Dexterity Function Research Articles

Effectiveness of robot-assisted exercise regimen parameters on extremity function and quality of life among stroke population – a scoping review

Background. The use of advanced technology in healthcare management is widespread in current practice. Many innovative technologies assist healthcare professionals in providing accurate, high-quality intervention protocols to alleviate patient issues effectively. Similarly, many technology-assisted evaluation and treatment methods are also in practice in the field of physiotherapy. In this study, our objective was to identify advanced innovative technologies used in the physiotherapy management of neurological problems, especially in the stroke population. Methods. Recent literature from the period of 01/01/2018 to 31/12/2023 was searched in the PubMed, Cochrane, and Medline databases using specific keywords: assisted technology, robotic therapy, assisted device, stroke population, and recent trends in physiotherapy. More than 50 articles were selected from the databases and carefully evaluated, including device-assisted exercises in the stroke population, with systematic reviews and meta-analyses identifying relevant RCT studies. Approximately 9 articles were scrutinized based on criteria for bias reduction and evaluated for the advantages and disadvantages of advanced technology support in physiotherapy interventions. Results. Robotic therapy-assisted intervention was compared with conventional management in many studies, revealing that quality of life and learning outcomes were more beneficial in the technology-assisted exercise group, especially among ischemic hemiplegic subjects. Upper extremity and hand dexterity functions also improved more in the advanced technology-assisted intervention. Limitations of the study were identified in the frequency and intensity of the technology-assisted exercise protocol, with its benefits not clearly outlined in previous studies. Conclusion. Advancement in physiotherapy management in association with technology device-assisted intervention will play a major role in the future. We recommend further investigation into exercise parameters such as duration, frequency, and intensity to better understand their beneficial effects for stroke patients, which could aid future physiotherapy practice

Assessing the Dexterity Function of Dominant Hand in PUBG Players with Cell Phone Elbow Syndrome

The objective of the study was to find out dexterity function of PUBG players with cell phone elbow syndrome and to determine its prevalence. The study was a cross-sectional design conducted at the University of Management and Technology, Lahore. A convenience sampling method was employed, resulting in a sample size of 204 PUBG-playing students. Tinel sign and Michigan hand outcome questionnaire were used as data collection tools for evaluation. The current study showed that 204 participants were enrolled, of which 22.55% of participants demonstrated moderate dexterity loss on the Michigan hand outcome questionnaire, and 15.2% had a positive Tinel sign test. The prevalence of cellphone elbow syndrome was 15%. These findings concluded 15% prevalence of cell phone elbow syndrome in PUBG players. While no significant association was observed between cell phone elbow syndrome and dexterity function, 46 participants exhibited moderate dexterity loss.

Hand Performance Assessed by Functional Dexterity Test Correlates With Clinical Disease Activity but Remains Altered in Rheumatoid Arthritis Patients Achieving Treatment Goals: A Cross-Sectional Cohort Study.

Direct hand function is not commonly evaluated in patients with rheumatoid arthritis (RA). The Functional Dexterity Test (FDT) assesses a patient's ability to use the hand for daily tasks and is an accepted quantitative assessment tool in occupational medicine. This pilot study aimed to examine the correlations of FDT-measured hand performance with disease activity status in a cohort of RA patients. Forty-eight patients with established RA performed the FDT during their regular follow-up visits. The dominant and non-dominant hands were assessed separately. FDT results were compared among patients with active RA and Clinical Disease Activity Index (CDAI)>10, RA patients achieving controlled disease activity state (CDAI≤10), and 20 volunteers with no rheumatic disease. Mean FDT for the dominant hand was 43s in active RA, 35s in controlled RA, and 25s in persons without arthritis. Corresponding FDT results for the non-dominant hand were 50, 38, and 29s, respectively. FDT significantly correlated with CDAI in the entire cohort of RA patients and the subgroup with CDAI>10. Patients with controlled disease, CDAI≤10, still demonstrated significantly reduced hand performance compared with non-rheumatic controls. FDT is a sensitive tool for assessing rheumatoid hand function. Reduced hand performance by FDT in many RA patients who have already achieved existing treatment goals speaks to the question of the suitability of direct hand performance assessment as an RA outcome measure.

Patient Perspectives on Upper-Limb Daily Function in Parkinson's Disease.

Dexterity impairments are common among people with Parkinson's disease (PWP), yet little is understood about the effect of upper-limb (UL) dysfunction on daily activity performance. The aims were to (1) map the dexterity activities most affected and meaningful to PWP; (2) explore the associations between perceived dexterity function and disease severity, cognitive and motor UL impairments, dexterity ability, self-reported activities of daily living (ADL) function, and quality of life (QOL); (3) investigate variables explaining perceived dexterity function; and (4) examine the differences in perceived dexterity function based on dominance affectedness. A total of 43 PWP (mean age = 70.00 years, standard deviation [SD] = 6.75) were assessed for perceived dexterity function (36-item Dexterity Questionnaire [DextQ-36]), dexterity ability (Coin Rotation Task), disease severity (modified Hoen and Yahr Scale), self-reported ADL function and motor UL impairments (Movement Disorder Society-Unified Parkinson's Disease Rating Scale), cognition (Montreal Cognitive Assessment), and QOL (Parkinson's Disease Questionnaire-39). The leading dexterity activities participants reported as difficult and meaningful included using a touchscreen, pulling on socks, and dialing a phone. Perceived dexterity significantly correlated with self-reported ADL function (r = 0.716), QOL (r = 0.691), disease severity (r = 0.470), and dominant-hand dexterity (r = 0.432). Dexterity ability and disease severity explained 30% of perceived dexterity variance. No differences in perceived dexterity function based on dominance affectedness were found. PWP encounter challenges in complex dexterity tasks that impact their independence. Before interventions focused on UL function are initiated, assessments of PWP should include inquiries about the meaningfulness of challenging dexterity activities.

Strength and dexterity of less affected hand of children with unilateral cerebral palsy: a comparison study with normal peers.

A key aspect of hand function is dexterity, which is described as fine voluntary movements used to manipulate small objects during a specific task. The contralateral hand in children with unilateral cerebral palsy (U-CP); is commonly referred to as a "good" and "unimpaired" hand, while others have noted that it has subtle limitations. Therefore, this study aimed to assess and compare between the strength and dexterity of less-affected hand of children with U-CP and the dominant hand of normal peers. A sample of 120 volunteer children from both sexes and age ranged from 6 to 10 years participated in this study. Out of the 120 children, sixty were normal typically developing (TD) and sixty children with U-CP. Assessment of fine motor dexterity and grip and pinch strength were carried out by the Functional dexterity test (FDT) and Pneumatic squeeze Blub Dynamometer respectively. The results showed that there was a significant lower in pinch and grip strength (p < 0.01) and significant higher FDT scores of children with U-CP compared with that of TD children (p = 0.001). Moreover, there was a significant higher functional levels in TD children compared with that of children with U-CP (p < 0.001) with no significant difference between groups in penalty distribution (p > 0.05). Children with U-CP underperformed with their less-affected hand than the dominant hand of TD age matched peers. Future researches on bilateral hand function may be used to determine the best rehabilitation interventions.

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Choosing between Orthotopic Neobladder and Ileal Conduit after Radical Cystectomy: Tools for Assessing Patient-Specific Characteristics and Enhancing the Decision-Making Process-A Review of Current Studies.

Objective: The aim of the study was to find tools to assess patient characteristics that would help in choosing between orthotopic neobladder and ileal conduit in patients undergoing radical cystectomy. An additional goal was to search for aids that improve preoperative counseling to support patients in the decision-making process. Methods: A systematic review of MEDLINE, Web of Science, and Scopus databases was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, in April 2024. Inclusion criteria were specified in PICO format. Two reviewers independently screened titles/abstracts and full papers. Upon study selection, the results and conclusions from the studies were abstracted and quantitatively summarized in the results section of this article. Results: Seven articles, involving a total 834 patients, were included. One article described frailty, two reviewed cognitive status, one article described functional dexterity, one described personality, two articles reviewed patients' values and goals, and one article reviewed role of patient-physician dialogue in the context of choosing UD after RC. The reviewed articles identified tools and approaches that could be valuable in evaluating the suitability for continent urinary diversion (CUD) or incontinent urinary diversion (ICUD). Conclusions: This is the first systematic review that summarizes the new available methods of patient assessment which improve preoperative counseling and choosing the most suitable UD after RC. Efficient tools for this purpose are still missing, and further studies that will aid in creating a simple aid for patient selection are necessary.

The pronator contracture syndrome: A new entity in supination restriction.

Forearm rotation is essential for daily activities and functional dexterity, involving both pronation and supination. Forearm rotation limitations can result from various pathologies, often linked to trauma, structural changes in radio-ulnar joints, and interosseous membrane alterations. Soft tissue contracture, such as post-burn scarring or specific neurological conditions, can also restrict forearm rotation. We present two cases of painless restricted passive and active supination, devoid of bony, neurovascular, soft tissue, or congenital abnormalities. We describe a surgical technique to improve forearm rotation in these patients.

Fluorescent human RPA to track assembly dynamics on DNA

DNA metabolic processes including replication, repair, recombination, and telomere maintenance occur on single-stranded DNA (ssDNA). In each of these complex processes, dozens of proteins function together on the ssDNA template. However, when double-stranded DNA is unwound, the transiently open ssDNA is protected and coated by the high affinity heterotrimeric ssDNA binding Replication Protein A (RPA). Almost all downstream DNA processes must first remodel/remove RPA or function alongside to access the ssDNA occluded under RPA. Formation of RPA-ssDNA complexes trigger the DNA damage checkpoint response and is a key step in activating most DNA repair and recombination pathways. Thus, in addition to protecting the exposed ssDNA, RPA functions as a gatekeeper to define functional specificity in DNA maintenance and genomic integrity. RPA achieves functional dexterity through a multi-domain architecture utilizing several DNA binding and protein-interaction domains connected by flexible linkers. This flexible and modular architecture enables RPA to adopt a myriad of configurations tailored for specific DNA metabolic roles. To experimentally capture the dynamics of the domains of RPA upon binding to ssDNA and interacting proteins we here describe the generation of active site-specific fluorescent versions of human RPA (RPA) using 4-azido-L-phenylalanine (4AZP) incorporation and click chemistry. This approach can also be applied to site-specific modifications of other multi-domain proteins. Fluorescence-enhancement through non-canonical amino acids (FEncAA) and Förster Resonance Energy Transfer (FRET) assays for measuring dynamics of RPA on DNA are also described. The fluorescent human RPA described here will enable high-resolution structure-function analysis of RPA-ssDNA interactions.

Effect of Transcranial Direct Current Bi-Hemispheric Stimulation on Fine Motor Activity of the Hand in Healthy Adults

Background: Evidence states that transcranial direct current stimulation (tDCS) can alter cortical excitability (Cathodal stimulation hyperpolarizes, while anodal stimulation excites). This study compares bihemispheric tDCS to sham stimulation on fine motor activity in healthy adults. Methods: 24 healthy 18-30-year subjects were recruited at Nizam's Institute of Medical Sciences in Hyderabad, India, and split into experimental (tDCS bihemispheric stimulation) and control (sham) groups. The O'Connor Finger Dexterity Test (OCFDT) and Purdue Pegboard Test (PPBT) results were analysed for hand dexterity before and after stimulation. Results: Variables like age, height, weight, and BMI of the groups were taken. Significance of differences in Intra- and inter-group hand function dexterity tests (OCFDT, PPBT) test results were done, and a p-value of &lt;0.05 was considered significant. Conclusion: The study found significant intra-group pre and post-differences in all components of OCFDT and assembly components of PPBT, but inter-group differences in other components of PPBT and OCFDT were insignificant. Results found were limited as tDCS can only stimulate the superficial cortex. In addition, the results in the sham group attributed to some amount of superficial stimulation in sham stimulation. Further research is needed to know the extent of stimulation effects and training effects to understand cortical activity differences in bi-hemispheric and sham stimulation, initial cognitive competence, motor planning, task practice, fine motor function feedback, intensity, electrode size, duration, number of sessions, stimulation site on tDCS effects. Keywords: Hand function, tDCS, Sham stimulation, Bi-hemispheric stimulation, Transcranial direct current stimulation,

An examination of relationships between vitamin B12 status and functional measures of peripheral neuropathy in young adult vegetarians.

Prevalence rates for vitamin B12 deficiency in U.S. adult vegetarians may exceed 30%, which is concerning given the role for this vitamin in numerous nervous system functions, including the synthesis of myelin sheaths. Defective myelin synthesis and repair are directly linked to peripheral neuropathy; yet, few investigations have examined how physical indicators of peripheral neuropathy (e.g., hand dexterity, vibration sensitivity and balance) are impacted in individuals adhering to vegetarian diets. This feasibility research explored the relationships between peripheral neuropathy and vitamin B12 status using a cross-sectional study design. In addition, a small pilot trial was conducted for limited-efficacy testing of vitamin B12 supplementation for reducing peripheral neuropathy. Healthy, able-bodied adults (n = 38; 19-40 years of age) reported exclusive adherence to a vegetarian or vegan diet for 3 years. Peripheral neuropathy was measured using a force plate for assessing balance, and a vibration sensitivity tester and pegboard tests to assess hand dexterity. Serum vitamin B12 and folate were measured using standard radioimmunoassay techniques. Twenty-six percent of the sample displayed deficient or marginal vitamin B12 status (serum vitamin B12 <221 pmol/L). Participants with adequate vitamin B12 status scored 10% higher on the Purdue pegboard assembly test and 20% higher on the left hand adjusted functional dexterity test in comparison to participants with marginal-to-deficient vitamin B12 status (p < 0.05). These data provide preliminary evidence that peripheral neuropathy can be detected in individuals with marginal-to-deficient vitamin B12 status.

The Functional Dexterity Test in Adult Populations: An Exploration of a Simplified Test Protocol and Parameters Guided by Statistical Outcomes

The Functional Dexterity Test (FDT) is a standardized assessment used to quantify dexterity, in-hand manipulation, related to function. Recommendations to modify the scoring have been proposed to eliminate penalties, adapt the test protocol, and change the outcome parameter. A new psychometrically sound scoring system has been used in the pediatric population; however, research in the adult population requires exploration. The purpose of this study was to test if alterations in test administration, outcome recording, and outcome parameters show predictive validity for measured outcomes for age, ethnicity, and self-identified gender. The new method of administering the FDT eliminates penalties for improper performance and uses a score of speed derived from the timed score. It was theorized that eliminating assessment of reported errors in quality of movement in the quantitative scoring may improve the test validity. Clinical Measurement. The FDT was administered to 148 healthy adults aged between 18 and 78years. No penalties were included in the quantitative scoring. Age, self-identified gender, ethnicity, and self-reported hand dominance were recorded. Time to complete the test was measured in seconds per usual protocol. The result was recorded as time and calculated as speed. Linear regression was performed to predict FDT speed from age, hand dominance, and self-identified gender. The three predictors (age, hand dominance, and gender) associated with a linear decline in dexterity were significant (p ≤0.02). Dexterity showed a linear decline with age, and participants showed faster speeds with the dominant hand. Gender was a significant predictor of speed, with males having faster speeds by an average of 0.047 pegs per second (p=0.01). Scores using a simplified administration and speed as an outcome showed moderate predictive validity with age, gender, and the dominant hand used in this adult population. Future research exploring relationships with activities of daily living is needed.

Cervical proprioception in Parkinson's disease and its correlation with manual dexterity function.

Cervical proprioception has a crucial role in posture and movement control. The study aimed to determine the relationship of cervical proprioception, cervical muscle strength and endurance with manual dexterity and hand strength in individuals with idiopathic Parkinson's disease (PD). Twenty individuals with PD (mean age:63.9 years) and 20 healthy individuals as a control group (mean age: 61.9 years) were recruited. Cervical joint position error (JPE), static endurance of neck muscles, activation of deep cervical flexor muscles (Craniocervical Flexion Test-CCFT), manual dexterity using Purdue Pegboard Test (PPT), cognitive and motor task on PPT, finger tapping test (FTT) and pinch-grip strength were assessed. Cervical JPE was significantly higher in individuals with PD than controls (p<0.05). The strength and endurance of the cervical muscles were significantly decreased in individuals with PD (p<0.05). There was a significant negative correlation of cervical JPE measurements with PPT, cognitive and motor tasks on PPT in the PD group (p<0.05). There was a significant negative correlation of the endurance of cervical flexor muscles with PPT and cognitive task on PPT (p<0.05). In addition, a significant positive correlation was found between cervical flexor endurance and hand strength in the PD group (p<0.05). Cervical proprioception and the strength and endurance of cervical muscles decrease in individuals with PD compared to healthy individuals. Impairment of cervical proprioception appears to be associated with poorer upper extremity performance. Detailed evaluation of the cervical region in PD may be useful in determining the factors affecting upper extremity function.

Exploring hand and upper limb function in patients with inclusion body myositis (IBM)

Inclusion body myositis (IBM) is an inflammatory myopathy characterized by progressive weakness of knee extensors and finger flexors. Many patients lose independence with fine motor tasks; however, a gap remains as to how these deficits correlate with performance on functional outcome measures. We describe functional hand impairments as measured by performance-based outcome measures in a cross-sectional sample of 74 patients with IBM. Subjects completed a series of outcome measures (Functional Dexterity Test (FDT), Performance of the Upper Limb (PUL), and Sollerman Hand Function Test (SHFT)) alongside a collection of patient reported outcomes (PROs). Assessments were compared to standard IBM measurements, including grip strength and IBM Functional Rating Scale (IBMFRS). FDT and SHFT demonstrated significant correlations to grip (p<0.001; Spearman correlations r=0.48–0.70). Significant correlation was found between all functional outcome measures and IBMFRS (p<0.001; Spearman correlations r=0.51–0.77), as well as PRO Upper Extremity Scale for IBM (IBM-PRO) (p<0.05; Spearman correlations r=0.55–0.73). Non-ambulatory patients demonstrated significantly weaker grip (p<0.001), resulting in lower PUL scores and increased FDT completion times (p<0.001). Collectively, these assessments may provide insight to understanding functional limitations of the hands and potentially allow for more inclusive clinical trials with future validation of hand assessments in IBM.

Dexterity enhancement of continuum robot for natural orifice transluminal endoscopic surgery in the dual-manipulator collaborative space.

Suturing and knotting in Natural Orifice Transluminal Endoscopic Surgery (NOTES) requires the robot not only to be able to work with multiple manipulators but also to have a high degree of dexterity. However, little attention has been paid to the design and enhancement of dexterity in multi-manipulated robots. In this paper, the dexterity of a new dual-manipulator collaborative continuum robot in collaborative space is analyzed and enhanced. A kinematic model of the continuum robot was developed. The dexterity function of the robot is evaluated based on the concepts of the low-Degree-of-FreedomJacobian matrix. Then an Adaptive Parameter Gray Wolf Coupled Cuckoo Optimization Algorithm with faster convergence and higher accuracy is innovatively proposed to optimize the objective function. Finally, experiments demonstrate that the dexterity of the optimized continuum robot is enhanced. The optimization results show that the optimized dexterity is 24.91% better than the initial state. Through the work of this paper, the robot for NOTES can perform suturing and knot more dexterously, which has significant implications for the treatment of digestive tract diseases.

Video parameters for action observation training in stroke rehabilitation: a scoping review

Purpose Action observation training (AOT) is a therapeutic approach used in stroke rehabilitation. Videos form the core of AOT, and knowledge of constituent parameters is essential to make the intervention robust and generalizable. Currently, there is a dearth of available information on video parameters to be used for AOT. Our purpose was to identify and describe the parameters that constitute AOT videos for stroke rehabilitation. Method Electronic databases like PubMed, CINAHL, Scopus, Web of Science, ProQuest, and Ovid SP from inception to date according to PRISMA-ScR guidelines. Title, abstract, and full-text screening were done independently by two authors, with a third author for conflict resolution. Data on video parameters like length, quality, perspective, speed, screen size and distance, sound, and control videos were extracted. Results Seventy studies were included in this review. The most-reported parameters were video length (85.71%) and perspective of view (62.85%). Movement speed (7.14%) and sound (8.57%) were the least reported. Static landscapes or geometrical patterns were found suitable as control videos. Conclusion Most video parameters except for length and perspective of view remain underreported in AOT protocols. Future studies with better descriptions of video parameters are required for comprehensive AOT interventions and result generalisation.

Tablet app-based dexterity training in multiple sclerosis (TAD-MS): a randomized controlled trial

Purpose Mobile health applications (mHealth apps) may lead to health benefits. In recent years, the use of apps in multiple sclerosis (MS) has increased. Apps to train and improve dexterity in MS are scarce. This study investigated the effectiveness of a tablet app-based home-based training to improve dexterity in individuals with MS. Materials and methods In a randomized controlled trial, two standardized 4-week home-based interventions focussing on different aspects of dexterity and upper limb function were compared. Assessments were done at baseline, post-intervention and 12-week follow-up. The primary endpoint was the Arm Function in Multiple Sclerosis Questionnaire, a dexterity-related measure of patient-reported activities of daily living. Secondary endpoints were dexterous function, grip strength and health-related quality of life. Results Forty-eight individuals were randomly assigned to a tablet app-based program (n = 26) or a control strengthening exercise program (n = 22). No significant differences were found for the primary endpoint (p = 0.35). Some significant differences in favour of the app-group were found in fine coordinated finger movements and strength. No significant differences were found at the 12-week follow-up for all endpoints. Adherence in both groups was above 90%. Conclusions App-based training was not superior compared to a control strengthening exercise program concerning the arm- and hand function from the participant’s perspective. However, app-based training was found to be effective in improving specific dimensions (finger movements and strength), and can easily be applied at home. Therefore, individuals living with MS with impaired dexterity should consider app-based training. Clinical Trial Registration Clinicaltrials.gov NCT03369470.

Excitatory Repetitive Transcranial Magnetic Stimulation Over the Ipsilesional Hemisphere for Upper Limb Motor Function After Stroke: A Systematic Review and Meta-Analysis

BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a promising therapy to promote recovery of the upper limb after stroke. According to the regulation of cortical excitability, rTMS can be divided into excitatory rTMS and inhibitory rTMS, and excitatory rTMS includes high-frequency rTMS (HF-rTMS) or intermittent theta-burst stimulation (iTBS). We aimed to evaluate the effects of excitatory rTMS over the ipsilesional hemisphere on upper limb motor recovery after stroke.MethodsDatabases of PubMed, Embase, ISI Web of Science, and the Cochrane Library were searched for randomized controlled trials published before 31 December 2021. RCTs on the effects of HF-rTMS or iTBS on upper limb function in patients diagnosed with stroke were included. Two researchers independently screened the literature, extracted the data, and assessed quality. The meta-analysis was performed by using Review Manager Version 5.4 software.ResultsFifteen studies with 449 participants were included in this meta-analysis. This meta-analysis found that excitatory rTMS had significant efficacy on upper limb motor function (MD = 5.88, 95% CI, 3.32–8.43, P < 0.001), hand strength (SMD = 0.53, 95% CI, 0.04–1.01, P = 0.03), and hand dexterity (SMD = 0.76, 95% CI, 0.39–1.14, P < 0.001). Subgroup analyses based on different types of rTMS showed that both iTBS and HF-rTMS significantly promoted upper limb motor function (iTBS, P < 0.001; HF-rTMS, P < 0.001) and hand dexterity (iTBS, P = 0.01; HF-rTMS, P < 0.001) but not hand strength (iTBS, P = 0.07; HF-rTMS, P = 0.12). Further subgroup analysis based on the duration of illness demonstrated that applying excitatory rTMS during the first 3 months (<1 month, P = 0.01; 1–3 months, P = 0.001) after stroke brought significant improvement in upper limb motor function but not in the patients with a duration longer than 3 months (P = 0.06). We found that HF-rTMS significantly enhanced the motor evoked potential (MEP) amplitude of affected hemisphere (SMD = 0.82, 95% CI, 0.32–1.33, P = 0.001).ConclusionOur study demonstrated that excitatory rTMS over the ipsilesional hemisphere could significantly improve upper limb motor function, hand strength, and hand dexterity in patients diagnosed with stroke. Both iTBS and HF-rTMS which could significantly promote upper limb motor function and hand dexterity, and excitatory rTMS were beneficial to upper limb motor function recovery only when applied in the first 3 months after stroke. HF-rTMS could significantly enhance the MEP amplitude of the affected hemisphere. High-quality and large-scale randomized controlled trials in the future are required to confirm our conclusions.Clinical Trial Registrationwww.crd.york.ac.uk/prospero/, identifier: CRD42022312288.

5-Year Activity and Participation Outcomes of the First Successful Pediatric Bilateral Hand Transplantation: A Case Report

Aims Describe the 5-year outcomes of the first successful pediatric bilateral hand transplantation. Methods The child underwent quadrimembral amputation at age two and received bilateral hand allografts at age eight. Rehabilitation included biomechanical, neurorehabilitation, and occupational approaches in acute and outpatient settings. Therapist observed outcomes, patient-reported measures, and parent-reported measures were repeated over a 5-year period. Results Observation assessments revealed functional dexterity skills and modified independence to full independence with self-care activities. The parent reported the child had moderate difficulty with upper extremity functioning 25-, 41-, and 48-months post-transplantation, and mild difficulty at 60-months; the child reported no difficulties in this domain at 41 months. Five years post-transplantation the child reported enjoying many age-appropriate activities, and high-quality peer relations were endorsed by both parent and child. Conclusion The child developed hand movements for daily activities and was completing daily activities with improved efficiency. Health-related quality of life outcomes were favorable.

More Than Movement: Exploring Motor Simulation, Creativity, and Function in Co-developed Dance for Parkinson's.

Dance is an enjoyable, non-therapy-focused activity that may provide a range of benefits for people with Parkinson’s. The internal simulation of movement through observation, imitation, and imagery, is intrinsic to dance and may contribute to functional improvements for people with Parkinson’s. This study explored the feasibility and potential benefits of a dance program designed by a collaborative team of dance artists, researchers, physiotherapists, and people living with Parkinson’s. The program incorporated motor simulation through observation, imitation and imagery of movement, supported by creative themes, expression, and music. A 6-week pilot trial of the program was conducted with 10 people with Parkinson’s. A focus group following the trial (N = 8) provided insights into the use of imagery, observation and imitation within dance, and the link between creativity and functional outcomes, as well as indicating multidimensional benefits of dance as reported in previous studies. Exploratory outcome measures also suggested potential effects on motor simulation, functional dexterity, and quality of life. The present study demonstrates the feasibility of a co-developed dance program for Parkinson’s and indicates how creative elements of dance may support functional outcomes. Future research should examine the role of motor simulation processes in dance for Parkinson’s, including the potential to develop transferable cognitive-motor skills. This study also highlights the value of collaborative partnerships in designing dance for health programs, which may optimise beneficial effects by using creative approaches to incorporate evidence-based elements, with guidance from individuals with lived experience to ensure the relevance to their goals.