The impact of finger position on pinch strength

Introduction Pinch strength is a widely used measurement of hand function, but digit position on the pinch gauge has not been described in the literature. The aim of this study was to assess for differences in tip, lateral, and three-jaw-chuck pinch force when the digits are placed on the groove or bridge of a Bernadette and Linda pinch gauge. Methods Thirty-six healthy volunteers each pinched six times in random order: one for each type of pinch force with the digits placed in each position. Results There were no significant differences in pinch strength measurements based on digit position, except for three-jaw-chuck pinch which was slightly higher on the groove. Equivalence was found within one pound for tip and lateral pinch but not for three-jaw-chuck. Conclusion Variations in finger position may result in similar pinch strength measurements for tip and lateral pinch. Clinicians may reliably assess lateral and tip pinch using either position; however, standardized positioning is still recommended.

Download Full-text

The Impact of Sensory, Motor and Pain Impairments on Patient- Reported and Performance Based Function in Carpal Tunnel Syndrome

The Open Orthopaedics Journal ◽

10.2174/1874325001711011258 ◽

2017 ◽

Vol 11 (1) ◽

pp. 1258-1267 ◽

Cited By ~ 6

Author(s):

Goris Nazari ◽

Niyati Shah ◽

Joy C MacDermid ◽

Linda Woodhouse

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Hand Function ◽

Pinch Strength ◽

Sensory Motor ◽

Tunnel Syndrome ◽

And Performance ◽

Quick Dash ◽

The Impact ◽

Vibration Threshold

Background: Research has suggested that persistent sensory and motor impairments predominate the symptoms experienced by patients with carpal tunnel syndrome (CTS); with intermittent pain symptoms, being less predominant. Objective: The study aims to determine the relative contribution of sensory, motor and pain impairments as contributors to patient-report or performance-based hand function. Methods: Fifty participants with a diagnosis of CTS confirmed by a hand surgeon and electrodiagnosis were evaluated on a single occasion. Impairments were measured for sensibility, pain and motor performance. A staged regression analysis was performed. In the first step, variables with each of the 3 impairment categories were regressed on the Symptom Severity Scale (SSS) to identify the key variables from this domain. Models were created for both self report (Quick Disabilities of arm, shoulder and hand- Quick DASH) and performance based (Dexterity) functional outcomes. Backward regression modelling was performed for SSS and then, to allow comparability of the importance of different impairments across models, the 7 significant variables from the SSS model were forced into the models. Results: Variables: age, touch threshold and vibration threshold of the little finger of unaffected hand, median-ulnar vibration threshold ratio of affected hand, mean pain tolerance of unaffected hand, grip strength and pinch strength of affected hand, explained 31%, 36% and 63% of the variance in SSS, Quick DASH and dexterity scores, respectively. Conclusion: Hand function in patients with CTS is described by variables that reflect sensory status of the median and ulnar nerves, the persons pain threshold, grip and pinch strength impairments and age.

Download Full-text

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

Journal of Neurosurgery Spine ◽

10.3171/2019.10.spine19685 ◽

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.

Download Full-text

Viscoelastometry for detecting oral anticoagulants

Thrombosis Journal ◽

10.1186/s12959-021-00267-w ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Philipp Groene ◽

Daniela Wagner ◽

Tobias Kammerer ◽

Lars Kellert ◽

Andreas Giebl ◽

...

Keyword(s):

Healthy Volunteers ◽

Prospective Observational Study ◽

Oral Anticoagulants ◽

Plasma Concentrations ◽

Factor Xa ◽

Clotting Time ◽

Emergency Situations ◽

Tissue Plasminogen ◽

The Impact

Abstract Background Determination of anticoagulant therapy is of pronounced interest in emergency situations. However, routine tests do not provide sufficient insight. This study was performed to investigate the impact of anticoagulants on the results of viscoelastometric assays using the ClotPro device. Methods This prospective, observational study was conducted in patients receiving dabigatran, factor Xa (FXa)-inhibitors, phenprocoumon, low molecular weight heparin (LMWH) or unfractionated heparin (UFH) (local ethics committee approval number: 17–525-4). Healthy volunteers served as controls. Viscoelastometric assays were performed, including the extrinsic test (EX-test), intrinsic test (IN-test) Russel’s viper venom test (RVV-test), ecarin test (ECA-test), and the tissue plasminogen activator test (TPA-test). Results 70 patients and 10 healthy volunteers were recruited. Clotting time in the EX-test (CTEX-test) was significantly prolonged versus controls by dabigatran, FXa inhibitors and phenprocoumon. CTIN-test was prolonged by dabigatran, FXa inhibitors and UFH. Dabigatran, FXa inhibitors and UFH significantly prolonged CTRVV-test in comparison with controls (median 200, 207 and 289 vs 63 s, respectively; all p < 0.0005). Only dabigatran elicited a significant increase in CTECA-test compared to controls (median 307 vs 73 s; p < 0.0001). CTECA-test correlated strongly with dabigatran plasma concentration (measured by anti-IIa activity; r = 0.9970; p < 0.0001) and provided 100% sensitivity and 100% specificity for detecting dabigatran. Plasma concentrations (anti-XA activity) of FXa inhibitors correlated with CTRVV-test (r = 0.7998; p < 0.0001), and CTRVV-test provided 83% sensitivity and 64% specificity for detecting FXa inhibitors. Conclusions In emergency situations, ClotPro viscoelastometric assessment of whole-blood samples may help towards determining the presence and type of anticoagulant class that a patient is taking. Trial registration German clinical trials database ID: DRKS00015302.

Download Full-text

Impact of Face Masks on 6-Minute Walk Test in Healthy Volunteers

Pulmonary Circulation ◽

10.1177/2045894020988437 ◽

2021 ◽

Vol 11 (1) ◽

pp. 204589402098843

Author(s):

Kevin M. Swiatek ◽

Charnetta Lester ◽

Nicole Ng ◽

Saahil Golia ◽

Janet Pinson ◽

...

Keyword(s):

Healthy Volunteers ◽

Face Mask ◽

Walk Test ◽

Six Minute Walk Test ◽

Significant Difference ◽

6 Minute Walk Test ◽

The Impact ◽

Minute Walk

Our objective was to establish the impact of wearing a face mask on the outcome of six-minute walk test in healthy volunteers. In a study of 20 healthy volunteers who each completed two 6MWTs, one with a mask and one without, there was no difference in distance walked. However, there was a significant difference in perception of dyspnea between the two groups.

Download Full-text

A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization: An orthosis that promotes function and improvement in patients with the first carpometacarpal joint osteoarthritis

Prosthetics and Orthotics International ◽

10.1177/0309364613488621 ◽

2013 ◽

Vol 38 (1) ◽

pp. 79-82 ◽

Cited By ~ 10

Author(s):

Monireh Ahmadi Bani ◽

Mokhtar Arazpour ◽

Stephen William Hutchins ◽

Fereydoun Layeghi ◽

Mahmood Bahramizadeh ◽

...

Keyword(s):

Grip Strength ◽

Clinical Relevance ◽

Hand Function ◽

Pinch Strength ◽

Conservative Approach ◽

Carpometacarpal Joint ◽

Custom Made ◽

First Carpometacarpal Joint ◽

Thumb Carpometacarpal ◽

Improved Function

Background and aim: Patients with mild to moderate first carpometacarpal joint osteoarthritis report pain, a reduction in pinch and grip strength and hand function. The purpose of this study was to analyze the effect of a custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization on pain, function, grip strength, and key pinch in these patients. Technique: A total of 11 volunteer patients participated in this study. All the above-mentioned parameters were evaluated at baseline and also 30, 60, and 90 days after using the splint. Discussion: A decrease in pain was observed after 30 days, and this continued to improve during treatment with the splint. After 90 days of using the splint, grip strength was improved. Function and pinch strength also increased significantly and was maintained during the study period compared to baseline. Clinical relevance A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization may be a suitable conservative approach for the treatment of first carpometacarpal joint osteoarthritis.

Download Full-text

Dilutional Acidosis following Hetastarch or Albumin in Healthy Volunteers

Anesthesiology ◽

10.1097/00000542-200011000-00008 ◽

2000 ◽

Vol 93 (5) ◽

pp. 1184-1187 ◽

Cited By ~ 61

Author(s):

Jonathan H. Waters ◽

Clifford A. Bernstein

Keyword(s):

Healthy Volunteers ◽

Repeated Measures ◽

Base Excess ◽

Rank Test ◽

Albumin Concentration ◽

Acid Base Balance ◽

Arterial Blood Gas ◽

Arterial Blood ◽

The Impact

Background The intent of this study was to evaluate the impact of the commonly used colloids-hetastarch and albumin-on in vivo acid-base balance. From this evaluation, a better understanding of the mechanism of dilutional acidosis was expected. Methods In a prospective, randomized fashion, 11 healthy volunteers were administered 15 ml/kg hetastarch solution, 6%, or 15 ml/kg albumin, 5%, intravenously over 30 min. Four weeks later, the study subjects were administered the other colloid. Arterial blood gas and electrolyte parameters were measured at baseline and at 30, 60, 90, 120, 210, and 300 min after colloid administration. Pre- and postlaboratory values were compared within groups using a paired t test and a Wilcoxon signed rank test and between groups using repeated-measures analysis of variance and a Wilcoxon rank sum test. Results Thirty min after infusion, subjects who were administered hetastarch showed statistically significant changes (P < 0.05) in base excess (from 2.5 +/- 0.9 mEq/l to 0.7 +/- 1.1 mEq/l), HCO3- concentration (from 27 +/- 1.0 mEq/l to 25 +/- 1.3 mEq/l), Cl- concentration (from 108 +/- 2 mEq/l to 112 +/- 2 mEq/l), albumin concentration (from 4.4 +/- 0.2 g/dl to 3.5 +/- 0.5 g/dl), and arterial carbon dioxide tension (Paco2; from 40.8 +/- 2.3 mmHg to 39. 2 +/- 3.2 mmHg), whereas only the albumin concentration (from 4.4 +/- 0.2 g/dl to 4.8 +/- 0.6 g/dl) changed significantly in the albumin-treated group. Conclusions Decreases in base excess were observed for 210 min after hetastarch administration but not after albumin. The mechanism for this difference is discussed.

Download Full-text

Abstract P315: Increase in Stress May Contribute to Lower Heart Rate Variability in Healthy Young Subjects

Circulation ◽

10.1161/circ.125.suppl_10.ap315 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Amanda C Costa ◽

Ana Gabriela C Silva ◽

Cibele T Ribeiro ◽

Guilherme A Fregonezi ◽

Fernando A Dias

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Healthy Volunteers ◽

Perceived Stress ◽

Low Frequency ◽

Statistical Correlation ◽

Total Power ◽

The Impact ◽

Nonparametric Correlation

Background: Stress is one of the risk factors for cardiovascular disease and decreased heart rate variability is associated to increased mortality in some cardiac diseases. The aim of the study was to assess the impact of perceived stress on cardiac autonomic regulation in young healthy volunteers. Methods: 35 young healthy volunteers (19 to 29 years old, 6 men) from a Brazilian population were assessed for perceived stress by the translated and validated Perceived Stress Scale (PSS, 14 questions) and had the R-R intervals recorded at rest on supine position (POLAR RS800CX) and analyzed (5 minutes, Kubius HRV software) by Fast-Fourier Transform for quantification of Heart Rate Variability (HRV). Results: Average data (±SD) for age, heart rate, BMI, waist circumference and percentage of body fat (%BF) were: 21.3±2.7 years; 65.5±7.9 bpm; 22.3±1.9 Kg/m 2 ; 76.0±6.1 cm and 32.1±6.6%; respectively. The mean score for the PSS-14 was 23.5±7.2 and for the HRV parameter as follow: SSDN=54.8±21.2ms; rMSSD=55.9±32.2ms; low-frequency (LF)= 794.8±579.7ms 2 ; High-frequency (HF)= 1508.0±1783.0 ms 2 ; LF(n.u.)= 41.1±16.2; HF(n.u.)= 58.9±16.2; LF/HF=0.89±0.80 and Total power (TP)= 3151±2570ms 2 . Spearman nonparametric correlation was calculated and there was a significant correlation of PSS-14 scores and LF (ms 2 ) (r=−0.343; p= 0.044). Other HRV variables did not shown significant correlation but also had negative values for Spearman r (TP r=−0.265, p=0.124; HF r=−0.158; SSDN r=−0.207; rMSSD r=−0.243, p=0.160). LF/HF and LF(n.u.) did not correlate to PSS-14 having Spearman r very close to zero (LF/HF r=−0.007, p=0.969; LF(n.u.) r=−0.005, p=0.976). No correlation was found for HRV parameters and BMI and there was a trend for statistical correlation of %BF and LF (ms 2 ) (r=−0.309, p=0.071). Conclusions: These data demonstrate a possible association of perceived stress level and HRV at rest. Changes in LF can be a consequence of both sympathetic and parasympathetic activity, however, analyzing the other variables HF, TP, SSDN and rMSSD (all negative Spearman r) and due to the lack of changes in LF/HF ratio and LF(n.u.) we interpret that increased stress may be associated to decrease in overall heart rate variability. These changes were seen in healthy individuals and may point out an important mechanism in cardiovascular disease development.

Download Full-text

Effectiveness of Triamcinolone Hexacetonide Intraarticular Injection in Interphalangeal Joints: A 12-week Randomized Controlled Trial in Patients with Hand Osteoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.140736 ◽

2015 ◽

Vol 42 (10) ◽

pp. 1869-1877 ◽

Cited By ~ 14

Author(s):

Natalia de Oliva Spolidoro Paschoal ◽

Jamil Natour ◽

Flavia S. Machado ◽

Hilda Alcântara Veiga de Oliveira ◽

Rita Nely Vilar Furtado

Keyword(s):

Adverse Effects ◽

Repeated Measures ◽

Controlled Trial ◽

Hand Function ◽

Intraarticular Injection ◽

Pinch Strength ◽

Hand Osteoarthritis ◽

Triamcinolone Hexacetonide ◽

Link Type ◽

Pain At Rest

Objective.To evaluate the effectiveness and tolerance of intraarticular injection (IAI) of triamcinolone hexacetonide (TH) for the treatment of osteoarthritis (OA) of hand interphalangeal (IP) joints.Methods.Sixty patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH/lidocaine (LD; n = 30) with TH 20 mg/ml and LD 2%, or just LD (n = 30). The injected joint was immobilized with a splint for 48 h in both groups. Patients were assessed at baseline and at 1, 4, 8, and 12 weeks by a blinded observer. The following variables were assessed: pain at rest [visual analog scale (VAS)r], pain at movement (VASm), swelling (physician VASs), goniometry, grip and pinch strength, hand function, treatment improvement, daily requirement of paracetamol, and local adverse effects. The proposed treatment (IAI with TH/LD) was successful if statistical improvement (p < 0.05) was achieved in at least 2 of 3 VAS. Repeated-measures ANOVA test was used to analyze intervention response.Results.Fifty-eight patients (96.67%) were women, and the mean age was 60.7 years (± 8.2). The TH/LD group showed greater improvement than the LD group for VASm (p = 0.014) and physician VASs (p = 0.022) from the first week until the end of the study. In other variables, there was no statistical difference between groups. No significant adverse effects were observed.Conclusion.The IAI with TH/LD has been shown to be more effective than the IAI with LD for pain on movement and joint swelling in patients with OA of the IP joints. Regarding pain at rest, there was no difference between groups. Trial registration number: ClinicalTrials.gov (NCT02102620).

Download Full-text

The influence of kihap on the impact of Dolio-chagui kicks in taekwondo

Motriz Revista de Educação Física ◽

10.1590/s1980-65742014000100008 ◽

2014 ◽

Vol 20 (1) ◽

pp. 54-57

Author(s):

Rodrigo Dias Martins ◽

Debora Cantergi ◽

Jefferson Fagundes Loss

Keyword(s):

Martial Arts ◽

Random Order ◽

T Test ◽

Real Effect ◽

The Real ◽

The Mean ◽

The Difference ◽

The Impact

The kihapis a technique used in several oriental martial arts. It is a yell used by practitioners with the ex pectation of enhancing the force of a hit. However, the real effect of using the kihapis unknown. Therefore, this study aims to compare the peak of acceleration of the Dolio-chaguikick in taekwondo performed with and without the use of kihap. Twenty two experienced taekwondo practitioners performed 30 kicks each against a punching bag, alternating in random order with and without kihap, while the acceleration of the punching bag was measured. A t-test was used to compare the difference between the mean acceleration in both conditions. Higher values were found with the use of kihap(7.8 ± 2.8 g) than without the use of kihap(7.1 ± 2.4 g), p< 0.01, r= 0.57. The results indicate that kihapenhances the impact of the kick.

Download Full-text