Quantification of weakness caused by distal median nerve lesion by dynamometry

Hand-worn devices for assessment and rehabilitation of motor function and their potential use in BCI protocols: a review

Introduction

Various neurological conditions can impair hand function. Affected individuals cannot fully participate in activities of daily living due to the lack of fine motor control. Neurorehabilitation emphasizes repetitive movement and subjective clinical assessments that require clinical experience to administer.

Methods

Here, we perform a review of literature focused on the use of hand-worn devices for rehabilitation and assessment of hand function. We paid particular attention to protocols that involve brain-computer interfaces (BCIs) since BCIs are gaining ground as a means for detecting volitional signals as the basis for interactive motor training protocols to augment recovery. All devices reviewed either monitor, assist, stimulate, or support hand and finger movement.

Results

A majority of studies reviewed here test or validate devices through clinical trials, especially for stroke. Even though sensor gloves are the most commonly employed type of device in this domain, they have certain limitations. Many such gloves use bend or inertial sensors to monitor the movement of individual digits, but few monitor both movement and applied pressure. The use of such devices in BCI protocols is also uncommon.

Discussion

We conclude that hand-worn devices that monitor both flexion and grip will benefit both clinical diagnostic assessment of function during treatment and closed-loop BCI protocols aimed at rehabilitation.

Normative data for the Baseline® 5 position hydraulic pinch meter and the relationship between lateral pinch strength and pinch span

INTRODUCTION

The Baseline® 5 position hydraulic pinch meter allows pinch strength assessment at five different pinch spans. The present study used this newly developed meter to assess where pinch span force is the greatest as previous literature is conflicting.

PURPOSE OF THE STUDY

The primary aim of the study was development of normative data using health subjects, whereas the secondary aims were to evaluate meter inter-rater reliability and to identify in which pinch span the greatest force was produced.

STUDY DESIGN

This is a clinical measurement, cross-sectional study.

METHODS

Ten occupational therapy student raters examined inter-rater reliability by calculating an average intraclass correlation. Recruitment of normative data subjects occurred across various locations in West Michigan to include a diverse population and followed testing procedures recommended by the American Society of Hand Therapists. Data were stratified by age categories and sex to develop normative standards. Data were analyzed using a one-way repeated measures ANOVA and a three-way mixed ANOVA.

RESULTS

Normative data were calculated from a sample of 605 subjects (292 males and 313 females). One-way ANOVA demonstrated a significant difference at the five different spans, noting a small effect size. Also noted were a nonsignificant three-way interaction between age category, pinch spans, and sex using both the right and left hands, along with a significant two-way interaction between spans and sex bilaterally.

DISCUSSION

The meter showed an excellent inter-rater reliability with an intraclass correlation = .98 and indicated the pinch span that produced the greatest amount of force was not consistent with previous literature.

Relationships Between Clinically Measured Upper-Extremity Physical Characteristics and Ball Spin Rate in Professional Baseball Pitchers

ABSTRACT

Wong, R, Laudner, K, Evans, D, Miller, L, Blank, T, and Meister, K. Relationships between clinically measured upper-extremity physical characteristics and ball spin rate in professional baseball pitchers. J Strength Cond Res 35(5): 1331-1337, 2021-During baseball pitching, physical characteristics of the shoulder, elbow, wrist, hand, and fingers have been hypothesized to be critical to creating ball spin. The purpose of this study was to determine if pitchers with greater shoulder, elbow, wrist, and finger range of motion (ROM), arm and hand length, wrist strength, or grip and finger strength would produce greater ball spin than those with less physical characteristics. Ninety, asymptomatic, professional baseball pitchers participated (age = 24.5 ± 3.9 years; height = 189.9 ± 6.1 cm; body mass = 92.6 ± 10.6 kg). Goniometers and a digital level were used to measure shoulder, elbow, wrist, and finger ROM, a tape measure was used to assess arm and hand lengths, and handheld dynamometers were used to measure wrist, grip, and finger strength. Ball spin was measured using a 3-dimensional Doppler radar and video system. Standard multiple regression analyses showed no significant relationships existed between ball spin and any of the upper-extremity ROM or limb length variables (R2 = 0.01-0.03; p = 0.40-0.94). However, there was a significant relationship for the summation of wrist strength (R2 = 0.24, p = 0.03). Both time to wrist extension strength {B = 0.50 (95% confidence interval [CI]: 0.23-0.76), p = 0.001} and radial deviation strength (B = 0.41 [95% CI: 0.15-0.66], p = 0.002) were significant predictors within this model. These results demonstrate that the rate of ball spin during a pitch may be partially altered by increasing wrist extension acceleration and radial deviation strength. However, the subsequent clinical measurements of shoulder, elbow, wrist, and finger ROM, arm and hand length, and grip and finger strength were not associated with ball spin.

Relationship between ultrasonographic hand muscle thickness measurements and muscle strength following median or ulnar nerve reconstruction

INTRODUCTION

The aim of this study was to assess the relationship between ultrasonographic hand muscle thickness measurements and hand muscle strength in patients who underwent median or ulnar nerve reconstruction.

METHODS

In this prospective, cross-sectional study, intrinsic hand muscle thicknesses were measured using ultrasound with a 4- to 13-MHz linear-array probe. Measurements of hand strength were performed using a dynamometer and a pinchmeter.

RESULTS

In the median nerve group (n = 11), a moderate correlation (r = 0.694; P = .018) was observed between lateral pinch strength and transverse thenar thickness. In the ulnar nerve group (n = 11), longitudinal thenar thickness below the flexor pollicis longus tendon was moderate to highly correlated with pinch and handgrip strengths (r = 0.726-0.893; P < .05); whole transverse thenar thickness was moderate to highly correlated with pinch strengths (r = 0.724-0.836; P < .05).

DISCUSSION

Sonographic measurements of intrinsic hand muscle thickness may be a useful tool for the assessment and follow-up of patients with median or ulnar nerve injury.

Clinical and electrophysiological examination of pinch strength in patients with amyotrophic lateral sclerosis

BACKGROUND

The split-hand concept has highlighted the preferential wasting of the thenar side of the hand in amyotrophic lateral sclerosis (ALS). Our objective is to re-explore pinch grip strength to assess whether it has the potential to be a practical biomarker of ALS.

METHODS

We measured different pinch grip strengths (thumb, index, and fifth) using a pinch gauge from both hands of 54 ALS patients and correlated this with the Medical Research Council (MRC) score, the upper-limb component of the revised ALS Functional Rating Scale - Revised (ALSFRS-R) score, and compound muscle action potentials (CMAPs) that comprise the split-hand index.

RESULTS

Pinch grip strength using any of the three fingers showed a positive correlation with its corresponding CMAP, MRC grading, and upper-limb ALSFRS-R score. The thumb pinch showed the strongest correlation with the split-hand index and MRC grading.

CONCLUSIONS

Pinch grip strength test using a simple gauge deserves further study as a potentially practical biomarker of ALS.

Does the educational level of women influence hand grip and pinch strength in carpal tunnel syndrome?

BACKGROUND

Grip and pinch strength are relevant functional variables for various activities of daily life and are related to the quality of life of patients with carpal tunnel syndrome (CTS).

OBJECTIVE

The main aim was to analyze the relationship between grip and pinch strength and the educational level in women with CTS.

STUDY DESIGN

Cross-sectional study.

METHODS

Thirty-one female patients with CTS awaiting surgery were assigned to the low education group if they only had primary education level (completed or not) and the high education group for those having higher education level. The assessments included: grip strength, pinch strength, Visual Analogue Scale, Quick DASH Questionnaire, Pain Catastrophizing Scale and the Tampa scale of kinesiophobia.

RESULTS

A statistically significant difference was obtained for grip strength (p = 0.027), pinch strength (p = 0.002) and catastrophizing (p = 0.038) between the two groups. No significant differences were observed for the other variables studied (p < 0.05). Grip strength was not related to individual factors: type of work, age, body mass index.

CONCLUSION

CTS patients with a low educational level exhibited reduced grip and pinch strength and more catastrophic thinking. Future studies should investigate the mechanisms involved in the loss of strength in patients with lower educational levels.