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Motor outcome after subcortical stroke: MEPs correlate with hand strength but not dexterity.

OBJECTIVE: Motor evoked potential (MEP) amplitude and threshold are predictors of functional outcome in the early stages after stroke, and improvement in these parameters usually accompanies motor recovery. The aim of this study in patients with subcortical stroke was to determine whether there is a correlation between MEP amplitude and threshold and the degree of recovery of strength and dexterity in the affected hand. METHODS: MEP amplitude and threshold were measured on the affected and unaffected sides in 23 patients who had suffered a subcortical ischaemic stroke up to 23 years previously. Grip strength was measured using a hand-held dynamometer and dexterity was assessed using a modification of the McCarron test battery. RESULTS: Grip strength correlated with both MEP amplitude and threshold (r=0.49 and r=-0.54, respectively, P<0.05), whereas the McCarron score for motor dexterity did not correlate significantly with either of these MEP parameters. CONCLUSIONS: Grip strength and dexterity correlate differentially with MEP parameters of excitability and conduction in the corticospinal pathway after recovery in patients with subcortical stroke. Grip strength is dependent on restoration of corticospinal excitability and conduction whereas additional factors such as cortical reorganization may underlie recovery of motor dexterity.

Adult↗

Recovery of hand grip strength and hand steadiness after exhausting manual stretcher carriage.

Rescue activities frequently require not only substantial and sustained hand-grip forces but also a subtle coordination of hand and finger muscles, e.g. when manipulating injection syringes after manual stretcher carriage. We investigated the recovery kinetics of manual coordination and muscle strength after exhausting stretcher carriage (4.5 km/h, load at each handle bar: 25 kg). Hand steadiness (frequency and duration of wall contacts when holding a metal pin into a small bore) and parameters of hand-grip strength were determined in 15 male volunteers before and immediately after the stretcher carriage. Measurements were repeated after 0.5, 1, 4 and 24 h of recovery. Mean carrying time was 215+/-87 s (SD), mean transport distance amounted to 264+/-104 m. During the carriage test, forces at the stretcher handles oscillated in the order of +/-50 N within each gait cycle. Immediately after exhaustion, hand steadiness was significantly deteriorated (threefold increase in frequency and duration of wall contacts), maximum and mean hand-grip force over 15 s were reduced by almost 20%. While the recovery of hand steadiness was complete by minute 30 after stretcher carriage, a significant reduction in maximum and mean hand-grip force by 12% could still be observed after 24 h. The present findings demonstrate that hand steadiness recovers much faster than maximum hand-grip strength after exhaustive manual stretcher carriage (less than 30 min vs. more than 24 h). Probably, muscle damage induced in particular by the eccentric components during stretcher transport seems to affect only the generation of large forces. By contrast, the generation and coordination of the much lower forces required for hand-steadiness appears to be impaired only during the short transient of metabolic recovery.

Adult↗

The relationship between hand strength and the forces used to access containers by well elderly persons.

OBJECTIVE: This study extended previous work of Rice, Leonard, and Carter [AJOT, 52(8), 621-626] and examined the relationship between grip and pinch strengths and the forces produced while accessing common household containers in healthy, elderly persons. METHOD: Forty-two women and 9 men 60 years of age and older were assigned randomly to one of four order groups in a counterbalanced, repeated-measures design. Grip strength was measured via a dynamometer and pinch strength via a pinch meter. The forces required to access six common household containers were measured with force sensing resistors applied to each container. Data analysis included Pearson product-moment correlations between the dependent variables of grip and pinch strength and force produced on the containers. Analyses of variance were used to determine differences by gender on the dependent measures and order of presentation of containers. RESULTS: A fair relationship (r = .31 to .44) was found between grip and pinch strength and the ability to open three containers. Little or no relationship was found between grip and pinch strength and the ability to open the remaining three containers (r = -.03 to .25). Significant gender differences existed on overall strength and the force used to access two of the six containers. No order effects were found. CONCLUSIONS: Strong relationships did not exist between the grip and pinch strength and the amount of force the elderly participants used to open the containers, which is similar to what Rice et al. found for younger persons. The participants appeared to use a greater proportion of their available strength when accessing the containers than did their younger counterparts previously studied. Further research is needed to determine at what level of weakness one would expect to see performance deficits in common daily occupations.

Activities of Daily Living↗

Body posture and hand strength of patients with temporomandibular disorder.

The aim of this study was to observe the difference between patients of craniocervical muscle pain and nonpatients in head-neck posture, masticatory muscle activity, and the force exerted by the hand. Fifty-one patients and 28 nonpatients were observed. The electric activity of the masseter muscles was recorded when the subjects were doing pinching or grasping with the jaw in positions of rest, clenched, and clenched with gauze. Measurement of right and left tilting or extension and flexion of the head and neck was made from photographs of frontal and lateral views. It was found that the pinching and grasping force was much stronger in men than in women and in nonpatients than in patients with pain. The pinching and grasping force was more powerful with the teeth clenched. Clenching with gauze did not increase, but more often decreased the strength of the hand. The activity of the masseter muscle during clenching was about 10 to 26 times that of the resting activity. The activity decreased slightly when clenching with pinching or grasping. Patients were more likely to have a stretched neck with more extension of the head. Their masseter muscle activity and hand force were significantly weaker than that of the nonpatients.

Adult↗

Grip strength and hand position of the dynamometer in 204 Finnish adults.

A primary purpose of this study was to establish data on hand strength by Jamar dynamometer for normal Finnish adults aged 30 to 50 years. A second aim was to find out how five various breadths of grip affect the strength value. A sample of 103 male and 101 female adults, aged 19 to 62, from the southern part of Finland were tested using standardized positioning and instructions. Male and female subjects reached the highest grip strength using the third handle breadth of dynamometer, except females over 50 years. Female grip strength was 60% to 70% less than male grip strength. There was no significant difference in strength between dominant and non-dominant hands.

Adult↗

Grip strength: effect of hand dominance.

AIM OF THE STUDY: Reliable and valid evaluation of hand strength is important for determining the effectivity of treatment strategies and it is accepted that grip and pinch strength provide an objective index for the functional integrity of upper extremity. This study was designed to evaluate the grip and pinch strength differences between sides for the right and left handed population. METHODS: The study included 128 right and 21 left hand dominant volunteers. Grip strength of the participants were measured by using a Jamar dynamometer. Pulp pinch strength measurements were performed by manual pinchmeter. RESULTS: When the study group was totally evaluated, a statistically significant difference was found between the grip and pinch strengths of dominant and nondominant hands in favour of the dominant hand. For further information we grouped 149 participants as right and left handed and investigated the number of subjects with stronger nondominant hand for each group. The percentage of stronger nondominant hand grip was 10.93% and 33.33% for right and left handed groups respectively. The results were less significant for pinch strength with 28.12% and 28.57% for right and left handed subjects respectively. CONCLUSION: We concluded that the dominant hand is significantly stronger in right handed subjects but no such significant difference between sides could be documented for left handed people.

Adult↗

8 french transradial coronary interventions: clinical outcome and late effects on the radial artery and hand function.

BACKGROUND: Limited information is available on the effects of 8 French (Fr) transradial procedures on radial patency. In addition, the effects of radial procedures and radial occlusion on hand function are unknown. METHODS: Two groups were recruited: twenty-four patients who had undergone 26 transradial 8 Fr interventions and 16 patients who had undergone 16 transradial 6 Fr procedures. At 1 year, radial patency, hand strength and hand endurance were measured. RESULTS: No major adverse cardiac events or vascular complications were noted in either group. Late radial occlusion was noted in 2/18 (11%) 8 Fr patients and 3/16 (19%) 6 Fr patients (p = ns). There were no differences in the 8 Fr group between the catheterized and uncatheterized radial arteries for diameter (3.2 +/- 1.1 mm versus 3.3 +/- 0.7 mm, respectively; p = NS) or volumetric flow (55 +/- 51 ml/minute versus 57 +/- 45 ml/minute, respectively; p = NS). No differences in hand strength or hand endurance were seen between the catheterized and uncatheterized arms in the 8 Fr group, between the 8 Fr and 6 Fr groups, or between occluded and non-occluded patients. CONCLUSION: Transradial use of 8 Fr guiding catheters appears to be feasible and safe in highly selected patients, albeit associated with a low incidence of silent radial occlusion. Additionally, neither the use of 8 Fr sheaths nor the presence of radial artery occlusion appear to adversely affect hand strength or endurance.

Aged↗

Norms for hand grip strength.

Norms for hand grip strength of healthy children are presented. Sex and age specific centiles for age 5 to 18 years have been determined using a portable strain gauge dynamometer with an accuracy of 0.5 N. The test group comprised 1417 healthy, urban school children from a middle class suburb of Brisbane. Mean maximum grip strength (of four tests, two with each hand) and mean peak grip strength (best of four tests) were recorded. Mean values of peak grip strength were 10 to 15% higher than the average maximum grip in all age groups. At all ages girls had a reduced grip strength compared with boys and although boys manifested a continual, approximately linear increase in grip strength through all age groups, girls manifested an approximately linear increase up to 13 years after which mean hand grip usually remained constant. By the age of 18 years boys had a mean grip strength some 60% higher than girls. Correlations with height and weight are also presented. "Handedness' influenced grip strength and was most noticeable in children aged over 10 years. The clinical use of hand grip strength centiles for the early indication of neurological and muscular disorders and for following the natural history of neuromuscular disease is discussed.

Adolescent↗

Measurement and prediction of single and multi-digit finger strength.

Hand and finger strength has direct application in the design of human-machine interfaces involving the whole hand or single digits. Limited finger strength data is available, however, particularly for practical situations such as pinching and poking. A study was conducted in which strength in a variety of couplings was collected from 100 participants, in order to enhance and supplement the existing literature. Differences between couplings, gender, and age groups were evaluated. Strength was significantly higher for multi-digit couplings as compared with single digit couplings (p < 0.05). In addition, female strength was approximately 70% of male strength across all couplings. No significant differences were found between three age groups ranging from 18 to 40 + years old. Multiple regression models were used to determine whether finger strength could be predicted from other strength measures and anthropometry. Regression results suggest that finger strength can be predicted with only moderate accuracy using these variables (R2-adj: 0.45 - 0.64; standard error: 12 - 19 N). Such models are easy to implement, however, and begin to overcome the limitations of direct finger strength measurements.

Adult↗

Occupational and other risk factors for hand-grip strength: the Honolulu-Asia Aging Study.

BACKGROUND: In certain occupations, including farm work, workers are exposed to hazardous substances, some of which are known to be toxic to the nervous system and may adversely affect muscle strength. Measurement of hand-grip strength may be useful for detecting neurotoxic exposure. METHODS: The authors studied 3522 participants of the Honolulu Heart Program and the Honolulu-Asia Aging Study to determine whether occupational exposures to pesticides, solvents, and metals assessed at exam I (1965-68) are associated with hand-grip strength at exam IV (1991-93) and change in hand-grip strength over 25 years. Correlation, analysis of variance and covariance, and linear regression were used to evaluate the associations. RESULTS: At exam IV, participants ranged in age from 71-93 years; mean hand-grip strength was 39.6 kg at exam I and 30.3 kg at exam IV. Over 25 years, the decline in hand-grip strength was an average of 8-9 kg for all exposures. Hand-grip strength was inversely associated with age and glucose but directly associated with cognitive function, BMI, and haemoglobin level. No other exposures were associated with hand-grip strength. CONCLUSION: This study did not provide evidence that occupational exposure to pesticides, solvents, and metals adversely affected hand-grip strength in this population, but confirmed other important associations with hand-grip strength.

Aged↗