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PubMedDate not supplied

Arthroscopic classification and treatment of lateral epicondylitis: two-year clinical results.

We assessed the clinical utility of 42 arthroscopic releases for lateral epicondylitis in 40 patients (average age, 43 years) with an average of 14 months of symptomatic history before surgery. At arthroscopy, we found 15 type I lesions (intact capsule), 15 type II lesions (linear capsular tear), and 12 type III lesions (complete capsular tear), and associated disorders were found in 69% of the patients. At an average follow-up of 2.8 years, patients were asked to report on elbow pain and function. Subjectively, the patients rated their pain at rest as an average of 0.9 (0 = no pain; 10 = severe pain). They rated their pain with activities of daily living as 1.4 and their pain with sports and work as 1.9. Functionally, they averaged 11.1 of 12 possible points. Of the 39 elbows in the 37 patients who were available for follow-up, 37 were rated "better" or "much better." Patients returned to work in an average of 2.2 weeks. Grip strength averaged 96% of the strength of the unaffected limb. Arthroscopic tennis elbow release is a reliable treatment that allows patients an expedited return to work and may result in greater postsurgical grip strength.

Activities of Daily Living↗
PubMed2004

Acute nondisplaced fractures of the scaphoid.

BACKGROUND: The optimal management for undisplaced scaphoid fractures has been the focus of much debate. Investigators have advocated internal fixation of these fractures; however, whether surgery improves clinically relevant patient outcomes compared with casting remains unknown. OBJECTIVE: To determine the effect of internal fixation versus casting for undisplaced scaphoid fractures on the rates of union, return to work, grip strength, and range of motion.

Adolescent↗
PubMed1999

Male torque strength in simulated oil rig tasks: the effects of grease-smeared gloves and handle length, diameter and orientation.

This paper examines the effects of two glove conditions and selected handle and task characteristics on tightening (clockwise) torques on cylindrical handles in simulated oil rig tasks. Ten males exerted MVC torques with the right hand on nine handles with different length-diameter combinations (3.8, 7.6, and 12.7 cm in length with 3.8, 6.7, and 8.4 cm in diameter) with dry and grease-smeared gloves in two orientations. The results showed a 50% reduction of torque when using grease-smeared glove compared to dry glove; a 15% increase with the long handle compared to the short one; a 25% increase with the medium diameter handle compared to the small one; and a 12% increase with the horizontally oriented handle compared with the vertical one. There were important interaction effects also.

Adult↗
PubMed1992

Effect of yoga training on reaction time, respiratory endurance and muscle strength.

There is evidence that the practice of yoga improves physical and mental performance. The present investigation was undertaken to study the effect of yoga training on visual and auditory reaction times (RTs), maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), 40 mmHg test, breath holding time after expiration (BHTexp), breath holding time after inspiration (BHTinsp), and hand grip strength (HGS). Twenty seven student volunteers were given yoga training for 12 weeks. There was a significant (P < 0.001) decrease in visual RT (from 270.0 +/- 6.20 (SE) to 224.81 +/- 5.76 ms) as well as auditory RT (from 194.18 +/- 6.00 to 157.33 +/- 4.85 ms). MEP increased from 92.61 +/- 9.04 to 126.46 +/- 10.75 mmHg, while MIP increased from 72.23 +/- 6.45 to 90.92 +/- 6.03 mmHg, both these changes being statistically significant (P < 0.05). 40 mmHg test and HGS increased significantly (P < 0.001) from 36.57 +/- 2.04 to 53.36 +/- 3.95 s and 13.78 +/- 0.58 to 16.67 +/- 0.49 kg respectively. BHTexp increased from 32.15 +/- 1.41 to 44.53 +/- 3.78s (P < 0.01) and BHTinsp increased from 63.69 +/- 5.38 to 89.07 +/- 9.61 s (P < 0.05). Our results show that yoga practice for 12 weeks results in significant reduction in visual and auditory RTs and significant increase in respiratory pressures, breath holding times and HGS.

Adolescent↗
PubMed2005

Treatment of scaphoid non-union with a percutaneous corticocancellous bone graft.

Thirty-three symptomatic scaphoid non-unions were treated by a simple, minimally invasive procedure using a percutaneous autologous corticocancellous bone graft. After an average follow-up of 3.5 years, union was observed in 29 cases. These patients had no, or mild, pain at work and an almost normal range of motion and grip strength. No progression to osteoarthritis was observed.

Adult↗
PubMed2001

Open carpal tunnel decompression in long-term haemodialysis patients [corrected].

This retrospective study assessed the treatment of 91 cases of carpal tunnel syndrome in long-term haemodialysis patients. One group of patients underwent an enlargement reconstruction of the flexor retinaculum with synovectomy and the other group was treated with a conventional carpal tunnel release. There were no major changes or differences between the outcomes of the two groups. However, there was an earlier functional recovery of grip strength and a lower recurrence rate in the enlargement plasty with synovectomy group.

Aged↗
PubMed2006

A prospective outcomes study of four-corner wrist arthrodesis using a circular limited wrist fusion plate for stage II scapholunate advanced collapse wrist deformity.

BACKGROUND: Scapholunate advanced collapse wrist deformity is a common pattern of degenerative arthrosis of the wrist. This study prospectively evaluated a series of patients who underwent four-corner fusion using a circular plate internal fixation technique. METHODS: Patients with symptomatic stage II scapholunate advanced collapse wrist deformity were treated with scaphoid excision and four-corner fusion using the Spider Limited Wrist Fusion Plate (KMI, San Diego, Calif.). Patients were prospectively evaluated at 6 months and 1 year using a standard study protocol with radiographs, functional tests, and an outcomes questionnaire. Outcomes were compared with those of historical series from the literature. RESULTS: Eleven patients were enrolled and 10 patients completed their 1-year follow-up. Grip strength, lateral pinch strength, and Jebsen-Taylor test scores at 1 year were not significantly different from preoperative values. Mean active range of motion was 87 degrees preoperatively and 74 degrees at 1-year follow-up (p = 0.19). The Michigan Hand Outcomes Questionnaire showed no significant improvement in function, activities of daily living, work, pain, or patient satisfaction. The mean pain scores decreased from 54 preoperatively to 42 1-year postoperatively (p = 0.30), indicating persistent wrist discomfort. Three patients had broken screws: one was asymptomatic, one required 3 months of strict wrist immobilization, and one was reoperated for symptomatic nonunion. CONCLUSIONS: Four-corner fusion using the first-generation Spider plate technique has the advantage of earlier mobility and more patient comfort from absence of protruding Kirschner wires; however, patients continued to have disabling pain, functional limitations, work impairment, and low satisfaction scores postoperatively. Although limited by a small patient sample, this series presents outcomes data that may be useful in counseling patients who are contemplating four-corner fusion using this internal fixation device. Further investigation is necessary to evaluate the biomechanical properties of the Spider plate. The data suggest that better implants should be designed to avoid implant failure, which occurred in three of the 11 patients in this series.

Activities of Daily Living↗
PubMed2005

Ingestion of tyrosine: effects on endurance, muscle strength, and anaerobic performance.

Acute tyrosine ingestion is thought to improve aerobic endurance, muscle strength and endurance, and anaerobic power of men undergoing severe physiologic stress. In a double-blind, crossover study, 20 men (32 +/- 1 y old) underwent 2 loadcarriage treadmill sessions, 1 after taking tyrosine (150 mg/ kg L-crystalline tyrosine) and 1 after taking placebo. Tyrosine dosage was based on subject weight and ingested 30 min before load carriage. A physical performance battery was administered after the load carriage: maximal and submaximal handgrip, pull-ups, and stair stepping with weight. Total time on treadmill was not significantly lengthened with ingestion of tyrosine (118.9 +/- 1.4 min) as compared with placebo (119.2 +/- 1.2 min). Total power for stair stepping (tyrosine 223 +/- 8 watts, placebo 216 +/- 9 watts) and muscle strength and endurance (handgrip) was not significantly improved by tyrosine ingestion. The results indicate that acute ingestion of tyrosine by healthy men has no measurable effect on endurance, muscle strength, or anaerobic power.

Adult↗
PubMed2002

Effect of grip span on lateral pinch grip strength.

Repetitive, high-force pinch grip exertions are common in many occupational activities. The goal of the current study was to quantify the relationship between lateral pinch grip span (distance between thumb and index finger) and lateral pinch grip strength. An experiment was conducted in which 40 participants performed maximal lateral pinch grip exertions at 11 levels of grip span distances (0, 10%, ... 100% of maximum functional lateral pinch grip span distance). The results show a significant effect of lateral pinch grip span, with strength at the maximum functional lateral pinch grip span 40% higher than that found at the smallest lateral pinch grip span considered. Between these two endpoints, strength increased monotonically with increasing pinch grip span. The application of these results in pinch grip design criteria for both high-force and long-duration exertions is discussed. Potential applications of this research include the design of hand tools and controls for which significant force is applied by the user.

Adult↗
PubMed2001

[Physical examination--measurement of muscle strength].

Measuring muscle strength and establishing paretic symptoms are done first of all by having the patient perform actions or movements that require normal muscle strength. Measuring or grading the strength of separate muscle groups is usually done by means of the so-called Medical Research Council (MRC) scale that runs from 0 to 5, with the movement against gravity as an important criterion. This scale is not very valid in tract 4 (more strength than needed to overcome gravity, but still subnormal). Using a manual dynamometer or a fixed dynamometer it is possible to measure the strength of most clinically important muscle groups of the extremities and to compare them with values found in a normal population. For following the individual patient with a neuromuscular disorder, strength measurement with the dynamometer is more reliable than grading using the MRC scale.

Diagnosis, Differential↗
PubMed2001

Grip strength in children.

The grip strength in a group of 487 healthy children aged between 5 years and 15 years was measured. There was a clear correlation between age and grip strength. Up to the age of 12 years, there was a striking parallellism between boys and girls. From the age of 13 years, boys developed a 25% stronger grip force than girls. The difference between the dominant and nondominant hand grip was not significant, but was constantly stronger in the right hand for right-hand dominant children. There was a high variation in grip forces (from 6.9 kg to 38.4 kg).

Adolescent↗
PubMed2005

Total wrist fusion: a study of 115 patients.

This retrospective study evaluated the outcome of total wrist fusion, predominantly using the Mannerfelt technique, in patients with rheumatoid arthritis. One hundred and fifteen patients were operated on for painful wrist destruction. The mean pain scores were 3.6 (1-4) pre-operatively, 1.9 (1-4) after 6 weeks and 1.3 (1-4) at 1 year. Although the radiological fusion rate was good, only 40% of the patients were very satisfied with the result. Ability to perform activities of daily living was only very much improved in 30% of the patients. Grip strength significantly improved after surgery.

Activities of Daily Living↗
PubMed1995

Neuromuscular recovery after parathyroidectomy in primary hyperparathyroidism.

BACKGROUND: Primary hyperparathyroidism today is diagnosed in the asymptomatic phase because of the inclusion of serum calcium in sequential multichannel analysis. The purpose of present study was to test for neuromuscular abnormalities in asymptomatic patients and to test the improvement of neuromuscular performance after parathyroidectomy. METHODS: Nine patients with primary hyperparathyroidism and nine patients with nodular goiter were enrolled in this study. Neuromuscular recovery including muscle power, sensation, and fine motor movement was studied before operation and 1 week and 4 weeks after operation. The muscle power was measured as grip power, palm pinch, lateral pinch, and three-chuck pinch. The sensation was measured as touch sensation and two-point discrimination. The fine motor movement was measured with the Purdue Pegboard Test and the Minnesota Manual Dexterity Test. RESULTS: Four weeks after the operation the patients with hyperparathyroidism had increased their muscle strength and had improved fine motor movement but no change was noted in two-point and touch sensation. When the postoperative muscle recovery was compared, there was a reversible correlation (r = -0.62; p < 0.05) with the preoperative muscle strength and no correlation with the preoperative serum calcium, phosphate, alkaline phosphatase, and intact parathyroid hormone levels. No such improvement was detectable among the control subjects. CONCLUSIONS: Surgery can improve muscle strength and fine motor movement but does not affect sensation in asymptomatic patients.

Adult↗
PubMed1995

Steindler and pectoralis major flexorplasty: a comparative analysis.

Previously published studies on transfers to restore elbow flexion have rarely compared the outcomes among different techniques. We found no comparison between the Steindler procedure and pectoralis major tendon transfer. This study compared functional outcomes after these two types of elbow flexorplasty performed in conjunction with shoulder arthrodesis for patients with brachial plexus injuries. The same examiner assessed 14 patients who underwent shoulder fusion and elbow flexorplasty. Five had a pectoralis major tendon transfer, and nine underwent a modified Steindler procedure. All patients had brachial plexus lesions that were irreparable or had not responded to neurolysis, repair, or grafting. Average follow-up time was 60 months (range, 12 months-10 years). All patients completed a questionnaire (pain, function) and underwent an objective assessment of range of motion, isometric strength, isotonic power, grip, and pinch strength. The BTE Work Simulator (Baltimore Therapeutic Equipment, Hanover, MD) was used for muscle strength testing. Improvement was noted in daily activities including dressing and bilateral activities and was reflected in a significant improvement over preoperative function. No differences (at p = .05 level of significance) were found in objective tests between the pectoralis major transfer and the Steindler groups. In the patient requiring stabilization of the shoulder and flexorplasty, the pectoralis major tendon transfer was at least equivalent to the modified Steindler flexorplasty in terms of range of motion, strength, and subjective measures.

Activities of Daily Living↗
PubMed2005

Bone mineral density, soft tissue body composition, strength, and functioning after hip fracture.

BACKGROUND: Although substantial decrements in bone, muscle, and functional ability have been reported to follow the occurrence of hip fracture in elderly women, little is known about the interrelation of these consequences. The authors evaluated the associations among physiologic and functional factors during recovery from hip fracture to determine whether any consistent sequence of events followed and whether markers of functional outcomes could be identified. METHODS: Two hundred five community-dwelling women aged 65 years and older who sustained hip fracture between 1992 and 1995 and were admitted to one of two acute care hospitals in metropolitan Baltimore, Maryland, participated in a 1-year prospective cohort study. Bone mineral density, lean mass, and fat mass were measured by dual-energy X-ray absorptiometry during the hospitalization and 2, 6, and 12 months later. Functional limitations were self-reported and grip strength was measured during interviews at the same time points. Correlation coefficients were calculated for all possible pairs of measures and time points. RESULTS: Losses of femoral neck bone mineral density and lean body mass and gains in fat mass were observed. Grip strength showed early improvement but declined by 1 year to levels close to those seen during hospitalization. Functional outcomes showed minimal correlation with bone or body composition and only moderate correlation with strength. CONCLUSIONS: Physiologic and functional declines follow hip fracture in elderly women. These are largely independent of one another and suggest that interventions to maximize recovery must simultaneously target multiple areas, including bone, muscle, strength, and function.

Aged↗
PubMed1997

Effects of detraining subsequent to strength training on neuromuscular function in patients with inflammatory arthritis.

The effects of detraining subsequent to strength training on neuromuscular function were examined in 39 recent-onset rheumatoid arthritis (RA) patients. Eighteen age- and sex-matched healthy people (H) served as controls. Patients were randomly allocated either to the experimental group (PE), who carried out progressive strength training for 6 months, or to the control group (PC), who maintained only their habitual physical activities. After 6 months, PE returned to their earlier physical activities and strength training was terminated. At baseline, the maximal strength of the trunk extensors (not significant), grip strength and maximal dynamic strength and the shape of the force-time curve of the knee extensors were lower in PE and PC (P < 0.05-0.001) than in H. Strength training in PE led to remarkable increases (P < 0.05-0.001) in the maximal strength of all muscle groups without changes in the shape of the force-time curve. The increases in muscle strength in PE obtained by strength training were lost to a great degree during the detraining period for the isometric trunk extension (P < 0.01) and flexion (P < 0.01) strength and for the dynamic knee extension strength (P < 0.05), but not for the grip strength. In PC, trunk extension and flexion strength decreased significantly throughout the study period. At the post-test, all the strength values in both patient groups were much lower than in H. RA is a chronic disease which seems to need continuous physical exercise with sufficient intensity to minimize/prevent the loss of muscle strength and functional capacity.

Adult↗