Hand Muscles Research Articles

Complete Improvement of Severe Forearm Complex Regional Pain Syndrome with Six High-Dose Incobotulinumtoxin A Injections: Clinical Implications with Respect to the Literature

There is some evidence that injections of botulinum neurotoxin effectively reduce pain in complex regional pain syndromes (CRPSs). But no or little experience appears to exist for the application of incobotulinum neurotoxin type A (incoBoNT/A) in complex pain disorders. Here, a case of CRPS type I, characterized by severe symptoms in the left forearm is presented, showed significant continuous improvement following a series of six repetitive (painful) injections into the finger, hand, and forearm muscles of incoBoNT/A every 3 months, administered at declining doses varying between 500 and 100 U. Remarkably, this treatment regimen led to the complete resolution of pain, vaso- and sudomotor symptoms, and hand dystonia. This highlights the possible efficacy of incoBoNT/A in the treatment of CRPS and encourages the further exploration of incoBoNT/A’s role in the successful management of complex pain disorders.

The effect of unilateral hand muscle contraction on frontal alpha asymmetry and inhibitory control in intrinsic reward contexts, a randomized controlled trial

Challenged inhibitory control has been implicated in various disorders, including addiction. Previous research suggests that asymmetry of frontal brain activity, indexed by frontal alpha asymmetry (FAA), is associated with inhibitory control and could be a target for neuromodulatory intervention. Some evidence suggests that unilateral muscle contraction (UMC) can modulate FAA; however, experimental evidence is scarce. We conducted a randomized controlled trial, with 65 participants (Mage = 26.6; SD = 7.4), 37 of whom were females. We collected EEG data to calculate FAA and assessed inhibitory performance using the Stop Signal Task (SST) in neutral and intrinsic reward (palatable food) conditions, both before and after a unilateral left-hand muscle contraction task aimed at enhancing right relative to left frontal activity. We found a significant main effect of group on FAA. Specifically, UMC group was associated with higher right relative to left frontal activity, associated with resting state inhibitory activity. Event-related potential analyses revealed a significant dissociation between the stop N2 and stop P3 components as a function of time. More specifically, as time progressed, the stop N2 was enhanced, while the stop P3 was reduced. These results did not lead to observable changes in the behavioral index of stopping. In conclusion, UMC did not affect any behavioral and brain activity indices. There is some indication of a potential effect on FAA. However, this effect could reflect coincidental differences in trait FAA. Our findings provide new insights into the temporal dynamics of brain activity indices of inhibitory control.

Early and Late Intrinsic Hand Muscle Reinnervation After End-to-Side AIN to Ulnar Motor Nerve Transfer.

The "supercharge" end-to-side (SETS) anterior-interosseous-nerve (AIN) to ulnar-motor nerve transfer is used to improve intrinsic muscle recovery in cases of severe ulnar nerve compression or proximal axonotmetic injuries. Previous work has found differing intrinsic muscle recovery after this transfer. The objectives of this study were to examine the patterns of recovery in first dorsal interossei (FDI) and abductor digiti minimi (ADM) and the impact of AIN transfer to a specific fascicular location on the ulnar-motor nerve. A retrospective review of one fellowship-trained surgeon's consecutive patients at a single center from December 2019 to September 2021 was conducted. Patients who had an AIN to ulnar-motor nerve transfer for any indication were included and were excluded if they had less than 9 months follow-up. Seventeen patients were included (88% male, mean age 55 ± 14 years). At early follow-up, compound muscle action potential amplitudes for ADM and FDI did not increase. Compound muscle action potential amplitude for ADM significantly increased at late follow-up (P < .01). Average British Medical Research Council (BMRC) strength increased at early follow-up for FDI (P < .05), but not ADM. The proportion of patients with BMRC ≥ 3 increased for FDI (P < .01) and ADM (P < .05) at late follow-up. Volar-ulnar AIN insertion position did not have a clear effect on outcomes. The SETS AIN to ulnar-motor nerve transfer demonstrates clinical and electrophysiologic evidence of intrinsic muscle recovery and reinnervation, with differing recovery of outcomes. The role of specific fascicular targeting is still unclear and required further examination as does the mechanism behind differing intrinsic recovering.

F-waves responses derived from low-intensity electrical stimulation: A method to explore split-hand pathogenesis

ObjectivesThe “split-hand syndrome” is a common clinical sign in amyotrophic lateral sclerosis (ALS), being characterized by more severe atrophy of the hand muscles on the radial side of the hand compared to the ulnar side. We aimed to investigate possible physiological differences between relevant hand muscles using low-intensity F-wave stimulation to assess spinal motoneuron excitability. MethodsWe recruited 36 healthy volunteers. F-waves were recorded from the abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM), using 20 supramaximal stimuli followed by 20 stimuli at a low-intensity required to obtain M-waves with 10 % amplitude of maximal CMAP. We evaluated the following F-wave parameters: F-M latency, chronodispersion, persistence, amplitude, F/CMAP amplitude ratio and number of F-wave repeaters (with low-intensity). In 10 subjects, low-intensity stimulation F-waves were compared after 20 and 50 stimuli in each muscle. ResultsLow-intensity stimulation resulted in lower F-wave amplitude and persistence and higher F/CMAP amplitude ratios. There were no significant differences in F-wave latencies and chronodispersion. When comparing the three muscles, we found higher F-wave persistence and F/CMAP amplitude ratios when recording over the ADM and APB compared to the FDI. We also found a higher number of F-wave repeaters in the ADM with low-intensity stimulation. Results from 20 to 50 low-intensity stimuli were similar. DiscussionA small number of low-intensity stimuli is appropriate to study F-wave latencies and chronodispersion. We found differences in some physiological properties of the ADM spinal motoneuron pool compared to other hand muscles.

Optimized Kalman filtering in dynamical environments for thumb robot motion estimation

&lt;span&gt;Stroke, a prevalent nerve disorder in Indonesia, necessitates post-stroke rehabilitation like physical and occupational therapy. Hand and finger muscle training, crucial for restoring movement, often involves innovative solutions like finger prosthetic robotics arms. In particular, the advancement in thumb robotics emphasizes the estimation of thumb motion, where the ensemble Kalman filter square root (EnKF-SR) and H-infinity methods are deemed dependable for both linear and nonlinear models. Simulation results, using 400 ensembles, demonstrated nearly identical accuracy between the methods, exceeding 99%, with a 6-7% increase in accuracy compared to 200 ensembles. These advancements offer promising prospects for effective post-stroke rehabilitation and improved thumb movement restoration.&lt;/span&gt;

Факторна структура підготовленості тхеквондистів 15-17 років

Purpose: to investigate the factor structure of preparedness of taekwondo players of 15-17 years old. Material and Methods. The following methods were used in the research: analysis of scientific and methodical literature, pedagogical testing, medical and biological methods, methods of mathematical statistics. Results: in the course of the research the factor structure of preparedness of taekwondoists of 15-17 years old by the general sample was studied and 9 orthogonal factors were separated in which the sum of loading variables ranges from 9,571 to 1,736, describing 84,804 % of the total variance. The contribution of the first factor, «morpho-functional», to the total variance is 22,788 % and consists of 10 indicators. The second factor accounts for 13,068 % of the total variance, which reflects the special high-speed abilities of taekwondo players of 15-17 years old in the structure of which 7 indicators are included. In the third factor, which accounts for 11,334 % of the total variance, 7 indicators were the main ones. The fourth orthogonal factor has a contribution of 9,259 % of the total variance, the highest correlation was found in 3 indicators. This factor is characterized as a manifestation of coordination abilities with a combination of high-speed endurance (coordination high-speed endurance). The most significant indexes of the fifth factor (6,868 %) are the power index on the left hand (r=0,529) and performance of a side kick with the left (r=0,682) and right (r=-0,569) foot with a deployment on 360° for 15 s. This factor determines the manifestation of strength and the performance of complex coordination kicks and is interpreted by us as «coordination strength». The structure of the sixth factor «Frequency of movements» with a total variance of 6,431 % includes 3 indicators. The seventh factor «ability to control movements» with a total variance of 5,720 % consists of 2 indicators with the highest correlation of lateral kicks with the left foot in the body for 15 s (r=-0,596) and fencing in motion before losing balance with the left foot (r=0,500). The eighth factor «keeping balance»has 2 indicators: fencing for 15 s in the upper level with the left foot (r=0,559) and tilt of a trunk forward from a sitting position (r=-0,514) with a contribution to the general variance of 5,203 %. This is due to the fact that when performing fencing for 15 s in the upper level with the left foot, the athlete stands on one leg and performs blows to the head with the other, to perform this technical technique, the taekwondo player needs a good display of flexibility. The ninth factor reflects reactivity of muscles of hands and has a contribution of 4,133 % of the general dispersion and is characterized by throwing a tennis ball on a distance (r=-0,519). Conclusions. The research has established a dependence between components of preparedness of taekwondo fighters of 15-17 years old, also the most significant factors which reflect morpho-functional indicators, a manifestation of special high-speed abilities, power, coordination and high-speed endurance have been established. With the help of factor analysis, 9 factors were separated, out of 42 considered indicators, the contribution of which is 22,788-4,133 % and is 84,804 % of the total variance. The largest contribution of 22,788 % to the total variance of the sample of taekwondoists of 15-17 years old has morphological and functional indicators.

Development of EMG-based criteria to evaluate the difficulty of realization of sign language: A potential contribution for understanding the negative hand paintings

The sign language uses a combination of complex finger and wrist configurations. The frequency of use of a particular sign is highly dependent on its physiological difficulty. However, no method allows to quantify accurately this difficulty. In the context of paleolithic negative hand paintings this absence of methods is problematic since the hand signs which are painted may be related to a primitive hand sign language. The objective of this study was to develop and validate a method based on electromyography recordings for quantifying sign language difficulty. Electromyography of the six main hand muscles were recorded and analyzed to determine individual muscle activity, summed muscle activity and muscle coactivation. Those results were correlated to subjective scales of difficulties to determine the electromyographic variables and/or the combinations of them which are good candidates for determining hand sign difficulties. Among all variables the summed muscle activities and the thumb muscle coactivation presented the most promising criterion. On the top of that, those criterions presented encouraging correlation with the frequence of occurrence of ten hand paintings of the Gargas Cave which open further studies for analyzing the origin of negative hand paintings.

Reducing the Distance Between Anode and Cathode to Make Handheld Nerve Stimulators More Selective in Nerve Fascicle Selection: Report of Two Cases

ABSTRACTPrecise nerve fascicle identification is important in certain peripheral nerve procedures. Although we believe bipolar nerve stimulation with intraoperative neuromonitoring is a superior method, many rely on clinical response evoked by handheld monopolar nerve stimulators. We present a modification in the use of the latter for a more precise fascicle stimulation. A 55‐year‐old man with a right high brachial plexus injury and a 47‐year‐old woman with a left median nerve schwannoma were scheduled for exploration and ulnar‐to‐musculocutaneous nerve transfer, and for surgical excision respectively. Intraoperatively, we used a disposable handheld monopolar nerve stimulator in an unorthodox way, placing the anode right next to the cathode (both touching the same nerve fascicle). In the first case, a fascicle that showed flexor carpi ulnaris (FCU) and intrinsic hand muscle contraction with standard stimulation (anode placed on patient's skin), showed only FCU activation with our modified method, and was chosen as donor. A BMC grade M4 elbow flexion was achieved 9 months after surgery. In the second case, safe schwannoma excision was performed after our modified stimulation technique caused thenar muscle activation in a single, unaffected fascicle, while standard monopolar stimulation showed activation in several fascicles. No unexpected motor/sensory deficits were noted during follow‐up. This report shows an easy modification in the use of handheld nerve stimulators that improves selectiveness when looking for nerve fascicles.

THE EFFECT OF A MODIFIED TENODESIS WRIST-HAND ORTHOSIS ON HAND FUNCTION IN PATIENTS WITH TETRAPLEGIA

BACKGROUND: An individual experiencing tetraplegia faces functional limitations due to impaired hand function. The use of an affordable tenodesis wrist-hand orthosis (WHO) can enable finger flexion with active wrist extension, thereby enhancing the three-jaw chuck grasp and overall hand functionality. OBJECTIVES: To assess hand function and satisfaction in patients with tetraplegia using a modified tenodesis wrist-hand orthosis (WHO), utilizing the Duruöz Hand Index (DHI) and the Orthotics and Prosthetics User Survey (OPUS) satisfaction with device and services subscales. METHODOLOGY: The study was conducted at a tertiary care center in central India, enrolling patients with tetraplegia admitted to the Department of Physical Medicine and Rehabilitation. A modified tenodesis wrist-hand orthosis (WHO) was designed using low-temperature thermoplastic components. Twenty-two individuals with a minimum wrist extensor power of grade 3/5 were included in the study. These patients were provided with the modified tenodesis WHO and underwent daily training sessions for a period of 2 weeks. Duruöz Hand Index (DHI) scores were assessed at baseline, 6 weeks, and 12 weeks post-enrolment. Patient satisfaction was evaluated using the Orthotics and Prosthetics User’s Survey (OPUS) satisfaction with device and services subscales. FINDINGS: The analysis of the DHI scores indicated a significant enhancement in functional abilities at both 6-week and 12-week follow-ups compared to the baseline assessment. Notably, the most substantial progress at 6 weeks follow-up was observed in tasks such as buttoning a shirt, while significant improvement at the 12-week mark was noted in activities like turning a key in a lock. The median OPUS device satisfaction score was 50, corresponding to a Rasch score of 68.8. Additionally, the median OPUS satisfaction score for services stood at 46, with a Rasch score of 72.7. Patients expressed the highest satisfaction levels with the courteous demeanor of the staff, prompt scheduling of appointments, and accurate fitting of the orthosis. CONCLUSION: The study findings indicate that the modified tenodesis WHO is an effective and satisfactory therapeutic device for improving hand function in patients with tetraplegia. The findings encourage further investigation and application of the modified tenodesis WHO in clinical practice. Layman's Abstract Individuals who are affected due to spinal cord injury (SCI) are often unable to perform the basic daily activities of life due to weakness. The hands are one of the most specialized parts of the human body and loss of its function can be incapacitating. Certain wrist hand orthoses (WHO) can aid such individuals by assisting the weak hand muscles. One such WHO is a tenodesis wrist hand orthosis. Modifications to the previously available tenodesis wrist hand orthosis were made to make it cheaper, lighter, and easier to manufacture. The effectiveness of this modified tenodesis WHO on improving hand activity and satisfaction in the individuals using it was assessed in this study which was conducted in a tertiary care center in central India. Twenty-two individuals with cervical SCI, who had some ability to extend their wrists against gravity, were admitted to the Physical Medicine and Rehabilitation department and enrolled in this study. Notable improvements were observed in functional tasks such as buttoning a shirt, opening a lock, eating with a fork, brushing teeth, and writing, with considerable satisfaction in those trained with the modified tenodesis WHO. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/42879/33253 How To Cite: Sonune S.P, Saha A, Joshi N.G, Pathak S, Bhadra P, Goel G. The effect of a modified tenodesis wrist-hand orthosis on hand function in patients with tetraplegia. Canadian Prosthetics &amp; Orthotics Journal. 2024; Volume 7, Issue 1, No.8. https://doi.org/10.33137/cpoj.v7i1.42879 Corresponding Author: Dr. Anyesha Saha,Affiliation: Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Saket Nagar, Bhopal (M.P.), India.E-Mails: saha.anyesha@gmail.com; anyesha.sr2023@aiimsbhopal.edu.inORCID ID: https://orcid.org/0009-0004-1574-0519

Risk factors affecting cervical spondylotic myelopathy complicated with traumatic central cord syndrome and the efficacy of different treatment options

ObjectiveTo analyze the influencing factors and treatment options of cervical spondylotic myelopathy (CSM) complicated with traumatic central cord syndrome (TCCS).MethodsA total of 243 patients with CSM admitted to our hospital from January 2021 to September 2022 were retrospectively analyzed, and then divided into the control group (n = 152) and the observation group (n = 91) according to the presence or absence of concurrent TCCS. The clinical data and imaging data of the two groups were compared, and multivariate logistic regression was used to analyze the influencing factors of CSM complicated with TCCS. Patients in the observation group were further divided into the zero notch anterior cervical interbody fusion device (Zero-P) group (n = 45) and the cervical spine locking plate (CSLP) group (n = 46) according to the treatment mode, and the perioperative indexes of the two groups were compared. The treatment effects were evaluated by the American Spinal Injury Association (ASIA) and the Japanese Orthopedic Association (JOA) before surgery, 1 week after surgery and 6 months after surgery. The height of intervertebral space and the cervical lordosis angle were measured.ResultsMultivariate logistic regression analysis showed that the injury mechanism (hyperextension injury), hand muscle weakness, cervical instability, age, degree of cervical spinal stenosis, degree of cervical spinal cord compression, and changes in intramedullary high signal were the risk factors, while the type of compression (soft), ASIA score and JOA score were the protective factor for CSM complicated with TCCS (P < 0.05). Patients in Zero-P group had much shorter operation time and hospitalization time than these in CSLP group (P < 0.05). The cervical lordosis angle and intervertebral space height at 1 week and 6 months after operation in the two groups were both largely higher than these before operation, and the cervical lordosis angle and intervertebral space height in the Zero-P group were significantly higher than these in the CSLP group one week after surgery (P < 0.05). The ASIA score and JOA score were obviously increased in the two groups 1 week and 6 months after surgery, and the ASIA score and JOA score in the Zero-P group were significantly higher than these in the CSLP group at 1 week after surgery (P < 0.05).ConclusionThe mechanism of TCCS in CSM is still controversial, which it is generally believed to be caused by cervical hyperextension injury. The clinical symptoms are diverse, and the treatment methods are also different. This study shows that the mechanism of injury, type of compression, hand muscle weakness, cervical instability, age, cervical stenosis compression, and intramedullary high signal changes are all risk factors for CSM complicated with TCCS. Early identification of risk factors and targeted interventions can effectively reduce the complicated rate of TCCS. Zero-P and CSLP surgical fixation have good efficacy in the treatment of TCCS, and there is little difference in efficacy between the two. However, Zero-P fixation surgery has the advantages of short operation time and fast postoperative recovery.

Train-of-four ratio, counts and post tetanic counts with the Tetragraph electromyograph in comparison to mechanomyography.

Automated EMG devices to detect compound muscle action potentials from the adductor pollicis muscle in response to ulnar nerve stimulation, regardless of hand and thumb position, may serve as a better reference ("gold standard") for clinical assessment of neuromuscular function than traditional mechanomyography (MMG) systems that need custom design and validation in lab settings. This evaluation compared the TetraGraph EMG system against a validated MMG device to investigate the accuracy and repeatability of this quantitative EMG monitor for detecting onset, offset and deep neuromuscular block. Simultaneous muscle action potential recordings from the EMG neuromuscular monitor and muscle contractions from an in-house developed MMG monitor in response to ulnar nerve stimulation were obtained from patients having elective surgery requiring neuromuscular block. Train-of-four (TOF) ratios, TOF counts, and post-tetanic counts (PTCs) were recorded simultaneously from the same hand muscle and compared. In total, 685 pairs of simultaneous TOF ratios were evaluated. The mean difference (bias) of TOF ratios between devices was small (-2.1%). TOF counts from 285 data pairs were within a count of 2 or less 96% of the time. During deep block, PTC comparisons from 215 data pairs were within a count of 2 or less 95% of the time. These findings, along with prior EMG device evaluations, indicate that real-time EMG neuromuscular monitoring technology to detect muscle action potentials from the adductor pollicis in the clinical setting is closely aligned with the force of thumb contraction determined from MMG. The accuracy of quantitative EMG technology of the TetraGraph EMG system lends strong support for this monitor, along with other similarly validated EMG monitors, to become a clinical standard for all phases (onset, depth and reversal) of neuromuscular block in clinical practice.

Clinical and neurophysiological characterization of p.Gly59Ser mutation in DCTN1: a study in a Thai family and a brief review.

Mutations in the Dynactin 1 (DCTN1) gene lead to various neurodegenerative disorders. The p.Gly59Ser mutation, the first pathogenic mutation identified in DCTN1, was initially reported in a family with distal hereditary motor neuropathy and early vocal cord paralysis. Since its discovery in 2003, this mutation has been documented in only three families worldwide, to the best of our knowledge. This study examines six patients from a Thai family carrying the p.Gly59Ser mutation in DCTN1 and includes a literature review. Five of the patients were female. The mean age of onset was 32.6 ± 1.9 years. Thai patients showed early involvement of intrinsic hand, facial, and bulbar muscles, with vocal cord impairment manifesting later in the disease course. Tongue fasciculations, not previously reported with this mutation, were observed in most Thai patients. Bilateral split-hands were consistently noted. Arytenoidectomy and cordotomy have proven beneficial in relieving upper airway obstruction and preventing life-threatening upper airway complications from vocal cord paralysis. The p.Gly59Ser mutation in DCTN1 presents with autosomal-dominant, adult-onset, lower motor neuronopathy/neuropathy. Compared to earlier reports, Thai patients exhibited more widespread involvement, including facial, bulbar, tongue, vocal cord, and limb muscles. In addition to vocal cord paralysis, the split-hand phenomenon emerges as another clinical hallmark of this condition.

Correlation Between Intrinsic Capacity and Muscle Strength and Quality in Older Patients with Cardiovascular Disease: A Cross-Sectional Study.

Cardiovascular disease (CVD) has become the leading cause of death worldwide. High muscle mass can reduce the incidence and mortality of CVD. In recent years, increasing attention has been given to the relationship between intrinsic capacity (IC) and CVD. This study aims to explore the relationship between the decline of IC, muscle strength, and muscle quality in older patients with CVD, providing a new method and basis for early recognition of IC decline in the older adults. This cross-sectional study included 475 older individuals from communities in Zhejiang. General data were collected, and a comprehensive geriatric assessment (CGA) was conducted. Participants with CVD were divided into three groups: IC retention, IC impairment, and IC significantly impaired. Bioelectrical impedance analysis (BIA) measurements were completed. Student's t-test or non-parametric tests (Mann-Whitney) were used to analyze the correlation between IC and muscle-related indicators. The best cutoff values were obtained using ROC curve analysis. Compared to non-CVD patients, CVD patients were older, more educated, and had higher rates of polypharmacy and comorbidity. IC decreased more significantly in CVD patients. Age (P=0.001), Fried (P=0.024), and GDS-5 (P=0.002) increased with the severity of IC decline. ADL (P=0.002), MMSE (P=0.000), MNA-SF (P=0.000), SARC-Calf (P=0.026), waist circumference (P=0.037), and muscle quality (P=0.010) decreased with the decline in IC. When IC decreased, the cutoff values for hand grip strength, waist circumference, and muscle quality were 25.45 kg, 72.55 cm, and 3.05, respectively. When IC decreased significantly, the cutoff values were 17.15 kg, 71.55 cm, and 2.28, respectively. The results of this study showed that in patients with CVD, the hand grip strength and muscle quality of patients with IC injury were lower than those of patients with IC retention.

Influence of Preoperative Motor Score and Patient Comorbidities on Transcranial Motor-Evoked Potential Acquisition in Intracranial Surgery: A Retrospective Cohort Study.

Intraoperative neurophysiological monitoring plays a pivotal role in modern neurosurgery, aiding in real-time assessment of eloquent neural structures to mitigate iatrogenic neural injury. This study represents the largest retrospective series to date in monitoring corticospinal tract integrity during intracranial surgery with transcranial motor-evoked potentials (TCMEPs), focusing on the influence of demographic factors, comorbidities, and preoperative motor deficits on the reliability of intraoperative neurophysiological monitoring. While the impact of patient-specific factors affecting TCMEP monitoring in spine surgery is well-documented, similar insights for intracranial surgery are lacking. A total of 420 craniotomy patients were retrospectively analyzed from electronic medical records from December 2017 to February 2023, excluding patients without preoperative Medical Research Council scores or medical histories. Using intrinsic hand muscles as a robust data set, 840 hand TCMEPs acquired during intracranial surgery were assessed. Demographic and clinical factors, including preoperative motor scores, were analyzed to identify associations with TCMEP acquisition and amplitude. Nonparametric statistics and multivariate regression analysis were employed. TCMEPs were successfully acquired in 734 (87.7%) patient hands, even in the presence of preoperative motor deficits in 13.9% of total patient hands. Preoperative motor scores did not predict the ability to acquire baseline TCMEPs ( P = .6). Notably, older age ( P < .001) and hypertension ( P = .01) were independent predictors of lower TCMEP acquisition rates. Preoperative motor scores significantly influenced TCMEP amplitudes, with higher scores correlating with higher amplitudes (1771 [SD = 1550] eve vs 882 [SD = 856] μV, P < .0001). Older age ( P < .001) and chronic kidney disease ( P = .04) were also associated with reduced TCMEP amplitudes. Our investigation into TCMEPs during intracranial surgery demonstrated a notably high acquisition rate in hand muscles, irrespective of preoperative motor deficits. Preoperative motor scores reliably correlated with TCMEP amplitudes in a linear fashion while advanced age and renal disease emerged as independent predictors of lower TCMEP amplitudes.

Bilateral hand dystonia following high-velocity thrust manipulation: a case report.

Thrust manipulation is one of the most commonly used techniques for managing musculoskeletal pain in clinical practice. This involves the application of a high-velocity, low-amplitude force directed to the joints with the intent of achieving joint cavitation. This current case report describes a female in her mid-20s who presented with excessive bilateral and involuntary hand muscle contractions after bilateral thrust manipulation. Dystonia appeared both at rest and during voluntary movements but was aggravated by actions such as finger flexion or spreading and disappeared during sleep. A diagnosis of complex regional pain syndrome (CRPS) type I combined with dystonia was made. Prednisolone administered between 2 and 5 weeks after symptom onset significantly reduced CRPS symptoms, but intramuscular botulinum toxin injection 5 weeks after symptom onset was ineffective at controlling her symptoms. Seven weeks after symptom onset, the patient was administered 2 mg trihexyphenidyl oral twice a day, 2.5 mg diazepam oral twice a day and 5 mg baclofen oral three times a day for 1 month and this significantly reduced dystonia, but complete resolution was not achieved. Clinicians should be aware that dystonia is a rare complication of thrust manipulation.

Effects of cervical transcutaneous spinal direct current stimulation on spinal excitability

ObjectiveTo investigate the effects of transcutaneous spinal direct current stimulation (tsDCS) on spinal cord excitability using neurophysiological methods. MethodsSpinal cord motoneuron excitability was assessed using various neurophysiological techniques in a sham-controlled randomized experiment, which involved delivering 2 mA tsDCS and testing four different montages. Transcranial magnetic stimulation (TMS), F-waves to supramaximal ulnar nerve stimulation and somatosensory evoked potentials to upper limb nerves stimulation were measured in the participants with the electrode configuration that yielded the greatest effect, for a total of about 18 min. 18 young volunteers were recruited. ResultsAmong the tested ones, the most promising tsDCS montage was the one with the anode placed on the 7th cervical spinous process and the cathode on the glottis. With this configuration, a significant enhancement of motor responses in the hand muscles to TMS of the contralateral hand motor area was observed during tsDCS (p<0.00001), reaching a plateau after 6 min. This facilitation rapidly declined within a few minutes after the tsDCS was stopped. ConclusionResults of the different techniques suggest a possible contribution to facilitatory neuromodulation of the motoneurons at the cervical spine level. SignificanceThe occurrence of enhanced excitability after tsDCS suggests potential application in individuals with partial corticospinal fiber impairment affecting hand motor function.

Contribution of Hand Muscle Strength and Waist Muscle Strength to Hand Slams of Greco Roman Style Wrestling Athletes in Bengkulu Province in 2024

This study aims to determine the contribution of hand muscle strength and waist muscle strength to the ability of scientific hand slams. The formulation of the problem in this study is how much is the contribution of hand muscle strength and waist muscle strength together to the ability of hand slams in wrestling? This research was conducted at the Bengkulu Province PPLP wrestling gym. The research method used is quantitative research, the research sample amounted to 12 Bengkulu Province wrestling athletes who were taken with total sampling technique. The contribution of hand muscle strength to the ability of hand slams is 77.44% and the contribution of waist muscle strength to the ability of hand slams is 81%. The data results of rcount = 0.88 &gt; rtable = 0.576 then Ho is rejected and Ha is accepted, meaning that there is a relationship between the contribution of hand muscle strength and waist muscle strength together to the ability of hand slams in wrestling. The contribution of hand muscle strength and waist muscle strength to the ability of hand slams is K = r² x 100% = (0.88)² x 100% = 77.44%. So it can be concluded that the positive contribution between hand muscle strength and waist muscle strength to the ability of hand slams is 77.44%.

Differences of interference myogram patterns from forearm muscles at different variants of the hand grip

Background. Most modern bioprostheses use two sensors located on the flexor and extensor muscles of the hand and fingers to register muscle activity, which severely limits the functionality of the device and complicates switching between grips. One of the solutions to this problem is to use an array of more sensors to recognize different grips using a neural network.Aim. To evaluate the possibility in principle of using an array of 8 sensors for recognizing different grips.Materials and methods. Research was conducted on 23 healthy volunteers, whose surface myograms were recorded at 13 different grips. An array of surface-type electroneuromyographic sensors (n = 8) with bipolar electrodes and electroneuromyographic signal amplification factor of 2000 times, myograph and software are of own development were used as a technical base for the research.Results. For most subjects, the differences in the investigated parameters when comparing grips with each other reached thousands of percent, especially when comparing the product of frequency and mean amplitude. In some pairs the differences were less significant and amounted to less than 400 %. The proportion of pairs with reliable differences varies from subject to subject when comparing the product of frequency and mean amplitude and ranges from 71 to 98 %. The average value for the whole group is 87 %. When comparing frequency only, the variation ranges from 67 to 93 %, with an average of 78 %.Conclusion. For most subjects, the majority of grips are confidently differentiated from each other. Due to pronounced individual peculiarities, the decision to use this or that parameter to control the bioprosthesis for a definite person is individual and should be made after a thorough neurophysiological research. Some people will require training in order to develop a new motor stereotype.

Challenging diagnosis: unveiling extensive multisystemic sarcoidosis with musculoskeletal involvement through a clinically ambiguous soft tissue mass in the palm.

We report about a 33-year-old man who was referred for assessment of a progressively enlarging mass of the palmar hand muscles, serving as the initial indication of extensive multisystemic sarcoidosis with musculoskeletal involvement. The case underscores the diagnostic challenges associated with the indolent course of sarcoidosis, highlighting the need for recognizing seemingly benign symptoms for early detection. Musculoskeletal imaging findings presented in the case stress the importance of considering sarcoidosis in the differential diagnosis of orthopedic cases. This report emphasizes the importance of understanding possible musculoskeletal imaging findings in sarcoidosis, thereby enabling radiologists to effectively guide patient management.

Design and Development of a Robust Control Platform for a 3-Finger Robotic Gripper Using EMG-Derived Hand Muscle Signals in NI LabVIEW

Robots are increasingly present in everyday life, replacing human involvement in various domains. In situations involving danger or life-threatening conditions, it is safer to deploy robots instead of humans. However, there are still numerous applications where human intervention remains indispensable. The strategy to control a robot can be developed based on intelligent adaptive programmed algorithms or by harnessing the physiological signals of the robot operator, such as body movements, brain EEG, and muscle EMG which is a more intuitive approach. This study focuses on creating a control platform for a 3-finger gripper, utilizing Electromyography (EMG) signals derived from the operator’s forearm muscles. The developed platform consisted of a Robotiq three-finger gripper, a Delsys Trigno wireless EMG, as well as an NI CompactRIO data acquisition platform. The control process was developed using NI LabVIEW software, which extracts, processes, and analyzes the EMG signals, which are subsequently transformed into control signals to operate the robotic gripper in real-time. The system operates by transmitting the EMG signals from the operator's forearm muscles to the robotic gripper once they surpass a user-defined threshold. To evaluate the system's performance, a comprehensive set of regressive tests was conducted on the forearm muscles of three different operators based on four distinct case scenarios. Despite of the gripper’s structural design weakness to perform pinching, however, the results demonstrated an impressive average success rate of 95% for tasks involving the opening and closing of the gripper to perform grasping. This success rate was consistent across scenarios that included alterations to the scissor configuration of the gripper.