Pinch Strength Research Articles

Motor function in multiple sclerosis assessed by navigated transcranial magnetic stimulation mapping.

Impaired motor function is a major cause of disability in multiple sclerosis (MS), involving various neuroplasticity processes typically assessed by neuroimaging. This study aimed to determine whether navigated transcranial magnetic stimulation (nTMS) could also provide biomarkers of motor cortex plasticity in patients with MS (pwMS). nTMS motor mapping was performed for hand and leg muscles bilaterally. nTMS variables included the amplitude and latency of motor evoked potentials (MEPs), corticospinal excitability measures, and the size of cortical motor maps (CMMs). Clinical assessment included disability (Expanded Disability Status Scale, EDSS), strength (MRC scale, pinch and grip), and dexterity (9-hole Pegboard Test). nTMS motor mapping was performed in 68 pwMS. PwMS with high disability (EDSS ≥ 3) had enlarged CMMs with less dense distribution of MEPs and various MEP parameter changes compared to pwMS with low disability (EDSS < 3). Patients with progressive MS had also various MEP parameter changes compared to pwMS with relapsing remitting form. MRC score correlated positively with MEP amplitude and negatively with MEP latency, pinch strength correlated negatively with CMM volume and dexterity with MEP latency. This is the first study to perform 4-limb cortical motor mapping in pwMS using a dedicated nTMS procedure. By quantifying the cortical surface representation of a given muscle and the variability of MEP within this representation, nTMS can provide new biomarkers of motor function impairment in pwMS. Our study opens perspectives for the use of nTMS as an objective method for assessing pwMS disability in clinical practice.

Associations between pinch strength, cardiovascular events and all-cause mortality in patients undergoing maintenance hemodialysis

Background and aimsPatients undergoing maintenance hemodialysis (MHD) experience increased mortality and cardiovascular disease (CVD) risks; however, the potential connection between pinch strength (PS) and the prognosis of these patients remains unknown. Consequently, this study aimed to comprehensively assess the influence of PS and handgrip strength (HGS) on both survival and cardiovascular events (CVE) in patients undergoing MHD.MethodsData were gathered from patients undergoing MHD at the Hemodialysis Center of Guangzhou Red Cross Hospital in March 2021. We performed a retrospective follow-up spanning 24 months, with death serving as the primary endpoint for observation and CVE as the secondary endpoint. Multifactorial Cox regression analysis, Kaplan–Meier survival curves, trend tests, and restricted cubic spline were applied to explore the association.ResultsDuring a 24-month follow-up, data were collected from 140 patients undergoing MHD with an average age of 66.71 ± 12.61 years. Among them, 52 (37.14%) experienced mortality, whereas 36 (40.00%) had CVE without baseline CVD. Kaplan–Meier survival curves demonstrated better survival rates and reduced CVE risk for patients in the second, third, and fourth quartiles compared with those in the first quartile for PS. Adjusted analyses in different models revealed higher PS levels were independently associated with all-cause mortality (major model, model 4, HR, 0.78; 95% CI, 0.64–0.95) but not with CVE risk (unadjusted HR, 0.90; 95% CI, 0.77–1.05). Compared with lower quartile PS levels, higher PS levels significantly reduced all-cause mortality (HR, 0.31; 95% CI, 0.10–1.02), and this trend remained consistent (P for trend = 0.021). Finally, the restricted cubic spline method using different models showed a linear relationship between PS and all-cause mortality (P > 0.05), when PS exceeded 4.99 kg, the all-cause mortality of MHD patients significantly decreased.ConclusionsPS was independently associated with all-cause mortality but not with CVE in patients undergoing MHD.

Metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis: Relationship to first metacarpal head shape, and clinical impact

PurposeThe aim of this study was to determine whether the shape of the first metacarpal head influences metacarpophalangeal hyperextension, and to evaluate the influence of metacarpophalangeal hyperextension on hand pain and function in patients with trapeziometacarpal osteoarthritis. Methods362 patients with painful basal thumb osteoarthritis were evaluated over a 2-year period. Pain rating on a visual analog scale, trapeziometacarpal and metacarpophalangeal motion, and grip and pinch strength were evaluated. The shape of the metacarpal head was assessed on strict lateral radiographs using the “A/r” ratio. ResultsRound metacarpal heads had significantly greater and more frequent metacarpophalangeal hyperextension than flat heads (28° vs. 8°, and 78% vs. 29%). Metacarpophalangeal hyperextension adversely impacted trapeziometacarpal motion in antepulsion (27° vs. 32°), abduction (25° vs. 30°) and pinch strength (3.6 vs. 4.6 KgF). ConclusionOur findings indicate that the shape of the metacarpal head influences metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis. Metacarpophalangeal hyperextension adversely impacted pinch strength and trapeziometacarpal motion. Level of EvidenceLevel IV, Retrospective case series.

The time course of motor and cognitive decline in older adults and their associations with brain pathologies: a multicohort study

Many studies have reported that impaired gait precedes cognitive impairment in older people. We aimed to characterise the time course of cognitive and motor decline in older individuals and the association of these declines with the pathologies of Alzheimer's disease and related dementias. This multicohort study used data from three community-based cohort studies (Religious Orders Study, Rush Memory and Aging Project, and Minority Aging Research Study, all in the USA). The inclusion criteria for all three cohorts were no clinical dementia at the time of enrolment and consent to annual clinical assessments. Eligible participants consented to post-mortem brain donation and had post-mortem pathological assessments and three or more repeated annual measures of cognition and motor functions. Clinical and post-mortem data were analysed using functional mixed-effects models. Global cognition was based on 19 neuropsychological tests, a hand strength score was based on grip and pinch strength, and a gait score was based on the number of steps and time to walk 8 feet and turn 360°. Brain pathologies of Alzheimer's disease and related dementias were assessed at autopsy. From 1994 to 2022, there were 1570 eligible cohort participants aged 65 years or older, 1303 of whom had cognitive and motor measurements and were included in the analysis. Mean age at death was 90·3 years (SD 6·3), 905 (69%) participants were female, and 398 (31%) were male. Median follow-up time was 9 years (IQR 5-11). On average, cognition was stable from 25 to 15 years before death, when cognition began to decline. By contrast, gait function and hand strength declined during the entire study. The combinations of pathologies of Alzheimer's disease and related dementias associated with cognitive and motor decline and their onsets of associations varied; only tau tangles, Parkinson's disease pathology, and macroinfarcts were associated with decline of all three phenotypes. Tau tangles were significantly associated with cognitive decline, gait function decline, and hand function decline (p<0·0001 for each); however, the association with cognitive decline persisted for more than 11 years before death, but the association with hand strength only began 3·57 years before death and the association with gait began 3·49 years before death. By contrast, the association of macroinfarcts with declining gait function began 9·25 years before death (p<0·0001) compared with 6·65 years before death (p=0·0005) for cognitive decline and 2·66 years before death (p=0·024) for decline in hand strength. Our findings suggest that average motor decline in older adults precedes cognitive decline. Macroinfarcts but not tau tangles are associated with declining gait function that precedes cognitive decline. This suggests the need for further studies to test if gait impairment is a clinical proxy for preclinical vascular cognitive impairment. National Institutes of Health.

Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial

Cervical spinal cord injury (SCI) leads to permanent impairment of arm and hand functions. Here we conducted a prospective, single-arm, multicenter, open-label, non-significant risk trial that evaluated the safety and efficacy of ARCEX Therapy to improve arm and hand functions in people with chronic SCI. ARCEX Therapy involves the delivery of externally applied electrical stimulation over the cervical spinal cord during structured rehabilitation. The primary endpoints were safety and efficacy as measured by whether the majority of participants exhibited significant improvement in both strength and functional performance in response to ARCEX Therapy compared to the end of an equivalent period of rehabilitation alone. Sixty participants completed the protocol. No serious adverse events related to ARCEX Therapy were reported, and the primary effectiveness endpoint was met. Seventy-two percent of participants demonstrated improvements greater than the minimally important difference criteria for both strength and functional domains. Secondary endpoint analysis revealed significant improvements in fingertip pinch force, hand prehension and strength, upper extremity motor and sensory abilities and self-reported increases in quality of life. These results demonstrate the safety and efficacy of ARCEX Therapy to improve hand and arm functions in people living with cervical SCI. ClinicalTrials.gov identifier: NCT04697472.

Effects of taxane-induced peripheral neuropathy on hand dexterity impairment: evaluation of quantitative and subjective assessments.

Chemotherapy-induced peripheral neuropathy (CIPN) commonly involves hand dexterity impairment. However, the factors affecting hand dexterity impairment are unknown and there is currently no established treatment. The purpose of the current study was to clarify factors influencing hand dexterity impairment in taxane-induced peripheral neuropathy using subjective and objective assessments. We assessed patient characteristics, treatment-related factors, subjective symptoms of CIPN (Patient Neurotoxicity Questionnaire [PNQ]), psychological symptoms, and upper limb dysfunction (Quick Disabilities of the Arm, Shoulder and Hand [Quick DASH]). Quantitative assessments were pinch strength, sensory threshold, hand dexterity impairment, and grip force control. Multiple regression analysis was performed using hand dexterity impairment as the dependent variable and age and PNQ, Quick DASH, and control of grip force as independent variables. Forty-three breast cancer patients were included in the analysis. Hand dexterity impairment in taxane-induced peripheral neuropathy patients was significantly correlated with age, grip force control, and PNQ sensory scores (p < 0.008). Multiple regression analysis demonstrated that PNQ sensory scores and grip force control were significantly associated with hand dexterity impairment (p < 0.01). Subjective symptoms (numbness and pain) and grip force control contributed to impaired hand dexterity in taxane-induced peripheral neuropathy.

Outcomes after radioscapholunate arthrodesis for intra-articular malunion of distal radius fractures

PurposeTo study the clinical, radiological, and functional outcomes after of radioscapholunate (RSL) fusion for intra-articular malunion of the distal radius.MethodsThis retrospective study included 26 patients (17 males and 9 females) with intra-articular malunion of distal radius fractures who underwent RSL arthrodesis using locked miniplates (without distal scaphoid excision) between 2012 and 2020. Their mean age was 43 years (range, 32–56). Patients were assessed radiographically for union and clinically for range of motion, grip strength, and pain (assessed by Visual Analogue Scale (VAS) for pain). Functional evaluation was performed by using the Mayo modified wrist score (MMWS) and the Disabilities for the Arm, Shoulder, and Hand (DASH) questionnaire.ResultsAll patients showed complete healing at the fusion site after a mean of 8.7 weeks (range, 8–12). The mean follow-up period was 72 months (range, 60–84). The pinch strength improved from a mean of 6.2 kg (range, 3–12) to a mean of 9.8 kg (range, 5–18) which represents 80% of the contralateral side. The mean pinch strength was 7 kg (range, 5–18) which presents 80% of the other side. VAS for pain showed a mean improvement of 72.6%. The DASH score improved to a mean of 19.2 (range, 14–24). The MMWS improved to a mean of 68 (range, 45–86). At the final follow-up period, no degenerative changes were detected in the midcarpal joint.ConclusionRSL arthrodesis (using locked miniplates without distal scaphoid excision) is a reliable surgical procedure to manage cases of radiocarpal OA after intra-articular malunion of distal radius fractures with good clinical and radiological outcomes.Level of evidenceLevel IV- therapeutic.

Short-term effects of running exercise on pinch strength, grip strength, and manual dexterity of the dominant and non-dominant hands

Occupations including first responders and military require manual tasks; therefore changes in hand strength and dexterity could affect performance. We hypothesised that pinch strength, grip strength, and dexterity will change after unloaded and loaded exercise. Twenty-four male (25 ± 4.0 yrs; 86.3 ± 9.3 kg) and 10 female (25 ± 6.0 yrs; 62.1 ± 5.9 kg) participants completed 3 conditions for 5 minutes: (1) no exercise (2) run with no load at 3.0 m/s and (3) run wearing a 9.1 kg belt. Heart rate was different among conditions (p ≤ 0.05). Pinch strength was significantly different for the non-dominant hand after exercise (p = 0.005) for male participants, but not for the dominant hand. Grip strength was significantly different for the non-dominant hand between loaded and unloaded run (p = 0.035) for male participants. Pinch and grip strength did not change after exercise for female participants. Dexterity times were not different after exercise, but female participants were significantly faster (p ≤ 0.039) than male participants.

Novel figure-of-eight reconstruction with free tendon graft for unrepairable collateral ligament of the thumb metacarpophalangeal joint

ObjectivesThis study aimed to report surgical technique and clinical outcomes for a novel figure-of-eight collateral ligament reconstruction technique using palmaris longus autograft for chronic irreparable collateral ligament injury of the thumb metacarpophalangeal joint. Material and methodsThe Jobe elbow collateral ligament reconstruction method was adapted for thumb metacarpophalangeal joint collateral ligament reconstruction. Sixteen reconstructions (7 ulnar collateral ligament, 9 radial collateral ligament) using palmaris longus autograft were reviewed retrospectively. Surgery was performed at a mean 12 months post-injury. All 16 patients were followed up for more than 1 year. Metacarpophalangeal joint radial and ulnar deviation, metacarpophalangeal and interphalangeal joint range of motion, key pinch and grip strength, Glickel functional grade and QuickDASH score were evaluated. ResultsPreoperative radial or ulnar deviation improved from 19.3° to 5.3° postoperatively. Metacarpophalangeal range of motion improved from 31.5° to 46.6°, and interphalangeal range of motion from 48.4° to 65.6°. Preoperative key pinch and grip strength were respectively 49% and 81% of contralateral values and improved to 82% and 87%. On Glickel grade, 9 cases were excellent and 7 good. ConclusionThe novel Jobe-like figure-of-eight reconstruction technique using palmaris longus graft was useful for reconstructing irreparable thumb metacarpophalangeal joint instability without an incision on the opposite side or an additional implant. Level of evidenceTherapeutic study, level IV.

The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial

BackgroundProprioceptive neuromuscular facilitation (PNF) is generally used for the lower limbs in children with Cerebral Palsy (CP). This study aimed to determine the effect of PNF and Neurodevelopmental Therapy (NDT) on functional abilities, muscle strength, and trunk control in children with CP. MethodsThirty spastic CP children classified as either level I–II in the Gross Motor Function Classification System (GMFCS) or level I–II in the Manual Ability Classification System (MACS) were included. The PNF (n = 15) and the NDT group (n = 15) had physiotherapy for six weeks. The ABILHAND-Kids scale, the Purdue Pegboard Test (PBPT), the Nine-Hole Peg Test (9-HPT), and the Jebson-Taylor Hand Function Test (JTHFT) were employed. Pinch meters, Jamar handheld dynamometers, and digital muscular strength assessments were used. ResultsThe PNF group increased shoulder flexion (p < 0.05), adduction (p < 0.05), elevation (p < 0.05), scapular abduction (p < 0.05), elbow extension (right) (p < 0.05), grip (p < 0.05), and pinch strengths (left p < 0.05, right p < 0.05). The PNF group had significantly lower 9-HPT (p < 0.05), JTHFT (card turning), JTHFT (simulated feeding), JTHFT (lifting light cans), and JTHFT (lifting weight cans) durations (p < 0.05), and significantly higher PBPT (right-left) PBPT (bimanual), PBPT (assembly).(p < 0.05), ABILHAND (p < 0.05), and TCMS total scores (p < 0.001). While JTHFT (simulated feeding-left), JTHFT (stacking checkers-left), JTHFT (lifting light cans-left), and JTHFT (lifting weight cans-right/left) (p < 0.05) durations decreased in the NDT group, PBPT (right) (p < 0.05) had an increase in duration. ConclusionPNF improves trunk control, upper extremity functional skills, selective proximal muscle strength, and distal upper extremity muscle and grip strength.

Low-Level Laser Therapy for Thumb Carpometacarpal Joint Osteoarthritis: A Randomized Controlled Trial.

Background and aim Low-level laser therapy (LLLT) is considered a promising non-invasive treatment option for osteoarthritis (OA). The current study aimed to evaluate the effectiveness of LLLT on patients with OA of the first carpometacarpal joint (CMC1) of the thumb. Methods An open-level, prospective, randomized controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, for one year. Initially, 120 patients were approached for the study. Among them, 112 eligible patients were randomly divided into two groups: the intervention group received LLLT in addition to conservative treatment, while the control group received conservative treatment alone for four weeks. Pain and functional capability (motor) improvement were assessed on a weekly follow-up basis by using various parameters such as the visual analogue scale (VAS), Ritchie articular index (tenderness scale), grip strength, key pinch strength, Dreiser functional index, and CMC1 palmer abduction. Eventually, 90 patients completed the follow-ups and were included in the analysis. Results The majority of patients diagnosed with CMC1 joint OA were in their fifties. At baseline, patients of both intervention and control groups were indifferent in terms of demography, pain intensity, motor responses, and duration of suffering. After four weeks of treatment, results indicated an overall improvement in both groups. However, the reduction of pain and increase in functional capability were not found statistically significant (p-value: ≥0.5). Conclusion LLLT with conventional treatment was not found significantly more effective enough than conventional treatment alone, but more well-designed clinical trials with larger sample sizes are needed to reach a definitive conclusion.

Exploratory analysis using machine learning algorithms to predict pinch strength by anthropometric and socio-demographic features

Objectives. This study examines the role of different machine learning (ML) algorithms to determine which socio-demographic factors and hand–forearm anthropometric dimensions can be used to accurately predict hand function. Methods. The cross-sectional study was conducted with 7119 healthy Iranian participants (3525 males and 3594 females) aged 10–89 years. Seventeen hand–forearm anthropometric dimensions were measured by JEGS digital caliper and a measuring tape. Tip-to-tip, key and three-jaw chuck pinches were measured using a calibrated pinch gauge. Subsequently, 21 features pertinent to socio-demographic factors and hand–forearm anthropometric dimensions were used for classification. Furthermore, 12 well-known classifiers were implemented and evaluated to predict pinches. Results. Among the 21 features considered in this study, hand length, stature, age, thumb length and index finger length were found to be the most relevant and effective components for each of the three pinch predictions. The k-nearest neighbor, adaptive boosting (AdaBoost) and random forest classifiers achieved the highest classification accuracy of 96.75, 86.49 and 84.66% to predict three pinches, respectively. Conclusions. Predicting pinch strength and determining the predictive hand–forearm anthropometric and socio-demographic characteristics using ML may pave the way to designing an enhanced tool handle and reduce common musculoskeletal disorders of the hand.

Manual Dexterity Predictors of Artificial Urinary Sphincter Success

ObjectiveTo determine better in-office measures for artificial urethral sphincter outcomes, we investigated the ability of preoperative timed peg-transfer, pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand Outcome questionnaire in predicting postoperative satisfaction, confidence, and ease of use of artificial urethral sphincter placement for stress urinary incontinence. Materials and MethodsA timed 9-hole peg test, pinch and grip strength assessment, and upper extremity questionnaire were administered during the preoperative visit before sphincter placement. In addition to standard preoperative workup, short form International Consultation of Incontinence Questionnaire and physician handshake were recorded. Activation occurred 6 weeks after surgery along with assessment of adequacy of pump placement. Three months from surgery a repeat incontinence questionnaire and a survey measuring satisfaction, difficulty of use, and confidence were given. Correlation between preoperative assessment variables and the postoperative questionnaire was assessed. ResultsThirty-nine patients were included. Average age and body mass index were 68.8 years and 28.8 kg/m2 respectively. Prior prostatectomy accounted for 92.3% of patients, and 46.2% had prior pelvic radiation. Postoperatively 59.0% of patients were very satisfied; 64.1% of patients reported no difficulty of use; 53.8% felt confidence within one day; and 66.7% had much better bladder control. Average pad improvement count was 5.3. Pinch test was associated with satisfaction (p= 0.011) while peg test was associated with confidence (p = 0.049). Handshake and upper extremity questionnaire were not significant. ConclusionsThe pinch and 9-hole peg transfer tests are cost-effective and easily performed adjuncts that could be used during artificial urethral sphincter evaluation for patients with unclear manual functional status.

458 Endoscopic Versus Open Carpal Tunnel Release: An Umbrella Review and a Meta-Analysis

INTRODUCTION: Whether open carpal tunnel release (OCTR) versus endoscopic carpal tunnel release (ECTR) has super outcomes remains a controversial topic. METHODS: A PubMed, Scopus and Cochrane databases was conducted for all meta-analyses comparing OCTR and ECTR performed between 2000-2022 in accordance to PRISMA and Joanna Briggs Institute guidance of umbrella reviews. The primary outcomes were: 1) functional ability: symptoms severity, grip strength, pinch strength, two-point discrimination, and pain, 2) operative outcomes: operation time, total complications, nerve injury, scar formation, and 3) time to return to work. Pooled analysis was performed to compare outcomes using Review Manager Version 5.2.11. RESULTS: 9 meta-analyses were included, 5 were of high quality and 4 were moderate quality on the Assessment of Multiple Systematic Reviews (AMSTAR) scale. Functional ability: OCTR was associated with better pinch strength after 3-months (0.70, 95% CI = 0.00, 1.40, p = 0.05) and after 6-months (0.77, 95% CI = 0.14, 1.40, p = 0.02, I2 = 84%). Operative outcomes: OCTR was associated with less nerve injury (3.26, 95% CI = 1.20, 8.86, p = 0.02, I2 = 0%) and more risk of scars formation (0.40, 95% CI = 0.24, 0.66, p = 0.0003, I2 = 41). Return to work: OCTR was associated with longer return to work (-10.89, 95% CI = -15.14, -6.64, p &lt; 0.00001, I2 = 83%). There were no significant differences between OCTR and ECTR in the hand function, symptom severity, grip strength, pain, operation time and total complications. CONCLUSIONS: In an umbrella review and meta-analysis of OCTR vs. ECTR, we found that while OCTR demonstrated higher pinch strength and lower nerve injury risk, ECTR was associated with less scar formation and a shorter time to return to work.

Opponensplasty With Abductor Pollicis Brevis Rerouting for Types II and IIIA Hypoplastic Thumbs

To evaluate the functional results after opponensplasty using an abductor pollicis brevis rerouting technique in type II and IIIA hypoplastic thumbs. Eleven hypoplastic thumbs in nine children with type II and IIIA hypoplastic thumbs were treated with abductor pollicis brevis rerouting. The mean follow-up period was 70 months (range, 12-172 months). We assessed preoperative to postoperative changes in the angles of the first and second metacarpal axes and the longitudinal axis of the first metacarpal and proximal thumb phalanx as well as grip and pinch strengths. The mean angle of the first and second metacarpal axes showed a significant improvement to 64° (range, 47° to 89°), and the mean angle of the first metacarpal and proximal phalanx of the thumb showed a significant reduction to 8° (range, 1° to 21°) after surgery. The mean postoperative grip and pinch strengths were 77% (range, 63% to 106%) and 72.0% (range, 33% to 97%), respectively, relative to the unaffected side. Abductor pollicis brevis rerouting for type II and IIIA hypoplastic thumbs can produce joint stability and a strong pronation effect in addition to the opponens function. Therapeutic V.

The possible relationship between the palmaris longus and joint hypermobility.

The palmaris longus (PL) contributes to the palmar fascia, wrist flexion, hand muscle balance, and pinch strength. Also, PL is used as a graft source. So, PL's presence is helpful for joint stability and grafting. On the other hand, joint hypermobility (JH) is associated with many complaints and disorders. Considering the adverse effects of JH and benefit-based evolution, the genesis rather than agenesis of PL can be expected in JH. Herein, it was hypothesized that PL might be together with JH, and individuals with PL may have higher scores of JH than those without. Between June 2023 and October 2023, 200 participants (F/M: 1/1) were included in the study. The Schaeffer's test and the Beighton scores were used to assess PL and JH, respectively. The participants were divided into two bilateral groups according to the presence or absence of PL. Then, the groups were compared for demographics and Beighton scores. Subgroup analyses were also done by considering gender. No significant differences were found between PL (+) and PL (-) groups considering females+males in age (p=0.559), gender (p=0.517), weight (p=0.375), height (p=0.061), work status (p=0.229), Beighton score (p=0.893), and JH (p=1.0). No significant differences were found between PL (+) and PL (-) groups considering females only in age (p=0.871), weight (p=0.189), height (p=0.127), work status (p=0.200), Beighton score (p=0.727), and JH (p=1.0). No significant differences were found between PL (+) and PL (-) groups considering males only in age (p=0.370), weight (p=0.981), height (p=0.400), BMI (p=0.601), work status (p=0.145), Beighton score (p=0.757), and JH (p=1.0). According to the results of this study, no relationship was found between PL and JH. However, this is the first study on the topic and has some limitations.

Supercharge end-to-side nerve transfer from anterior interosseous nerve to augment intrinsic recovery in high ulnar nerve injuries of varying magnitudes

High ulnar nerve injuries result in intrinsic muscle weakness and are inconvenient for patients. Moreover, conventional surgical techniques often fail to achieve satisfactory motor recovery. A potential reconstructive solution in the form of the supercharge end-to-side (SETS) anterior interosseous nerve (AIN) transfer method has emerged. Therefore, this study aims to compare surgical outcomes of patients with transected and in-continuity high ulnar nerve lesions following SETS AIN transfer. Between June 2015 and May 2023, patients with high ulnar palsy in the form of transection injuries or lesion-in-continuity were recruited. The assessment encompassed several objective results, including grip strength, key pinch strength, compound muscle action potential, sensory nerve action potential, and two-point discrimination tests. The muscle power of finger abduction and adduction was also recorded. Additionally, subjective questionnaires were utilized to collect data on patient-reported outcomes. Overall, the patients were followed up for up to 2 years. Patients with transected high ulnar nerve lesions exhibited worse baseline performance than those with lesion-in-continuity, including motor and sensory functions. However, they experienced greater motor improvement but less sensory recovery, resulting in comparable final motor outcomes in both groups. In contrast, the transection group showed worse sensory outcomes. Our findings suggest that SETS AIN transfer benefits patients with high ulnar nerve palsy, regardless of the lesion type. Nonetheless, improvements may be more pronounced in patients with transected lesions.

Hand Grip and Pinch Strength in a Healthy Children Norms for 6 to 18 Years in Al-Kharj City, Kingdom of Saudi Arabia

Background: Measuring and comparing grip and pinch strengths with their normative data is a valid method to detect intensity of the numerous damages of hand. The aim of the study was to establish the normative data of grip strength and three types of pinch strengths (Key, Tip and Palmar) in healthy Saudi’s children. Method: In this cross-sectional study, of grip strength and three types of pinch strengths (Tip, Key and Palmar) were recorded for 82 healthy children (41 boys and 41 girls) heathy children aged 7-18 years. The Camry Electronic Hand Dynamometer and Hydraulic Pinch Gauge were used to measure grip strength and pinch strength, respectively. Result: Normative data of grip and pinch strengths were provided. Grip and pinch strengths of both genders were close to each other’s and increasing consistently with increasing age. The maximum grip strength and pinch strength was obtained in the group of 14-18 years among both genders. In addition: Study results showed that there was a significant association between weight and all the hand grip strength and pinch strength (p &lt; 0.05) in boys whereas BMI considered as an effective parameter on grip strength and tip pinch strength in girls. Conclusions: Findings from the present study provide reference values for hand grip strength and pinch strength for healthy children from 6- which will be useful to guide rehabilitation outcomes in routine clinical practice.18 years of age which will be useful to guide rehabilitation outcomes in routine clinical practice.

Efficacy of Intra-Articular Corticosteroid Injection for Nonsurgical Management of Trapeziometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

As osteoarthritis (OA) of the trapeziometacarpal (TMC) joint leads to a high degree of disease burden with compromises in rudimentary and fine movements of the hand, intra-articular injections may be a desirable treatment option. However, because there are no evidence-based guidelines, the choice of intra-articular injection type is left to the discretion of the individual surgeon in collaboration with the patient. The purpose of our study was to perform a systematic review and meta-analysis using level I studies to compare outcomes following corticosteroid and alternative methods of intra-articular injections for the management of TMC OA. Our hypothesis was that intra-articular corticosteroid injections were no more effective than other methods of intra-articular injections for the management of TMC OA. A systematic literature search was performed. Eligible for inclusion were randomized control trials reporting on intra-articular corticosteroid injection for the management of TMC OA. Clinical outcomes were recorded. The 10 included studies comprised 673 patients. The mean age was 57.8 ± 8.3 years, with a mean follow-up of 6.4 ± 2.7 months. There was no significant difference in visual analog scale scores, grip strength and tip pinch strength between corticosteroids and hyaluronic acid at short- and medium-term follow-up. Further, there was no difference in visual analog scale pain scores at rest at medium-term follow-up between corticosteroids and platelet-rich plasma. Despite short-term improvement with intra-articular corticosteroid injections, there was no significant difference in pain and functional outcomes following intra-articular corticosteroid injections compared to hyaluronic acid or platelet-rich plasma administration. Given the affordability, ease of administration, and efficacy associated with corticosteroids, they are a favorable option when considering the choice of intra-articular injection for the management of TMC OA. Therapeutic II.

The Effectiveness of Exercise-Based Rehabilitation in People With Hand Osteoarthritis: A Systematic Review With Meta-analysis.

OBJECTIVE: To investigate the effectiveness of exercise-based rehabilitation programs compared with nonexercise intervention or no intervention for people with hand osteoarthritis (OA). DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched 5 databases on July 23, 2023. STUDY SELECTION CRITERIA: We included randomized controlled trials that compared the effectiveness of rehabilitation programs that included an exercise component, with nonexercise intervention or no intervention for people with hand OA. DATA SYNTHESIS: Standardized mean differences (SMDs) were pooled using a random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. RESULTS: Fourteen trials were included in the meta-analysis (n = 1341 participants). In the immediate term (<24 weeks), there was low-certainty evidence of an effect of exercise-based rehabilitation on improving pain (13 trials; SMD = -0.65; 95% CI: -1.06, -0.25), function (11 trials; SMD = -0.35; 95% CI: -0.54, -0.15), and grip strength (14 trials; SMD = 0.21; 95% CI: 0.03, 0.38). There was moderate-certainty evidence of an effect on reducing stiffness (7 trials; SMD = -0.33; 95% CI: -0.51, -0.16). There was low-certainty evidence of no effect on improving pinch strength and quality of life. For the long term (≥24 weeks), there was low-certainty evidence that exercise-based rehabilitation had no additional effect on improving pain, function, and stiffness. CONCLUSION: Exercise-based rehabilitation improved pain, function, stiffness, and grip strength in people with hand OA in the immediate term; the benefits were not maintained in the long term. J Orthop Sports Phys Ther 2024;54(7):1-11. Epub 20 March 2024. doi:10.2519/jospt.2024.12241.