis of these patients remains unknown. Consequently, this study aimed to comprehensively assess the influence of PS and handgrip strength (HGS) on both survival and cardiovascular events (CVE) in patients undergoing MHD.
METHODS
Data were gathered from patients undergoing MHD at the Hemodialysis Center of Guangzhou Red Cross Hospital in March 2021. We performed a retrospective follow-up spanning 24 months, with death serving as the primary endpoint for observation and CVE as the secondary endpoint. Multifactorial Cox regression analysis, Kaplan-Meier survival curves, trend tests, and restricted cubic spline were applied to explore the association.
RESULTS
During a 24-month follow-up, data were collected from 140 patients undergoing MHD with an average age of 66.71 ± 12.61 years. Among them, 52 (37.14%) experienced mortality, whereas 36 (40.00%) had CVE without baseline CVD. Kaplan-Meier survival curves demonstrated better survival rates and reduced CVE risk for patients in the second, third, and fourth quartiles compared with those in the first quartile for PS. Adjusted analyses in different models revealed higher PS levels were independently associated with all-cause mortality (major model, model 4, HR, 0.78; 95% CI, 0.64-0.95) but not with CVE risk (unadjusted HR, 0.90; 95% CI, 0.77-1.05). Compared with lower quartile PS levels, higher PS levels significantly reduced all-cause mortality (HR, 0.31; 95% CI, 0.10-1.02), and this trend remained consistent (P for trend = 0.021). Finally, the restricted cubic spline method using different models showed a linear relationship between PS and all-cause mortality (P > 0.05), when PS exceeded 4.99 kg, the all-cause mortality of MHD patients significantly decreased.
CONCLUSIONS
PS was independently associated with all-cause mortality but not with CVE in patients undergoing MHD.
Topics: Humans; Renal Dialysis; Male; Female; Aged; Cardiovascular Diseases; Retrospective Studies; Middle Aged; Pinch Strength; Kaplan-Meier Estimate; Cause of Death; Follow-Up Studies; Kidney Failure, Chronic; Hand Strength
PubMed: 38698329
DOI: 10.1186/s12882-024-03587-x -
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 -
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 -
BMC Musculoskeletal Disorders May 2010Hand strength is an important independent surrogate parameter to assess outcome and risk of morbidity and mortality. This study aimed to determine the predictive power...
BACKGROUND
Hand strength is an important independent surrogate parameter to assess outcome and risk of morbidity and mortality. This study aimed to determine the predictive power of cofactors and to predict population-based normative grip and pinch strength.
METHODS
A representative population survey was used as the basis for prediction analyses (n = 978). Bivariate relationships between grip/pinch strengths of the dominate hand were explored by means of all relevant mathematical functions to maximize prediction. The resulting best functions were combined into a multivariate regression.
RESULTS
Polynoms (up to the third degree) were the best predictive functions. On the bivariate level, height was best correlated to grip (46.2% explained variance) and pinch strength (37.7% explained variance) in a linear relationship, followed by sex, age, weight, and occupational demand on the hand. Multivariate regression provided predicted values close to the empirical ones explaining 76.6% of the variance for grip strength and 67.7% for pinch strength.
CONCLUSION
The five easy-to-measure cofactors sex, age, body height, categorized occupational demand on the hand, and body weight provide a highly accurate prediction of normative grip and pinch strength.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anthropometry; Body Height; Body Weight; Female; Fingers; Hand; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Occupations; Physical Fitness; Predictive Value of Tests; Regression Analysis; Sex Factors; Switzerland; Young Adult
PubMed: 20482832
DOI: 10.1186/1471-2474-11-94 -
Medicine Jun 2018Although cross tape has recently been used by clinicians for various musculoskeletal conditions, scientific studies on the direction of cross tape application are... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Although cross tape has recently been used by clinicians for various musculoskeletal conditions, scientific studies on the direction of cross tape application are lacking.
METHODS
The present study aimed to investigate whether the direction of cross tape application affected the outcomes of the modified O-ring test and maximal pinch strength using a pinch gauge and the conformity between these 2 tests when cross tape was applied to the forearm muscles of individuals with no upper extremity pain and no restriction of joint range of motion.This study used a single-blinding crossover design. The subjects comprised 39 adults (16 men and 23 women). Cross tape was applied to the dominant hand so that the 4 rows were at an angle of 45° to the right or left of the direction of the flexor digitorum superficialis muscle fibers, and then the subjects underwent a modified O-ring test and a test of maximal pinch strength using a pinch gauge. Both tests were performed in both directions, and the order of the directions and tests was randomized. SPSS 18.0 was used for statistical analysis. Cohen's kappa coefficient was used to analyze the conformity of the results from the 2 tests. The statistical significance level was P < .05.
RESULTS
A positive response in the modified O-ring test and maximal pinch strength were both affected by cross tape direction. The modified O-ring test and maximal pinch strength using pinch gauge results were in agreement (P < .00), and the kappa coefficient was significant at 1.00.
CONCLUSION
The direction of cross tape application that produced a positive response in the modified O-ring test also produced greater maximal pinch strength. Thus, we propose that when applying cross tape to muscles, the direction of the 4 lines of the cross tape should be 45° relative to the direction of the muscle fibers, toward the side that produces a positive response in the modified O-ring test or produces the greatest maximal pinch strength using a pinch gauge.
Topics: Adult; Athletic Tape; Cross-Over Studies; Female; Fingers; Forearm; Humans; Male; Pinch Strength; Range of Motion, Articular; Reproducibility of Results; Single-Blind Method
PubMed: 29851806
DOI: 10.1097/MD.0000000000010879 -
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 Hand Surgery Apr 2009We conducted a systematic review of the literature to summarize the available data on reconstructive surgeries involving pinch reconstruction and elbow extension... (Comparative Study)
Comparative Study Review
PURPOSE
We conducted a systematic review of the literature to summarize the available data on reconstructive surgeries involving pinch reconstruction and elbow extension restoration in people with tetraplegia.
METHODS
English-language and French-language articles and abstracts published between 1966 and February 2007, identified through MEDLINE and EMBASE searches, bibliography review, and expert consultation, were reviewed for original reports of outcomes with pinch reconstruction and elbow extension restoration in tetraplegic patients after a spinal cord injury. Two reviewers independently extracted data on patient characteristics, surgical methods, and patient outcomes.
RESULTS
Our search identified 765 articles, of which 37 met eligibility criteria (one article contained information on both elbow and pinch procedures). Results from 377 pinch reconstructions in 23 studies and 201 elbow extension restorations in 14 studies were summarized. The mean Medical Research Council score for elbow extension went from 0 to 3.3 after reconstruction. The overall mean postoperative strength measured after surgery for pinch reconstruction was 2 kg.
CONCLUSIONS
More than 500 patients having these procedures experienced a clinically important improvement for both procedures-one restoring elbow extension, and the other, pinch strength. Upper-limb surgeries markedly improved the hand function of people with tetraplegia.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
Topics: Elbow Joint; Humans; Pinch Strength; Quadriplegia; Range of Motion, Articular; Spinal Cord Injuries; Tenodesis
PubMed: 19345872
DOI: 10.1016/j.jhsa.2008.12.002