American Society Of Hand Therapists Research Articles

Sustained Grasp Strength Characteristics What Changes with Skeletal Muscle Injuries

Background: Grasping is present in most of the activities of daily living. The estimated total use of the hands in activities of daily living is more than five hours a day, not counting work and sports activities. The hand grasp strength peak is only relevant for short durations of applied forces, in the activities. The sustained strength gives a more realistic assessment of strength capabilities, during daily tasks. Objective: To characterize the sustained grasp strength over 5 seconds, in different grasps configurations, and identify changes in these when a musculoskeletal injury is present. Patients: Thirty right-handed participants, fifteen healthy (Control Group), and fifteen injured (Experimental Group) with musculoskeletal hand conditions, on the right side, 18 men and 12 women, were integrated into this study. In both groups, there were 9 men and 6 women. Methods: The Biometrics E-link® Dynamometer G200, was used, being kilograms as the measurement unit. The test position, to assess the hand grasp sustained strength, was recommended by the American Society of Hand Therapists. The strength was collected for 5 seconds, in the right hand, on eight grasp configurations, which can be performed on the dynamometer. Results: Men have more sustained strength than women, in all the grasp configurations assessed. The Experimental Group has inferior results regarding the peak strength, and the behavior of the strength is less stable. The man obtains the maximum endurance, and it is always over zero. The Inferior Pincer and the Parallel Extension are the grasp configurations that require less strength, being both precision grasps. The Medium Wrap is the grasp configuration that requires more strength, and it is also the one that has more differences between groups, regarding the strength and the peak strength. The three strongest grasps have the same configuration being the difference in the diameter of the grabbed object. Conclusion: The strength behavior for 5 seconds is similar between participants, with or without musculoskeletal conditions, being less high, less regular, and decreasing faster when there is an injury.

Gender differences in hand grip strength of children in Bosnia and Herzegovina aged 11 to 14 years. A cross - sectional study

Hand grip strength (HGS) serves as a multifaceted and critical parameter within the domain of motor function and is widely recognized as a pivotal aspect in the comprehensive evaluation of the development of school-aged children. The aim of the research was to determine the values of HGS, the trend of changes and differences between boys and girls aged 11-14 years from Bosnia and Herzegovina. A cross-sectional survey was conducted on a sample of 585 students. The subsample was divided into 307 boys (11y = 81; 12y = 87; 13y = 77; 14y = 62) and 278 girls (11y = 66; 12y = 83; 13 y =79; 14y = 50). Hand muscle strength was measured using the method of isometric dynamometry in laboratory conditions, with a standardized test - Hand grip (according to the American Society of Hand Therapists). The force achieved during the maximum hand grip (dynamometry) was measured with a digital hand dynamometer CAMRY-EH101, USA. Statistically significant differences between male and female respondents were confirmed (for age 12, T = -2.651, p<0.009; for age 13, T =-5.178; p<0.000; for age 14, T =-7.124; p<0.000). In both sexes, the dominance of the strength of the right (dominant) hand than left (non-dominant) hand is evident. The study confirmed a positive trend of strength development in both sexes, as well as gender differences in the HGS test between children aged 12 to 14 years.

The how and why of handgrip strength assessment

Introduction: Occupational therapists and physiotherapists routinely assess Hand grip Strength (HGS) to evaluate hand function. This study explored the experiences of clinicians who regularly assess and evaluate HGS including the testing protocol utilised, evaluation methods and the influence of various biological and functional factors. Method: This exploratory survey ( n = 49) was distributed online to members of the Australian Hand Therapy Association. The questionnaire asked recipients to identify HGS testing protocols, evaluation methods, use of normative data, reasons for assessment and the influence of biological and functional factors on HGS. Demographic data was also collected. Results: Sixty-four percent of respondents were occupational therapists and 59% had over 10 years’ experience assessing HGS. The standardised American Society of Hand Therapists (ASHT) testing protocol was consistently adopted by only 67% of respondents . Variations in contraction time, scoring and evaluation methods were identified. Gender, age, employment and lifestyle were considered the functional and biological factors which influence HGS. Conclusion: This study details how and why occupational therapists and physiotherapists in Australia assess and evaluate HGS. Use of the ASHT testing protocol is not universal. Clinicians rely on the reason for assessment, clinical experience and practice context to determine how they assess and evaluate HGS.

Assessment and treatment of nonsurgical thumb carpometacarpal joint osteoarthritis: A modified Delphi-based consensus paper of the American Society of Hand Therapists

BackgroundWhile the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. PurposeThis study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. Study DesignThis was a consensus paper via the modified Delphi approach. MethodsA modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist’s research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. ResultsThe expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient’s unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. ConclusionsThe findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA.

Proprioception evaluation and treatment: Hand therapist practice patterns

BackgroundLittle is known about how hand therapists assess proprioception and treat deficits in clinical practice and what types of diagnoses they see most often. To our knowledge, no survey has been completed regarding proprioception practice patterns among hand therapists. PurposeThe purpose of this study was to examine current practice patterns related to the treatment and assessment of proprioception deficits by hand therapists in the United States. Study DesignThis was a cross-sectional study using a survey instrument. MethodsThe survey was sent to occupational and physical therapists identified as certified hand therapists or members of the American Society of Hand Therapists. The Checklist for Reporting Results of Internet E-Surveys was used in reporting results. ResultsMembers of American Society of Hand Therapists (n=152) responded to the survey. The participants were asked if they provided rehabilitation services to people who have proprioceptive deficits, and 122 (82%) responded yes, and 27 (18%) responded no. Most therapists use a standardized technique for assessing proprioceptive deficits. Hand therapists' mean confidence level in treating proprioception deficits was 7.2 out of 10 compared to the mean confidence level reported evaluating them, which was 6.1 out of 10. ConclusionsMost hand therapists evaluate and treat proprioception deficits across a variety of diagnoses. While the frequency and duration of proprioception treatment varies, most hand therapists reported high use of open- and closed-chain exercises and activities along with elastic taping as part of their intervention approach.

Hand therapist use of patient-reported outcomes

BackgroundThe use of standardized outcome measures is essential for best clinical practice by hand therapists to determine patient status, progress, and the outcome of interventions. A better understanding of current patient-reported outcome (PRO) use in hand and upper extremity practice is warranted. PurposeThis study sought to understand what outcome measures are being used in clinical practice, how they are being used, and the perceived usefulness of PROs by active members of the American Society of Hand Therapists (ASHT). Study DesignThis study employed a cross-sectional design. MethodsThe web-based survey was distributed through Qualtrics (Qualtrics, Salt Lake City, Utah) to active members of ASHT with an email address on file. The survey consisted of multiple choice and open-ended questions. ResultsA total of 348 members responded to the survey. Seven hundred thirty-two different outcome measures were reported to be used by the hand therapist respondents. The most used outcome measure was QuickDASH by 38% of the respondents. Two hundred seventy-five (88%) indicated that their workplace advocated the use of PROs. Most respondents indicated that there were not constraints preventing the use of a PRO. Few therapists respondents use a psychosocial PRO in clinical practice. ConclusionsMost of the hand therapist respondents to our survey use a PRO and discuss the results with their clients. The QuickDASH was the PRO used most often by hand therapists. Only a few hand therapists use a psychosocial tool to measure patient status in clinical practice.

Modelo predictivo de fuerza de agarre para un grupo de trabajadores administrativos de la ciudad de Bogotá

ContextGrip strength is the force that is exerted with the hand to squeeze or release any object and it is considered an indicator of health. Authors have concluded that grip strength varies depending on age, sex, height, weight, habits, genetic factors, among others. ObjectivesTo establish a mathematical model for the prediction of grip strength in a group of office workers in the city of Bogotá. MethodsThe grip strength of the dominant and non-dominant hand was measured with a Jamar hydraulic dynamometer in 293 healthy office workers of a public entity in the city of Bogota. The protocol of the American Society of Hand Therapists was followed. Age, sex, height, weight, and BMI were recorded for each participant. Stepwise linear regression was applied to establish prediction models for the dominant and non-dominant hand, using R-studio software. ResultsThe participants were 185 men and 108 women, all with right dominance. In general, men recorded higher values of grip strength than women. The strength of the dominant hand was higher than that of the non-dominant hand. The proposed mathematical models allow estimating the grip strength of the dominant hand and the non-dominant hand with a predictability of 64.52% and 63.23%, respectively. ConclusionsThe proposed predictive models included the variables sex, height, and weight for the estimation of the grip strength of the dominant hand, and the variables sex, height, weight and age for the grip strength of the non-dominant hand.

Handgrip Measurement Method Affects Asymmetry but Not Weakness Identification in Community-Dwelling Older Adults.

The Asian Working Group for Sarcopenia (AWGS) 2019 recommends different measurement protocols for handgrip strength (HGS). We aimed to explore (1) whether these protocols induce a significant difference in HGS; (2) whether these differences be clinically meaningful; and (3) whether these protocols affect the identification of HGS weakness or asymmetry. Cross-sectional study. A total of 356 community-dwelling older adults (mean age 67.9years; 146 women). Maximal HGS was measured according to protocols from the National Health and Nutrition Examination Survey (Method A, standing with full elbow extended) and the American Society of Hand Therapists (Method B, sitting with elbow flexed at 90°). HGS was analyzed using the maximal value of 2 or 3 repetitions of the dominant hand or 4 or 6 repetitions of both hands. The difference in maximal HGS between Method A and Method B might have clinical meaning in approximately half of the participants. When measured using Method A, respective proportions of individuals with differences in HGS between the 6 repetitions group and the other repetition groups beyond the noninferiority threshold were 42%, 20%, and 25% in men and 39%, 21%, and 17% in women. Using Method B, the corresponding percentages were 25%, 18%, and 6% in men, and 27%, 20%, and 5% in women, respectively. Different protocols did not significantly affect the identification of HGS weakness, as different protocols reached diagnostic accuracies of 0.910 to 0.967 in men and 0.911 to 0.986 in women when using Method A (6 repetitions) as the reference standard. However, different protocols significantly affected the identification of HGS asymmetry, as different protocols had diagnostic accuracies of 0.667 to 0.886 in men and 0.658 to 0.863 in women. The different protocols recommended by the AWGS 2019 update significantly affect maximal HGS values and the identification of HGS asymmetry but not HGS weakness.

Desired student characteristics for hand therapy clinical placements: A mixed method study

Study Design: Mixed method design.Introduction: Conceptualizing the desired characteristics of a student for a clinical site is vital information during the matching process.Purpose of the Study: The objective of this study was to identify the specific student characteristics preferred by the hand therapy clinician educator.Methods: A questionnaire was emailed to members of the American Society of Hand Therapists. A semi structured interview was developed to investigate the topic further. Data was collected and analyzed to determine descriptive statistics and themes regarding the preferred student characteristics.Results: The most common themes found regarding desired student characteristics by hand therapists were students that possess strong interpersonal skills, a willingness to self-study and learn independently, and students that exhibit professional behaviors.Discussion: If students are successfully matched to clinical placements, this may encourage sites to take students in the future and also reduce the need for the clinical educator or university to address problems that arise during the experience.Conclusion: Hand therapy clinical educators desire students with strong interpersonal skills, a willingness to self-study and learn independently, demonstrate professionalism and clinical reasoning skills, who possess a sincere interest in hand therapy and demonstrate cultural competence when interacting with patients from different backgrounds and social environments. Finally, hand therapy clinical educators want students to be honest about what they know and what they don't know regarding hand therapy.

The use of occupation-based interventions and assessments in hand therapy: A cross-sectional survey

IntroductionThe purpose of this study was to gather information on how hand therapists incorporate occupation-based interventions in their clinical practice and what outcome measures hand therapists use to measure the occupational performance of their clients Study DesignCross-Sectional Survey Design. MethodsThe 16-item Survey was distributed to members of the American Society of Hand Therapists on two occasions. ResultsThree hundred eleven hand therapists responded to the survey. Hand therapists use a variety of occupation-based interventions (OBI) in clinical practice and most believe they are important. Findings from this study reveal that incorporating an occupation-based assessment along with or in place of an assessment of body functions and structures is not performed routinely. One hundred twenty-six (41%) respondents indicated that they use occupation-based activities 26-50% of the time with their clients. DiscussionThe top three OBI interventions used by hand therapists included dressing tasks, cooking and meal preparation, and in hand manipulation of coins and medication. The lack of understanding of the theoretical models regarding occupation-based interventions may be a barrier toward implementation of occupation-based interventions and assessments as many hand therapists may have trained under a medical model. ConclusionMost respondents to this survey indicated that they believe OBI should be performed by hand therapists and use them routinely in practice. The most frequently used type of assessment was the DASH (Disabilities of the Shoulder Arm & Hand). The least frequently used assessment was the Short Form 36 and patient specific occupation-based assessment.

Comparison of the BTE tech EVJ handgrip to the Jamar hand dynamometer for measuring grip strength

INTRODUCTION: This study compared the inter-instrument reliability of the Jamar Hand Dynamometer (Jamar) to the BTE EVJ Handgrip tool (EVJ). The EVJ is a new digital handgrip instrument designed by BTE Technologies Inc. (BTE Tech) utilizing Bluetooth technology to automatically upload data to a computer or electronic health record. METHOD: This repeated measure study engaged 338 participants (N= 199 females, N= 139 males) ages 20 to 50. All participants were tested on both devices following the protocol established by the American Society of Hand Therapists (ASHT). RESULTS: Comparative statistics included ICC values (0.81–0.84), Pearson R (correlation coefficient) (0.68–0.77), and Bland Altman plots (93–95% of data within 2 SD), indicating good inter-instrument agreement. CONCLUSIONS: The EVJ Handgrip, developed by BTE Technologies, demonstrated good inter-instrument reliability with the Jamar Hand Dynamometer and may be reliable to use when referencing the published normative values in the clinical environment.

The impact of COVID-19 on hand therapy practice

BackgroundHand therapists and health care providers across the spectrum have been profoundly impacted by COVID-19. Greater insight and information regarding how practitioners have been affected by this unparalleled pandemic is important. PurposeSurvey research was performed to examine the impact of the COVID-19 pandemic on hand therapy practice. Study designOnline survey research. MethodsFour constructs guided the development of the survey: psychosocial and financial impact; safety practice patterns; changes in current practice patterns; use of telehealth. The survey was distributed to members of the American Society of Hand Therapists from April 14, 2020 through May 4, 2020. Descriptive demographic data were obtained. Frequencies were examined using ChiSquare, correlations were examined using Spearman Correlation Coefficient, and means were compared via independent t-test. ResultsA total of 719 members responded to the survey. Eighty-six percent of therapists reported feeling more stress than they did prior to the COVID-19 pandemic. This level of stress was similar across ages, practice settings, financial stability or instability, and geographical settings. Older therapists (rs = 0.04) and those that practiced longer (rs = 0.009) felt more comfortable with in-person treatment. Ninety-eight percent of therapists reported a decrease in caseload. Postoperative cases (P= .0001) and patients ages 19-49 were more likely to receive in-person treatment (P= .002). 46% of therapists reported providing telehealth services. Nontraumatic, nonoperative cases (P= .0001) and patients aged 65 or older were more likely to receive telehealth services (P= .0001). Younger therapists (rs = 0.03) and therapists working in outpatient therapist owned, outpatient corporate owned, and outpatient academic medical centers (X2 [4, N = 637] = 15.9463, P= .003) were more likely to utilize telehealth. ConclusionStress was felt globally among hand therapy clinicians regardless of financial security or insecurity, age, practice area, or geographical setting. Therapists saw a drastic decrease in caseloads. In-person caseloads shifted primarily to postoperative cases. Study DesignWeb based survey

Fuerza prensil en adultos chilenos sanos de 20 a 69 años: un estudio transversal

ObjectiveTo characterize hand grip strength performance of the dominant hand and the non-dominant hand in men and women between 20 and 69 years of age from Valdivia, Chile. MethodsThrough a stratified non-probabilistic sampling by convenience, 401 healthy subjects were recruited and stratified in quinquennial age groups. Hand grip strength in the dominant hand and non-dominant hand was measured using the protocol established by the American Society of Hand Therapists (ASHT). Results were stratified and compared by age, sex, and hand dominancy. Results401 subjects (203 women) completed the study, of whom ∼94% had right dominance. Overall, the dominant hand of the men and women exhibited better hand grip performance in every quinquennial age group (p<.05), and the difference between the dominant hand and the non-dominant hand in the men and women was similar (∼4%). Peak performance in the dominant hand was seen in the men aged between 25-29 (46.2±6.6kg) years while in the women it was between 40-44 years of age (29.7±3.7kg), whereas in the non-dominant hand peak performance was between the ages 50-54 in the men (43.2±6.3kg) and between 40-44 in the women (28.2±4.1kg). ConclusionsAs expected, grip strength was higher in men in every quinquennial group, nevertheless, changes in performance with age were different between the men and the women, therefore these differences should be taken into account when this tool is used to assess upper limb function in a healthy population.

The Relationship of Grip and Pinch Strength to Musculoskeletal Disorders in Female Carpet Weavers in Southeastern Iran, 2019.

Background:The repetitive and prolonged exertion of grip and pinch strength are current among carpet weaver tasks. The three objectives of this study were (1) to investigate the relationship between symptoms of musculoskeletal disorders and grip and pinch strength of carpet weavers in carpet weaving workshops in Kerman province, (2) to compare the grip and pinch strength of carpet weavers with normal values, and (3) to identify the relationship between hand postures of carpet weavers during work and force exertion.Methods:In this cross-sectional study, grip strength and key, tip and palmar pinch strengths of 101 female carpet weavers aged 20 to 71 years were measured in Kerman province, in 2018. Nordic Musculoskeletal Questionnaire (Extended version) was also used to evaluate musculoskeletal disorders.Results:Bivariate and multivariate linear regression analyses showed that participants who suffered from musculoskeletal disorders had lower grip and pinch strength than others and this decrease was statistically significant in upper back, wrists/hands, and knees. Moreover, there was a significant difference between grip and three types of pinch strength of carpet weavers and normal values. Furthermore, for both hands, the grip strength in the position recommended by American Society of Hand Therapists was significantly greater than that in the normal position carpet weavers usually adopt.Conclusion:Based on the results, the high prevalence of musculoskeletal disorders has led to a significant decrease in the grip and pinch strength of carpet weavers. Therefore, it is necessary to undertake ergonomic interventions in designing the carpet weaving workstation.

Virtual health care & telehealth: Current therapy practice patterns

Study designSurvey Study. PurposeTo investigate recent practice changes with respect to the provision of virtual visits by hand therapists due to the COVID-19 pandemic by asking about changes in the frequency of virtual visits, the assessments and treatments currently provided virtually, and the opinions of therapists on the future on virtual visits in hand therapy practice. MethodsThe survey was distributed to the American Society of Hand Therapists (ASHT), the Australian Hand Therapy Association (AHTA), the Canadian Society of Hand Therapists (CSHT), and the European Federation for the Societies of Hand Therapy (EFSHT). ResultsOf the 819 responses, there were 573 therapists (70%) who reported that they currently use virtual visits in their practice. Only 38 therapists (4.6%) were providing virtual visits prior to COVID-19, representing a 15-fold increase in virtual visits since the beginning of the pandemic. Only 26% (n = 213) reported that they used patient-reported outcome measures (PROM) in conjunction with their virtual visits. Approximately 78% (n = 638) said that they thought there is a sustainable future for this method of care in hand therapy practice. DiscussionThis survey has helped identify the changing landscape in the provision of rehabilitation and established some of the common assessments and interventions currently utilized by hand therapists in the virtual environment. Next, steps for research are to investigate the reliability and validity of some of the assessments and interventions used, to establish whether virtual care will provide good outcomes for patients, and ultimately understand the optimal combination of conventional therapy and virtual care.

Developing a student competency exam for hand therapy clinical experiences: A cross-sectional survey of hand therapists

Study DesignCross-sectional survey design. IntroductionStudents pursuing hand therapy clinical rotations are expected to demonstrate foundational knowledge prior to the experience. Purpose of the StudyIdentify content that should be included on a potential competency exam for students pursuing hand therapy rotations from the perspectives of current hand therapists. MethodsThis questionnaire, devised from the Scope of Practice and Domains of Hand Therapy, was emailed to members of the American Society of Hand Therapists. Data was collected and analyzed with SurveyMonkey to determine descriptive statistics and frequency distributions. ResultsAll knowledge areas included in the survey were ranked important or very important. Knowledge areas with the highest responses of much importance were the range of motion assessments of the upper extremity, anatomy and physiology, and interpersonal skills and therapeutic communications. DiscussionHand therapy clinical instructors expect their students to demonstrate competency in relevant topics prior to starting their clinical experiences. A hand therapy competency exam addressing the valued knowledge areas may ensure students are prepared for the rigorous expectations of a hand therapy clinical rotation. ConclusionA competency test, including knowledge areas presented in this study, given to students before starting a specialty rotation, may ensure that the student has the foundational knowledge needed to succeed in a hand therapy setting, provide an understanding of students’ strengths and weaknesses, and help clinicians become more willing to accept students for hand therapy rotations.

Normative data for the Baseline® 5 position hydraulic pinch meter and the relationship between lateral pinch strength and pinch span

IntroductionThe Baseline® 5 position hydraulic pinch meter allows pinch strength assessment at five different pinch spans. The present study used this newly developed meter to assess where pinch span force is the greatest as previous literature is conflicting. Purpose of the StudyThe primary aim of the study was development of normative data using health subjects, whereas the secondary aims were to evaluate meter inter-rater reliability and to identify in which pinch span the greatest force was produced. Study DesignThis is a clinical measurement, cross-sectional study. MethodsTen occupational therapy student raters examined inter-rater reliability by calculating an average intraclass correlation. Recruitment of normative data subjects occurred across various locations in West Michigan to include a diverse population and followed testing procedures recommended by the American Society of Hand Therapists. Data were stratified by age categories and sex to develop normative standards. Data were analyzed using a one-way repeated measures ANOVA and a three-way mixed ANOVA. ResultsNormative data were calculated from a sample of 605 subjects (292 males and 313 females). One-way ANOVA demonstrated a significant difference at the five different spans, noting a small effect size. Also noted were a nonsignificant three-way interaction between age category, pinch spans, and sex using both the right and left hands, along with a significant two-way interaction between spans and sex bilaterally. DiscussionThe meter showed an excellent inter-rater reliability with an intraclass correlation = .98 and indicated the pinch span that produced the greatest amount of force was not consistent with previous literature.

Client buy-in: An essential consideration for graded motor imagery in hand therapy

Study DesignThis is a cross-sectional survey research. IntroductionCurrent evidence provides efficacy of graded motor imagery (GMI) in chronic pain conditions but also reveals barriers to its implementation. Purpose of the StudyThe purpose of this study was to describe current utilization of GMI in hand therapy practice. MethodsSurvey tool, informed by literature and Revised Neurophysiology of Pain Questionnaire (NPQ) was electronically distributed to members of the American Society of Hand Therapists. Results132 therapists completed the survey. 65.2% reported they would always or very likely use GMI in clients with central sensitization, but no relationship between the likelihood of therapists using GMI to score achieved on the NPQ was found. Lack of patient buy-in, was the main barrier cited. “Sell it well” with pain neuroscience education the most cited strategy. DiscussionGMI is frequently used in clients with central sensitization but requires client buy-in. ConclusionsUnderstanding and explaining pain mechanism is essential for implementing GMI.

Standardization of grip strength measurements. Effects on repeatability and peak force

The aim of our study was to test grip strength and assess the effects of various degrees of standardization on repeatability and level of peak force. Sixteen healthy persons and eight subjects with an impaired hand function have been tested using a strain-gauge dynamometer. We compared four measurement protocols: (A) the subject is free to assume a comfortable arm position; (B) the subject is also free to assume a comfortable arm position but in addition a challenging stimulus to exceed a previous maximal effort, is given; (C) the arm was held in a predescribed and partly fixated position, as recommended by the American Society of Hand Therapists; (D) the position of the dynamometer is standardized using two reference points both on the hand and on the dynamometer. We found high test-retest reliabilities for each measurement protocol without any significant difference. There were, however, significant differences in strength level. With measurements according to protocol B the highest peak values were noted. Since the measurement protocol B combined good reliability with realistic peak forces, this procedure seems most suitable for grip strength measurements.

Certified hand therapists membership in the American Society of Hand Therapists: A survey study

Study DesignSurvey research. MethodsA pilot tested survey was administered through an electronic mailing system to 5777 CHTs with email addresses on file at Hand Therapy Certification Commission. The survey was electronically distributed on two separate occasions to maximize the response rate. ResultsThe response rate was 53% (n = 1271). The majority of the respondents who were not members of ASHT, 49% (441), indicated that member fees are too expensive, and 35% (311) respondents selected other as the reason. They specified that they were members in another country, the expenses were too high, or that they were retired. Ten percent (93) of respondents answered that they did not know what member benefits were offered, and 4% (40) responded that they do not value the member benefits offered. Finally, 2% (14) of participants answered that they do not value membership in any other professional organization. DiscussionWhile ASHT membership cost is lower than the benefits the member receives, some do not believe that the costs outweighs the benefits. The combination of these factors accounts for approximately half of all CHTs choosing not to join ASHT. ConclusionMany established members value their membership and find it beneficial not only for themselves but also for furthering the profession as well. Many CHTs identified cost as the most apparent factor for not joining ASHT.