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PubMed1995

Physiological reaction and manual performance during work in cold storages.

Subjects were 10 workers (Group R) working in two cold storages (air temperature was between -20 degrees C and -23.2 degrees C), and eight workers (Group C) working in a general storehouse (air temperature was between 12 degrees C and 15.2 degrees C). They were all male workers operating forklift-trucks. Average (SE) age for Group R was 41.4(1.3) years and for Group C was 47.3(1.6) years. Hand tremor, handgrip strength, pinch strength, counting task, flicker value, peak flow rate and blood pressure were measured five times (before work, at 10 a.m., before lunch, at 3 p.m. and after work) per day. Blood samples were collected before lunch. Free fatty acid (FFA) of Group R was significantly higher than that of Group C. There were no significant differences in handgrip strength, pinch strength, counting task, flicker value and peak flow rate between Group R and Group C. However, changes in hand tremor and diastolic blood pressure for Group R were significantly greater than those for Group C. Only for Group R, there was a significant relationship between FFA and the hand tremor values measured the second time. Work loads of Group R would be increased by not only the extreme coldness but also large temperature difference between the inside and the outside of the cold storages. The actual forklift work in these cold storages did not cause a distinct reduction in manual performance, but caused an increase in stress which would be expressed as an increase in catecholamine excretion.

Adaptation, Physiological↗

PubMed1999

Handedness in opposite and same-sex dizygotic twins: testing the testosterone hypothesis.

Prenatal exposure to testosterone is proposed to promote development of the right hemisphere and increase the incidence of sinistrality. This proposition was tested by comparing the hand preference of 59 opposite-sex and 61 same-sex dizygotic twins. Because testosterone is thought to pass between twins in utero, it was predicted that females with a male twin would show a high incidence of sinistrality compared to females with a female twin. Similarly, it was predicted that males with a male twin would be more likely to be sinistral than males with a female twin. Measures of the strength of hand preference and the incidence of sinistrality revealed no difference between the opposite and same-sex twins for either sex. The data also failed to confirm reports that first-born twins are more likely to be sinistral than second-born twins. These data add to a growing body of research which is critical of the testosterone hypothesis.

Adolescent↗

PubMed2000

Analysis of muscle strength and bone structure in children with renal disease.

Bone structure and muscular strength of 30 children with renal disease were investigated by peripheral computed tomography and grip strength. Sixteen children suffered from nephrotic syndrome (NS) and had previously been treated with corticosteroids. Fourteen children suffered from chronic renal failure (CRF) ranging from mild renal failure to end-stage renal disease. Six children had received kidney transplants and corticosteroids for immunosuppression. There was a significant decrease in grip strength of children with NS (SD -0.91+/-1.5; P=0.042) and children with CRF (SD -1.38+/-1.4; P<0.001) compared with normal children. Furthermore, there was a significant correlation between cortical area and grip strength in all children with renal disease (r=0.92; P<0.0001). Trabecular bone mineral density did not correlate well with grip strength. These findings resemble results found in healthy children. Trabecular bone mineral density was significantly elevated in children with CRF compared with normal children (SD 1.14+/-1.4; P=0.008). Grip strength as a marker of muscle mass and cortical area as a marker of bone strength correlate well in children with renal disease, similar to the correlation in healthy children. Grip strength is significantly lower in children with NS and CRF compared with normal children. These data suggest that muscular impairment could be involved in renal osteopathy.

Adolescent↗

PubMed2004

Cardiopulmonary fitness and muscle strength in patients with osteogenesis imperfecta type I.

OBJECTIVE: To evaluate cardiopulmonary function, muscle strength, and cardiopulmonary fitness (VO 2 peak) in patients with osteogenesis imperfecta (OI). STUDY DESIGN: In 17 patients with OI type I (mean age 13.3 +/- 3.9 years) cardiopulmonary function was assessed at rest using spirometry, plethysmography, electrocardiography, and echocardiography. Exercise capacity was measured using a maximal exercise test on a bicycle ergometer and an expired gas analysis system. Muscle strength in shoulder abductors, hip flexors, ankle dorsal flexor, and grip strength were measured. All results were compared with reference values. RESULTS: Cardiopulmonary function at rest was within normal ranges, but when it was compared with normal height for age and sex, vital capacities were reduced. Mean absolute and relative VO 2 peak were respectively -1.17 (+/- 0.67) and -1.41 (+/- 1.52) standard deviations lower compared with reference values ( P < .01). Muscle strength also was significantly reduced in patients with OI, ranging from -1.24 +/- 1.40 to -2.88 +/- 2.67 standard deviations lower compared with reference values. CONCLUSIONS: In patients with OI type I, no pulmonary or cardiac abnormalities at rest were found. The exercise tolerance and muscle strength were significantly reduced in patients with OI, which might account for their increased levels of fatigue during activities of daily living.

Adolescent↗

PubMed2005

The use of polarized polychromatic non-coherent light as therapy for acute tennis elbow/lateral epicondylalgia: a pilot study.

OBJECTIVE: The aim of this study was to assess the efficacy of polarized, polychromatic, non-coherent, low energy light (Bioptron 2, Bioptron AG, Switzerland) in the treatment of acute tennis elbow. BACKGROUND: Tennis elbow, or lateral epicondylitis, is one of the most common lesions affecting the arm. A plethora of treatment regimes have been described for this condition, but no specific therapy has emerged as a gold standard. METHODS: A pilot study was carried out with 25 patients who had acute tennis elbow. Bioptron 2 device was applied over lateral epicondyle three times per week for 4 weeks. Pain on VAS, function on VAS, and painfree grip strength were measured at the beginning (week 0) and at the end of the study (week 4). RESULTS: The pain on VAS was reduced at the end of treatment (t(24) = 3.84, p = 0.001). Function on VAS was increased at the end of treatment (t(24) = 4.23, p < 0.001). Pain-free grip strength was increased at the end of treatment (t(24) = 4.23, p < 0.004). CONCLUSION: Although the results suggested that the Bioptron 2 could reduce patients' symptoms with acute tennis elbow, future controlled studies are needed to establish the relative and absolute effectiveness of Bioptron 2.

Adult↗

PubMed2002

Development of an apparatus to estimate coordinated exertion of force.

The purpose of this study was to develop a practical apparatus for estimation of the coordinated exertion of force and to develop methods for display, test duration, and sampling interval. A total of 84 healthy male college students were required to match their grip strength to a changing demand value appearing on the display of a personal computer (using two descriptions in the form of a bar chart and wave form). The variables were the maximal difference and the total sum of the differences between demanded and produced grip strength over time. In estimating coordinated exertion of force, an actual force (kgf) scale was more effective than a relative force (%) scale. Reliability tests indicated that a 30-sec. test was effective. Both bar chart and wave form displays were effective.

Adult↗

PubMed2001

Treatment of ulnar impaction syndrome with the wafer procedure.

Our objective was to evaluate the efficacy of wafer resection of the distal ulna (the wafer procedure) as treatment for ulnar impaction syndrome. Between 1995 and 1997, 26 patients were surgically treated for refractory wrist pain secondary to ulnar impaction syndrome. The diagnosis was based on physical examination, radiologic imaging, and wrist arthroscopy, and confirmatory pathoanatomy was identified at the time of surgery in all cases. The study population consisted of 18 women and 8 men, and patient age averaged 42 years. Follow-up averaged 27 months (range, 17-41 months). Twenty-three patients were completely satisfied with pain relief and the functional status of their wrists at final follow-up. Range of motion returned to baseline in the majority of cases, usually by 3 months, and grip strength increased an average of 11 kg (P < or = .005). The wafer procedure is an effective treatment alternative to ulnar-shortening osteotomy for ulnar impaction syndrome and avoids the risk of nonunion and hardware-related complications.

Adult↗

PubMed1993

Muscle strength and history of heavy manual work among elderly trained women and randomly chosen sample population.

The association between a history of heavy work and muscle strength was studied among 51 physically active women aged 66-85 years trained in sports and 41 women aged 70-81 years selected randomly from the population register. Maximal isometric muscle strength of hand grip, arm flexion, leg extension and trunk flexion and extension were measured using specially constructed dynamometers. The capacity of the abdominal muscles was evaluated by means of a sit-up test. The study included an interview dealing with the subjects' histories of heavy manual employment. The mean histories of heavy work for the trained and untrained women were 24 and 36 years, respectively. The trained women showed significantly greater maximal isometric muscle strength and abdominal muscle capacity than the untrained women. Among the trained women there was no correlation between the amount of heavy work and muscle performance. Among the untrained women the amount of heavy work correlated positively with maximal isometric trunk extension strength. The results would suggest that among elderly women, whether physically active or not, a history of heavy work has no systematic association with muscle strength.

Aged↗

PubMed1997

A randomized, controlled trial of creatine monohydrate in patients with mitochondrial cytopathies.

Fatigue in patients with mitochondrial cytopathies is associated with decreased basal and postactivity muscle phosphocreatine (PCr). Creatine monohydrate supplementation has been shown to increase muscle PCr and high-intensity power output in healthy subjects. We studied the effects of creatine monohydrate administration (5 g PO b.i.d. x 14 days --> 2 g PO b.i.d. x 7 days) in 7 mitochondrial cytopathy patients using a randomized, crossover design. Measurements included: activities of daily living (visual analog scale); ischemic isometric handgrip strength (1 min); basal and postischemic exercise lactate; evoked and voluntary contraction strength of the dorsiflexors; nonischemic, isometric, dorsiflexion torque (NIDFT, 2 min); and aerobic cycle ergometry with pre- and post-lactate measurements. Creatine treatment resulted in significantly (P < 0.05) increased handgrip strength, NIDFT, and postexercise lactate, with no changes in the other measured variables. We concluded that creatine monohydrate increased the strength of high-intensity anaerobic and aerobic type activities in patients with mitochondrial cytopathies but had no apparent effects upon lower intensity aerobic activities.

Activities of Daily Living↗

PubMed2000

Handgrip strength is an independent predictor of distal radius bone mineral density in postmenopausal women.

Several cross-sectional studies have reported a positive correlation between muscle strength and local bone mineral density. However, very few studies have evaluated the possible role of confounding variables, which may be substantial as both bone mineral density and muscle strength are multifactorial variables. We studied 140 postmenopausal women who underwent their first osteodensitometry in our hospital. Of these, 102 women affected neither by bone diseases apart from primary osteoporosis nor treated with drugs affecting bone mass were selected. Distal radius bone mineral density of the non-dominant arm was assessed by dual photon absorptiometry. Handgrip strength was measured by a handheld dynamometer. The following factors influencing bone mass were also considered: age, years since menopause, years of cyclic ovarian activity, body weight, body height, body mass index, and both calcium and alcohol dietary intake. Statistical evaluation was performed by stepwise multiple regression analysis. This showed that only two variables were independently related to bone mineral density: handgrip strength (which was the best bone density predictor among the studied independent variables) and years since menopause. R2 value was 0.43 (F=38.04, p < 0.001). All the other variables studied were not significantly related to bone density when the effects of both strength and years since menopause were considered. In conclusion, the data showed that handgrip strength was a strong independent predictor of distal radius bone mineral density in postmenopausal women. Clinical assessment of osteoporosis risk factors, including muscle strength, is recommended: although it is not an adequate substitute for bone densitometry, it can help clinicians to identify the risk groups at which to direct bone density measurement.

Adult↗

PubMed2006

Nonrheumatoid metacarpophalangeal joint arthritis. Unconstrained pyrolytic carbon implants: indications, technique, and outcomes.

Unconstrained pyrolytic surface replacement arthroplasty provides the benefits of a more natural center of rotation with preservation of native ligamentous joint stability. Initial short-term results show excellent motion, pain relief, and restoration of pinch and grip strength. These results are encouraging, and suggest that pyrolytic carbon arthroplasty may be a reasonable option for joint salvage in patients suffering from MP joint osteoarthritis.

Adult↗

PubMed2006

[Scapho-trapezio-trapezoidal arthrodesis for scapho-trapezio-trapezoidal osteoarthritis].

Scapho-trapezio-trapezoid arthrodesis was originally performed for the treatment of scapho-lunate instability. However, only a few publications have described this technique for treatment of osteoarthritis of the scapho-trapezio-trapezoid (STT) joint. The purpose of this paper is to analyze the results of triscaphoid arthrodesis for STT osteoarthritis with a long-term follow-up. Thirteen cases of osteoarthritis of the STT joint in twelve patients, all treated by STT arthrodesis, were reviewed with an average follow-up of 60 months. Pain was classified according to Alnot's classification: eight patients were classified as grade III, two as grade IV and two as grade II. The average preoperative range of motion of the wrist was 51 degrees for flexion, 39 degrees for extension, 9 degrees for radial deviation and 28 degrees for ulnar deviation. Grip strength was compared to the contralateral side. Radiographic changes were classified according to Crosby's classification, including sublevels for carpal instability. Four wrists were classified 2a and nine wrists were classified 2b. The average radio-lunate and scapho-lunate angles were 14 and 45 degrees respectively. Pain was improved in all patients (P = 0.05) all of whom were subjectively satisfied. Strength and range-of-motion did not statistically decrease after STT arthrodesis except for wrist extension (P = 0.03). Radio-lunate and scapho-lunate angles were unchanged in five patients and improved in five patients. There were four non-unions of whom two patients without pain were not re-operated. The other two were re-operated with the same technique leading to fusion. Scapho-trapezio-trapezoid arthrodesis is an efficient procedure for STT osteoarthritis with regard to pain reduction. Strength and global range-of-motion are not modified by this procedure. Moreover, as it limits carpal instability, this procedure is preferable in active patients.

Adult↗

PubMed1999

Manipulative management of post-Colles' fracture weakness and diminished active range of motion.

OBJECTIVE: To discuss the management of a patient with wrist weakness and a diminution in active range of motion resulting from Colles' fracture. CLINICAL FEATURES: A 58-year-old woman complained of persistent loss of grip strength and mobility in her right wrist. These complaints were from Colles' fracture occurring 19 months before initiation of care. Dynamometer and goniometric testing revealed significant loss of grip strength and range of motion compared with the uninvolved, nondominant wrist. INTERVENTION AND OUTCOME: Specific joint manipulation for improvement in mobility and grip strength of the wrist was performed. The patient's right wrist was evaluated for grip strength and active range of motion over a 3-week period, providing a baseline of function before treatment. After 4 visits of baseline measurements, a series of 4 treatments and 4 reevaluations was performed. The patient exhibited a significant increase in grip strength and active range of motion. CONCLUSION: Appropriate intervention of chiropractic manipulation and examination procedures culminated in a successful resolution of this case. When such cases are recognized, appropriate management may occur conservatively with judicious application of joint manipulation and reevaluation procedures.

Colles' Fracture↗

PubMed1995

Functional results of dynamic splinting after transmetacarpal, wrist, and distal forearm replantation.

The results of replantation at the wrist and distal forearm are reported to be better than at the metacarpal level, in part because the latter involve direct injury to the intrinsic muscles. This study evaluates a new post-operative protocol for replantation at the metacarpal, wrist and distal forearm levels. 3 days after replantation, the patient was placed in a dynamic crane outrigger splint with MP joint control, compensating for intrinsic muscle function loss. From 4 to 12 weeks, an anticlaw splint alternated with the outrigger splint. After 12 weeks, a dynamic wrist extension orthosis was added to the anti-claw splint. 11 patients (four replantations at the transmetacarpal level, three at the wrist and four in the distal forearm) had this protocol between 1988 and 1993. For distal forearm replantation, TAM of fingers averaged 216 degrees, grip strength 42 lb, and pinch strength 7.2 lb with 75% good or excellent results. For wrist replantations, TAM of fingers averaged 243 degrees, grip strength 37 lb and pinch strength 10.6 lb with 100% good or excellent results. For transmetacarpal replantations, TAM of fingers averaged 189 degrees, grip strength 37 lb and pinch strength 5.6 lb, with 75% good and excellent results. Early protected mobilization, as described here, preserves tendon gliding, muscle strength and excursion. Our results support this protocol for wrist and distal forearm replantation and especially for transmetacarpal replantation, the results of which tend to be poor according to the medical literature.

Adult↗

PubMedDate not supplied

Rapid relief of a painful, long-standing posttraumatic digital neuroma treated by transcutaneous vibratory stimulation (TVS).

A case of a patient with a painful posttraumatic digital neuroma that had been present for 13 years is presented. Treatment for the painful neuroma was twice a week for one month using transcutaneous vibratory stimulation (TVS). The patient was assessed using various tests before and after this period of treatment. There was a reduction in pain, and dexterity and strength improved. The method of treatment and the assessment techniques are described. In this case, the therapeutic benefit of the method could be clearly differentiated from the natural healing course, since no significant improvement had occurred spontaneously over many years.

Electric Stimulation Therapy↗

PubMed2002

Silicone arthroplasty for trapeziometacarpal arthritis.

Twenty-three patients who had undergone trapeziectomy and Helal silicone rubber ball interposition for trapeziometacarpal arthritis were reviewed. The average age at operation was 63 (range 48-84) years and the mean follow-up was 59 (range 12-138) months. Of the 23 patients reviewed, two had pain at rest and four had some discomfort on exertion. Mean post-operative thumb extension was 37 degrees whilst mean palmar abduction was 40 degrees. Mean post-operative grip strength was 19 kg and thumb-pinch strength was 4.0 kg, 77% and 78% of the age- and sex-matched normal values. There were no cases of prosthetic dislocation, prosthetic fracture or silicone synovitis.

Aged↗

PubMed2006

Gene transfer demonstrates that muscle is not a primary target for non-cell-autonomous toxicity in familial amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal, progressive paralysis arising from the premature death of motor neurons. An inherited form is caused by a dominant mutation in the ubiquitously expressed superoxide dismutase (SOD1). SOD1 mutant expression within motor neurons is a determinant of onset and early disease, and mutant accumulation within microglia accelerates disease progression. Muscle also is a likely primary source for toxicity, because retraction of motor axons from synaptic connections to muscle is among the earliest presymptomatic events. To test involvement of muscle in ALS, viral delivery of transcription-mediated siRNA is shown to suppress mutant SOD1 accumulation within muscle alone but to be insufficient to maintain grip strength, whereas delivery to both motor neurons and muscle is sufficient. Use of a deletable mutant gene to diminish mutant SOD1 from muscle did not affect onset or survival. Finally, follistatin expression encoded by adeno-associated virus chronically inhibited myostatin and produced sustained increases in muscle mass, myofiber number, and fiber diameter, but these increases did not affect survival. Thus, SOD1-mutant-mediated damage within muscles is not a significant contributor to non-cell-autonomous pathogenesis in ALS, and enhancing muscle mass and strength provides no benefit in slowing disease onset or progression.

Amyotrophic Lateral Sclerosis↗

PubMed2004

The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis.

The aim of the present study was to compare the effect of a new prefabricated Thämert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the splint group. They wore the orthotic devices for 6 weeks. Outcome measures were obtained at baseline and directly after the intervention. These outcome measures were maximal grip strength on the involved side with a pain scale from 1 to 10 to determine the extent of pain during gripping, and the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ). Analysis of variances with repeated measures, a Mann Whitney test and multiple linear regression analysis were used to compare the two groups. Main effect for time was significant for maximal grip strength and sum scores on the PRFEQ, but no differences between groups were found, even when a distinction between acute and chronic symptoms was made. Change in pain score during gripping did not differ significantly between the groups. A multiple linear regression analysis showed that the use of the splint did not significantly contribute to the prediction of change in maximal grip strength and in overall PRFEQ. The conclusion is that the forearm/hand splint is not more effective than the elbow band as a treatment for lateral epicondylitis.

Adult↗