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At least 127 records · Page 7Linked to original sources

Relationship of radiographic and clinical variables to pinch and grip strength among individuals with osteoarthritis.

OBJECTIVE: Little is known about how specific radiographic features are related to hand strength in osteoarthritis (OA). This study examined associations of radiographic variables with pinch and grip strength among individuals with radiographic hand OA. METHODS: Participants (n = 700, 80% female, mean age 69 years) were part of a study on the genetics of generalized OA. All had bilateral radiographic hand OA. Linear models were used to examine associations of grip and pinch strength with 1) OA in joint groups (proximal interphalangeal, metacarpophalangeal [MCP], carpometacarpal [CMC]), 2) OA in rays (first through fifth), and 3) summed Kellgren/Lawrence (K/L) grades for severity of OA in all joints. Adjusted models controlled for age, sex, hand pain, chondrocalcinosis, and hand hypermobility. Mixed models accounted for clustering within families. RESULTS: In bivariate analyses, all joint groups, all rays, and total summed K/L grades were significantly negatively associated with grip and pinch strength (P < 0.05). In adjusted models, the only joint group significantly associated with grip strength was the CMCs, and only OA in the MCP joint was significantly associated with pinch strength (P < 0.05). The only ray significantly associated with grip strength (P < 0.05) was ray 1, and no individual rays were significantly associated with pinch strength. A higher summed K/L grade was significantly associated with both lower grip strength and lower pinch strength. CONCLUSION: Among individuals with radiographic hand OA, increasing radiographic severity is associated with reduced grip and pinch strength, even when controlling for self-reported pain. Individuals with radiographic OA in specific locations (CMC joints, MCP joints, and ray 1) may be at particular risk for reduced hand strength.

Aged↗

A comparison of hand-held isometric strength measurement with isokinetic muscle strength measurement in the elderly.

OBJECTIVE: To compare hand-held isometric muscle strength measurement to an isokinetic muscle strength measurement in a healthy elderly population. DESIGN: Cross-sectional survey. SETTING: Retirement community in Southeastern Arizona. PARTICIPANTS: Thirty-two volunteers (16 men and 16 women) age 60 and over (mean age 70.3 years) who were free of musculoskeletal problems and did not have significant health problems. INTERVENTIONS: None. MEASUREMENTS: Isometric muscle strength was determined using a hand-held isometric strength device (Penny and Giles) for elbow flexion and extension and knee flexion and extension. Isokinetic muscle strength (average peak torque and average work per repetition) was measured on the same individuals using a Lido isokinetic dynamometer. RESULTS: Correlations between the strength measurement techniques were generally favorable with the lowest correlation being .72, (95 percent confidence interval .50-.86) and the highest being .85, (95 percent confidence interval .72-.93). However, there was substantial variability of hand-held strength reading at some levels of isokinetic strength. CONCLUSIONS: Hand-held dynamometry for strength measurement correlates strongly with measurement of strength using isokinetic dynamometry. Despite these high correlations, there is remaining variability of hand-held muscle strength readings when compared with isokinetic strength measurement at some levels of isokinetic muscle strength. Modification of the testing methodology or instrumentation used in this study is needed to improve the consistency of these measurements.

Aged↗

Mechanical counter-pressure vs. gas-pressurized spacesuit gloves: grip and sensitivity.

INTRODUCTION: An elastic mechanical counter pressure (MCP) glove for spacesuits is under development. In this study we compared handgrip and pinch grip strength levels for the MCP glove and the current extravehicular mobility unit (EMU) gas-pressurized glove. METHODS: We employed handgrip and pinch grip dynamometers to assess strength levels and von Frey monofilaments to evaluate hand sensitivity. Tests were conducted with the gloved hand inserted in an evacuation chamber at 200 mmHg below atmospheric pressure to simulate conditions in space. RESULTS: Average bare hand strength was 463 N and decreased to 240 N for EMU and 250 N for MCP. Pinch grip and key grip testing showed no difference among conditions. However, there was a significant decrease in palmar grip strength from 111 N barehanded to 67 N in both gloves. Barehanded endurance time was 160 s and dropped to 63 and 69 s for EMU and MCP, respectively. Sensitivity was significantly better for MCP compared with the EMU. DISCUSSION: The MCP glove improved hand sensitivity when compared with the EMU glove and performed as well as the EMU glove in terms of overall handgrip strength, endurance at 25% of maximum handgrip strength, pinch grip, palmar grip, and key grip tests. Improvements in fabric composition and glove design may further improve ergonomic and other functional parameters of the MCP glove.

Adult↗

Grip and pinch strength: normative data for adults.

The primary purpose of this study was to establish clinical norms for adults aged 20 to 75+ years on four tests of hand strength. A dynamometer was used to measure grip strength and a pinch gauge to measure tip, key, and palmar pinch. A sample of 310 male and 328 female adults, ages 20 to 94, from the seven-county Milwaukee area were tested using standardized positioning and instructions. Right hand and left hand data were stratified into 12 age groups for both sexes. This stratification provides a means of comparing the score of individual patients to that of normal subjects of the same age and sex. The highest grip strength scores occurred in the 25 to 39 age groups. For tip, key, and palmar pinch the average scores were relatively stable from 20 to 59 years, with a gradual decline from 60 to 79 years. A high correlation was seen between grip strength and age, but a low to moderate correlation between pinch strength and age. The newer pinch gauge used in this study appears to read higher than that used in a previous normative study. Comparison of the average hand strength of right-handed and left-handed subjects showed only minimal differences.

Adult↗

Results of ray resection and amputation for ring avulsion injuries at the proximal interphalangeal joint.

We investigated the long-term functional results of ray resection (14 cases) and amputation (nine cases) for ring avulsion injuries of ring finger which could not be replanted or underwent failed replantation. The mean follow-up was 37 (range, 24-63) months in the ray resection group and 32 (range, 24-40) months in the amputation group. Grip strength, key pinch strength, chuck pinch strength, hand circumference and palmar volume were decreased in the ray resection group but only grip strength and pulp pinch strength were significantly decreased in the amputation group. These results suggest that ray resection should be avoided in patients with occupations that need strong key and chuck pinch functions.

Adolescent↗

Arthrodesis of the wrist.

In a retrospective study, the wrists of 18 patients who underwent arthrodesis by the AO technique were assessed clinically, for hand strength and function. Follow-up averaged 4 years (range from 1 to 7 years). Although wrist arthrodesis improved grip strength, it was still only 50% to 60% of normal. Hand function improved to within normal limits in 78% of patients and bony union occurred in 94.4%. Thirteen patients were back at work within 18 months. The AO technique of wrist arthrodesis allows correction of deformity, relief of pain, increased grip strength and improved hand function.

Arthrodesis↗

[Measuring grip strength of the hand with a sensor glove by gripping with submaximal and maximal strength].

Grip strength measurements with the aid of dynamometers are dependent on the cooperation and motivation of the individual examined. Recognising a simulated loss of grip is a hitherto unresolved problem. With a sensor glove developed at the Berlin University of Technology, the force distribution pattern of any form of grip can be captured via ten pressure sensors and evaluated by computer. In five subjects, the force distribution patterns at submaximum and maximum force of five different grips were determined in three successive measurements each. The data were recorded in force-time diagrams. For each act of grasping, the measurements produced a curve with near-constant measuring signals within a defined period (plateau). The difference in the plateau heights of successive grips and the structures of the individual plateaux (oscillation, standard deviation) were used as distinguishing criteria. The dynamics of the measuring signals showed statistically significant differences between grips with submaximum and maximum force (p < 0.0001).

Adult↗

Arthritis hand function test: inter-rater reliability among self-trained raters.

OBJECTIVE: The purpose of this project was to examine the inter-rater reliability of the Arthritis Hand Function Test (AHFT), a new instrument for measuring hand strength and dexterity in adults with arthritis. METHODS: Six occupational therapists (two at each of three sites) trained themselves as AHFT administrators using the test manual and training videotape. They recruited 30 adult subjects (10 at each site) with rheumatoid arthritis or osteoarthritis affecting the hands. There were 21 women and 9 men in the sample (mean age, 57.5 years; average time since diagnosis, 14.8 years). Subjects were tested twice, once by each rater from that site. RESULTS: Inter-rater reliability ranged from 0.45 to 0.99 (Pearson r). Because subjects were tested twice, AHFT scores were examined for an order effect. Although scores on all strength items declined by the second test session, and improved for all dexterity items, only the aggregate applied dexterity score showed significant change across all three sites (P = 0.002, 0.001, and 0.031, respectively). CONCLUSIONS: These results suggest the AHFT is a reliable instrument for measuring hand strength and dexterity that requires minimal training on the part of occupational therapist raters.

Arthritis↗

Grip strength in different positions of elbow and shoulder.

This study investigated the effect of shoulder position on grip strength in 80 men and 80 women. A Jamar dynamometer was used to measure the grip strength in the four testing positions. The four hand strength tests consisted of three positions in which the elbow was maintained in full extension combined with varying degrees of shoulder flexion (ie, 0 degrees, 90 degrees, and 180 degrees) and of one position in which the elbow was flexed at 90 degrees with the shoulder in 0 degrees of flexion. Only the dominant hand was tested. The highest mean grip strength measurement was recorded when the shoulder was positioned at 180 degrees of flexion with elbow in full extension; whereas the position of 90 degrees elbow flexion with shoulder in 0 degrees of flexion had the lowest grip strength score. In addition, the grip strength measured with the elbow in extension, regardless of shoulder position (ie, 0 degrees, 90 degrees, and 180 degrees of flexion), was significantly higher than when the elbow was flexed at 90 degrees with the shoulder positioned at 0 degrees of flexion. Finally, grip strength differed significantly for both sexes and for each age group. The grip values of the standardized 90 degrees elbow flexed position were further analyzed to determine the average performances in the study population. For men, grip strength peaked within the 20 to 39 years age group and gradually declined thereafter. For women, the highest mean grip strength measurement was recorded in the 40- to 49-year-old age group and then deteriorated with age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Relationship of carpal canal contents volume to carpal canal pressure in carpal tunnel syndrome patients.

Forty patients long-term haemodialysis with a second recurrence of carpal tunnel syndrome and concomitant loss of flexor tendon function due to flexor adhesions were treated by excision of the flexor digitorum superficialis tendons. During the procedure the carpal canal pressure was measured using a continuous infusion technique. The preoperative mean carpal canal pressure was 81 (SD, 53)mmHg. After removal of all the flexor digitorum superficialis tendons, the carpal canal pressure decreased to 10 (SD, 8)mmHg. The clinical symptoms of carpal tunnel syndrome were relieved and hand strength and finger motion were improved in all patients.

Carpal Tunnel Syndrome↗

A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor.

OBJECTIVE: To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand. BACKGROUND: Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor. METHODS: One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer. RESULTS: Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness. CONCLUSION: Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.

Aged↗

Using the coefficient of variation to detect sincerity of effort of grip strength: a literature review.

Many clinicians use the coefficient of variation (CV) to assess sincerity of effort, without understanding the premise on which it is based or its physiological and mathematical bases. Clinicians who use computerized evaluation systems that calculate the CV may not even be aware of the formula used to derive it. The wide use of the CV in detecting sincerity of effort of grip strength is puzzling, since it lacks empirical support in the literature. This paper examines the physiological rationale for using measures of variability to detect sincerity of effort, the mathematical basis on which the CV is founded, and the reliability and validity of the CV. The conclusions based on this literature review are that the CV is not an appropriate method for determining whether an effort is sincere and that CV values may be inflated in injured patients with compromised hand strength.

Diagnosis, Computer-Assisted↗

Characteristics of tremor in normal subjects and in the diagnosis and treatment of Parkinsonism.

Tensotremorography was used to record voluntary forces and to study the characteristics of the involuntary and voluntary components of isometrically recorded hand strength. The frequency ranges for changes in the spectral density of oscillations recorded here supported the existence of two suprasegmental systems associated with voluntary control and continuous regulation of force maintaining or holding a posture. Cross-correlation analysis of hand force maintained in conditions of visual feedback in normal conditions and in conditions of central disorders of the movement control system is presented.

Basal Ganglia↗

Compression of the ulnar nerve at the elbow by an intraneural ganglion.

A rare cause of ulnar nerve compression at the elbow is presented in this report. A 42 year old right-handed mechanic developed subacute, progressive numbness, tingling and weakness in his right hand. Electrophysiologic studies demonstrated a severe conduction block affecting the ulnar nerve in the retrotrochlear groove but without any sign of major axonal loss. His hand functions were carefully studied prior to surgery. While fine motor tasks were not affected, the hand strength was markedly diminished. At surgery, a 1-cm diameter intraneural ganglion at the site of the conduction block was found and excised. The patient made a dramatic recovery within 6 weeks post-surgery. The conduction block completely resolved and the hand functions also returned to normal. This and other reported cases point to the importance of early diagnosis and intervention.

Adult↗

The effects of socioeconomic status on hand size and strength, vestibular function, visuomotor integration, and praxis in preschool children.

Differences in hand size and strength, vestibular function, visuomotor integration, and praxis in preschool children as a function of socioeconomic status were investigated. Twenty-two children of lower socioeconomic status, aged 3 to 5 years, were each matched with a child of higher socioeconomic status on the basis of race, sex, hand dominance, age, height, and weight. Measures used were the Developmental Test of Visual-Motor Integration (Beery, 1982), hand size and strength, the Standing Balance subtests of the Southern California Sensory Integration Tests (Ayres, 1972), the Bowman Unilateral Hopping Test (Flannigan, 1987), the Southern California Postrotary Nystagmus Test (Ayres, 1975), the praxis tests of the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1984), and the Bowman Quality of Prone Extension Scale (Etheredge, 1987). Analyses with two separate Hotelling's T2 for correlated samples (Huck, Cormier, & Bounds, 1974) revealed significant differences in hand size and strength as well as praxis, and subsequent post hoc analyses revealed better scores for the higher socioeconomic status group on right hand strength and on the Praxis on Verbal Command subtest of the SIPT. A paired t test also revealed that the higher socioeconomic status group scored better on visuomotor integration. Analysis with Hotelling's T2 revealed no significant differences between the two groups on the vestibular measures. The results of this study suggest that on certain tests used by occupational therapists, children from a higher socioeconomic status group may function at a higher developmental level than those from a lower socioeconomic status group. When interpreting clients' test results, therefore, therapists should consider the possible influence of socioeconomic status.

Child Development↗

[The efficiency of home and outpatient exercise program in patients with rheumatoid arthritis].

OBJECTIVE: To compare the efficiency of home and outpatient exercise program in patients with rheumatoid arthritis. METHODS: Patients with rheumatoid arthritis were randomly assigned to home exercise program group and outpatient exercise program group. Variables of muscle and hand strength, joint mobility, visual analog scale of pain were assessed before and after the 3 months exercise course. RESULTS: Out of 43 patients, 31 completed the study. Both groups improved in measures of muscle strength, joint mobility and pain. Differences between groups were statistically significant for measures of grip strength in the home exercise group (p=0.0001), and joint mobility--in the outpatient exercise group (p=0.047). CONCLUSIONS: Exercise program was more effective in improving grip strength in the home exercise program group and joint mobility improved more in the outpatient exercise group.

Adult↗

The application of force-sensing resistor sensors for measuring forces developed by the human hand.

Most attempts to measure forces developed by the human hand have been implemented by placing force sensors on the object of interaction. Other researchers have placed sensors just on the subject's fingertips. In this paper, a system is described that measures forces over the entire hand using thin-film sensors and associated electronics. This system was developed by the authors and is able to obtain force readings from up to 60 thin-film sensors at rates of up to 400 samples/s per sensor. The sensors can be placed anywhere on the palm and/or fingers of the hand. The sensor readings, together with a video stream containing information about hand posture, are logged into a portable computer using a multiplexer, analogue-to-digital converter and software developed for the purpose. The system has been successfully used to measure forces involved in a range of everyday tasks such as driving a vehicle, lifting saucepans and hitting a golf ball. In the latter case, results are compared with those from an instrumented golf club. Future applications include the assessment of hand strength following disease, trauma or surgery, and to enable quantitative ergonomic investigations.

Activities of Daily Living↗

The physiology of rock climbing.

In general, elite climbers have been characterised as small in stature, with low percentage body fat and body mass. Currently, there are mixed conclusions surrounding body mass and composition, potentially because of variable subject ability, method of assessment and calculation. Muscular strength and endurance in rock climbers have been primarily measured on the forearm, hand and fingers via dynamometry. When absolute hand strength was assessed, there was little difference between climbers and the general population. When expressed in relation to body mass, elite-level climbers scored significantly higher, highlighting the potential importance of low body mass. Rock climbing is characterised by repeated bouts of isometric contractions. Hand grip endurance has been measured by both repeated isometric contractions and sustained contractions, at a percentage of maximum voluntary contraction. Exercise times to fatigue during repeated isometric contractions have been found to be significantly better in climbers when compared with sedentary individuals. However, during sustained contractions until exhaustion, climbers did not differ from the normal population, emphasising the importance of the ability to perform repeated isometric forearm contractions without fatigue becoming detrimental to performance. A decrease in handgrip strength and endurance has been related to an increase in blood lactate, with lactate levels increasing with the angle of climbing. Active recovery has been shown to provide a better rate of recovery and allows the body to return to its pre-exercised state quicker. It could be suggested that an increased ability to tolerate and remove lactic acid during climbing may be beneficial. Because of increased demand placed upon the upper body during climbing of increased difficulty, possessing greater strength and endurance in the arms and shoulders could be advantageous. Flexibility has not been identified as a necessary determinant of climbing success, although climbing-specific flexibility could be valuable to climbing performance. As the difficulty of climbing increases, so does oxygen uptake (VO(2)), energy expenditure and heart rate per metre of climb, with a disproportionate rise in heart rate compared with VO(2). It was suggested that these may be due to a metaboreflex causing a sympathetically mediated pressor response. In addition, climbers had an attenuated blood pressure response to isometric handgrip exercises when compared with non-climbers, potentially because of reduced metabolite build-up causing less stimulation of the muscle metaboreflex. Training has been emphasised as an important component in climbing success, although there is little literature reviewing the influence of specific training components upon climbing performance. In summary, it appears that success in climbing is not related to individual physiological variables but is the result of a complex interaction of physiological and psychological factors.

Anthropometry↗