Limitations of Wrist Strength to Manual Exertion Capability in 2D Biomechanical Modeling

1994 ◽  
Vol 38 (10) ◽  
pp. 559-563 ◽  
Author(s):  
Khaled W. Al-Eisawi ◽  
Carter J. Kerk ◽  
Jerome J. Congleton
Keyword(s):  
Elbow Flexion ◽  
Biomechanical Modeling ◽  
Wrist Flexion ◽  
Ulnar Deviation ◽  
Biomechanical Models ◽  
Radial Deviation ◽  
Flexion Extension ◽  
Flexion Strength ◽  
Theoretical Minimum

The objective of this study is to evaluate the assumption in biomechanical models that wrist strength does not limit manual exertion capability. An experiment was designed and run on right-handed males to test isometric elbow flexion strength at two included elbow angles: 90° and 135° and in two forearm positions: supinated and mid between supination and pronation. Isometric wrist flexion strength was also measured at the same elbow angles and at two wrist positions in the flexion/extension plane: neutral and 45° extended. Isometric wrist radial deviation strength was measured at the same two elbow angles and at two wrist positions in the radial/ulnar deviation plane: neutral and 30° ulnarly deviated. An equation was developed to calculate the theoretical minimum wrist strength limits for which wrist strength does not limit maximal moments about the elbow. These calculated limits were compared to the corresponding measured wrist strength moments. In general, wrist strength was found to be non-limiting, but in some specific circumstances, it can be limiting. Among the posture/exertion combinations tested, only wrist flexion strength in the extended wrist posture was found to be limiting. There was some evidence that strong-wrist people show less wrist strength limitations than weak-wrist people in some postures. It was also found that the neutral wrist posture is not associated with the highest wrist strength.

Wrist strength limitations to manual exertion capability

1998 ◽  
Vol 1 (2) ◽  
pp. 107-121
Author(s):  
Khaled W. Al-Eisawi ◽  
Carter J. Kerk ◽  
Jerome J. Congleton
Keyword(s):  
Biomechanical Modeling ◽  
Two Dimensional ◽  
Wrist Flexion ◽  
College Age ◽  
Biomechanical Models ◽  
Radial Deviation ◽  
Flexion Strength ◽  
Made In

This study evaluated wrist strength limitations to manual exertion capability in two-dimensional static biomechanical modeling. The researchers hypothesized that wrist strength does not limit manual exertion capability - an assumption commonly made in many strength biomechanical models. An experiment was conducted on 15 right-handed males of college age. Isometric wrist flexion strength was measured at two elbow angles: 90 degree and 135 degree and in two wrist positions: neutral and 45 degree extended. Isometric wrist radial deviation strength was measured at the same two elbow angles and in two wrist positions: neutral and 30 degree ulnarly deviated. Minimum wrist strength limits for which wrist strength does not limit maximal moments about the elbow in manual hand exertions were calculated and compared to their corresponding measured wrist strength moments using paired t-tests. In general, wrist strength was non-limiting. However, wrist flexion strength in the 45 degree extended wrist posture was limiting. Weak-wrist subjects showed more wrist strength limitations than strong-wrist subjects.

Quantification of Hand Grip Force under Dynamic Conditions

1993 ◽  
Vol 37 (10) ◽  
pp. 715-719 ◽  
Author(s):  
Katherine R. Lehman ◽  
W. Gary Allread ◽  
P. Lawrence Wright ◽  
William S. Marras
Keyword(s):  
Grip Force ◽  
Wrist Flexion ◽  
Range Of Movement ◽  
Ulnar Deviation ◽  
Dynamic Conditions ◽  
Radial Deviation ◽  
Hand Grip ◽  
Flexion Extension ◽  
Maximum Grip ◽  
Lower Grip

A laboratory experiment was conducted to determine whether grip force capabilities are lower when the wrist is moved than in a static position. The purpose was to determine the wrist velocity levels and wrist postures that had the most significant effect on grip force. Maximum grip forces of five male and five female subjects were determined under both static and dynamic conditions. The dominant wrist of each subject was secured to a CYBEX II dynamometer and grip force was collected during isokinetic wrist deviations for four directions of motion (flexion to extension, extension to flexion, radial to ulnar, and ulnar to radial). Six different velocity levels were analyzed and grip forces were recorded at specific wrist positions throughout each range of movement. For flexion-extension motions, wrist positions from 45 degrees flexion to 45 degrees extension were analyzed whereas positions from 20 degrees radial deviation to 20 degrees ulnar deviation were studied for radial-ulnar activity. Isometric exertions were also performed at each desired wrist position. Results showed that, for all directions of motion, grip forces for all isokinetic conditions were significantly lower than for the isometric exertions. Lower grip forces were exhibited at extreme wrist flexion and extreme radial and ulnar positions for both static and dynamic conditions. The direction of motion was also found to affect grip strength; extension to flexion exertions produced larger grip forces than flexion to extension exertions and radial to ulnar motion showed larger grip forces than ulnar to radial deviation. Although, males produced larger grip forces than females in all exertions, significant interactions between gender and velocity were noted.

Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review

2014 ◽  
Vol 40 (5) ◽  
pp. 450-457 ◽  
Author(s):  
B. M. Saltzman ◽  
J. M. Frank ◽  
W. Slikker ◽  
J. J. Fernandez ◽  
M. S. Cohen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grip Strength ◽  
Complication Rate ◽  
Contralateral Side ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Non Union ◽  
Radial Deviation ◽  
Hand Grip ◽  
Flexion Extension

We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I–III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11º) versus 43 (SD 11º); wrist flexion, 32 (SD 10º) versus 36 (SD 11º); flexion-extension arc, 62 (SD 14º) versus 75 (SD 10º); radial deviation, 14 (SD 5º) versus 10 (SD 5º); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative radial deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate. Level of evidence: Level III (Level I-III studies), Systematic Review. Therapeutic.

scholarly journals Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Anne Schwarz ◽  
Miguel M. C. Bhagubai ◽  
Saskia H. G. Nies ◽  
Jeremia P. O. Held ◽  
Peter H. Veltink ◽  
...  
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Healthy Subjects ◽  
Peak Velocity ◽  
Movement Time ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Shoulder Flexion ◽  
Flexion Extension

Abstract Background Upper limb kinematic assessments provide quantifiable information on qualitative movement behavior and limitations after stroke. A comprehensive characterization of spatiotemporal kinematics of stroke subjects during upper limb daily living activities is lacking. Herein, kinematic expressions were investigated with respect to different movement types and impairment levels for the entire task as well as for motion subphases. Method Chronic stroke subjects with upper limb movement impairments and healthy subjects performed a set of daily living activities including gesture and grasp movements. Kinematic measures of trunk displacement, shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension, forearm pronation/supination, wrist flexion/extension, movement time, hand peak velocity, number of velocity peaks (NVP), and spectral arc length (SPARC) were extracted for the whole movement as well as the subphases of reaching distally and proximally. The effects of the factors gesture versus grasp movements, and the impairment level on the kinematics of the whole task were tested. Similarities considering the metrics expressions and relations were investigated for the subphases of reaching proximally and distally between tasks and subgroups. Results Data of 26 stroke and 5 healthy subjects were included. Gesture and grasp movements were differently expressed across subjects. Gestures were performed with larger shoulder motions besides higher peak velocity. Grasp movements were expressed by larger trunk, forearm, and wrist motions. Trunk displacement, movement time, and NVP increased and shoulder flexion/extension decreased significantly with increased impairment level. Across tasks, phases of reaching distally were comparable in terms of trunk displacement, shoulder motions and peak velocity, while reaching proximally showed comparable expressions in trunk motions. Consistent metric relations during reaching distally were found between shoulder flexion/extension, elbow flexion/extension, peak velocity, and between movement time, NVP, and SPARC. Reaching proximally revealed reproducible correlations between forearm pronation/supination and wrist flexion/extension, movement time and NVP. Conclusion Spatiotemporal differences between gestures versus grasp movements and between different impairment levels were confirmed. The consistencies of metric expressions during movement subphases across tasks can be useful for linking kinematic assessment standards and daily living measures in future research and performing task and study comparisons. Trial registration: ClinicalTrials.gov Identifier NCT03135093. Registered 26 April 2017, https://clinicaltrials.gov/ct2/show/NCT03135093.

On the Dynamics and Control of a Full Wrist Exoskeleton for Tremor Alleviation

2019 ◽  
Author(s):  
Jiamin Wang ◽  
Oumar Barry ◽  
Andrew J. Kurdila ◽  
Sujith Vijayan
Keyword(s):  
Controller Design ◽  
Human Motion ◽  
Structural Function ◽  
Wrist Flexion ◽  
Unknown Parameters ◽  
Ulnar Deviation ◽  
Marquardt Algorithm ◽  
Flexion Extension ◽  
Dynamics And Control ◽  
And Control

Abstract This paper introduces a novel wearable full wrist exoskeleton designed for the alleviation of tremor in patients suffering from Parkinson’s Disease and Essential Tremor. The design introduces a structure to provide full observation of wrist kinematics as well as actuation in wrist flexion/extension and radial/ulnar deviation. To examine the feasibility of the design, the coupled dynamics of the device and the forearm is modeled via a general multibody framework. The dynamic analysis considers human motion, wrist stiffness, and tremor dynamics. The analysis of the model reveals that the identification of the wrist kinematics is indispensable for the controller design. Nonlinear regression based on the Levenberg-Marquardt algorithm has been applied to estimate the unknown parameters in a kinematic structural function designed to approximate the wrist kinematics, which leads to the construction of the control system framework. Finally, several simulation cases are demonstrated to conclude the study.

scholarly journals Importance of the Wrist Extensor Muscle Training: Two Cases of Elbow Flexorplasty following Traumatic Brachial Plexus Injuries

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Shigeki Kubota ◽  
Tadashi Kubo ◽  
Hiromi Kameda ◽  
Yoshiyasu Itoh
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Postoperative Rehabilitation ◽  
Wrist Extensor ◽  
Antagonist Muscles ◽  
Extensor Muscles ◽  
Muscle Groups ◽  
Flexion Strength

The modified Steindler procedure—a reconstructive surgery used to restore elbow flexion following upper brachial plexus injuries—involves shifting the origins of the muscle groups responsible for wrist flexion and forearm pronation originating from the medial epicondyle to the proximal direction to be used as flexors of the elbow. In the postoperative rehabilitation, we focused on strengthening not only the transferred muscle but also the wrist extensor muscles as antagonist muscles. After reconstruction surgery for elbow flexion via the modified Steindler procedure for traumatic brachial plexus injury, we performed long-term rehabilitation to strengthen the antagonist muscles. As a result, in two cases, excellent elbow flexion strength and gripping strength were achieved, confirming the importance of the antagonist muscles.

scholarly journals Variation of Grip Strength and Wrist Range of Motion with Forearm Rotation in Healthy Young Volunteers Aged 23 to 30

2018 ◽  
Vol 11 (02) ◽  
pp. 088-093 ◽  
Author(s):  
Stacy Fan ◽  
Jeremy Cepek ◽  
Caitlin Symonette ◽  
Douglas Ross ◽  
Shrikant Chinchalkar ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Repeated Measure ◽  
Neutral Position ◽  
Wrist Flexion ◽  
Hand Rehabilitation ◽  
Forearm Rotation ◽  
Ulnar Deviation ◽  
Radial Deviation ◽  
Significant Difference

Abstract Background Grip strength and wrist range of motion (ROM) are important metrics used to evaluate hand rehabilitation and outcomes of wrist interventions. Published normative data on these metrics do not recognize the contribution of forearm rotation. This study aims to identify and quantify variations in grip strength and wrist ROM with forearm rotation in healthy young individuals. Materials and Methods Wrist ROM and grip strength were measured in 30 healthy volunteers aged 23 to 30. Participant demographics, grip strength, and wrist ROM (wrist flexion and extension, ulnar and radial deviation) at three forearm positions (full supination, neutral, and full pronation) were measured using a digital dynamometer and standard goniometers. Data analysis was conducted using a one-way repeated measure ANOVA. Forearm position values were compared using post hoc analysis. Results Grip strength in males was greatest in neutral position (males: nondominant 51.4 kg, dominant 56.1 kg) followed by supination (males: nondominant 46.6 kg, dominant 51.7 kg) and weakest in pronation (males: nondominant 40.1 kg, dominant 42.9 kg). Grip strength in females was similar between supination (nondominant: 26.1 kg, dominant: 28.5 kg) and neutral (nondominant: 27.4 kg, dominant: 29.1 kg) positions, but both were greater than in pronation (nondominant: 22.3 kg, dominant: 24.1 kg). Wrist flexion in males was significantly reduced in supination compared with neutral and pronated positions (nondominant: supination 63.1°, neutral 72.6°, pronation 73.3°; dominant: supination 62.4°, neutral 70.2°, pronation 70.3°), whereas not significant wrist flexion in females was also weaker in supination (supination 74.4°, neutral 79.9°). Wrist extension in males was greater in pronation (supination 64.6°, pronation 69.5°) whereas females showed no significant difference in any of the forearm positions. Ulnar deviation in males did not differ with forearm position, but females demonstrated greater ulnar deviation in supination on the nondominant hand (supination 44.6°, pronation 33.2°). Whereas there was no difference in radial deviation with forearm position in females, it was markedly greater in pronation versus supination on both sides in males (nondominant: supination 16.3°, pronation 24.6°; dominant: supination 15.4°, pronation 23.9°). Conclusion This study characterizes variations in grip strength and wrist ROM in three forearm positions in healthy young individuals. All measurements differed with forearm rotation and were not influenced by hand dominance. These results suggest that wrist ROM and grip strength should be evaluated in different positions of forearm rotation, rather than a fixed position. This has functional implications particularly in patients involved with specialized activities such as sports, instrument-playing, or work-related activities.

Arm Posture and Muscular Activity while Inserting and Aiming with Laparoscopic Tools

2005 ◽  
Vol 49 (14) ◽  
pp. 1399-1403
Author(s):  
Trejo, A.E. Jung ◽  
M.S. Hallbeck
Keyword(s):  
Biceps Brachii ◽  
Muscular Activity ◽  
Elbow Flexion ◽  
Dominant Hand ◽  
Wrist Flexion ◽  
Triceps Brachii ◽  
Upper Trapezius ◽  
Flexion Extension ◽  
Laparoscopic Tools ◽  
Wrist Flexors

Two laparoscopic tools, a scissor-type grasper and an ergonomically designed grasper, were compared in terms of arm posture and muscle activity during insertion into a trocar and during a standardized aiming task. Participants were asked to insert a laparoscopic tool into a simulated abdomen and hit five cross-shaped targets using their dominant hand; similar to reaching an organ during laparoscopic surgery. Twenty-six right-handed novice participants volunteered for the study. Two electrogoniometers were used to measure wrist flexion/extension, wrist deviation, and elbow flexion/extension angles. Six surface electrodes were used to measure %MVE of wrist flexors, wrist extensors, biceps brachii, triceps brachii, deltoid, and upper trapezius. The conditions used were five target positions, two touch screen monitor angles, and five hand postures. The scissors-type tool caused the largest wrist flexion, but the smallest %MVE from the wrist flexors. The method of gripping the tools was the most important factor determining joint angles and muscular load during the insertion and aiming tasks.

Proximal Row Carpectomy through a Palmar Approach

1998 ◽  
Vol 23 (3) ◽  
pp. 406-409 ◽  
Author(s):  
R. LUCHETTI ◽  
O. SORAGNI ◽  
T. FAIRPLAY
Keyword(s):  
Grip Strength ◽  
Slight Reduction ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Ulnar Deviation ◽  
Dynamic Studies ◽  
Palmar Approach ◽  
Flexion Extension ◽  
Subchondral Sclerosis

From 1990 to 1994, nine proximal row carpectomies were done through a palmar approach. With an average follow-up of 20 months, seven of the nine patients were completely painfree. Average range of wrist flexion/extension remained unchanged, and average radial/ulnar deviation increased from 25° to 46°. All the patients demonstrated an increase in grip strength in the operated hand. Four cases showed a slight reduction in articular space and subchondral sclerosis in the radiocapitate articulation, in spite of good function. Dynamic studies demonstrated no sign of radiocarpal instability. All the patients were very satisfied with the results and returned to their previous work within 2 months, on average.

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