Biomedical subjects

Denis Gravel

Publications and source records attributed to Denis Gravel.

At least 19 recordsLinked to original sources

PubMed2007

A method to evaluate contractures effects during the gait of children with Duchenne dystrophy.

Joint contractures are the second major impairment affecting the locomotor system of children with Duchenne muscular dystrophy (DMD). While the negative influence of joint contractures has been documented, the passive moments produced by joint contractures could benefit the gait of patients with muscle weakness. We describe a biomechanical model that quantifies the mechanical contribution of ankle and hip flexion contractures to the gait of DMD children. Kinematic and kinetic parameters were measured under the same experimental conditions during the gait and passive resistance assessment of two subjects: one healthy child as a control, and one child with DMD. The child with DMD had a plantar flexion contracture and a greater ankle stiffness coefficient than the control child. During gait, the contribution of the ankle passive moment to the net moment was more important for the child with DMD than for the control child. At the hip, passive joint moments and passive moment contribution were more important for the control child but this was not related to the presence of hip flexion contracture. These preliminary results suggest the model might be used to evaluate contractures effect on a larger cohort of subjects.

Ankle Joint↗

PubMed2006

Gender influence on fatigability of back muscles during intermittent isometric contractions: a study of neuromuscular activation patterns.

BACKGROUND: Gender difference in the fatigability of muscles can be attributed to muscle mass (or strength) and associated level of vascular occlusion, substrate utilization, muscle composition, and neuromuscular activation patterns. The purpose of this study was to assess the role of neuromuscular activation patterns to explain gender differences in back muscle fatigability during intermittent isometric tasks. METHODS: Sixteen males and 15 females performed maximal voluntary contractions (Strength) and a fatigue test to exhaustion (fatigue criterion=time to exhaustion), while standing in a static dynamometer measuring L5/S1 extension moment. The fatigue test consisted of repetitions of an 8-s cycle (1.5 s ramp to reach 40% of maximal voluntary contraction +5s plateau at 40% of maximal voluntary contraction +1.5s rest). Surface electromyography signals were collected bilaterally from 4 back muscles (multifidus at the L5 level, iliocostalis lumborum at L3, and longissimus at L1 and T10). FINDINGS: Males were stronger (P<0.05) than females (316, SD 82>196, SD 25 Nm) but showed significantly shorter time-to-exhaustion values (7.1, SD 5.2<13.0, SD 6.1 min.), the latter result being corroborated by electromyographic indices of fatigue. However, the gender effect on time to exhaustion disappeared when accounting for Strength, thus supporting the muscle mass hypothesis. Among the various electromyographic indices computed to assess neuromuscular activation patterns, the amount of alternating activity between homolateral and between contralateral muscles showed a gender effect (females>males). INTERPRETATION: These results support the muscle mass hypothesis as well as the neuromuscular activation hypothesis to explain gender differences in back muscle fatigability.

Adult↗

PubMed2006

Bilateral level of effort of the plantar flexors, hip flexors, and extensors during gait in hemiparetic and healthy individuals.

BACKGROUND AND PURPOSE: Muscle weakness is recognized as a key factor in gait performance of poststroke individuals, but its impact on lower-limb muscular effort has been scarcely studied. The aims of this study were to compare the level of effort of the lower limbs of hemiparetic and able-bodied individuals and to assess the effect of side, cadence, and muscle group. METHODS: Seventeen chronic hemiparetic participants (7 females and 10 males) with a mean age of 60.5+/-13.4 years were assessed when walking. They were compared with a group of 14 able-bodied individuals. The level of effort was estimated from the muscular utilization ratio (MUR), which relates the walking moment of a given muscle group to its maximal potential moment. Peak MUR and MUR(area) were used as main outcome measures. RESULTS: Hemiparetic individuals showed greater peak MUR values (45% to 78%) than the able-bodied subjects matched for cadence (24% to 63%). For both groups, the peak MUR values were similar between sides and increased with cadence. At self-selected cadence, the plantar flexors showed greater peak MUR values, whereas at maximal cadence, levels of effort for all muscles were equivalent. The MUR(area) values at the hip joint were greater for the hemiparetic group, and both groups had values that increased with cadence. Differences between sides and muscle groups were noted for the hemiparetic and healthy individuals, respectively. Large peak MUR values were associated with high MUR(area) values. CONCLUSIONS: For a similar cadence, the levels of effort of hemiparetic individuals were greater than those of the able-bodied. In the presence of muscle weakness, similar bilateral levels of effort could mean that hemiparetic individuals relied on their sense of effort while walking.

Aged↗

PubMed2006

The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis.

BACKGROUND: The asymmetrical motor pattern of persons with hemiparesis influences the performance of activities that require interactions between the two sides of the body. METHODS: Twelve subjects with a chronic hemiparesis were asked to stand up and sit down at their natural speed in the following foot positions: (1) spontaneous; (2) symmetrical; (3) asymmetrical with the affected foot placed backward; and (4) asymmetrical with the unaffected foot placed backward. Forces were recorded under each foot using two force plates and under each thigh with an instrumented chair. Each foot position was tested at two chair heights corresponding to 100% and 120% of leg length. For each condition, the duration and the asymmetry of loading expressed by the vertical forces were calculated for four different events: onset, transition (forces under feet and thighs), seat-off or seat-on and at the end of the task. FINDINGS: The time to execute the tasks ranged from 2.31 s to 3.69 s with higher values observed for the stand-to-sit task than for the sit-to-stand task. Overall, the asymmetry of vertical forces was greatest in the middle part of the tasks and was not influenced by the chair height. When the subjects were still in contact with the seat, the loading asymmetry originated from a difference between sides at both the thigh and the foot. The asymmetrical foot position with the affected foot backward promoted loading on the affected side during both tasks. Interpretation. This study shows that loading asymmetry was present before seat-off and after seat-on in sit-to-stand and stand-to-sit tasks, respectively. It shows that positioning the affected foot behind reduces the asymmetry whereas positioning the unaffected foot behind increases the asymmetry. Foot position should be taken into consideration when clinicians assess or train for these mobility tasks.

Acceleration↗

PubMed2006

Muscular utilization of the plantarflexors, hip flexors and extensors in persons with hemiparesis walking at self-selected and maximal speeds.

Gait performance secondary to a stroke is partially dependent on residual muscle strength. However, to pinpoint more precisely the mechanism of this relationship, biomechanical models, such as the muscular utilization ratio (MUR) that integrates both muscle strength and gait parameters into the concept of level of effort, are warranted. The aim of the present study was to evaluate the MUR of plantarflexors, hip flexors and extensor muscles during their concentric action in 17 chronic hemiparetic participants walking at self-selected and maximal speeds. Results revealed that peak MUR increased with gait speed. At self-selected speed (0.73+/-0.27 m/s), peak MUR values on the paretic side were 64% (+/-18.7), 46% (+/-27.6) and 33% (+/-25.6) for the plantarflexors, hip flexors and extensor muscles, respectively. At maximal speed (1.26+/-0.39 m/s), corresponding values were 77% (+/-23.6), 72% (+/-33.0) and 58% (+/-32.1). Peak MUR showed negative associations (-0.33 -0.68), although not all significant, with voluntary muscle strength. The results of this study indicated that the peak MUR increased with gait speed. The plantarflexors were the most used muscle group at self-selected speed, whereas at maximal speed the three muscle groups showed similar peak MUR values. This last finding suggested an important role of the hip muscles in reaching a faster speed. Lastly, because moderate associations were found between peak MUR values and the voluntary muscle strength of hip flexors and extensors, it can be concluded that the weakest paretic muscle groups show, in general, the highest level of effort during gait.

Acceleration↗

PubMed2005

Back muscle strength and fatigue in healthy and chronic low back pain subjects: a comparative study of 3 assessment protocols.

OBJECTIVE: To compare the sensitivity of 3 different back test protocols in measuring differences in strength and fatigue between subjects with and without chronic low back pain (CLBP). DESIGN: Descriptive study using a repeated-measures design. SETTING: A research laboratory within a rehabilitation center. PARTICIPANTS: Eighteen healthy subjects and 13 subjects with CLBP were assessed in a single session to compare the 3 protocols. The protocols were an upright position test (UPP), a semicrouched lifting test (LIF), and the Sorensen fatigue test. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Moments of force and surface electromyography were recorded bilaterally from 4 homologous back muscles while the subjects performed static trunk extension efforts for each protocol. Fatigue was quantified by the slopes of the linear regression of electromyography time-series. RESULTS: The back muscle fatigue and strength scores did not differ significantly for the 2 subject groups for any of the 3 protocols. The electromyography fatigue indices revealed that the Sorensen fatigue test and UPP produced more fatigue in the back muscles than the LIF. CONCLUSIONS: It was impossible to specify which protocol is more sensitive to low back status because no between-group difference was observed for any of the 3 tests.

Adult↗

PubMed2005

Bilateral changes in somatosensory sensibility after unilateral below-knee amputation.

OBJECTIVE: To evaluate possible alteration in proprioceptive and cutaneous sensibility in the nonamputated leg of unilateral transtibial amputees. DESIGN: Cross-sectional study with between-subjects (amputees vs controls) and within-subjects (nonamputated vs amputated leg) comparisons. SETTING: Canadian rehabilitation hospital research laboratory. PARTICIPANTS: Two groups of amputees (34 due to traumatic causes, 14 due to vascular causes), recruited more than 1 year after their prosthetic training; and 2 groups (n=34, n=14) of age-matched control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Threshold of movement detection and touch-pressure perception at the knee and foot levels. RESULTS: In the traumatic group, the sensory thresholds of the nonamputated leg were significantly higher than the control values in the 2 modalities tested. The movement detection was reduced at the knee and ankle levels, whereas a decrease in touch-pressure sensibility was observed only at the plantar site. As expected, a large proportion of the vascular amputees presented with severe sensory deficits in the nonamputated leg, particularly a loss in touch-pressure perception at the foot. The thresholds of movement detection were similar and correlated at both knees in the 2 groups of amputees. For the touch-pressure thresholds, no significant relationship was found between sides at the knee level. CONCLUSIONS: Sensory changes observed in the nonamputated leg suggest that central sensory adaptations occur after amputation. For movement detection, they were marked by a matching of perception on both sides of the body. Functional significance of these changes remains to be determined.

Adaptation, Physiological↗

PubMed2005

Reliability and validity of static knee strength measurements obtained with a chair-fixed dynamometer in subjects with hip or knee arthroplasty.

OBJECTIVES: To evaluate the reliability (intertrial, interevaluator) and the concurrent validity of strength measurements obtained with a chair-fixed dynamometer and to recommend a clinical protocol that minimizes standard error of measurement (SEM). DESIGN: Within-session repeated measures of maximal static strength of knee flexors and extensors at 30 degrees and 60 degrees of flexion on the chair-fixed and Cybex dynamometers. SETTING: Ambulatory physiotherapy department of a rehabilitation hospital. PARTICIPANTS: Convenience sample of 50 subjects with total hip (n=25) or knee (n=25) arthroplasty. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Reliability was quantified by indices of dependability and corresponding SEMs estimated with the generalizability theory, whereas coefficients of correlation were used to assess the validity. RESULTS: Indices of dependability confirmed excellent intertrial (0.98-1.00) and a very good interevaluator (.92-.99) reliability for the strength measures obtained for different movements and positions. An average of 3 trials minimized the magnitude of the SEMs (>2 Nm for all measurements). When comparing the strength values obtained with the Cybex dynamometer to those measured with the chair-fixed dynamometer, strongest relations were attained when the tested knee was positioned at 60 degrees compared with 30 degrees for subjects with a total knee (.78-.92 vs .87-.93) or hip (.73-.85 vs .86-.91) arthroplasty. CONCLUSIONS: A clinical protocol averaging 3 trials with the knee positioned at 60 degrees after a familiarization period, both for knee flexors and extensors, performed by a trained therapist is recommended to minimize measurement errors on strength values measured with the chair-fixed dynamometer.

Aged↗

PubMed2004

Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence. METHODS: This was a single-blind randomized controlled trial. Sixty-four women with stress urinary incontinence were randomly assigned to 8 weeks of either multimodal pelvic floor rehabilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscle training (n = 23), or control non-pelvic floor rehabilitation (n = 20). The primary outcome measure consisted of a modified 20-minute pad test. The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic floor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70% of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) were continent on pad testing compared with 0% of women in the control group. Scores on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Incontinence Impact Questionnaire improved significantly in both treatment groups (all P <.002), whereas no changes were observed in the control group. Pelvic floor muscle function, however, did not improve significantly in either active group. CONCLUSION: Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.

Abdominal Muscles↗

PubMed2004

Effects of repeated distension arthrographies combined with a home exercise program among adults with idiopathic adhesive capsulitis of the shoulder.

OBJECTIVE: The purpose of this study was to measure the effect of repeated distension arthrographies combined with a home exercise program on impairments and disability of the upper limb in subjects with adhesive capsulitis of the shoulder. DESIGN: A total of 15 subjects with idiopathic adhesive capsulitis participated in the study. Intervention consisted of three distension arthrographies with steroid, done at 3-wk intervals, and a home exercise program. The repeated-measures design included five clinical evaluations with disability, pain, range of motion, and pain-free static strength outcomes. Two evaluations done before the first arthrography verified the stability of the condition. RESULTS: There was a significant improvement of all outcomes at the end of intervention. The greatest effects occurred after the first distension arthrography. After the second, less marked, albeit significant, changes were observed in three motions of the shoulder and in the pain level. After the third distension arthrography, very small changes were noted. A comparison between sides revealed incomplete recovery of the range of motion on the affected side. CONCLUSIONS: These findings showed that two distension arthrographies with steroid combined with a home exercise program reduce shoulder disability and impairments. Adding a third distension arthrography does not seem to provide any further benefit.

Adult↗

PubMed2003

Muscle recovery from a short fatigue test and consequence on the reliability of EMG indices of fatigue.

The purpose of the present study was to evaluate if rest intervals of 10 or 15 min allow the back muscles to recover completely, from an electromyographic (EMG) point of view, after performing a fatiguing contraction. Twelve healthy males stood in a dynamometer with the trunk in a vertical position and performed three trunk extension fatiguing trials (30 s contractions sustained at 75% of the maximal voluntary contraction) separated successively by a 15 min (between trial 1 and 2) and a 10 min (between trial 2 and 3) rest period. The EMG signals from four pairs of back muscles were collected at 2,048 Hz with active surface electrodes. Different EMG indices computed from the temporal and frequency domains of the EMG signal were considered to evaluate muscular fatigue and recovery from trial 1 to trial 2 and from trial 2 to trial 3. No significant differences (one-way ANOVAs between the three trials, alpha=0.05) were obtained for the different EMG indices computed. The percentage of variance explained by the inter-trial effect was none in most cases, corroborating that no systematic error was present between the trials and suggesting that complete muscle recovery was allowed with 10 or 15 min rest periods. These results support the use of rest periods of 10 to 15 min between multiple fatigue tests, at least for back muscles and for high intensity short duration fatigue tasks as the one used in the present study.

Adult↗

PubMed2003

Biomechanical analysis of a posterior transfer maneuver on a level surface in individuals with high and low-level spinal cord injuries.

OBJECTIVE: The purpose of this study was to determine the movement patterns and the muscular demand during a posterior transfer maneuver on a level surface in individuals with spinal cord injuries. DESIGN: Six participants with high-level spinal cord injury (C7 to T6) were compared to five participants with low-level spinal cord injury (T11 to L2) with partial or complete control of abdominal musculature. BACKGROUND: Developing an optimal level of independence for transfer activities figures among the rehabilitation goals of individuals with spinal cord injury. There has been no biomechanical study which specifically describes the posterior transfer maneuver. METHODS: Tridimensional kinematics at the elbow, shoulder, head and trunk, as well as surface electromyographic data of the biceps, triceps, anterior deltoid, posterior deltoid, pectoralis major, latissimus dorsi, trapezius and rectus abdominus muscles were recorded during the posterior transfer. To quantify the muscular demand, the electromyographic data were amplitude normalized to the peak value obtained from maximum voluntary contractions. The transfer was divided into pre-lift, lift, and post-lift phases for analysis. RESULTS: The duration of the lift phase was significantly shorter (P<0.05) for the high-level spinal cord injury (1.24; SD, 0.37 s) when compared to the low-level spinal cord injury (1.74; SD, 0.39 s). The patterns and magnitudes of the angular displacements were found similar between groups (P values: 0.45-0.98). However, the high-level spinal cord injury initiated the task from a forward flexed posture, whereas the low-level spinal cord injury adopted an almost upright alignment of the trunk. Higher muscular demands were calculated for all muscles among high-level spinal cord injury participants during the transfer when compared to the low-level spinal cord injury. However, only the anterior deltoid (high level=92.4%; low level=34.2%) and the pectoralis major (high level=109.8%; low level=25.6%) reached statistical significance during the lift phase.Conclusions. Participants with high-level spinal cord injury presented different movement characteristics and higher muscular demands during the posterior transfer than low-level spinal cord injury ones. This is probably to compensate for the additional trunk and upper limb musculature impairment. RELEVANCE: The findings of this study may help to develop guidelines of specific strengthening programs for the thoracohumeral, scapulothoracic and shoulder muscles designed to restore optimal transfer capacity in individuals with spinal cord injury. Furthermore, innovative rehabilitation programs targeting the ability to control the trunk could be beneficial for these individuals.

Abdominal Muscles↗

PubMed2003

Back strength cannot be predicted accurately from anthropometric measures in subjects with and without chronic low back pain.

OBJECTIVES: (1) To develop a multiple regression equation using anthropometric measurements to predict back strength and (2) to estimate the effect of practice on the back strength results and back strength predictions. DESIGN: Comparative study with repeated measures performed on three days. BACKGROUND: The assessment of back muscle relative endurance (% maximal strength) requires the measurement of maximal back strength which is problematic with low back pain patients. METHODS: The back strength (L5/S1 static extension moment), age and 26 anthropometric parameters were obtained from 83 male volunteers [42 healthy subjects and 41 chronic low back pain patients] aged between 20 and 60 years. A subsample of 20 healthy subjects and 20 patients were assessed through three days of testing to evaluate the variations of back strength with practice. RESULTS: The final regression model (n=42 healthy subjects) explained 39% of the variance in back strength. Back strength increased with practice (Day1<Day2 & 3) for both healthy and patients groups. However, the error of prediction of back strength derived from the regression model showed a significant improvement with practice for the patients only. CONCLUSIONS: Back strength cannot be predicted from simple anthropometric measures without important errors. The decrease of the error of prediction obtained for the patient group is indicative of a decreasing influence of psychological factors that are independent of motor learning because the effect of motor learning would have occurred on both groups if present. RELEVANCE: The prediction of back strength would be useful to determine (1) the relative force level of a given exercise or (2) the preinjury back strength. Unfortunately, anthropometric measurements are not enough good predictors of back strength.

Adult↗

PubMed2003

Surface electromyography assessment of back muscle intrinsic properties.

The purpose of this study was to assess (1) the reliability and (2) the sensitivity to low back pain status and gender of different EMG indices developed for the assessment of back muscle weakness, muscle fiber composition and fatigability. Healthy subjects (men and women) and chronic low back pain patients (men only) performed, in a static dynamometer, maximal and submaximal static trunk extension tasks (short and long duration) to assess weakness, fiber composition and fatigue. Surface EMG signals were recorded from four (bilateral) pairs of back muscles and three pairs of abdominal muscles. To assess reliability of the different EMG parameters, 40 male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three occasions. Reliable EMG indices were achieved for both healthy and chronic low back pain subjects when specific measurement strategies were applied. The EMG parameters used to quantify weakness and fiber composition were insensitive to low back status and gender. The EMG fatigue parameters did not detect differences between genders but unexpectedly, healthy men showed higher fatigability than back pain patients. This result was attributed to the smaller absolute load that was attributed to the patients, a load that was defined relative to their maximal strength, a problematic measure with this population. An attempt was made to predict maximal back strength from anthropometric measurements but this prediction was prone to errors. The main difficulties and some potential solutions related to the assessment of back muscle intrinsic properties were discussed.

Abdominal Wall↗

PubMed2002

Electromyographic assessment of back muscle weakness and muscle composition: reliability and validity issues.

OBJECTIVE: To assess the reliability and construct validity of various electromyographic indices developed to assess back muscle weakness and muscle fiber composition. DESIGN: A prospective study with repeated measures performed on 3 days along with comparisons of groups presenting different back strength and/or back muscle fiber composition. SETTING: A biomechanics laboratory within a rehabilitation center. PARTICIPANTS: Forty male volunteers (20 healthy, 20 with chronic low back pain) were assessed on 3 different days to assess reliability and to make group comparisons. Thirteen healthy women were also assessed once to obtain a third group with known lower strength and different back muscle fiber composition. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Surface electromyography was recorded for 4 pairs of homologous back muscles while the subjects performed, on a dynamometer, static trunk extension efforts. Electromyographic parameters were computed to assess muscle weakness and muscle fiber composition. The reliability of the data collected across the 3 sessions and comparisons between groups were determined. RESULTS: Electromyographic parameters generally showed good to excellent reliability, but were insensitive to differences in back muscle strength and did not appear to be related to muscle composition. Some trends were observed in the electromyographic parameters across the force levels, but the large interindividual variability impeded statistical comparisons. CONCLUSIONS: The assessment of muscle weakness and muscle fiber composition through electromyographic analysis does not appear feasible, at least on an individual basis, for the muscles of the back.

Adult↗

PubMed2002

Effect of force-feedback treatments in patients with chronic motor deficits after a stroke.

OBJECTIVE: To assess the effects a motor reeducation approach based on static dynamometers used to provide feedback on the force produced. DESIGN: The study design was a single-blind, randomized, controlled trial. Chronic stroke subjects participated in a 6-wk, thrice-weekly, force-feedback program of either the upper paretic limb (n = 13) or the lower paretic limb (n = 12). Baseline and postintervention assessments of the performance of both the upper and the lower limb were measured for each subject, the untreated paretic limb of each group serving as a control for the other group. RESULTS: With the exception of the handgrip force, strength measurements of the treated limb increased after completion of the treatment. The outcome measurements of the upper limb of the subjects included in the upper paretic limb were not significantly different after treatment from those measured in the lower paretic limb. In contrast, gait velocity and the distance walked in 2 min increased after treatment in the lower paretic limb as compared with the upper paretic limb, whereas the scores in the Fugl-Meyer test for the lower limb and the timed up-and-go test did not increase for either group after treatment. CONCLUSION: The results indicate that treatment of the lower limb based on force feedback produces an improvement of gait velocity.

Adult↗

PubMedDate not supplied

The reliability of the time to execute various forms of the finger-to-nose test in healthy subjects.

The objective of this study was to establish reliability estimates of different versions of the Finger-to-Nose test (FNT) using the generalisability theory. Generalizability theory was used to estimate the relative contribution of trials and occasions to the total measurement error and to generate reliability coefficients. Forty-two healthy adults (aged 20-63 yrs old) free of arm pain or other pathology participated. Participants performed 10 versions of the FNT during two evaluation sessions separated by a 24-hour interval. The time (s) to perform five trials of each version was recorded. The mean reliability coefficient for the one-occasion/one-trial testing situation among the test versions was 0.79 (range = 0.77-0.82). For all versions, the principal source of variance of the test performances came from the participants; minimally important sources of measurement error were also associated with occasion and the interaction effects between participants and occasion. Number of trials was not found to be an important source of error. The 10 versions of the FNT under investigation provide reliable measures of upper limb coordination among healthy adults when assessed by the one evaluator generalised across two days. These results are important to the development of norms for this measure.

Adult↗

PubMedDate not supplied

Reliability and validity of pinch and thumb strength measurements in de Quervain's disease.

The purpose of this study is to evaluate the test-retest reliability and construct validity of pinch and thumb strength measurements in subjects with de Quervain's disease. Maximal palmar pinch and thumb strength (adduction, extension, abduction, and flexion) were measured using, respectively, a pinch gauge and a biaxial dynamometer. The reliability was estimated using the generalizability theory. The validity hypotheses were as follows: 1) the pinch and thumb strength of the symptomatic side would be significantly lower than that of the asymptomatic side, and 2) the strength loss would be greater for thumb extension and abduction. The reliability was high for all strength measurements, pinch strength being the more reliable one. The pinch and thumb strength in all directions evaluated was significantly decreased on the symptomatic side (p<0.003); no direction showed a greater decrease than the others. The results suggest that pinch and thumb strength measurements are reliable and able to show a decreased strength on the symptomatic side in this population.

Adult↗