scholarly journals Fine adaptive precision grip control without maximum pinch strength changes after upper limb neurodynamic mobilization

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Frédéric Dierick ◽  
Jean-Michel Brismée ◽  
Olivier White ◽  
Anne-France Bouché ◽  
Céline Périchon ◽  
...  
Keyword(s):  
Median Nerve ◽  
Upper Limb ◽  
Precision Grip ◽  
Pinch Strength ◽  
Pressure Sensation

AbstractBefore and immediately after passive upper limb neurodynamic mobilizations targeting the median nerve, grip ($$G_F$$ G F ) and load ($$L_F$$ L F ) forces applied by the thumb, index and major fingers (three-jaw chuck pinch) were collected using a manipulandum during three different grip precision tasks: grip-lift-hold-replace (GLHR), vertical oscillations (OSC), and vertical oscillations with up and down collisions (OSC/COLL/u, OSC/COLL/d). Several parameters were collected or computed from $$G_F$$ G F and $$L_F$$ L F . Maximum pinch strength and fingertips pressure sensation threshold were also examined. After the mobilizations, $$L_F$$ L F max changes from 3.2 ± 0.4 to 3.4 ± 0.4 N (p = 0.014), d$$G_F$$ G F from 89.0 ± 66.6 to 102.2 ± 59.6 $$N~\text{s}^{-1}$$ N s - 1 (p = 0.009), and d$$L_F$$ L F from 43.6 ± 17.0 to 56.0 ± 17.9 $$N~\text{s}^{-1}$$ N s - 1 ($$p<$$ p < 0.001) during GLHR. $$L_F$$ L F SD changes from 0.9 ± 0.3 to 1.0 ± 0.2 N (p = 0.004) during OSC. $$L_F$$ L F peak changes from 17.4 ± 8.3 to 15.1 ± 7.5 N ($$p<$$ p < 0.001), $$G_F$$ G F from 12.4 ± 6.7 to 11.3 ± 6.8 N (p = 0.033), and $$L_F$$ L F from 2.9 ± 0.4 to 3.00 ± 0.4 N (p = 0.018) during OSC/COLL/u. $$G_F$$ G F peak changes from 13.5 ± 7.4 to 12.3 ± 7.7 N (p = 0.030) and $$L_F$$ L F from 14.5 ± 6.0 to 13.6 ± 5.5 N (p = 0.018) during OSC/COLL/d. Sensation thresholds at index and thumb were reduced (p = 0.001, p = 0.008). Precision grip adaptations observed after the mobilizations could be partly explained by changes in cutaneous median-nerve pressure afferents from the thumb and index fingertips.

scholarly journals Fine adaptive control of precision grip without maximum pinch strength changes after median nerve mobilization

2020 ◽  
Author(s):  
Frédéric Dierick ◽  
Jean-Michel Brismée ◽  
Olivier White ◽  
Anne-France Bouché ◽  
Céline Périchon ◽  
...  
Keyword(s):  
Adaptive Control ◽  
Time Delay ◽  
Median Nerve ◽  
Precision Grip ◽  
Pinch Strength ◽  
Longitudinal Tension ◽  
First Time ◽  
Pressure Sensation

ABSTRACTFine dexterity critically depends on information conveyed by the median nerve. While the effects of its compression and vibration are well characterized, little is known about longitudinal tension and excursion. Using a force-sensitive manipulandum, a numeric dynamometer and Semmes-Weinstein monofilaments, we examined the adaptations of precision grip control, maximum pinch strength and fingertips pressure sensation threshold before and immediately after the application of longitudinal tension and excursion mobilizations applied on the median nerve. Grip (GF) and load (LF) forces applied by the thumb, index and major fingers were collected in 40 healthy young participants during three different grip precision tasks along the direction of gravity. For grip-lift-drop task, maximum GF and LF and their first time derivatives were computed. For up-down oscillations, means of GF and LF and their variability were computed. For oscillations with up and down collisions, peaks of GF and LF, time delay between GF peak and contact, and values of GF and LF at contact were collected. Our findings show that median nerve mobilizations induce significant fine adaptations of precision grip control in the three different tasks but mainly during grip-lift-drop and oscillations with collisions. Fingertips pressure sensation thresholds at index and thumb were significantly reduced after the mobilizations. No significant changes were observed for maximum pinch strength. We conclude that precision grip adaptations observed after median mobilizations could be partly explained by changes in cutaneous median-nerve mechanoreceptive afferents from the thumb and index fingertips.

Pseudogout of the Wrist Presenting as Acute Median Nerve Compression

1985 ◽  
Vol 10 (2) ◽  
pp. 261-262
Author(s):  
D. R. A. GOODWIN ◽  
R. ARBEL
Keyword(s):  
Median Nerve ◽  
Upper Limb ◽  
Calcium Pyrophosphate ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Septic Condition

Two cases are reported of acute median nerve compression due to calcium pyrophosphate deposition in the wrist, masquerading as a septic condition. There have been recent reports in the literature of the effects of calcium pyrophosphate in joints of the upper limb (Resnick 1983 and Hensley, 1983) These conditions are uncommon and the presentation and initial symptomatology of our case led in the first patient to misdiagnosis and an unnecessary operation, which was avoided in the second case.

scholarly journals Formation, trajectory and distribution variants of the median nerve of the fetus

2017 ◽  
Vol 23 (3) ◽  
pp. 142-149
Author(s):  
I. S. Tudorache ◽  
P. Bordei ◽  
D. M. Iliescu
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Lateral Root ◽  
Axillary Artery ◽  
Single Case ◽  
Musculocutaneous Nerve ◽  
Single Nerve ◽  
Nerve Fascicle ◽  
Medial Nerve

AbstractOur study was performed by dissection on a number of 54 nervous trunks of the median nerve of the fetus. We found that the median nerve is always formed from two roots, their joining being at different levels of the upper limb, between the axilla and the elbow. The axilla nerve trunk was formed at the level of the axillary region, in 38.89% of the cases, in 22.22% of the cases the union was made at the middle part of the arm, and in 38.89% of the cases in the elbow. The lateral root of the medial nerve was formed in 55.56% of cases from a single nerve fascicle, in 44.44% of cases consisting of two nerve fascicles. The medial root was formed in 61.11% of cases from a single nerve fascicle, in 38.89% of the cases being made up of two nerve fascicles. In 27.78% of cases, the medial root passed behind the axillary artery. Regarding the volume of the two roots, we found that in 44.44% of the cases, the lateral root was more voluminous, in 27.78% of cases, the median root was larger and in 27.78% of cases, the two roots were approximately equal. We have encountered situations where a ramification for the forearms muscles emerged from the lateral root. Occasionally, a ram for the brachial muscle was detached from the medial root, and from the lateral root a ram for the biceps muscle, both muscles receiving branches also from the musculocutaneous nerve. We have encountered a single case where the median nerve inches the anterior muscles of the arm, missing the musculocutaneous nerve. In cases of low joining of the roots, we have encountered cases where a lateral root formed a ram for forearm muscles. The anastomoses between the two median nerve roots can sometimes be located just above their union or anterior to the lower portion of the axillary artery. In one case, we encountered between the two roots, above their union, the existence of three oblique anastomoses, the two upper ones from the lateral to the medial root, and the third from the medial root to the lateral root. Common are anastomoses between the roots of the roots and the root on the opposite side. The most common are the anastomosis between the medial fascicle of the lateral root and the medial root of the median nerve. In one case, we encountered a double overlap between the musculocutaneous nerve and the lateral nerve root. In one case, we encountered a strong anastomosis between the medial nerve fascicle of the medial root and the radial nerve. Common and at all levels of the upper limb are the anastomoses between the median and ulnar nerves. In the case of a low union of the two median roots, we encountered anastomoses between a root of the root and the ulnar nerve, or between a root and the ulnar nerve. I encountered a single case with an anastomosis, Martin- Gruber, which was previously passing through the ulnar and interos-like arteries and from which the anterior forearm muscles were detached.

Toward Consensus in Assessing Upper Limb Muscle Strength and Pinch and Grip Strength in People With Tetraplegia Having Upper Limb Reconstructions

2021 ◽  
Author(s):  
Jennifer A. Dunn ◽  
Sabrina Koch-Borner ◽  
M. Elise Johanson ◽  
Johanna Wangdell
Keyword(s):  
Grip Strength ◽  
Upper Limb ◽  
Manual Muscle Testing ◽  
Pinch Strength ◽  
Consensus Methods ◽  
Serratus Anterior ◽  
Multicenter Studies ◽  
International Consensus ◽  
Muscle Testing ◽  
Upper Limb Surgery

Objectives: To reach agreement on standardized protocols for assessing upper limb strength and grip and pinch force for upper limb reconstructive surgery for tetraplegia. Methods: Selected members of an expert panel composed of international therapists formed at the 2018 International Congress for Upper Limb Surgery for Tetraplegia conducted a literature review of current practice that identified gaps and inconsistencies in measurement protocols and presented to workshop attendees. To resolve discrepancies, a set of questions was presented to workshop attendees who voted electronically. Consensus was set at 75% agreement. Results: For manual muscle testing, consensus was reached for using the Medical Research Council scale, without plus or minus, and the use of resistance through range when testing grade 4 and grade 5 strength. Pectoralis major and serratus anterior should be routinely tested, however there was no consensus on other shoulder muscles. Grip and pinch strength should be tested according to the American Society of Hand Therapists positioning. For grip strength, either the Jamar or Biometrics dynamometer expressed in kilograms should be used. For grip and pinch strength, three measurements should be performed at each testing. No consensus was reached on a device for pinch strength. Conclusion: This work is an important step to enable comparable data in the future. Further consensus methods will work toward developing more comprehensive guidelines in this population. Building international consensus for pre- and postoperative measures of function supports objective evaluation of novel therapies and interpretation of multicenter studies.

Saint Anthony'S Fire Or Carpal Tunnel Syndrome?

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Brian Fitzgerald
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Upper Limb ◽  
Carpal Tunnel ◽  
Unusual Feature ◽  
Limb Ischaemia ◽  
Median Nerve Neuropathy ◽  
Tunnel Syndrome

Summary A case of unilateral upper limb ischaemia from ergot overdosage is presented. An unusual feature was a median nerve neuropathy suggestive of carpal tunnel syndrome. The arteriographic appearances are demonstrated and management discussed.

scholarly journals Acute Upper Limb Ischemia Due to Delayed Presentation of a Brachial Artery Pseudoaneurysm Post-Venipuncture

2019 ◽  
Vol 54 (1) ◽  
pp. 80-84 ◽  
Author(s):  
Adele H. H. Lee ◽  
Sara D. Qi ◽  
Nathaniel Chiang
Keyword(s):  
Median Nerve ◽  
Upper Limb ◽  
Brachial Artery ◽  
Limb Ischemia ◽  
High Morbidity ◽  
Delayed Presentation ◽  
Artery Pseudoaneurysm ◽  
Hand Ischemia ◽  
Iatrogenic Trauma ◽  
Median Nerve Neuropathy

Brachial artery pseudoaneurysms (BAPs) are rare but could lead to complications of high morbidity. We report a case of a BAP presenting with hand ischemia and median nerve neuropathy nearly a decade after the inciting iatrogenic trauma, successfully treated with excision and direct repair. This report highlights that untreated pseudoaneurysms can be indolent and present late with both symptoms of embolization and local compression.

scholarly journals Cortical Oscillations in Cervical Dystonia and Dystonic Tremor

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Christopher W Hess ◽  
Bryan Gatto ◽  
Jae Woo Chung ◽  
Rachel L M Ho ◽  
Wei-en Wang ◽  
...  
Keyword(s):  
Upper Limb ◽  
Sensorimotor Cortex ◽  
Cervical Dystonia ◽  
General Pattern ◽  
Precision Grip ◽  
Head Movements ◽  
Therapeutic Interventions ◽  
Beta Band ◽  
Head Turning ◽  
Dystonic Tremor

Abstract Dystonia involves sustained or repetitive muscle contractions, affects different skeletal muscles, and may be associated with tremor. Few studies have investigated if cortical pathophysiology is impaired even when dystonic muscles are not directly engaged and during the presence of dystonic tremor (DT). Here, we recorded high-density electroencephalography and time-locked behavioral data in 2 cohorts of patients and controls during the performance of head movements, upper limb movements, and grip force. Patients with cervical dystonia had reduced movement-related desynchronization in the alpha and beta bands in the bilateral sensorimotor cortex during head turning movements, produced by dystonic muscles. Reduced desynchronization in the upper beta band in the ipsilateral motor and bilateral sensorimotor cortex was found during upper limb planar movements, produced by non-dystonic muscles. In a precision grip task, patients with DT had reduced movement-related desynchronization in the alpha and beta bands in the bilateral sensorimotor cortex. We observed a general pattern of abnormal sensorimotor cortical desynchronization that was present across the head and upper limb motor tasks, in patients with and without DT when compared with controls. Our findings suggest that abnormal cortical desynchronization is a general feature of dystonia that should be a target of pharmacological and other therapeutic interventions.

scholarly journals Assessment of the strength of the trunk and upper limb muscles in stroke subjects with portable dynamometry: a literature review

2015 ◽  
Vol 28 (1) ◽  
pp. 169-186 ◽  
Author(s):  
Júlia Caetano Martins ◽  
Luci Fuscaldi Teixeira-Salmela ◽  
Larissa Tavares Aguiar ◽  
Lucas Araújo Castro e Souza ◽  
Eliza Maria Lara ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Upper Limb ◽  
Psychometric Property ◽  
Trunk Muscles ◽  
Pinch Strength ◽  
Elbow Flexors ◽  
Extensive Search ◽  
Limb Muscles ◽  
Clinical Measurements ◽  
Adequate Reliability

Introduction Clinical measurements of strength in stroke subjects are usually performed and portable dynamometers are one of the most employed instruments. Objective To verify the standardization procedures of the methods used to assess the strength of the trunk and upper limb muscles with portable dynamometers in stroke subjects, as well as to assess the psychometric properties which were already investigated. Materials and methods An extensive search was performed on the MEDLINE, SciELO, LILACS, and PEDro databases, by combining specific key words, followed by active manual searches by two independent researchers. Results and discussion Fifty-eight studies were included: three related to the trunk and 55 to the upper limb muscles, including handgrip and pinch strength assessments. The most investigated muscular groups were handgrip, elbow flexors/extensors, wrist extensors, and lateral pinch. Nine studies reported adequate reliability levels and the seated position was employed in the majority of the studies which assessed trunk, handgrip, and pinch strength, while the supine position was used for the other muscular groups. The number of trials most used was three, while the reported contractions and rest times were variable. Final considerations Most studies reported the positioning and/or the data collection protocols; however, there was no consensus on the standardization procedures. The only investigated psychometric property was reliability. Few studies evaluated the trunk muscles and other psychometric properties.

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