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Harms RL, Ferrari A, Meier IB, Martinkova J, Santus E, Marino N, Cirillo D, Mellino S, Catuara Solarz S, Tarnanas I, Szoeke C, Hort J, Valencia A, Ferretti MT, Seixas A, Santuccione Chadha A. Digital biomarkers and sex impacts in Alzheimer's disease management - potential utility for innovative 3P medicine approach. EPMA J 2022; 13:299-313. [PMID: 35719134 PMCID: PMC9203627 DOI: 10.1007/s13167-022-00284-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
Digital biomarkers are defined as objective, quantifiable physiological and behavioral data that are collected and measured by means of digital devices. Their use has revolutionized clinical research by enabling high-frequency, longitudinal, and sensitive measurements. In the field of neurodegenerative diseases, an example of a digital biomarker-based technology is instrumental activities of daily living (iADL) digital medical application, a predictive biomarker of conversion from mild cognitive impairment (MCI) due to Alzheimer's disease (AD) to dementia due to AD in individuals aged 55 + . Digital biomarkers show promise to transform clinical practice. Nevertheless, their use may be affected by variables such as demographics, genetics, and phenotype. Among these factors, sex is particularly important in Alzheimer's, where men and women present with different symptoms and progression patterns that impact diagnosis. In this study, we explore sex differences in Altoida's digital medical application in a sample of 568 subjects consisting of a clinical dataset (MCI and dementia due to AD) and a healthy population. We found that a biological sex-classifier, built on digital biomarker features captured using Altoida's application, achieved a 75% ROC-AUC (receiver operating characteristic - area under curve) performance in predicting biological sex in healthy individuals, indicating significant differences in neurocognitive performance signatures between males and females. The performance dropped when we applied this classifier to more advanced stages on the AD continuum, including MCI and dementia, suggesting that sex differences might be disease-stage dependent. Our results indicate that neurocognitive performance signatures built on data from digital biomarker features are different between men and women. These results stress the need to integrate traditional approaches to dementia research with digital biomarker technologies and personalized medicine perspectives to achieve more precise predictive diagnostics, targeted prevention, and customized treatment of cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-022-00284-3.
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Affiliation(s)
| | | | | | - Julie Martinkova
- Women’s Brain Project, Guntershausen, Switzerland
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Enrico Santus
- Women’s Brain Project, Guntershausen, Switzerland
- Bayer, NJ USA
| | - Nicola Marino
- Women’s Brain Project, Guntershausen, Switzerland
- Dipartimento Di Scienze Mediche E Chirurgiche, Università Degli Studi Di Foggia, Foggia, Italy
| | - Davide Cirillo
- Women’s Brain Project, Guntershausen, Switzerland
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | | | | | - Ioannis Tarnanas
- Altoida Inc., Houston, TX USA
- Global Brain Health Institute, Dublin, Ireland
| | - Cassandra Szoeke
- Women’s Brain Project, Guntershausen, Switzerland
- Centre for Medical Research, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St Anne’s University Hospital Brno, Brno, Czech Republic
| | - Alfonso Valencia
- Barcelona Supercomputing Center, Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
- ICREA - Institució Catalana de Recerca I Estudis Avançats, Pg. Lluís Companys 23, 08010 Barcelona, Spain
| | | | - Azizi Seixas
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136 USA
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Tsao L, Kim S, Ma L, Nussbaum MA. An exploratory study comparing three work/rest schedules during simulated repetitive precision work. ERGONOMICS 2021; 64:1579-1594. [PMID: 34224340 DOI: 10.1080/00140139.2021.1950844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
The pattern of work and rest can influence both physical fatigue and task performance in manual operations. However, there is relatively limited evidence regarding the influences of specific work/rest schedules in tasks requiring high repetitiveness and precision demands, along with relatively low exertion levels. Eighteen participants completed an exploratory study that simulated such tasks, to compare the effects of three distinct work/rest schedules (i.e. short frequent [short] and long infrequent breaks [long], and a self-selected schedule) on muscle fatigue, task performance (in terms of accuracy and speed), and preference. Schedules with long or self-selected breaks generally induced less muscle fatigue, compared with the short break condition. Participants preferred the self-selected condition the most and the long-break condition the least. The different schedules tested did not influence task performance. A self-selected schedule may be beneficial for repetitive precision task, to achieve a balance across muscle fatigue, task performance, and individual preference. Practitioner summary: Influences of three work/rest schedules (i.e. short and long breaks, and a self-selected schedule) on fatigue, performance, and preference were explored during repetitive precision tasks. Schedules with long or self-selected breaks induced less muscle fatigue and none of the three schedules influenced performance. A self-selected schedule was the most preferred.
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Affiliation(s)
- Liuxing Tsao
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
- Department of Industrial Engineering, Tsinghua University, Beijing, China
- Teaching Center for Writing and Communication, School of Humanities, Tsinghua University, Beijing, China
| | - Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Liang Ma
- Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
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Yang Y, Xu J, Elkhuizen WS, Song Y. The development of a low-cost photogrammetry-based 3D hand scanner. HARDWAREX 2021; 10:e00212. [PMID: 35607699 PMCID: PMC9123424 DOI: 10.1016/j.ohx.2021.e00212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/26/2021] [Accepted: 06/17/2021] [Indexed: 06/09/2023]
Abstract
Acquiring an accurate 3D scan of the human hand is a challenging task, mainly due to the complicated geometry and the instability of the hand. In this paper, we present a low-cost photogrammetry-based scanner that is designed for scanning the human hand. The scanner has fifty modules, each has a Raspberry Pi with an 8-megapixels camera. They are uniformly positioned in two parallel frames and 96% of a hand surface can be viewed by at least 3 cameras. Using the timestamp method, we synchronize the shutters of the 50 cameras within the range of 80 ms to minimize the influence of the instability of the hand. Moreover, the scanner is easy to build with its modular design, and easy to operate with a laptop that is connected to the system by WiFi. Using a 3D printed prosthetic hand, we compared the 3D scanning accuracy of the proposed scanner with the Artec Spider® scanner. The mean absolute error between the two scans is 0.62 ± 0.28 mm. It is concluded that the proposed hand scanner can be used as a low-cost yet accurate tool in many applications, such as personalized product design.
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Affiliation(s)
- Yusheng Yang
- Delft University of Technology, The Netherlands
- Shanghai University, China
| | - Jun Xu
- Delft University of Technology, The Netherlands
| | | | - Yu Song
- Delft University of Technology, The Netherlands
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Aljihmani L, Kerdjidj O, Zhu Y, Mehta RK, Erraguntla M, Sasangohar F, Qaraqe K. Classification of Fatigue Phases in Healthy and Diabetic Adults Using Wearable Sensor. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6897. [PMID: 33287112 PMCID: PMC7729463 DOI: 10.3390/s20236897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022]
Abstract
Fatigue is defined as "a loss of force-generating capacity" in a muscle that can intensify tremor. Tremor quantification can facilitate early detection of fatigue onset so that preventative or corrective controls can be taken to minimize work-related injuries and improve the performance of tasks that require high-levels of accuracy. We focused on developing a system that recognizes and classifies voluntary effort and detects phases of fatigue. The experiment was designed to extract and evaluate hand-tremor data during the performance of both rest and effort tasks. The data were collected from the wrist and finger of the participant's dominant hand. To investigate tremor, time, frequency domain features were extracted from the accelerometer signal for segments of 45 and 90 samples/window. Analysis using advanced signal processing and machine-learning techniques such as decision tree, k-nearest neighbor, support vector machine, and ensemble classifiers were applied to discover models to classify rest and effort tasks and the phases of fatigue. Evaluation of the classifier's performance was assessed based on various metrics using 5-fold cross-validation. The recognition of rest and effort tasks using an ensemble classifier based on the random subspace and window length of 45 samples was deemed to be the most accurate (96.1%). The highest accuracy (~98%) that distinguished between early and late fatigue phases was achieved using the same classifier and window length.
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Affiliation(s)
- Lilia Aljihmani
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
| | - Oussama Kerdjidj
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
| | - Yibo Zhu
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Ranjana K. Mehta
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Madhav Erraguntla
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Farzan Sasangohar
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Khalid Qaraqe
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
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Jakobi JM, Haynes EM, Smart RR. Is there sufficient evidence to explain the cause of sexually dimorphic behaviour in force steadiness? Appl Physiol Nutr Metab 2018; 43:1207-1214. [DOI: 10.1139/apnm-2018-0196] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neuromuscular noise is a determining factor in the control of isometric force steadiness (FS), quantified as coefficient of variation (CV) of force around a preestablished target output. In this paper we examine sex-related differences of neural, muscular, and tendon influences on neuromuscular noise to understand FS in females and males. We use evidence from the literature to identify that CV of force is higher in females compared with males in the upper and lower body, with sex-related differences becoming less apparent with increasing age. Evaluation of sex-related physiology in tandem with results from FS studies indicate that differences in fibre type, contractile properties, and number of motor units (MUs) are unlikely contributors to differences in FS between females and males. MU type, behaviour of the population (inclusive of number of active MUs from the population), agonist–antagonist activity, maximal strength, and tendon mechanics are probable contributors to sexually dimorphic behaviour in FS. To clearly determine underlying causes of sex-related differences in FS, further study and reporting between females and males is required. Females and males are included in many studies; however, rich data on sexually dimorphic behaviour is lost when data are collapsed across sex or identified as nonsignificant without supporting values. This poses a challenge to identifying the underlying cause of females having higher CV of force than males. This review provides evidence of sexually dimorphic behaviour in FS and suggests that physiological differences between females and males effect neuromuscular noise, and in-turn contribute to sex-related differences in FS.
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Affiliation(s)
- Jennifer M. Jakobi
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Elijah M.K. Haynes
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Rowan R. Smart
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
- School of Health and Exercise Sciences, Healthy Exercise and Aging Lab Group, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
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Dean DJ, Walther S, Bernard JA, Mittal VA. Motor clusters reveal differences in risk for psychosis, cognitive functioning, and thalamocortical connectivity: evidence for vulnerability subtypes. Clin Psychol Sci 2018; 6:721-734. [PMID: 30319928 PMCID: PMC6178957 DOI: 10.1177/2167702618773759] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abnormal development of parallel cortical-striatal networks may contribute to abnormal motor, cognitive, and affective behavior prior to the onset of psychosis. Partitioning individuals at clinical high-risk (CHR) using motor behavior may provide a novel perspective on different etiological pathways or patient subtypes. A K-means cluster analysis was conducted in CHR (N=69; 42% female, mean age=18.67 years) young adults using theoretically distinct measures of motor behavior. The resulting subtypes were then compared on positive and negative symptoms at baseline, and 2-year risk of psychosis conversion. CHR participants were followed for 2 years to determine conversion to psychosis. CHR subtypes and healthy controls (N=61; 57% female, mean age=18.58 years) were compared on multiple cognitive domains and cortical-striatal connectivity. Results suggest 3 vulnerability subtypes of CHR individuals with different profiles of motor performance, symptoms, risk for conversion to psychosis, cognition, and thalamocortical connectivity. This approach may reflect a novel strategy for promoting tailored risk assessment as well as future research developing individualized medicine.
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Affiliation(s)
- Derek J. Dean
- University of Colorado Boulder, Department of Psychology and Neuroscience, Boulder, CO, USA
- University of Colorado Boulder, Center for Neuroscience, Boulder, CO, USA
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Jessica A. Bernard
- Texas A&M University, Department of Psychological and Brain Sciences, College Station, TX, USA
- Texas A&M University, Institute for Neuroscience, College Station, TX, USA
| | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Evanston, IL, USA
- Northwestern University, Department of Psychiatry, Chicago IL, USA
- Northwestern University, Institute for Policy Research, Evanston, IL, USA
- Northwestern University, Medical Social Sciences, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Evanston/Chicago, IL, USA
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Silva NS, de Almeida PHTQ, Mendes PVB, Komino CSM, Jùnior JMN, Da Cruz DMC. Electromyographic Activity of the Upper Limb in Three Hand Function Tests. Hong Kong J Occup Ther 2017; 29:10-18. [PMID: 30186068 PMCID: PMC6092000 DOI: 10.1016/j.hkjot.2016.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 09/20/2016] [Accepted: 11/19/2016] [Indexed: 11/29/2022] Open
Abstract
Objective/Background Occupational therapists usually assess hand function through standardised
tests, however, there is no consensus on how the scores assigned to hand
dexterity can accurately measure hand function required for daily activities
and few studies evaluate the movement patterns of the upper limbs during
hand function tests. This study aimed to evaluate the differences in muscle
activation patterns during the performance of three hand dexterity
tests. Methods Twenty university students underwent a surface electromyographic (sEMG)
assessment of eight upper limb muscles during the performance of the box and
blocks test (BEST), nine-hole peg test (9HPT), and functional dexterity test
(FDT). The description and comparison of each muscle activity during the
test performance, gender differences, and the correlation between individual
muscles’ sEMG activity were analysed through appropriate statistics. Results Increased activity of proximal muscles was found during the performance of
BEST (p < .001). While a higher activation of the distal muscles occurred
during the FDT and 9HPT performance, no differences were found between them.
Comparisons of the sEMG activity revealed a significant increase in the
muscle activation among women (p = .05). Strong and positive correlations (r
> .5; p < .05) were observed between proximal and distal sEMG
activities, suggesting a coordinate pattern of muscle activation during hand
function tests. Conclusion The results suggested the existence of differences in the muscle activation
pattern during the performance of hand function evaluations. Occupational
therapists should be aware of unique muscle requirements and its impact on
the results of dexterity tests during hand function evaluation.
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Affiliation(s)
- Natália Sanches Silva
- Department of Occupational Therapy, Universidade Federal de Sao Carlos - UFSCar, Sao Carlos, State of Sao Paulo, Brazil
| | | | - Paulo Vinicius Braga Mendes
- Department of Occupational Therapy, Universidade Federal de Sao Carlos - UFSCar, Sao Carlos, State of Sao Paulo, Brazil
| | | | - José Marques Novo Jùnior
- Department of Bioengineering, Universidade de São Paulo - USP, Sao Carlos, State of Sao Paulo, Brazil
| | - Daniel Marinho Cezar Da Cruz
- Department of Occupational Therapy, Universidade Federal de Sao Carlos - UFSCar, Sao Carlos, State of Sao Paulo, Brazil
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Casamento-Moran A, Hunter SK, Chen YT, Kwon MH, Fox EJ, Yacoubi B, Christou EA. Sex differences in spatial accuracy relate to the neural activation of antagonistic muscles in young adults. Exp Brain Res 2017; 235:2425-2436. [DOI: 10.1007/s00221-017-4968-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/24/2017] [Indexed: 12/20/2022]
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Sakamoto Y, Okamoto S, Shimizu K, Araki Y, Hirakawa A, Wakabayashi T. Hands-on Simulation versus Traditional Video-learning in Teaching Microsurgery Technique. Neurol Med Chir (Tokyo) 2017; 57:238-245. [PMID: 28381653 PMCID: PMC5447816 DOI: 10.2176/nmc.oa.2016-0317] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Bench model hands-on learning may be more effective than traditional didactic practice in some surgical fields. However, this has not been reported for microsurgery. Our study objective was to demonstrate the efficacy of bench model hands-on learning in acquiring microsuturing skills. The secondary objective was to evaluate the aptitude for microsurgery based on personality assessment. Eighty-six medical students comprising 62 men and 24 women were randomly assigned to either 20 min of hands-on learning with a bench model simulator or 20 min of video-learning using an instructional video. They then practiced microsuturing for 40 min. Each student then made three knots, and the time to complete the task was recorded. The final products were scored by two independent graders in a blind fashion. All participants then took a personality test, and their microsuture test scores and the time to complete the task were compared. The time to complete the task was significantly shorter in the simulator group than in the video-learning group. The final product scores tended to be higher with simulator-learning than with video-learning, but the difference was not significant. Students with high “extraversion” scores on the personality inventory took a shorter time to complete the suturing test. Simulator-learning was more effective for microsurgery training than video instruction, especially in understanding the procedure. There was a weak association between personality traits and microsurgery skill.
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Affiliation(s)
- Yusuke Sakamoto
- Department of Neurosurgery, Nagoya University, Graduate School of Medicine.,Department of Neurosurgery, Kamiiida Daiichi General Hospital
| | - Sho Okamoto
- Department of Neurosurgery, Nagoya University, Graduate School of Medicine
| | - Kenzo Shimizu
- Department of Neurosurgery, Nagoya University, Graduate School of Medicine.,Department of Neurosurgery and Spine Surgery, Aichi Spine Institute Ito Orthopedics and Internal Clinic
| | - Yoshio Araki
- Department of Neurosurgery, Nagoya University, Graduate School of Medicine
| | - Akihiro Hirakawa
- Nagoya University Hospital, Center for Advanced Medicine and Clinical Research, Statistical Analysis Section
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Affiliation(s)
- Dana M DiPasquale
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA
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Tesio L, Simone A, Zebellin G, Rota V, Malfitano C, Perucca L. Bimanual dexterity assessment: validation of a revised form of the turning subtest from the Minnesota Dexterity Test. Int J Rehabil Res 2016; 39:57-62. [PMID: 26579699 PMCID: PMC4900427 DOI: 10.1097/mrr.0000000000000145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/11/2015] [Indexed: 11/26/2022]
Abstract
Bimanual coordination underlies many daily activities. It is tested by various versions of the old Minnesota Dexterity Test (dating back to 1931, 'turning' subtest). This, however, is ill standardized, may be time-consuming, and has poor normative data. A timed-revised form of the turning subtest (MTTrf) is presented. Age-related norms and test-retest reliability were computed. Sixty-four healthy individuals, 24-79 years, comprising 34 women, were required to pick up 60 small plastic disks from wells, rotate each disk, and transfer it to the other hand, which must replace it, as quickly as possible. Two trials were requested for each hand (ABBA sequence). The average time (seconds) across the 4 trials gave the test score. Participants were grouped (CART algorithm) into 3 statistically distinct (P<0.05) age×score strata, with cutoff 53+ and 73+ years, and tested at baseline and after 1 week. Test-retest reliability was measured both as consistency [intraclass correlation coefficient (ICCs) model 2.1] and as agreement (Bland-Altman plot). From the ICCs, the individual test-retest minimal real difference (in seconds) was computed. The whole MTTrf took less than 4 min to administer. Baseline scores ranged from 40 to 78 s. The ICCs ranged from 0.45 to 0.81 and the minimal real difference ranged from 6.68 to 13.40 s across the age groups. Fifty-nine out of 64 observations (92%) fell within the confidence limits of the Bland-Altman plot. The MTTrf is a reliable and practical test of bimanual coordination. It may be a useful addition to protocols of manual testing in occupational therapy.
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Affiliation(s)
- Luigi Tesio
- Department of Biomedical Sciences for Health
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
- PhD Program in Advanced Sciences And Technologies in Rehabilitation Medicine and Sports, University of Rome Tor Vergata, Rome
| | - Anna Simone
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
| | - Giuliano Zebellin
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
- PhD Program in Advanced Sciences And Technologies in Rehabilitation Medicine and Sports, University of Rome Tor Vergata, Rome
| | - Viviana Rota
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
| | - Calogero Malfitano
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
- School of Specialization, Physical and Rehabilitation Medicine, Universitá degli Studi, Milan, Italy
| | - Laura Perucca
- Department of Biomedical Sciences for Health
- Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, Milan
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Chen PT, Jou IM, Lin CJ, Chieh HF, Kuo LC, Su FC. Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome? Clin Orthop Relat Res 2015; 473:2371-82. [PMID: 25690168 PMCID: PMC4457761 DOI: 10.1007/s11999-015-4189-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 02/03/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. QUESTIONS/PURPOSES We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? METHODS We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (Fr) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. RESULTS The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2-7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1-5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2-3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2-2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035-0.050 for thumb and 0.016-0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3-1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9-2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039-0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6-0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3-0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6-0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3-0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20-0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16-0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05-0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04-0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04-0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02-0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20-0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02-0.02 N], p = 0.01). CONCLUSIONS Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. CLINICAL RELEVANCE The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.
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Affiliation(s)
- Po-Tsun Chen
- Department of Biomedical Engineering, National Cheng Kung University, No. 1, University Road, Tainan City, 701 Taiwan
| | - I-Ming Jou
- Department of Orthopedics, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Ju Lin
- Department of Biomedical Engineering, National Cheng Kung University, No. 1, University Road, Tainan City, 701 Taiwan ,Musculoskeletal Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Feng Chieh
- Department of Biomedical Engineering, National Cheng Kung University, No. 1, University Road, Tainan City, 701 Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, National Cheng Kung University, No. 1, University Road, Tainan City, 701 Taiwan ,Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan ,Musculoskeletal Research Center, National Cheng Kung University, Tainan, Taiwan
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Horton LM, Nussbaum MA, Agnew MJ. Rotation during lifting tasks: effects of rotation frequency and task order on localized muscle fatigue and performance. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2015; 12:95-106. [PMID: 25551257 DOI: 10.1080/15459624.2014.957829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Though widely considered to reduce the risk of work-related musculoskeletal disorders, there is limited evidence suggesting that rotating between tasks is effective in doing so. The purpose of the current study was to quantify the effects of rotation and parameters of rotation (frequency and task order) on muscle fatigue and performance. This was done using a simulated lifting task, with rotation between two levels of loading of the same muscle groups. Twelve participants completed six experimental sessions during which repetitive box lifting was performed for one hour either with or without rotation. When rotation was present, it occurred every 15 minutes or every 30 minutes and was between two load levels (box weights). Rotation reduced fatigue and cardiovascular demand compared to the heavier load without rotation, with a mean reduction of ∼33% in perceived discomfort and a ∼17% reduction in percentage of heart rate reserve. Further, rotation increased fatigue and cardiovascular demand compared to the lighter load without rotation, with a mean increase of ∼34% perceived discomfort and a ∼19% increase in percentage of heart rate reserve. Neither rotation frequency nor task order had definitive effects, though maximum discomfort ratings were nearly 20% higher when starting with the lighter load task. These parameters of rotation should be further evaluated under more realistic task conditions.
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Affiliation(s)
- Leanna M Horton
- a Department of Industrial and Systems Engineering , Virginia Tech , Blacksburg , Virginia
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Activation and intermuscular coherence of distal arm muscles during proximal muscle contraction. Exp Brain Res 2013; 232:739-52. [PMID: 24317552 DOI: 10.1007/s00221-013-3784-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/19/2013] [Indexed: 01/03/2023]
Abstract
In the human upper extremity (UE), unintended effects of proximal muscle activation on muscles controlling the hand could be an important aspect of motor control due to the necessary coordination of distal and proximal segments during functional activities. This study aimed to elucidate the effects of concurrent activation of elbow muscles on the coordination between hand muscles performing a grip task. Eleven healthy subjects performed precision grip tasks while a constant extension or flexion moment was applied to their elbow joints, inducing a sustained submaximal contraction of elbow muscles to counter the applied torque. Activation of four hand muscles was measured during each task condition using surface electromyography (EMG). When concurrent activation of elbow muscles was induced, significant changes in the activation levels of the hand muscles were observed, with greater effects on the extrinsic finger extensor (23.2 % increase under 30 % elbow extensor activation; p = 0.003) than extrinsic finger flexor (14.2 % increase under 30 % elbow flexor activation; p = 0.130). Elbow muscle activation also induced involuntary changes in the intrinsic thumb flexor activation (44.6 % increase under 30 % elbow extensor activation; p = 0.005). EMG-EMG coherence analyses revealed that elbow muscle activation significantly reduced intermuscular coherence between distal muscle pairs, with its greatest effects on coherence in the β-band (13-25 Hz) (average of 17 % decrease under 30 % elbow flexor activation). The results of this study provide evidence for involuntary, muscle-specific interactions between distal and proximal UE muscles, which may contribute to UE motor performance in health and disease.
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Horton LM, Nussbaum MA, Agnew MJ. Effects of rotation frequency and task order on localised muscle fatigue and performance during repetitive static shoulder exertions. ERGONOMICS 2012; 55:1205-1217. [PMID: 22849348 DOI: 10.1080/00140139.2012.704406] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Though widely considered to reduce physical exposures and increase exposure variation, there is limited evidence that rotating between tasks is effective in reducing the risk of work-related musculoskeletal disorders (WMSDs). The purpose of this study was to assess the effects of rotation, specifically focusing on rotation frequency and task order, on muscle fatigue and performance when rotating between tasks that load the same muscle group. Twelve participants completed six experimental sessions during which repetitive static shoulder abduction tasks were performed at two exertion levels for one hour either with or without rotation. Compared to only performing a higher or lower exertion task, rotating between the two tasks decreased and increased fatigue, respectively. Increasing rotation frequency adversely affected task performance, and task order had a minor effect on muscle fatigue. These rotation parameters may be important considerations when implementing rotation in the workplace. PRACTITIONER SUMMARY Rotation is widely used and assumed to reduce the risk of WMSDs, yet little research supports that it is effective in doing so. Results here show that specific aspects of a rotation scheme may influence muscle fatigue and task performance, though further research is needed under more realistic task conditions.
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Affiliation(s)
- Leanna M Horton
- Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), Blacksburg , VA, USA
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Strauß G, Maier T, Krinninger M, Berger T, Dietz A, Lüth T. Klinischer Einsatz eines Mikromanipulators. HNO 2012; 60:807-13. [DOI: 10.1007/s00106-012-2540-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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