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PubMed2004

Observational assessment of forceful exertion and the perceived force demands of daily activities.

The primary objective of this study was to assess the accuracy and precision with which analysts observe and estimate the force produced as subjects performed exertions on a work simulator. Eight analysts observed 32 subjects and estimated force as a percent of subjects' maximum voluntary contraction (% MVC). Analysts exhibited bias toward the mean, as high force exertions (> 67% MVC) were underestimated (mean: 11.6% MVC) and low force exertions (<34% MVC) were overestimated (mean: 6.7% MVC). Average error for medium force exertions (34-67% MVC) was not statistically different from zero (2.1% MVC). For all force levels, precision of the estimate was very poor (standard deviation range: 16.2-20.7% MVC). Experience of the analyst in performing ergonomic analysis did not affect accuracy. A secondary objective of the study was to conduct a survey in which subjects identified activities of daily living they perceived as equivalent to controlled force levels. A total of 59 different activities ranging from minimal force required to near maximum were listed by at least 5% of the participants. This list may be used to assist health care practitioners and patients convey the force demands required of occupational tasks as well as for evaluating the diminished strength of the patient.

Activities of Daily Living↗
PubMed2005

Interaction between resistance training and flexibility training in healthy young adults.

To test the hypothesis that increases in muscle strength and flexibility are developed by specific training programs, 43 healthy young adults were tested before and after 4 different interventions conducted twice a week for 12 weeks: (a) resistance training only (n = 13); (b) flexibility training only (n = 11); (c) resistance and flexibility training (n = 9); and (d) no intervention (n = 10). There was no change in either strength or flexibility in the control group (p > 0.05). Resistance training improved muscle strength either alone (+14%; effect size = 0.53; p < 0.001) or in combination with flexibility training (+16%; effect size = 0.66; p = 0.032), but did not change flexibility (p = 0.610). Flexibility increased with specific training alone (+33%; p < 0.001) or in combination with resistance training (+18%; p < 0.001). In conclusion, in young, healthy subjects, resistance training alone did not increase flexibility, but resistance training did not interfere with the increase in joint range of motion during flexibility training. These results support the concept that specific training should be employed in order to increase either muscle strength or flexibility.

Adult↗
PubMed1994

Grip strength in end stage renal disease.

The grip strength of 110 patients with end stage renal disease was measured. Their grip strength tended to be low compared with published norms. Significant correlations were found between the patients' grip strength and their gender, height, weight, and diabetic status. A regression equation including gender, height, and diabetic status as independent variables explained more than 40% of the variance in patients' grip strength.

Adult↗
PubMedDate not supplied

Effect of wrist positioning on the repeatability and strength of power grip.

OBJECTIVE: This study tested the between-day repeatability and effect of wrist positioning on grip strength measurement. METHOD: Thirty healthy men 20 years to 69 years of age were tested twice, 1 week apart, in six wrist positions. RESULTS: The findings showed good repeatability for grip strength, with the intraclass correlation coefficient [ICC(1, 3)] ranging from .9043 to .9663. Significant differences were found in grip strength among the six positions (p < . 001), with grip strength measured at 15 degrees or 30 degrees of wrist extension (EXT) and 0 degrees ulnar deviation (UD) significantly greater than that of 0 degrees UD and 0 degrees EXT or 15 degrees UD with or without EXT This finding suggests the clinical importance of standardizing the testing position for grip strength measurement. CONCLUSION: The high repeatability of the tests supports the use of the grip strength measurement to evaluate treatment progress.

Adult↗
PubMed1996

Grip strength in patients with tennis elbow. Influence of elbow position.

We measured the grip force in 20 chronic tennis elbows: The grip strength, measured with the elbow in 90 degrees flexion as well as in full extension, was significantly less (p < 0.001) on the pathological side when compared to the other, uninvolved side. on the pathological side, the grip strength measured with the elbow in full extension, was significantly reduced when compared to the grip strength measured with the elbow at 90 degrees flexion (p < 0.0001). on the normal side, the grip strength measured with the elbow in extension was not significantly different when compared to the grip strength measured with the elbow in 90 degrees flexion.

Adult↗
PubMedDate not supplied

The impact of hand dominance and ulnar and median nerve impairment on strength and basic daily activities.

The authors sought to determine the impact of hand dominance and its relation to function among ulnar alone and combined ulnar and median nerve lesions in leprosy patients. The study sample consisted of 62 persons affected with leprosy (mean age 36.1 years) who were either suffering from ulnar nerve lesions alone (34 patients) or combined ulnar and median lesions (28 patients). The data from the earlier work of this institution with normal hands in the adjacent rural uninvolved population were taken as controls. Grip, pulp-to-pulp, lateral, and three-jaw-chuck pinch strengths were measured using a hydraulic hand dynamometer and a pinch gauge. Basic daily activities were assessed using the battery developed at Karigiri. Means, standard errors, correlations, and t-tests were used in the analyses. The overall difference between grip and pinch strength measurements in both dominant and nondominant hands was 40% less than those in normal hands if the ulnar nerve alone was involved. If impairment of this nerve was combined with that of the median nerve, the overall difference in strength measurements increased to 51%. The hand strength of the dominant side was statistically significant between single and two nerves for pulp-to-pulp pinch (p = 0.019). No other strength tests produced statistically significantly results related to hand dominance (grip strength, lateral, chuck pinch) with either one or two nerve involvement. To observe differences in basic daily activities, scores were compared to Karigiri norms. The bilateral basic daily activities score was impaired by 45% compared with norms with only ulnar nerve involvement and by 59% with ulnar and median nerve involvement. The different pinch strengths related to basic daily activities was not significantly affected in nondominant hands, whether it was ulnar alone or combined ulnar and median nerve lesions. In this population diagnosed with leprosy, ulnar nerve impairment at the level of the elbow reduced the grip and pinch strengths and performance in basic daily activities by 40% and 45%, respectively. If combined with median nerve lesion at wrist level, the strengths and daily activity losses increased to 50% and 60%, respectively. There is no effect on grip strength either in ulnar or ulnar and median nerve injuries, irrespective of whether dominant or nondominant hands were involved. Different pinch strengths related to basic daily activities were significantly affected only in the dominant hand with involvement of these nerves.

Activities of Daily Living↗
PubMed2006

Strength deficits in primary focal hand dystonia.

Cortical activation is reduced when patients with focal dystonia perform movements that do not induce dystonic posturing. This finding suggests that the cortical drive to muscles may in some circumstances actually be reduced not increased, as suggested by basal ganglia models of dystonia as a hyperkinetic disorder. The purpose of this study was to examine flexor and extensor strength at the wrist (a clinically affected joint) and elbow (a nonclinically affected joint) in 18 patients with primary focal hand dystonia compared to matched control subjects. We measured peak torque from maximum voluntary contractions, and agonist and antagonist muscle activation by means of surface electromyograms. Patients were significantly weaker than controls at both the elbow and wrist joints and in both flexors and extensors compared to controls. Peak elbow flexion torque was, on average, 14.4% lower in the dystonic compared to the control group, elbow extensor peak torque was 28.6% lower, wrist flexor peak torque was 17.4% lower, and wrist extensor peak torque was 20.7% lower. Strength did not differ as a function of clinical severity. Reductions in peak torque were accompanied by reduced agonist activation, although this finding only reached statistical significance at the elbow. The amount of co-contraction of antagonistic muscles was not significantly different between the two groups. These results are discussed in the context of dystonia as a disorder resulting from dysfunction of basal ganglia output.

Adult↗
PubMed1999

The skill components of a therapeutic chopsticks task and their relationship with hand function tests.

Chopsticks are the primary tools used for eating and the physical movements of control are familiar to Chinese people. Chopsticks are easy to obtain in most rehabilitative settings. Occupational therapists often guide patients to practice miscellaneous chopsticks tasks to increase hand function in any case. The objective of this study was to investigate the skill components of the therapeutic chopsticks task and their relationship with hand function tests, and to identify clinical value. Eighty normal subjects (41 males and 39 females) whose age ranged from 17 to 26 years old participated in this study. Five standard hand function tests including three dexterity tests [Minnesota Rate of Manipulation Test (MRMT), Purdue Pegboard Test, and O'Connor Tweezer Dexterity Test (OTDT)], and two strength tests (Jamar Handgrip Test, and Pinchometer Test) were chosen to measure the dexterity and strength of hands. Additionally, the Test of Chopsticks Manipulation (TCM) was designed and used to assess the chopsticks manipulation skills. Subjects were tested with all the hand function tests and TCM in a random sequence. Results of six tests were obtained for each subject. Factor analysis showed that the skill components of TCM should be categorized into the "dexterity" component. In addition, a significant relationship (p < 0.05) was only seen between TCM and OTDT, there was no significant correlation between TCM and the other hand function tests. Findings in this study are valuable in setting the rehabilitation programs for patients with dexterity problems.

Adolescent↗
PubMed2003

Effect of menstrual cycle phase on the concentration of bioavailable 17-beta oestradiol and testosterone and muscle strength.

To investigate the effect of changes in sex hormone concentration on muscle strength and the bioavailability of 17-beta oestradiol (oestradiol) and testosterone, seven eumenorrheic females were tested during two phases of the menstrual cycle. Maximum voluntary isometric strength of the first dorsal interosseus muscle was measured during the early follicular and mid-luteal phases of the menstrual cycle. These phases were chosen for testing as the concentration of total oestradiol is significantly different in these two phases. Total oestradiol has been repeatedly associated with changes in muscle strength in females, whereas the effects of bioavailable oestradiol are unknown. The concentrations of total and bioavailable oestradiol and testosterone were measured in addition to the concentration of total progesterone. Concentrations of total progesterone and oestradiol were significantly different between the early follicular and mid-luteal phases of the menstrual cycle (P <0.05 and P <0.001 respectively). The concentration of total testosterone (0.7+/-0.2 and 0.8+/-0.1 nmol.l(-1) respectively) and the ratio of total oestradiol to progesterone (153.0+/-251.2 and 108.5+/-27.8 respectively) did not change significantly between the early follicular and mid-luteal phases. Bioavailable testosterone (102.2+/-66.3 and 105.0+/-90.2 pmol.l(-1) respectively) and bioavailable oestradiol (90.5+/-35.5 and 120.0+/-60.6 pmol.l(-1) respectively) did not differ significantly between phases. There were no significant differences in muscle strength during the menstrual cycle (P =0.1). Mean maximum voluntary isometric force of the first dorsal interosseus muscle did not correlate significantly with the mean concentration of any reproductive hormone measured. These results indicate that cyclical variation in endogenous reproductive hormones does not affect muscle strength.

Adult↗
PubMed1994

[Changes in abdominal muscle strength with respect to aging].

It has been generally agreed that muscle strength decreases with advance of age in adulthood. In order to study the effect of aging in abdominal muscle strength, abdominal muscle strength, height, body weight and grip strength were measured in 144 healthy subjects aged from 20 to 88 years old. The abdominal muscle strength was measured using a grip dynamometer. Curve between aging and strength revealed that the abdominal muscle strength gradually decreased with aging during many decades, but rapidly decreased in the fifth decade and over in males and seventh decade and over in females. Among these data, significant correlations were observed between abdominal muscle strength and age (only in males; r = -0.64), abdominal muscle strength and grip strength (in males; r = 0.75, in females; r = 0.47), age and grip strength (in males; -0.72, in females; r = -0.60), and, age and height (in males; r = -0.55, in females; r = -0.46). The results suggest that decrease of abdominal muscle strength is due to aging, although the degree of the decrease is affected by the generation studied. The method to measure abdominal muscle strength originally developed by us is easy and useful to understand changes of age-related muscular strength.

Abdominal Muscles↗
PubMed1996

Results of interfascicular nerve grafting for radial nerve lesions.

During the 10 year interval 1979-1989, 20 patients underwent nerve grafting of a radial nerve lesion, 13 high radial and 7 posterior interosseous. Average follow-up was 38 months (range 12 months-10 years). Overall 72% of patients achieved a Highet Scale rating of M3 or better function and 44% M4 or better recovery. Age of the patient and length of the nerve graft did not seem to influence outcome. Time from initial injury to nerve grafting did affect outcome, with 85% of patients grafted within 6 months obtaining M3 or better recovery. No patient grafted 12 months after injury recovered any useful function. Lesions of the posterior interosseous nerve had a consistently superior recovery. Power grip strength in the affected hand of patients averaged 60% of the unaffected hand while key pinch averaged 74%. There was good correlation between the Highet Scale rating of recovery and the ultimate power grip or key pinch strength obtained. Hand dexterity, as assessed by the turning and displacing tests of the Minnesota Rate of Manipulation Test, displayed a wide range of scores in both affected and unaffected hands. Nevertheless, a relative score derived from the results obtained in the displacing test did show correlation with the Highet Scale rating. All patients with M4 or better recovery obtained relative scores for the affected hand that were in the middle of the range of scores considered an average performance for a normal population. Patients who achieved M4 or better nerve recovery following radial nerve grafting also obtained a functional hand as evidenced by the results of grip, key pinch strength, and hand dexterity testing. Lesser degrees of recovery were accompanied by poorer strength and dexterity ratings reflecting inferior function.

Adult↗
PubMed1993

Grasp reflex strength from right and left hands is associated with pH stressor from the umbilical arterial blood in human newborns: handedness and sex-related differences.

Grasp reflex and its asymmetry was studied in relation to pH of the umbilical blood in human newborns, to examine whether the degree of acidity in fetal blood (birth stress) is associated with cerebral laterality. Low pH values were considered as an index for birth stress. Grasp-reflex strength was found to be directly related to pH in total sample. There were sex-related differences. Namely, this correlation was true only for female newborns, not for males. Right minus left grasp-reflex strength linearly increased with pH, i.e., low pH values were associated with left-hand dominance, but only in males. The grasp-reflex asymmetry was not related to pH in females. It was concluded that blood pH may be associated with motor asymmetry and motor development in human newborns, but show sex-related differences; female brain seemed to be more sensitive to pH changes than male brain. The results partly supported the Bakan's hypothesis that birth stress may be associated with left-handedness.

Dominance, Cerebral↗
PubMed2006

Most scaphoid non-unions heal with bone chip grafting and Kirschner-wire fixation. Thirty-nine patients reviewed 10 years after operation.

BACKGROUND: Many recommend to operate scaphoid pseudarthroses with wedge grafts and screw fixation. These are difficult operations. We have employed a simpler procedure and wished to review our results with regard to healing and long-term clinical results. PATIENTS AND METHODS: We reviewed 39 unselected scaphoid pseudarthroses which had been operated with Kirschner-wire fixation and bone chip transplantation 10 (3.5-12) years previously. Postoperative cast treatment was 15 (11-30) weeks. RESULTS: Four pseudarthroses failed to unite, one of which was after a trans-scaphoid perilunar dislocation. In another the pins were dislocated by an injury while the arm was in plaster. There were no other complications. All 14 proximal pseudarthroses united. There was no loss of grip strength but some loss of key-pinch strength and wrist mobility. Most patients reported no or little pain and none used analgesics because of wrist pain. The disability of the arm, shoulder and hand (DASH) score was 2 (0-33). Very few cases of mild arthrosis had arisen after operation. Three patients would not have consented to operation if they had known the outcome in advance. CONCLUSIONS: Kirschner-wire fixation and bone chip grafting of scaphoid pseudarthroses is an undemanding operation with few complications that produces good long-term results. Results are excellent also for proximal pole pseudarthroses.

Adolescent↗
PubMed1998

Manual performance in cold conditions while wearing NBC clothing.

Manual performance while wearing a whole body covering NBC garment was studied at -10 degrees C. Hands were protected by thin cotton gloves, which were covered with rubber gloves. The test subjects were exposed for 40 min in one of the four conditions: standing at -10 degrees C, standing for 10 min followed by walking (5 km/h) for 30 min on a treadmill, standing while holding a solid steel bar (see section 2.2), or standing at 20 degrees C. Six different manual tasks were performed after each 40-min exposure. All tests were also performed with bare hands at 20 degrees C. Moreover, the effect of contact cooling on skin temperatures and rewarming thereafter was examined by means of gripping a steel bar (-10 degrees C) during cold exposure. During exposure to -10 degrees C conditions finger skin temperature rapidly decreased to 10.7 +/- 2.2 degrees C (mean +/- SD). Improvement of body heat balance by exercise increased finger temperatures to 19.6 +/- 9.0 degrees C. Hand temperature remained at a higher level both during rest and exercise at -10 degrees C (20.1 +/- 1.7 and 20.6 +/- 6.1 degrees C, respectively). Cold exposure deteriorated manual performance and especially those functions that are related to finger dexterity. Finger skin temperature had high correlation with screwing, peg-board and magazine loading tests (r = -0.90, r = -0.77 and r = -0.72, respectively, p < 0.01) but no relation was found with hand grip strength (r = -0.03). Manual performance was impaired in every test both by gloves and cooling. Contact cooling decreased skin temperatures on the palm side of the hand and fingers around twice as effectively in normothermic subjects and 3.9-6.5 times more effectively in cooled subjects in comparison to cooling by cold air alone. Contact cooling had no significant effect on skin temperatures on the dorsal side of the fingers. The rewarming rate after the release of the steel bar was clearly higher in the dominant hand in comparison to the non-dominant hand. In conclusion, the present results show that the thermal insulation of rubber gloves was clearly insufficient, allowing unacceptably low finger temperatures during work in the cold. However, only those tasks requiring finger dexterity were clearly adversely affected. Heat production by physical exercise was able to increase finger skin temperature and to partly restore manual performance. Handling of cold tools is especially harmful for the palm side temperature of the non-dominant hand.

Acclimatization↗
PubMed1994

Amount of asymmetry in grasp reflex depends on the grasp reflex of the left hand in human neonates.

Grasp-reflex strengths from right and left hands were measured in 33 human neonates. There was no significant correlation between right minus left grasp-reflex strength and grasp-reflex strength from the right hand. The grasp-reflex strength of the left hand was negatively linearly correlated with the right minus left grasp-reflex strength. It was suggested that the right brain may be the main determinant for the motor asymmetry in hands.

Brain↗