scholarly journals A Comparative Study of Efficacy and Functionality of Ten Commercially Available Wrist-Hand Orthoses in Healthy Females: Wrist Range of Motion and Grip Strength Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Alejandra Aranceta-Garza ◽  
Karyn Ross
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Evidence Base ◽  
Secondary Outcome ◽  
Functional Study ◽  
Strength Analysis ◽  
Hand Position ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
The Impact

Objective: Wrist-hand orthoses (WHOs) are prescribed for a range of musculoskeletal/neurological conditions to optimise wrist/hand position at rest and enhance performance by controlling its range of motion (ROM), improving alignment, reducing pain, and optimising grip strength. The objective of this research was to study the efficacy and functionality of ten commercially available WHOs on wrist ROM and grip strength.Design: Randomised comparative functional study of the wrist/hand with and without WHOs.Participants: Ten right-handed female participants presenting with no underlying condition nor pain affecting the wrist/hand which could influence motion or grip strength. Each participant randomly tested ten WHOs; one per week, for 10 weeks.Main outcome measures: The primary outcome was to ascertain the impact of WHOs on wrist resting position and flexion, extension, radial, and ulnar deviation. A secondary outcome was the impact of the WHOs on maximum grip strength and associated wrist position when this was attained.Results: From the 2,400 tests performed it was clear that no WHO performed effectively or consistently across participants. The optimally performing WHO for flexion control was #3 restricting 86.7%, #4 restricting 76.7% of extension, #9 restricting 83.5% of radial deviation, and #4 maximally restricting ulnar deviation. A grip strength reduction was observed with all WHOs, and ranged from 1.7% (#6) to 34.2% (#4).Conclusion: WHOs did not limit movement sufficiently to successfully manage any condition requiring motion restriction associated with pain relief. The array of motion control recorded might be a contributing factor for the current conflicting evidence of efficacy for WHOs. Any detrimental impact on grip strength will influence the types of activities undertaken by the wearer. The design aspects impacting wrist motion and grip strength are multifactorial, including: WHO geometry; the presence of a volar bar; material of construction; strap design; and quality of fit. This study raises questions regarding the efficacy of current designs of prefabricated WHOs which have remained unchanged for several decades but continue to be used globally without a robust evidence-base to inform clinical practise and the prescription of these devices. These findings justify the need to re-design WHOs with the goal of meeting users' needs.

scholarly journals Arthroscopic Dorsal Capsuloplasty in Scapholunate Tears EWAS 3: Preliminary Results after a Minimum Follow-up of 1 Year

2018 ◽  
Vol 07 (04) ◽  
pp. 324-330
Author(s):  
Rémy Coulomb ◽  
Pascal Kouyoumdjian ◽  
Olivier Mares ◽  
Benjamin Degeorge
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Case Series ◽  
Contralateral Side ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
Test Range ◽  
Flexion Extension ◽  
Functional Scores

Purpose We retrospectively evaluated the results of all arthroscopic dorsal scapholunate (SL) capsuloplasty without pinning in patients presenting predynamic instability and dorsal capsuloscapholunate septum lesions on arthro–computed tomography scan after failed medical treatment. Materials and Methods Fifteen patients, mean age 34.3 years, underwent all arthroscopically assisted dorsal capsuloplasty. Patients were assessed preoperatively and postoperatively by a clinical (pain, Watson's test, range of motion, and strength), functional (quick disabilities of the arm, shoulder, and hand), patient-rated wrist evaluation, and Mayo wrist score scores), and radiological (SL gap and dorsal intercalated segmental instability [DISI]) examination. SL tears were evaluated during surgery by European Wrist Arthroscopy Society (EWAS) classification. Results The mean follow-up period was 20.2 months (range, 12–41). Preoperatively, positive Watson's test was noted in all cases. DISI deformity was noted in three cases without any SL gap. The SL instability was graded EWAS IIIB (n = 8) or EWAS IIIC (n = 7). Postoperatively, positive Watson's test was noted in only one case. Activity pain decreased from 7.8 preoperatively to 2.4 postoperatively. Range of motion in flexion–extension increased from 92.9 degrees preoperatively to 126.2 degrees postoperatively. Grip strength increased from 24.2 preoperatively to 38.2 postoperatively. At final follow-up, range of motion in flexion–extension and grip strength were estimated at 87 and 91% compared with contralateral side, respectively. All functional scores were significantly improved at the last follow-up. No radiographic SL gapping in grip views or DISI deformity was noted. Discussion Cadaveric studies demonstrated that the dorsal portion of SL ligament is critical for the stability of the SL complex. The entire arthroscopic SL capsuloplasty technique provides reliable results for pain relief, avoiding postoperative stiffness associated with open procedures. It is an alternative technique for patients with predynamic SL instability after failure of medical management and shall not prelude the resort to any further open procedure. Level of Evidence This is a level IV, case series.

The Effect of Radioscapholunate Fusion On Wrist Movement and the Subsequent Effects of Distal Scaphoidectomy and Triquetrectomy

2010 ◽  
Vol 35 (9) ◽  
pp. 740-745 ◽  
Author(s):  
M.J. Berkhout ◽  
M.N. Shaw ◽  
L.J. Berglund ◽  
K.N. An ◽  
R.A. Berger ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Salvage Procedure ◽  
Ulnar Deviation ◽  
Radiocarpal Joint ◽  
Flexion Extension ◽  
Radioscapholunate Fusion ◽  
Tracking Device ◽  
Radioscapholunate Arthrodesis

Radioscapholunate arthrodesis is a salvage procedure indicated for osteoarthritis of the radiocarpal joint involving the lunate facet of the radius. This cadaver study examines changes in wrist motion resulting from radioscapholunate arthrodesis, and the effects of surgical techniques to improve the range of motion. Simulated radioscapholunate arthrodesis, distal scaphoidectomy and triquetrectomy were carried out sequentially on six cadaver forearms and measurements (maximum flexion/extension and radial/ulnar deviation) were taken in the intact situation and after each surgical step using a magnetic tracking device. Radioscapholunate arthrodesis diminishes the amplitudes of movements of the wrist in all directions, but range of motion in the radioscapholunate fused wrist improves after scaphoidectomy and improves further after triquetrectomy (88% of original flexion/extension and 98% of original radial/ulnar deviation). Radioscapholunate arthrodesis causes a significant change in kinematics between the hamate and the triquetrum in flexion/extension.

scholarly journals Radial Column Excision and Four-Corner Fusion for the Treatment of Basal Thumb Arthritis and Scapholunate Advanced Collapse Wrist or Midcarpal Arthritis

2017 ◽  
Vol 06 (04) ◽  
pp. 294-300 ◽  
Author(s):  
Avanthi Mandaleson ◽  
Michael Wagels ◽  
Stephen Tham
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Pinch Grip ◽  
The Mean ◽  
Therapeutic Study

Background The combination of trapeziometacarpal arthritis and intercarpal pattern of degenerative wrist arthritis is uncommon. Purpose To report on the clinical and radiologic results of patients who have undergone radial column excision (scaphoidectomy and trapeziectomy) (RCE) and four-corner fusion (4CF). We describe the patterns of disease that present with basal thumb and midcarpal arthritis and treatment outcomes of a single-surgeon series. Patients and Methods A consecutive series of seven patients underwent RCE and 4CF over a 2-year period, for basal thumb osteoarthritis with concurrent degenerative midcarpal wrist arthritis. Six patients were available for review. All six patients were women with a mean age of 73 years (range: 67–78; SD 4.6). Mean follow-up time was 48.2 months (34–59 months). Radiographic and clinical outcomes were recorded for all patients, to include wrist range of motion, key pinch, grip strength, and patient-rated wrist evaluation (PRWE). Results There were no failures or revision procedures. The mean range of motion was flexion of 40 degrees (range: 30–40 degrees), extension of 30 degrees (range: 20–42 degrees), radial deviation of 18 degrees (range: 10–30 degrees), and ulnar deviation of 15 degrees (range: 0–25 degrees). The mean key pinch was 4.2 kg (range: 0.5–10, SD ± 3.5) and mean grip strength was 9.4 kg (range: 0–19, SD ± 8.9). The PRWE results in four patients were within normal values. Conclusion RCE with 4CF resulted in acceptable clinical outcomes in four of six patients treated, with no failures at a mean follow-up of 48.2 months. Level of Evidence Level IV, therapeutic study.

scholarly journals Do Impairments Predict Hand Dexterity After Distal Radius Fractures? A 6-Month Prospective Cohort Study

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 441-447 ◽  
Author(s):  
Pavlos Bobos ◽  
Emily A. Lalone ◽  
Ruby Grewal ◽  
Joy C. MacDermid
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Small Object ◽  
Large Object ◽  
Post Injury ◽  
Ulnar Deviation ◽  
Hand Grip ◽  
Hand Dexterity ◽  
Flexion Extension ◽  
Relationship Of

Background: The relationship of routinely measured grip and motion measures may be related to hand dexterity. This has not yet been thoroughly examined following a distal radius fracture (DRF). The purpose of this study was to investigate if impairments in range of motion (ROM) and grip strength predict hand dexterity 6 months following a DRF. Methods: Patients with DRFs were recruited from a specialized hand clinic. Hand grip was assessed with a J-Tech dynamometer; ROM was measured using standard landmarks and a manual goniometer. Multiple regression analyses were performed to identify whether potential predictors (grip, ROM, age, hand dominance, and sex) were associated with 3-month or 6-month outcomes in large- and small-object subtests of the NK dexterity test in the affected hand. Results: Age, sex, and arc motion for radial-ulnar deviation were significant predictors of large-object hand dexterity explaining the 23% of the variation. For small-object hand dexterity, age and flexion-extension arc motion were significant predictors explaining 11% of the variation at 3 month after the fracture (n = 391). At 6 months post injury (n = 319), grip strength, arc motion for flexion-extension, and age were found to be significant predictors of large-object dexterity explaining 34% of the variance. For the small objects, age, grip strength, sex, and arc motion of radial-ulnar deviation explained 25% of the variation. Conclusions: Although this confirms that the impairments in ROM and grip that occur after a DRF can explain almost one-third of the variation in hand dexterity, it also suggests the need for dexterity testing to provide more accurate assessment.

scholarly journals Clinical outcome of combined scaphocapitate fusion and posterior interosseous neurectomy for stage III Kienbock’s disease

2019 ◽  
Vol 5 (6) ◽  
pp. 1025
Author(s):  
Hossam Elden A. Abodonia ◽  
Mohammed H. Elbadawy ◽  
Ahmed A. Basha
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Positive Impact ◽  
Contralateral Side ◽  
Stage Iii ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
The Mean ◽  
Kienbock’S Disease

<p class="abstract"><strong>Background:</strong> Treatment of Kienbock’s disease is still controversial. Several authors have described various surgical treatment options for Kienbock’s disease, all of whom reported successful treatment outcomes. The purpose of this study is to explore the clinical results of posterior interosseous neurectomy and scaphocapitate fusion as a treatment option for stage III Kienbock’s disease.</p><p class="abstract"><strong>Methods:</strong> This study evaluated the range of motion, grip and functional results after treatment of ten wrists of stage III Kienbock’s disease. Four males and six females with average age of 26.3 years, seven dominant and three non-dominant wrists were included. Two patients were smokers while six were housewives, three manual workers and a lawyer. The average follow up period was 14.2 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Four patients revealed excellent, three good and three fair results. The mean modified Mayo score was 81.5. Flexion-extension range was 105.5° representing 74.9% of the contralateral side range. The mean flexion and extension range of operated side was increased, while the flexion increase was nonsignificant. Regarding radial-ulnar deviation, the mean range was 33.5° representing 76.5% of the contralateral side. The mean ulnar and radial deviation was increased, while the radial increase was nonsignificant. The mean grip strength was significantly increased to 90 mmHg representing 93.2% of the contralateral side.</p><p><strong>Conclusions:</strong> Scaphocpitate fusion is a recommended solution for treatment of late stages of Kienbock’s disease with lunate collapse. Longer postoperative time has a positive impact on grip strength and flexion-extension range of motion.</p>

PATIENT RELATED FUNCTIONAL OUTCOME AFTER TOTAL WRIST ARTHROPLASTY: A SINGLE CENTER STUDY OF 206 CASES

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 81-87 ◽  
Author(s):  
Marcus Sagerfors ◽  
Anil Gupta ◽  
Ole Brus ◽  
Marco Rizzo ◽  
Kurt Pettersson
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Outcome Measures ◽  
Performance Measure ◽  
Hand Grip Strength ◽  
Ulnar Deviation ◽  
Hand Grip ◽  
Total Wrist Arthroplasty ◽  
Patient Related Outcome ◽  
Wrist Arthroplasty

Objectives: To prospectively evaluate patient related outcome measures after total wrist arthroplasty (TWA) using four different total wrist implants operated at a single referral center in Sweden. Methods: 206 primary TWAs were assessed preoperatively and after one year postoperatively with respect to the following eight outcome measures: Range of motion (flexion/extension, radial/ulnar deviation, pronation/supination), hand grip strength, Canadian Occupational Performance Measure (COPM), performance and satisfaction, Visual Analog Scale (VAS) pain scores at rest and in activity. Results: The Maestro TWA had a significantly greater improvement of radial/ulnar deviation than the Biax and Remotion TWAs. COPM performance and satisfaction improved more for the Maestro and Universal 2 prostheses than the Biax and Remotion. Conclusions: All four TWAs offer reduced VAS-scores and improved COPM-scores with preserved hand grip strength and somewhat improved range of motion. The Maestro TWA performed favorably compared to the Remotion TWA. Implant design may affect patient related outcome.

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.

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.

Effect of Wrist Posture on Discomfort for Simple Repetitive Exertions

2000 ◽  
Vol 44 (30) ◽  
pp. 5-473-5-476 ◽  
Author(s):  
Eilís J. Carey ◽  
Timothy J. Gallwey
Keyword(s):  
Range Of Motion ◽  
The Other ◽  
Maximum Strength ◽  
Angular Deviation ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
Male Subjects

This study investigated the effects of exertion, pace and level of simple and combined flexion/extension and radial/ulnar deviation of the wrist on discomfort for simple repetitive exertions. Eight male subjects participated in the study and the level of exertion and angular deviation were defined relative to the maximum strength and Range of Motion (ROM) of the subjects respectively. Extreme flexion caused higher discomfort than the other simple types of deviation, and the combination of flexion and ulnar deviation resulted in higher discomfort than the other types of combined deviation. Exertion was the most significant factor, followed by level of deviation.

Results of Scaphotrapeziotrapezoid Fusion for Isolated Idiopathic Arthritis

1996 ◽  
Vol 21 (3) ◽  
pp. 378-380 ◽  
Author(s):  
V. B. SRINIVASAN ◽  
J. P. MATTHEWS
Keyword(s):  
Pain Relief ◽  
Grip Strength ◽  
Relative Difference ◽  
The Other ◽  
Pinch Strength ◽  
Average Difference ◽  
Ulnar Deviation ◽  
Non Union ◽  
Joint Fusion ◽  
Flexion Extension

Scaphotrapeziotrapezoid (STT) joint fusion was carried out for pain relief in eight patients with isolated arthritis. Seven patients had satisfactory relief of symptoms. The subjective results were excellent in five, good in two and bad in one patient, who had non-union of the arthrodesis and was also the only patient to develop trapeziometacarpal arthritis. Average grip strength was 0.8 and lateral pinch strength was 0.7 of that in the other hand. There was a very small relative difference in dexterity. There was an average difference of 9° of flexion–extension and 13° of radio-ulnar deviation. It is concluded that for isolated idiopathic STT arthritis, fusion gives very satisfactory results with minimal complications.

Sign in / Sign up

Export Citation Format

Share Document