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Hand Function (hand + function)

Distribution by Scientific Domains

Medical Sciences	95%

Selected Abstracts

Effects of Aging on Hand Function

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2001
Vinoth K. Ranganathan MSE
OBJECTIVES: The purpose of this study was to quantify age-induced changes in handgrip and finger-pinch strength, ability to maintain a steady submaximal finger pinch force and pinch posture, speed in relocating small objects with finger grip, and ability to discriminate two identical mechanical stimuli applied to the finger tip. DESIGN: A cross-sectional study. SETTINGS: Greater Cleveland area of Ohio. PARTICIPANTS: Healthy, independent, young (n = 27, range 20,35 years) and older (n = 28, range 65,79 years) subjects. MEASUREMENTS: Handgrip strength, maximum pinch force (MPF), ability to maintain a steady pinch force at three relative force levels (5%, 10%, and 20% MPF) and three absolute force levels (2.5 Newtons (N), 4 N, and 8 N), ability to maintain a precision pinch posture, speed in relocating pegs from a nearby location onto the pegboard, and the shortest distance for discriminating two stimuli were measured in both young and older groups. RESULTS: Compared with young subjects, the older group's handgrip force was 30% weaker (P < .001), MPF was 26% lower (P < .05), and ability to maintain steady submaximal pinch force and a precision pinch posture was significantly less (P < .05). The time taken to relocate the pegs and the distance needed to discriminate two identical stimuli increased significantly with age (P < .01). The decrease in the ability to maintain steady submaximal pinch force was more pronounced in women than men. CONCLUSION: Aging has a degenerative effect on hand function, including declines in hand and finger strength and ability to control submaximal pinch force and maintain a steady precision pinch posture, manual speed, and hand sensation. [source]

Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2000
P A Wright BSc PhD
Functional electrical stimulation (FES) of the upper limb has been used for patients with a variety of neurological conditions, although few studies have been conducted on its use on the upper limb of children with cerebral palsy (CP). The aim of this study was to investigate the effect of cyclic FES on the wrist extensor muscles of a group of eight children (five boys, three girls) with hemiplegic CP (mean age 10 years). The study design involved a baseline (3 weeks), treatment (6 weeks), and follow-up (6 weeks). FES was applied for 30 minutes daily during the treatment period of the study. Improvements in hand function (p,0.039) and active wrist extension (p=0.031) were observed at the end of the treatment period. These improvements were largely maintained until the end of the follow-up period. No significant change was observed in the measurements of wrist extension moment during the treatment period (p=0.274). Hand function in this group of children improved after they were exposed to FES of wrist extensor muscles. This suggests that FES could become a useful adjunct therapy to complement existing management strategies available for this patient population. [source]

Ascertaining the prevalence of childhood disability

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2005
T. Hutchison
Abstract Objectives, To reapply 1985 Office of Population Census and Surveys (OPCS) disability survey methods, modified as necessary, to a sample of children to ascertain presence of disability. To compare OPCS-based prevalence with prevalence based on carer's views and medical records. Design, Analytical study. Setting, Community Child Health Department in UK. Participants, Principal carers of 100 children aged 5,15, selected from a district special needs register. Main outcome measures, Comparable information about disability from three sources and diagnosis from carers and medical records. Results, Medical records of 46% contained a diagnosis. Carers were always aware of this, although a single question did not always elicit their knowledge. OPCS-derived threshold disability criteria in categories of Hand function, Personal care, Consciousness and Continence gave prevalence results similar to medical records and carers. OPCS criteria yielded higher prevalence of disability in the areas of Locomotion (8%), Communication (14%) and Hearing (18%). Carers, OPCS and medical records disagreed markedly about prevalence of disabilities of Vision, probably because of the use of differing definitions. OPCS learning criteria were judged unsuitable and standard attainment targets (SATs) were substituted. These provided similar prevalence figures to carers and medical records. OPCS behaviour criteria were also unsuitable and were replaced by the General Health and Behaviour Questionnaire (GHBQ). This found an increased prevalence of problems compared with carers and doctors. Conclusions, Diagnostic labels have limited use when collecting data about disabled children. Doubt is cast on the validity of some of the 1985 OPCS threshold criteria, and reassessment is suggested before their future use. Further work is needed on the use of SATs and GHBQ in the benchmarking of disability. To collect population data it would be easier and at least equally effective (with caution in the case of Vision) to ask carers directly rather than applying descriptive thresholds and external judgements. Similar information could be obtained from medical records, however, they are likely to be out of date. [source]

Level of purposeful hand function as a marker of clinical severity in Rett syndrome

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2010
JENNY DOWNS
Aim, We investigated relationships between hand function and genotype and aspects of phenotype in Rett syndrome. Method, Video assessment in naturalistic settings was supplemented by parent-reported data in a cross-sectional study of 144 females with a mean age of 14 years 10 months (SD 7y 10mo; range 2y,31y 10mo), 110 of whom had a mutation of the methyl CpG binding protein 2 (MECP2) gene. Ordinal logistic regression was used to assess relationships between hand function and MECP2 mutation, age, a modified Kerr score, Functional Independence Measure for Children (WeeFIM), ambulation level, and frequency of hand stereotypies. Results, Approximately two-thirds of participants demonstrated purposeful hand function, ranging from simple grasping skills to picking up and manipulating small objects. In participants with a confirmed MECP2 mutation, those with the p.R168X mutation had the poorest hand function on multivariate analysis with C-terminal deletion as the baseline (odds ratio [OR] 0.19; 95% confidence interval [CI] 0.04,0.95), whereas those with the p.R133C or p.R294X mutation had better hand function. Participants aged 19 years or older had lower hand function than those aged less than 8 years (OR 0.36; 95% CI 0.14,0.92). Factors that were associated with better hand function were lower Kerr scores for a 1-point increase in score (OR 0.77; 95% CI 0.69,0.86), higher WeeFIM scores for a 1-point increase in score (OR 1.08; 95% CI 1.04,1.12), and greater ambulation than those completely dependent on carers for mobility (OR 22.64; 95% CI 7.02,73.08). The results for participants with a confirmed pathogenic mutation were similar to results obtained when participants without a mutation were also included. Interpretation, Our novel assessment of hand function in Rett syndrome correlated well with known profiles of common MECP2 mutations and overall clinical severity. This promising assessment could measure clinical responses to therapy. [source]

Longitudinal development of hand function in children with unilateral cerebral palsy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2010
MARIE HOLMEFUR PHD REG OT
Aim The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years. Method A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y 8mo [SD 1y 1mo]). Children were assessed with the Assisting Hand Assessment (AHA) 3 to 11 times per child over a mean period of 4 years 6 months. Two models were used for grouping children: by AHA score at 18 months and by Manual Ability Classification System (MACS) levels. Estimated average motor development curves were fitted with a nonlinear mixed-effects model. Results Children with a high AHA score (high ability level) at 18 months reached a significantly higher ability level and at a higher progression rate than children with a low 18-month AHA score. Limits of development differed between the three MACS levels. Interpretation Results indicate that the AHA score at 18 months can be used to discuss future development of affected hand use in bimanual tasks in children with unilateral CP. [source]

Long-term follow-up of children with obstetric brachial plexus palsy I: functional aspects

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2007
Christina Strömbeck MD
The aims of this study were to describe the development of sequelae in obstetric brachial plexus palsy (OBPP) and to identify possible differences in functional outcome from 5 years of age to follow-up, 2 to 15 years later. A cohort of 70 participants (35 males, 35 females; age range 7-20y, mean 13y 6mo [SD 4y 3mo], median 13y) with OBPP of varying degrees of severity were monitored. Differences in status between 5 years of age and follow-up were studied. Active joint motion in the shoulder and hand function, especially grip strength, generally remained unchanged or improved, whereas a slight but significant deterioration occurred in elbow function. Shoulder surgery resulted in considerable improvement of shoulder function. Participants with nerve reconstruction had a similar profile of change as the non-operated group. It was concluded that ongoing follow-up of children with OBPP, beyond the preschool years, is required due to decreases in elbow function, a commonly occurring restriction in external rotation of the shoulder, together with individual variations in long-term outcomes. In a related article (part II: neurophysiological aspects) long-term neurophysiological and sensory aspects of OBPP are reported. [source]

Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy

Effects of Aging on Hand Function

Sarcoidal granulomatous tenosynovitis of the hands occurring in an organ transplant patient

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 8 2007
J. Andrew Carlson
Six years after kidney-pancreas transplant, a 47-year-old white man developed multiple subcutaneous and tenosynovial nodules of hands and wrists, limiting mobility. Biopsy of multiple nodules showed fibrosing, sarcoidal granulomas, some of which contained pigmented material. Microbiology, immunohistochemistry, scanning electron microscopy with backscattered electron imaging and energy dispersive X-ray analysis and polymerase chain reaction assays failed to show any infectious agents or foreign material. There was no historical, clinical or laboratory evidence of systemic sarcoidosis. It is not known whether the donor had sarcoidosis. Despite empiric antimycobacterial therapy and ongoing immunosuppressive therapy (corticosteroids, mycophenolate, cyclosporine), the man has progressively developed more nodules, limiting hand function. Sarcoidosis occurring in non-donor tisssue post-transplantation is an exceedingly rare complication of transplantation. We discuss this case and review the literature on sarcoidal tenosynovitis and sarcoidosis occurring post-transplantation. [source]

Iatrogenic Forearm Compartment Syndrome in a Cardiac Intensive Care Unit Induced by Brachial Artery Puncture and Acute Anticoagulation

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2002
M.H.A, SHAY SHABAT M.D.
A previously healthy patient developed late compartment syndrome in the cardiac intensive care unit after a brachial artery puncture due to acute heparinization after successful percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. The cardiologists recognized the problem and immediately consulted an orthopedic surgeon, who promptly performed surgery. The latter consisted of decompression and fasciotomy. The patient recovered excellent hand function without any neurologic or muscular deficits. Knowledge and understanding of the clinical aspects of this complication are crucial in this devastating syndrome. [source]

Does three months of nightly splinting reduce the extensibility of the flexor pollicis longus muscle in people with tetraplegia?

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2007
Lisa Harvey
Abstract Background and Purpose.,The extensibility of the paralysed flexor pollicis longus (FPL) muscle is an important determinant of an effective tenodesis grip in people with C6 and C7 tetraplegia. Therapists believe that splinting can reduce the extensibility of the FPL muscle and thus improve hand function. However, there remains much controversy around the optimal position of splinting and its effectiveness is yet to be verified. The aim of the present study was to determine whether a three-month thumb splinting protocol reduces extensibility of the FPL muscle in people with tetraplegia.,Method.,An assessor-blinded, within-subject, randomized controlled trial was undertaken. Twenty people with tetraplegia and bilateral paralysis of all thumb muscles were recruited from a sample of convenience. One randomly selected hand of each subject was splinted each night for three months. The splint immobilized the FPL muscle in a relatively shortened position by positioning the carpometacarpal and metacarpophalangeal joint of the thumb in flexion. The other hand remained unsplinted for the duration of the study. Carpometacarpal angle was measured with the application of a standardized torque by a blinded assessor at the beginning and end of the three-month study period. A device specifically designed for this purpose that stabilized the wrist and other joints of the thumb in full extension was used.,Results.,No subject withdrew from the study. The three-month splinting protocol had a mean treatment effect on carpometacarpal joint angle of 0° (95% CI, ,6° to 6°).,Conclusion.,Splinting the FPL muscle in a relatively shortened position each night for three months does not reduce its extensibility. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Status 5 Years after Bilateral Hand Transplantation

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2006
S. Schneeberger
Graft survival and function early after hand transplantation is good. It remains unknown, however, whether long-term survival is limited by chronic rejection. We here describe the clinical course and the status 5 years after bilateral hand transplantation with emphasis on immunosuppression (IS), function, morphology and graft vascular changes. Clinical observation, evaluation of hand function, skin biopsies, X-ray, ultrasound, angiography, CT angiography, electrophysiologic studies including compound motor and sensory action potentials (CMAP, CSAP) and somatosensory evoked potentials were performed and results recorded at regular intervals. Following reduction of IS one mild (grade II) rejection episode occurred at 4 years. Subsequently, skin histology remained normal and without signs of chronic rejection. Hand function continuously improved during the first 3 years and remained stable with minor improvement thereafter. CMAP and CSAP progressively increased during the observation period. Latencies of the cortical responses were prolonged but amplitudes were within normal range. Investigation of hand vessels revealed no signs of occlusion but showed revascularization of a primarily occluded right radialis artery. Motor and sensory function improved profoundly between years 1 and 5 after hand transplantation. No signs whatsoever of chronic rejection have been observed. [source]

Hand exercise leads to modest improvement in grip and pinch strength, but no difference in hand function, pain, stiffness or dexterity in older people with hand osteoarthritis

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2010
Claire Ballinger
No abstract is available for this article. [source]

Static resting splints in early rheumatoid arthritis were not effective in improving grip strength, ulnar deviation, dexterity, hand function or pain

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2009
Margaret Wallen
No abstract is available for this article. [source]

Splinting the hand in the functional position after acquired brain injury did not influence muscle length, hand function or pain

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 4 2003
Marion Walker
No abstract is available for this article. [source]

Improving hand function in children with cerebral palsy.

ACTA PAEDIATRICA, Issue 3 2009
Theory, evidence, intervention
No abstract is available for this article. [source]

Factors of significance for mobility in children with myelomeningocele

ACTA PAEDIATRICA, Issue 2 2003
S Norrlin
Aim: To investigate neurological impairment, hand function and cognitive function in a group of children with myelomeningocele, in order to identify factors of significance for independent mobility and the physical assistance required for mobility in daily activities. Methods: The study material comprised 32 children, aged 6,11 y and without mental retardation. Mobility was assessed with the Pediatric Evaluation of Disability Inventory, scored as caregiver assistance. Statistical differences and correlations between the caregiver assistance scores and the selected variables were analysed. Results: Nine children scored independent mobility. The independent children had better hand coordination (p= 0.004) and walking ability (p= 0.01), lower cele levels (p= 0.011), higher performance IQ (p= 0.027), better visuospatial function (p= 0.029) and executive function (p= 0.037) than the others. The caregiver assistance scores were lower for both the children with early and severe symptoms of brainstem dysfunction and the children with scoliosis. Statistically significant correlations were found between the need for caregiver assistance and reduced walking ability, high cele level, poor hand strength and coordination, visuospatial function, executive function and performance IQ. In the subgroup of children who needed a wheelchair or walking aids, hand strength was the only variable significantly correlated with caregiver assistance (rs= 0.703, p= 0.000). Conclusion: Most of the children were dependent on others in daily activities. Impaired hand function and cognitive function were significant for mobility, and this has implications for the therapy programme in children with myelomeningocele. [source]

Subthalamic nucleus stimulation for Parkinson's disease preferentially improves akinesia of proximal arm movements compared to finger movements

MOVEMENT DISORDERS, Issue 10 2003
Roland Wenzelburger MD
Abstract Deep brain stimulation of the subthalamic nucleus (STN-DBS) reduces akinesia in Parkinson's disease but its impact on fine motor functions was unknown. We assessed the effects of DBS and a levodopa (L -dopa) test on the timing of the precision grip in 18 patients. Improvement on UPDRS-items reflecting hand functions and the shortening of the first phases of the precision grip were more distinct in the L -dopa test than in the pure STN-DBS condition. Other akinesia items and the time for build-up of lifting force were equally improved in both conditions. This suggests that routine STN-DBS might not be equally effective on all aspects of fine motor functions. © 2003 Movement Disorder Society [source]