scholarly journals Impact of Handedness on Disability After Unilateral Upper-Extremity Peripheral Nerve Disorder

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 327-334
Author(s):  
Benjamin A. Philip ◽  
Vicki Kaskutas ◽  
Susan E. Mackinnon
Keyword(s):  
Health Status ◽  
Peripheral Nerve ◽  
Upper Extremity ◽  
Dominant Hand ◽  
Disability And Health ◽  
Peripheral Nerve Disorder ◽  
Standardized Measures ◽  
Nondominant Hand ◽  
Alternative Measures ◽  
Dash Questionnaire

Background: Impairment of the dominant hand should lead to greater disability than impairment of the nondominant hand, but few studies have tested this directly, especially in the domain of upper-extremity peripheral nerve disorder. The aim of this study was to identify the association between hand dominance and standardized measures of disability and health status after upper-extremity peripheral nerve disorder. Methods: An existing database was reanalyzed to identify the relationship between affected-side (dominant vs nondominant) on individuals with unilateral upper-extremity peripheral nerve disorder (N = 400). Primary measure of disability was the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: We found no differences in standardized measures of disability or health status between patients with affected dominant hand and patients with an affected nondominant hand. However, a post hoc exploratory analysis revealed that patients with an affected dominant hand reported substantially reduced ability to perform 2 activities in the DASH questionnaire: “write” and “turn a key.” Conclusions: Following unilateral upper-extremity peripheral nerve disorder, impairment of the dominant hand (compared with impairment of the nondominant hand) is associated with reduced ability to perform specific activities, but this reduced ability is not reflected in standardized measures of disability and health status. To adequately identify disability following unilateral impairment of the dominant hand with the DASH, individual items must be used instead of the total score. New or alternative measures are also recommended.

scholarly journals Functional improvement in hand strength and dexterity after surgical treatment of cervical spondylotic myelopathy: a prospective quantitative study

2020 ◽  
Vol 32 (6) ◽  
pp. 907-913
Author(s):  
Tyler S. Cole ◽  
Kaith K. Almefty ◽  
Jakub Godzik ◽  
Amy H. Muma ◽  
Randall J. Hlubek ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Grip Strength ◽  
Upper Extremity ◽  
Cervical Spondylotic Myelopathy ◽  
Hand Function ◽  
Hand Strength ◽  
Pinch Strength ◽  
Dominant Hand ◽  
Nondominant Hand ◽  
The Impact

OBJECTIVECervical spondylotic myelopathy (CSM) is the primary cause of adult spinal cord dysfunction. Diminished hand strength and reduced dexterity associated with CSM contribute to disability. Here, the authors investigated the impact of CSM severity on hand function using quantitative testing and evaluated the response to surgical intervention.METHODSThirty-three patients undergoing surgical treatment of CSM were prospectively enrolled in the study. An occupational therapist conducted 3 functional hand tests: 1) palmar dynamometry to measure grip strength, 2) hydraulic pinch gauge test to measure pinch strength, and 3) 9-hole peg test (9-HPT) to evaluate upper extremity dexterity. Tests were performed preoperatively and 6–8 weeks postoperatively. Test results were expressed as 1) a percentile relative to age- and sex-stratified norms and 2) achievement of a minimum clinically important (MCI) difference. Patients were stratified into groups (mild, moderate, and severe myelopathy) based on their modified Japanese Orthopaedic Association (mJOA) score. The severity of stenosis on preoperative MRI was graded by three independent physicians using the Kang classification.RESULTSThe primary presenting symptoms were neck pain (33%), numbness (21%), imbalance (12%), and upper extremity weakness (12%). Among the 33 patients, 61% (20) underwent anterior approach decompression, with a mean (SD) of 2.9 (1.5) levels treated. At baseline, patients with moderate and low mJOA scores (indicating more severe myelopathy) had lower preoperative pinch (p < 0.001) and grip (p = 0.01) strength than those with high mJOA scores/mild myelopathy. Postoperative improvement was observed in all hand function domains except pinch strength in the nondominant hand, with MCI differences at 6 weeks ranging from 33% of patients in dominant-hand strength tests to 73% of patients in nondominant-hand dexterity tests. Patients with moderate baseline mJOA scores were more likely to have MCI improvement in dominant grip strength (58.3%) than those with low mJOA scores/severe myelopathy (30%) and high mJOA scores/mild myelopathy (9%, p = 0.04). Dexterity in the dominant hand as measured by the 9-HPT ranged from < 1 in patients with cord signal change to 15.9 in patients with subarachnoid effacement only (p = 0.03).CONCLUSIONSPatients with CSM achieved significant improvement in strength and dexterity postoperatively. Baseline strength measures correlated best with the preoperative mJOA score; baseline dexterity correlated best with the severity of stenosis on MRI. The majority of patients experienced MCI improvements in dexterity. Baseline pinch strength correlated with postoperative mJOA MCI improvement, and patients with moderate baseline mJOA scores were the most likely to have improvement in dominant grip strength postoperatively.

scholarly journals Association Between Upper-Extremity Health Condition and Depressive Status in an Elderly General Population

2021 ◽  
Vol 58 ◽  
pp. 004695802110599
Author(s):  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Noboru Oya ◽  
Fumitaka Endo ◽  
Hitoshi Shitara ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Health Status ◽  
General Population ◽  
Upper Extremity ◽  
Elderly People ◽  
Depression Scale ◽  
Health Condition ◽  
Illness Behavior ◽  
Psychological Status ◽  
Dominant Hand

Background: This study was designed to investigate whether psychological status is associated with upper-extremity health status in an elderly general population. Methods: Using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand (QuickDASH-JSSH), we evaluated 200 Japanese elderly people (76 men, 124 women; mean age, 71.6 years, 60-98 years) to assess their upper-extremity-specific health status. Each had completed a self-administered questionnaire including gender and dominant hand items. As an indicator of hand muscle function, we measured their bilateral hand grip. Study participants were assessed for depressive symptoms using the Geriatric Depression Scale Short-Japanese Version (GDS-S-J). Statistical analyses were applied to clarify associations between self-assessed upper-extremity dysfunction and screening results for depressive symptoms in an elderly general population. Results: Those reporting no complaint of an upper extremity were 72 (36 men and 36 women) (36.0%). The GDS-J score was found to have significant positive correlation with age ( r = 0.20, P= 0.0045) and the QuickDASH score ( r = 0.25, P = 0.0004). The GDS-J score was found to have significant negative correlation with dominant grip ( r = −0.15, P = 0.04) and non-dominant grip strength ( r = −0.21, P = 0.004). For all participants, multiple regression analysis revealed the QuickDASH score as associated with the GDS-J score. Conclusion: Self-administered upper-extremity health condition as assessed using QuickDASH is correlated with depressive symptoms in elderly people. Objective pathophysiology and subjective illness behavior must be identified in daily clinical practice. A biopsychosocial approach must be used when advising and treating patients.

scholarly journals Relationships Among Manual Body Functions, Manual Capacity, and Bimanual Performance Using the Prosthetic Upper Extremity Functional Index in Children With Congenital Hand Differences

2014 ◽  
Vol 94 (6) ◽  
pp. 767-775 ◽  
Author(s):  
Monique S. Ardon ◽  
Wim G.M. Janssen ◽  
Steven E.R. Hovius ◽  
Henk J. Stam ◽  
Magdalena Murawska ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Hand Function ◽  
Surgical Techniques ◽  
Pinch Strength ◽  
Dominant Hand ◽  
Functional Index ◽  
Cross Sectional ◽  
Nondominant Hand ◽  
Bimanual Performance ◽  
Cross Sectional Design

Background Most surgical techniques intervene at the level of body functions of the upper limb, aiming to improve manual capacity and activity performance. However, the nature of the relationships among these levels of functioning and evidence for hand function variables predicting performance have scarcely been investigated. Objective The primary aim of this study was to assess aspects of hand function and manual capacity that influence bimanual performance in children with congenital hand differences (CHDs), ranging from surgically corrected polydactyly or syndactyly to radial dysplasia. A secondary aim was to assess whether the number of items on the Prosthetic Upper Extremity Functional Index (PUFI) can be reduced without losing information on bimanual performance in this population. Design A cross-sectional design was used. Methods One hundred six 10- to 14-year-old children with CHD participated in the study, which was conducted in a university hospital's outpatient clinic. Bimanual performance was evaluated with child self-reports on an adapted version of the PUFI, calculating ease of performance and actual use of the affected hand. Additionally, hand function and manual capacity were assessed. Results The median score on ease of performance was high, and, on average, the children used their affected hand actively in 97% of all activities. Manual capacity of the nondominant hand and lateral pinch strength of the dominant hand predicted attainment of maximum PUFI scores. Nonmaximum PUFI scores were predicted by opposition strength of the nondominant hand and lateral pinch strength of the dominant hand. In addition, in this patient group, only 6 items of the PUFI explained all variance in PUFI scores. Limitations The generalizability of the results is limited by the carefully selected age range. Second, the cross-sectional design of the study limits statements on causality on the relationships found. Conclusion Children with a CHD generally have good bimanual performance and, on average, perform activities with active use of the affected hand. Therapy directed toward increasing manual capacity and finger muscle strength might assist in improving bimanual performance in children with CHD. Furthermore, the number of items on the PUFI could be reduced from 38 to 6 items in children with CHD.

Evaluating Shoulder Impairment

1998 ◽  
Vol 3 (5) ◽  
pp. 1-3
Author(s):  
Richard T. Katz ◽  
Sankar Perraraju
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Sensory Loss ◽  
Motor Deficits ◽  
Nerve Lesion ◽  
Fourth Edition ◽  
Specific Patient ◽  
Industrial Medicine ◽  
Shoulder Motion ◽  
Upper Extremity Impairment

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, offers several categories to describe impairment in the shoulder, including shoulder amputation, abnormal shoulder motion, peripheral nerve disorders, subluxation/dislocation, and joint arthroplasty. This article clarifies appropriate methods for rating shoulder impairment in a specific patient, particularly with reference to the AMA Guides, Section 3.1j, Shoulder, Section 3.1k, Impairment of the Upper Extremity Due to Peripheral Nerve Disorders, and Section 3.1m, Impairment Due to Other Disorders of the Upper Extremity. A table shows shoulder motions and associated degrees of motion and can be used in assessing abnormal range of motion. Assessments of shoulder impairment due to peripheral nerve lesion also requires assessment of sensory loss (or presence of nerve pain) or motor deficits, and these may be categorized to the level of the spinal nerves (C5 to T1). Table 23 is useful regarding impairment from persistent joint subluxation or dislocation, and Table 27 can be helpful in assessing impairment of the upper extremity after arthroplasty of specific bones of joints. Although inter-rater reliability has been reasonably good, the validity of the upper extremity impairment rating has been questioned, and further research in industrial medicine and physical disability is required.

Screwdriver torque strength and physiological cost of muscles dependent on hand preference and direction of rotation

1998 ◽  
Vol 1 (1) ◽  
pp. 13-22
Author(s):  
Helmut Strasser ◽  
Baoquiu Wang
Keyword(s):  
Hand Preference ◽  
Dominant Hand ◽  
Muscle Forces ◽  
Maximum Torque ◽  
Physiological Cost ◽  
Nondominant Hand ◽  
Physiological Differences ◽  
Torque Values ◽  
The Right

The focus of this research was to investigate how maximum torque and muscle forces were affected by pronation and supination, i.e., inward and outward rotation of the forearm in a series of screwdriver tests with 6 varied handles. Consecutively, maximum torque for pronation and supination was determined, submaximum isometric levels of torque were demanded, and, finally, an equal dynamic screwing work for all subjects was simulated. Physiological cost of performance was simultaneously measured by registrations of electromyographic activities (EA) from 4 muscles, which were expected to be involved intensively in screwing tasks. Significant and essential differences between maximum torque values produced by pronation and supination of the right and the left arm of the mainly right-handed subjects were found. For clockwise work, as it is necessary e.g., for driving in screws, inward rotations (pronations) of the nondominant hand are at least as strong as outward rotations of the dominant hand. Differences of about 8% favour of pronations were found. Yet, for counter clockwise work involved e.g., in removing a tightened screw, inward rotations of the dominant hand yielded a much more stronger torque strength than outward rotations of the nondominant hand. Differences of more than 50% right-handed subjects were measured. Also, EA values of the 4 muscles monitored on the right arm differed significantly. Systematically operational and physiological differences due to the varied screwdriver grips, as results of investigations which were not the main objective of the study, corresponded well with the findings of prior studies.

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