Purdue Pegboard Research Articles

Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia.

Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children's Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group. AALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups. Consent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P < .001) and walking efficiency (P = .02) improved from T1-T4, and only dorsiflexion range of motion (46.7% vs 14.7%; P = .008) and handgrip strength (22.2% vs 37.1%; P = .03) differed in vincristine and dexamethasone every 4 weeks vs vincristine and dexamethasone 12 weeks at T4. Proxy-reported outcomes improved from T1 to T4 (P < .001), and most did not differ between groups. CIPN is prevalent early in B-ALL therapy and persists at least 12 months posttherapy. Most outcomes did not differ between treatment groups despite reduction in vincristine frequency. Children with B-ALL should be monitored for CIPN, even with reduced vincristine frequency.

The Influence of Caffeine Consumption and the Polymorphisms of DRD2 and ADORA2A Genes on Fine Motor Task Performance

Caffeine is the most commonly used psychoactive drug and has been associated with increased attention, focus and motor activity through adenosine receptor (ADORA2A) antagonism. ADORA2A and DRD2 are co‐localized in the central nervous system and blocking the adenosine receptor has been show to act as a dopamine receptor (DRD2) agonist which influence focus and motor tasks. Finally, single nucleotide polymorphisms of ADORA2A varies in response to caffeine which may influence the dopamine response.PURPOSEThe purpose of this study was to determine the influence of caffeine as well as the effects of the adenosine (ADORA2A) and dopamine (DRD2) polymorphisms during unilateral and bilateral motor tasks.METHODSThirty‐four subjects (age: 18‐23) were recruited and gave informed consent to participate in the study. An oral bolus of caffeine (CAF), 5mg•kg‐1, or placebo (PLA), maltodextrin, was given in a double‐blind, randomized, and counterbalanced design 60 min prior to testing. The Purdue Pegboard Test (PPT) was used to assess the unilateral movements by placing pegs with the right hand and left hand; this was coded for dominant and non‐dominant. Bilateral movements were also assessed with PPT by placing pegs with both hands and during a peg/washer/collar assembly task. Buccal cells were obtained using a 0.9% NaCl mouth rinse, spun down, and lysed via proteinase k. DNA was extracted using QiAmp Mini spin columns with amplification and allelic discrimination for ADORA2A (rs5751876) and DRD2 (rs1800497) obtained via One‐Step qPCR. All samples were run in duplicate with negative and positive controls. Data was analyzed using a 2 (condition) x 2 (SNP) with repeated measures for each subset of the PPT and a 2 (condition) x 2 (ADORA2A) x 2 (DRD2) with repeated measures to for each subset to find the interaction of ADORA2A and DRD2, p&lt;0.05)RESULTSFor the ADORA2A SNP, the main effect of caffeine demonstrated a significant increase in performance for each unilateral task from placebo to caffeine trials, dominant hand (16.4+1.6 to 17.4, p&lt;0.01), non‐dominant hand, (15.8+1.8 to 16.0, p&lt;0.05) and combined (45.5+4.3 to 46.2, p&lt;0.05). No difference was found for the bilateral movements. ADORA2A interaction effects demonstrated that TT genotype scored better under the caffeine condition, 15.8+1.9 to 16.2+ 0.8 for placebo and caffeine respectively. For DRD2, there were no significant differences in the main effects or interaction effects. The 3‐way ANOVA, condition x ADORA2A x DRD2, demonstrated no significant differences for the main effects or interaction effects.DISCUSSIONA bolus of caffeine improved performance for the test subset scores that involved unilateral movements but had no influence on scores for bilateral movements. The reduction in performance could be due to slower reaction times or neural coupling to coordinate movements between the limbs during bilateral movements. The increased performance in the non‐dominant hand for the TT genotype may be due to the increased sensitivity of this specific SNP to caffeine. While not significant, variations in responses to caffeine were observed when assessing task performance by grouped ADORA2A/DRD2 polymorphisms and the possible combinations. One grouping, TC/CC:AG/AA, demonstrated negative response to caffeine, whereas two other groupings (TT:GG, TC/CC:GG) demonstrated positive responses to caffeine. Further research and an increased sample size will help demonstrate the specific SNP interactions.

The Relative Importance of Vascular Risk Factors on Early Cognitive Aging Varies Only Slightly Between Men and Women

ObjectiveTo investigate the sex-specific course and impact of vascular risk factors on cognitive aging in a rather young and healthy community-dwelling cohort.MethodsWe used data from a population-based cohort study, collected three times during 6 years, comprising 1,911 examinations from 798 participants aged 35–66 years at baseline. Cognitive performance on the Color-Word-Interference-Test, the Trail Making Tests (TMT) A&B, the Word Fluency Test, a 12-item word list, the Purdue Pegboard Test and a principal component global score were used as outcomes in linear mixed models. We evaluated (1) sex differences in cognitive trajectories, (2) the mediating role of hypertension, diabetes, smoking and obesity [body mass index (BMI) > 30] on sex differences and (3) in sex-stratified analyses, potential sex-specific effects of these risk factors on cognition.ResultsFor all cognitive tests, we observed cognitive decline with age. Rates of decline slightly differed across sexes, showing a later but steeper decline for women in tests of memory (word list) and word fluency, but a steeper decline for men in tests of psychomotor speed and mental set shifting (TMT A&B) in older age. Women generally scored better on cognitive tests, but the slightly higher prevalence of classical vascular risks factors in men in our cohort could not explain these sex differences. Sex-stratified analyses revealed a generally small, concordantly negative, but quantitatively slightly different impact of diabetes, smoking and obesity on cognitive functions but mixed effects for arterial hypertension, depending on the blood pressure values, the treatment status and the duration of arterial hypertension.ConclusionCognitive sex differences in this rather young and healthy cohort could not be explained by a differing prevalence of vascular risks factors across sexes. The association of cardiovascular risk factors with cognition, however, slightly differed between men and women, whereby effects were generally small. Whereas longtime diabetes, obesity and smoking had a sex-specific, but concordantly negative impact on psychomotor speed, executive and motor functions, we found some opposing effects for arterial hypertension. Our results can help to identify sex-specific susceptibilities to modifiable risk factors, to attract attention to potential information bias and to stimulate further research into alternative causes and mechanism of sex differences in cognitive aging.

White matter tract disruption is associated with ipsilateral hand impairment in subacute stroke: a diffusion MRI study.

The ipsilateral hand (ILH) is impaired after unilateral stroke, but the underlying mechanisms remain unresolved. Based on the degeneracy theory of network connectivity that many connectivity patterns are functionally equivalent, we hypothesized that ILH impairment would result from the summation of microstructural white matter (WM) disruption in the motor network, with a task-related profile. We aimed to determine the WM disruption patterns associated with ILH impairment. This was a cross-sectional analysis of patients in the ISIS-HERMES Study with ILH and diffusion-MRI data collected 1month post-stroke. Patients performed three tasks, the Purdue Pegboard Test (PPT), handgrip strength, and movement time. Fractional anisotropy (FA) derived from diffusion MRI was measured in 33 WM regions. We used linear regression models controlling for age, sex, and education to determine WM regions associated with ILH impairment. PPT was impaired in 42%, grip in 59%, and movement time in 24% of 29 included patients (mean age, 51.9 ± 10.5years; 21 men). PPT was predicted by ipsilesional corticospinal tract (i-CST) (B = 17.95; p = 0.002) and superior longitudinal Fasciculus (i-SLF) (B = 20.52; p = 0.008); handgrip by i-CST (B = 109.58; p = 0.016) and contralesional anterior corona radiata (B = 42.69; p = 0.039); and movement time by the corpus callosum (B = - 1810.03; p = 0.003) i-SLF (B = - 917.45; p = 0.015), contralesional pons-CST (B = 1744.31; p = 0.016), and i-corticoreticulospinal pathway (B = - 380.54; p = 0.037). ILH impairment was associated with WM disruption to a combination of ipsilateral and contralesional tracts with a pattern influenced by task-related processes, supporting the degeneracy theory. We propose to integrate ILH assessment in rehabilitation programs and treatment interventions such as neuromodulation.

Ipsilateral hand impairment predicts long-term outcome in patients with subacute stroke.

Ipsilateral hand (ILH) impairment is documented following motor stroke, but its impact on long-term outcome remains unknown. We assessed ILH impairment in subacute stroke and tested whether ILH impairment predicted long-term outcome. We performed a longitudinal study in 209 consecutive patients with unilateral stroke and sensorimotor deficit at admission. ILH impairment was evaluated using the Purdue Pegboard Test (PPT) and handgrip strength and defined as mild (z-score<-1) or moderate (z-score<-1.65). We used logistic regression (LR) to predict outcome assessed 9 (range, 7-12) months post-stroke with the modified Rankin scale (mRS) categorized into good (mRS≤1) and poor outcome (mRS≥2). For internal validation, LR-bootstrapping and cross-validation with LASSO and Random Forest were performed. ILH impairment assessed at 89.04±45.82days post-stroke was moderate in 10.53% (95% CI 6.7, 14.83) for PPT and 17.22% (95% CI 11.96, 22.49) for grip, and mild in 21.05% (95% CI 15.78, 26.79) for PPT and 35.89 (95% CI 29.67, 42.58) for grip. Good outcome was predicted by ILH-PPT (B=1.03 [95% CI 0.39, 3.31]), ILH-grip (B=1.16 [95% CI 0.54, 3.53]), low NIHSS-discharge (B=-1.57 [95% CI -4.0, -1.19]), and no depression (B=-0.62 [95% CI -1.63, -0.43]), accounting for stroke delay (B=-0.011 [95% CI -0.06, 0.01]). Model efficiency was 91.6% (AUC=0.977; 95% CI 0.959, 0.996). LASSO and Random Forest methods provided similar results, confirming the LR model robustness. ILH impairment is frequent after motor stroke and predicts long-term outcome. We propose to integrate ILH impairment into rehabilitation programs to improve recovery and serve research interventions such as neuromodulation.

Total elbow arthroplasty in elderly trauma patients: adding a new perspective for functional evaluation

PurposeTotal elbow arthroplasty (TEA) has evolved over the last years, with satisfactory early results, mainly not only in degenerative arthritis, but also increasingly after trauma. Outcome studies in recently published papers are mainly based on the range of motion (ROM), complication rate as well as patient-reported outcome scales and questionnaires. The purpose of this study was to add a new perspective with the “Purdue Pegboard” skill tests in a homogenous set of elderly trauma patients to contribute to a more precise objective outcome measurement in this specific population.MethodsA retrospective review was performed on a consecutive cohort of all patients with age above 60 years that received TEA after trauma. Data from follow-up examinations over a standardized time-schedule within 2 years after TEA were included. Mayo Elbow Performance Score (MEPS), “Disability of Arm, Shoulder and Hand” (DASH) Questionnaire, ROM as well as test-scores using the Pegboard test were evaluated.ResultsMean age was 76.0 years ± 10.3. Indications for TEA were posttraumatic arthrosis in 68.8% (n = 11) and extensive fractures that could not be reconstructed surgically in 31.3% (n = 5). The mean score of MEPS was 82.81 ± 16.63 and 29.18 ± 12.01 in the DASH. ROM presented with a mean of 109.7° ± 15.4. Patients demonstrated good, but marginally reduced test scores in the Pegboard skill tests in comparison with the healthy reference population. No relevant differences between the arm with and the arm without TEA (0.3 ± 3.6; p = 0.715) were noted after 2 years.ConclusionIn the elderly trauma patient with complex fractures of the elbow, TEA is a good alternative to joint reconstruction using various osteosynthesis techniques. TEA is able to avoid revision surgery after open reduction and internal fixation of complex fractures. In cases of failed reconstruction, it is also a viable secondary procedure in posttraumatic arthrosis. Good outcomes in functionality and dexterity can be achieved. Skill tests like the Purdue Pegboard could add a valuable perspective in assessing functional outcomes after TEA.

Bimanual performance in children with unilateral perinatal arterial ischaemic stroke or periventricular haemorrhagic infarction.

Long term outcome data on bimanual performance in children with perinatal arterial ischaemic stroke (PAIS) and periventricular haemorrhagic infarction (PVHI) with and without unilateral spastic cerebral palsy (USCP) is sparse. To assess bimanual performance in children with PAIS or PVHI with and without USCP and to explore the relationship with unilateral hand function and full-scale IQ (FSIQ) in a cross-sectional study. Fifty-two children with PAIS (n=27) or PVHI (n=25) participated at a median age of 12 years and 1 month (range 6-20 years). The Bruininks Oseretsky Test of Motor Proficiency-2 (bimanual precision and dexterity subtest), Assisting Hand Assessment, Purdue Pegboard Test and Wechsler Intelligence scale were administered. Bimanual dexterity was worse in children with USCP (p<0.02) without a difference for the pathology groups. In children without USCP (n=21), those with PAIS showed a better bimanual precision compared to children with PVHI (p<0.04). The AHA score and the Purdue Pegboard score of the dominant hand explained 51% of the variance in bimanual precision and dexterity in children with USCP. In absence of USCP, FSIQ together with AHA scores explained 66% of the variance in bimanual precision and FSIQ together with the Purdue Pegboard Test score of the dominant hand, 71% of the variance in bimanual dexterity. Children with PAIS without USCP have a more favourable bimanual hand function compared to children with PVHI. This difference appears to be associated with a preserved FSIQ.

User-Centered Design to Enhance mHealth Systems for Individuals With Dexterity Impairments: Accessibility and Usability Study.

BackgroundMobile health systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities. The Interactive Mobile Health and Rehabilitation (iMHere) system was developed to empower people with disabilities and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated the accessibility and usability of the system. Potential opportunities to improve and simplify the user interface were identified, and the iMHere modules were redesigned accordingly.ObjectiveIn this study, we aim to evaluate the usability of the redesigned modules within the iMHere 1.0 app.MethodsWe evaluated the original and redesigned iMHere modules—MyMeds and SkinCare. The Purdue Pegboard Test was administered to assess the participants’ dexterity levels. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess their efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred.ResultsIn total, 24 participants with disabilities and varying degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness when using the redesigned modules compared with the original modules. The participants also reported improved usability and preferred the redesigned modules.ConclusionsThis study demonstrated that the iMHere system became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

Passive Mobilization With Place and Hold Versus Active Motion Therapy After Flexor Tendon Repair: A Randomized Trial

Mobilization after flexor tendon repair in fingers has been a subject of debate for several years. Many hand surgery clinics have turned to early active mobilization. However, there is no strong scientific evidence suggesting that early active mobilization produces a better range of motion (ROM) than the Kleinert regimen when place and hold is added. Therefore, the purpose of this prospective randomized trial was to investigate whether active mobilization is superior to passive mobilization with place and hold after flexor tendon repair in the fingers. Our hypothesis was that patients who follow the active mobilization protocol have a better ROM than those who follow the passive protocol with place and hold. Sixty-four patients with a flexor tendon injury in zone I or II were included. After surgery, randomization to undergo either active mobilization or passive mobilization with place and hold was performed. The patients were followed-up for 12 months using outcome measurements, including ROM, strength, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test. We were unable to find any significant difference between the 2 groups for any of the outcome measurements, ROM, grip strength, key pinch, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test. The outcomes were equivalent for both the mobilization groups. Therapeutic I.

Correlations between Hand Dexterity and Bimanual Coordination on the Activities of Daily Living in Older Adults with Mild Cognitive Impairment

Background/Aims: Many motor impairments are present in older adults with cognitive decline. One of them is the impairment of hand dexterity and bimanual coordination that result in poor functional ability in the activities of daily living (ADL). This study investigated the effects of hand dexterity and bimanual coordination declination on the sub-domains of ADL in older adults with mild cognitive impairment (MCI). Methods: Thirty-one senior individuals with MCI were recruited in this study. The Purdue Pegboard Test was used to measure hand dexterity, and bimanual coordination was assessed by the continuous circle-drawing task. Their ADL were assessed with the General Activity Daily Living questionnaire. Results: The correlations analysis showed an association between the dominant hand and bimanual dexterity with the domestic domain of ADL and all conditions of hand dexterity with the complex domain of ADL. Moreover, the multiple regression analysis showed that the predictor of the greatest effect for domestic and complex domains was dominant hand dexterity. Discussion/Conclusion: These results revealed that dominant hand dexterity strongly affected domestic and complex ADL in older adults with MCI. There were age-related changes regarding lateral asymmetrical motor reduction, especially in cognitive tasks. However, complex tasks involving cognitive function may need dominant, nondominant and bimanual hand dexterity.

Gamma-transcranial alternating current stimulation on the cerebellum and supplementary motor area improves bimanual motor skill

BackgroundBimanual movements require sophisticated coordination of both hands. For improving bimanual motor skills, previous studies employed non-invasive brain stimulation methods to evaluate their effects on symmetrical and/or gross bimanual motor skills. However, asymmetrical and elaborate movements were not sufficiently improved. Studies using non-invasive brain stimulation have examined the effects of stimulation on the primary and supplementary motor areas (SMA), but not on the cerebellar regions. ObjectiveWe investigated whether the transcranial alternating current stimulation (tACS), which modulates oscillations in the cerebral cortex, of the cerebellum and SMA improves bimanual movements. MethodsBimanual movements were assessed in 22 healthy young adults (mean age: 21.3 ± 1.5 years) via 13 trials of the Purdue Pegboard Test (PPT). A DC stimulator delivered 70 Hz tACS (γ-tACS) at 1 mA intensity via electrodes placed over the SMA, cerebellum and left shoulder in 5 s fade in/out cycles of 5 s for a total stimulus duration of 60 s for in each trial. Four stimulation conditions were applied and compared for statistical differences. ResultsThe γ-tACS of the cerebellum, γ-tACS of the SMA and simultaneous stimulation of both regions caused significant improvement in PPT performance scores. The γ-tACS of the cerebellum improved PPT performance in all subjects and was more effective than the γ-tACS of the SMA. ConclusionThe γ-tACS of the cerebellum effectively and reliably improves complex bimanual motor skills. Although the neural mechanisms of the stimulation effect remain unclear, these results can guide the future development of new stimulation methods for improving bimanual motor skills.

Fractional Anisotropy and Troponin T Parallel Structural Nerve Damage at the Upper Extremities in a Group of Patients With Prediabetes and Type 2 Diabetes - A Study Using 3T Magnetic Resonance Neurography.

BackgroundRecent studies have found that troponin T parallels the structural and functional decay of peripheral nerves at the level of the lower limbs in patients with type 2 diabetes (T2D). The aim of this study was to determine whether this finding can also be reproduced at the level of the upper limbs.MethodsTen patients with fasting glucose levels >100 mg/dl (five with prediabetes and five with T2D) underwent magnetic resonance neurography of the right upper arm comprising T2-weighted and diffusion weighted sequences. The fractional anisotropy (FA), an indicator for the structural integrity of peripheral nerves, was calculated in an automated approach for the median, ulnar, and radial nerve. All participants underwent additional clinical, serological, and electrophysiological assessments.ResultsHigh sensitivity Troponin T (hsTNT) and HbA1c were negatively correlated with the average FA of the median, ulnar and radial nerve (r = −0.84; p = 0.002 and r = −0.68; p = 0.032). Both FA and hsTNT further showed correlations with items of the Michigan Hand Outcome Questionnaire (r = −0.76; p = 0.010 and r = 0.87; p = 0.001, respectively). A negative correlation was found for hsTNT and HbA1c with the total Purdue Pegboard Test Score (r = −0.87; p = 0.001 and r = −0.68; p = 0.031).ConclusionThis study is the first to find that hsTNT and HbA1c are associated with functional and structural parameters of the nerves at the level of the upper limbs in patients with impaired glucose tolerance and T2D. Our results support the hypothesis that hyperglycemia-related microangiopathy, represented by elevated hsTNT levels, is a contributor to nerve damage in diabetic polyneuropathy.

SLICC-Frailty Index is independently associated with impaired physical function, activities of daily living and quality of life measures.

The SLICC Frailty Index (SLICC-FI) was developed to assess health deficits including disease activity, organ damage, comorbidities and functional status. We examined any relationship between SLICC-FI and objective physical function measures, activities of daily living performance and quality of life in SLE. SLICC-FI was estimated using data from patient files and patient-reported questionnaires. Jamar Dynamometer, pinch gauge and Purdue pegboard test measured grip strength, pinch strength and dexterity, respectively. Activities of daily living performance was assessed by the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and HAQ. Quality of life was evaluated by LupusQol questionnaire. This cross-sectional study included 240 SLE patients (90% female, mean (s.d.) age: 47.63 (13.01), median (IQR) disease duration: 9 (4-16)). Mean (s.d.) SLICC-FI was 0.09 (0.06). Forty-three (17.9%) patients were classified as robust, 105 (43.8%) as relatively less fit, 77 (32.1%) as least fit and 15 (6.2%) as frail. In univariate analysis, SLICC-FI was significantly associated with DASH and HAQ with an inverse association with grip strength, pinch strength and all purdue scores (all P < 0.001). A negative correlation was found between SLICC-FI score and all LupusQoL domain scores (all P < 0.001). All associations remained statistically significant in multivariate regression analysis, after adjustment for age, disease duration, SLEDAI-2K, SLICC, immunosuppressives, corticosteroids and Charlson score. SLICC-FI is independently associated with poor physical function and activities of daily living performance and impaired quality of life and may help to identify patients in need of additional interventions beyond routine care.

The Impact of Fidget Spinners on Fine Motor Skills in Individuals with and without ADHD: An Exploratory Analysis

Fidget spinners have been marketed as repetitive motion devices that improve attention and motor performance, and as such, they have become quite appealing to individuals with Attention Deficit Hyperactive Disorder (ADHD). To date, no studies have explored changes in brain activity that may occur due to fidgeting in ADHD. Our aim was to use functional Near-Infrared Spectroscopy (fNIRS) to examine the prefrontal cortex (PFC) during the performance of a standardized fine motor skills test after using a fidget spinner. Eight right-handed adults with ADHD and eight age and gender matched adults without ADHD (4F/4M, 4 control/4 fidget) performed the Purdue Pegboard Test (PPT) while their brain oxygenation was monitored using fNIRS. Relative neural efficiency (RNE) and involvement (RNI) were calculated and analyzed for all subtasks of PPT including the less cognitively demanding fine motor subtasks and more complex assembly tasks. The fidget spinner improved both task performance and RNE in the ADHD group but not the non-ADHD group for the less cognitively demanding subtasks. Our results indicate Fidget spinners may improve both relative neural efficiency and fine motor performance in adults with ADHD for less cognitively demanding tasks.

Unilateral hand force control impairments in older women.

Older women may experience deficits in sensorimotor control at their upper limb because of aging progress compromising the motor system. This study aimed to investigate whether younger and older women differ in sensorimotor capabilities assessed by unilateral force control performances at a lower targeted force level. Twenty-one older and 21 younger women performed isometric unilateral force control tasks at 10 % of maximum voluntary contraction for each hand, respectively. Purdue Pegboard Test (PPT) was used to measure unilateral hand dexterity. Five force control variables (i.e., maximal and submaximal force, force error, variability, and regularity) and PPT scores were analyzed in two-way mixed ANOVAs (Group × Hand Condition), respectively. The absolute force power was analyzed in three-way mixed ANOVA (Group × Hand Condition × Frequency Band). The findings revealed that older women produced less maximal and submaximal unilateral forces than in younger women. Greater variability, regularity, and force frequency oscillations below 4 Hz were observed in older women as compared with those in younger women. Force error in the dominant hand was greater in older women than those in younger women. Finally, older women showed lower PPT scores than younger women. These findings suggested that older women may have deficits in unilateral force control capabilities as well as motor dexterity.

Does cervical proprioception affect hand dexterity of physiotherapists with and without mechanical neck pain?

Purposes. This study was conducted to compare between cervical proprioception and hand dexterity in physiotherapists with and without mechanical neck pain, and to determine the relationship between cervical proprioception and hand dexterity in physiotherapists. Materials and methods. Sixty physiotherapists (30 with chronic mechanical neck pain (G1), mild to moderate neck pain lasted more than 6 months and 30 healthy control (GII)). Both sexes were enrolled with; age ranged from 25 to 35 years, normal body mass index (BMI) and at least one year of practice of manual work. All participants undergone evaluation of cervical joint position error (JPE) using cervical range of motion device (CROM) through head-to-neutral repositioning (NHR) and head-to-target repositioning (THR) tests in flexion direction in addition to evaluation of hand dexterity using Purdue pegboard test. Results. There was statistically significant difference in median values of JPE and hand dexterity between both groups. There was statistically significant indirect medium to strong correlation between JPE in flexion (NHR and THR) and hand dexterity (in dominant and assembly tests). Conclusions. Physiotherapists with neck pain have impairment in cervical proprioception which in turn negatively affects hand dexterity. Hand dexterity is important functional property for physiotherapist to apply different manual techniques. So, impairment of hand dexterity may interfere with the efficiency of manual application.

Feasibility of Using a Commercial Board Game to Assess Upper Extremity Function in Older Adults

Upper extremity function, particularly the hand, declines with aging and is predictive of executive ability and independence. Standard assessments typically focus on strength partly due to a lack of easily administered functional tasks requiring multi-joint coordination and precision grasp. This study aimed to determine the feasibility of using an inexpensive board game to assess upper extremity function in older adults. Six healthy older adults (77 +/- 5.1 years) completed reaching tasks using the Connect4® game that requires grasping and placing small discs into a vertical board. Tasks included different hand configurations (unilateral, bilateral), and two dual-task conditions (serial subtraction by 7s and placing colored discs to match specific color patterns). The time to complete each task was recorded. For comparison purposes, participants completed a standardized pegboard test (Purdue Pegboard) using one or both hands. Connect4 results were similar to age-normative findings reported for the Purdue Pegboard. Dominant versus non-dominant hand performance did not differ while bilateral coordination tasks were slower than unilateral tasks for both the Purdue Pegboard (p<0.05) and Connect4 (p<0.01). Pegboard and Connect4 times were moderately to strongly correlated for all hand configurations. Dual-task conditions using Connect4 led to longer completion times (p<0.05). Preliminary results support the use of Connect4 as a functional upper extremity assessment tool for older adults. It is inexpensive, engaging, easy to use, and allows for cognitive-motor assessment using dual-task protocols, a critical factor in maintaining functional independence in older individuals. Further research will include a formal validation study across a wider age range.

The association of bone and blood manganese with motor function in Chinese workers

Manganese (Mn) is an essential element. However, Mn overexposure is associated with motor dysfunction. This cross-sectional study assessed the association between bone Mn (BnMn) and whole blood Mn (BMn) with motor function in 59 Chinese workers. BnMn and BMn were measured using a transportable in vivo neutron activation analysis system and inductively coupled plasma mass spectrometry, respectively. Motor function (manual coordination, postural sway, postural hand tremor, and fine motor function) was assessed using the Coordination Ability Test System (CATSYS) and the Purdue Pegboard. Relationships between Mn biomarkers and motor test scores were analyzed with linear regression models adjusted for age, education, current employment, and current alcohol consumption. BMn was significantly inversely associated with hand tremor intensity (dominant hand (β=-0.04, 95 % confidence interval (CI):-0.07, -0.01; non-dominant hand β=-0.05, 95 % CI:-0.08, -0.01) hand tremor center frequency (non-dominant hand β=-1.61, 95 % CI:-3.03, -0.19) and positively associated with the Purdue Pegboard Assembly Score (β = 4.58, 95 % CI:1.08, 8.07). BnMn was significantly inversely associated with finger-tapping performance (non-dominant hand β=-0.02, 95 % CI:-0.04,-0.004), mean sway (eyes closed and foam β=-0.68, 95 % CI:-1.31,-0.04), and positively associated with hand tremor center frequency (dominant hand, β = 0.40, 95 % CI:0.002, 0.80). These results suggest BMn is related to better postural hand tremor and fine motor control and BnMn is related to worse motor coordination and postural hand tremor but better (i.e., less) postural sway. The unexpected positive results might be explained by choice of biomarker or confounding by work-related motor activities. Larger, longitudinal studies in this area are recommended.

Is surgical subspecialization associated with hand grip strength and manual dexterity? A cross-sectional study

BackgroundThe aim of this study was to compare hand grip strength (HGS) and manual dexterity of academic, subspecialized surgeons. MethodsA single-center cross-sectional study was performed among 61 surgeons. HGS was analysed with a hand dynamometer and manual dexterity was extensively analysed with a Purdue Pegboard Test. Correlations between HGS and manual dexterity and specific characteristics of the surgeons were analysed using Pearson's correlation coefficient (r). ResultsHGS and manual dexterity were comparable between surgeons from different specialities. HGS was positively correlated with male gender (r = 0.59, p < 0.001) and hand glove size (r = 0.61, p < 0.001), whereas manual dexterity was negatively correlated with male gender (r = −0.35, p = 0.006), age (r = −0.39, = 0.002), and hand glove size (r = −0.46, p < 0.001). ConclusionsSurgical subspecialization was not correlated with HGS or manual dexterity. Male surgeons have greater HGS, whereas female surgeons have better manual dexterity. Manual dexterity is also correlated with age, showing better scores for younger surgeons.

Associations between cognition, Aβ, and tau in adults with Down syndrome

AbstractBackgroundAdults with Down syndrome (DS) are widely affected by AD pathology by their 30’s and have a 70‐80% chance of clinical dementia by their 60’s. The aim of the present study was to explore the relationship between cognitive decline and tau pathology using a regression model to explore the associations between longitudinal rates of cognition and the cross‐sectional tau burden in adults with DS.MethodNinety‐two participants (age=39.19±8.44 at time of tau scan) with DS with multiple cognitive assessments over a period of 9 years, PiB scans over a period of 8 years, and one [18F]AV‐1451 scan were analyzed. Cognitive assessments included tests of overall function (DSMSE), memory (cued recall), executive function (Stroop), and motor function (Purdue pegboard). FreeSurfer (v5.3.0) was used for the definition of ROIs. A two‐stage analysis was performed for cognition and AV‐1451 correlations or PiB and AV‐1451 correlations: 1) a linear mixed model was applied to estimate the rates of change for cognitive outcomes or PiB over time and 2) the cognitive or PiB estimated rates from the trajectories were used as predictors of interest in a correlation analysis with AV‐1451 for each Braak‐associated (1‐6) region as the outcome.ResultStatistically significant associations were found between AV‐1451 retention in all Braak regions and cognitive assessments at alpha=0.05 , including cued recall, DSMSE, and the Purdue pegboard task, but not for the Stroop test (Table 1). Statistically significant associations were also found in Braak regions 3‐6 at alpha=0.05 between longitudinal PiB estimated amyloid trajectories and cross‐sectional AV‐1451 retention.ConclusionFor this DS population, we found inverse associations between rates of neuropsychological decline and higher tau pathology. In particular, decline in global cognition, verbal memory and motor function were all associated with higher tau pathology, while executive function was not. Further, longitudinal analyses demonstrated an association between cross‐sectional and accumulating amyloid pathology with increased tau pathology in regions associated with higher Braak stages.