Wrist Position Research Articles

Effects of wrist and finger posture on finger independence

Intended actions of one finger produce involuntary movement or force in other fingers. Mechanical and neural factors limit finger independence. The interplay between anatomical factors, wrist and finger postures, and finger independence remain unclear. The purpose of this study was to determine the effects of wrist and metacarpophalangeal (MCP) posture on involuntary finger forces and extensor digitorum (ED) activity. Twenty participants performed submaximal isometric finger extensions in three wrist positions (30° extension, neutral, and 30° flexion) and two MCP postures (straight and 90° flexion). Involuntary index finger force increased with MCP flexion, suggesting the importance of intertendinous connections in finger independence. Consistent with previous research, ED activity was generally higher in wrist extension than neutral and flexed postures. Understanding the role of passive properties within the hand may help us improve finger rehabilitation strategies.

The Development of a Multicommand Tactile Event-Related Potential-Based Brain–Computer Interface Utilizing a Low-Cost Wearable Vibrotactile Stimulator

A tactile event-related potential (ERP)-based brain–computer interface (BCI) system is an alternative for enhancing the control and communication abilities of quadriplegic patients with visual or auditory impairments. Hence, in this study, we proposed a tactile stimulus pattern using a vibrotactile stimulator for a multicommand BCI system. Additionally, we observed a tactile ERP response to the target from random vibrotactile stimuli placed in the left and right wrist and elbow positions to create commands. An experiment was conducted to explore the location of the proposed vibrotactile stimulus and to verify the multicommand tactile ERP-based BCI system. Using the proposed features and conventional classification methods, we examined the classification efficiency of the four commands created from the selected EEG channels. The results show that the proposed vibrotactile stimulation with 15 stimulus trials produced a prominent ERP response in the Pz channels. The average classification accuracy ranged from 61.9% to 79.8% over 15 stimulus trials, requiring 36 s per command in offline processing. The P300 response in the parietal area yielded the highest average classification accuracy. The proposed method can guide the development of a brain–computer interface system for physically disabled people with visual or auditory impairments to control assistive and rehabilitative devices.

Advanced Pressure-Sending Wristband for Disease Detection Based on Traditional Chinese Medicine Pulse Diagnosis

This paper explores the integration of Traditional Chinese Medicine (TCM) pulse diagnosis with modern sensor technology to develop a sophisticated wristband system for monitoring vital organ health. Leveraging the principles of TCM, the proposed system focuses on the “Three regions and nine indicators” method to accurately detect pulse variations at different wrist positions and depths. By utilizing a pressure sensor array that covers the Cun, Guan, and Chi pulse positions, the wristband aims to enhance diagnostic accuracy beyond conventional wearable technologies. The system incorporates advanced micro-electro-mechanical techniques to minimize size while maintaining functionality, enabling continuous health monitoring through a coplanar crossed sensing array. Additionally, the use of machine learning algorithms facilitates the analysis of pulse data to identify potential health issues related to the heart, lungs, liver, kidneys, and spleen. An accompanying mobile app provides real-time feedback and health insights, promoting proactive health management. This innovative approach merges TCM’s holistic diagnosis methods with cutting-edge technology to offer a powerful tool for early disease detection and health monitoring, potentially transforming the landscape of personal healthcare devices.

Association Of Awkward Wrist Posture With Symptoms of Carpal Tunnel Syndrome In Online Motorcycle Taxi Drivers In Palembang

Association Of Awkward Wrist Posture With Symptoms of Carpal Tunnel Syndrome In Online Motorcycle Taxi Drivers In Palembang

Comparing Isolated Thumb Force Generation, Wrist Rotation, and Clinical Measurements in Healthy and Osteoarthritic Individuals before and after Surgery.

Thumb carpometacarpal (CMC) osteoarthritis (OA) is caused by the degeneration of joint surfaces at the base of the thumb. If conservative treatments have failed, surgery may be needed to improve symptoms. Typically, standard clinical tools, such as the pinch gauge, are used to measure thumb force. However, these devices have utilized multiple digits and do not represent forces specifically generated by the thumb. Therefore, different devices are necessary to accurately measure isolated thumb force. The primary objective was to research the effect of thumb force after ligament reconstruction with tendon interposition surgery. To accomplish this, several sub-objectives were implemented: (1) create a testing device to collect isolated thumb forces, (2) collect a normative thumb force data set of males and females to compare the impact of aging and surgery, (3) collect and compare clinical data to see if these data sets matched isolated thumb forces, (4) determine the effect of wrist position on isolated thumb force data in different wrist positions, and (5) collect thumb force in directions that mimic daily activities, a directional force downward (push) and inward (pull). On average, older participants generated statistically larger forces than younger participants. Additionally, only 50% of CMC OA participants showed greater than 5 N of improvement at 6-months post-surgery compared to pre-surgery, but did not reach healthy force levels. When evaluating wrist rotation, OA participants' push and pull decreased by 8 N and 7 N in the horizontal wrist position, and their push and pull increased by 2 N and 5 N in the vertical wrist position. Evaluation and results with standard clinical tools showed different post-surgery trends than isolated force data, which suggested the clinical approach has mixed results and may be under- or over-estimating the recovery process. These data sets allow surgeons and hand therapists to identify changes in isolated thumb force generation to create specialized therapies and treatment options, which is an improvement upon current clinical measurement tools.

The Relationships Between Wrist Joint Position Sense, Anthropometric Characteristics and Grip Strength of the Hand in Healthy Individuals

The Relationships Between Wrist Joint Position Sense, Anthropometric Characteristics and Grip Strength of the Hand in Healthy Individuals

Ultrasound-Based Grading of Carpal Tunnel Syndrome: A Comparative Study of Cross-Sectional Area and Shear Wave Elastography at Different Wrist Joint Angles.

Carpal Tunnel Syndrome (CTS) is a prevalent neuropathy where accurate diagnosis is crucial for effective treatment planning. This study introduces a novel approach for CTS grading using ultrasound, specifically through the analysis of the cross-sectional area (CSA) and shear wave elastography (SWE) of the median nerve in various wrist positions. Our research involved subjects from outpatient clinics, diagnosed with CTS through Nerve Conduction Studies (NCS), and a control group of healthy individuals. High-frequency ultrasound and SWE measurements were conducted in three wrist positions: straight, 45° extension, and 45° flexion. The key findings revealed significant differences in median nerve CSA and SWE values between the CTS and control groups across all wrist positions, with notable variances in SWE values correlating with wrist positioning. SWE demonstrated enhanced sensitivity and specificity in distinguishing between mild, moderate, and severe CTS, especially at 45° wrist flexion. In contrast, CSA measurements were limited in differentiating between the varying severity stages of CTS. The study concludes that SWE, particularly at 45° wrist flexion, provides a more precise diagnostic benchmark for CTS severity grading than CSA. This advancement in non-invasive diagnostic methodology not only aids in accurate CTS grading but also has significant implications in formulating tailored treatment strategies, potentially reducing the reliance on more invasive diagnostic methods like NCS. This study marks a significant advancement in the ultrasound diagnosis of CTS. It particularly highlights the importance of applying SWE technology across various wrist joint angles, offering a new diagnostic benchmark. This discovery provides data support and additional insights for achieving an early consensus on ultrasound-based grading diagnosis of CTS.

Direct Suturing of Ulnar or Median Nerve Defects in High-Degree Elbow Flexion: An Experimental Cadaver Study

The aim of this study is to determine the maximum loss of median and ulnar nerve substances that can be treated by direct suture in elbow flexion and to quantify this elbow flexion. The other objective is to determine the participation of the wrist position in this direct suture in elbow flexion. We performed an experimental study on 6 ulnar nerve lesions and 6 median nerve lesions. For each defect, a direct tensionless suture was performed with elbow flexion and in three different positions of the wrist (wrist extension, neutral position, and wrist flexion). A 90° elbow flexion allowed direct suturing of defects up to 40 mm in the 3 positions of the wrist. A bowstringing effect (i.e., increase of the perpendicular distance of the nerve from the axis of rotation of the elbow) was noted starting from 25 mm of nerve defect. Wrist extension placed tension on the nerve suture for both nerves. The results of this first anatomical study clarified the conditions for direct suturing of ulnar and median nerve defects in the flexed elbow position and flexed wrist position. This is an approach to consider for limited nerve defects to the elbow or when allograft harvesting is to be avoided.

Dentist: Wrist Position, Handgrip Strength, and Body Mass Index Associated with Carpal Tunnel Syndrome in Daily Practice

Dentist: Wrist Position, Handgrip Strength, and Body Mass Index Associated with Carpal Tunnel Syndrome in Daily Practice

Wearable Multi-Sensor Positioning Prototype for Rowing Technique Evaluation.

The goal of this study is to determine the feasibility of a wearable multi-sensor positioning prototype to be used as a training tool to evaluate rowing technique and to determine the positioning accuracy using multiple mathematical models and estimation methods. The wearable device consists of an inertial measurement unit (IMU), an ultra-wideband (UWB) transceiver, and a global navigation satellite system (GNSS) receiver. An experiment on a rowing shell was conducted to evaluate the performance of the system on a rower's wrist, against a centimeter-level GNSS reference trajectory. This experiment analyzed the rowing motion in multiple navigation frames and with various positioning methods. The results show that the wearable device prototype is a viable option for rowing technique analysis; the system was able to provide the position, velocity, and attitude of a rower's wrist, with a positioning accuracy ranging between ±0.185 m and ±1.656 m depending on the estimation method.

The relationship between smartphone usage position, pain, smartphone addiction, and hand function.

The hand is the most frequently used part of the body during daily life activities. Any musculoskeletal problem that may occur in the hand can lead to loss of function. This study examined the relationship between the wrist and elbow position adapted during smartphone use, pain and discomfort, smartphone addiction, and hand function. Pain and discomfort were evaluated with the visual analog scale, wrist and elbow angle during phone use were evaluated with a universal goniometer, smartphone addiction was evaluated with the Smartphone Addiction Scale-Short Version, and functional status of the hand was evaluated with the Michigan Hand Outcomes Questionnaire. A total of 120 university students (female: n= 60), with an average age of 22.71 ± 2.7years, were included in this cross-sectional study. A relationship was found between the angle of the wrist and elbow during smartphone use and pain/discomfort (r= 0.692, p= 0.001), smartphone addiction (r= 0.575, p= 0.001), and hand function parameters (r= 0.20-0.55, p⩽ 0.05). Due to the increased use of smartphones in today's environment, a preventive program should be developed in which texting for extended periods is avoided, along with frequent breaks to rest the hands, and stretching exercises for the upper extremities during rest.

Evaluation of Normal Ranges of Wrist Radiologic Indexes in Jordanian Population.

The wrist is a complex joint that plays a role in several everyday tasks. Various radiological indices have been created to assess the alignment and structure of the wrist using standard X-ray images. Nevertheless, these indicators may differ based on variables such as age, gender, ethnicity, handedness, and wrist position. This research aimed to assess the radiological indices of the wrist in a group of healthy people from Jordan and investigate the impact of age and gender on these indices. We obtained data from a sample of 385 patients who presented at our hospital with minor non-specific wrist pain and satisfied the specified criteria for inclusion. We conducted measurements of radial inclination, radial height, volar tilt, ulnar variance, and carpal height ratio using both anteroposterior and lateral views of the wrist. We used linear regression and independent sample t-test to examine the correlation between age, gender, and radiological indicators. The reliability of the measurements was assessed using the intraclass correlation coefficient (ICC). Our study revealed a negative correlation between age and carpal height ratio (r = -0.13, p = 0.03). However, no significant gender differences were seen in any of the radiological indices (p > 0.05). Our findings indicate that ulnar variance had the greatest level of reliability across observers, with an intra-observer intraclass correlation coefficient (ICC) of 0.95 and an inter-observer ICC of 0.8. Conversely, volar tilt exhibited the lowest inter-observer reliability, with an ICC of 0.1.Our results provide a valuable point of reference for the wrist morphology and alignment in the Jordanian population. Our suggestion is that the carpal height ratio might indicate alterations in the wrist joint due to aging, whereas ulnar variation may serve as a dependable indicator of wrist alignment. We suggest doing more research to investigate the biological and anatomical factors behind these results and to compare them with other demographic groups.

Combining Functional Electrical Stimulation (FES) to Elicit Hand Movements and a Mechanical Orthosis to Passively Maintain Wrist and Fingers Position in Individuals With Tetraplegia: A Feasibility Test

Combining Functional Electrical Stimulation (FES) to Elicit Hand Movements and a Mechanical Orthosis to Passively Maintain Wrist and Fingers Position in Individuals With Tetraplegia: A Feasibility Test

Enhancing Balance and Strength in Older Adults: The Impact of Pilates and Vibro-Swing Exercises.

BACKGROUND The Vibro-Swing system consists of 2 spiraled tubes containing 4 steel balls that move to generate a vibrational musculoskeletal and nervous system stimulus. This study included 45 older adults and aimed to compare balance, muscle strength, and proprioception with and without a 6-week program of Pilates training using the Vibro-Swing system. MATERIAL AND METHODS The present study included 45 older adults (mean age: 78.31±4.50). The experimental group (n=24) underwent a Pilates with Vibro-Swing exercise. The control group (n=21) participated in regular Pilates exercise. Both groups engaged in exercise for 40-50 minutes per session, twice a week, for 6 weeks, resulting in a total of 12 intervention sessions. Assessments were conducted before and after the intervention. The pre-post test evaluated balance (gait analysis, 10-meter walk test [10 MWT], functional reach test [FRT]), muscle strength (Five Times Sit-to-Stand Test [FTSS], grip strength), and proprioception (wrist joint position sense [WRT_30°]). RESULTS The experimental group exhibited statistically significant differences in velocity, cadence, 10MWT, FRT, FTSS, right grip, left grip, and wrist joint position sense (extension 30°) between the pre- and post-test (P>0.05). The experimental group exhibited statistically significant differences in gait velocity, cadence, 10 MWT, FTSS, right grip strength, FRT, and [WRT_30°] results compared with the control group (P>0.05). CONCLUSIONS The Pilates with Vibro-Swing exercise resulted in greater improvements in balance, muscle strength, and wrist joint proprioception.

Changes in Ultrasound Parameters of the Median Nerve at Different Positions of the Radiocarpal Joint in Patients with Carpal Tunnel Syndrome.

Ultrasound imaging (US) is being increasingly used to aid in the diagnosis of entrapment neuropathies. This study aims to evaluate the shear modulus and cross-sectional area (CSA) of the median nerve in patients with carpal tunnel syndrome (CTS). A total of 35 patients with CTS participated in the study. CSA and shear modulus testing were performed in shear wave elastography (SWE) mode in five positions of the right and left radiocarpal joints (intermediate position 0°, 45° of extension, maximum extension, 45° of flexion, and maximum flexion). There were significant side-to-side differences in the median nerve shear modulus at each wrist position as compared to the asymptomatic side. There were significant side-to-side differences in the median nerve CSA at each wrist position as compared to the asymptomatic side. Shear modulus increases in patients with CTS at different angular positions of flexion and extension of the radiocarpal joint. In individuals with CTS, the CSA of the median nerve is greater on the symptomatic side compared to the asymptomatic side. The CSA decreases in positions of maximum extension and 45° of flexion and in maximum flexion relative to the resting position.

Normative values and the influence of sex, hand dominance, and direction of movement on active wrist joint position sense in young healthy adults

BackgroundActive wrist joint position sense (JPS) is a feasible method for determining wrist proprioception. However, the normative values and factors affecting wrist JPS are not known. ObjectivesTo identify normative values of active wrist JPS in young healthy adults and explore the influence of sex, hand dominance and direction of wrist movement. DesignCross-sectional study. MethodJPS of 100 individuals aged 18–40 years, (male: female = 51:49) were measured at two wrist positions (20° flexion/extension) using the active wrist JPS test. Absolute error (in degrees) was calculated and summarized using descriptive measures. Kruskal-Wallis analysis of variance was performed to determine the differences in JPS error based on sex, dominance and direction of wrist movement. ResultsMean absolute JPS flexion error on the dominant side was 3.47°(SD = 3.91°), and non-dominant side was 3.26°(SD = 3.23°). Mean absolute JPS extension error on the dominant side was 3.35°(SD = 3.43°), and non-dominant side was 4.59°(SD = 4.82°). Compared to males, females had more absolute error for flexion and extension on the dominant side. No significant difference was found in the absolute error between the dominant and non-dominant sides or between flexion and extension. ConclusionThese normative values of active JPS in young healthy adults can help clinicians while assessing proprioceptive impairments of the wrist. Differences in JPS errors due to sex were found, but not due to dominance or direction of movement. These findings can guide future research on mechanisms involved in wrist JPS.

Investigating the biomechanical behaviour of tendon-loaded wrist joint using web-like kinematic network model

The complexity of wrist anatomy and mechanics makes it challenging to develop standardized measurements and establish a normative reference database of wrist biomechanics despite being studied extensively. Moreover, heterogeneity factors in both demographic characteristics (e.g. gender) and physiological properties (e.g. ligament laxity) could lead to differences in biomechanical behaviour even within healthy groups. We investigated the kinematic behaviour of the carpal bones by creating a virtual web-like network between the bones using electromagnetic (EM) sensors. Our objective was to quantify the changes in the carpal bones’ biomechanical relative motions and orientations during active wrist motion in the form of orb-web architecture. Models from five cadaveric specimens at different wrist positions: (1) Neutral to 30° Extension, (2) Neutral to 50° Flexion, (3) Neutral to 10° Radial Deviation, (4) Neutral to 20° Ulnar Deviation, and (5) Dart-Throw Motion – Extension (30° Extension/10° RD) to Dart-Throw Motion Flexion (50° Flexion/20° UD), in both neutral and pronated forearm have been analyzed. Quantification analyses were done by measuring the changes in the network thread length, as well as determining the correlation between the threads at different wrist positions. We observed similarities in the kinematic web-network patterns across all specimens, and the interactions between the network threads were aligned to the carpal bones’ kinematic behaviour. Furthermore, analyzing the relative changes in the wrist web network has the potential to address the heterogeneity challenges and further facilitate the development of a 3D wrist biomechanics quantitative tool.

INVESTIGATING THE PREVALENCE OF CARPAL TUNNEL SYNDROME IN OFFICE WORKERS

The widespread use of advanced technology and gadgets has led to numerous health problems, including wrist pain due to Carpal Tunnel Syndrome (CTS). CTS is a common and costly issue among office workers. Although research indicates that CTS is not inherently related to work, it is a work-related neuropathy resulting from the compression of the median nerve due to repetitive stressful wrist postures, such as hyperextension or hyperflexion. Objective: This study aims to measure the prevalence of Carpal Tunnel Syndrome (CTS) among office workers, considering computer usage and typing as risk factors, and to assess how job demands contribute to CTS at the workplace. Methods: A quantitative research model using a prospective survey design was employed. The study was conducted among office workers from the manufacturing and services industries in Punjab, Pakistan. A convenient sample of 280 office workers participated. Data were collected using the standardized Boston Carpal Tunnel Syndrome Questionnaire to evaluate the impact of CTS on activities of daily living (ADLs) and socioeconomic life. The study duration was six months. Data analysis was performed using SPSS software version 23.0. Results: The study found a comparatively high prevalence of work-related wrist and hand complaints, including clinically proven CTS, among youthful office employees in Pakistan. Regular discomfort while working significantly increased the likelihood of developing CTS. Extended periods of computer use without breaks also heightened the risk of wrist and hand symptoms. Conclusion: There is a significant prevalence of CTS among office workers in Pakistan linked to prolonged computer use and repetitive wrist postures. Effective interventions and ergonomic practices are essential to reduce the incidence and impact of CTS in the workplace.

Is there a relationship between somatosensory impairment and the perception of pain in stroke survivors? An exploratory study.

Pain and somatosensory impairments are commonly reported following stroke. This study investigated the relationship between somatosensory impairments (touch detection, touch discrimination and proprioceptive discrimination) and the reported presence and perception of any bodily pain in stroke survivors. Stroke survivors with somatosensory impairment ( N = 45) completed the Weinstein Enhanced Sensory Test (WEST), Tactile Discrimination Test, and Wrist Position Sense Test for quantification of somatosensation in both hands and the McGill Pain Questionnaire, visual analog scale and the Neuropathic Pain Symptom Inventory (NPSI) for reporting presence and perception of pain. No relationship was observed between somatosensory impairment (affected contralesional hand) of touch detection, discriminative touch or proprioceptive discrimination with the presence or perception of pain. However, a weak to moderate negative relationship between touch detection in the affected hand (WEST) and perception of pain intensity (NPSI) was found, suggesting that stroke survivors with milder somatosensory impairment of touch detection, rather than severe loss, are likely to experience higher pain intensity [rho = -0.35; 95% confidence interval (CI), -0.60 to -0.03; P = 0.03]. Further, a moderate, negative relationship was found specifically with evoked pain (NPSI) and touch detection in the affected hand (rho = -0.43; 95% CI, -0.72 to -0.02; P = 0.03). In summary, our findings indicate a weak to moderate, albeit still uncertain, association, which prevents making a definitive conclusion. Nevertheless, our findings contribute to our understanding of the complexities surrounding the experience of pain in survivors of stroke and provide direction for future studies.

Investigation of sensory and motor functions of wrist in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a systemic and autoimmune disease that affects many tissues and organs in the body, especially the synovial joint and periarticular structures. One of the most affected joints is the hand joints, and there is also involvement in the wrist joint. ObjectivesThe purpose of this study was to assess the sensory and motor functions of the wrist with a gold standard method and to determine the relationship between the motor and sensory functions of the wrist and wrist-related pain/disability level and hand grip strength in patients with RA. MethodFlexor and extensor muscle strength and joint position sense of the wrist were evaluated using isokinetic dynamometer, hand grip strength was measured using dynamometer, and wrist related pain and disability was assessed by Patient Rated Wrist Evaluation (PRWE) questionnaire. ResultsThirty-one patients with RA and 31 healthy controls were included in the study. Control group had better results regarding wrist flexor and extensor muscle strength and wrist joint position sense than RA patients for both hands/wrists. A positive and strong correlation and a negative and weak correlation were found between muscle strength and joint position sense of the wrist and hand grip strength, respectively. ConclusionsCompared to healthy subjects, RA patients showed wrist-related sensorimotor deficits. Therefore, evaluation of the wrist should not be ignored in the examination of patients with RA. In addition, when planning the treatment program of the patients, not only hand exercises but also exercises involving the wrist should be taken into consideration.