Hand Steadiness Research Articles

A mechanical device for precise self-administration of ocular drugs

Individuals with glaucoma are routinely prescribed and required to self-administer eye drop-based medication multiple times a day. Unfortunately, the process of self-administering eye drops requires a level of dexterity, strength, and visual acuity that the elderly population often do not possess, resulting in poor adherence and worsening condition. In this paper, we detail a prototyped eye drop assist device designed to safely and reliably deliver prescription medications. The ergonomic device safely anchors the eye drop bottle tip an optimal distance away from the face, aligns to the pupil, and provides feedback to the user when their head is at an appropriate tilt for a successful eye drop administration. We experimentally verify that the device improves hand steadiness, provides accurate head tilt feedback, precisely positions the bottle tip, and predictably delivers eye drops into the eye according to a parameterized model.

Patient and clinician perceptions of the pulse oximeter in a remote monitoring setting for COVID-19: Qualitative study.

As a response to the COVID-19 pandemic, the Royal Prince Alfred Hospital in New South Wales, Australia, launched the rpavirtual program, the first full-scale virtual hospital in Australia, to remotely monitor and follow-up stable COVID-19 patients. As part of the intervention, a pulse oximeter wearable device was delivered to patients to monitor their oxygen saturation levels, a critical indicator of COVID-19 patient deterioration. Understanding users' perceptions towards the device is fundamental to assessing its usability and acceptability and contributing to the effectiveness of the intervention, but no research to date has explored the user experience of the pulse oximeter for remote monitoring in this setting. To explore the utilization, performance, and acceptability of the pulse oximeter by clinicians and patients in rpavirtual during COVID-19. Semi-structured interviews and usability testing were conducted. Stable COVID-19 adult patients (≥18 years old) who used the pulse oximeter and were monitored by rpavirtual and rpavirtual clinicians monitoring these patients were interviewed. Clinicians could be nurses, doctors or staff part of the team who assisted patients with the use of the pulse oximeter. Usability testing was conducted with patients who had the pulse oximeter when they were contacted. Interviews were coded using the Theoretical Framework of Acceptability. Usability testing was conducted using a think-aloud protocol. Data was collected until saturation was reached. Twenty-one patients (average age: 51 years) and 15 clinicians (average age: 41 years) completed the interview. Eight patients (average age: 51 years) completed the usability testing. All participants liked the device and thought it was easy to use. They also had a good understanding of how to use the device and the device's purpose. Patient age and device-use related characteristics (e.g., the warmth of hands, hand steadiness) were identified by users as factors negatively impacting the accurate use of the pulse oximeter. Patients and clinicians had very positive perceptions of the pulse oximeter for COVID-19 remote monitoring, indicating high acceptability and usability of the device. However, factors that may impact the accuracy of the device should be considered when delivering interventions using the pulse oximeter for remote monitoring. Targeted instructions about the use of the device may be necessary for specific populations (e.g. elderly, patients unfamiliar with technology). Further research should focus on the integration of the pulse oximeter data into electronic medical records for real-time and secure patient monitoring.

Comparative Assessment of Effect on Psychomotor Performance Efficacy and Adherence of Levosulpiride and Olanzapine in Patients with Schizophrenia: A Parallel, Open-label, Prospective Observational Study

Abstract Context: Schizophrenia is mostly treated with atypical antipsycotics, which may be required for lifetime. Olanzapine is commonly used in this condition, whereas levosulpiride is approved in India for the same. Knowing the effect of these drugs on psychomotor function helps in choosing a suitable drug to a particular patient based on his daily activities. Aims: The aim is to compare the effect of levosulpiride and olanzapine on psychomotor performance, efficacy, and adherence in patients with schizophrenia. Settings and Design: This was open-label, parallel arm, prospective observational study carried out in a tertiary care hospital of central India from December 2019 to December 2021. Subjects and Methods: Thirty-six patients visiting psychiatry OPD, diagnosed by treating psychiatrist as schizophrenia were assessed by CFFT, hand steadiness test (HST), arithmetic ability test, and reaction time (RT) for psychomotor function, and symptoms were scored on positive and negative syndrome scale (PANSS) and brief negative symptom scale (BNSS) rating scales at the first visit, end of 4 and 8 weeks. Adherence was assessed by the Medication adherence rating scale at 8 weeks. Results: Statistically significant increase in RT was seen in both levosulpiride (P = 0.04) and olanzapine (P = 0.0065) groups, whereas only the olanzapine group had a significant change in CFFT (P = 0.04) and HST (P = 0.01) at 8 weeks. On head-to-head comparison, a statistically significant worsening in HST score (P = 0.01) was seen in olanzapine group. Both the groups had significant decreases in all PANSS (P < 0.001) and BNSS (P < 0.001) scores. When change in PANSS and BNSS scores were compared with each other, the levosulpiride group had a significantly more decrease in scores on PANSS negative scale (P = 0.03). Patients in both groups were adherent to treatment. Conclusions: Our study concluded that levosulpiride is better than olanzapine on its fine motor control. Both the drugs increase RT while only olanzapine worsened fine motor control and CFF. Both the drugs were effective for schizophrenia with 8 weeks treatment, while levosulpiride is superior to olanzapine in improving negative symptoms of schizophrenia.

A Comparative Study on the Effect of Regular Intake of Caffeine on Hand Steadiness Test in Right Hand Dominant Females

Caffeine is a CNS stimulant affecting normal cellular functions and increase energetic metabolism throughout the brain by enhancing alertness. Steadiness Tester – 9 Holes measures one of the aspect of psychomotor phenomena of steadiness. Our study was done to find out the difference in hand steadiness between caffeine users and non -caffeine users. Our study was done on 60 subjects aged between 18-45 years. All the subjects were females. 30 subjects were included in group A as only caffeine users and 30 were Tee totaller acting as controls under Group B. consent was obtained from all the volunteers. All the subjects were tested on a standard laboratory 9 hole steadiness tester. Subjects were asked to hold a stylus in a series of holes decreasing from 12.5 mm to 2.5 mm without touching the sides of the holes. The number of contacts or errors during the test were noted. The results showed that group B were steadiest in comparison to Group A. Statistically significant differences was found in the hole 4 at p< 0.05 and highly statistical significant results obtained from holes 5 to 9 at p≤0.001. Group B controls were steadier than Group A due to non-consumption of tobacco, alcohol, caffeine and any type of drug abuse.

Review of Wearable Sensor-Based Health Monitoring Glove Devices for Rheumatoid Arthritis.

Early detection of Rheumatoid Arthritis (RA) and other neurological conditions is vital for effective treatment. Existing methods of detecting RA rely on observation, questionnaires, and physical measurement, each with their own weaknesses. Pharmaceutical medications and procedures aim to reduce the debilitating effect, preventing the progression of the illness and bringing the condition into remission. There is still a great deal of ambiguity around patient diagnosis, as the difficulty of measurement has reduced the importance that joint stiffness plays as an RA identifier. The research areas of medical rehabilitation and clinical assessment indicate high impact applications for wearable sensing devices. As a result, the overall aim of this research is to review current sensor technologies that could be used to measure an individual’s RA severity. Other research teams within RA have previously developed objective measuring devices to assess the physical symptoms of hand steadiness through to joint stiffness. Unfamiliar physical effects of these sensory devices restricted their introduction into clinical practice. This paper provides an updated review among the sensor and glove types proposed in the literature to assist with the diagnosis and rehabilitation activities of RA. Consequently, the main goal of this paper is to review contact systems and to outline their potentialities and limitations. Considerable attention has been paid to gloved based devices as they have been extensively researched for medical practice in recent years. Such technologies are reviewed to determine whether they are suitable measuring tools.

Psychomotor abilities in diagnostic upper gastrointestinal endoscopy derived from procedural task analysis techniques and expert review.

BACKGROUND:Any prediction of a person's ability to succeed in a motor skill depends on the detection and accurate measurement of the basic abilities for the performance of that skill. Task analysis is needed to determine the psychomotor skills and abilities required to perform an action. This study aimed to determine the components of psychomotor abilities for diagnostic upper gastrointestinal (GI) endoscopy through procedural task analysis (PTA) and expert review.MATERIAL AND METHODS:A multisource, multimethod task analysis was conducted in six metropolitan teaching hospitals affiliated with the adult gastroenterology and hepatology training centers in the Islamic Republic of Iran in 2019. Observation, video-recording, and think-aloud protocols were used while diagnostic upper GI endoscopy was performed. To confirm the accuracy of the PTA, the incorporated the views of the adult gastroenterology and hepatology subspecialty experts through the checklist of PTA assessment criteria. Finally, to determine the psychomotor abilities for each stage of the procedure, the study incorporated a panel of experts from occupational therapy, physical education, physical medicine, and adult gastroenterology and hepatology subspecialty.RESULTS:Of the 15 psychomotor abilities examined, 11 were determined for upper GI endoscopy procedure, of which six cases (including visuospatial and perceptual abilities, hand–eye coordination, multilimb coordination, finger dexterity, arm–hand steadiness, and manual dexterity) were the most frequent.CONCLUSIONS:PTA techniques and subsequent expert review were used to identify the components of psychomotor abilities for diagnostic upper GI endoscopy. It is suggested that PTA is performed for other procedures, and after psychomotor abilities are specified, proportional tests are developed.

A comparative study of effect of sodium valproate & flunarizine on psychomotor performance in patients of common migraine: A randomized, parallel, open label, prospective observational study

Introduction: Psychomotor performance results from the coordination of sensory and motor system through the integrative and organizational process of brain and central nervous system. Psychotropic drugs may adversely affect work performance which depends on psychomotor activities. Both valproate and flunarizine are widely used drugs in prophylaxis of migraine and they are known to have effect on psychomotor performance. Hence this study was carried out to evaluate the effect of valproate & flunarizine on psychomotor performance in patients of migraine with the help of battery of subjective & objective psychomotor tests over a period of 8 weeks. Materials and Methods: Patients were allocated to one of the two groups on first day of examination. Baseline psychomotor tests were measured using battery of tests including critical flicker fusion test (CFFT), hand steadiness test (HST), arithmetic ability test & reaction time monitoring. At the end of 4 weeks & 8 weeks, again tests using same methods employed previously were performed. Efficacy was calculated by using Migraine dairy template (0, 4, 8 weeks) & CGI Scale (end). A total of 44 patients were recruited with 22 patients in each arm. Results: Flunarizine (n=20) & valproate (n=20) significantly increased CFFT, AAT scores at the end of 8 weeks compared to baseline and significantly reduced HST, RT, Frequency, Duration and severity at the end of 8 weeks compared to baseline. When flunarizine was compared to valproate no statistical significance was found in scores of CFFT, AAT, HST, RT, Frequency, duration, severity, global improvement and efficacy index. Conclusion: Flunarizine & Valproate were found to be equally efficacious to improve psychomotor performance. Keywords: Sodium valproate, Flunarizine, Psychomotor, Migraine, Prophylaxis, Performance.

Chemical exchange saturation transfer imaging in hepatic encephalopathy.

Hepatic encephalopathy (HE) is a common complication in liver cirrhosis and associated with an invasion of ammonia into the brain through the blood-brain barrier. Resulting higher ammonia concentrations in the brain are suggested to lead to a dose-dependent gradual increase of HE severity and an associated impairment of brain function. Amide proton transfer-weighted (APTw) chemical exchange saturation transfer (CEST) imaging has been found to be sensitive to ammonia concentration. The aim of this work was to study APTw CEST imaging in patients with HE and to investigate the relationship between disease severity, critical flicker frequency (CFF), psychometric test scores, blood ammonia, and APTw signals in different brain regions.Whole-brain APTw CEST images were acquired in 34 participants (14 controls, 20 patients (10 minimal HE, 10 manifest HE)) on a 3 T clinical MRI system accompanied by T1 mapping and structural images. T1 normalized magnetization transfer ratio asymmetry analysis was performed around 3 ppm after B0 and B1 correction to create APTw images. All APTw images were spatially normalized into a cohort space to allow direct comparison. APTw images in 6 brain regions (cerebellum, occipital cortex, putamen, thalamus, caudate, white matter) were tested for group differences as well as the link to CFF, psychometric test scores, and blood ammonia.A decrease in APTw intensities was found in the cerebellum and the occipital cortex of manifest HE patients. In addition, APTw intensities in the cerebellum correlated positively with several psychometric scores, such as the fine motor performance scores MLS1 for hand steadiness / tremor (r = 0.466; p = .044) and WRT2 for motor reaction time (r = 0.523; p = .022). Moreover, a negative correlation between APTw intensities and blood ammonia was found for the cerebellum (r = −0.615; p = .007) and the occipital cortex (r = −0.478; p = .045). An increase of APTw intensities was observed in the putamen of patients with minimal HE and correlated negatively with the CFF (r = −0.423; p = .013).Our findings demonstrate that HE is associated with regional differential alterations in APTw signals. These variations are most likely a consequence of hyperammonemia or hepatocerebral degeneration processes, and develop in parallel with disease severity.

A Randomized Open-label Study to Evaluate the Effects of Escitalopram and Mirtazapine on Psychomotor Functions and Memory in Patients with Depression

Objective: To compare the effects of escitalopram and mirtazapine on psychomotor functions and memory and also to correlate the antidepressant efficacy of these drugs with psychomotor functions. Materials and Methods: This study was carried out at a tertiary care teaching hospital on 104 newly diagnosed literate patients with endogenous depression as per the inclusion and exclusion criteria. Patients were prescribed either escitalopram (20 mg OD) or mirtazapine (15 mg OD) or amitriptyline (75 mg BD). Psychomotor functions were assessed by digit-letter substitution, six-letter cancellation, choice reaction time, hand steadiness, and flicker fusion tests, and memory was assessed by PGI memory scale at the baseline and at the end of the 1st week, 1st month, and 4th month. Efficacy of drugs was measured by the Hamilton Depression Rating Scale (HDRS) at the baseline and each follow-up. The antidepressant efficacy of these drugs with various psychomotor function tests was correlated using Pearson's correlation test. P 0.05). A strong correlation was observed between psychomotor functions and HDRS score in patients treated with escitalopram (positive correlation), mirtazapine (positive correlation), and amitriptyline (negative correlation). Conclusion: Escitalopram and mirtazapine improve psychomotor function in patients with endogenous depression while amitriptyline deteriorates it. Thus, escitalopram and mirtazapine may be preferred to amitriptyline in clinical practice.

Performance, Mood, and Anxiety During a Climb of Mount Everest.

Various studies have shown the deleterious effects of high-altitude hypoxia on visual, motor, somatosensory, cognitive, and emotional function and also in intelligence tests, reaction time, speech comprehension, hand steadiness, visual contrast discrimination, and word association tests. Because optimal cognitive abilities may be crucial for mountain climbers' safety, this study was intended to evaluate the changes in cognitive performance, mood, and anxiety during an Everest expedition lasting almost 3 months. A set of physiological (Lake Louise score, oxygen saturation), cognitive (Colorado perceptual speed [CPS] test, number comparison [NC] test), and emotional measurements (Profile of Mood States, anxiety responses, psychological inflexibility) were collected from nine climbers on a partly unsupported Mount Everest expedition at various time points during the course of the expedition at Everest Base Camp (EBC). For confidence intervals we used 95% simultaneous Bonferroni corrected interval (BCI) for the differences. During this expedition, the estimates of trait anxiety decreased 13% toward the end of expedition after successful summiting (p = 0.004). Simultaneously, fatigue appeared to diminish and the CPS speed results improved 13%. Most expedition members suffered mild symptoms of acute mountain sickness during the first days in the EBC, but this did not affect the speed or the number of mistakes made in the CPS or NC tests. In CPS test the differences between pretest and the physically most demanding period (EBC4, BCI: 0.01, 4.43) and between EBC1 and EBC4 (BCI: 0.57, 4.99), between EBC2 and EBC4 (BCI: 0.45, 4.88), and between EBC3 and EBC4 (BCI: 1.12, 5.55) were significant, showing ever improving results during the expedition. The most important finding in this study was that well-motivated and trained, self-selected individuals, who volunteer for a long-duration mission, are capable of maintaining high levels of performance, steady mood state, and a good level of vigor on a Mount Everest expedition lasting nearly 3 months.

Local vibration inhibits H-reflex but does not compromise manual dexterity and does not increase tremor

The present work aimed at investigating the effects of local vibration on upper limb postural and kinetic tremor, on manual dexterity and on spinal reflex excitability. Previous studies have demonstrated a decrease in spinal reflex excitability and in force fluctuations in the lower limb but an increase in force fluctuation in the upper limbs. As hand steadiness is of vital importance in many daily-based tasks, and local vibration may also be applied in movement disorders, we decided to further explore this phenomenon. Ten healthy volunteers (26±3years) were tested for H reflex, postural and kinetic tremor and manual dexterity through a Purdue test. EMG was recorded from flexor carpi radialis (FCR) and extensor digitorum communis (EDC). Measurements were repeated at baseline, after a control period during which no vibration was delivered and after vibration. Intervention consisted in holding for two minutes a vibrating handle (frequency 75Hz, displacement∼7mm), control consisted in holding for two minutes the same handle powered off. Reflex excitability decreased after vibration whilst postural tremor and manual dexterity were not affected. Peak kinetic tremor frequency increased from baseline to control measurements (P=0.002). Co-activation EDC/FCR increased from control to vibration (P=0.021). These results show that two minutes local vibration lead to a decrease in spinal excitability, did not compromise manual dexterity and did not increase tremor; however, in contrast with expectations, tremor did not decrease. It is suggested that vibration activated several mechanisms with opposite effects, which resulted in a neutral outcome on postural and kinetic tremor.

Comparison of Effect of Antidepressants on Psychomotor Functions.

Objective:The comparison of the effect of antidepressants on psychomotor functions in patients with endogenous depression.Materials and Methods:This prospective interventional study was carried out at a tertiary care teaching hospital on 95 literate patients with newly diagnosed endogenous depression matching inclusion and exclusion criteria. Patients were prescribed either desvenlafaxine (50 mg) or fluoxetine (40 mg) or sertraline (50 mg). Psychomotor functions were assessed by digit letter substitution, six letter cancellation, choice reaction time, hand steadiness and flicker fusion test at the baseline 1st month and 3rd month. Efficacy of drugs was also measured by Hamilton rating scale for depression. Data were analyzed by using ANOVA and P < 0.05 was considered as statistically significant.Results:A total of 95 patients were enrolled. Fluoxetine, desvenlafaxine, and sertraline were prescribed in 32, 32, and 31 patients, respectively. At the end of 3 months, a significant improvement in psychomotor functions was observed in patients treated with sertraline (P < 0.05), while desvenlafaxine-treated patients did not show any significant change in any of the tests. Surprisingly, fluoxetine-treated patients showed deterioration in all psychomotor tests (P < 0.05). Hamilton rating score improved at the end of 3 months treatment as compared to baseline. Most commonly observed adverse reactions in all three drug groups were nausea (n = 20), dizziness (n = 3), headache (n = 20), and diarrhea (n = 3).Conclusion:Sertraline significantly improves psychomotor function as compared to desvenlafaxine while fluoxetine impairs.

Hand-arm vibration effects on performance, tactile acuity, and temperature of hand

Effects of vibration appear as mechanical and psychological disorders, including stress reactions, cognitive and movement disorders, problem in concentration and paying attention to the assigned duties. The common signs and symptoms of hand-arm vibration (HAV) in the fingers and hands may appear as pins and needles feeling, tingling, numbness, and also the loss of finger sensation and dexterity. Laboratory Virtual Instrument Engineering Workbench programming software designed for occupational vibrations measurement was used to calculate HAV acceleration. Hole steadiness test is designed to measure involuntary movement of people. V-Pieron test is designed for one of the other aspects of the psycho motor phenomena of steadiness by moving the stylus across a V-form ruler. The two points test was an experiment of touch acuity, which used a caliper by placing the two styli very close on the pad of finger knuckles. The temperature of finger skin is also measured simultaneous to the above tests. Wilcoxon test indicated that a significant decrement in hand steadiness occurred after gripping a vibrating handle for 2 min (P ≤ 0.003). Wilcoxon test also represented a significant change in errors after gripping a grinder vibratory handle (P ≤ 0.003). The differences at all of the knuckles were significant with a confidence interval percentage of 99%. There was a significant reduction in finger skin temperature before and after exposure to vibration (mean = 0.45°C, based on paired sample test). The obtained results considerably demonstrated the relation between hand performance and vibrations due to gripping a grinder. It can be concluded that an injury or accident may happen after exposure to vibrations for the fine duties, in fast actions.

Effect of Adaptive Yoga Therapy in Increasing Hand Steadiness among Children with Intellectual Disability

Yoga is an ancient Indian tradition which has diverse effect through physical and mental practices. Several studies showed the effect of yoga in the various health aspects of human body. It improves the general health, neurological functioning and physical activity. Researches also showed a great literature on the effect of yoga on the attention, concentration and problem solving of the students. Present research was intended to see the effect of yoga on the hand steadiness of children with ID. To conduct the experiment researcher had selected 20 children with ID with predetermined inclusionary criteria from GRIID and randomly assigned to the two groups (Experimental/Control).intervention was given to the experimental group, regularly for 5 days week, daily one hour up to 3 months and no any treatment given to the control group. They have attended their routine classes. In results it is found that students who got the intervention, showed a significant effect on decrease in the errors on hand steadiness test in comparison to the control group with t value 3.84 and 6.43 respectively.

EFFECT OF ENERGY DRINKS ON SELECTED FINE MOTOR TASKS.

This study assessed the effect of energy shots on selected fine motor tasks. The participants were college-age male (n=19; M age=20.5 yr., SD=0.7) and female (n=21; M age=21.1 yr., SD=0.7) volunteers who were assessed on hand steadiness, choice reaction time, rotary pursuit, and simple reaction time. The energy shots group scored significantly poorer on the hand steadiness tests and significantly better on choice reaction time and simple reaction time tests. The enhanced reaction time and disruption in hand steadiness afforded by energy shots would not be apparent in many gross motor activities, but it is possible that reaction time improvement could be beneficial in sports that require quick, reflexive movements. However, the potential adverse psychological and physiological effects warrant discretionary use of such products.

Age and grip strength predict hand dexterity in adults.

In the scientific literature, there is much evidence of a relationship between age and dexterity, where increased age is related to slower, less nimble and less smooth, less coordinated and less controlled performances. While some suggest that the relationship is a direct consequence of reduced muscle strength associated to increased age, there is a lack of research that has systematically investigated the relationships between age, strength and hand dexterity. Therefore, the aim of this study was to examine the associations between age, grip strength and dexterity. 107 adults (range 18-93 years) completed a series of hand dexterity tasks (i.e. steadiness, line tracking, aiming, and tapping) and a test of maximal grip strength. We performed three phases of analyses. Firstly, we evaluated the simple relationships between pairs of variables; replicating the existing literature; and found significant relationships of increased age and reduced strength; increased age and reduced dexterity, and; reduced strength and reduced dexterity. Secondly, we used standard Multiple Regression (MR) models to determine which of the age and strength factors accounted for the greater variance in dexterity. The results showed that both age and strength made significant contributions to the data variance, but that age explained more of the variance in steadiness and line tracking dexterity, whereas strength explained more of the variance in aiming and tapping dexterity. In a third phase of analysis, we used MR analyses to show an interaction between age and strength on steadiness hand dexterity. Simple Slopes post-hoc analyses showed that the interaction was explained by the middle to older aged adults showing a relationship between reduced strength and reduced hand steadiness, whereas younger aged adults showed no relationship between strength and steadiness hand dexterity. The results are discussed in terms of how age and grip strength predict different types of hand dexterity in adults.

Comparison of tremor induced by valproate and lithium in bipolar disorder using a hand steadiness tester

Background: Quantitative measurement of valproate and lithium induced tremor using hand steadiness tester and their comparison in bipolar disorder. Methods: 200 newly diagnosed patients of bipolar disorder were randomly allocated into two equal groups receiving lithium (300mg twice daily) and sodium valproate (500 mg twice daily) after they fulfilled the inclusion / exclusion criteria of the study. 87 patients from Lithium group and 93 from Valproate completed the study. Hand Tremor was assessed quantitatively at 0, 6, 12, 18 and 24 weeks using hand steadiness tester. Anxiety level of the study subjects was assessed to be insignificant using a standardized anxiety scale. Final data was assessed after 24 weeks by using Stat Calc and Z test. P value &lt;0.05 was considered to be significant. Results: No significant difference was found in terms of the development and transition of tremor induced by valproate and lithium (p=0.22). However more men developed tremor with lithium when compared with females (p&lt;0.05) and the mean age of patients who developed tremor appeared to be significantly higher in lithium group (54.7±3.9) than valproate (39.6±5.1). Conclusions: Tremor of hands is a common side effect of lithium and valproate treatment. Timely, objective assessment of onset and extent of tremor has always remained a challenge to the clinicians. Hand Steadiness tester is a simple, portable, inexpensive, non-invasive instrument that can be used to ascertain the development and transition of tremor in a quantitative manner. This would guide the clinicians as when to intervene for better management of such tremors.

Effects of Exercise Intensity on Hand Steadiness

Effects of Exercise Intensity on Hand Steadiness

Comparative study of effects of gabapentin, vigabatrin and sodium valproate on psychomotor performance in healthy volunteers

Context: The cognitive and psychomotor functions may become impaired in epileptic patients due to underlying etiology, effect of seizures and side-effects of antiepileptic drugs. It is desirable for the drug to have a minimal effect on cognitive abilities. Few studies have evaluated the psychomotor effects of newer antiepileptic agents and hence do not have the proper evidence base for their psychomotor adverse effects. Aims: The aim of this study is to evaluate the effects of gabapentin (GBP), vigabatrin (VGB), valproate (VAL) on psychomotor functions. Settings and Design: Randomized, prospective, double-blind, placebo (PLB) controlled crossover study. Subjects and Methods: A total of 24 healthy volunteers were included to administer single oral doses of GBP 300 mg, VGB 500 mg, sodium valproate 200 mg and PLB following a Latin square design. The objective parameters - six-digit cancellation test, digit symbol substitution test, critical flicker fusion test, arithmetic ability test, digit span test, hand steadiness test and subjective parameters like visual analog scale (VAS) were tested at 0, 1, 2 and 3 h. Statistical Analysis Used: Repeated measures ANOVA was used to compare the difference in mean score. Fisher's exact test was used for statistical analysis of adverse effects. Results: Sodium valproate impaired all subjective and objective psychomotor functions while GBP, VGB did not show any impairment when compared with PLB. GBP when compared with VGB, no difference was observed in any test, but when both the drugs were compared with sodium valproate, statistically significant difference at the end of third hourwas observed. Conclusions: VGB and GBP have few adverse cognitive and psychomotor effects as compared with sodium valproate, therefore are safe as add on therapy or monotherapy.

Neuromotor function in ship welders after cessation of manganese exposure

The aim of the present study was to investigate whether previous long-term exposure to manganese (Mn) via inhalation of welding fumes can cause persistent impairment in neuromotor function even long after cessation of exposure. Quantitative tests of tremor, motor speed, manual dexterity, diadochokinesis, eye-hand coordination and postural stability were administered to 17 retired ship welders (mean age 69 years), with mean exposure time 28 years. The welders' exposure had ceased on average 18 years before the study. A cumulative exposure index (CEI) was calculated for each of the former welders. The welders were compared with 21 referents from the same shipyards (mean age was 66 years). Former welders performed less well than referents in the grooved pegboard test, and poorer performance was associated with CEI. The performance in most of the other neurobehavioral tests was similar between groups, but the welders tended to perform slightly better than the referents in tests demanding hand steadiness. The latter finding may be due to a training effect from their former working tasks or selection bias into or out of this occupation. In the present study of welders with previous welding fume exposure, former welders and referents performed similarly in most of the neurobehavioral tests. Previous adverse effects on the neuromotor system might have ceased, and decreased neuromotor function due to normal aging processes in both groups might have disguised any slight effect of previous Mn exposure. The poorer performance in the grooved pegboard test among welders may indicate an adverse effect on motor function of long-term exposure to Mn, but this finding has to be confirmed by other studies.