Grip Pinch Strength Research Articles

Responsiveness of performance-based outcome measures for mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1.

To assess changes and responsiveness in outcome measures of mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1. A 9-year longitudinal study conducted with 113 patients. The responsiveness of the Timed Up and Go test, Berg Balance Scale, quantitative muscle testing, grip and pinch-grip strength, and Purdue Pegboard Test was assessed using criterion and construct approaches. Patient-reported perceived changes (worse/stable) in balance, walking, lower-limb weakness, stair-climbing and hand weakness were used as criteria. Predefined hypotheses about expected area under the receiver operating characteristic curves (criterion approach) and correlations between relative changes (construct approach) were explored. The direction and magnitude of median changes in outcome measures corresponded with patient-reported changes. Median changes in the Timed Up and Go test, grip strength, pinch-grip strength and Purdue Pegboard Test did not, in general, exceed known measurement errors. Most criterion (72%) and construct (70%) approach hypotheses were supported. Promising responsiveness was found for outcome measures of mobility, balance and muscle strength. Grip strength and manual dexterity measures showed poorer responsiveness. The performance-based outcome measures captured changes over the 9-year period and responsiveness was promising. Knowledge of measurement errors is needed to interpret the meaning of these longitudinal changes.

Range of movement, power and pinch grip strength post flexor tendon repair

Background: Flexor tendon injuries (FTI) are common hand injuries that pose a challenge to the multi-disciplinary team. Despite being the most researched topic in hand literature, the optimal surgical and post-operative treatment of FTI remains unclear and results after flexor tendon repair (FTR) continue to be unpredictable.Purpose: The purpose of this study was to determine the range of movement (ROM), power and pinch grip strength post FTR and to establish factors that may affect these.Method: The study was conducted at an academic hospital in Gauteng, South Africa, between January 2013 and September 2015. At one, three and six months post FTR, the ROM of the injured and contralateral finger(s) were measured. At three and six months post FTR the participants’ bilateral power and pinch grip strength were also measured.Results: One hundred and twenty-six participants (n=126) enrolled in the study. There was a drop-out rate of 48%, leaving 65 participants that completed six months’ follow-up: 41 males (63%) and 24 females (37%) with mean age of 32 years (SD±10, n=65). Out of 65 participants, 2% (n=1) had an excellent outcome, 32% (n=21) a good outcome, 32% (n=21) a fair outcome and 34% (n=22) a poor outcome with regard to ROM. At six months post FTR the average power grip was 60% (SD±25, n=65) of the unaffected hand, while the average pinch grip was 52% (SD±42, n=65) of the unaffected hand. Sixty-eight per cent (n=44) of patients had post-operative complications: the most common complication was tenodesis/adhesions (25%, n=16), followed by contracture (22%, n=14). Four patients (6%) had ruptures and 11 (17%) underwent further surgery. Factors that had a positive effect on outcome at six months post FTR were: younger age, no associated injury, less duration between injury and surgery, having controlled active motion instead of passive motion occupational therapy protocol, and not having a language barrier. Injury in zone IV was associated with worse ROM and power grip strength than other zones.Conclusion: Although there were some promising outcomes, during this period participants did not consistently achieve the good or excellent outcomes that are achieved in some developed countries.Level of evidence: Level 4

EFFECT OF THE P.A.R.Q.V.E ON RHIZARTHRITIS.

ABSTRACTObjective:To evaluate the effect of a clinical management program involving education on hand function in patients with rhizarthritis. Methods:One hundred and eight patients with rhizarthritis and multiple arthritis (191 hands with clinical and radiographic rhizarthritis) followed for two years as part of an educational program on osteoarthritis were administered the SF-36, DASH, and HAQ questionnaires and measured for the strength of their palmar grip, pulp to pulp pinch, key (lateral) pinch, and tripod pinch at the time of inclusion and after 24 months. Age, race, level and frequency of physical activity, sex, body mass index, percentage of body fat, and degree of osteoarthritis were correlated to the test outcomes. Results:Women improved less than men on the HAQ (p=0.037). Each 1% reduction in fat percentage increased the chance of HAQ score improvement by 9.2% (p=0.038). Physical activity did not influence improvement in the parameters evaluated (p>0.05). Palmar grip improvement was affected by age and presence of rhizarthritis (p<0.05); patients with unilateral rhizarthritis improved 5.3 times more than patients without the disease (p=0.015), while improvement in palmar grip strength decreased 6.8% per year (p=0.004). Pulp pinch grip strength improved more in women than in men (p=0.018). Conclusion:Patients with rhizarthritis and multiple arthritis improved quality of life and grip strength through clinical treatment, an educational program, and fat loss. Level of Evidence II; Retrospective study.

Compression plate arthrodesis for osteoarthritis of the first carpometacarpal joint: A retrospective study of 77 cases

Osteoarthritis of the first carpometacarpal joint (CMCJ1) is a common, painful condition with positive radiological findings in up to 32% of people over 50 years of age and up to 91% of people over 80 years of age. Currently, there is insufficient evidence to recommend one surgical treatment option over the others. We conducted a retrospective review of 77 patients treated for CMCJ1 osteoarthritis with plate arthrodesis between 1979 and 1996. The review included physical examination, including range of motion (ROM) of the thumb interphalangeal joint, metacarpophalangeal joint and CMCJ1, pinch grip, key grip and power grip strength, and a questionnaire on subjective outcomes (appearance, dexterity, load bearing, pain, strength, subjective overall result and if patients would choose the procedure again). The complication rate was 26%. However, the general patient satisfaction was high with 88% of patients saying they would choose to have the procedure done again. There was a significant decrease (side-to-side difference) in the ROM for palmar and radial abduction as well as opposition when compared to the opposite hand. Furthermore, there was a significant reduction (side-to-side difference) in pinch, key grip and power grip strength. ROM did not seem to have any influence on pain (and vice versa), load bearing, and the subjective overall result. No gender differences were noted. Despite the high complication rate, CMCJ1 arthrodesis remains a viable option for the treatment of CMCJ1 osteoarthritis in select patients requiring good thumb stability.

Upper limb function in children with attention-deficit/hyperactivity disorder (ADHD)

Upper limb function was investigated in children with ADHD using objective methods. We hypothesised that children with ADHD exhibit abnormal dexterity, force application during manipulation of a novel object, and movement rhythmicity. Two groups of age- and gender-matched children were investigated: 35 typically developing children (controls, 10.5±0.4years, 32M-3F) and 29 children (11.5±0.5years, 27M-2F) with formally diagnosed ADHD according to DSM-IV-TR criteria. Participants underwent a series of screening tests and tests of upper limb function while "off" medication. Objective quantification of upper limb function involved measurement of force during a grip and lift task, maximal finger tapping task, and maximal pinch grip. Acceleration at the index finger was also measured during rest, flexion and extension, and a postural task to quantify tremor. The Movement Assessment Battery for Children-2 (MABC-2) was also administered. Significant between-group differences were observed in movement rhythmicity, manipulation of a novel object, and performance of the MABC-2 dexterity and aiming and catching components. Children with ADHD lifted a novel object using a lower grip force (P=0.036), and held the object with a more variable grip force (P=0.003), than controls. Rhythmicity of finger tapping (P=0.008) and performance on the dexterity (P=0.007) and aiming and catching (P=0.042) components of the MABC-2 were also significantly poorer in the ADHD group than controls. Movement speed, maximum pinch grip strength, and tremor were unaffected. The results of the study show for the first time that ADHD is associated with deficits in multiple, but not all domains of upper limb function.

Vitamin D and calcium supplementation, skeletal muscle strength and serum testosterone in young healthy adult males: Randomized control trial

Cholecalciferol and/or calcium supplementation might increase skeletal muscle strength and serum testosterone in young adult males. We performed a randomized control trial assessing the effect of cholecalciferol/calcium on skeletal muscle strength and serum testosterone in vitamin D deficient young males. Two-by-two factorial RCT. Two-hundred and twenty-eight young males were block-randomized to (i) double-placebo, (ii) calcium/placebo, (iii) cholecalciferol/placebo and (iv) cholecalciferol/calcium. Doses for cholecalciferol were 60000IU/wk for 8weeks followed by 60000IU/fortnightly, and doses for elemental calcium were 500 mg/twice daily for 6months. A total of 180 subjects completed the study protocol. Their ean age, body mass index and baseline 25(OH)D were 20.2±2.2years, 23.0±3.6kg/m2 and 21.5±9.5nmol/L, respectively. Handgrip (primary outcome), pinch-grip strength, distance walked in 6minutes, dyspnoea-score, quality of life by Short Form 36, serum 25(OH)D, 1,25(OH)2 D, iPTH, total testosterone and free androgen index (FAI). After intervention, mean serum 25(OH)D was >75.0nmol/L in cholecalciferol groups. However, the handgrip strength (29.7±4.4, 29.3±4.6, 30.6±5.0 and 28.8±4.3kg, P=.28) was comparable in the 4 groups. Subgroups analysis among subjects with baseline serum 25OH)D < 25.0 and <12.0nmol/L showed similar results. The mean serum testosterone decreased significantly at 6months; however, delta change was similar in 4 groups. Change in handgrip strength and other outcomes was similar in 4 groups with and without adjustment for delta testosterone and FAI. Six months of cholecalciferol/calcium supplementation had no significant effect on skeletal muscle strength and serum testosterone in young adult males.

Abnormalities of Vital Signs in Children with Cerebral Palsy: Relationship to Physical Disabilities

The autonomic functions of children with cerebral palsy (CP) have not been sufficiently explored, and corresponding abnormalities are underdiagnosed. In addition, studies evaluating the associations between autonomic dysfunctions and the different aspects of motor performance among these children are scarce. We aimed to investigate vital signs in children with CP and compare them to those of children with typical motor development (TMD) and to determine the associations of autonomic dysfunction with the demographic and clinical data and motor characteristics of these children. A convenience sample of 118 children with CP was evaluated in this cross-sectional study. A group of 69 matched children with TMD served as a control group. We measured the vital signs and key pinch and hand grip strengths of all children in the study. Vital signs were recorded while the children rested in a comfortable sitting position. Children with CP were evaluated for muscle tone and motor abilities. Systolic BP, diastolic BP, heart rate, and respiratory rate were significantly higher in children with CP than in children with TMD (p values of 0.03, 0.006, 0.02, and 0.001, respectively), while blood oxygen saturation and oral body temperature were significantly lower (p values of 0.00 and 0.003, respectively). We detected only weak to moderate correlations between some vital sign abnormalities and children with lower motor performance (diplegic and quadriplegic children, children with level IV or V on the gross motor function classification system (GMFCS), and children with low key pinch and hand grip strength). Children with CP had abnormalities in their vital signs at rest, reflecting a state of dysautonomia. Abnormalities included high systolic BP, diastolic BP, heart rate, and respiratory rate and low blood oxygen saturation and oral body temperature. Children with lower motor performance were at a greater risk of dysautonomia.

Analysis of functional outcome of complex forearm injuries

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Complex forearm injuries are often associated with contamination, crushing, loss of tissues and patient arrives at odd hours when specialists are not available. These injuries can lead to complications like infective non-union, stiffness, disabilities and secondary amputations.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;23 patients having complex forearm injuries treated primarily at tertiary care center by single surgeon were included in the study. Pinch strength, grip strength, residual deformity and DASH score was assessed at final follow-up. In 23 patients treated, 16 patients underwent primary internal fixation of both bone, primary external fixator was done in 4 patient, delayed fixations in 6patients, primary bone grafting in 3 patients and in 1 patient delayed bone grafting was done Skin grafting was performed in 6 cases, and flaps in 13 patients. Vascular repair was done in four patients&lt;/span&gt;.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;All 23 patients came for follow-up. An average number of surgery performed per patient was 3.81 and mean hospital stay of 28.2 days. The mean duration of follow up was 47.2 months. The average DASH score was 10.24 with average key and tip pinch and grip strength of 62.24%, 58.48% and 54.75% respectively. 3 patients had superficial infection and two patient deep infections. Superficial infections were managed with IV antibiotics. The patients with nerve and vascular injuries had higher DASH score. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Early wound coverage can improve functional outcomes. Training in plastic coverage of wounds using pedicle flaps and skin grafting, microsurgical nerve and vessel repairs for orthopedic surgeon can be of great help for the patients.&lt;/span&gt;&lt;/p&gt;

Effectiveness of Lavendula stoechas essential oil in treatment of mild to moderate carpal tunnel syndrome: A randomized controlled trial

Study DesignRandomized controlled trial. IntroductionCarpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. To date, no previous study has evaluated the efficacy of topical Lavendula stoechas (Lavender) oil in CTS patients. Purpose of the StudyTo investigate the effectiveness of topical Lavender essential oil in pain intensity, isometric pinch strength, electrophysiological features, and functional status of patients with mild to moderate CTS. MethodsForty eight patients with mild to moderate CTS were enrolled in this randomized placebo-controlled trial. Group A was treated with night wrist orthotic and topical lavender oil ointment. Group B was treated with night wrist orthotic and a placebo ointment. Patients were evaluated at baseline, and after 40 days of intervention with Boston CTS questionnaire (BCTQ), visual analog scale (VAS) for pain, pinch grip strength, power grip, median compound motor action potential latency, and median sensory nerve action potential latency. ResultsAt the end of the study period, both groups improved significantly in terms of BCTQ, VAS, isometric pinch powers, and electrodiagnosis study parameters. However, group A showed significantly greater improvements in BCTQ (mean difference, 0.39 ± 0.31 vs 0.6 ± 0.35; P = .03), VAS (3.37 ± 1.86 vs 1.33 ± 2.07; P = .001), and pinch grip strength (0.73 ± 0.63 vs 0.27 ± 0.54; P = .01) than group B. No significant differences in power grip, median compound motor action potential latency, and median sensory nerve action potential latency were seen between the 2 groups. ConclusionThis study was the first trial of topical lavender oil used in patients with CTS. Wrist orthotic combined with topical lavender oil was more effective than orthotic and placebo in treatment of mild to moderate CTS. Level of Evidence1b.

Assessment of the Ipsilesional Hand Function in Stroke Survivors: The Effect of Lesion Side

The aim of this study was to examine the effect of the side of brain lesion on the ipsilesional hand function of stroke survivors. Twenty-four chronic stroke survivors, equally allocated in 2 groups according to the side of brain lesion (right or left), and 12 sex- and age-matched healthy controls performed the Jebsen-Taylor Hand Function Test (JTHFT), the Nine-Hole Peg Test (9HPT), the maximum power grip strength (PwGSmax) test, and the maximum pinch grip strength (PnGSmax) test. Only the ipsilesional hand of the stroke survivors and both hands (left and right) of the controls were assessed. PwGS max and PnGS max were similar among all tested groups. Performances in JTHFT and 9HPT were affected by the brain injury. Individuals with left brain damage showed better performance in 9HPT than individuals with right brain damage, but performance in JTHFT was similar. Individuals after a brain injury have the capacity to produce maximum strength preserved when using their ipsilesional hand. However, the dexterity of their hands and digits is affected, in particular for stroke individuals with right brain lesion.

Effect of Hand Dominance on Functional Status and Recovery of Hand in Stroke Patients

Stroke is characterized by hemiplegia, including motor deficits and various neurological manifestations mainly in contralateral half of the body lasting more than 24 hours with a presumed vascular cause. The goal of stroke rehabilitation is to make people independent and this is possible with appropriate functioning of the affected hand and upper extremity. Stroke patients have to depend on the nondominant hand when the effected hand is the dominant side. However this disadvantage might end up in better results with more effort for recovery of the dominant hand. In this study, we aimed to understand the effect of hand dominance on both functional loss and regain after stroke. 18 patients with right or left hemiplegia participated in the study. Patients were grouped as dominant side and nondominant side hemiplegic (groups D and ND). Patients were evaluated in the 1st week, 1st month and 3rd month. Brunnstrom stages, Motricity index, MAS and FIM, NHPT and hand grip strength were recorded for every patient in every visit. None of the parameters showed significant difference between two groups. Only NHPT used to assess fine manual dexterity revealed a significant difference in the final analysis. Correlation analysis displayed a positive correlation between hand grip strength with FIM and pinch grip strength with NHPT. We concluded that there was no significant difference in functional improvement between dominant and non-dominant side hemiplegic groups during the first three months after stroke. However longer follow ups and larger patient groups are needed to clarify the effect of hand dominance on long term functional status.

Revision Ligament Reconstruction Tendon Interposition for Trapeziometacarpal Arthritis: A Case-Control Investigation

To test the null hypothesis that there is no difference in patient-reported and objective outcomes of revision ligament reconstruction and tendon interposition (LRTI) compared with primary LRTI. This case-control investigation enrolled 10 patients who had undergone revision LRTI at a tertiary care center. All patients had previously undergone primary trapeziectomy with LRTI. Patients with a minimum of 2 years' follow-up were eligible. All patients completed an in-office study evaluation. Controls (treated only with primary LRTI) were matched from our practice to reach a 1:2 case-control ratio. Outcome measures included Michigan Hand Questionnaire (primary outcome), Quick-Disability of the Arm, Hand, and Shoulder (QuickDASH) questionnaire, visual analog scale (VAS) for pain and improvement, and physical examination. Statistical analyses were conducted to compare patient groups. Patients who underwent revision LRTI reported significantly worse outcomes on all measured standardized questionnaires compared with primary patients. The Michigan Hand Questionnaire indicated worse overall outcomes (54 vs 79) as well as worse pain, appearance, and ability to complete activities of daily living. Compared with those who did not undergo revision LRTI, patients who did also reported more impairment (Quick-Disability of the Arm, Hand, and Shoulder, 47 vs 23), greater pain (VAS pain, 6.3 vs 1), and less improvement after surgery (VAS improvement, 2.7 vs 7.9). There was also a significantly higher rate of patient-reported depression in the revision LRTI group (50% vs 10% of patients treated with primary LRTI). We did not find a significant difference in objective outcomes of pinch strength, grip strength, and thumb palmar abduction between the 2 groups. After revision LRTI, patient-reported outcomes indicate worse perceived function and greater pain than are expected following primary LRTI despite similar motion and strength. Revision surgery can be offered in the setting of persistent or recurrent symptoms, but patients should be counseled that improvement of symptoms is unpredictable. Therapeutic III.

Hand impairment and functional ability: A matched case comparison study between people with rheumatoid arthritis and healthy controls

Introduction The aim of this study was to compare hand impairment and function in a cohort of patients with rheumatoid arthritis and matched healthy participants. Methods A matched case comparison research design comparing hand impairment and functional ability between patients with rheumatoid arthritis and healthy participants (males or females, aged ≥ 50 years). Functional ability was assessed using the Michigan Hand Questionnaire, power and pinch grip strength and the nine-hole peg test. Results A total of 100 participants (50 patients with rheumatoid arthritis and 50 matched healthy participants) were recruited. Patients with rheumatoid arthritis reported significantly lower overall hand function, activities of daily living, work, aesthetics, satisfaction ( p &lt; 0.001) and significantly higher pain scores when compared with healthy controls. The patients with rheumatoid arthritis had significantly lower maximum power and pinch grip strength in both left and right hands ( p &lt; 0.001) when compared with healthy controls. The rheumatoid arthritis group took significantly longer to complete the nine-hole peg test using both right and left hands compared with healthy controls ( p &lt; 0.001, respectively). Additionally, in rheumatoid arthritis patients, a significant moderate, positive correlation between power grip strength and activities of daily living (r = 0.584, n = 50, p &lt; 0.01) and a weak-to-moderate, significant negative correlation between power grip strength and pain (r = −0.314, n = 50, p &lt; 0.05) were reported. Conclusion Despite the recent substantial improvement of drug therapy and disease control, the functional impact of rheumatoid arthritis on hand pain and function remains significant.

Exercise training and postural correction improve upper extremity symptoms among touchscreen smartphone users.

Background:Repetitive movements and poor posture are associated with over-use of smartphones when texting or playing games and significantly contribute to the symptoms of pain and discomfort in the upper extremities.Objective:This study investigated the effect of exercise training and postural correction on disabilities of the arm, shoulder, and hand (DASH), hand grip and key pinch strength among smartphone users.Methods:One hundred university students were randomly divided into two groups; the experimental group participated in a 12-week programme of exercise training and postural corrections. The control group were instructed to follow their usual routine for smartphone utilization. Measurements of DASH scores, hand grip strength, and key pinch grip strength were conducted before and after 12 weeks for both groups.Results:There were no significant differences between the start values of both groups for DASH scores, hand grip strength, and key pinch strength (p > 0.05). However, there was a significant improvement in all outcomes measured in the experimental group (p < 0.05), with significant changes in the outcomes of the control group.Conclusion:Postural correction combined with a selected exercise training programme improved the hand grip, key pinch grip strength, and upper extremity disability and symptoms associated with smartphone use among university students.

The Impairments and Functional Outcomes of Patients Post Flexor Tendon Repair of the Hand

Backgrounds: Flexor tendon injuries are common hand injuries for which optimal surgical and postoperative treatment has not yet been established. The variability in results is great, with good outcomes being achieved in specialized hands units in developed countries. Minimal research has been undertaken in developing countries, in particular South Africa, regarding flexor tendon repair (FTR) and the outcomes thereof. Objectives: The purpose of this study was to establish the range of movement (ROM), grip strength, and hand function at 6 months post FTR as well as to determine the factors that affect the impairments and functional outcome at 6 months post FTR. Materials and Methods: The study was conducted at a tertiary hospital in South Africa. At 1, 3, and 6 months post FTR, the ROM of the injured and contralateral finger(s) were measured using a finger goniometer. The Total Active Motion (TAM) classification system was applied to each affected digit, and the average TAM was determined for the participants’ affected hand. At 3 and 6 months post FTR, the participants’ bilateral power and pinch grip strength were measured using a Jamar dynamometer and a pinch meter. The power and pinch grip strengths were calculated as a percentage of the unaffected hand. At 3 and 6 months post FTR, participants performed the Jebsen Hand Function Test (JHFT), and a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire was administered in an interview format. Results: A total of 126 participants enrolled in the study. There was a dropout rate of 48%, leaving 65 participants who completed 6 months follow-up, 41 males (63%) and 24 females (37%) aged 32 years (SD ± 12, n = 65). Out of 65 participants, 2% (n = 1) had an excellent outcome, 32% (n = 21) had a good outcome, 32% (n = 21) had a fair outcome, and 34% (n = 22) had a poor outcome with regard to TAM. At 6 months post FTR, the average power grip was 60% (SD ± 25, n = 65) of the unaffected hand while the average pinch grip was 52% (SD ± 42, n = 65) of the unaffected hand. The average score on the QuickDASH questionnaire was 19.34 (SD ± 16.89) at 6 months. Of the 41 participants who were employed prior to injury, 71% (n = 29) had returned to work by 6 months post surgery and scored an average of 15.89 (SD ± 23.74) on the QuickDASH work module. Sixty-eight percent (n = 44) of the patients had postoperative complications: the most common complication was tenodesis/adhesions (25%, n = 16), followed by contracture (22%, n = 14). There were only 4 ruptures (6%, n = 4) in this sample. Eleven participants (17%) underwent further surgery. The factors that affect the impairments and functional outcome at 6 months post FTR include age, zone of injury, number of digits injured, associated injury, delay between injury and surgery, and language barrier. Conclusion: Although there were some promising outcomes, during this period, participants did not consistently achieve the good or excellent functional outcomes achieved in developed countries. More research needs to be conducted regarding the outcome of FTR in South Africa, particularly in the public sector.

Pyrocarbon Interposition Arthroplasty of the Trapeziometacarpal Joint With the PyroDisk

Introduction: Pyrocarbon is a high-strength, low-friction carbon material. It is isoelastic to bone and therefore considered ideal for a hemiarthroplasty. Pyrocarbon interposition arthroplasty is an alternative to the traditional tendon interposition arthroplasty in the trapeziometacarpal joint, but follow-up series are rare. Objectives: We aimed to evaluate the short-term results and safety of pyrocarbon prosthesis in a younger population. Methods: Between February 2006 and April 2009, 25 patients (29 arthroplasties) were operated with a PyroDisk interposition arthroplasty (Ascension Orthopedics/Integra, Austin, Texas). The mean age was 61 years (range, 52-71 years). Four patients were males and 21 females. The mean follow-up time was 28 months (range, 10-44 months). The patients were evaluated subjectively using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score as well as a visual analogue scale (VAS 0-10 cm) regarding pain at rest and at activity, and the cosmetic. Grip strength was recorded with a JAMAR dynamometer and the pinch grip strength as well as volar and radial thumb abduction noted. Results: Six prostheses were revised: 4 due to prostheses dislocation, 1 due to scapho-trapezium-trapezoid (STT) arthritis and persistent, and 1 due to persistent pain without any cause. All 6 patients were converted into abductor pollicis longus (APL) tendon interposition arthroplasty. The average pinch grip strength was 5.0 kg force (range, 1.2-9.5 kg) in the operated hands. In patients with unilateral surgery (n = 21), the pinch grip strength was 86 % of the untreated hands. The mean VAS pain at rest was 1.1 cm (SD = 2.0 cm), and 17 of 25 patients were pain free at rest. Six patients reported mild pain (VAS 1-3), and 2 patients reported VAS 7 at rest. VAS pain at activity was 4.2 cm (SD = 2.5 cm). The average DASH score was 32 (range, 0-93). Conclusion: The use of PyroDisk arthroplasty gives good range of motion and pain relief at rest, and the pinch grip after mean 28 months was close to the nonaffected side but not completely normalized. However, a large number (6/29) of the prostheses were revised, which is a major concern.

PT08.1: Pinch Grip Strength is a Simple Indicator for Prognosis and Muscle Depletion in Patients with Far Advanced Cancer

PT08.1: Pinch Grip Strength is a Simple Indicator for Prognosis and Muscle Depletion in Patients with Far Advanced Cancer

Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax), maximal pinch grip strength (PGSMax), Jebsen-Taylor Hand Function Test (JTHFT) and Nine Hole Peg Test (9-HPT). All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50) and between JTHFT and 9-HPT (r = 0.55). Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

Examining hand dominance using dynamometric grip strength testing as evidence for overwork weakness in Charcot-Marie-Tooth disease: a systematic review and meta-analysis.

This systematic review with a meta-analysis of studies was carried out to evaluate the potential of overwork weakness on the basis of grip strength of dominant and nondominant hands in individuals with Charcot-Marie-Tooth disease (CMT). Numerous electronic databases were searched from the earliest records to February 2016. Studies of any design including participants older than 18 years of age with a confirmed diagnosis of CMT that measured grip strength of both hands using dynamometric testing were eligible for inclusion. Of 12 593 articles identified following removal of duplicates, five articles fulfilled the criteria. A total of 166 participants, mostly with CMT1 or CMT2, were described from the studies included. Hand and finger pinch grip strength for the dominant compared with the nondominant hand was not statistically different. There is no definitive evidence that preferential use of the dominant hand in CMT impairs function relative to the nondominant hand. Thus, robust exercise trials of progressive resistance training are needed to understand the extent of adaptations possible and provide evidence of the safety of such regimens.

Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax), maximal pinch grip strength (PGSMax), Jebsen-Taylor Hand Function Test (JTHFT) and Nine Hole Peg Test (9-HPT). All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50) and between JTHFT and 9-HPT (r = 0.55). Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.