Palm Grip Research Articles

Broadening the Utilization of Flexible and Wearable Pressure Sensors for the Monitoring of Health and Physiological Activities

Recently, the high need for artificial intelligence, human motion monitoring, and wearable devices that can be utilized to track human health conditions, particularly for patients experiencing any sickness, has drawn serious interest from researchers. The flexible pressure sensors are a promising possibility for these human–machine interface applications because of their quick reaction, huge sensitivity, and ultra-low detection limit. These flexible sensing devices provide real-time statistics about the conditions of the human body, like blood pressure and heartbeat estimation, to recognize cardiovascular-related diseases. We have developed a versatile and wearable capacitive sensing device by changing the polydimethylsiloxane (PDMS) dielectric layer's structure using a scrubber layer which introduced the porosity in the dielectric layer. The developed sensor showed excellent response under static pressure and dynamic pressure applications. Due to large sensitivity, high working stability, and speedy reaction (120 ms), the versatility of the pressure sensor has been demonstrated in various human motion monitoring applications like wrist bending, palm grip, elbow bending, knee twisting, and vocal-cord vibration detection. In addition, the developed sensor was also used in human–machine interface applications to perceive heartbeat and wrist-pulse motion under typical and after-exercise conditions.

Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia.

With population aging, the prevalence of sarcopenia has increased. It is a pathology often neglected, with the potential to cause great damage if not diagnosed and treated. The objective of this study was to identify sarcopenic elderly people through the SARC-F score and palm grip test and to evaluate foot and ankle functionality parameters: gait speed, plantar sensitivity, and baropodometry. This is a descriptive and cross-sectional study. The sample consisted of 20 sarcopenic elderly diagnosed through the SARC-F score and the handgrip strength test, from which demographic data were obtained, and the three functional tests related to the foot and ankle were performed. No individual was aware of the term sarcopenia. Regarding gait speed, 20 (100%) presented values compatible with sarcopenia (average of 0.52 m/s). Regarding plantar sensitivity, five (25%) of the patients showed changes in the exam with the detection of insensitivity. Regarding baropodometry, higher pressure values were observed in the right foot (average of 52.9±7.01%) compared to the left (average of 47.10±7.01%) and in the hindfoot (average of 55.85±16.21%) compared to the forefoot (mean 44.15±15.35%). When correlating the analyzed variables with the SARC-F scores, the only association that showed statistical significance (p<0.05) was the dynamometry on the right. The SARC-F score and the handgrip strength test are easy to apply in the screening of sarcopenia, and the functional parameters of the foot and ankle were shown to be altered in the studied group.

Selective interference of hand posture with grasping capability estimation.

Previous studies have shown that judgments about how one would perform an action are affected by the current body posture. Hence, judging one's capability to grasp an object between index and thumb is influenced by their aperture at the time of the judgment. This finding can be explained by a modification of the internal representation of one's hand through the effect of sensorimotor input. Alternatively, the influence of grip aperture might be mediated by a response congruency effect, so that a "less" vs. "more" open grip would bias the judgment toward a "less" vs. "more" capable response. To specify the role of sensorimotor input in prospective action judgments, we asked participants to estimate their capability to grasp circles between index and thumb while performing a secondary task that requires them to squeeze a ball with these two fingers (precision grip) or with a different hand configuration (palm grip). Experiment 1 showed that participants underestimated their grasping capability when the squeezing task involved the same grip as the judged action (precision grip) and their estimates were bound to the relative size of objects as revealed by size-contrast illusions (Ebbinghaus). Experiment 2 showed that the grip reduction caused by the squeezing task also interfered with the discrimination of large numbers in magnitude judgments, but this incongruency effect was only observed for the palm grip. The dissociated effects of the two grips in graspability and numerical judgments indicate that sensorimotor input may affect the perceived ability to grasp objects, independently of response congruency, by modifying the representation of the hand in action.

Flexible conductive hydrogel fabricated with polyvinyl alcohol, carboxymethyl chitosan, cellulose nanofibrils, and lignin-based carbon applied as strain and pressure sensor

Employing renewable, environmentally friendly, low-cost lignocellulose to design flexible pressure sensitive hydrogel (PSH) as strain and pressure sensors in wearable electronics represents the global perspective to build sustainable and green society. Lignin-based carbon (LC), as the conductive filler, were uniform distributed in the hydrogel system composing by polyvinyl alcohol (PVA), carboxymethyl chitosan (CMC), and cellulose nanofibrils (CNF) to assemble PSH. The analysis revealed that the cross-linking of components through hydrogen bonds formed among hydroxyl group, amino group and carboxyl group exerts the hydrogel with stretching ability and fatigue resistance. The results indicated that the fracture tensile strength and compression stress of the PC/CNF/LC hydrogel were 133 kPa and 37.7 kPa, respectively. Because of the existence of LC, PSH hydrogel exhibits the sensitive deformation-dependent conductivity and can be applied as a flexible strain and pressure sensor monitoring body motions such as elbow flexion, finger bend and palm grip. Therefore, the assembled PSH hydrogel is a prominent candidate applying as the strain and pressure sensor devices.

Resolution of Thumb Pain following Adoption of Mathieu Needle Holder: An Ergonomic Analysis.

Background:As surveys reveal the prevalence of musculoskeletal pain among surgeons, it is important to have an appreciation and understanding of surgical ergonomics to protect against long-term injuries and mitigate the symptoms of existing conditions. Surgeons diagnosed with thumb carpometacarpal (CMC) joint osteoarthritis, a progressive and debilitating condition, can be especially vulnerable to the pain caused by the repetitive manual tasks of operating.Methods:In this article, the authors describe a case of occupational thumb CMC arthritis in a right-hand dominant plastic surgeon and provide an ergonomic analysis of the different needle holders.Results:Following diagnosis, the simple switch from the traditional Hegar needle holder to the Mathieu needle driver with its palm grip and rotating ratchet lock mechanism stalled the progression of the disease, allowing the surgeon to continue operating pain free.Conclusions:This is the first report of utilization of an alternative needle holder leading to the resolution of thumb pain. In sharing this case, the authors hope to bring awareness to the importance of hand ergonomics in the operating room and offer a practical tip to surgeons with CMC arthritis.

Evaluation and Comparison of Arm-Joint and Toothbrush Motion Between Pen Grip and Palm Grip During Tooth Brushing

Objective: We aimed to examine the hypothesis that the two different hand-grip techniques (pen grip and palm grip) affect tooth-brushing motion.Methods: Eight dental hygienists participated in this study. Their tooth-brushing motion for 15 seconds was captured using a motion-capture system. The buccal and palatal sides of the right and left upper molars using both the pen and palm grips were brushed, and the frequency of joint angles of the shoulder, elbow, and wrist was calculated during tooth-brushing.Results: Individuals showed smaller intra-individual variations in the peak frequency of the toothbrush and joint angles during the brushing of all sides with both the pen and palm grips. For some arm joints, using the palm grip showed higher intra-individual variations than inter-individual, but the intra-individual variations among all joints using the pen grip were lower in all brushing areas.Conclusion: A distinct individual tooth-brushing rhythm in the reciprocatory motion was established by each dental hygienist using both the pen and palm grips. The coordinated movements of all joints of subjects using pen grips reflected the stability of the tooth-brushing motion of each arm joint. However, when using the palm grip, it is not necessary to ensure joint stability during tooth-brushing motion. Examination by three-dimensional toothbrushing motion analysis revealed that the reciprocatory performance during tooth-brushing was easier with the palm grip than with the pen grip.

Arthroplasty of the distal ulna distal in managing patients with post-traumatic disorders of the distal radioulnar joint: measurement of quality of life

ObjectiveTo measure the quality of life and clinical–functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension® prosthesis of the distal ulna. MethodsTen patients were evaluated after 12 months of follow-up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post-traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint. The study was prospective. Seven patients had previously undergone wrist procedures (two cases with Darrach, three with Sauvé–Kapandji and two with ligament reconstruction of the fibrocartilage complex) and three presented fractures of the distal ulna that evolved with pain, instability and osteoarthrosis of the distal radioulnar joint. The following were assessed: quality of life (DASH scale); percentage degree of palm grip strength (kgf) and pronosupination range of motion in relation to the unaffected side; pain (VAS); return to work; subjective evaluation of radiography; and complications. ResultsThe patients presented a mean range of motion of 174.5° (normal side: 180°). Quality of life was analyzed by applying the DASH questionnaire and the mean value found was 5.9. The mean pain score using the VAS was 2.3. The mean degree of palm grip strength (kgf) was 50.7, which represented 90.7% of the strength on the unaffected side. The complication rate was 10%: this patient presented slight dorsal instability of the ulna and persistent pain, and did not return to work. This patient is still being followed up in the outpatient clinic and occupational therapy sector, with little improvement. He does not wish to undergo a new procedure. The mean length of follow-up was 16.8 months, with a minimum of 10 and maximum of 36 months. ConclusionThis concept is subject to the test of time. Implantation of a prosthesis is a very interesting addition to the surgical arsenal for those who are specialists in hand surgery. Arthroplasty of the distal ulna is a safe and effective method with clinical–functional and quality-of-life improvements for patients and presents a low complication rate.

Artroplastia de ulna distal no manejo dos pacientes com distúrbios pós‐traumáticos da articulação radioulnar distal: mensuração da qualidade de vida

ObjectiveTo measure the quality of life and clinical‐functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension® prosthesis of the distal ulna. MethodsTen patients were evaluated after 12 months of follow‐up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post‐traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint. The study was prospective. Seven patients had previously undergone wrist procedures (two cases with Darrach, three with Sauvé‐Kapandji and two with ligament reconstruction of the fibrocartilage complex) and three presented fractures of the distal ulna that evolved with pain, instability and osteoarthrosis of the distal radioulnar joint. The following were assessed: quality of life (DASH scale); percentage degree of palm grip strength (kgf) and pronosupination range of motion in relation to the unaffected side; pain (VAS); return to work; subjective evaluation of radiography; and complications. ResultsThe patients presented a mean range of motion of 174.5° (normal side: 180°). Quality of life was analyzed by applying the DASH questionnaire and the mean value found was 5.9. The mean pain score using the VAS was 2.3. The mean degree of palm grip strength (kgf) was 50.7, which represented 90.7% of the strength on the unaffected side. The complication rate was 10%: this patient presented slight dorsal instability of the ulna and persistent pain, and did not return to work. This patient is still being followed up in the outpatient clinic and occupational therapy sector, with little improvement. He does not wish to undergo a new procedure. The mean length of follow‐up was 16.8 months, with a minimum of 10 and maximum of 36 months. ConclusionThis concept is subject to the test of time. Implantation of a prosthesis is a very interesting addition to the surgical arsenal for those who are specialists in hand surgery. Arthroplasty of the distal ulna is a safe and effective method with clinical‐functional and quality‐of‐life improvements for patients and presents a low complication rate.

A New Needle Holder Facilitating Palm Grip Suturing

Purpose: The finger grip and the palm grip are the most common needle holder grips for hand suturing in surgery. The major advantages of the palm grip are an increased versatility and the possibility to apply controlled force. However, there is a risk for a potential loss of precision and uncontrolled movement of the needle when disengaging the ratchet mechanism of the palmed instrument. The purpose of this study was to develop a new needle holder, referred to as the Frimand needle holder (FNH), and evaluate surgeons' perception of it. It was designed to overcome the above-mentioned disadvantages, hence facilitating palm and finger grip suturing. Moreover, we evaluated suture precision and attitudes related to the use of the finger grip and the palm grip. Methods: Thirty-two surgeons performed sutures utilizing both the palm grip and the finger grip on postmortem porcine skin and small bowels, comparing the FNH to a standard Crile-Wood needle holder (CWNH). The participants assessed the FNH on an evaluation form. Precision was determined by letting the surgeons perform 20 sutures utilizing the finger grip and the palm grip on a polyurethane pad with premarked insert and exit sites. The distance between the designated exit site and the real exit site defined precision and was measured with a digital sliding dimension scale. Results: We found that 28 (88%) of the 32 surgeons use the palm grip to some extent, and 31 surgeons (97%) experienced an advantage when suturing with the FNH using the palm grip. Twenty-four (75%) of the 32 surgeons would prefer to suture with the FNH instead of the CWNH. There was no significant difference in precision between the finger grip and the palm grip. Conclusion: This study presents a new needle holder facilitating palm grip suturing. A majority of the participants preferred the new FNH over the standard CWNH for hand suturing.

Hand Grip-EMG Muscle Response

One of the most important factors in hand-arm system research is the information about hand grip force and pressing force on a tool handle. This article focuses on an alternative method to measure grip force. For grip force, one of the most popular solutions is a special handle with force sensors. However, when we want to use it with regular hand tool like e.g. a drill, it seems to be uncomfortable because we must interfere in handle construction. A solution proposed in this article is based on technique for evaluating and recording the electrical activity produced by muscles, electromyography (EMG). It has been assumed that EMG signal will be proportional to muscle tension responsible for palm grip. This solution have one signi cant advantage when comparing to special handle. It can be used with regular tool without interfering in the handle. Measurement presented in this article have been carried out with use of surface electromyography (sEMG). It is not invasive method which enables to measure EMG signal through placing stickers with electrodes directly on a skin.

1H4 モーションキャプチヤを用いた歯磨きにおけるペングリップとパームグリップ時の上肢運動の解析(&lt;OS6&gt;医工連携における機械技術の新展開1)

1H4 モーションキャプチヤを用いた歯磨きにおけるペングリップとパームグリップ時の上肢運動の解析(&lt;OS6&gt;医工連携における機械技術の新展開1)

ARTHROPLASTY FOR TRAPEZIUM EXCISION AND TENDON INTERPOSITION IN RHIZARTHROSIS CASES: PROSPECTIVE STUDY

Objective: To prospectively evaluate the results from a series of patients who underwent surgical treatment for rhizarthrosis using the technique of trapezium resection associated with interposition of yarn from the long abductor tendon of the thumb. Methods: From May to August 2005, ten patients underwent surgical treatment for rhizarthrosis. Patients with primary osteoarthrosis of the trapezium-metacarpal joint, in stages II, III and IV of the Eaton classification, with persistent pain that was refractory to clinical treatment, were included. For the functional assessment, the visual analogue scale, DASH questionnaire and Buck-Gramcko score were used. For the overall assessment on the patients, strength measurements were made for palm grip, pulp to pulp pinch, lateral pinch, three-point pinch, opposition and radial and palmar abductions. The migration index for the first metacarpal was also determined on radiographs at rest and under stress. Results: The pain relief was considered to be good (p = 0.005), with functional improvements in modules 2 (p = 0.02) and 3 (p = 0.022) of DASH. The Buck-Gramcko score showed one excellent and three very good results. There was an improvement in almost all of the overall assessment and was only non-significant regarding lateral pinch and abduction. For all patients, there was migration of the first metacarpal. Conclusion: Trapeziectomy associated with interposition of yarn from the long abductor tendon of the thumb was shown to be a relatively simple and effective technique for pain relief and functional improvement.

Artroplastia de excisão do trapézio e interposição tendinosa na rizartrose: estudo prospectivo

OBJETIVO: Avaliar prospectivamente os resultados de uma série de pacientes submetidos ao tratamento cirúrgico da rizartrose, com a técnica de ressecção do trapézio associada à interposição de um novelo do tendão abdutor longo do polegar. MÉTODOS: De maio a agosto de 2005, 10 pacientes foram submetidos ao tratamento cirúrgico da rizartrose. Foram incluídos pacientes com osteoartrose primária da articulação trapézio-metacárpica, estágios II, III, IV da classificação de Eaton, com dor persistente refratária ao tratamento clínico. Para avaliação funcional foi utilizada a escala visual analógica, questionário DASH e o escore de Buck-Gramcko. Na avaliação global do paciente foram mensuradas as forças de preensão palmar, pinça polpa a polpa, pinça lateral, pinça de três pontos, oponência e abduções radial e palmar. Realizou-se, ainda, o índice de migração do primeiro metacarpal na radiografia de repouso e sob estresse. RESULTADOS: Foram considerados bons, no alívio da dor (p = 0,005), com melhora da função na avaliação pelo DASH módulos 2 (p = 0,02) e 3 (p = 0,022) O escore de Buck-Gramcko apresentou um resultado excelente e três ótimos. Houve melhora em quase toda avaliação global, sendo não significante apenas na pinça lateral e abdução. Em todos pacientes houve migração do primeiro metacarpal. CONCLUSÃO: A trapeziectomia associada à interposição de um novelo do tendão abdutor longo do polegar mostrou-se uma técnica de execução relativamente simples e eficaz no alívio da dor e na melhora funcional.

Fraqueza muscular esquelética e intolerância ao exercício em pacientes com doença pulmonar obstrutiva crônica

The aim of this study was to evaluate the functional capacity and the performance of respiratory and quadriceps muscles in patients with chronic obstructive pulmonary disease (COPD) and relate them to nutritional status and forced expiratory volume in the first second (FEV1). METHODS: Twelve patients with moderate COPD (70±7 years, FEV1 52±17% predicted, body mass index (BMI) 23±4kg/m2) and seven healthy volunteers (69±8 years, FEV1 127±12% predicted, BMI 27±3kg/m2) were evaluated. All of them underwent body composition analysis, measurement of respiratory muscle strength (maximum inspiratory pressure, MIP, and maximum expiratory pressure, MEP), cardiorespiratory exercise test (CET) and evaluation of palm grip strength, peak torque and total work or endurance of the quadriceps femoris. RESULTS: The patients with COPD had lower values for the free-fat mass (FFM) index (18±1 versus 21±1kg/m2, p<0.05), maximum load attained in the CET (60±20 versus 102±18 watts, p<0.01), MIP (58±19 versus 87±21cmH2O, p<0.05), palm grip strength (38±6 versus 47±5kg, p<0.05), peak torque (103±21 versus 138±18Nm, p<0.05) and total work of the quadriceps femoris (1570±395 versus 2333±568J, p<0.05) when compared with the control group (independent Student’s t test). There was no correlation between FEV1 and the variables studied, while the FFM correlated with the total work of the quadriceps (Pearson, r=0.6290, p<0.05). CONCLUSIONS: These results indicate that patients with COPD show weakness of the inspiratory and quadriceps muscles and lower functional capacity, when compared with a healthy group. Moreover, they suggest that the degree of airflow obstruction is not a good predictor for quantifying the nutritional and muscle impairments in patients with COPD.

A New Scalpel for Circular Incisions: Compass Scalpel

A scalpel is a very sharp knife used for surgery as well as for various arts and crafts. The blade usually is flat and straight, allowing it to be run easily against a straight edge to produce straight lines. The handles of medical scalpels are flatter and do not have the same level of grip as art scalpels because this would make cleaning more difficult. There are different ways of gripping and using medical scalpels including the fingertip grip, the palm grip, and the pencil grip. We present a novel scalpel for circular incisions. It resembles a pair of compasses used to draw circles in different dimensions. The idea originated from the need to make circular incisions for nipple-areola complexes in reduction mammaplasties. As part of the reduction procedure, the areolar size and shape are reduced proportionally. To make a circular incision, a circular line is drawn initially, then incised with an classical scalpel. Basically, a pair of compasses is used to draw arcs and/or to measure a geometric construction. Joining the starting point to the end with compasses obtains a circle. Collapsible compasses can make circles in different dimensions. They generally are used in a clockwise direction (Fig. 1). The compass scalpel has a blunt tip on one end that minimazes trauma to the skin where is applied. It has an attached surgical blade on the other end. It is used with a combination of palm grip and fingertip grip. Its main advantage is that a precise rapid adjustment (e.g., adjustment of the circular diameter desired) can be done at the operation because it is collapsible. A curved scale also is perpendicularly attached to the fixed compass to give a precise measurement (Fig. 2). The accuracy of this method depends on how the assistant positions the tension on the skin. If the circle

Wavelet Transfer Function in the Analysis of the Influence of a Palm Grip on Actual Vibrations of an Upper Limb

Algorithms used to determine the vibrations to which hand-tool operators are exposed take into account only vibrations measured on a tool. Thus, the significant influence of constraints joining the elements of the tool-operator system is neglected. This paper attempts to determine the influence of grip on vibrations recorded both on the tool and on the limb. The estimation was based on the use of the wavelet transfer function, in which the analysis was done by filtration with wavelet functions. Signals recorded with the specially designed system were utilised in investigations.

A comparison of forearm and thumb muscle electromyographic responses to the use of laparoscopic instruments with either a finger grasp or a palm grasp

Laparoscopic techniques allow for less-invasive treatment of common surgical problems. Laparoscopic instruments are different from standard surgical instruments and generally incorporate a pistol-grip handle configuration with rings for the fingers. This handle configuration has been reported as being uncomfortable, leading to finger compression neuropathies in some cases. As an alternative, the surgeon can choose to grasp laparoscopic instruments using a more powerful palm grip during grasping motions. This study evaluates the hypothesis that the use of the palm grip requires less muscle tension than the finger-grip when grasping with laparoscopic instruments. Nine general surgeons used an AutosutureR laparoscopic grasper with a ringed pistol-grip handle held in both a finger-in-ring (F) or palm (P) hand grip position to grasp and close two spring-loaded metal plates. The same task was performed with a surgical haemostat clamp (H) for comparison. Each subject performed the grasping task in a random sequence for the three instrument configurations at two grasping forces levels (0.7 and 4.2 N), and with the instrument at three angles to the subjects' sagittal plane (0°, 45° and 90°). Surface electromyographic (EMG) signals were acquired from the flexor carpi ulnaris (FCU), flexor digitorum profundus (FDP), flexor digitorum superficialis (FDS), extensor carpi ulnaris (ECU), extensor digitorum comunis (EDC) and the thenar compartment (TH). The peak root mean squared (RMS) EMG voltage was averaged for five repetitions at each instrument, force and angle condition. Statistical analysis was carried out by repeated measures ANOVA. The muscle EMG RMS amplitude while using the palm grip was decreased in the FDS, TH and EDC, was unchanged in the ECU and FCU, and was slightly higher in the FDP when compared with the finger grip. These differences were most prominent at 90° to the sagittal plane where the subjects' wrists neared maximal flexion. It is concluded that the palm grip is more powerful than the finger grip when grasping with laparoscopic instruments, particularly at angles perpendicular to the surgeon's sagittal plane.