Interethnic differences at the thermometric response to cold test: functional disorders of blood circulation in hand fingers and exposure to hand-arm vibration.

PubMed

Riolfi, A; Princivalle, A; Romeo, L; Caramaschi, P; Perbellini, L

2008-02-01

To report some notable aspects regarding thermometric response to cold test in black African subjects compared with Caucasians: both groups comprised persons exposed to hand-arm vibration and controls. An overall sample of 48 workers was examined in order to study their blood circulation in hand fingers: a control group of 12 healthy Caucasian workers never exposed before to hand-arm vibration; 12 Caucasian workers exposed for several years to vibrating tools and affected by occupational Raynaud's phenomenon; 12 healthy black African workers exposed to hand-arm vibration for almost 3 years; and 12 healthy black African workers never exposed to hand-arm vibration. Computerized skin thermometry was performed and thermometric curves were analyzed according to thermometric interpretation criteria such as the area-over-curve (AOC), the fifth minute of recovery/baseline temperature ratio (5REC/BT) and the temperature at the tenth minute of recovery (10REC) after cold test. Thermometric parameters in Caucasian subjects confirmed the basis of the existing literature in controls (basal finger temperature higher than 32 degrees C and complete recovery to the initial temperature after the cold test) and also in patients with Raynaud's phenomenon (basal temperature often lower than control subjects and slow recovery of finger temperature after cold test). Statistically significant difference was found between healthy Caucasians and healthy black subjects in all the parameters tested: healthy black subjects showed values of AOC and 10REC suggesting almost constantly lower finger temperatures during the thermometry test. Black people, both exposed and non-exposed to hand-arm vibration showed thermometric parameters suggesting poor blood microcirculation, which seems even poorer than in Caucasian people complaining Raynaud's phenomenon. Our chronothermometric tests suggest some significant interethnic differences in peripheral microcirculation, which seems rather poor in black

Radiographic hand osteoarthritis: patterns and associations with hand pain and function in a community-dwelling sample.

PubMed

Marshall, M; van der Windt, D; Nicholls, E; Myers, H; Hay, E; Dziedzic, K

2009-11-01

Patterns of radiographic osteoarthritis (ROA) of the hand are often examined by row, with the four joints of the thumb studied inconsistently. The objectives of this study were to determine relationships of ROA at different hand joints, use the findings to define radiographic sub-groups and investigate their associations with pain and function. Sixteen joints in each hand were scored for the presence of ROA in a community-dwelling cohort of adults, 50-years-and-over, with self-reported hand pain or problems. Principal components analysis (PCA) with varimax rotation was used to study patterns of ROA in the hand joints and identify distinct sub-groups. Differences in pain and function between these sub-groups were assessed using Australian/Canadian Osteoarthritis Index (AUSCAN), Grip Ability Test (GAT) and grip and pinch strength. PCA was undertaken on data from 592 participants and identified four components: distal interphalangeal joints (DIPs), proximal interphalangeal joints (PIPs), metacarpophalangeal joints (MCPs), thumb joints. However, the left thumb interphalangeal (IP) joint cross-loaded with the PIP and thumb groups. On this basis, participants were categorised into four radiographic sub-groups: no osteoarthritis (OA), finger only OA, thumb only OA and combined thumb and finger OA. Statistically significant differences were found between the sub-groups for AUSCAN function, and in women alone for grip and pinch strength. Participants with combined thumb and finger OA had the worst scores. Individual thumb joints can be clustered together as a joint group in ROA. Four radiographic sub-groups of hand OA can be distinguished. Pain and functional difficulties were highest in participants with both thumb and finger OA.

Measuring hand function in the young child.

PubMed

Ho, Emily S

2010-01-01

Assessing outcomes is vital in any hand therapy practice setting, as it is the primary method of determining whether or not a treatment program is working. In the pediatric population, determining improvements in hand function can be challenging. The author describes using a developmental perspective to evaluate hand function for infants and young children. The utilization of a consistent approach to play along with standard toys is described in this article as a method to evaluate the quality of hand function throughout developmental grasp patterns. Copyright © 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly

ERIC Educational Resources Information Center

Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah

2009-01-01

On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…

[Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand].

PubMed

Zhu, C; Yi, N; Shi, M N; Liang, Y Y; Zhou, Y B; Dang, R; Qi, Z S; Zhao, H Y

2017-07-20

Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n =18) and comprehensive training group (CT, n =28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups ( t =0.834, P >0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in

The Hand Test: Fifteen Years Later

ERIC Educational Resources Information Center

Hoover, Thomas O.

1978-01-01

The Hand Test, a projective device involving drawings of hands in semi-ambiguous poses, has increased in popularity among clinical and school psychologists in the 15 years since its inception. Research on the test is reviewed and its merit in clinical and diverse assessment situations is discussed. (Author/JAC)

Functional Anatomy of Writing with the Dominant Hand

PubMed Central

Najee-ullah, Muslimah ‘Ali; Hallett, Mark

2013-01-01

While writing performed by any body part is similar in style, indicating a common program, writing with the dominant hand is particularly skilled. We hypothesized that this skill utilizes a special motor network supplementing the motor equivalence areas. Using functional magnetic resonance imaging in 13 normal subjects, we studied nine conditions: writing, zigzagging and tapping, each with the right hand, left hand and right foot. We identified brain regions activated with the right (dominant) hand writing task, exceeding the activation common to right-hand use and the writing program, both identified without right-hand writing itself. Right-hand writing significantly differed from the other tasks. First, we observed stronger activations in the left dorsal prefrontal cortex, left intraparietal sulcus and right cerebellum. Second, the left anterior putamen was required to initiate all the tested tasks, but only showed sustained activation during the right-hand writing condition. Lastly, an exploratory analysis showed clusters in the left ventral premotor cortex and inferior and superior parietal cortices were only significantly active for right-hand writing. The increased activation with right-hand writing cannot be ascribed to increased effort, since this is a well-practiced task much easier to perform than some of the other tasks studied. Because parietal-premotor connections code for particular skills, it would seem that the parietal and premotor regions, together with basal ganglia-sustained activation likely underlie the special skill of handwriting with the dominant hand. PMID:23844132

Functional anatomy of writing with the dominant hand.

PubMed

Horovitz, Silvina G; Gallea, Cecile; Najee-Ullah, Muslimah 'ali; Hallett, Mark

2013-01-01

While writing performed by any body part is similar in style, indicating a common program, writing with the dominant hand is particularly skilled. We hypothesized that this skill utilizes a special motor network supplementing the motor equivalence areas. Using functional magnetic resonance imaging in 13 normal subjects, we studied nine conditions: writing, zigzagging and tapping, each with the right hand, left hand and right foot. We identified brain regions activated with the right (dominant) hand writing task, exceeding the activation common to right-hand use and the writing program, both identified without right-hand writing itself. Right-hand writing significantly differed from the other tasks. First, we observed stronger activations in the left dorsal prefrontal cortex, left intraparietal sulcus and right cerebellum. Second, the left anterior putamen was required to initiate all the tested tasks, but only showed sustained activation during the right-hand writing condition. Lastly, an exploratory analysis showed clusters in the left ventral premotor cortex and inferior and superior parietal cortices were only significantly active for right-hand writing. The increased activation with right-hand writing cannot be ascribed to increased effort, since this is a well-practiced task much easier to perform than some of the other tasks studied. Because parietal-premotor connections code for particular skills, it would seem that the parietal and premotor regions, together with basal ganglia-sustained activation likely underlie the special skill of handwriting with the dominant hand.

Assessment of the Ipsilesional Hand Function in Stroke Survivors: The Effect of Lesion Side.

PubMed

Cunha, Bianca Pinto; de Freitas, Sandra Maria Sbeghen Ferreira; de Freitas, Paulo Barbosa

2017-07-01

The aim of this study was to examine the effect of the side of brain lesion on the ipsilesional hand function of stroke survivors. Twenty-four chronic stroke survivors, equally allocated in 2 groups according to the side of brain lesion (right or left), and 12 sex- and age-matched healthy controls performed the Jebsen-Taylor Hand Function Test (JTHFT), the Nine-Hole Peg Test (9HPT), the maximum power grip strength (PwGS max ) test, and the maximum pinch grip strength (PnGS max ) test. Only the ipsilesional hand of the stroke survivors and both hands (left and right) of the controls were assessed. PwGS max and PnGS max were similar among all tested groups. Performances in JTHFT and 9HPT were affected by the brain injury. Individuals with left brain damage showed better performance in 9HPT than individuals with right brain damage, but performance in JTHFT was similar. Individuals after a brain injury have the capacity to produce maximum strength preserved when using their ipsilesional hand. However, the dexterity of their hands and digits is affected, in particular for stroke individuals with right brain lesion. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Translation, cultural adaptation and reproducibility of the Cochin Hand Functional Scale questionnaire for Brazil

PubMed Central

Chiari, Aline; de Souza Sardim, Carla Caires; Natour, Jamil

2011-01-01

OBJECTIVE: To translate, to perform a cultural adaptation of and to test the reproducibility of the Cochin Hand Functional Scale questionnaire for Brazil. METHODS: First, the Cochin Hand Functional Scale questionnaire was translated into Portuguese and was then back-translated into French. These translations were reviewed by a committee to establish a Brazilian version of the questionnaire to be tested. The validity and reproducibility of the Cochin Hand Functional Scale questionnaire was evaluated. Patients of both sexes, who were aged 18 to 60 years and presented with rheumatoid arthritis affecting their hands, were interviewed. The patients were initially interviewed by two observers and were later interviewed by a single rater. First, the Visual Analogue Scale for hand pain, the Arm, Shoulder and Hand Disability questionnaire and the Health Assessment Questionnaire were administered. The third administration of the Cochin Hand Functional Scale was performed fifteen days after the first administration. Ninety patients were assessed in the present study. RESULTS: Two questions were modified as a result of the assessment of cultural equivalence. The Cronbach's alpha value for this assessment was 0.93. The intraclass intraobserver and interobserver correlation coefficients were 0.76 and 0.96, respectively. The Spearman's coefficient indicated that there was a low level of correlation between the Cochin Hand Functional Scale and the Visual Analogue Scale for pain (0.46) and that there was a moderate level of correlation of the Cochin Scale with the Health Assessment Questionnaire (0.66) and with the Disability of the Arm, Shoulder and Hand questionnaire (0.63). The average administration time for the Cochin Scale was three minutes. CONCLUSION: The Brazilian version of the Cochin Hand Functional Scale was successfully translated and adapted, and this version exhibited good internal consistency, reliability and construct validity. PMID:21789372

Relation between hand function and gross motor function in full term infants aged 4 to 8 months.

PubMed

Nogueira, Solange F; Figueiredo, Elyonara M; Gonçalves, Rejane V; Mancini, Marisa C

2015-01-01

In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. RESULTS revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

Relation between hand function and gross motor function in full term infants aged 4 to 8 months

PubMed Central

Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

2015-01-01

Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437

Evaluation of the kinesthetic sense and function of the hand in early period in operated cervical disc hernia.

PubMed

Kara, Býlge; Yildirim, Yücel; Karadýbak, Dýdem; Acar, Umýt

2006-06-01

A prospective study made into cervical disc hernias. To determine the kinesthetic sense and hand functions, which are important for the patients with cervical disc hernia to return to work life and daily activities that need skill. Neurosurgical department. Data Symptoms in cervical disc hernias and hand functions are affected depending on long-term pain. The evaluation of the hand is essential in assessing the patients' overall recovery and ability to return to daily activities and work life. Thirty-four patients with cervical disc hernia, who were operated on, were included in the study. Eight different test positions in the assessment of the hand's kinesthetic sense and hand function sort (HFS) in the evaluation of the hand function were applied. The disability levels of the patients were determined with The Neck Pain and Disability Scale, on the preoperative and postoperative discharge day and in the postoperative second month. Patients were divided into groups according to the side involved. In the evaluation of the kinesthetic test of the hand, only in the postoperative second month was a significant difference observed between the 1, 2, 3, and 4 test positions of the right side of the groups. On the other hand, no significant difference was found between the groups in the assessment of the hand function. In the measurement of hand functions and disability levels, strong and important correlations were determined. An early assessment of the hand's kinesthetic sense and function is instrumental in the patients' evaluation of recovery and resumption of work.

Talk to the Hand: U.S. Army Biophysical Testing.

PubMed

Santee, William R; Potter, Adam W; Friedl, Karl E

2017-07-01

Many people are unaware of the science underlying the biophysical properties of Soldier clothing and personal protective equipment, yet there is a well-refined biomedical methodology initiated by Army physiologists in World War II. This involves a methodical progression of systematic material testing technologies, computer modeling, and human testing that enables more efficient development and rapid evaluation of new concepts for Soldier health and performance. Sophisticated manikins that sweat and move are a central part of this testing continuum. This report briefly summarizes the evolution and use of one specialized form of the manikin technologies, the thermal hand model, and its use in research on Soldier hand-wear items that sustain dexterity and protect the hand in extreme environments. Thermal manikin testing methodologies were developed to provide an efficient and consistent analytical tool for the rapid evaluation of new clothing concepts. These methods have been upgraded since the original World War II and Korean War eras to include articulation and sweating capabilities, as characterized and illustrated in this article. The earlier "retired" versions of thermal hand models have now been transferred to the National Museum of Health and Science. The biophysical values from manikin testing are critical inputs to the U.S. Army Research Institute of Environmental Medicine mathematical models that provide predictions of soldier comfort, duration of exposure before loss of manual dexterity, and time to significant risk of freezing (skin temperature <-1°C) and nonfreezing cold injuries (skin temperature <5°C). The greater thickness of better insulated handwear reduces dexterity and also increases surface area which makes added insulation increasingly less effective in retaining heat. Measurements of both thermal resistance (insulation) and evaporative resistance (permeability) collectively characterize the biophysical properties and enable mathematical

Effect of sensory and motor connectivity on hand function in pediatric hemiplegia.

PubMed

Gupta, Disha; Barachant, Alexandre; Gordon, Andrew M; Ferre, Claudio; Kuo, Hsing-Ching; Carmel, Jason B; Friel, Kathleen M

2017-11-01

We tested the hypothesis that somatosensory system injury would more strongly affect movement than motor system injury in children with unilateral cerebral palsy (USCP). This hypothesis was based on how somatosensory and corticospinal circuits adapt to injury during development; whereas the motor system can maintain connections to the impaired hand from the uninjured hemisphere, this does not occur in the somatosensory system. As a corollary, cortical injury strongly impairs sensory function, so we hypothesized that cortical lesions would impair hand function more than subcortical lesions. Twenty-four children with unilateral cerebral palsy had physiological and anatomical measures of the motor and somatosensory systems and lesion classification. Motor physiology was performed with transcranial magnetic stimulation and somatosensory physiology with vibration-evoked electroencephalographic potentials. Tractography of the corticospinal tract and the medial lemniscus was performed with diffusion tensor imaging, and lesions were classified by magnetic resonance imaging. Anatomical and physiological results were correlated with measures of hand function using 2 independent statistical methods. Children with disruptions in the somatosensory connectivity and cortical lesions had the most severe upper extremity impairments, particularly somatosensory function. Motor system connectivity was significantly correlated with bimanual function, but not unimanual function or somatosensory function. Both sensory and motor connectivity impact hand function in children with USCP. Somatosensory connectivity could be an important target for recovery of hand function in children with USCP. Ann Neurol 2017;82:766-780. © 2017 American Neurological Association.

Effects of two-handed task training on upper limb function of chronic hemiplegic patients after stroke

PubMed Central

Yang, Byung Il; Song, Bo Kyoung; Joung, Sang Mi

2017-01-01

[Purpose] The purpose of this study was to determine whether two-handed task training is effective on motor learning of injured cerebral cortex activation and upper extremity function recovery after stroke. [Subjects and Methods] Two hemiplegic subjects participated in this study: one patient was affected on the dominant side of the body and the other was affected on the non-dominant side of the body, and both scored in the range of 58–66 in the Fugl-Meyer assessment. The excitability of the corticospinal tract and Manual Function Test were examined. [Results] The excitability of the corticospinal tract and the Manual Function Test showed significant differences in the activation of both sides of the cerebral cortex and in the variation in learning effect of upper extremity motor function recovery in patients with hemiplegic non-dominant hand (left). [Conclusion] The results suggested that two-handed task training had a different influence on dominant hand (right) and non-dominant hand (left) motor recovery. PMID:28210051

Hand Function in Children with an Upper Brachial Plexus Birth Injury: Results of the Nine-Hole Peg Test

ERIC Educational Resources Information Center

Immerman, Igor; Alfonso, Daniel T.; Ramos, Lorna E.; Grossman, Leslie A.; Alfonso, Israel; Ditaranto, Patricia; Grossman, John A. I.

2012-01-01

Aim: The aim of this study was to evaluate hand function in children with Erb upper brachial plexus palsy. Method: Hand function was evaluated in 25 children (eight males; 17 females) with a diagnosed upper (C5/C6) brachial plexus birth injury. Of these children, 22 had undergone primary nerve reconstruction and 13 of the 25 had undergone…

Hand Matters: Left-Hand Gestures Enhance Metaphor Explanation

ERIC Educational Resources Information Center

Argyriou, Paraskevi; Mohr, Christine; Kita, Sotaro

2017-01-01

Research suggests that speech-accompanying gestures influence cognitive processes, but it is not clear whether the gestural benefit is specific to the gesturing hand. Two experiments tested the "(right/left) hand-specificity" hypothesis for self-oriented functions of gestures: gestures with a particular hand enhance cognitive processes…

The evolution of functional hand replacement: From iron prostheses to hand transplantation

PubMed Central

Zuo, Kevin J; Olson, Jaret L

2014-01-01

The hand is an integral component of the human body, with an incredible spectrum of functionality. In addition to possessing gross and fine motor capabilities essential for physical survival, the hand is fundamental to social conventions, enabling greeting, grooming, artistic expression and syntactical communication. The loss of one or both hands is, thus, a devastating experience, requiring significant psychological support and physical rehabilitation. The majority of hand amputations occur in working-age males, most commonly as a result of work-related trauma or as casualties sustained during combat. For millennia, humans have used state-of-the-art technology to design clever devices to facilitate the reintegration of hand amputees into society. The present article provides a historical overview of the progress in replacing a missing hand, from early iron hands intended primarily for use in battle, to today’s standard body-powered and myoelectric prostheses, to revolutionary advancements in the restoration of sensorimotor control with targeted reinnervation and hand transplantation. PMID:25152647

[Study on an Exoskeleton Hand Function Training Device].

PubMed

Hu, Xin; Zhang, Ying; Li, Jicai; Yi, Jinhua; Yu, Hongliu; He, Rongrong

2016-02-01

Based on the structure and motion bionic principle of the normal adult fingers, biological characteristics of human hands were analyzed, and a wearable exoskeleton hand function training device for the rehabilitation of stroke patients or patients with hand trauma was designed. This device includes the exoskeleton mechanical structure and the electromyography (EMG) control system. With adjustable mechanism, the device was capable to fit different finger lengths, and by capturing the EMG of the users' contralateral limb, the motion state of the exoskeleton hand was controlled. Then driven by the device, the user's fingers conducting adduction/abduction rehabilitation training was carried out. Finally, the mechanical properties and training effect of the exoskeleton hand were verified through mechanism simulation and the experiments on the experimental prototype of the wearable exoskeleton hand function training device.

Relationship between self-reported upper limb disability and quantitative tests in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2007-03-15

To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS). A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire. PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%. Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.

Hand reach star excursion balance test: An alternative test for dynamic postural control and functional mobility.

PubMed

Eriksrud, Ola; Federolf, Peter; Anderson, Patrick; Cabri, Jan

2018-01-01

Tests of dynamic postural control eliciting full-body three-dimensional joint movements in a systematic manner are scarce. The well-established star excursion balance test (SEBT) elicits primarily three-dimensional lower extremity joint movements with minimal trunk and no upper extremity joint movements. In response to these shortcomings we created the hand reach star excursion balance test (HSEBT) based on the SEBT reach directions. The aims of the current study were to 1) compare HSEBT and SEBT measurements, 2) compare joint movements elicited by the HSEBT to both SEBT joint movements and normative range of motion values published in the literature. Ten SEBT and HSEBT reaches for each foot were obtained while capturing full-body kinematics in twenty recreationally active healthy male subjects. HSEBT and SEBT areas and composite scores (sum of reaches) for total, anterior and posterior subsections and individual reaches were correlated. Total reach score comparisons showed fair to moderate correlations (r = .393 to .606), while anterior and posterior subsections comparisons had fair to good correlations (r = .269 to .823). Individual reach comparisons had no to good correlations (r = -.182 to .822) where lateral and posterior reaches demonstrated the lowest correlations (r = -.182 to .510). The HSEBT elicited more and significantly greater joint movements than the SEBT, except for hip external rotation, knee extension and plantarflexion. Comparisons to normative range of motion values showed that 3 of 18 for the SEBT and 8 of 22 joint movements for the HSEBT were within normative values. The findings suggest that the HSEBT can be used for the assessment of dynamic postural control and is particularly suitable for examining full-body functional mobility.

Fine motor skills predict performance in the Jebsen Taylor Hand Function Test after stroke.

PubMed

Allgöwer, Kathrin; Hermsdörfer, Joachim

2017-10-01

To determine factors characterizing the differences in fine motor performance between stroke patients and controls. To confirm the relevance of the factors by analyzing their predictive power with regard to the Jebsen Taylor Hand Function Test (JTHFT), a common clinical test of fine motor control. Twenty-two people with slight paresis in an early chronic phase following stroke and twenty-two healthy controls were examined. Performance on the JTHFT, Nine-Hole Peg Test and 2-point discrimination was evaluated. To analyze object manipulation skills, grip forces and temporal measures were examined during (1) lifting actions with variations of weight and surface (2) cyclic movements (3) predictive/reactive catching tasks. Three other aspects of force control included (4) visuomotor tracking (5) fast force changes and (6) grip strength. Based on 9 parameters which significantly distinguished fine motor performance in the two groups, we identified three principal components (factors): grip force scaling, motor coordination and speed of movement. The three factors are shown to predict JTHFT scores via linear regression (R 2 =0.687, p<0.001). We revealed a factor structure behind fine motor impairments following stroke and showed that it explains JTHFT results to a large extend. This result can serve as a basis for improving diagnostics and enabling more targeted therapy. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Sensorimotor performance and function in people with osteoarthritis of the hand: A case-control comparison.

PubMed

Magni, Nicoló Edoardo; McNair, Peter John; Rice, David Andrew

2018-04-01

To determine whether hand left/right judgements, tactile acuity, and body perception are impaired in people with hand OA. To examine the relationships between left right judgements, tactile acuity and hand pain. To explore the relationships between sensorimotor measures (left/right judgements and tactile acuity) and measures of hand function in people with hand OA. Twenty patients with symptomatic hand OA and 19 healthy pain-free controls undertook a hand left/right judgment task, a control left/right judgement task, two-point discrimination (TPD) threshold testing (assessing tactile acuity), a neglect-like symptoms questionnaire (assessing body perception) and several established measures of hand function. Neglect-like symptoms were experienced more frequently in the hand OA group (P < 0.05). People with hand OA were slower (P < 0.05) and less accurate (P < 0.05) in the hand left/right judgement task when compared to healthy controls, with no significant difference in the control task. Significant associations were found between hand left/right judgement reaction time and pain intensity (P < 0.05) and accuracy and pain intensity (P < 0.05). TPD was not different between groups, and no correlation was found between TPD and left/right judgement performance. No association was found between left/right judgement performance and measures of hand function (all P > 0.05). However, TPD (tactile acuity) was related to several measures of hand function (all P < 0.05). People with hand OA had more frequent neglect-like symptoms and were slower and less accurate compared to healthy controls at hand left/right judgments, which was indicative of disrupted working body schema. Future studies may wish to examine whether interventions targeting sensorimotor dysfunction are effective at reducing pain and improving hand function and dexterity in people with hand OA. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Hand disorders, hand function, and activities of daily living in elderly men with type 2 diabetes.

PubMed

Cederlund, Ragnhild I; Thomsen, Niels; Thrainsdottir, Soley; Eriksson, Karl-Fredrik; Sundkvist, Göran; Dahlin, Lars B

2009-01-01

This study aimed to examine hand disorders, symptoms, overall hand function, activities of daily living (ADLs), and life satisfaction in elderly men with type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). Subjects were interviewed and evaluated with a battery of clinical and laboratory tests, including hand assessment, and a questionnaire. HbA1c differed between groups (highest in DM, especially in long-term DM). Limited joint motion (LJM), for example, prayer sign and Dupuytren's contracture, was most common in individuals with DM, followed by individuals with IGT, as compared to those with NGT. Vibrotactile sense was impaired symmetrically in the index and little fingers in DM. However, there were no differences for sensibility, dexterity, grip strength, and cold intolerance between groups. Individuals with long-term (>15 years) DM were more affected regarding sensibility and ADL than individuals with short-term DM, who had more sleep disturbances. ADL difficulties were less among IGT subjects. Vibrotactile sense showed correlations with Semmes-Weinstein monofilament test and static two-point discrimination. Dupuytren's contracture and impaired vibrotactile sense in finger pulps occurred in patients with DM but not in those with IGT, although LJM occurred in both IGT and DM patients. A longer duration of DM was associated with more severe neuropathy and ADL difficulties. Life satisfaction was high, and hand disorders did not have a significant impact on ADL.

Eye-hand preference in schizophrenia: sex differences and significance for hand function.

PubMed

Liu, Yi-Chia; Yang, Yen Kuang; Lee, I Hui; Lin, Keh-Chung; Jeffries, Keith J; Lee, Li-Ching

2004-06-01

Hand preference and eye dominance were investigated in 73 (30 women, 43 men) schizophrenic patients and 71 (30 women, 41 men) healthy controls. There were significantly more schizophrenic patients and normal controls who were significantly right-hand dominant. However, schizophrenic patients showed a significant excess of left-eye dominance relative to controls (65.8% vs 29.6%; Odds Ratio= 4.75, p< .001). In addition, female schizophrenic patients showed a higher rate of nonright (either left or inconsistent) eye dominance (80%) than male schizophrenic patients (55.8%) and controls (33.3%). Analysis of hand performance on the Purdue Pegboard Test indicated that schizophrenic patients who showed crossed eye-hand dominance scored higher than did patients without crossed eye-hand dominance.

Fire Testing of Ethanol-Based Hand Cleaner

DOT National Transportation Integrated Search

1998-04-01

A variety of laboratory and full-scale fire tests were conducted on an ethanol-based gel-type hand cleaner currently used in commercial aircraft lavatories. The waterless-type hand cleaner has a relatively low flash point, raising concern over its fi...

Hand2 loss-of-function in Hand1-expressing Cells Reveals Distinct Roles In Epicardial And Coronary Vessel Development

PubMed Central

Barnes, Ralston M.; Firulli, Beth A.; VanDusen, Nathan J.; Morikawa, Yuka; Conway, Simon J.; Cserjesi, Peter; Vincentz, Joshua W.; Firulli, Anthony B.

2011-01-01

Rationale The bHLH transcription factors Hand1 and Hand2 are essential for embryonic development. Given their requirement for cardiogenesis, it is imperative to determine their impact on cardiovascular function. Objective Deduce the role of Hand2 within the epicardium. Method & Results We engineered a Hand1 allele expressing Cre recombinase. Cardiac Hand1 expression is largely limited to cells of the primary heart field, overlapping little with Hand2 expression. Hand1 is expressed within the septum transversum (ST) and the Hand1-lineage marks the proepicardial organ and epicardium. To examine Hand factor functional overlap, we conditionally deleted Hand2 from Hand1-expressing cells. Hand2 mutants display defective epicardialization and fail to form coronary arteries, coincident with altered ECM deposition and Pdgfr expression. Conclusion These data demonstrate a hierarchal relationship whereby transient Hand1 ST expression defines epicardial precursors that are subsequently dependent upon Hand2 function. PMID:21350214

A Wearable Multi-Site System for NMES-Based Hand Function Restoration.

PubMed

Crema, Andrea; Malesevic, Nebojsa; Furfaro, Ivan; Raschella, Flavio; Pedrocchi, Alessandra; Micera, Silvestro

2018-02-01

Reaching and grasping impairments significantly affect the quality of life for people who have experienced a stroke or spinal cord injury. The long-term well-being of patients varies greatly according to the restorable residual capabilities. Electrical stimulation could be a promising solution to restore motor functions in these conditions, but its use is not clinically widespread. Here, we introduce the HandNMES, an electrode array (EA) for neuromuscular electrical stimulation (NMES) aimed at grasp training and assistance. The device was designed to deliver electrical stimulation to extrinsic and intrinsic hand muscles. Six independent EAs, positioned on the user forearm and hand, deliver NMES pulses originating from an external stimulator equipped with demultiplexers for interfacing with a large number of electrodes. The garment was designed to be adaptable to user needs and anthropometric characteristics; size, shape, and contact materials can be customized, and stimulation characteristics such as intensity of stimulation and virtual electrode location, and size can be adjusted. We performed extensive tests with nine healthy subjects showing the efficacy of the HandNMES in terms of stimulation performance and personalization. Because encouraging results were achieved, in the coming months, the HandNMES device will be tested in pilot clinical trials.

Abnormally reduced primary motor cortex output is related to impaired hand function in chronic stroke.

PubMed

Buetefisch, Cathrin M; Pirog Revill, Kathleen; Haut, Marc W; Kowalski, Greg M; Wischnewski, Miles; Pifer, Marissa; Belagaje, Samir R; Nahab, Fadi; Cobia, Derin J; Hu, Xiaoping; Drake, Daniel; Hobbs, Gerald

2018-06-20

Stroke often involves primary motor cortex (M1) and its corticospinal projections (CST). As hand function is critically dependent on these structures, its recovery is often incomplete. The neuronal substrate supporting affected hand function is not well understood but likely involves reorganized M1 and CST of the lesioned hemisphere (M1 IL and CST IL ). We hypothesized that affected hand function in chronic stroke is related to structural and functional reorganization of M1 IL and CST IL . We tested 18 patients with chronic ischemic stroke involving M1 or CST. Their hand function was compared to 18 age matched healthy subjects. M1 IL thickness and CST IL fractional anisotropy (FA) were determined with MRI and compared to measures of the other hemisphere. Transcranial magnetic stimulation (TMS) was applied to M1 IL to determine its input output function (stimulus response curve, SRC). The plateau of the SRC (MEPmax), inflection point and slope parameters of the curve were extracted. Results were compared to measures in 12 age matched healthy controls. MEPmax of M1 IL was significantly smaller (p=0.02) in the patients, indicating reduced CST IL motor output, and was correlated with impaired hand function (p=0.02). M1 IL thickness (p<0.01) and CST IL -FA (p<0.01) were reduced but did not correlate with hand function. The results indicate that employed M1 IL or CST IL structural measures do not explain the extent of impairment in hand function once M1 and CST are sufficiently functional for TMS to evoke a motor potential. Instead, impairment of hand function is best explained by the abnormally low output from M1 IL .

Hand Function and Appearance following Reconstruction for Congenital Hand Differences: A Qualitative Analysis of Children and Parents.

PubMed

Kelley, Brian P; Franzblau, Lauren E; Chung, Kevin C; Carlozzi, Noelle; Waljee, Jennifer F

2016-07-01

Congenital hand differences induce social, psychological, and functional challenges for children. However, little is known about how children perceive their outcomes after reconstructive or what concerns children have. A total of 33 children (aged 6 to 17 years) who were treated for congenital hand differences, and their parents, participated in qualitative, semistructured interviews regarding the child's hand function and appearance. Discussion focused on the influence of congenital hand differences on the child's daily activities, school, and participation in sports and music. The interviews were open format to allow for spontaneous emergence of relevant themes followed by guided questioning. The interviews were transcribed verbatim and analyzed using qualitative coding, iterative comparisons, and frequency analysis to reveal perceptions of children and parents. In this sample, 73 percent of children and parents reported difficulty with hand function. Children experienced difficulties with personal care (58 percent), school activities (30 percent), and household tasks (27 percent). Children were bothered by hand appearance (48 percent), pain (30 percent), and weakness (24 percent). Complex anomalies were associated with greater disability and limitation in sports and music. Children with congenital hand differences are concerned with the aesthetics of their hands and limitations in their ability to perform activities. Children were often discouraged by activities that their peers accomplished easily, but with increasing age demonstrated adaptive behaviors to accommodate in their "own way," suggesting the uniqueness of their limitations. Patients may benefit from early hand therapy guided toward areas of concern to enhance functional adaptation.

Influence of body heat content on hand function during prolonged cold exposures.

PubMed

Flouris, A D; Cheung, S S; Fowles, J R; Kruisselbrink, L D; Westwood, D A; Carrillo, A E; Murphy, R J L

2006-09-01

We examined the influence of 1) prior increase [preheating (PHT)], 2) increase throughout [heating (HT)], and 3) no increase [control (Con)] of body heat content (H(b)) on neuromuscular function and manual dexterity of the hands during a 130-min exposure to -20 degrees C (coldEx). Ten volunteers randomly underwent three passive coldEx, incorporating a 10-min moderate-exercise period at the 65th min while wearing a liquid conditioning garment (LCG) and military arctic clothing. In PHT, 50 degrees C water was circulated in the LCG before coldEx until core temperature was increased by 0.5 degrees C. In HT, participants regulated the inlet LCG water temperature throughout coldEx to subjective comfort, while the LCG was not operating in Con. Thermal comfort, rectal temperature, mean skin temperature, mean finger temperature (T(fing)), change in H(b) (DeltaH(b)), rate of body heat storage, Purdue pegboard test, finger tapping, handgrip, maximum voluntary contraction, and evoked twitch force of the first dorsal interosseus muscle were recorded. Results demonstrated that, unlike in HT and PHT, thermal comfort, rectal temperature, mean skin temperature, twitch force, maximum voluntary contraction, and finger tapping declined significantly in Con. In contrast, T(fing) and Purdue pegboard test remained constant only in HT. Generalized estimating equations demonstrated that DeltaH(b) and T(fing) were associated over time with hand function, whereas no significant association was detected for rate of body heat storage. It is concluded that increasing H(b) not only throughout but also before a coldEx is effective in maintaining hand function. In addition, we found that the best indicator of hand function is DeltaH(b) followed by T(fing).

How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives.

PubMed

Chiu, Haw-Yen; Hsu, Hsiu-Yun; Kuo, Li-Chieh; Su, Fong-Chin; Yu, Hui-I; Hua, Shih-Che; Lu, Chieh-Hsiang

2014-01-01

To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA) test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM) and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination (S2PD and M2PD), maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05) in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001) revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001) between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.

How the Impact of Median Neuropathy on Sensorimotor Control Capability of Hands for Diabetes: An Achievable Assessment from Functional Perspectives

PubMed Central

Chiu, Haw-Yen; Hsu, Hsiu-Yun; Kuo, Li-Chieh; Su, Fong-Chin; Yu, Hui-I; Hua, Shih-Che; Lu, Chieh-Hsiang

2014-01-01

To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA) test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM) and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination (S2PD and M2PD), maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05) in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001) revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001) between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective. PMID:24722361

Determination of the relationship between cognitive function and hand dexterity in patients with chronic obstructive pulmonary disease (COPD): a cross-sectional study.

PubMed

Soysal Tomruk, Melda; Ozalevli, Sevgi; Dizdar, Gorkem; Narin, Selnur; Kilinc, Oguz

2015-07-01

Hand dexterity is important for daily living activities and can be related to cognitive functions in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between cognitive dysfunction and hand dexterity in patients with COPD. 35 COPD patients and 36 healthy individuals were assessed. The Minnesota Hand Dexterity Test and Mini Mental State Examination (MMSE) were used for assessment of cognitive function and hand dexterity. Hand dexterity test scores and cognitive function of COPD patients' were significantly lower than the healthy group (p < 0.01). The MMSE scores were negatively correlated with hand dexterity scores in the COPD group (p < 0.05). There was a relationship between cognitive function and hand dexterity in the patients with COPD; however, hand dexterity did not alter according to hypoxemia severity. Hand dexterity which is important in daily living activities should be evaluated in greater detail with further studies in COPD patients.

Effect of neurofeedback and electromyographic-biofeedback therapy on improving hand function in stroke patients.

PubMed

Rayegani, S M; Raeissadat, S A; Sedighipour, L; Rezazadeh, I Mohammad; Bahrami, M H; Eliaspour, D; Khosrawi, S

2014-01-01

The aim of the present study was to evaluate the effect of applying electroencephalogram (EEG) biofeedback (neurobiofeedback) or electromyographic (EMG) biofeedback to conventional occupational therapy (OT) on improving hand function in stroke patients. This study was designed as a preliminary clinical trial. Thirty patients with stroke were entered the study. Hand function was evaluated by Jebsen Hand Function Test pre and post intervention. Patients were allocated to 3 intervention cohorts: (1) OT, (2) OT plus EMG-biofeedback therapy, and (3) OT plus neurofeedback therapy. All patients received 10 sessions of conventional OT. Patients in cohorts 2 and 3 also received EMG-biofeedback and neurofeedback therapy, respectively. EMG-biofeedback therapy was performed to strengthen the abductor pollicis brevis (APB) muscle. Neurofeedback training was aimed at enhancing sensorimotor rhythm after mental motor imagery. Hand function was improved significantly in the 3 groups. The spectral power density of the sensorimotor rhythm band in the neurofeedback group increased after mental motor imagery. Maximum and mean contraction values of electrical activities of the APB muscle during voluntary contraction increased significantly after EMG-biofeedback training. Patients in the neurofeedback and EMG-biofeedback groups showed hand improvement similar to conventional OT. Further studies are suggested to assign the best protocol for neurofeedback and EMG-biofeedback therapy.

Development and pilot testing of HEXORR: Hand EXOskeleton Rehabilitation Robot

PubMed Central

2010-01-01

Background Following acute therapeutic interventions, the majority of stroke survivors are left with a poorly functioning hemiparetic hand. Rehabilitation robotics has shown promise in providing patients with intensive therapy leading to functional gains. Because of the hand's crucial role in performing activities of daily living, attention to hand therapy has recently increased. Methods This paper introduces a newly developed Hand Exoskeleton Rehabilitation Robot (HEXORR). This device has been designed to provide full range of motion (ROM) for all of the hand's digits. The thumb actuator allows for variable thumb plane of motion to incorporate different degrees of extension/flexion and abduction/adduction. Compensation algorithms have been developed to improve the exoskeleton's backdrivability by counteracting gravity, stiction and kinetic friction. We have also designed a force assistance mode that provides extension assistance based on each individual's needs. A pilot study was conducted on 9 unimpaired and 5 chronic stroke subjects to investigate the device's ability to allow physiologically accurate hand movements throughout the full ROM. The study also tested the efficacy of the force assistance mode with the goal of increasing stroke subjects' active ROM while still requiring active extension torque on the part of the subject. Results For 12 of the hand digits'15 joints in neurologically normal subjects, there were no significant ROM differences (P > 0.05) between active movements performed inside and outside of HEXORR. Interjoint coordination was examined in the 1st and 3rd digits, and no differences were found between inside and outside of the device (P > 0.05). Stroke subjects were capable of performing free hand movements inside of the exoskeleton and the force assistance mode was successful in increasing active ROM by 43 ± 5% (P < 0.001) and 24 ± 6% (P = 0.041) for the fingers and thumb, respectively. Conclusions Our pilot study shows that this device

Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

PubMed

Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin

2017-10-01

The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

Hand grip strength and dexterity function in children aged 6-12 years: A cross-sectional study.

PubMed

Omar, Mohammed T A; Alghadir, Ahmad H; Zafar, Hamayun; Al Baker, Shaheerah

Cross-sectional and clinical measurement. Assessment of hand function considers an essential part in clinical practice. To develop normative values of hand grip strength and dexterity function for 6-12-year-old children in Saudi Arabia. Grip strength and dexterity function was measured in 525 children using Grip Track hand dynamometer (JTECH Medical, Midvale, UT, USA) and 9-hole pegboard test respectively. The grip strength and dexterity function was improved as age progressed regardless of gender. Across all age groups, the hand grip strength of boys was significantly higher than girls for dominant hand (31.75 ± 10.33 vs 28.24 ± 9.35; P < .001) and nondominant hand (31.01 ± 10.27 vs 27.27 ± 9.30; P < .001). The girls performed slightly faster than boys for dominant hand (19.70 vs 20.68; P < .05) and nondominant hand (21.79 vs 23.46; P < .05). In general, girls completed a 9-HPT faster than boys in the 2 of 7 age groups: 11 years (9-HPT scores = 2.10 seconds; P < .01) and 12 years (9-HPT scores = 1.93 seconds; P < .01). The overall patterns of hand grip strength and dexterity function observed in the present study are similar to the previous studies that established acceleration of grip strength with advanced age, and faster performance scores in older children than younger children in both genders. Norms of hand grip strength and dexterity enable therapists to identify some developmental characteristics of hand function among Saudi children, determine the presence of impairment, and compare scores from children in different clinical settings. Not applicable. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Determining the functional sensibility of the hand in patients with peripheral nerve repair: Feasibility of using a novel manual tactile test for monitoring the progression of nerve regeneration.

PubMed

Hsu, Hsiu-Yun; Kuo, Li-Chieh; Kuan, Ta-Shen; Yang, Hsiu-Ching; Su, Fong-Chin; Chiu, Haw-Yen; Shieh, Shyh-Jou

Case-controlled cohort study. Sensory function is difficult to observe during nerve regeneration processes. Traditional sensory tests are limited to identifying the level of functioning hand sensation for sensory stimulus is given passively to the cutaneous surface of the hand. To examine the outcome changes in the manual tactile test (MTT), Semmes-Weinstein monofilament (SWM) and 2-point discrimination (2PD) tests for patients with nerve repair and to investigate the concurrent validity of MTT by comparing it with the results of traditional tests. Fifteen patients with nerve injury of the upper limbs were recruited, along with 15 matched healthy controls. The MTT, SWM, and 2PD tests were used to examine the sensory status of the subjects. Three subtests (barognosis, roughness differentiation, and stereognosis) in MTT showed that the patients improved with time. A moderate and mild correlation was found between the MTT and 2PD results and between the barognosis and SWM results. The MTT provides practical and functional perspectives on detecting nerve progression during the courses of degeneration and regeneration. IV. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Real-time and wearable functional electrical stimulation system for volitional hand motor function control using the electromyography bridge method

PubMed Central

Wang, Hai-peng; Bi, Zheng-yang; Zhou, Yang; Zhou, Yu-xuan; Wang, Zhi-gong; Lv, Xiao-ying

2017-01-01

Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy. A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method. Through a series of novel design concepts, including the integration of a detecting circuit and an analog-to-digital converter, a miniaturized functional electrical stimulation circuit technique, a low-power super-regeneration chip for wireless receiving, and two wearable armbands, a prototype system has been established with reduced size, power, and overall cost. Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects, the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy. Test results showed that wrist flexion/extension, hand grasp, and finger extension could be reproduced with high accuracy and low latency. This system can build a bridge of information transmission between healthy limbs and paralyzed limbs, effectively improve voluntary participation of hemiplegic patients, and elevate efficiency of rehabilitation training. PMID:28250759

Electrogoniometer measurement and directional analysis of wrist angles and movements during the Sollerman hand function test.

PubMed

Dauncey, Thomas; Singh, Harvinder P; Dias, Joseph J

Clinical measurement. To investigate the characteristics of wrist motion (area, axis, and location) during activities of daily living (ADL) using electrogoniometry. A sample of 83 normal volunteers performed the Sollerman hand function test (SHFT) with a flexible biaxial electrogoniometer applied to their wrists. This technique is accurate and reliable and has been used before for assessment of wrist circumduction in normal volunteers. A software package was used to overlay an ellipse of best fit around the 2-dimensional trace of the electrogoniometer mathematically computing the area, location, and axis angle of the ellipse. Most ADL could be completed within 20% of the total area of circumduction (3686°° ± 1575°°) of a normal wrist. An oblique plane in radial extension and ulnar flexion (dart-throwing motion plane) was used for rotation (-14° ± 32°) and power grip tasks (-29° ± 25°) during ADL; however, precision tasks (4° ± 28°), like writing, were performed more often in the flexion extension plane. In the dominant hand, only 2 power tasks were located in flexion region (cutting play dough [ulnar] and pouring carton [radial]), precision tasks were located centrally, and rotation and other power tasks were located in extension region. This study has identified that wrist motion during the ADL requires varying degrees of movement in oblique planes. Using electrogoniometry, we could visualize the area, location, and plane of motion during ADL. This could assist future researchers to compare procedures leading to loss of motion in specific quadrants of wrist motion and its impact on patient's ability in performing particular ADL. It could guide hand therapists to specifically focus on retraining the ADL that may be affected when wrist range of motion is lost after injury. Diagnostic level III. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Dual-task performance involving hand dexterity and cognitive tasks and daily functioning in people with schizophrenia: a pilot study.

PubMed

Lin, Keh-chung; Wu, Yi-fang; Chen, I-chen; Tsai, Pei-luen; Wu, Ching-yi; Chen, Chia-ling

2015-01-01

This study investigated separate and concurrent performance on cognitive and hand dexterity tasks and the relationship to daily functioning in 16 people with schizophrenia and 16 healthy control participants. Participants performed the Purdue Pegboard Test and the Serial Seven Subtraction Test under single- and dual-task conditions and completed two daily functioning evaluations. The hand dexterity of all participants declined in the dual-task condition, but the discrepancy between single-task and dual-task hand dexterity was greater in the schizophrenia group than in the control group (p<.03, d>.70, for all). The extent of discrepancy in hand dexterity was negatively correlated with daily functioning in the schizophrenia group (rs=-.3 to -.5, ps=.04-.26). Ability to perform dual tasks may be an indicator of daily functioning in people with schizophrenia. Use of dual-task training may be considered as a therapeutic activity with these clients. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Comparison of Hand Function Between Children With Type 1 Diabetes Mellitus and Children Without Type 1 Diabetes Mellitus.

PubMed

Atay, Canan; Kaya Mutlu, Ebru; Taskiran, Hanifegul; Ozgen, Ilker Tolga

2018-01-01

This study compared the hand function of children between the ages of 8 and 12 years with type 1 diabetes mellitus (T1DM) with that of children without diabetes. The Modified Jebsen-Taylor Hand Function Test and the Purdue Pegboard Test were used to assess hand function. The Pediatric Quality of Life Inventory 4.0 was used for evaluating health-related quality of life. Duration of writing was found to be significantly longer on the dominant side of the T1DM group compared with the children without T1DM. The durations of card turning, moving large, light objects, and large, heavy objects on the nondominant side of the T1DM group were also found to be significantly longer than those in the children without T1DM. The total scale score of health-related quality of life was significantly lower in the T1DM group compared with the children without T1DM. T1DM affects hand function, particularly the dominant side for writing and nondominant side for card turning and moving large objects.

Perspectives on hand function in girls and women with Rett syndrome.

PubMed

Downs, Jenny; Parkinson, Stephanie; Ranelli, Sonia; Leonard, Helen; Diener, Pamela; Lotan, Meir

2014-06-01

Rett syndrome is a rare neurodevelopmental disorder that is usually associated with a mutation on the X-linked MECP2 gene. Hand function is particularly affected and we discuss theoretical and practical perspectives for optimising hand function in Rett syndrome. We reviewed the literature pertaining to hand function and stereotypies in Rett syndrome and developed a toolkit for their assessment and treatment. There is little published information on management of hand function in Rett syndrome. We suggest assessment and treatment strategies based on available literature, clinical experience and grounded in theories of motor control and motor learning. Additional studies are needed to determine the best treatments for hand function in Rett syndrome. Meanwhile, clinical needs can be addressed by supplementing the evidence base with an understanding of the complexities of Rett syndrome, clinical experience, environmental enrichment animal studies and theories of motor control and motor learning.

The effects of mirror therapy on arm and hand function in subacute stroke in patients.

PubMed

Radajewska, Alina; Opara, Józef A; Kucio, Cezary; Błaszczyszyn, Monika; Mehlich, Krzysztof; Szczygiel, Jarosław

2013-09-01

The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

Variations in cerebral organization as a function of handedness, hand posture in writing, and sex.

PubMed

Levy, J; Reid, M

1978-06-01

During the past century, it has become increasingly apparent that there is a great deal of variation in the direction and degree of cerebral lateralization, a plurality of people having language and related functions strongly specialized to the left hemisphere and visuospatial functions strongly specialized to the right, with substantial minorities manifesting various deviations from this pattern. In particular, in 35%-50% of sinistrals and 1%-10% of dextrals, the right hemisphere is specialized for linguistic skills, and in some unknown fraction of the two handedness groups, verbal and/or spatial abilities are, to varying extents, bilateralized. Levy (1973) suggested that the hand posture adopted during writing might be an index of the lateral relationship between the dominant writing hand and the language hemisphere, a normal posture indicating contralateral language specialization, and an inverted posture indicating ipsilateral language specialization. In the present investigation, two tachistoscopic tests of cerebral lateralization, one measuring spatial functions and one measuring verbal function, were administered to 73 subjects classified by handedness, hand posture during writing, and sex. Among both dextral and sinistral subjects with a normal writing posture, language and spatial functions were specialized to the contralateral and ipsilateral hemispheres, respectively, and lateral differentiation of the brain was strong. The reverse was seen in subjects having an inverted writing posture. In all groups, females were less laterally differentiated than males. In 70 out of 73 subjects, the direction of cerebral laterization was accurately predicted by handedness and hand posture. The 3 subjects (2 females and 1 male) who failed to manifest the predicted relations were all left-handers having an inverted hand posture . In this group, lateral differentiation was so weak that the reliability of the tachistoscopic tests was reduced, and we attribute these three

Functional magnetic resonance imaging exploration of combined hand and speech movements in Parkinson's disease.

PubMed

Pinto, Serge; Mancini, Laura; Jahanshahi, Marjan; Thornton, John S; Tripoliti, Elina; Yousry, Tarek A; Limousin, Patricia

2011-10-01

Among the repertoire of motor functions, although hand movement and speech production tasks have been investigated widely by functional neuroimaging, paradigms combining both movements have been studied less so. Such paradigms are of particular interest in Parkinson's disease, in which patients have specific difficulties performing two movements simultaneously. In 9 unmedicated patients with Parkinson's disease and 15 healthy control subjects, externally cued tasks (i.e., hand movement, speech production, and combined hand movement and speech production) were performed twice in a random order and functional magnetic resonance imaging detected cerebral activations, compared to the rest. F-statistics tested within-group (significant activations at P values < 0.05, familywise error corrected), between-group, and between-task comparisons (regional activations significant at P values < 0.001, uncorrected, with cluster size > 10 voxels). For control subjects, the combined task activations comprised the sum of those obtained during hand movement and speech production performed separately, reflecting the neural correlates of performing movements sharing similar programming modalities. In patients with Parkinson's disease, only activations underlying hand movement were observed during the combined task. We interpreted this phenomenon as patients' potential inability to recruit facilitatory activations while performing two movements simultaneously. This lost capacity could be related to a functional prioritization of one movement (i.e., hand movement), in comparison with the other (i.e., speech production). Our observation could also reflect the inability of patients with Parkinson's disease to intrinsically engage the motor coordination necessary to perform a combined task. Copyright © 2011 Movement Disorder Society.

Manual Tactile Test Predicts Sensorimotor Control Capability of Hands for Patients With Peripheral Nerve Injury.

PubMed

Hsu, Hsiu-Yun; Shieh, Shyh-Jou; Kuan, Ta-Shen; Yang, Hsiu-Ching; Su, Fong-Chin; Chiu, Haw-Yen; Kuo, Li-Chieh

2016-06-01

To comprehend the merits of a Manual Tactile Test (MTT) in assessing hand sensorimotor functions by exploring the relations among 3 subtests along with the precision pinch performances for patients with peripheral nerve injuries (PNIs); and to understand the accuracy of the MTT by constructing the sensitivity and specificity of the test for patients with PNI. Case-control study. Hospital and local community. Patients with PNI (n=28) were recruited along with age-, sex-, and handedness-matched healthy controls (n=28) (N=56). Not applicable. The Semmes-Weinstein monofilament, moving and static 2-point discrimination, roughness differentiation, stereognosis and barognosis subtests of the MTT, and precision pinch performance were used to examine the sensory and sensorimotor status of the hand. The worst results in all sensibility tests were found for the patients with PNI (P<.001) in comparison with the controls. Multiple linear regression analysis showed the MTT was a better indicator for predicting the sensorimotor capacity of hands in the patients with PNI (r(2)=.189, P=.003) than the traditional test (r(2)=.088, P=.051). The results of the receiver operating characteristic curve estimation show that the area under the curve was .968 and .959 for the roughness differentiation and stereognosis subtests, respectively, and .853 for the barognosis subtest, therefore revealing the accuracy of the MTT in assessing sensorimotor status for patients with PNI. This study indicates that the MTT is highly accurate and a significant predictor of sensorimotor performance in hands of patients with PNI. The MTT could therefore help clinicians obtain a better understanding of the sensorimotor and functional status of the hand with nerve injuries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Factors predicting health status and recovery of hand function after hand burns in the second year after hospital discharge.

PubMed

Knight, Amber; Wasiak, Jason; Salway, Jacqueline; O'Brien, Lisa

2017-02-01

Hands are the most commonly burnt body part given humans' innate response to guard their face from injury, and are known to have detrimental functional and psychological consequences. Conflicting evidence exists regarding the impact of hand burns on long-term health status and global functioning. The objective of this study was to identify patient and clinical characteristics that predict health status and hand function of people at 12-24 months after hand burn. The Burns Specific Health Scale-Brief (BSHS-B) and the Brief Michigan Hand Outcome Questionnaire (Brief MHQ) were administered to community-dwelling adults who were between one and two years after admission to a statewide burns service for burns including one or both hands. Demographic, injury, and treatment data were collected to identify which factors predict health status and hand function in the second year after admission. Linear regression analyses adjusted for total burn surface area and burn depth were conducted to identify important predictors or outcomes. The sample (n=41) was 80.5% male, with a mean age of 44.5 years and total body surface area (TBSA) of 8.4%. Psychiatric illness (regression coefficient -56.6, confidence interval (95% CI) -76.70, -36.49) and female gender (-20.3; 95% CI -0.77, -40.29) were key predictors of poorer global health status on the BSHS-B. Females also scored worse on body image (-5.35; 95% CI -1.83, -8.87) and work (-4.13; 95% CI -0.64, -7.62) domains of BSHS-B. The need for reconstructive or secondary surgery (-38.84; 95% CI -58.04, -19.65) and female gender (-16.30; 95% CI -4.03, -28.57) were important predictors of poorer hand function. Women and those with a history of psychiatric illness are particularly vulnerable to poorer outcomes in health status and/or hand function after burns, and may benefit from more intensive rehabilitation support and long-term follow-up. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Functional study of hands among patients dialysed for more than 10 years.

PubMed

Chazot, C; Chazot, I; Charra, B; Terrat, J C; Vanel, T; Calemard, E; Ruffet, M; Laurent, G

1993-01-01

Sixty-six haemodialysed (HD) in centre patients (24 h/m2/week, acetate bath, cuprophane membrane), with a mean age of 59.2 years, treated for 16.7 +/- 4.5 years, underwent clinical examination of their hands to determine anatomical and functional alterations. For each hand a functional score was calculated from a medicolegal technique based on sensitivity and angulation amplitude (rating from 0 to 100). Dialysis-related arthropathy (DRA), including carpal-tunnel (CT) syndrome, was scored as well as hand muscle amyotrophia. Trigger fingers, abnormal synovial hypertrophy, and one or more non-functional tendons were found in 15, 26, and 33% of the patients respectively. Thirteen percent had pseudoporphyria. Amyotrophy was moderate or severe in 39%. The global functional score (mean of the two unilateral functional scores) decreased with time spent on haemodialysis and was correlated with the DRA score. The unilateral functional score was linked to tendinous lesions, amyotrophy, and presence of pulses, but not to CT surgery or presence of AV fistula. Hands with ulnar insult at the elbow shown by electromyography had significantly lower functional scores. Repercussions of hand functional alteration may have an important social and psychological impact in daily life. The responsibility of amyloidosis is evidenced by tendinous lesions and nervous entrapment. Ulnar palsy is also important because of the vital motor role of that nerve in hand function.

Hand function and quality of life before and after fasciectomy for Dupuytren contracture.

PubMed

Engstrand, Christina; Krevers, Barbro; Nylander, Göran; Kvist, Joanna

2014-07-01

To describe changes in joint motion, sensibility, and scar pliability and to investigate the patients' expectations, self-reported recovery, and satisfaction with hand function, disability, and quality of life after surgery and hand therapy for Dupuytren disease. This prospective cohort study collected measurements before surgery and 3, 6, and 12 months after surgery and hand therapy. Ninety patients with total active extension deficits of 60° or more from Dupuytren contracture were included. Outcomes measures were range of motion; sensibility; scar pliability; self-reported outcomes on expectations, recovery, and satisfaction with hand function; Disabilities of the Arm, Shoulder, and Hand scores; safety and social issues of hand function; physical activity habits; and quality of life with the Euroqol. The extension deficit decreased, and there was a transient decrease in active finger flexion during the first year after surgery. Sensibility remained unaffected. Generally, patients with surgery on multiple fingers had worse scar pliability. The majority of the patients had their expectations met, and at 6 months, 32% considered hand function as fully recovered, and 73% were satisfied with their hand function. Fear of hurting the hand and worry about not trusting the hand function were of greatest concern among safety and social issues. The Disability of the Arm, Shoulder, and Hand score and the Euroqol improved over time. After surgery and hand therapy, disability decreased independent of single or multiple operated fingers. The total active finger extension improved enough for the patients to reach a functional range of motion despite an impairment of active finger flexion still present 12 months after treatment. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Nerve Transfers for Improved Hand Function Following Cervical Spinal Cord Injury

DTIC Science & Technology

the cervical spine resulting in diminished or complete loss of arm and/or hand function. Cervical SCI patients consistently rank hand function as the...most desired function above bowel and bladder function, sexual function, standing, and pain control. The overall goal of the proposed study is to...evaluate the efficacy of nerve transfers to treat patients with cervical SCIs. Over the last decade, nerve transfers have been used with increasing

Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema.

PubMed

Karadibak, Didem; Yavuzsen, Tugba

2015-06-01

[Purpose] This study evaluated the functional ability and kinesthetic sense of the hands of women with breast cancer-related lymphedema. [Subjects and Methods] Fifty-seven women experiencing lymphedema after breast surgery and adjuvant radiotherapy were included. The patients were divided into two groups: women with hand edema (HE+, n = 29) and without hand edema (HE-, n = 28) after breast cancer treatment. Arm edema severity, hand size, functional mobility and kinesthetic sense of the hand, and daily living skills were evaluated. [Results] The mean age of the patients was 55.8 years. In both groups, functional mobility, kinesthetic sense, and daily living skills decreased significantly with increasing edema severity. However, there was no significant difference between groups with respect to functional mobility or daily living skills. The kinesthetic sense of the hand was better in the HE- group than the HE+ group. There was a significant negative relationship between the severity of edema and hand function. [Conclusion] Breast cancer-related lymphedema can negatively impact women's functional mobility and kinesthetic sense of the hands as well as daily living skills.

Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema

PubMed Central

Karadibak, Didem; Yavuzsen, Tugba

2015-01-01

[Purpose] This study evaluated the functional ability and kinesthetic sense of the hands of women with breast cancer-related lymphedema. [Subjects and Methods] Fifty-seven women experiencing lymphedema after breast surgery and adjuvant radiotherapy were included. The patients were divided into two groups: women with hand edema (HE+, n = 29) and without hand edema (HE−, n = 28) after breast cancer treatment. Arm edema severity, hand size, functional mobility and kinesthetic sense of the hand, and daily living skills were evaluated. [Results] The mean age of the patients was 55.8 years. In both groups, functional mobility, kinesthetic sense, and daily living skills decreased significantly with increasing edema severity. However, there was no significant difference between groups with respect to functional mobility or daily living skills. The kinesthetic sense of the hand was better in the HE− group than the HE+ group. There was a significant negative relationship between the severity of edema and hand function. [Conclusion] Breast cancer-related lymphedema can negatively impact women’s functional mobility and kinesthetic sense of the hands as well as daily living skills. PMID:26180295

Hand Strength, Handwriting, and Functional Skills in Children With Autism.

PubMed

Alaniz, Michele L; Galit, Eleanor; Necesito, Corina Isabel; Rosario, Emily R

2015-01-01

To establish hand strength development trends in children with autism and to investigate correlations between grip and pinch strength, components of handwriting, and functional activities in children with and without autism. Fifty-one children were divided into two groups: typically developing children and children on the autism spectrum. Each child completed testing for pinch and grip strength, handwriting legibility, pencil control, and independence in functional activities. The children with autism followed the same strength development trends as the typically developing children. Grip strength correlated with pencil control in both groups and with handwriting legibility in the typically developing children but not in the children with autism. Grip and pinch strength correlated with independence with functional activities in both groups. This study provides evidence that grip and pinch strength are important components in developing pencil control, handwriting legibility, and independence with functional fine motor tasks. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Hand grip strength and cognitive function among elderly cancer survivors.

PubMed

Yang, Lin; Koyanagi, Ai; Smith, Lee; Hu, Liang; Colditz, Graham A; Toriola, Adetunji T; López Sánchez, Guillermo Felipe; Vancampfort, Davy; Hamer, Mark; Stubbs, Brendon; Waldhör, Thomas

2018-01-01

We evaluated the associations of handgrip strength and cognitive function in cancer survivors ≥ 60 years old using data from the National Health and Nutrition Examination Survey (NHANES). Data in two waves of NHANES (2011-2014) were aggregated. Handgrip strength in kilogram (kg) was defined as the maximum value achieved using either hand. Two cognitive function tests were conducted among adults 60 years and older. The Animal Fluency Test (AFT) examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) assesses processing speed, sustained attention, and working memory. Survey analysis procedures were used to account for the complex sampling design of the NHANES. Multiple linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depressive symptoms and leisure time physical activity). Among 383 cancer survivors (58.5% women, mean age = 70.9 years, mean BMI = 29.3 kg/m2), prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). In women, each increase in kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed an inverted U-shape association where cognitive function peaked at handgrip strength of 40-42 kg. Handgrip strength, a modifiable factor, appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to address their causal relationship.

Distributed analysis functional testing using GangaRobot in the ATLAS experiment

NASA Astrophysics Data System (ADS)

Legger, Federica; ATLAS Collaboration

2011-12-01

Automated distributed analysis tests are necessary to ensure smooth operations of the ATLAS grid resources. The HammerCloud framework allows for easy definition, submission and monitoring of grid test applications. Both functional and stress test applications can be defined in HammerCloud. Stress tests are large-scale tests meant to verify the behaviour of sites under heavy load. Functional tests are light user applications running at each site with high frequency, to ensure that the site functionalities are available at all times. Success or failure rates of these tests jobs are individually monitored. Test definitions and results are stored in a database and made available to users and site administrators through a web interface. In this work we present the recent developments of the GangaRobot framework. GangaRobot monitors the outcome of functional tests, creates a blacklist of sites failing the tests, and exports the results to the ATLAS Site Status Board (SSB) and to the Service Availability Monitor (SAM), providing on the one hand a fast way to identify systematic or temporary site failures, and on the other hand allowing for an effective distribution of the work load on the available resources.

GROUND-WATER MODEL TESTING: SYSTEMATIC EVALUATION AND TESTING OF CODE FUNCTIONALITY AND PERFORMANCE

EPA Science Inventory

Effective use of ground-water simulation codes as management decision tools requires the establishment of their functionality, performance characteristics, and applicability to the problem at hand. This is accomplished through application of a systematic code-testing protocol and...

Evaluation of validity and reliability of the Persian version of the functional index of hand osteoarthritis.

PubMed

Kordi Yoosefinejad, Amin; Motealleh, Alireza; Babakhani, Mohammad

2017-05-01

The Functional index of hand osteoarthritis (FIHOA) is a commonly used patient-reported outcome questionnaire designed to measure function in patients with hand osteoarthritis. The objective of this study was to evaluate the validity and reliability of the Persian version of the FIHOA. The Persian-translated version of FIHOA was administered to 72 native Persian-speaking patients in Iran with hand osteoarthritis. Thirty-six of the patients completed the questionnaire on two occasions 1 week apart. The physical component of the SF-36 and a numerical rating scale were used to evaluate the construct validity of the Persian version of FIHOA. Internal consistency was high (Cronbach's alpha = 0.89). Test-retest reliability for the total score was excellent (weighted kappa = 0.89, 95% CI 0.79-0.94). A significant positive correlation between total FIHOA score and numerical rating scale (r = 0.70) and a significant negative correlation between total FIHOA score and the physical component scale of the SF-36 (r = -0.76) were observed. The Persian version of the FIHOA showed adequate validity and reliability to evaluate functional disability in Persian-speaking patients with hand osteoarthritis.

Factors affecting functional recovery after surgery and hand therapy in patients with Dupuytren's disease.

PubMed

Engstrand, Christina; Krevers, Barbro; Kvist, Joanna

2015-01-01

Prospective cohort study. The evidence of the relationship between functional recovery and impairment after surgery and hand therapy are inconsistent. To explore factors that were most related to functional recovery as measured by DASH in patients with Dupuytren's disease. Eighty-one patients undergoing surgery and hand therapy were consecutively recruited. Functional recovery was measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Explanatory variables: range of motion of the finger joints, five questions regarding safety and social issues of hand function, and health-related quality of life (Euroqol). The three variables "need to take special precautions", "avoid using the hand in social context", and health-related quality of life (EQ-5D index) explained 62.1% of the variance in DASH, where the first variable had the greatest relative effect. Safety and social issues of hand function and quality of life had an evident association with functional recovery. IV. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

Improving hand functional use in subjects with multiple sclerosis using a musical keyboard: a randomized controlled trial.

PubMed

Gatti, Roberto; Tettamanti, Andrea; Lambiase, Simone; Rossi, Paolo; Comola, Mauro

2015-06-01

Playing an instrument implies neuroplasticity in different cerebral regions. This phenomenon has been described in subjects with stroke, suggesting that it could play a role in hand rehabilitation. The aim of this study is to analyse the effectiveness of playing a musical keyboard in improving hand function in subjects with multiple sclerosis. Nineteen hospitalized subjects were randomized in two groups: nine played a turned-on musical keyboard by sequences of fingers movements (audio feedback present) and 10 performed the same exercises on a turned-off musical keyboard (audio feedback absent). Training duration was half an hour per day for 15 days. Primary outcome was the perceived hand functional use measured by ABILHAND Questionnaire. Secondary outcomes were hand dexterity, measured by Nine-Hole Peg Test, and hand strength, measured by Jamar and Pinch dynamometers. Two-way analysis of variance was used for data analysis. The interaction time × group was significant (p = 0.003) for ABILHAND Questionnaire in favour of experimental group (mean between-group difference 0.99 logit [IC95%: 0.44; 1.54]). The two groups showed a significant time effect for all outcomes except for Jamar measure. Playing a musical keyboard seems a valid method to train the functional use of hands in subjects with multiple sclerosis. Copyright © 2014 John Wiley & Sons, Ltd.

The Role of Cortical Plasticity in Recovery of Function Following Allogeneic Hand Transplantation

DTIC Science & Technology

2015-10-01

transplantation, functional magnetic resonance imaging, hand replantation, cortical reorganization, functional recovery 16. SECURITY CLASSIFICATION OF: U...functional magnetic resonance imaging (fMRI) data suggest that areas of the sensory and motor cortex devoted to representing the hand prior to...function, recovery, functional magnetic resonance imaging 3. Accomplishments Major Goals Achieved: Year Two My lab is relocated to Washington University

On the road to a neuroprosthetic hand: a novel hand grasp orthosis based on functional electrical stimulation.

PubMed

Leeb, Robert; Gubler, Miguel; Tavella, Michele; Miller, Heather; Del Millan, Jose R

2010-01-01

To patients who have lost the functionality of their hands as a result of a severe spinal cord injury or brain stroke, the development of new techniques for grasping is indispensable for reintegration and independency in daily life. Functional Electrical Stimulation (FES) of residual muscles can reproduce the most dominant grasping tasks and can be initialized by brain signals. However, due to the very complex hand anatomy and current limitations in FES-technology with surface electrodes, these grasp patterns cannot be smoothly executed. In this paper, we present an adaptable passive hand orthosis which is capable of producing natural and smooth movements when coupled with FES. It evenly synchronizes the grasping movements and applied forces on all fingers, allowing for naturalistic gestures and functional grasps of everyday objects. The orthosis is also equipped with a lock, which allows it to remain in the desired position without the need for long-term stimulation. Furthermore, we quantify improvements offered by the orthosis compare them with natural grasps on healthy subjects.

Test-retest reliability of neurophysiological tests of hand-arm vibration syndrome in vibration exposed workers and unexposed referents.

PubMed

Gerhardsson, Lars; Gillström, Lennart; Hagberg, Mats

2014-01-01

Exposure to hand-held vibrating tools may cause the hand-arm vibration syndrome (HAVS). The aim was to study the test-retest reliability of hand and muscle strength tests, and tests for the determination of thermal and vibration perception thresholds, which are used when investigating signs of neuropathy in vibration exposed workers. In this study, 47 vibration exposed workers who had been investigated at the department of Occupational and Environmental Medicine in Gothenburg were compared with a randomized sample of 18 unexposed subjects from the general population of the city of Gothenburg. All participants passed a structured interview, answered several questionnaires and had a physical examination including hand and finger muscle strength tests, determination of vibrotactile (VPT) and thermal perception thresholds (TPT). Two weeks later, 23 workers and referents, selected in a randomized manner, were called back for the same test-procedures for the evaluation of test-retest reliability. The test-retest reliability after a two week interval expressed as limits of agreement (LOA; Bland-Altman), intra-class correlation coefficients (ICC) and Pearson correlation coefficients was excellent for tests with the Baseline hand grip, Pinch-grip and 3-Chuck grip among the exposed workers and referents (N = 23: percentage of differences within LOA 91 - 100%; ICC-values ≥0.93; Pearson r ≥0.93). The test-retest reliability was also excellent (percentage of differences within LOA 96-100 %) for the determination of vibration perception thresholds in digits 2 and 5 bilaterally as well as for temperature perception thresholds in digits 2 and 5, bilaterally (percentage of differences within LOA 91 - 96%). For ICC and Pearson r the results for vibration perception thresholds were good for digit 2, left hand and for digit 5, bilaterally (ICC ≥ 0.84; r ≥0.85), and lower (ICC = 0.59; r = 0.59) for digit 2, right hand. For the latter two indices the test

A retrospective outcomes study examining the effect of interactive metronome on hand function.

PubMed

Shank, Tracy M; Harron, Wendy

2015-01-01

Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation

PubMed Central

Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Background Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. Method This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Results Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. Conclusions A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies. PMID:28614403

Prism adaptation in alternately exposed hands.

PubMed

Redding, Gordon M; Wallace, Benjamin

2013-08-01

We assessed intermanual transfer of the proprioceptive realignment aftereffects of prism adaptation in right-handers by examining alternate target pointing with the two hands for 40 successive trials, 20 with each hand. Adaptation for the right hand was not different as a function of exposure sequence order or postexposure test order, in contrast with adaptation for the left hand. Adaptation was greater for the left hand when the right hand started the alternate pointing than when the sequence of target-pointing movements started with the left hand. Also, the largest left-hand adaptation appeared when that hand was tested first after exposure. Terminal error during exposure varied in cycles for the two hands, converging on zero when the right hand led, but no difference appeared between the two hands when the left hand led. These results suggest that transfer of proprioceptive realignment occurs from the right to the left hand during both exposure and postexposure testing. Such transfer reflects the process of maintaining spatial alignment between the two hands. Normally, the left hand appears to be calibrated with the right-hand spatial map, and when the two hands are misaligned, the left-hand spatial map is realigned with the right-hand spatial map.

Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in healthcare workers

PubMed Central

Callahan, Adrienne; Baron, Elma; Fekedulegn, Desta; Kashon, Michael; Yucesoy, Berran; Johnson, Victor J.; Santo Domingo, Diana; Kirkland, Brent; Luster, Michael I.; Nedorost, Susan

2013-01-01

Background Irritant hand dermatitis (IHD) is common in healthcare workers. Objective We studied endogenous irritant contact dermatitis threshold by patch testing, and exogenous factors such as season and hand washing for their association with IHD in healthcare workers. Methods Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide (NaOH) and benzalkonium chloride (BAK) at varying concentrations was measured in 113 healthcare workers. Examination for hand dermatitis occurred at one month intervals for a period of six months in the Midwestern US. Results Positive patch testing to low concentration SLS was associated with IHD (p=0.0310) after adjusting for age, gender, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, glove and hand sanitizer usage). Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (IRR=1.78, 95% CI: 0.92, 3.45). Hand washing frequency (≥ 10 times a day; IRR=1.55, 95% CI: 1.01, 2.39) and cold season (IRR=2.76, 95% CI: 1.35, 5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population. Conclusions Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate and treat susceptible individuals. PMID:23857011

Improvements in hand function in adults with chronic tetraplegia following a multi-day 10Hz rTMS intervention combined with repetitive task practice

PubMed Central

Gomes-Osman, Joyce; Field-Fote, Edelle C.

2014-01-01

Background and Purpose Evidence suggests the use of stimulation to increase corticomotor excitability improves hand function in persons with cervical spinal cord injury (SCI). We assessed effects of multi-day application of 10Hz repetitive transcranial magnetic stimulation (rTMS) applied to the corticomotor hand area combined with repetitive task practice (RTP) in participants with tetraplegia and neurologically healthy participants. Methods Using a double-blind randomized crossover design, 11 participants with chronic tetraplegia and 10 neurologically healthy participants received 3 sessions of 10Hz rTMS+RTP and 3 sessions of sham-rTMS+RTP to the corticomotor hand region controlling the weaker hand. RTMS was interleaved with RTP of a skilled motor task between pulse trains. Hand function (Jebsen-Taylor Hand Function Test [JTT], pinch, and grasp strength) and corticomotor excitability (amplitude of motor-evoked potential) were assessed prior to and following the rTMS+RTP and sham-rTMS+RTP phases. We assessed significance using paired t-tests on pre-post differences and effect sizes using standardized response mean (SRM). Results RTMS+RTP was associated with larger effect sizes compared to sham-rTMS+RTP for improvement in JTT for both the trained hand (SRM=0.85 and 0.42, respectively), non-trained hand (0.55, 0.31, respectively), and for grasp strength of the trained hand in the SCI group (0.67, 0.39, respectively) alone. Effect sizes for all other measures were small and there were no statistical between-condition differences in the outcomes assessed. Discussion and Conclusions RTMS may be a valuable adjunct to RTP for improving hand function in persons with tetraplegia. Higher stimulation dose (frequency, intensity, number of sessions) may be associated with larger effects. Video Abstract available (See Supplemental Digital Conent 1) for more insights from the authors. PMID:25415549

Determinants of hand dermatitis, urticaria and loss of skin barrier function in professional cleaners in New Zealand.

PubMed

Douwes, Jeroen; Slater, Tania; Shanthakumar, Mathangi; McLean, Dave; Firestone, Ridvan Tua; Judd, Lissa; Pearce, Neil

2017-04-01

This study assessed the risk of dermatitis, urticaria and loss of skin barrier function in 425 cleaners and 281 reference workers (retail workers and bus drivers). Symptoms, atopy and skin barrier function were assessed by questionnaire, skin prick tests, and measurement of transepidermal water loss. Cleaners had an increased risk of current (past 3 months) hand/arm dermatitis (14.8% vs. 10.0%; OR = 1.9, p < 0.05) and urticaria (11% vs. 5.3%; OR = 2.4, p < 0.05) and were more likely to have dermatitis as adults (17.6% vs. 11.4%; OR = 1.8, p < 0.05). The risk of atopy was not increased, but associations with symptoms were more pronounced in atopics. Transepidermal water loss was significantly higher in cleaners. Wet-work was a significant risk factor for dermatitis and hand washing and drying significantly reduced the risk of urticaria. In conclusion, cleaners have an increased risk of hand/arm dermatitis, urticaria and loss of skin barrier function.

Hand skill measurement: a gauge for treatment.

PubMed

Bell, E; Jurek, K; Wilson, T

1976-02-01

Objective measurements of performance are vital with the increasing necessity to justify the need for occupational therapy services, and to conduct studies that measure the effectiveness of treatment procedures. This paper reports on a measurement of hand skill that was standardized by comparing hand skill performance among the able-bodied, or normal, population. The performance on this test o patients with various types of disabilities and the implications for treatment are discussed. For the paraplegic, the hand skill test indicates the need for occupational therapy services; for the quadriplegic, the test measures the effectiveness of functional orthotic devices; and for the hemiplegic, the hand skill test determines the potential for success in one aspect of self-care, dressing.

HandTutor™ enhanced hand rehabilitation after stroke--a pilot study.

PubMed

Carmeli, Eli; Peleg, Sara; Bartur, Gadi; Elbo, Enbal; Vatine, Jean-Jacques

2011-12-01

This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.

Particle Impact Ignition Test Data on a Stainless Steel Hand Valve

NASA Technical Reports Server (NTRS)

Peralta, Stephen

2010-01-01

This slide presentation reviews the particle impact ignition test of a stainless steel hand valve. The impact of particles is a real fire hazard with stainless steel hand valves, however 100 mg of particulate can be tolerated. Since it is unlikely that 100 mg of stainless steel contaminant particles can be simultaneously released into this type of valve in the WSTF configuration, this is acceptable and within statistical confidence as demonstrated by testing.

Rasch Analysis of a New Hierarchical Scoring System for Evaluating Hand Function on the Motor Assessment Scale for Stroke

PubMed Central

Sabari, Joyce S.; Woodbury, Michelle; Velozo, Craig A.

2014-01-01

Objectives. (1) To develop two independent measurement scales for use as items assessing hand movements and hand activities within the Motor Assessment Scale (MAS), an existing instrument used for clinical assessment of motor performance in stroke survivors; (2) To examine the psychometric properties of these new measurement scales. Design. Scale development, followed by a multicenter observational study. Setting. Inpatient and outpatient occupational therapy programs in eight hospital and rehabilitation facilities in the United States and Canada. Participants. Patients (N = 332) receiving stroke rehabilitation following left (52%) or right (48%) cerebrovascular accident; mean age 64.2 years (sd 15); median 1 month since stroke onset. Intervention. Not applicable. Main Outcome Measures. Data were tested for unidimensionality and reliability, and behavioral criteria were ordered according to difficulty level with Rasch analysis. Results. The new scales assessing hand movements and hand activities met Rasch expectations of unidimensionality and reliability. Conclusion. Following a multistep process of test development, analysis, and refinement, we have redesigned the two scales that comprise the hand function items on the MAS. The hand movement scale contains an empirically validated 10-behavior hierarchy and the hand activities item contains an empirically validated 8-behavior hierarchy. PMID:25177513

Functional Assessment of the Vanderbilt Multigrasp Myoelectric Hand: A Continuing Case Study

PubMed Central

Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael

2015-01-01

This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject’s index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies. PMID:25571412

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis: A Randomized Trial.

PubMed

Knutson, Jayme S; Gunzler, Douglas D; Wilson, Richard D; Chae, John

2016-10-01

It is unknown whether one method of neuromuscular electrical stimulation for poststroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) with cyclic neuromuscular electrical stimulation (cNMES). Stroke patients with chronic (>6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/wk of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the laboratory for 12 weeks. The task practice for the CCFES group was stimulation assisted. The primary outcome was change in Box and Block Test (BBT) score at 6 months post treatment. Upper extremity Fugl-Meyer and Arm Motor Abilities Test were also measured. At 6 months post treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% confidence interval [CI], 2.2-7.0), than the cNMES group, 1.8 (95% CI, 0.6-3.0), between-group difference of 2.8 (95% CI, 0.1-5.5), P=0.045. No significant between-group difference was found for the upper extremity Fugl-Meyer (P=0.888) or Arm Motor Abilities Test (P=0.096). Participants who had the largest improvements on BBT were <2 years post stroke with moderate (ie, not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI, 5.6-13.6), were greater than those of the cNMES group, 4.1 (95% CI, 1.7-6.5), between-group difference of 5.5 (95% CI, 0.8-10.2), P=0.023. CCFES improved hand dexterity more than cNMES in chronic stroke survivors. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319. © 2016 American Heart Association, Inc.

Effects of smartphone overuse on hand function, pinch strength, and the median nerve.

PubMed

İnal, Esra Erkol; Demİrcİ, kadİr; Çetİntürk, Azİze; Akgönül, Mehmet; Savaş, Serpİl

2015-08-01

In this study we investigated the flexor pollicis longus (FPL) tendon and median nerve in smartphone users by ultrasonography to assess the effects of smartphone addiction on the clinical and functional status of the hands. One hundred two students were divided into 3 groups: non-users, and high or low smartphone users. Smartphone Addiction Scale (SAS) scores and grip and pinch strengths were recorded. Pain in thumb movement and rest and hand function were evaluated on the visual analog scale (VAS) and the Duruöz Hand Index (DHI), respectively. The cross-sectional areas (CSAs) of the median nerve and the FPL tendon were calculated bilaterally using ultrasonography. Significantly higher median nerve CSAs were observed in the dominant hands of the high smartphone users than in the non-dominant hands (P<0.001). SAS scores correlated with VAS pain for movement and rest, DHI scores, and pinch strength (P<0.05; r=0.345, 0.272, 0.245, and 0.281, respectively). Smartphone overuse enlarges the median nerve, causes pain in the thumb, and decreases pinch strength and hand functions. © 2015 Wiley Periodicals, Inc.

Dissociable neural responses to hands and non-hand body parts in human left extrastriate visual cortex.

PubMed

Bracci, Stefania; Ietswaart, Magdalena; Peelen, Marius V; Cavina-Pratesi, Cristiana

2010-06-01

Accumulating evidence points to a map of visual regions encoding specific categories of objects. For example, a region in the human extrastriate visual cortex, the extrastriate body area (EBA), has been implicated in the visual processing of bodies and body parts. Although in the monkey, neurons selective for hands have been reported, in humans it is unclear whether areas selective for individual body parts such as the hand exist. Here, we conducted two functional MRI experiments to test for hand-preferring responses in the human extrastriate visual cortex. We found evidence for a hand-preferring region in left lateral occipitotemporal cortex in all 14 participants. This region, located in the lateral occipital sulcus, partially overlapped with left EBA, but could be functionally and anatomically dissociated from it. In experiment 2, we further investigated the functional profile of hand- and body-preferring regions by measuring responses to hands, fingers, feet, assorted body parts (arms, legs, torsos), and non-biological handlike stimuli such as robotic hands. The hand-preferring region responded most strongly to hands, followed by robotic hands, fingers, and feet, whereas its response to assorted body parts did not significantly differ from baseline. By contrast, EBA responded most strongly to body parts, followed by hands and feet, and did not significantly respond to robotic hands or fingers. Together, these results provide evidence for a representation of the hand in extrastriate visual cortex that is distinct from the representation of other body parts.

Dissociable Neural Responses to Hands and Non-Hand Body Parts in Human Left Extrastriate Visual Cortex

PubMed Central

Ietswaart, Magdalena; Peelen, Marius V.; Cavina-Pratesi, Cristiana

2010-01-01

Accumulating evidence points to a map of visual regions encoding specific categories of objects. For example, a region in the human extrastriate visual cortex, the extrastriate body area (EBA), has been implicated in the visual processing of bodies and body parts. Although in the monkey, neurons selective for hands have been reported, in humans it is unclear whether areas selective for individual body parts such as the hand exist. Here, we conducted two functional MRI experiments to test for hand-preferring responses in the human extrastriate visual cortex. We found evidence for a hand-preferring region in left lateral occipitotemporal cortex in all 14 participants. This region, located in the lateral occipital sulcus, partially overlapped with left EBA, but could be functionally and anatomically dissociated from it. In experiment 2, we further investigated the functional profile of hand- and body-preferring regions by measuring responses to hands, fingers, feet, assorted body parts (arms, legs, torsos), and non-biological handlike stimuli such as robotic hands. The hand-preferring region responded most strongly to hands, followed by robotic hands, fingers, and feet, whereas its response to assorted body parts did not significantly differ from baseline. By contrast, EBA responded most strongly to body parts, followed by hands and feet, and did not significantly respond to robotic hands or fingers. Together, these results provide evidence for a representation of the hand in extrastriate visual cortex that is distinct from the representation of other body parts. PMID:20393066

Automated cross-modal mapping in robotic eye/hand systems using plastic radial basis function networks

NASA Astrophysics Data System (ADS)

Meng, Qinggang; Lee, M. H.

2007-03-01

Advanced autonomous artificial systems will need incremental learning and adaptive abilities similar to those seen in humans. Knowledge from biology, psychology and neuroscience is now inspiring new approaches for systems that have sensory-motor capabilities and operate in complex environments. Eye/hand coordination is an important cross-modal cognitive function, and is also typical of many of the other coordinations that must be involved in the control and operation of embodied intelligent systems. This paper examines a biologically inspired approach for incrementally constructing compact mapping networks for eye/hand coordination. We present a simplified node-decoupled extended Kalman filter for radial basis function networks, and compare this with other learning algorithms. An experimental system consisting of a robot arm and a pan-and-tilt head with a colour camera is used to produce results and test the algorithms in this paper. We also present three approaches for adapting to structural changes during eye/hand coordination tasks, and the robustness of the algorithms under noise are investigated. The learning and adaptation approaches in this paper have similarities with current ideas about neural growth in the brains of humans and animals during tool-use, and infants during early cognitive development.

Engaging Cervical Spinal Cord Networks to Reenable Volitional Control of Hand Function in Tetraplegic Patients.

PubMed

Lu, Daniel C; Edgerton, V Reggie; Modaber, Morteza; AuYong, Nicholas; Morikawa, Erika; Zdunowski, Sharon; Sarino, Melanie E; Sarrafzadeh, Majid; Nuwer, Marc R; Roy, Roland R; Gerasimenko, Yury

2016-11-01

Paralysis of the upper limbs from spinal cord injury results in an enormous loss of independence in an individual's daily life. Meaningful improvement in hand function is rare after 1 year of tetraparesis. Therapeutic developments that result in even modest gains in hand volitional function will significantly affect the quality of life for patients afflicted with high cervical injury. The ability to neuromodulate the lumbosacral spinal circuitry via epidural stimulation in regaining postural function and volitional control of the legs has been recently shown. A key question is whether a similar neuromodulatory strategy can be used to improve volitional motor control of the upper limbs, that is, performance of motor tasks considered to be less "automatic" than posture and locomotion. In this study, the effects of cervical epidural stimulation on hand function are characterized in subjects with chronic cervical cord injury. Herein we show that epidural stimulation can be applied to the chronic injured human cervical spinal cord to promote volitional hand function. Two subjects implanted with a cervical epidural electrode array demonstrated improved hand strength (approximately 3-fold) and volitional hand control in the presence of epidural stimulation. The present data are sufficient to suggest that hand motor function in individuals with chronic tetraplegia can be improved with cervical cord neuromodulation and thus should be comprehensively explored as a possible clinical intervention. © The Author(s) 2016.

Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers.

PubMed

Callahan, Adrienne; Baron, Elma; Fekedulegn, Desta; Kashon, Michael; Yucesoy, Berran; Johnson, Victor J; Domingo, Diana Santo; Kirkland, Brent; Luster, Michael I; Nedorost, Susan

2013-01-01

Irritant hand dermatitis (IHD) is common in health care workers. We studied endogenous irritant contact dermatitis threshold by patch testing and exogenous factors such as season and hand washing for their association with IHD in health care workers. Irritant patch testing with sodium lauryl sulfate (SLS), sodium hydroxide, and benzalkonium chloride at varying concentrations was measured in 113 health care workers. Examination for hand dermatitis occurred at 1-month intervals for a period of 6 months in the Midwestern United States. Positive patch testing to low-concentration SLS was associated with IHD (P = 0.0310) after adjusting for age, sex, ethnicity, season, history of childhood flexural dermatitis, mean indoor relative humidity, and glove and hand sanitizer usage. Subjects with a positive patch test to SLS were 78% more likely to have occurrence of IHD (incidence rate ratio [IRR] = 1.78; 95% confidence interval [CI], 0.92-3.45). Hand washing frequency (≥10 times a day; IRR = 1.55; 95% CI, 1.01-2.39) and cold season (IRR = 2.76; 95% CI, 1.35-5.65) were associated with IHD. No association was found between history of childhood flexural dermatitis and IHD in this population. Both genetic and environmental factors are important in the etiology of IHD and should be considered in designing strategies to protect, educate, and treat susceptible individuals.

Functional Fitness Testing Results Following Long-Duration ISS Missions.

PubMed

Laughlin, Mitzi S; Guilliams, Mark E; Nieschwitz, Bruce A; Hoellen, David

2015-12-01

Long-duration spaceflight missions lead to the loss of muscle strength and endurance. Significant reduction in muscle function can be hazardous when returning from spaceflight. To document these losses, NASA developed medical requirements that include measures of functional strength and endurance. Results from this Functional Fitness Test (FFT) battery are also used to evaluate the effectiveness of in-flight exercise countermeasures. The purpose of this paper is to document results from the FFT and correlate this information with performance of in-flight exercise on board the International Space Station. The FFT evaluates muscular strength and endurance, flexibility, and agility and includes the following eight measures: sit and reach, cone agility, push-ups, pull-ups, sliding crunches, bench press, leg press, and hand grip dynamometry. Pre- to postflight functional fitness measurements were analyzed using dependent t-tests and correlation analyses were used to evaluate the relationship between functional fitness measurements and in-flight exercise workouts. Significant differences were noted post space flight with the sit and reach, cone agility, leg press, and hand grip measurements while other test scores were not significantly altered. The relationships between functional fitness and in-flight exercise measurements showed minimal to moderate correlations for most in-flight exercise training variables. The change in FFT results can be partially explained by in-flight exercise performance. Although there are losses documented in the FFT results, it is important to realize that the crewmembers are successfully performing activities of daily living and are considered functional for normal activities upon return to Earth.

Functional range of motion of the hand joints in activities of the International Classification of Functioning, Disability and Health.

PubMed

Gracia-Ibáñez, Verónica; Vergara, Margarita; Sancho-Bru, Joaquín L; Mora, Marta C; Piqueras, Catalina

Cross-sectional research design. Active range of motion (AROM) is used as indicator of hand function. However, functional range of motion (FROM) data are limited, and fail to represent activities of daily living (ADL). To estimate dominant hand FROM in flexion, abduction and palmar arching in people under 50 years of age performing ADL. AROMs and hand postures in 24 representative ADL of the International Classification of Functioning, Disability and Health (ICF) were recorded in 12 men and 12 women. FROM data were reported by activity and ICF area, and compared with AROMs. The relationship between ROM measures to gender and hand size was analyzed by correlation. FROM was 5° to 28° less than available AROM depending on the joint and movement performed. Joints do not necessarily move through full AROM while performing ADL which has benefits in retaining function despite loss of motion. This may also suggest that ADL alone are insufficient to retain or restore full AROM. Therapists should consider FROM requirements and normal AROM when defining hand therapy goals, interventions and evaluating the success of treatment. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Ontogenetic trends in gnostic hand function in 3- to 12-yr-old children.

PubMed

van Grunsven, W; Njiokiktjien, C; Vranken, M; Vuylsteke-Wauters, M

2003-06-01

The intimate relation between the sensory and motor functions of the hands during object manipulation and exploratory touch, the well-known improvement in object handling and constructive performance in ontogenesis and the emergent laterality thereof, assume changes in morphognostic capabilities in children. In this study we tried to corroborate the hypothesis of Mesker that mature and lateralized finger-thumb opposition is preceded by a stage of two-sided manual form agnosia in preschool children, followed by acquisition of morphognosis of the fingers and, finally, the thumbs. This study examined the development of gnostic hand function in 290 children from 3 to 11 years of age who drew the outlines of a meaningless wooden object passively felt with each hand without visual control. Analysis showed a clear ontogenetic change across the two age groups of increasing morphognostic function: 48% of the 6-yr.-olds drew correctly what the fingers of both left and right hands had perceived (thumbs, 14%). Of the 11-yr.-olds 91% and 61% performed perfectly with the right and left hands, respectively. The fingers preceded the thumbs in reproduction by most children, and the correct reproduction by the left thumb precedes that of the right thumb. The ontogenesis of bimanual sensorimotor functioning is discussed in the light of cortical and callosal development.

Design of an Inertial-Sensor-Based Data Glove for Hand Function Evaluation.

PubMed

Lin, Bor-Shing; Lee, I-Jung; Yang, Shu-Yu; Lo, Yi-Chiang; Lee, Junghsi; Chen, Jean-Lon

2018-05-13

Capturing hand motions for hand function evaluations is essential in the medical field. Various data gloves have been developed for rehabilitation and manual dexterity assessments. This study proposed a modular data glove with 9-axis inertial measurement units (IMUs) to obtain static and dynamic parameters during hand function evaluation. A sensor fusion algorithm is used to calculate the range of motion of joints. The data glove is designed to have low cost, easy wearability, and high reliability. Owing to the modular design, the IMU board is independent and extensible and can be used with various microcontrollers to realize more medical applications. This design greatly enhances the stability and maintainability of the glove.

Design and Test of a Closed-Loop FES System for Supporting Function of the Hemiparetic Hand Based on Automatic Detection using the Microsoft Kinect sensor.

PubMed

Simonsen, Daniel; Spaich, Erika G; Hansen, John; Andersen, Ole K

2016-10-26

This paper describes the design of a FES system automatically controlled in a closed loop using a Microsoft Kinect sensor, for assisting both cylindrical grasping and hand opening. The feasibility of the system was evaluated in real-time in stroke patients with hand function deficits. A hand function exercise was designed in which the subjects performed an arm and hand exercise in sitting position. The subject had to grasp one of two differently sized cylindrical objects and move it forward or backwards in the sagittal plane. This exercise was performed with each cylinder with and without FES support. Results showed that the stroke patients were able to perform up to 29% more successful grasps when they were assisted by FES. Moreover, the hand grasp-and-hold and hold-and-release durations were shorter for the smaller of the two cylinders. FES was appropriately timed in more than 95% of all trials indicating successful closed loop FES control. Future studies should incorporate options for assisting forward reaching in order to target a larger group of stroke patients.

Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.

PubMed

Ferree, Steven; van der Vliet, Quirine M J; van Heijl, Mark; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

2017-04-01

Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. All eligible polytrauma patients with hand injuries were included and a Quick Disability of Arm, Shoulder and Hand questionnaire (QDASH) and Patient-Rated Wrist/Hand Evaluation (PRWHE) were administered. Patients were contacted 1-6 years after trauma. In a cohort of 2046 polytrauma patients 72 patients (3.5%) suffered a hand injury. The functional outcome scores of 52 patients (72%) were obtained. The Metacarpal (48%) and carpal (33%) bones were the most frequently affected. The median QDASH score for all patients with hand injury was 17 (IQR 0-31) and the PRWHE 14 (IQR 0-41). Patients with a concomitant upper extremity injury (p=0.002 for PRWHE, p0.006 for QDASH) and those with higher ISS scores (p=0.034 for PRWHE, QDASH not significant) had worse functional outcome scores. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries (3 plexus injuries, 1 severe brain injury). The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS). Copyright © 2017 Elsevier Ltd. All

Optimal Scoring Methods of Hand-Strength Tests in Patients with Stroke

ERIC Educational Resources Information Center

Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

2011-01-01

The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods…

[Functional magnetic resonance imaging. What are the benefits expected in hand surgery?].

PubMed

Moutet, F; Delon-Martin, C; Martin, O; Sirigu, A; Delaquaize, F; Benali, H; Masquelet, A-C

2013-06-01

Functional MRI (fMRI) allowed considerable advances upon understanding of cerebral functioning. Cortical plasticity, which allows the voluntary command of a restored function by a transferred muscle remains to be investigated in its intimacy. The authors present here the round table held at the 48th annual meeting of the French Society for Surgery of the Hand on December 22nd, 2012. It tries to review the analysis of the phenomenon observed during multiple tendinous transfers for restoration of proximal radial nerve palsy. Were successively approached: 1) Methods of acquisition and analysis of the signals (C. D-M.); 2) Movement reorganization (O.M.); 3) Motor plasticity after hand allograft (A. S.); 4) The potential interest of the fMRI in hand rehabilitation (F. D.); 5) The analysis of cerebral plasticity in general (H. B.). A rather philosophical conclusion opens other fields to f MRI (A.M.). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The effect of sensory-motor training on hand and upper extremity sensory and motor function in patients with idiopathic Parkinson disease.

PubMed

Taghizadeh, Ghorban; Azad, Akram; Kashefi, Sepiede; Fallah, Soheila; Daneshjoo, Fatemeh

2017-11-14

Blinded randomized controlled trial. Patients with Parkinson disease (PD) have sensory problems, but there is still no accurate understanding of the effects of sensory-motor interventions on PD. To investigate the effects of sensory-motor training (SMT) on hand and upper extremity sensory and motor function in patients with PD. Forty patients with PD were allocated to the SMT group or the control group (CG) (mean ages ± standard deviation: SMT, 61.05 ± 13.9 years; CG, 59.15 ± 11.26 years). The CG received the common rehabilitation therapies, whereas the SMT group received SMT. The SMT included discrimination of temperatures, weights, textures, shapes, and objects and was performed 5 times each week for 2 weeks. Significantly reducing the error rates in the haptic object recognition test (dominant hand [DH]: F = 15.36, P = .001, and effect size [ES] = 0.29; nondominant hand [NDH]: F = 9.33, P = .004, and ES = 0.21) and the error means in the wrist proprioception sensation test (DH: F = 9.11, P = .005, and ES = 0.19; NDH: F = 13.04, P = .001, and ES = 0.26) and increasing matched objects in the hand active sensation test (DH: F = 12.15, P = .001, and ES = 0.24; NDH: F = 5.03, P = .03, and ES = 0.12) founded in the SMT. Also, the DH (F = 6.65, P = .01, and ES = 0.15), both hands (F = 7.61, P = .009, and ES = 0.17), and assembly (F = 7.02, P = .01, and ES = 0.15) subtests of fine motor performance, as well as DH (F = 10.1, P = .003, and ES = 0.21) and NDH (F = 8.37, P = .006, and ES = 0.18) in upper extremity functional performance, were improved in the SMT. SMT improved hand and upper extremity sensory-motor function in patients with PD. The SMT group showed improved sensory and motor function. But these results were limited to levels 1 to 3 of the Hoehn and Yahr Scale. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Virtual Reality to Maximize Function for Hand and Arm Rehabilitation: Exploration of Neural Mechanisms

PubMed Central

MERIANS, Alma S.; TUNIK, Eugene; ADAMOVICH, Sergei V.

2015-01-01

Stroke patients report hand function as the most disabling motor deficit. Current evidence shows that learning new motor skills is essential for inducing functional neuroplasticity and functional recovery. Adaptive training paradigms that continually and interactively move a motor outcome closer to the targeted skill are important to motor recovery. Computerized virtual reality simulations when interfaced with robots, movement tracking and sensing glove systems are particularly adaptable, allowing for online and offline modifications of task based activities using the participant’s current performance and success rate. We have developed a second generation system that can exercise the hand and the arm together or in isolation and provides for both unilateral and bilateral hand and arm activities in three-dimensional space. We demonstrate that by providing haptic assistance for the hand and arm and adaptive anti-gravity support, the system can accommodate patients with lower level impairments. We hypothesize that combining training in VE with observation of motor actions can bring additional benefits. We present a proof of concept of a novel system that integrates interactive VE with functional neuroimaging to address this issue. Three components of this system are synchronized, the presentation of the visual display of the virtual hands, the collection of fMRI images and the collection of hand joint angles from the instrumented gloves. We show that interactive VEs can facilitate activation of brain areas during training by providing appropriately modified visual feedback. We predict that visual augmentation can become a tool to facilitate functional neuroplasticity. PMID:19592790

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis: A Randomized Trial

PubMed Central

Knutson, Jayme S.; Gunzler, Douglas D.; Wilson, Richard D.; Chae, John

2016-01-01

Background and Purpose It is unknown whether one method of neuromuscular stimulation for post-stroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) to cyclic neuromuscular electrical stimulation (cNMES). Methods Stroke patients with chronic (> 6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/week of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the lab over 12 weeks. The task practice for the CCFES group was stimulation-assisted. The primary outcome was change in Box and Blocks Test (BBT) score at 6-months post-treatment. Upper extremity Fugl-Meyer (UEFM) and Arm Motor Abilities Test (AMAT) were also measured. Results At 6-months post-treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% CI: 2.2, 7.0), than the cNMES group, 1.8 (95% CI: 0.6, 3.0); between-group difference, 2.8 (95% CI: 0.1, 5.5), p=0.045. No significant between-group difference was found for the UEFM (p=.888) or AMAT (p=.096). Participants who had the largest improvements on BBT were less than two years post-stroke with moderate (i.e., not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI: 5.6, 13.6), were greater than those of the cNMES group, 4.1 (95% CI: 1.7, 6.5); between-group difference, 5.5 (95% CI: 0.8, 10.2), p=0.023. Conclusions CCFES improved hand dexterity more than cNMES in chronic stroke survivors. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319. PMID:27608819

Early intensive hand rehabilitation after spinal cord injury ("Hands On"): a protocol for a randomised controlled trial.

PubMed

Harvey, Lisa A; Dunlop, Sarah A; Churilov, Leonid; Hsueh, Ya-Seng Arthur; Galea, Mary P

2011-01-17

Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. NCT01086930 (12th March 2010)ACTRN12609000695202 (12th August 2009).

Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study

PubMed Central

Fluet, Gerard G.; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V.; Tunik, Eugene; Merians, Alma S.

2016-01-01

Purpose The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. Methods This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl–Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Results Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. Conclusion This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. PMID:27669997

Outcome measurement of hand function following mirror therapy for stroke rehabilitation: A systematic review.

PubMed

Cantero-Téllez, Raquel; Naughton, Nancy; Algar, Lori; Valdes, Kristin

2018-02-28

Systematic review. Mirror therapy is a treatment used to address hand function following a stroke. Measurement of outcomes using appropriate assessment tools is crucial; however, many assessment options exist. The purpose of this study is to systematically review outcome measures that are used to assess hand function following mirror therapy after stroke and, in addition, to identify the psychometric and descriptive properties of the included measures and through the linking process determine if the outcome measures are representative of the International Classification of Functioning, Disability and Health (ICF). Following a comprehensive literature search, outcome measures used in the included studies were linked to the ICF and analyzed based on descriptive information and psychometric properties. Eleven studies met inclusion criteria and included 24 different assessment tools to measure hand or upper limb function. Most outcome measures used in the selected studies (63%) were rated by the evaluating therapist. Thirteen outcome measures (54%) linked to the ICF body function category and 10 measures (42%) linked to activities and participation. One outcome measure was linked to not defined, and all other ICF categories were not represented. A majority of outcome measures have been assessed for validity, reliability, and responsiveness, but responsiveness was the least investigated psychometric property. Current studies on mirror therapy after stroke are not consistent in the assessment tools used to determine hand function. Understanding of study outcomes requires analysis of the assessment tools. The outcome measures used in the included studies are not representative of personal and environmental factors, but tools linking to body functions and activities and participations provide important information on functional outcome. Integrating a combination of measures that are psychometrically sound and reflective of the ICF should be considered for assessment of

Immediate effects of somatosensory stimulation on hand function in patients with poststroke hemiparesis: a randomized cross-over trial.

PubMed

Sim, Sun-Mi; Oh, Duck-Won; Chon, Seung-chul

2015-12-01

This study aimed to determine the immediate effects of somatosensory stimulation on hand function in patients with poststroke hemiparesis. Eleven patients with poststroke hemiparesis participated in this study. Four types (no stimulation, vibration, and light and rough touches) of somatosensory stimulation were performed randomly for 4 days applying only one type of somatosensory stimulation each day. The box and block test (BBT), the Jebsen-Taylor hand function test (JTHFT), hand grip strength (HGS), and movement distance and peak velocity of the wrist joint during a forward-reaching task were measured. The BBT and JTHFT scores for no stimulation [BBT: median (interquartile range), 0.00 (-1.00 to 1.00) and JTHFT: 2.57 (-0.47 to 4.92)] were significantly different from those for vibration [BBT: 3.00 (2.00-5.00) and JTHFT: -16.02 (-23.06 to -4.31)], light touch [BBT: 3.00 (1.00-4.00) and JTHFT: -5.00 (-21.20 to -0.94)], and rough touch [BBT: 2.00 (1.00-4.00) and JTHFT: -6.19 (-18.22 to -3.70)]. The JTHFT score was significantly higher for vibration than that for rough touch (P<0.05). The increase in HGS was significantly greater for light touch than that for no stimulation (P<0.05) and for vibration than that for light touch (P<0.05). There were significant differences for the sagittal and coronal planes in movement distance and for the sagittal and horizontal planes in peak velocity during the forward-reaching task (P<0.05). The findings suggest that somatosensory stimulation may be advantageous to improve the hand function of patients with poststroke hemiparesis, with more favorable effects observed in vibration stimulation.

Engaging cervical spinal cord networks to re-enable volitional control of hand function in tetraplegic patients

PubMed Central

Lu, Daniel C.; Edgerton, V. Reggie; Modaber, Morteza; AuYong, Nicholas; Morikawa, Erika; Zdunowski, Sharon; Sarino, Melanie E.; Nuwer, Marc R.; Roy, Roland R.; Gerasimenko, Yury

2016-01-01

Background Paralysis of the upper-limbs from spinal cord injury results in an enormous loss of independence in an individual’s daily life. Meaningful improvement in hand function is rare after one year of tetraparesis. Therapeutic developments that result in even modest gains in hand volitional function will significantly impact the quality of life for patients afflicted with high cervical injury. The ability to neuromodulate the lumbosacral spinal circuitry via epidural stimulation in regaining postural function and volitional control of the legs has been recently shown. A key question is whether a similar neuromodulatory strategy can be used to improve volitional motor control of the upper-limbs, i.e., performance of motor tasks considered to be less “automatic” than posture and locomotion. In this study, the effects of cervical epidural stimulation on hand function are characterized in subjects with chronic cervical cord injury. Objective Herein we show that epidural stimulation can be applied to the chronic injured human cervical spinal cord to promote volitional hand function. Methods and results Two subjects implanted with an cervical epidural electrode array demonstrated improved hand strength (approximately three-fold) and volitional hand control in the presence of epidural stimulation. Conclusions The present data are sufficient to suggest that hand motor function in individuals with chronic tetraplegia can be improved with cervical cord neuromodulation and thus should be comprehensively explored as a possible clinical intervention. PMID:27198185

[Does the hand solely belong in the hands of a qualified hand surgeon?

PubMed

Güven, Asim; Kols, Kerstin; Fischer, Klaus; Schönberger, Michael; Allert, Sixtus

2017-09-01

Background In Germany, Hand Surgery is an additional qualification that can only be obtained by a three-year training after a completed residency in General Surgery, Plastic Surgery or Trauma and Orthopaedic Surgery. Nevertheless, injuries and diseases of the hand are also treated by physicians without this particular qualification. It is questionable whether these treatments more often lead to medical malpractice. Material and Methods 376 charges of medical malpractice in surgical treatments of the hand and forearm that were closed in 2014 and 2015 were collected by the Arbitration Board for Medical Liability Issues of the Medical Association of North Germany.Cases with proven medical malpractice were classified by the qualification of the physician in charge and analysed. A statistical analysis was performed with the use of the program SPSS (IBM). Results Medical malpractice was proven in 42 of 113 cases with an attending physician who held the additional qualification for Hand Surgery (37.2 %). For physicians without this qualification, the figures were 79 out of 155 (51.0 %) in the group of trauma and orthopaedic surgeons and 54 out of 108 (50.0 %) in the group of general surgeons. The differences between the hand surgeons and the trauma and orthopaedic surgeons (p = 0.017) and between hand surgeons and general surgeons were significant (p = 0.037). Conclusions It was shown that physicians with an additional qualification in hand surgery had signifcantly fewer proven medical malpratice cases than physicians without this qualification. The following trends were observed in the cases of the physicians without the additional qualification in hand surgery: underestimation of the severity of trauma to soft tissues and infections of the hand, errors in the surgical examination of the hand, including functional tests of tendons and nerves, as well as in diagnostic findings after X-ray studies of the hand. Georg Thieme Verlag KG Stuttgart · New York.

Hand sensibility measures used by therapists.

PubMed

Mielke, K; Novak, C B; Mackinnon, S E; Feely, C A

1996-03-01

Sensory evaluations are frequently used to assess patients with functional loss resulting from nerve injury. The results of these tests are routinely utilized by hand surgeons as an indication for conservative management or surgical intervention in the evaluation of surgical outcome and in the determination of disability ratings. Reports in the literature regarding specific tests for sensibility show variation in their application. The purpose of this study was to evaluate which tests are used to evaluate hand sensibility and the techniques of application currently used by hand therapists. Two hundred members of the American Society of Hand Therapists were randomly selected and a survey was sent to these members. The results of this study identify the need to develop standardized protocols for sensory evaluations and the need for therapists to follow the standardized methods for administration of moving and static two-point discrimination, and Semmes-Weinstein monofilaments, if comparisons of results between centers are to be meaningful.

Quantification of functional hand grip using electromyography and inertial sensor-derived accelerations: clinical implications.

PubMed

Martin-Martin, Jaime; Cuesta-Vargas, Antonio I

2014-12-11

Assessing hand injury is of great interest given the level of involvement of the hand with the environment. Knowing different assessment systems and their limitations generates new perspectives. The integration of digital systems (accelerometry and electromyography) as a tool to supplement functional assessment allows the clinician to know more about the motor component and its relation to movement. Therefore, the purpose of this study was the kinematic and electromyography analysis during functional hand movements. Ten subjects carried out six functional movements (terminal pinch, termino-lateral pinch, tripod pinch, power grip, extension grip and ball grip). Muscle activity (hand and forearm) was measured in real time using electromyograms, acquired with the Mega ME 6000, whilst acceleration was measured using the AcceleGlove. Electrical activity and acceleration variables were recorded simultaneously during the carrying out of the functional movements. The acceleration outcome variables were the modular vectors of each finger of the hand and the palm. In the electromyography, the main variables were normalized by the mean and by the maximum muscle activity of the thenar region, hypothenar, first interosseous dorsal, wrist flexors, carpal flexors and wrist extensors. Knowing muscle behavior allows the clinician to take a more direct approach in the treatment. Based on the results, the tripod grip shows greater kinetic activity and the middle finger is the most relevant in this regard. Ball grip involves most muscle activity, with the thenar region playing a fundamental role in hand activity. Relating muscle activation, movements, individual load and displacement offers the possibility to proceed with rehabilitation by individual component.

Improvement in pinch function after surgical treatment for thumb in the plane of the hand.

PubMed

Iba, K; Wada, T; Aoki, M; Yamashita, T

2012-02-01

Thumb in the plane of the hand (TPH) is a congenital deformity in which the nail plane of the radial-most digit is parallel to that of other digits, but structurally the digit retains the characteristics of a thumb. Four hands from four patients were retrospectively diagnosed as having TPH, with the underlying congenital conditions being symbrachydactyly, cleft hand and constriction band syndrome. Thumb web-plasty was carried out in all hands; one required additional rotation osteotomy of the metacarpal. Postoperative hand function was markedly improved and pinch function was possible in all cases. In most cases of TPH, the thumb has the potential to act in opposition, indicating that a thumb web-plasty is worth considering as an initial procedure.

Hand rehabilitation after stroke using a wearable, high DOF, spring powered exoskeleton.

PubMed

Tianyao Chen; Lum, Peter S

2016-08-01

Stroke patients often have inappropriate finger flexor activation and finger extensor weakness, which makes it difficult to open their affected hand for functional grasp. The goal was to develop a passive, lightweight, wearable device to enable improved hand function during performance of activities of daily living. The device, HandSOME II, assists with opening the patient's hand using 11 elastic actuators that apply extension torques to finger and thumb joints. Device design and initial testing are described. A novel mechanical design applies forces orthogonal to the finger segments despite the fact that all of the device DOFs are not aligned with human joint DOF. In initial testing with seven stroke subjects with impaired hand function, use of HandSOME II significantly increased maximum extension angles and range of motion in all of the index finger joints (P<;0.05). HandSOME II allows performance of all the grip patterns used in daily activities and can be used as part of home-based therapy programs.

Rehabilitation of hand in subacute tetraplegic patients based on brain computer interface and functional electrical stimulation: a randomised pilot study

NASA Astrophysics Data System (ADS)

Osuagwu, Bethel C. A.; Wallace, Leslie; Fraser, Mathew; Vuckovic, Aleksandra

2016-12-01

Objective. To compare neurological and functional outcomes between two groups of hospitalised patients with subacute tetraplegia. Approach. Seven patients received 20 sessions of brain computer interface (BCI) controlled functional electrical stimulation (FES) while five patients received the same number of sessions of passive FES for both hands. The neurological assessment measures were event related desynchronization (ERD) during movement attempt, Somatosensory evoked potential (SSEP) of the ulnar and median nerve; assessment of hand function involved the range of motion (ROM) of wrist and manual muscle test. Main results. Patients in both groups initially had intense ERD during movement attempt that was not restricted to the sensory-motor cortex. Following the treatment, ERD cortical activity restored towards the activity in able-bodied people in BCI-FES group only, remaining wide-spread in FES group. Likewise, SSEP returned in 3 patients in BCI-FES group, having no changes in FES group. The ROM of the wrist improved in both groups. Muscle strength significantly improved for both hands in BCI-FES group. For FES group, a significant improvement was noticed for right hand flexor muscles only. Significance. Combined BCI-FES therapy results in better neurological recovery and better improvement of muscle strength than FES alone. For spinal cord injured patients, BCI-FES should be considered as a therapeutic tool rather than solely a long-term assistive device for the restoration of a lost function.

Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study.

PubMed

Fluet, Gerard G; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V; Tunik, Eugene; Merians, Alma S

2017-07-01

The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document

Switching to the Rubber Hand

PubMed Central

Yeh, Su-Ling; Lane, Timothy Joseph; Chang, An-Yi; Chien, Sung-En

2017-01-01

Inducing the rubber hand illusion (RHI) requires that participants look at an imitation hand while it is stroked in synchrony with their occluded biological hand. Previous explanations of the RHI have emphasized multisensory integration, and excluded higher cognitive functions. We investigated the relationship between the RHI and higher cognitive functions by experimentally testing task switch (as measured by switch cost) and mind wandering (as measured by SART score); we also included a questionnaire for attentional control that comprises two subscales, attention-shift and attention-focus. To assess experience of RHI, the Botvinick and Cohen (1998) questionnaire was used and illusion onset time was recorded. Our results indicate that rapidity of onset reliably indicates illusion strength. Regression analysis revealed that participants evincing less switch cost and higher attention-shift scores had faster RHI onset times, and that those with higher attention-shift scores experienced the RHI more vividly. These results suggest that the multi-sensory hypothesis is not sufficient to explain the illusion: higher cognitive functions should be taken into account when explaining variation in the experience of ownership for the rubber hand. PMID:29312048

The synergic effects of mirror therapy and neuromuscular electrical stimulation for hand function in stroke patients.

PubMed

Yun, Gi Jeong; Chun, Min Ho; Park, Ji Young; Kim, Bo Ryun

2011-06-01

To investigate the synergic effects of mirror therapy and neuromuscular electrical stimulation (NMES) for hand function in stroke patients. Sixty patients with hemiparesis after stroke were included (41 males and 19 females, average age 63.3 years). Twenty patients had NMES applied and simultaneously underwent mirror therapy. Twenty patients had NMES applied only, and twenty patients underwent mirror therapy only. Each treatment was done five days per week, 30 minutes per day, for three weeks. NMES was applied on the surface of the extensor digitorum communis and extensor pollicis brevis for open-hand motion. Muscle tone, Fugl-Meyer assessment, and power of wrist and hand were evaluated before and after treatment. There were significant improvements in the Fugl-Meyer assessment score in the wrist, hand and coordination, as well as power of wrist and hand in all groups after treatment. The mirror and NMES group showed significant improvements in the Fugl-Meyer scores of hand, wrist, coordination and power of hand extension compared to the other groups. However, the power of hand flexion, wrist flexion, and wrist extension showed no significant differences among the three groups. Muscle tone also showed no significant differences in the three groups. Our results showed that there is a synergic effect of mirror therapy and NMES on hand function. Therefore, a hand rehabilitation strategy combined with NMES and mirror therapy may be more helpful for improving hand function in stroke patients than NMES or mirror therapy only.

A computerized tablet with visual feedback of hand position for functional magnetic resonance imaging

PubMed Central

Karimpoor, Mahta; Tam, Fred; Strother, Stephen C.; Fischer, Corinne E.; Schweizer, Tom A.; Graham, Simon J.

2015-01-01

Neuropsychological tests behavioral tasks that very commonly involve handwriting and drawing are widely used in the clinic to detect abnormal brain function. Functional magnetic resonance imaging (fMRI) may be useful in increasing the specificity of such tests. However, performing complex pen-and-paper tests during fMRI involves engineering challenges. Previously, we developed an fMRI-compatible, computerized tablet system to address this issue. However, the tablet did not include visual feedback of hand position (VFHP), a human factors component that may be important for fMRI of certain patient populations. A real-time system was thus developed to provide VFHP and integrated with the tablet in an augmented reality display. The effectiveness of the system was initially tested in young healthy adults who performed various handwriting tasks in front of a computer display with and without VFHP. Pilot fMRI of writing tasks were performed by two representative individuals with and without VFHP. Quantitative analysis of the behavioral results indicated improved writing performance with VFHP. The pilot fMRI results suggest that writing with VFHP requires less neural resources compared to the without VFHP condition, to maintain similar behavior. Thus, the tablet system with VFHP is recommended for future fMRI studies involving patients with impaired brain function and where ecologically valid behavior is important. PMID:25859201

Mirror therapy improves hand function in subacute stroke: a randomized controlled trial.

PubMed

Yavuzer, Gunes; Selles, Ruud; Sezer, Nebahat; Sütbeyaz, Serap; Bussmann, Johannes B; Köseoğlu, Füsun; Atay, Mesut B; Stam, Henk J

2008-03-01

To evaluate the effects of mirror therapy on upper-extremity motor recovery, spasticity, and hand-related functioning of inpatients with subacute stroke. Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months. Rehabilitation education and research hospital. A total of 40 inpatients with stroke (mean age, 63.2y), all within 12 months poststroke. Thirty minutes of mirror therapy program a day consisting of wrist and finger flexion and extension movements or sham therapy in addition to conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks. The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), and hand-related functioning (self-care items of the FIM instrument). The scores of the Brunnstrom stages for the hand and upper extremity and the FIM self-care score improved more in the mirror group than in the control group after 4 weeks of treatment (by 0.83, 0.89, and 4.10, respectively; all P<.01) and at the 6-month follow-up (by 0.16, 0.43, and 2.34, respectively; all P<.05). No significant differences were found between the groups for the MAS. In our group of subacute stroke patients, hand functioning improved more after mirror therapy in addition to a conventional rehabilitation program compared with a control treatment immediately after 4 weeks of treatment and at the 6-month follow-up, whereas mirror therapy did not affect spasticity.

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.

PubMed

Luchetti, Martina; Cutti, Andrea G; Verni, Gennaro; Sacchetti, Rinaldo; Rossi, Nicolino

2015-01-01

This work explores the functional and psychosocial impact of the multigrip Michelangelo (M) prosthetic hand. Transradial myoelectric prosthesis users (6 men, median age: 47 y) participated in a crossover longitudinal study. A multifactorial assessment protocol was applied before the application of M and after 3 mo (functional assessment) and 6 mo (psychosocial assessment) of home use. Functional assessment included both practical tests (i.e., Southampton Hand Assessment Procedure [SHAP], Box and Blocks Test [BBT], and Minnesota Manual Dexterity Test [MMDT]) and self-report functional scales. Psychosocial assessment consisted of a clinical interview and a battery of self-report questionnaires concerning current anxious-depressive symptoms and health-related quality of life, body image concerns, adjustment and satisfaction with prosthesis, social support, coping style, and personality. Increased manual dexterity was observed after 3 mo based on improvements in the SHAP, BBT, and MMDT. Two important themes emerged from the clinical interviews at the 6 mo follow-up: (1) the enhanced functionality and (2) the "like a real hand" aspect of the M, which further increased prosthesis integration to the Self. A few patients expressed concerns about M dimension, noise, and weight. The M appeared to restore hand function and natural appearance. The present findings provide preliminary evidence, and additional studies are needed.

Introduction to Density Functional Theory: Calculations by Hand on the Helium Atom

ERIC Educational Resources Information Center

Baseden, Kyle A.; Tye, Jesse W.

2014-01-01

Density functional theory (DFT) is a type of electronic structure calculation that has rapidly gained popularity. In this article, we provide a step-by-step demonstration of a DFT calculation by hand on the helium atom using Slater's X-Alpha exchange functional on a single Gaussian-type orbital to represent the atomic wave function. This DFT…

The Application of Surface Potential Test on Hand-making Insulation for Generator Stator End-winding

NASA Astrophysics Data System (ADS)

Lu, Zhu-mao; Liu, Qing; Wang, Tian-zheng; Bai, Lu; Li, Yan-peng

2017-05-01

This paper presents the advantage of surface potential test on hand-making insulation for generator stator end-winding insulation detection, compared with DC or AC withstand voltage test, also details the test principle, connection method and test notes. And through the case, surface potential test on hand-making insulation proved effective for insulation quality detection after generator stator end-winding maintenance, and the experimental data is useful and reliable for the electrical equipment operation and maintenance in the power plant.

The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis.

PubMed

Magni, Nicoló Edoardo; McNair, Peter John; Rice, David Andrew

2017-06-13

Hand osteoarthritis is a common condition characterised by joint pain and muscle weakness. These factors are thought to contribute to ongoing disability. Some evidence exists that resistance training decreases pain, improves muscle strength, and enhances function in people with knee and hip osteoarthritis. However, there is currently a lack of consensus regarding its effectiveness in people with hand osteoarthritis. Therefore, the aim of this systematic review and meta-analysis was to establish whether resistance training in people with hand osteoarthritis increases grip strength, decreases joint pain, and improves hand function. Seven databases were searched from 1975 until July 1, 2016. Randomised controlled trials were included. The Cochrane Risk of Bias Tool was used to assess studies' methodological quality. The Grade of Recommendations Assessment, Development, and Evaluation system was adopted to rate overall quality of evidence. Suitable studies were pooled using a random-effects meta-analysis. Five studies were included with a total of 350 participants. The majority of the training programs did not meet recommended intensity, frequency, or progression criteria for muscle strengthening. There was moderate-quality evidence that resistance training does not improve grip strength (mean difference = 1.35; 95% confidence interval (CI) = -0.84, 3.54; I 2  = 50%; p = 0.23 ). Low-quality evidence showed significant improvements in joint pain (standardised mean difference (SMD) = -0.23; 95% CI = -0.42, -0.04; I 2  = 0%; p = 0.02) which were not clinically relevant. Low-quality evidence demonstrated no improvements in hand function following resistance training (SMD = -0.1; 95% CI = -0.33, 0.13; I 2  = 28%; p = 0.39). There is no evidence that resistance training has a significant effect on grip strength or hand function in people with hand osteoarthritis. Low-quality evidence suggests it has a small, clinically

Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity.

PubMed

Fiori, Simona; Guzzetta, Andrea; Pannek, Kerstin; Ware, Robert S; Rossi, Giuseppe; Klingels, Katrijn; Feys, Hilde; Coulthard, Alan; Cioni, Giovanni; Rose, Stephen; Boyd, Roslyn N

2015-01-01

To provide first evidence of construct validity of a semi-quantitative scale for brain structural MRI (sqMRI scale) in children with unilateral cerebral palsy (UCP) secondary to periventricular white matter (PWM) lesions, by examining the relationship with hand sensorimotor function and whole brain structural connectivity. Cross-sectional study of 50 children with UCP due to PWM lesions using 3 T (MRI), diffusion MRI and assessment of hand sensorimotor function. We explored the relationship of lobar, hemispheric and global scores on the sqMRI scale, with fractional anisotropy (FA), as a measure of brain white matter microstructure, and with hand sensorimotor measures (Assisting Hand Assessment, AHA; Jebsen-Taylor Test for Hand Function, JTTHF; Melbourne Assessment of Unilateral Upper Limb Function, MUUL; stereognosis; 2-point discrimination). Lobar and hemispheric scores on the sqMRI scale contralateral to the clinical side of hemiplegia correlated with sensorimotor paretic hand function measures and FA of a number of brain structural connections, including connections of brain areas involved in motor control (postcentral, precentral and paracentral gyri in the parietal lobe). More severe lesions correlated with lower sensorimotor performance, with the posterior limb of internal capsule score being the strongest contributor to impaired hand function. The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure-function relationships but requires further validation in other populations of CP.

Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity

PubMed Central

Fiori, Simona; Guzzetta, Andrea; Pannek, Kerstin; Ware, Robert S.; Rossi, Giuseppe; Klingels, Katrijn; Feys, Hilde; Coulthard, Alan; Cioni, Giovanni; Rose, Stephen; Boyd, Roslyn N.

2015-01-01

Aim To provide first evidence of construct validity of a semi-quantitative scale for brain structural MRI (sqMRI scale) in children with unilateral cerebral palsy (UCP) secondary to periventricular white matter (PWM) lesions, by examining the relationship with hand sensorimotor function and whole brain structural connectivity. Methods Cross-sectional study of 50 children with UCP due to PWM lesions using 3 T (MRI), diffusion MRI and assessment of hand sensorimotor function. We explored the relationship of lobar, hemispheric and global scores on the sqMRI scale, with fractional anisotropy (FA), as a measure of brain white matter microstructure, and with hand sensorimotor measures (Assisting Hand Assessment, AHA; Jebsen–Taylor Test for Hand Function, JTTHF; Melbourne Assessment of Unilateral Upper Limb Function, MUUL; stereognosis; 2-point discrimination). Results Lobar and hemispheric scores on the sqMRI scale contralateral to the clinical side of hemiplegia correlated with sensorimotor paretic hand function measures and FA of a number of brain structural connections, including connections of brain areas involved in motor control (postcentral, precentral and paracentral gyri in the parietal lobe). More severe lesions correlated with lower sensorimotor performance, with the posterior limb of internal capsule score being the strongest contributor to impaired hand function. Conclusion The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure–function relationships but requires further validation in other populations of CP. PMID:26106533

Increased functional connectivity between cortical hand areas and praxis network associated with training-related improvements in non-dominant hand precision drawing.

PubMed

Philip, Benjamin A; Frey, Scott H

2016-07-01

Chronic forced use of the non-dominant left hand yields substantial improvements in the precision and quality of writing and drawing. These changes may arise from increased access by the non-dominant (right) hemisphere to dominant (left) hemisphere mechanisms specialized for end-point precision control. To evaluate this prediction, 22 healthy right-handed adults underwent resting state functional connectivity (FC) MRI scans before and after 10 days of training on a left hand precision drawing task. 89% of participants significantly improved left hand speed, accuracy, and smoothness. Smoothness gains were specific to the trained left hand and persistent: 6 months after training, 71% of participants exhibited above-baseline movement smoothness. Contrary to expectations, we found no evidence of increased FC between right and left hemisphere hand areas. Instead, training-related improvements in left hand movement smoothness were associated with increased FC between both sensorimotor hand areas and a left-lateralized parieto-prefrontal network implicated in manual praxis. By contrast, skill retention at 6 months was predicted by changes including decreased FC between the representation of the trained left hand and bilateral sensorimotor, parietal, and premotor cortices, possibly reflecting consolidation and a disengagement of early learning processes. These data indicate that modest amounts of training (<200min total) can induce substantial, persistent improvements the precision and quality of non-dominant hand control in healthy adults, supported by strengthened connectivity between bilateral sensorimotor hand areas and a left-lateralized parieto-prefrontal praxis network. Copyright © 2016 Elsevier Ltd. All rights reserved.

The influence of functional electrical stimulation on hand motor recovery in stroke patients: a review.

PubMed

Quandt, Fanny; Hummel, Friedhelm C

2014-01-01

Neuromuscular stimulation has been used as one potential rehabilitative treatment option to restore motor function and improve recovery in patients with paresis. Especially stroke patients who often regain only limited hand function would greatly benefit from a therapy that enhances recovery and restores movement. Multiple studies investigated the effect of functional electrical stimulation on hand paresis, the results however are inconsistent. Here we review the current literature on functional electrical stimulation on hand motor recovery in stroke patients. We discuss the impact of different parameters such as stage after stoke, degree of impairment, spasticity and treatment protocols on the functional outcome. Importantly, we outline the results from recent studies investigating the cortical effects elicited by functional electrical stimulation giving insights into the underlying mechanisms responsible for long-term treatment effects. Bringing together the findings from present research it becomes clear that both, treatment outcomes as well as the neurophysiologic mechanisms causing functional recovery, vary depending on patient characteristics. In order to develop unified treatment guidelines it is essential to conduct homogenous studies assessing the impact of different parameters on rehabilitative success.

The influence of functional electrical stimulation on hand motor recovery in stroke patients: a review

PubMed Central

2014-01-01

Neuromuscular stimulation has been used as one potential rehabilitative treatment option to restore motor function and improve recovery in patients with paresis. Especially stroke patients who often regain only limited hand function would greatly benefit from a therapy that enhances recovery and restores movement. Multiple studies investigated the effect of functional electrical stimulation on hand paresis, the results however are inconsistent. Here we review the current literature on functional electrical stimulation on hand motor recovery in stroke patients. We discuss the impact of different parameters such as stage after stoke, degree of impairment, spasticity and treatment protocols on the functional outcome. Importantly, we outline the results from recent studies investigating the cortical effects elicited by functional electrical stimulation giving insights into the underlying mechanisms responsible for long-term treatment effects. Bringing together the findings from present research it becomes clear that both, treatment outcomes as well as the neurophysiologic mechanisms causing functional recovery, vary depending on patient characteristics. In order to develop unified treatment guidelines it is essential to conduct homogenous studies assessing the impact of different parameters on rehabilitative success. PMID:25276333

Transplantation of severed digits to forearm stump for restoration of partial hand function.

PubMed

Cheng, G L; Pan, D D; Qu, Z Y

1985-10-01

Three cases of mutilating injury of the distal end of the forearm, wrist, and palm treated by transplantation of severed digits to the forearm stump are reported. Follow-up examinations made at 1 year and 4 months to 31/2 years postoperatively revealed fair sensory and motor functions. The functional result is better than that obtained after Krukenberg's operation or prosthesis fitting, and is comparable to that of "hand" reconstruction by autotransplantation of toes. Since this procedure can fulfill the basic requirements of hand function by reconstruction, namely, good sensibility; basic motor functions of pinching, grasping, and powerful gripping; and acceptable outward appearance, and can be accomplished in a one-stage operation without sacrificing toes, it should be considered as first choice whenever a suitable case is encountered.

Design and Preliminary Feasibility Study of a Soft Robotic Glove for Hand Function Assistance in Stroke Survivors

PubMed Central

Yap, Hong Kai; Lim, Jeong Hoon; Nasrallah, Fatima; Yeow, Chen-Hua

2017-01-01

Various robotic exoskeletons have been proposed for hand function assistance during activities of daily living (ADL) of stroke survivors. However, traditional exoskeletons involve the use of complex rigid systems that impede the natural movement of joints, and thus reduce the wearability and cause discomfort to the user. The objective of this paper is to design and evaluate a soft robotic glove that is able to provide hand function assistance using fabric-reinforced soft pneumatic actuators. These actuators are made of silicone rubber which has an elastic modulus similar to human tissues. Thus, they are intrinsically soft and compliant. Upon air pressurization, they are able to support finger range of motion (ROM) and generate the desired actuation of the finger joints. In this work, the soft actuators were characterized in terms of their blocked tip force, normal and frictional grip force outputs. Combining the soft actuators and flexible textile materials, a soft robotic glove was developed for grasping assistance during ADL for stroke survivors. The glove was evaluated on five healthy participants for its assisted ROM and grip strength. Pilot test was performed in two stroke survivors to evaluate the efficacy of the glove in assisting functional grasping activities. Our results demonstrated that the actuators designed in this study could generate desired force output at a low air pressure. The glove had a high kinematic transparency and did not affect the active ROM of the finger joints when it was being worn by the participants. With the assistance of the glove, the participants were able to perform grasping actions with sufficient assisted ROM and grip strength, without any voluntary effort. Additionally, pilot test on stroke survivors demonstrated that the patient's grasping performance improved with the presence and assistance of the glove. Patient feedback questionnaires also showed high level of patient satisfaction and comfort. In conclusion, this paper

A test procedure for evaluating surgical hand disinfection.

PubMed

Babb, J R; Davies, J G; Ayliffe, G A

1991-06-01

A technique for assessing the immediate and prolonged efficacy of surgical scrubs and alcoholic hand rubs is described. A mean baseline count is obtained from all volunteers and logarithmic reductions in resident skin flora immediately after one or more applications, and after wearing gloves for 3 h, are measured. Loose-fitting surgical gloves are used for sampling resident flora. Preparations were applied using a standard technique for 2 min, apart from one test with 70% isopropanol (IPA) in which the application time was 30 s. Two studies are described, one of which compared four chlorhexidine scrubs, and the second 70% IPA, 7.5% povidone-iodine scrub, 2% triclosan cleanser and unmedicated bar soap. In spite of their constituent similarity, the four chlorhexidine scrubs varied considerably in efficacy and user acceptability. A 2 min application of 70% IPA was the most effective treatment, and gave log10 reductions of 1.65 for immediate and 1.58 for prolonged effect. This was marginally more effective than a 30 s application, but the difference was not significant. 'Hibiscrub' was the most effective aqueous formulation and gave reductions of 1.01 for immediate effect and 1.16 for prolonged effect. The test described could be used by reference centres and manufacturers to assess the efficacy of new and existing surgical hand disinfection formulations.

Correlation of pain relief with physical function in hand osteoarthritis: randomized controlled trial post hoc analysis.

PubMed

Barthel, H Richard; Peniston, John H; Clark, Michael B; Gold, Morris S; Altman, Roy D

2010-01-01

Nonsteroidal anti-inflammatory drugs are recommended for the relief of pain associated with hand osteoarthritis (OA) but do not alter the underlying structural changes that contribute to impaired physical function. The current analysis examined the relationship of pain relief with measures of function and global rating of disease in patients with hand OA. This was a combined analysis of 2 prospective, randomized, double-blind, 8-week, multicenter, parallel-group studies comparing diclofenac sodium 1% gel with placebo gel (vehicle) in patients with radiographically confirmed mild to moderate hand OA. Patients (n = 783) aged > or = 40 years applied diclofenac sodium 1% gel (2 g) or vehicle to each hand 4 times daily for 8 weeks. Outcome measures included pain intensity assessed on a 100-mm Visual Analog Scale (VAS); the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) subscales for pain, stiffness, and physical function (100-mm VAS); and a global rating of disease (100-mm VAS). Change in VAS pain intensity from baseline to week 8 was categorized (<0%, 0%-<15%, 15%-<30%, 30%-<50%, 50%-<70%, and > or = 70%) without regard to treatment and compared in each category with the mean change from baseline in each AUSCAN subindex and the global rating of disease. Pearson correlations between changes in outcome measures from baseline to week 8 were calculated. Changes in VAS pain intensity were accompanied by similar changes in AUSCAN scores and global rating of disease. Pearson correlations confirmed significant associations (P < 0.001) between change in VAS pain intensity and changes in AUSCAN pain (correlation coefficient [r] = 0.81), AUSCAN function (r = 0.75), AUSCAN stiffness (r = 0.66), and global rating of disease (r = 0.76). Pain relief correlated with improvements in physical function, stiffness, and global rating of disease in patients with hand OA, irrespective of treatment. This suggests that pain or anticipation of pain inhibits physical function and

Functional asymmetries in early learning during right, left, and bimanual performance in right-handed subjects.

PubMed

Aznárez-Sanado, Maite; Fernández-Seara, Maria A; Loayza, Francis R; Pastor, Maria A

2013-03-01

To elucidate differences in activity and connectivity during early learning due to the performing hand. Twenty right-handed subjects were recruited. The neural correlates of explicit visuospatial learning executed with the right, the left hand, and bimanually were investigated using functional magnetic resonance imaging. Connectivity analyses were carried out using the psychophysiological interactions model, considering right and left anterior putamen as index regions. A common neural network was found for the three tasks during learning. Main activity increases were located in posterior cingulate cortex, supplementary motor area, parietal cortex, anterior putamen, and cerebellum (IV-V), whereas activity decrements were observed in prefrontal regions. However, the left hand task showed a greater recruitment of left hippocampal areas when compared with the other tasks. In addition, enhanced connectivity between the right anterior putamen and motor cortical and cerebellar regions was found for the left hand when compared with the right hand task. An additional recruitment of brain regions and increased striato-cortical and striato-cerebellar functional connections is needed when early learning is performed with the nondominant hand. In addition, access to brain resources during learning may be directed by the dominant hand in the bimanual task. Copyright © 2012 Wiley Periodicals, Inc.

Supplemental tests in the evaluation of occupational hand dermatitis in soldiers.

PubMed

Wolf, R; Movshowitz, M; Brenner, S

1996-03-01

Hand dermatitis in soldiers is a considerable problem. The purpose of the study was to evaluate appropriate screening tests to improve the diagnosis of hand dermatitis in soldiers. A group of 111 soldiers with occupational dermatitis from contact with fuels and oils underwent "tailored patch tests" with allergens relevant to their field of work and their environment. The control group consisted of 24 soldiers with various jobs similar to those of civilian life, who had not been exposed to oils and fuels. Seventy-three civilian patients, attending the clinic for patch testing, were also included. Twenty soldiers, who had a history of intensive contact with oil and fuels, but no contact dermatitis, and who were admitted because of various skin diseases (fungal infections, acne, etc.) also underwent the supplemental testing and served as an additional control group. Of the soldiers, 31 (29%) showed one or more positive skin tests of the oil series and 30 patients of this group one or more positive reactions to the standard patch tests trays. No patient of the control groups had a positive test to the oil series. Our results show the value of the supplementary tests as a first-step screening test for detection of oil allergy in soldiers and automobile-mechanics or in workers handling other gasoline- or diesel-powered engineering equipment. The test method appears to be practical, easy to perform, reliable and giving clear and accurate results, with a negligible rate of false positive reactions.

Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia

DTIC Science & Technology

2017-09-01

AWARD NUMBER: W81XWH-16-1-0395 TITLE: Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in...estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

Fitting a hand-glove prosthesis to enhance the reconstructed mutilated hand.

PubMed

Leow, M E; Kour, A K; Pereira, B P; Pho, R W

1998-03-01

Microsurgical reconstruction of the severely mutilated hand aimed at improving prehensile functions often does not address the esthetic aspects of the hand. The poor appearance of the reconstructed hand affects its active display and use. A hand-glove prosthesis may be prescribed in this instance to enhance the overall form and function of the mutilated hand. We reviewed 16 cases of mutilating hand injuries in which surgical reconstructions were performed and the patients were subsequently fitted with a hand-glove prosthesis to augment the outcome. An improved appearance was achieved in all patients fitted with the prosthesis. The patients' sense of confidence was also enhanced, which in turn promoted the active and open use of the reconstructed hands. While prescribed primarily to improve the appearance of the reconstructed hands, these prostheses were documented to enhance the physical hand functions in 11 cases by increasing the span of the hand and providing an opposable post and a palmar base for holding and for anchorage. The prosthesis enhanced assistive functions of the reconstructed hands and freed the contralateral normal hand for use in bimanual activities, such as holding a wallet and taking out money, supporting a note pad for writing, and holding a plate at buffet receptions. At the 18-month follow-up visit, 13 (87%) of the patients continued to use their prosthesis. Wear and tear were problems associated with the frequent use of the prosthesis. The expected life span of the prosthesis with daily use ranged from 2 to 3 years. All the patients acknowledged that the prosthesis played a role in their rehabilitation and that it helped them to overcome the initial psychological trauma and to come to terms with their physical loss.

The Effects of Industrial Protective Gloves and Hand Skin Temperatures on Hand Grip Strength and Discomfort Rating

PubMed Central

2017-01-01

Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation) of 30.44 (5.35) years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI), hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C) and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove). The data were analyzed using the Shapiro–Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA) of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C) had a significant influence on grip when compared to medium (25 °C) and high (45 °C) hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves. PMID:29207573

Functional connectivity analysis of brain hemodynamics during rubber hand illusion.

PubMed

Arizono, Naoki; Kondo, Toshiyuki

2015-08-01

Embodied cognition has been eagerly studied in the recent neuroscience research field. In particular, hand ownership has been investigated through the rubber hand illusion (RHI). Most of the research measured the brain activities during the RHI by using EEG, fMRI, etc., however, near-infrared spectroscopy (NIRS) has not yet been utilized. Here we attempt to measure the brain activities during the RHI task with NIRS, and analyze the functional connectivity so as to understand the relationship between NIRS features and the state of embodied cognition. For the purpose, we developed a visuo-tactile stimulator in the study. As a result, we found that the subjects felt illusory experience showed significant peaks of oxy-Hb in both prefrontal and premotor cortices during RHI. Furthermore, we confirmed a reliable causality connection from right prefrontal to right premotor cortex. This result suggests that the RHI is associated with the neural circuits underlying motor control. Therefore, we considered that the RHI with the functional connectivity analysis will become an appropriate model investigating a biomarker for neurorehabilitation, and the diagnosis of the mental disorders.

Effects of waterproof covering on hand immersion tests using water at 10 degrees C, 12 degrees C and 15 degrees C for diagnosis of hand-arm vibration syndrome.

PubMed

Suizu, K; Harada, N

2005-05-01

To compare effects of waterproof covering on finger skin temperature (FST) and subjective hand pain during immersion tests using cold water at 10 degrees C, 12 degrees C and 15 degrees C. In the (Draft International Standard) of the International Organization for Standardization (ISO/DIS 14835-1), a water temperature of 12 degrees C and use of water covering are proposed. Six healthy male subjects took part in the immersion tests and immersed both hands into water at 10 degrees C, 12 degrees C and 15 degrees C for 5 min, repeatedly, with waterproof covering (polyethylene gloves) or without (bare hands). The FST data from middle fingers and subjective pain scores for hand pain were analyzed. Furthermore, the test with water at 12 degrees C was repeated to assess the repeatability of the test. The glove and water temperature factors for FST were significant at every minute from 1 min during immersion up to 2 min after recovery, showing higher values for waterproof covering than for bare hands and showing lowest values for water temperature of 10 degrees C and highest for 15 degrees C. The glove and water temperature factors for subjective pain score were significant at the 1-min and 2-min points during immersion, showing lower scores for waterproof covering than for bare hands and showing highest scores for water temperature of 10 degrees C and lowest for 15 degrees C. The results of the first and second tests using water of 12 degrees C showed no systematic difference in FST and hand pain between the tests, with a few exceptions. Subjective pain during the cold immersion test with polyethylene gloves and water at 12 degrees C can be reduced, while the differences in FST between water temperatures of 10 degrees C and 12 degrees C were small or not apparent at some points during immersion and recovery. The test also seems to be suitable for repeatability. Further investigation on hand-arm vibration syndrome (HAVS) patients to validate the use of the immersion test

Measuring the validation of assessing the non-dominant-hand function by ALSFRS-r in Chinese ALS patients.

PubMed

Hu, Fangfang; Jin, Jiaoting; Jia, Rui; Xiang, Li; Qi, Huaguang; Zhao, Xing; Dang, Jingxia

2017-12-01

ALSFRS-r is a widely accepted rating scale for measuring the global function of Amyotrophic Lateral Sclerosis (ALS) patients, but we found some limitations of ALSFRS-r in assessing the function of non-dominant hand in Chinese ALS patients. We reviewed 95 ALS patients who expressed upper-limb symptoms at first visit and analyzed the ALSFRS-r score and subscale. In both upper limb involved patients, the ALSFRS-r had no difference between dominant-hand and non-dominant-hand onset groups (39.15±5.55 vs 38.0±5.91, p=0.477). But in only one upper limb involved patients, the ALSFRS-r score in non-dominant-hand onset patients was higher than dominant-hand onset patients (43.94±3.44 vs 40.87±4.42, p<0.05), especially in item of handwriting, cutting food and handing utensils (3.56±0.89 vs 2.2±1.27 p=0.001, 3.44±1.03 vs 1.8±1.21 p=0.000). When the item of cutting food and handing utensils was replaced by using food bowl and chopsticks to assess the function of non-dominant-hand, the modified ALSFRS-r score was significantly lower than original ALSFRS-r (43.94±3.44 vs 42.88±3.07 p=0.001), the progression rate was slower (0.81±0.63 vs 0.64±0.63, p=0.001). So, for Chinese ALS patients, using food bowl and chopsticks should replace the item of cutting food and handling utensils to assess the non-dominant-hand function, especially in non-dominant-hand onset patients. Copyright © 2017. Published by Elsevier Ltd.

MusicGlove: motivating and quantifying hand movement rehabilitation by using functional grips to play music.

PubMed

Friedman, Nizan; Chan, Vicky; Zondervan, Danny; Bachman, Mark; Reinkensmeyer, David J

2011-01-01

People with stroke typically must perform much of their hand exercise at home without professional assistance as soon as two weeks after the stroke. Without feedback and encouragement, individuals often lose motivation to practice using the affected hand, and this disuse contributes to further declines in hand function. We developed the MusicGlove as a way to facilitate and motivate at home practice of hand movement. This low-cost device uses music as an interactive and motivating medium to guide hand exercise and to quantitatively assess hand movement recovery. It requires the user to practice functional movements, including pincer grip, key-pinch grip, and finger-thumb opposition, by using those movements to play different musical notes, played along to songs displayed by an interactive computer game. We report here the design of the glove and the results of a single-session experiment with 10 participants with chronic stroke. We found that the glove is well suited for use by people with an impairment level quantified by a Box and Blocks score of at least around 7; that the glove can be used to obtain a measure of hand dexterity (% of notes hit) that correlates strongly with the Box and Blocks score; and that the incorporation of music into training significantly improved both objective measures of hand motor performance and self-ratings of motivation for training in the single session.

Aristotle's illusion reveals interdigit functional somatosensory alterations in focal hand dystonia.

PubMed

Tinazzi, Michele; Marotta, Angela; Fasano, Alfonso; Bove, Francesco; Bentivoglio, Anna Rita; Squintani, Giovanna; Pozzer, Lara; Fiorio, Mirta

2013-03-01

In focal hand dystonia, the cortical somatosensory representation of the fingers is abnormal, with overlapping receptive fields and reduced interdigit separation. These abnormalities are associated with deficits in sensory perception, as previously demonstrated by applying tactile stimuli to one finger at a time. What is still unknown is whether the sensory deficits can be observed when tactile perception involves more than one finger. To address this issue, we applied 'Aristotle's illusion' to 15 patients with focal hand dystonia, 15 patients with dystonia not affecting the hand (blepharospasm and cervical dystonia) and 15 healthy control subjects. In this illusion, one object touching the contact point of two crossed fingertips is perceived as two objects by a blindfolded subject. The same object placed between two parallel fingertips is correctly perceived as one. The illusory doubling sensation is because of the fact that the contact point between the crossed fingers consists of non-adjacent and functionally unrelated skin regions, which usually send sensory signals to separate spots in the somatosensory cortex. In our study, participants were touched by one sphere between the second-third digits, the second-fourth digits and the fourth-fifth digits of both hands, either in crossed or in parallel position, and had to refer whether they felt one or two stimuli. The percentage of 'two stimuli' responses was an index of the illusory doubling. Both healthy control subjects and dystonic patients presented Aristotle's illusion when the fingers were crossed. However, patients with focal hand dystonia presented a significant reduction of the illusion when the sphere was placed between the crossed fourth and fifth digits of the affected hand. This reduction correlated with the severity of motor disease at the fingers. Similar findings were not observed in non-hand dystonia and control groups. The reduction of Aristotle's illusion in non-affected fingers and its

The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

PubMed

Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter

2017-02-01

Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, p<0.0001 on testing with Lin's correlation coefficient). A significant relationship was shown between the HABS score and a reliable binary outcome of the requirement for surgical excision on Mann-Whitney U testing (U=152; Z=9.8; p=0.0001). A receiver operator characteristic (ROC) curve analysis found a cut off score of 5.5, indicating that those with a HABS score below 6 did not require an operation, whereas those with a score above 6 did. The HABS score was shown to be more sensitive and specific that assessment of burn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Further Development and Test of an Artificial Hand for Communication with Deaf-Blind People. Final Report.

ERIC Educational Resources Information Center

Laenger, Charles J., Sr.; Peel, H. Herbert

The report details the development and design of a mechanical hand for communicating with deaf blind persons. It is explained that the device, which looks and functions like the human hand, forms the symbols of the one-hand manual alphabet upon command from a standard electric typewriter keyboard. The report addresses the following topics (sample…

Assessment from Functional Perspectives: Using Sensorimotor Control in the Hand as an Outcome Indicator in the Surgical Treatment of Carpal Tunnel Syndrome

PubMed Central

Hsu, Hsiu-Yun; Su, Fong-Chin; Kuo, Yao-Lung; Jou, I-Ming; Chiu, Haw-Yen; Kuo, Li-Chieh

2015-01-01

To investigate whether sensorimotor control of the hand could be an outcome indicator after carpal tunnel release (CTR), this work examined changes in the results of patients’ manual tactile test (MTT), pinch-holding-up activity (PHUA), two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) tests. Participants included 30 predominantly sensory neuropathy CTS patients, as confirmed by a nerve conduction study. The MTT, precision pinch performance in PHUA and traditional sensibility (2PD and SWM) tests were used to examine different aspects of sensory status at the time-points of two weeks before operation and one month post-operation, with a single-blind design. The results showed significant improvements in the sensory function as detected by the 2PD and SWM tests (p<0.001) and sensorimotor function as detected by the MTT (p<0.001) and PHUA test (p<0.05) for patients receiving CTR. The responsiveness of the SWM, MTT and PHUA tests (effect size>0.5, p<0.01) are better than that of two-point discrimination test (effect size<0.5, p<0.001). However, pinch strength saw a decline compared to baseline with a moderate effect sizes (effect size = 0.7, p<0.001). This cohort study found that the MTT and PHUA test can both meet all the statistical criteria with regard to assessing treatment outcomes for patients with CTS. In addition, the results of this work provide clinicians with the information that the sensorimotor functions of the hands, as assessed by MTT and PHUA, are responsive to clinical changes due to CTR. PMID:26053242

Assessment from Functional Perspectives: Using Sensorimotor Control in the Hand as an Outcome Indicator in the Surgical Treatment of Carpal Tunnel Syndrome.

PubMed

Hsu, Hsiu-Yun; Su, Fong-Chin; Kuo, Yao-Lung; Jou, I-Ming; Chiu, Haw-Yen; Kuo, Li-Chieh

2015-01-01

To investigate whether sensorimotor control of the hand could be an outcome indicator after carpal tunnel release (CTR), this work examined changes in the results of patients' manual tactile test (MTT), pinch-holding-up activity (PHUA), two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) tests. Participants included 30 predominantly sensory neuropathy CTS patients, as confirmed by a nerve conduction study. The MTT, precision pinch performance in PHUA and traditional sensibility (2PD and SWM) tests were used to examine different aspects of sensory status at the time-points of two weeks before operation and one month post-operation, with a single-blind design. The results showed significant improvements in the sensory function as detected by the 2PD and SWM tests (p<0.001) and sensorimotor function as detected by the MTT (p<0.001) and PHUA test (p<0.05) for patients receiving CTR. The responsiveness of the SWM, MTT and PHUA tests (effect size>0.5, p<0.01) are better than that of two-point discrimination test (effect size<0.5, p<0.001). However, pinch strength saw a decline compared to baseline with a moderate effect sizes (effect size = 0.7, p<0.001). This cohort study found that the MTT and PHUA test can both meet all the statistical criteria with regard to assessing treatment outcomes for patients with CTS. In addition, the results of this work provide clinicians with the information that the sensorimotor functions of the hands, as assessed by MTT and PHUA, are responsive to clinical changes due to CTR.

Hand rehabilitation using MIDI keyboard playing in adolescents with brain damage: a preliminary study.

PubMed

Chong, Hyun Ju; Cho, Sung-Rae; Kim, Soo Ji

2014-01-01

As a sequential, programmed movement of fingers, keyboard playing is a promising technique for inducing execution and a high level of coordination during finger movements. Also, keyboard playing can be physically and emotionally rewarding for adolescents in rehabilitation settings and thereby motivate continued involvement in treatment. The purpose of this study is to evaluate the effects of keyboard playing using Musical Instrument Digital Interface (MIDI) on finger movement for adolescents with brain damage. Eight adolescents with brain damage, ages 9 to 18 years (M = 13 years, SD = 2.78), in physical rehabilitation settings participated in this study. Measurements included MIDI keyboard playing for pressing force of the fingers and hand function tests (Grip and Pinch Power Test, Box and Block Test of Manual Dexterity [BBT], and the Jebsen Taylor Hand Function Test). Results showed increased velocity of all fingers on the MIDI-based test, and statistical significance was found in the velocity of F2 (index finger), F3 (middle finger), and F5 (little finger) between pre- and post-training tests. Correlation analysis between the pressing force of the finger and hand function tests showed a strong positive correlation between the measure of grip power and the pressing force of F2 and F5 on the Grip and Pinch Strength Test. All fingers showed strong correlation between MIDI results and BBT. For the Jebsen Taylor Hand Function Test, only the moving light objects task at post-training yielded strong correlation with MIDI results of all fingers. The results support using keyboard playing for hand rehabilitation, especially in the pressing force of individual finger sequential movements. Further investigation is needed to define the feasibility of the MIDI program for valid hand rehabilitation for people with brain damage.

Evaluation of Patients' Satisfaction and Functional Outcome of Dorsal Hand Unit Reconstruction in Burn Patients in Shiraz, Southern Iran.

PubMed

Mohammadi, Ali Akbar; Foroutan, Ali; Mohammadi, Soheil; Zardosht, Mitra

2018-06-13

The aim of this study was to assess patients' satisfaction and functional outcome of dorsal hand unit reconstruction in burn patients in Shiraz, southern Iran.From September 2013 to February 2017, 11 patients (15 hands) with hand aesthetic complaint who were unhappy with their hand appearance were included for dorsal hand unit reconstruction. Under general anesthesia and tourniquet control, the burned tissue on dorsal surface of the hands was excised and a thick partial thickness skin graft was used for coverage, whereas the fingers were fixed by sutures to the palm. After 1 year, the five-points scale was used for evaluation of patients' satisfaction regarding the five major activities considered for hand function before and after operation. The mean age of the patients was 25.8 ± 5.17 years. The skin grafts were well taken. Six (40%) and eight patients (53%) reported the result of operation as completely satisfied and satisfied, respectively. Dorsal hand unit reconstruction in patients with dorsal hand contracture and significant dorsal scar was shown to simultaneously improve the function and aesthetic outcome of the surgery.

Artificial neural network EMG classifier for functional hand grasp movements prediction.

PubMed

Gandolla, Marta; Ferrante, Simona; Ferrigno, Giancarlo; Baldassini, Davide; Molteni, Franco; Guanziroli, Eleonora; Cotti Cottini, Michele; Seneci, Carlo; Pedrocchi, Alessandra

2017-12-01

Objective To design and implement an electromyography (EMG)-based controller for a hand robotic assistive device, which is able to classify the user's motion intention before the effective kinematic movement execution. Methods Multiple degrees-of-freedom hand grasp movements (i.e. pinching, grasp an object, grasping) were predicted by means of surface EMG signals, recorded from 10 bipolar EMG electrodes arranged in a circular configuration around the forearm 2-3 cm from the elbow. Two cascaded artificial neural networks were then exploited to detect the patient's motion intention from the EMG signal window starting from the electrical activity onset to movement onset (i.e. electromechanical delay). Results The proposed approach was tested on eight healthy control subjects (4 females; age range 25-26 years) and it demonstrated a mean ± SD testing performance of 76% ± 14% for correctly predicting healthy users' motion intention. Two post-stroke patients tested the controller and obtained 79% and 100% of correctly classified movements under testing conditions. Conclusion A task-selection controller was developed to estimate the intended movement from the EMG measured during the electromechanical delay.

Artificial neural network EMG classifier for functional hand grasp movements prediction

PubMed Central

Ferrante, Simona; Ferrigno, Giancarlo; Baldassini, Davide; Molteni, Franco; Guanziroli, Eleonora; Cotti Cottini, Michele; Seneci, Carlo; Pedrocchi, Alessandra

2016-01-01

Objective To design and implement an electromyography (EMG)-based controller for a hand robotic assistive device, which is able to classify the user's motion intention before the effective kinematic movement execution. Methods Multiple degrees-of-freedom hand grasp movements (i.e. pinching, grasp an object, grasping) were predicted by means of surface EMG signals, recorded from 10 bipolar EMG electrodes arranged in a circular configuration around the forearm 2–3 cm from the elbow. Two cascaded artificial neural networks were then exploited to detect the patient's motion intention from the EMG signal window starting from the electrical activity onset to movement onset (i.e. electromechanical delay). Results The proposed approach was tested on eight healthy control subjects (4 females; age range 25–26 years) and it demonstrated a mean ± SD testing performance of 76% ± 14% for correctly predicting healthy users' motion intention. Two post-stroke patients tested the controller and obtained 79% and 100% of correctly classified movements under testing conditions. Conclusion A task-selection controller was developed to estimate the intended movement from the EMG measured during the electromechanical delay. PMID:27677300

Functional range of movement of the hand: declination angles to reachable space.

PubMed

Pham, Hai Trieu; Pathirana, Pubudu N; Caelli, Terry

2014-01-01

The measurement of the range of hand joint movement is an essential part of clinical practice and rehabilitation. Current methods use three finger joint declination angles of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints. In this paper we propose an alternate form of measurement for the finger movement. Using the notion of reachable space instead of declination angles has significant advantages. Firstly, it provides a visual and quantifiable method that therapists, insurance companies and patients can easily use to understand the functional capabilities of the hand. Secondly, it eliminates the redundant declination angle constraints. Finally, reachable space, defined by a set of reachable fingertip positions, can be measured and constructed by using a modern camera such as Creative Senz3D or built-in hand gesture sensors such as the Leap Motion Controller. Use of cameras or optical-type sensors for this purpose have considerable benefits such as eliminating and minimal involvement of therapist errors, non-contact measurement in addition to valuable time saving for the clinician. A comparison between using declination angles and reachable space were made based on Hume's experiment on functional range of movement to prove the efficiency of this new approach.

Implied functional crossed cerebello-cerebral diaschisis and interhemispheric compensation during hand grasping more than 20 years after unilateral cerebellar injury in early childhood.

PubMed

Nakahachi, Takayuki; Ishii, Ryouhei; Canuet, Leonides; Iwase, Masao

2015-01-01

Crossed cerebello-cerebral diaschisis (CCCD) conventionally refers to decreased resting cerebral activity caused by injury to the contralateral cerebellum. We investigated whether functional activation of a contralesional cerebral cortical region controlling a specific task is reduced during task performance in a patient with a unilateral cerebellar lesion. We also examined functional compensation by the corresponding ipsilesional cerebral cortex. It was hypothesized that dysfunction of the primary sensorimotor cortex (SM1) contralateral to the cerebellar lesion would be detected together with a compensatory increase in neural activity of the ipsilesional SM1. To test these possibilities, we conducted non-invasive functional neuroimaging techniques for bilateral SM1 during hand grasping, a task known to activate predominantly the SM1 contralateral to the grasping hand. Activity in SM1 during hand grasping was measured electrophysiologically by magnetoencephalography and hemodynamically by near-infrared spectroscopy in an adult with mild right hemiataxia associated with a large injury of the right cerebellum due to resection of a tumor in early childhood. During left hand grasping, increased neural activity was detected predominantly in the right SM1, the typical developmental pattern. In contrast, neural activity increased in the bilateral SM1 with slight right-side dominance during right (ataxic) hand grasping. This study reported a case that implied functional CCCD and compensatory neural activity in the SM1 during performance of a simple hand motor task in an adult with unilateral cerebellar injury and mild hemiataxia 24 years prior to the study without rehabilitative interventions. This suggests that unilateral cerebellar injuries in early childhood may result in persistent functional abnormalities in the cerebrum into adulthood. Therapeutic treatments that target functional CCCD and interhemispheric compensation might be effective for treating ataxia due to

Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke.

PubMed

Rong, Wei; Tong, Kai Yu; Hu, Xiao Ling; Ho, Sze Kit

2015-03-01

An electromyography-driven robot system integrated with neuromuscular electrical stimulation (NMES) was developed to investigate its effectiveness on post-stroke rehabilitation. The performance of this system in assisting finger flexion/extension with different assistance combinations was evaluated in five stroke subjects. Then, a pilot study with 20-sessions training was conducted to evaluate the training's effectiveness. The results showed that combined assistance from the NMES-robot could improve finger movement accuracy, encourage muscle activation of the finger muscles and suppress excessive muscular activities in the elbow joint. When assistances from both NMES and the robot were 50% of their maximum assistances, finger-tracking performance had the best results, with the lowest root mean square error, greater range of motion, higher voluntary muscle activations of the finger joints and lower muscle co-contraction in the finger and elbow joints. Upper limb function improved after the 20-session training, indicated by the increased clinical scores of Fugl-Meyer Assessment, Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was reduced in the finger and elbow joints reflected by the Modified Ashworth Scale. The findings demonstrated that an electromyography-driven NMES-robot used for chronic stroke improved hand function and tracking performance. Further research is warranted to validate the method on a larger scale. Implications for Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES) techniques are still separate systems in current post-stroke hand rehabilitation. This is the first study to investigate the combined effects of the NMES and robot on hand rehabilitation. The finger tracking performance was improved with the combined assistance from the EMG-driven NMES-robot hand system. The assistance from the robot could improve the finger movement accuracy and the assistance from the NMES could reduce the

Smart Hand For Manipulators

NASA Astrophysics Data System (ADS)

Fiorini, Paolo

1987-10-01

Sensor based, computer controlled end effectors for mechanical arms are receiving more and more attention in the robotics industry, because commonly available grippers are only adequate for simple pick and place tasks. This paper describes the current status of the research at JPL on a smart hand for a Puma 560 robot arm. The hand is a self contained, autonomous system, capable of executing high level commands from a supervisory computer. The mechanism consists of parallel fingers, powered by a DC motor, and controlled by a microprocessor embedded in the hand housing. Special sensors are integrated in the hand for measuring the grasp force of the fingers, and for measuring forces and torques applied between the arm and the surrounding environment. Fingers can be exercised under position, velocity and force control modes. The single-chip microcomputer in the hand executes the tasks of communication, data acquisition and sensor based motor control, with a sample cycle of 2 ms and a transmission rate of 9600 baud. The smart hand described in this paper represents a new development in the area of end effector design because of its multi-functionality and autonomy. It will also be a versatile test bed for experimenting with advanced control schemes for dexterous manipulation.

STS-37 crewmembers test CETA hand cart during training session in JSC's WETF

NASA Technical Reports Server (NTRS)

1989-01-01

STS-37 Atlantis, Orbiter Vehicle (OV) 104, Mission Specialist (MS) Jerry L. Ross and MS Jerome Apt test crew and equipment translation aid (CETA) manual hand over hand cart during underwater session in JSC's Weightless Environment Training Facility (WETF) Bldg 29. Wearing an extravehicular mobility unit (EMU), Ross pulls the CETA manual cart along the rail while Apt holds onto the back of the cart. The test will determine how difficult it is to maneuver cargo in such a manner when it is done in space on STS-37. The goal is to find the best method for astronauts to move around the exterior of Space Station Freedom (SSF).

Hand involvement in children with Charcot-Marie-Tooth disease type 1A.

PubMed

Burns, Joshua; Bray, Paula; Cross, Lauren A; North, Kathryn N; Ryan, Monique M; Ouvrier, Robert A

2008-12-01

Charcot-Marie-Tooth disease type 1A (CMT1A), a demyelinating neuropathy characterised by progressive length-dependent muscle weakness and atrophy, is thought to affect the foot and leg first followed some time later by hand weakness and dysfunction. We aimed to characterise hand strength, function and disease-related symptoms in children with CMT1A. Intrinsic and extrinsic hand strength was measured by hand-held dynamometry, function by nine-hole peg test, and disease-related symptoms by interview and examination in 84 affected children aged 2-16 years. Hand weakness and dysfunction was present from the earliest stages of the disease. While hand strength and function measures tended to increase with age throughout childhood, at no point did they reach normal values. Day-to-day hand problems such as poor handwriting, weakness, pain and sensory symptoms also worsened with age. The hand is affected at all ages in children with CMT1A, but may be under-recognised in its early stages, potentially delaying therapy.

Testing the reliability of hands and ears as biometrics: the importance of viewpoint.

PubMed

Stevenage, Sarah V; Walpole, Catherine; Neil, Greg J; Black, Sue M

2015-11-01

Two experiments are presented to explore the limits when matching a sample to a suspect utilising the hand as a novel biometric. The results of Experiment 1 revealed that novice participants were able to match hands at above-chance levels as viewpoint changed. Notably, a moderate change in viewpoint had no notable effect, but a more substantial change in viewpoint affected performance significantly. Importantly, the impact of viewpoint when matching hands was smaller than that when matching ears in a control condition. This was consistent with the suggestion that the flexibility of the hand may have minimised the negative impact of a sub-optimal view. The results of Experiment 2 confirmed that training via a 10-min expert video was sufficient to reduce the impact of viewpoint in the most difficult case but not to remove it entirely. The implications of these results were discussed in terms of the theoretical importance of function when considering the canonical view and in terms of the applied value of the hand as a reliable biometric across viewing conditions.

The right inhibition? Callosal correlates of hand performance in healthy children and adolescents callosal correlates of hand performance.

PubMed

Kurth, Florian; Mayer, Emeran A; Toga, Arthur W; Thompson, Paul M; Luders, Eileen

2013-09-01

Numerous studies suggest that interhemispheric inhibition-relayed via the corpus callosum-plays an important role in unilateral hand motions. Interestingly, transcallosal inhibition appears to be indicative of a strong laterality effect, where generally the dominant hemisphere exerts inhibition on the nondominant one. These effects have been largely identified through functional studies in adult populations, but links between motor performance and callosal structure (especially during sensitive periods of neurodevelopment) remain largely unknown. We therefore investigated correlations between Purdue Pegboard performance (a test of motor function) and local callosal thickness in 170 right-handed children and adolescents (mean age: 11.5 ± 3.4 years; range, 6-17 years). Better task performance with the right (dominant) hand was associated with greater callosal thickness in isthmus and posterior midbody. Task performance using both hands yielded smaller and less significant correlations in the same regions, while task performance using the left (nondominant) hand showed no significant correlations with callosal thickness. There were no significant interactions with age and sex. These links between motor performance and callosal structure may constitute the neural correlate of interhemispheric inhibition, which is thought to be necessary for fast and complex unilateral motions and to be biased towards the dominant hand. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.

The cortical activation pattern by a rehabilitation robotic hand: a functional NIRS study

PubMed Central

Chang, Pyung-Hun; Lee, Seung-Hee; Gu, Gwang Min; Lee, Seung-Hyun; Jin, Sang-Hyun; Yeo, Sang Seok; Seo, Jeong Pyo; Jang, Sung Ho

2014-01-01

Introduction: Clarification of the relationship between external stimuli and brain response has been an important topic in neuroscience and brain rehabilitation. In the current study, using functional near infrared spectroscopy (fNIRS), we attempted to investigate cortical activation patterns generated during execution of a rehabilitation robotic hand. Methods: Ten normal subjects were recruited for this study. Passive movements of the right fingers were performed using a rehabilitation robotic hand at a frequency of 0.5 Hz. We measured values of oxy-hemoglobin (HbO), deoxy-hemoglobin (HbR) and total-hemoglobin (HbT) in five regions of interest: the primary sensory-motor cortex (SM1), hand somatotopy of the contralateral SM1, supplementary motor area (SMA), premotor cortex (PMC), and prefrontal cortex (PFC). Results: HbO and HbT values indicated significant activation in the left SM1, left SMA, left PMC, and left PFC during execution of the rehabilitation robotic hand (uncorrected, p < 0.01). By contrast, HbR value indicated significant activation only in the hand somatotopic area of the left SM1 (uncorrected, p < 0.01). Conclusions: Our results appear to indicate that execution of the rehabilitation robotic hand could induce cortical activation. PMID:24570660

Comparison of positive pressure gloves on hand function in adults with burns.

PubMed

O'Brien, Kimberly A; Weinstock-Zlotnick, Gwen; Hunter, Hope; Yurt, Roger W

2006-01-01

The purpose of this study was to analyze the impact of a standard, custom-made pressure glove vs The NewYork-Presbyterian Dexterity Glove (NYPDG) with silon application on the palmer surface on functional hand use of burn survivors. A standard, custom-made pressure glove and NYPDG were given to 18 participants in a randomized order. Subjects wore each glove for 7 to 10 days during all activities of daily living (ADL). Variables such as hand function, difficulty of fine and gross motor ADL, and participant glove preference were assessed with each glove condition. Data collection of the second glove took place 7 to 10 days later incorporating a quasiexperimental, repeated measure design. A crossover design was used to analyze the data. The NYPDG demonstrated significantly better results in all of the four outcome categories measured: time to complete the Jebsen, the Jebsen Likert scale, fine motor ADL, and gross motor ADL. This study demonstrated that functional tasks took less time to complete and were more easily performed when using the NYPDG.

Standardization of the face-hand test in a Brazilian multicultural population: prevalence of sensory extinction and implications for neurological diagnosis.

PubMed

Luvizutto, Gustavo José; Fogaroli, Marcelo Ortolani; Theotonio, Rodolfo Mazeto; Nunes, Hélio Rubens de Carvalho; Resende, Luiz Antônio de Lima; Bazan, Rodrigo

2016-12-01

The face-hand test is a simple, practical, and rapid test to detect neurological syndromes. However, it has not previously been assessed in a Brazilian sample; therefore, the objective of the present study was to standardize the face-hand test for use in the multi-cultural population of Brazil and identify the sociodemographic factors affecting the results. This was a cross sectional study of 150 individuals. The sociodemographic variables that were collected included age, gender, race, body mass index and years of education. Standardization of the face-hand test occurred in 2 rounds of 10 sensory stimuli, with the participant seated to support the trunk and their vision obstructed in a sound-controlled environment. The face-hand test was conducted by applying 2 rounds of 10 sensory stimuli that were applied to the face and hand simultaneously. The associations between the face-hand test and sociodemographic variables were analyzed using Mann-Whitney tests and Spearman correlations. Binomial models were adjusted for the number of face-hand test variations, and ROC curves evaluated sensitivity and specificity of sensory extinction. There was no significant relationship between the sociodemographic variables and the number of stimuli perceived for the face-hand test. There was a high relative frequency of detection, 8 out of 10 stimuli, in this population. Sensory extinction was 25.3%, which increased with increasing age (OR=1.4[1:01-1:07]; p=0.006) and decreased significantly with increasing education (OR=0.82[0.71-0.94]; p=0.005). In the Brazilian population, a normal face-hand test score ranges between 8-10 stimuli, and the results indicate that sensory extinction is associated with increased age and lower levels of education.

Retraining and assessing hand movement after stroke using the MusicGlove: comparison with conventional hand therapy and isometric grip training

PubMed Central

2014-01-01

Background It is thought that therapy should be functional, be highly repetitive, and promote afferent input to best stimulate hand motor recovery after stroke, yet patients struggle to access such therapy. We developed the MusicGlove, an instrumented glove that requires the user to practice gripping-like movements and thumb-finger opposition to play a highly engaging, music-based, video game. The purpose of this study was to 1) compare the effect of training with MusicGlove to conventional hand therapy 2) determine if MusicGlove training was more effective than a matched form of isometric hand movement training; and 3) determine if MusicGlove game scores predict clinical outcomes. Methods 12 chronic stroke survivors with moderate hemiparesis were randomly assigned to receive MusicGlove, isometric, and conventional hand therapy in a within-subjects design. Each subject participated in six one-hour treatment sessions three times per week for two weeks, for each training type, for a total of 18 treatment sessions. A blinded rater assessed hand impairment before and after each training type and at one-month follow-up including the Box and Blocks (B & B) test as the primary outcome measure. Subjects also completed the Intrinsic Motivation Inventory (IMI). Results Subjects improved hand function related to grasping small objects more after MusicGlove compared to conventional training, as measured by the B & B score (improvement of 3.21±3.82 vs. -0.29±2.27 blocks; P=0.010) and the 9 Hole Peg test (improvement of 2.14±2.98 vs. -0.85±1.29 pegs/minute; P=0.005). There was no significant difference between training types in the broader assessment batteries of hand function. Subjects benefited less from isometric therapy than MusicGlove training, but the difference was not significant (P>0.09). Subjects sustained improvements in hand function at a one month follow-up, and found the MusicGlove more motivating than the other two therapies, as measured by the IMI. Music

Retraining and assessing hand movement after stroke using the MusicGlove: comparison with conventional hand therapy and isometric grip training.

PubMed

Friedman, Nizan; Chan, Vicky; Reinkensmeyer, Andrea N; Beroukhim, Ariel; Zambrano, Gregory J; Bachman, Mark; Reinkensmeyer, David J

2014-04-30

It is thought that therapy should be functional, be highly repetitive, and promote afferent input to best stimulate hand motor recovery after stroke, yet patients struggle to access such therapy. We developed the MusicGlove, an instrumented glove that requires the user to practice gripping-like movements and thumb-finger opposition to play a highly engaging, music-based, video game. The purpose of this study was to 1) compare the effect of training with MusicGlove to conventional hand therapy 2) determine if MusicGlove training was more effective than a matched form of isometric hand movement training; and 3) determine if MusicGlove game scores predict clinical outcomes. 12 chronic stroke survivors with moderate hemiparesis were randomly assigned to receive MusicGlove, isometric, and conventional hand therapy in a within-subjects design. Each subject participated in six one-hour treatment sessions three times per week for two weeks, for each training type, for a total of 18 treatment sessions. A blinded rater assessed hand impairment before and after each training type and at one-month follow-up including the Box and Blocks (B & B) test as the primary outcome measure. Subjects also completed the Intrinsic Motivation Inventory (IMI). Subjects improved hand function related to grasping small objects more after MusicGlove compared to conventional training, as measured by the B & B score (improvement of 3.21±3.82 vs. -0.29±2.27 blocks; P=0.010) and the 9 Hole Peg test (improvement of 2.14±2.98 vs. -0.85±1.29 pegs/minute; P=0.005). There was no significant difference between training types in the broader assessment batteries of hand function. Subjects benefited less from isometric therapy than MusicGlove training, but the difference was not significant (P>0.09). Subjects sustained improvements in hand function at a one month follow-up, and found the MusicGlove more motivating than the other two therapies, as measured by the IMI. MusicGlove games scores correlated

Custom-made silicone hand prosthesis: A case study.

PubMed

Nayak, S; Lenka, P K; Equebal, A; Biswas, A

2016-09-01

Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.

Reliability of the "Ten Test" for assessment of discriminative sensation in hand trauma.

PubMed

Berger, Michael J; Regan, William R; Seal, Alex; Bristol, Sean G

2016-10-01

"Ten Test" (TT) is a bedside measure of discriminative sensation, whereby the magnitude of abnormal sensation to moving light touch is normalized to an area of normal sensation on an 11-point Likert scale (0-10). The purposes of this study were to determine reliability parameters of the TT in a cohort of patients presenting to a hand trauma clinic with subjectively altered sensation post-injury and to compare the reliability of TT to that of the Weinstein Enhanced Sensory Test (WEST). Study participants (n = 29, mean age = 37 ± 12) comprised patients presenting to an outpatient hand trauma clinic with recent hand trauma and self reported abnormal sensation. Participants underwent TT and WEST by two separate raters on the same day. Interrater reliability, response stability and responsiveness of each test were determined by the intraclass correlation coefficient (ICC: 2, 1), standard error of measurement (SEM) with 95% confidence intervals (CI) and minimal detectable difference score, with 95% CI (MDD95), respectively. The TT displayed excellent interrater reliability (ICC = 0.95, 95% CI 0.89-0.97) compared to good reliability for WEST (ICC = 0.78, 95% CI 0.58-0.89). The range of true scores expected with 95% confidence based on the SEM (i.e. response stability), was ±1.1 for TT and ±1.1 for WEST. MDD95 scores reflecting test responsiveness were 1.5 and 1.6 for TT and WEST, respectively. The TT displayed excellent reliability parameters in this patient population. Reliability parameters were stronger for TT compared to WEST. These results provide support for the use of TT as a component of the sensory exam in hand trauma. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Complex trauma of the hand].

PubMed

Pechlaner, S; Hussl, H

1998-01-01

The hand is very exposed to injuries in the daily man's work. The multiple functions of the hand are based on vitality, sensibility, motor function and stability. In severe hand injuries the functional results of the repair are often very poor. In a complex injury of the hand we are faced with the damage of the soft tissue and bone and the loss of vitality and function of the hand. The cause of hand injuries are mainly a crush trauma or the rotating saw. Basically, we recommend an extended primary repair. After the radical debridement we have to reconstruct the damaged structures. We start doing the osteosynthesis and stabilization of the joints. Thereafter, suturing of extensor and flexor tendons. Then, we do the microsurgical reconstructions of vessels and nerves. In case tendons and bones are exposed we have to cover the defect with a pedicled or a free flap. In a long ischemic time we have to change our concept and do the reconstruction of the vessels first. Our results in vitality and sensibility are listed. In the result of a complex hand injury each single functional restoration is very important. Therefore, it is necessary that severe hand injuries are treated at well established centres for hand surgery.

Electromechanical hand incorporates touch sensors and trigger function

NASA Technical Reports Server (NTRS)

Dane, D. H.

1970-01-01

Electromechanical hand incorporates touch sensors, concealed fingers, and a structure that allows the hand to hold a tool on a flat surface. The hands can be mounted on most types of existing manipulators either directly or by means of modified mounting brackets.

Exercise-induced hand tremor: a possible test for beta 2-adrenoceptor selectivity in man?

PubMed Central

Abila, B; Wilson, J F; Marshall, R W; Richens, A

1986-01-01

The effects of intravenous doses of propranolol, sotalol, timolol, atenolol and placebo on exercise-induced tachycardia and exercise-induced increases in hand tremor were assessed in four healthy volunteers. All active drugs produced significant reductions in exercise-induced tachycardia. Exercise caused consistent significant increases in hand tremor which were blocked by the three non-cardioselective drugs but not by atenolol or placebo. The blockade of exercise-induced hand tremor is suggested as a possible test for the assessment of the selectivity of beta-adrenoceptor blockade in man. PMID:2874824

Mental Practice Combined with Physical Practice to Enhance Hand Recovery in Stroke Patients

PubMed Central

Liu, Hua; Song, Lu-ping

2014-01-01

Objectives. To evaluate whether combining mental practice with physical practice training enhances hand function in patients with stroke. Methods. 10 for treatment and 10 for control were recruited for this pre/posttraining matched case control study. In the treatment group, subjects underwent combining mental practice with physical practice for four weeks. In the control group, subjects only participated in physical practice. Change of hand function and the number of activated voxels of the contralateral somatosensory motor cortex (SMC) acquired by functional magnetic resonance imaging were measured. Results. After training, the Action Research Arm Test score increased by 12.65 for treatment and by 5.20 for control. There was a significant difference in the Action Research Arm Test score between the two groups (P = 0.04). The activated voxels number of the contralateral SMC increased in both groups, but the activated voxels number in the contralateral SMC and the improvement of hand function for treatment were greater than for control. In the treatment group, the number of activated voxels of the contralateral SMC was positively correlated with better hand function scores. Conclusions. Combining mental practice with physical practice may be a more effective treatment strategy than physical training alone for hand recovery in stroke patients. PMID:25435713

Investigation of the effects of mirror therapy on the upper extremity functions of stroke patients using the manual function test.

PubMed

Kim, Hwanhee; Shim, Jemyung

2015-01-01

[Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 items), grasp and pinch (2 items), and manipulation (2 items). The experiment was conducted with the subjects sitting in a chair. The mirror was vertically placed in the sagittal plane on the desk. The paretic hand was placed behind the mirror, and the non-paretic hand was placed in front of the mirror so that it was reflected in the mirror. In this position, the subjects completed activities repetitively according to the mirror therapy program over the course of four weeks. [Results] There were significant increases in the grasp-and-pinch score and manipulation score. [Conclusion] In conclusion, the grasp-and-pinch and manipulation functions were improved through mirror therapy.

Computer vision-based classification of hand grip variations in neurorehabilitation.

PubMed

Zariffa, José; Steeves, John D

2011-01-01

The complexity of hand function is such that most existing upper limb rehabilitation robotic devices use only simplified hand interfaces. This is in contrast to the importance of the hand in regaining function after neurological injury. Computer vision technology has been used to identify hand posture in the field of Human Computer Interaction, but this approach has not been translated to the rehabilitation context. We describe a computer vision-based classifier that can be used to discriminate rehabilitation-relevant hand postures, and could be integrated into a virtual reality-based upper limb rehabilitation system. The proposed system was tested on a set of video recordings from able-bodied individuals performing cylindrical grasps, lateral key grips, and tip-to-tip pinches. The overall classification success rate was 91.2%, and was above 98% for 6 out of the 10 subjects. © 2011 IEEE

Maintained hand function and forearm bone health 14 months after an in-home virtual-reality videogame hand telerehabilitation intervention in an adolescent with hemiplegic cerebral palsy.

PubMed

Golomb, Meredith R; Warden, Stuart J; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C

2011-03-01

Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.

Quest for a Realistic In Vivo Test Method for Antimicrobial Hand-Rub Agents: Introduction of a Low-Volume Hand Contamination Procedure▿

PubMed Central

Macinga, David R.; Beausoleil, Christopher M.; Campbell, Esther; Mulberry, Gayle; Brady, Ann; Edmonds, Sarah L.; Arbogast, James W.

2011-01-01

A novel method has been developed for the evaluation of alcohol-based hand rubs (ABHR) that employs a hand contamination procedure that more closely simulates the in-use conditions of ABHR. Hands of human subjects were contaminated with 0.2 ml of a concentrated suspension of Serratia marcescens (ATCC 14756) to achieve baseline contamination between 8 and 9 log10 CFU/hand while allowing product to be applied to dry hands with minimal soil load. Evaluation of 1.5 ml of an ABHR gel containing 62% ethanol produced log10 reductions of 2.66 ± 0.96, 2.40 ± 0.50, 2.41 ± 0.61, and 2.33 ± 0.49 (means ± standard deviations) after 1, 3, 7, and 10 successive contamination/product application cycles. In a study comparing this low-volume contamination (LVC) method to ASTM E1174, product dry times were more realistic and log10 reductions achieved by the ABHR were significantly greater when LVC was employed (P < 0.05). These results indicate that a novel low-volume hand contamination procedure, which more closely represents ABHR use conditions, provides more realistic estimates of in-use ABHR efficacies. Based on the LVC method, log10 reductions produced by ABHR were strongly dependent on the test product application volume (P < 0.0001) but were not influenced by the alcohol concentration when it was within the range of 62 to 85% (P = 0.378). PMID:22003004

Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review

PubMed Central

2011-01-01

Introduction Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion and joint stiffness leading to impaired hand function and difficulty with daily activities. The effectiveness of different rehabilitation interventions on specific treatment goals has not yet been fully explored. The objective of this systematic review is to provide evidence based knowledge on the treatment effects of different rehabilitation interventions for specific treatment goals for hand OA. Methods A computerized literature search of Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ISI Web of Science, the Physiotherapy Evidence Database (PEDro) and SCOPUS was performed. Studies that had an evidence level of 2b or higher and that compared a rehabilitation intervention with a control group and assessed at least one of the following outcome measures - pain, physical hand function or other measures of hand impairment - were included. The eligibility and methodological quality of trials were systematically assessed by two independent reviewers using the PEDro scale. Treatment effects were calculated using standardized mean difference and 95% confidence intervals. Results Ten studies, of which six were of higher quality (PEDro score >6), were included. The rehabilitation techniques reviewed included three studies on exercise, two studies each on laser and heat, and one study each on splints, massage and acupuncture. One higher quality trial showed a large positive effect of 12-month use of a night splint on hand pain, function, strength and range of motion. Exercise had no effect on hand pain or function although it may be able to improve hand strength. Low level laser therapy may be useful for improving range of motion. No rehabilitation interventions were found to improve stiffness. Conclusions There is emerging high quality evidence to support that rehabilitation interventions can offer significant benefits to individuals

78 FR 20695 - Walk-Through Metal Detectors and Hand-Held Metal Detectors Test Method Validation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Detectors and Hand-Held Metal Detectors Test Method Validation AGENCY: National Institute of Justice, DOJ... ensure that the test methods in the standards are properly documented, NIJ is requesting proposals (including price quotes) for test method validation efforts from testing laboratories. NIJ is also seeking...

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

PubMed

Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G

1999-10-06

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open up new perspectives in the coming millennium.

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

PubMed

Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G

2000-03-20

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open iup new perspectives in the coming millennium.

The Effect of Alcohol-Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results.

PubMed

Strawsine, Ellen; Lutmer, Brian

2017-11-16

This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15 min preceding subject testing. © 2017 American Academy of Forensic Sciences.

Maintained Hand Function and Forearm Bone Health 14 Months After an In-Home Virtual-Reality Videogame Hand Telerehabilitation Intervention in an Adolescent With Hemiplegic Cerebral Palsy

PubMed Central

Golomb, Meredith R.; Warden, Stuart J.; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C.

2015-01-01

Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article. PMID:21383228

The thermoregulatory function of the human hand: How do palm and digit proportions affect heat loss?

PubMed

Payne, Stephanie; Macintosh, Alison; Stock, Jay

2018-03-30

The current study assessed whether ecogeographical patterns seen in hand proportions correlate with heat loss directly. Using a brief severe cold immersion experiment on the hand, the influence of hand and digit dimensions on heat loss was evaluated. A sample of 113 living individuals were tested. Two-dimensional and three-dimensional scanning techniques were used to assess hand and digit dimensions. Thermal imaging analysis was used to quantify heat loss during a 3-min ice-water immersion of the hands. When body size was accounted for, hand width and digit length relative to total hand length were significant predictors of heat loss from the hand. The current study provides empirical evidence to support the link between thermodynamic principles relating to surface area-to-volume ratio, and ecogeographical patterns associated with temperature. © 2018 Wiley Periodicals, Inc.

Correlations between the Hand Test Pathology score and Personality Assessment Inventory scales for pain clinic patients.

PubMed

George, J M; Wagner, E E

1995-06-01

Pearson correlations between the Hand Test Pathology (PATH) score and Personality Assessment Inventory scales produced a cluster of relationships characteristic of an antisocial orientation. Likewise, PATH significantly differentiated between a "P" (Pathology) group flagged by a high Negative Impression score on the inventory, and an "N" (Normal) group of 100 pain patients. It was suggested that the interpretive simplicity of Hand Test scores renders the scores amenable to further correlational studies involving the inventory.

Cortical language lateralization in right handed normal subjects using functional magnetic resonance imaging.

PubMed

Vikingstad, E M; George, K P; Johnson, A F; Cao, Y

2000-04-01

In 95% of right handed individuals the left hemisphere is dominant for speech and language function. The evidence for this is accumulated primarily from clinical populations. We investigated cortical topography of language function and lateralization in a sample of the right handed population using functional magnetic resonance imaging and two lexical-semantic paradigms. Activated cortical language networks were assessed topographically and quantitatively by using a lateralization index. As a group, we observed left hemispheric language dominance. Individually, the lateralization index varied continuously from left hemisphere dominant to bilateral representation. In males, language primarily lateralized to left, and in females, approximately half had left lateralization and the other half had bilateral representation. Our data indicate that a previous view of female bilateral hemispheric dominance for language (McGlone, 1980. Sex differences in human brain asymmetry: a critical survey. Behav Brain Sci 3:215-263; Shaywitz et al., 1995. Sex differences in the functional organization of the brain for language. Nature 373:607-609) simplifies the complexity of cortical language distribution in this population. Analysis of the distribution of the lateralization index in our study allowed us to make this difference in females apparent.

Development of a Prototype Over-Actuated Biomimetic Prosthetic Hand

PubMed Central

Williams, Matthew R.; Walter, Wayne

2015-01-01

The loss of a hand can greatly affect quality of life. A prosthetic device that can mimic normal hand function is very important to physical and mental recuperation after hand amputation, but the currently available prosthetics do not fully meet the needs of the amputee community. Most prosthetic hands are not dexterous enough to grasp a variety of shaped objects, and those that are tend to be heavy, leading to discomfort while wearing the device. In order to attempt to better simulate human hand function, a dexterous hand was developed that uses an over-actuated mechanism to form grasp shape using intrinsic joint mounted motors in addition to a finger tendon to produce large flexion force for a tight grip. This novel actuation method allows the hand to use small actuators for grip shape formation, and the tendon to produce high grip strength. The hand was capable of producing fingertip flexion force suitable for most activities of daily living. In addition, it was able to produce a range of grasp shapes with natural, independent finger motion, and appearance similar to that of a human hand. The hand also had a mass distribution more similar to a natural forearm and hand compared to contemporary prosthetics due to the more proximal location of the heavier components of the system. This paper describes the design of the hand and controller, as well as the test results. PMID:25790306

Effects of intensive repetition of a new facilitation technique on motor functional recovery of the hemiplegic upper limb and hand

PubMed Central

Kawahira, Kazumi; Shimodozono, Megumi; Etoh, Seiji; Kamada, Katsuya; Noma, Tomokazu; Tanaka, Nobuyuki

2010-01-01

Objective To study the effects on the hemiplegic upper limb of repetitive facilitation exercises (RFEs) using a novel facilitation technique, in which the patient's intention to move the hemiplegic upper limb or finger was followed by realization of the movement using multiple sensory stimulations. Methods Twenty-three stroke patients were enrolled in a cross-over study in which 2-week RFE sessions (100 repetitions each of five-to-eight types of facilitation exercise per day) were alternated with 2-week conventional rehabilitation (CR) sessions, for a total of four sessions. Treatments were begun with the 2-week RFE session in one group and the 2-week CR session in the second group. Results After the first 2-week RFE session, both groups showed improvements in the Brunnstrom stages of the upper limb and the hand, in contrast to the small improvements observed during the first CR session. The Simple Test for Evaluating Hand Function (STEF) score, which evaluates the ability of manipulating objects, in both groups improved during both sessions. After the second 2-week RFE and CR sessions, both groups showed little further improvement except in the STEF score. Conclusion The novel RFEs promoted the functional recovery of the hemiplegic upper limb and hand to a greater extent than the CR sessions. PMID:20715890

Development of Advanced Robotic Hand System for space application

NASA Technical Reports Server (NTRS)

Machida, Kazuo; Akita, Kenzo; Mikami, Tatsuo; Komada, Satoru

1994-01-01

The Advanced Robotic Hand System (ARH) is a precise telerobotics system with a semi dexterous hand for future space application. The ARH will be tested in space as one of the missions of the Engineering Tests Satellite 7 (ETS-7) which will be launched in 1997. The objectives of the ARH development are to evaluate the capability of a possible robot hand for precise and delicate tasks and to validate the related technologies implemented in the system. The ARH is designed to be controlled both from ground as a teleoperation and by locally autonomous control. This paper presents the overall system design and the functional capabilities of the ARH as well as its mission outline as the preliminary design has been completed.

Extending a Hands-On Test

ERIC Educational Resources Information Center

de Mestre, Neville

2004-01-01

This paper describes a "hands-on task" called Number Tiles, which is Task 43 in the collection constructed for the Mathematics Task Centre Project, and available at www.blackdouglas.com.au or www.curriculum.edu.au. This task is rich in possibilities and directions. It should be used as a planned curriculum experience at several year levels to…

Using Optimal Test Assembly Methods for Shortening Patient-Reported Outcome Measures: Development and Validation of the Cochin Hand Function Scale-6: A Scleroderma Patient-Centered Intervention Network Cohort Study.

PubMed

Levis, Alexander W; Harel, Daphna; Kwakkenbos, Linda; Carrier, Marie-Eve; Mouthon, Luc; Poiraudeau, Serge; Bartlett, Susan J; Khanna, Dinesh; Malcarne, Vanessa L; Sauve, Maureen; van den Ende, Cornelia H M; Poole, Janet L; Schouffoer, Anne A; Welling, Joep; Thombs, Brett D

2016-11-01

To develop and validate a short form of the Cochin Hand Function Scale (CHFS), which measures hand disability, for use in systemic sclerosis, using objective criteria and reproducible techniques. Responses on the 18-item CHFS were obtained from English-speaking patients enrolled in the Scleroderma Patient-Centered Intervention Network Cohort. CHFS unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit to CHFS items. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible form length between 1 and 17 items. The final short form selected was the form with the least number of items that maintained statistically equivalent convergent validity, compared to the full-length CHFS, with the Health Assessment Questionnaire (HAQ) disability index (DI) and the physical function domain of the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29). There were 601 patients included. A 6-item short form of the CHFS (CHFS-6) was selected. The CHFS-6 had a Cronbach's alpha of 0.93. Correlations of the CHFS-6 summed score with HAQ DI (r = 0.79) and PROMIS-29 physical function (r = -0.54) were statistically equivalent to the CHFS (r = 0.81 and r = -0.56). The correlation with the full CHFS was high (r = 0.98). The OTA procedure generated a valid short form of the CHFS with minimal loss of information compared to the full-length form. The OTA method used was based on objective, prespecified criteria, but should be further studied for viability as a general procedure for shortening patient-reported outcome measures in health research. © 2016, American College of Rheumatology.

Testing a new alcohol-free hand sanitizer to combat infection.

PubMed

Dyer, D L; Gerenraich, K B; Wadhams, P S

1998-08-01

Universal precautions require that perioperative health care personnel wash their hand before and after all patient contact. Time constraints, however, can make adhering to universal precautions, including proper hand washing, difficult. Some perioperative health care workers, therefore, routinely use rise-free hand sanitizers to supplement normal hand washing. This study evaluated immediate and persistent antimicrobial effectiveness of two alcohol--containing hand sanitizers and a novel surfactant, allantoin, benzalkonium chloride (SAB) hand sanitizer using a federally approved effectiveness protocol. Results indicate that all three products were equally effective after a single application. After repeated use, the alcohol-containing sanitizers did not meet federal performance standards, and the alcohol-free sanitizer did. These properties and others illustrated in this article indicate that the nonflammable, alcohol-free SAB hand sanitizer is the most favorable of the rise-free hand sanitizer formulas for normal hand washing.

Liver function tests

MedlinePlus

Liver function tests are common tests that are used to see how well the liver is working. Tests include: ... E, Bowne WB, Bluth MH. Evaluation of liver function. In: McPherson RA, Pincus MR, eds. Henry's Clinical ...

Liver Function Tests

MedlinePlus

... food, store energy, and remove poisons. Liver function tests are blood tests that check to see how well your liver ... hepatitis and cirrhosis. You may have liver function tests as part of a regular checkup. Or you ...

Kidney function tests

MedlinePlus

Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include: ... Oh MS, Briefel G. Evaluation of renal function, water, electrolytes ... and Management by Laboratory Methods . 23rd ed. Philadelphia, ...

[Hand osteoarthritis].

PubMed

Šenolt, Ladislav

Hand osteoarthritis (OA) is a common chronic disorder causing pain and limitation of mobility of affected joints. The prevalence of hand OA increases with age and more often affects females. Clinical signs obviously do not correlate with radiographic findings - symptomatic hand OA affects approximately 26 % of adult subjects, but radiographic changes can be found in up to two thirds of females and half of males older than 55 years.Disease course differ among individual patients. Hand OA is a heterogeneous disease. Nodal hand OA is the most common subtype affecting interphalangeal joints, thumb base OA affects first carpometacarpal joint. Erosive OA represents a specific subtype of hand OA, which is associated with joint inflammation, more pain, functional limitation and erosive findings on radiographs.Treatment of OA is limited. Analgesics and nonsteroidal anti-inflammatory drugs are the only agents reducing symptoms. New insights into the pathogenesis of disease should contribute to the development of novel effective treatment of hand OA.

Individual muscle control using an exoskeleton robot for muscle function testing.

PubMed

Ueda, Jun; Ming, Ding; Krishnamoorthy, Vijaya; Shinohara, Minoru; Ogasawara, Tsukasa

2010-08-01

Healthy individuals modulate muscle activation patterns according to their intended movement and external environment. Persons with neurological disorders (e.g., stroke and spinal cord injury), however, have problems in movement control due primarily to their inability to modulate their muscle activation pattern in an appropriate manner. A functionality test at the level of individual muscles that investigates the activity of a muscle of interest on various motor tasks may enable muscle-level force grading. To date there is no extant work that focuses on the application of exoskeleton robots to induce specific muscle activation in a systematic manner. This paper proposes a new method, named "individual muscle-force control" using a wearable robot (an exoskeleton robot, or a power-assisting device) to obtain a wider variety of muscle activity data than standard motor tasks, e.g., pushing a handle by hand. A computational algorithm systematically computes control commands to a wearable robot so that a desired muscle activation pattern for target muscle forces is induced. It also computes an adequate amount and direction of a force that a subject needs to exert against a handle by his/her hand. This individual muscle control method enables users (e.g., therapists) to efficiently conduct neuromuscular function tests on target muscles by arbitrarily inducing muscle activation patterns. This paper presents a basic concept, mathematical formulation, and solution of the individual muscle-force control and its implementation to a muscle control system with an exoskeleton-type robot for upper extremity. Simulation and experimental results in healthy individuals justify the use of an exoskeleton robot for future muscle function testing in terms of the variety of muscle activity data.

The Ways of the Hand: A Study of Hand Function among Blind, Visually Impaired and Visually Impaired Multi-Handicapped Children and Adolescents.

ERIC Educational Resources Information Center

Rogow, Sally M.

1987-01-01

The manual development of 148 blind, visually impaired, and visually impaired multi-handicapped students, aged 3-19, was studied. Results indicated a significant relationship between object manipulation and speech, and an inverse relationship between object manipulation and stereotypic hand mannerisms. Optimal development of manual functions and…

Assessment of input-output properties and control of neuroprosthetic hand grasp.

PubMed

Hines, A E; Owens, N E; Crago, P E

1992-06-01

Three tests have been developed to evaluate rapidly and quantitatively the input-output properties and patient control of neuroprosthetic hand grasp. Each test utilizes a visual pursuit tracking task during which the subject controls the grasp force and grasp opening (position) of the hand. The first test characterizes the static input-output properties of the hand grasp, where the input is a slowly changing patient generated command signal and the outputs are grasp force and grasp opening. Nonlinearities and inappropriate slopes have been documented in these relationships, and in some instances the need for system returning has been indicated. For each subject larger grasp forces were produced when grasping larger objects, and for some subjects the shapes of the relationships also varied with object size. The second test quantifies the ability of the subject to control the hand grasp outputs while tracking steps and ramps. Neuroprosthesis users had rms errors two to three times larger when tracking steps versus ramps, and had rms errors four to five times larger than normals when tracking ramps. The third test provides an estimate of the frequency response of the hand grasp system dynamics, from input and output data collected during a random tracking task. Transfer functions were estimated by spectral analysis after removal of the static input-output nonlinearities measured in the first test. The dynamics had low-pass filter characteristics with 3 dB cutoff frequencies from 1.0 to 1.4 Hz. The tests developed in this study provide a rapid evaluation of both the system and the user. They provide information to 1) help interpret subject performance of functional tasks, 2) evaluate the efficacy of system features such as closed-loop control, and 3) screen the neuroprosthesis to indicate the need for retuning.

Hand osteoarthritis: an epidemiological perspective.

PubMed

Kalichman, Leonid; Hernández-Molina, Gabriela

2010-06-01

Hand osteoarthritis (OA) is a highly prevalent condition with a wide spectrum of clinical presentations. We review herein the prevalence, impact on hand function, and various risk factors related to hand OA. PubMed and MEDLINE databases (1950-2009) were searched for the keywords: "hand," "hand osteoarthritis," "distal interphalangeal," "proximal interphalangeal," "metacarpophalangeal," and "carpometacarpal." Published material emphasizing cohort, cross-sectional, and case-control studies regarding epidemiology, clinical features, functional impairment, and associated risk factors of hand OA were included. Hand OA is a heterogeneous, age- and gender-dependent disorder, occurring more frequently in women over 50 years of age. In the elderly population, the prevalence of radiographic hand OA can reach 80%. OA has a strong genetic predisposition, apparently gender- and phenotype-specific. A history of heavy manual labor or a repetitive use of the hand also has been linked to OA. Other variables such as weight, smoking, joint hyperlaxity, age of menarche, bone and cartilage mineralization factors, grip strength, and handedness may play a role. Symptomatic hand OA may cause functional impairment due to loss of strength, thus limiting the individual's ability to perform daily tasks. Several risk factors for hand OA have been identified; however, their interrelationship is not clearly understood. The development of preventive strategies and future research goals is needed. Copyright 2010 Elsevier Inc. All rights reserved.

Two in-vivo protocols for testing virucidal efficacy of handwashing and hand disinfection.

PubMed

Steinmann, J; Nehrkorn, R; Meyer, A; Becker, K

1995-01-01

Whole-hands and fingerpads of seven volunteers were contaminated with poliovirus type 1 Sabin strain in order to evaluate virucidal efficacy of different forms of handwashing and handrub with alcohols and alcohol-based disinfectants. In the whole-hand protocol, handwashing with unmedicated soap for 5 min and handrubbing with 80% ethanol yielded a log reduction factor (RF) of > 2, whereas the log RF by 96.8% ethanol exceeded 3.2. With the fingerpad model ethanol produced a greater log RF than iso- or n-propanol. Comparing five commercial hand disinfectants and a chlorine solution (1.0% chloramine T-solution) for handrub, Desderman and Promanum, both composed of ethanol, yielded log RFs of 2.47 and 2.26 respectively after an application time of 60 s, similar to 1.0% chloramine T-solution (log RF of 2.28). Autosept, Mucasept, and Sterillium, based on n-propanol and/or isopropanol, were found to be significantly less effective (log RFs of 1.16, 1.06 and 1.52 respectively). A comparison of a modified whole-hand and the fingerpad protocol with Promanum showed similar results with the two systems suggesting both models are suitable for testing the in-vivo efficacy of handwashing agents and hand disinfectants which are used without any water.

Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke.

PubMed

Colomer, Carolina; Llorens, Roberto; Noé, Enrique; Alcañiz, Mariano

2016-05-11

Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants' performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors. Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory). Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating. Our results support the clinical effectiveness

[The effect of floating-needle therapy combined with rehabilitation training for the hand function recovery of post-stroke patients].

PubMed

Yang, Jiangxia; Xiao, Hong

2015-08-01

To explore the improvement of hand motion function,spasm and self-care ability of daily life for stroke patients treated with floating-needle combined with rehabilitation training. Eighty hand spasm patients of post-stroke within one year after stroke were randomly divided into an observation group and a control group, 40 cases in each one. In the two groups, rehabilitation was adopted for eight weeks,once a day,40 min one time. In the observation group, based on the above treatment and according to muscle fascia trigger point, 2~3 points in both the internal and external sides of forearm were treated with floating-needle. The positive or passive flexion and extension of wrist and knuckle till the relief of spasm hand was combined. The floating-needle therapy was given for eight weeks, on the first three days once a day and later once every other day. Modified Ashworth Scale(MAS), activity of daily life(ADL, Barthel index) scores and Fugl-Meyer(FMA) scores were used to assess the spasm hand degree,activity of daily life and hand motion function before and after 7-day, 14-day and 8-week treatment. After 7-day, 14-day and 8-week treatment, MAS scores were apparently lower than those before treatment in the two groups(all P<0. 05), and Barthel scores and FMA scores were obviously higher than those before-treatment(all P<0. 05). After 14-day and 8-week treatment, FMA scores in the observation group were markedly higher than those in the control group(both P<0. 05). Floating-needle therapy combined with rehabilitation training and simple rehabilitation training could both improve hand spasm degree, hand function and activity of daily life of post-stroke patients, but floating-needle therapy combined with rehabilitation training is superior to simple rehabilitation training for the improvement of hand function.

Factors that Affected Functional Outcome After a Delayed Excision and Split-Thickness Skin Graft on the Dorsal Side of Burned Hands.

PubMed

Shichinohe, Ryuji; Yamamoto, Yuhei; Kawashima, Kunihiro; Kimura, Chu; Ono, Kentaro; Horiuchi, Katsumi; Yoshida, Tetsunori; Murao, Naoki; Hayashi, Toshihiko; Funayama, Emi; Oyama, Akihiko; Furukawa, Hiroshi

Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.

Skeletal Fixation in a Mutilated Hand.

PubMed

Bhardwaj, Praveen; Sankaran, Ajeesh; Sabapathy, S Raja

2016-11-01

Hand fracture fixation in mutilating injuries is characterized by multiple challenges due to possible skeletal disorganization and concomitant severe injury of soft tissue structures. The effects of skeletal disruption are best analyzed as divided into specific locales in the hand: radial, ulnar, proximal, and distal. Functional consequences of injuries in each of these regions are discussed. Although a variety of implants are now in vogue, K-wire fixation has stood the test of time and is especially useful in multiple fracture situations. Segmental bone loss is quite common in such injuries, which can be safely reconstructed in a staged manner. Copyright © 2016 Elsevier Inc. All rights reserved.

A comparison of hand grasp breakaway strengths and bare-handed grip strengths of the astronauts, SML 3 test subjects, and the subjects from the general population

NASA Technical Reports Server (NTRS)

Rajulu, Sudhakar L.; Klute, Glenn K.

1993-01-01

Astronauts have the task of retrieving and deploying satellites and handling massive objects in a around the payload bay. Concerns were raised that manual handling of such massive objects might induce loads to the shuttle suits exceeding the design-certified loads. The Crew and Thermal Division of NASA JSC simulated the satellite handling tasks (Satellite Manload Tests 1 and 3) and determined the maximum possible load that a suited member could impart onto the suit. In addition, the tests revealed that the load to the suit by an astronaut could be calculated from the astronaut's maximum hand grasp breakaway strength. Thus, this study was conducted to document that hand grasp breakaway strengths of the astronauts who were scheduled to perform EVA during the upcoming missions. In addition, this study verified whether the SML 3 test results were sufficient for documenting the maximum possible load. An attempt was made to predict grasp strength from grip strength and hand anthropometry. Based on the results from this study, the SML 3 test results were deemed sufficient to document the maximum possible load on the suit. Finally, prediction of grasp strength from grip strength was not as accurate as expected. Hence, it was recommended that grasp strength be collected from the astronauts in order to obtain accurate load estimation.

Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia.

PubMed

Wäckerlin, Stephanie; Gemperli, Armin; Sigrist-Nix, Diana; Arnet, Ursina

2018-06-04

Context/Objective To evaluate the availability and self-declared unmet need of assistive devices to compensate for impaired hand function of individuals with tetraplegia in Switzerland. Design Cross-sectional survey. Setting Community. Participants Individuals with tetraplegia, aged 16 years or older, living in Switzerland. Interventions not applicable. Outcome Measures The self-report availability and unmet need of 18 assistive devices for impaired hand function was analyzed descriptively. The availability of devices was further evaluated stratified by sex, age, SCI severity, independence in grooming, time since injury, living situation, working status, and income. Associations between availability of devices and person characteristics were investigated using logistic regression analysis. Results Overall 32.7% of participants had any assistive device for impaired hand function at their disposal. The most frequent devices were adapted cutlery (14.8%), type supports (14.1%), environmental control systems (11.4%), and writing orthosis (10.6%). In the bivariate analysis several factors showed significant associations with at least one assistive device. Nevertheless, when controlling for potential confounding in multivariate analysis only independence in grooming (adapted cutlery, environmental control systems, type support, speech recognition software), SCI severity (writing orthosis, type support), and sex (adapted kitchenware) remained significantly associated with the availability of the mentioned assistive devices. The self-declared unmet need was generally low (0.7% - 4.3%), except for adapted kitchenware with a moderate unmet need (8.9%). Conclusion This study indicates that most individuals with tetraplegia in Switzerland are adequately supplied with assistive devices to compensate for impaired hand function. The availability depends mainly on SCI severity and independence in grooming.

Functional and cosmetic outcome of single-digit ray amputation in hand.

PubMed

Bhat, A K; Acharya, A M; Narayanakurup, J K; Kumar, B; Nagpal, P S; Kamath, A

2017-12-01

To assess patient satisfaction, functional and cosmetic outcomes of single-digit ray amputation in hand and identify factors that might affect the outcome. Forty-five patients who underwent ray amputation were evaluated, 37 males and eight females whose mean age was 36.6 years ranging between 15 and 67 years. Twenty-eight patients had dominant hand involvement. Twenty-one patients underwent primary ray amputation, and 24 patients had secondary ray amputation. Eight out of the 23 patients with central digit injuries underwent transposition. Grip strength, pinch strength, tactile sensibility and functional evaluation using Result Assessment Scale (RAS) and DASH score were analysed. Cosmetic assessment was performed using visual analogue scale (VAS) for cosmesis. Median time of assessment after surgery was 20 months. Average loss of grip strength and pinch strength was found to be 43.3 and 33.6%, respectively. Average RAS score was 3.75. Median DASH score was 23.4. Eighty-three percentage of patients had excellent or good cosmesis on the VAS. Transposition causes significant increase in DASH scores for central digit ray amputations but was cosmetically superior. Middle finger ray amputation had the maximum loss of grip strength, and index finger ray amputation had greater loss of pinch strength. Affection of neighbouring digits caused greater grip and pinch loss, and a higher DASH score. Primary ray resection decreased the total disability and eliminated the costs of a second procedure. Following ray amputation, one can predict an approximate 43.3% loss of grip strength and 33.6% loss of pinch strength. The patients can be counselled regarding the expected time off from work, amount of disability and complications after a single-digit ray amputation. Majority of the patients can return to the same occupation after a period of dedicated hand therapy. Therapeutic, Level III.

Dextrous robot hands

NASA Technical Reports Server (NTRS)

Venkataraman, Subramanian T. (Editor); Iberall, Thea (Editor)

1990-01-01

Recent studies of human hand function and their implications for the design of robot hands are discussed in reviews and reports. Topics addressed include human grasp choice and robotic grasp analysis, opposition space and human prehension, coordination in normal and prosthetic reaching, and intelligent exploration by the human hand. Consideration is given to a task-oriented dextrous manipulation architecture, the control architecture for the Belgrade/USC hand, the analysis of multifingered grasping and manipulation, and tactile sensing for shape interpretation. Diagrams, graphs, and photographs are provided.

Hand-grasping and finger tapping induced similar functional near-infrared spectroscopy cortical responses

PubMed Central

Kashou, Nasser H.; Giacherio, Brenna M.; Nahhas, Ramzi W.; Jadcherla, Sudarshan R.

2016-01-01

Abstract. Despite promising advantages such as low cost and portability of functional near-infrared spectroscopy (fNIRS), it has yet to be widely implemented outside of basic research. Specifically, fNIRS has yet to be proven as a standalone tool within a clinical setting. The objective of this study was to assess hemodynamic concentration changes at the primary and premotor motor cortices as a result of simple whole-hand grasping and sequential finger-opposition (tapping) tasks. These tasks were repeated over 3 days in a randomized manner. Ten healthy young adults (23.8±4.8  years) participated in the study. Quantitatively, no statistically significant differences were discovered between the levels of activation for the two motor tasks (p>0.05). Overall, the signals were consistent across all 3 days. The findings show that both finger-opposition and hand grasping can be used interchangeably in fNIRS for assessment of motor function which would be useful in further advancing techniques for clinical implementation. PMID:27335888

The exploded hand syndrome: a report of five industrial injury cases.

PubMed

Al-Qattan, M M

2013-10-01

The term 'exploded hand syndrome' refers to a specific type of crush injury to the hand in which a high compressive force excessively flattens the hand leading to thenar muscle extrusion through burst lacerations. Out of 89 crushed hands seen over a period of seven years, only five had exploded hand syndrome. They were all male industrial workers ranging in age between 24 and 55 years. All patients had thenar muscle extrusion. Other concurrent injuries included fractures/dislocations, compartment syndrome, and ischaemia. All patients were treated by excision of the extruded intrinsic muscles, as well as primary management of concurrent injuries. All patients had functional assessment including: motor power and sensory testing, range of motion of hand joints, and the quick DASH score. Objective testing showed reduced sensibility in the thumb, reduced grip strength (mean 52% of contralateral hand), reduced pinch strength (mean of 27% of contralateral hand), reduced thumb opposition (the mean Kapandji Score was 5 out of 10), and deficits in the range of motion of the metacarpophalangeal and interphalangeal joints of the thumb. The quick DASH score ranged from 11 to 49 and only two patients were able to go back to regular manual work.

Functional and morphological studies of photodamaged skin on the hands of middle-aged Japanese golfers.

PubMed

Kikuchi-Numagami, K; Suetake, T; Yanai, M; Takahashi, M; Tanaka, M; Tagami, H

2000-06-01

The skin of golfers' hands provides a suitable model to study the effect of chronic sun exposure, because one of their hands is exposed to the outer environment, especially sunlight, while the other one is always protected by a glove during play. Our purpose was to find out the influence of photodamage on the properties of the skin surface of middle-aged Japanese by using non-invasive methods. We measured hydration state, and water barrier function of the stratum corneum (SC) and the color of the skin of the dorsum of the hands. In a separate study, we evaluated the skin surface contour by using replicas taken from the skin in a slightly stretched or relaxed position. We found a significant decrease in hydration of the skin surface of the exposed skin as compared to that of the protected skin, whereas no such difference was found with transepidermal water loss, a parameter for water barrier function of the SC. Luminance of skin color was also reduced in the sun-exposed skin. Replica analysis revealed that large wrinkles developing in a relaxed position were more prominent on the exposed than on the protected skin, while fine furrows noted in a slightly stretched position were shallower on the former than the latter. The data obtained indicate that the chronically exposed skin of golfers' hands shows morphological and functional changes resulting from long time exposure to the outer environment especially sunlight. Furthermore, bioengineering non-invasive methods are found to be useful to detect early photodamage of the skin in a more quantitative fashion which is rather difficult to demonstrate clinically.

The Plastic Surgery Hand Curriculum.

PubMed

Silvestre, Jason; Levin, L Scott; Serletti, Joseph M; Chang, Benjamin

2015-12-01

Designing an effective hand rotation for plastic surgery residents is difficult. The authors address this limitation by elucidating the critical components of the hand curriculum during plastic surgery residency. Hand questions on the Plastic Surgery In-Service Training Exam for six consecutive years (2008 to 2013) were characterized by presence of imaging, vignette setting, question taxonomy, answer domain, anatomy, and topic. Answer references were quantified by source and year of publication. Two hundred sixty-six questions were related to hand surgery (22.7 percent of all questions; 44.3 per year) and 61 were accompanied by an image (22.9 percent). Vignettes tended to be clinic- (50.0 percent) and emergency room-based (35.3 percent) (p < 0.001). Questions required decision-making (60.5 percent) over interpretation (25.9 percent) and recall skills (13.5 percent) (p < 0.001). Answers focused on interventions (57.5 percent) over anatomy/pathology (25.2 percent) and diagnoses (17.3 percent) (p < 0.001). Nearly half of the questions focused on the digits. The highest yield topics were trauma (35.3 percent), reconstruction (24.4 percent), and aesthetic and functional problems (14.2 percent). The Journal of Hand Surgery (American volume) (20.5 percent) and Plastic and Reconstructive Surgery (18.0 percent) were the most-cited journals, and the median publication lag was 7 years. Green's Operative Hand Surgery was the most-referenced textbook (41.8 percent). These results will enable trainees to study hand surgery topics with greater efficiency. Faculty can use these results to ensure that tested topics are covered during residency training. Thus, a benchmark is established to improve didactic, clinical, and operative experiences in hand surgery.

Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

PubMed

Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung

2017-01-01

The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the

Prediction of in vivo developmental toxicity by combination of Hand1-Luc embryonic stem cell test and metabolic stability test with clarification of metabolically inapplicable candidates.

PubMed

Nagahori, Hirohisa; Suzuki, Noriyuki; Le Coz, Florian; Omori, Takashi; Saito, Koichi

2016-09-30

Hand1-Luc Embryonic Stem Cell Test (Hand1-Luc EST) is a promising alternative method for evaluation of developmental toxicity. However, the problems of predictivity have remained due to appropriateness of the solubility, metabolic system, and prediction model. Therefore, we assessed the usefulness of rat liver S9 metabolic stability test using LC-MS/MS to develop new prediction model. A total of 71 chemicals were analyzed by measuring cytotoxicity and differentiation toxicity, and highly reproducible (CV=20%) results were obtained. The first prediction model was developed by discriminant analysis performed on a full dataset using Hand1-Luc EST, and 66.2% of the chemicals were correctly classified by the cross-validated classification. A second model was developed with additional descriptors obtained from the metabolic stability test to calculate hepatic availability, and an accuracy of 83.3% was obtained with applicability domain of 50.7% (=36/71) after exclusion of 22 metabolically inapplicable candidates, which potentially have a metabolic activation property. A step-wise prediction scheme with combination of Hand1-Luc EST and metabolic stability test was therefore proposed. The current results provide a promising in vitro test method for accurately predicting in vivo developmental toxicity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Command control for functional electrical stimulation hand grasp systems using miniature accelerometers and gyroscopes.

PubMed

Tong, K Y; Mak, A F T; Ip, W Y

2003-11-01

Recent commercially available miniature sensors have the potential to improve the functions of functional electrical stimulation (FES) systems in terms of control, reliability and robustness. A new control approach using a miniature gyroscope and an accelerometer was studied. These sensors were used to detect the linear acceleration and angular velocity of residual voluntary movements on upper limbs and were small and easy to put on. Five healthy subjects and three cervical spinal cord injured subjects were recruited to evaluate this controller. Sensors were placed on four locations: the shoulder, upper arm, wrist and hand. A quick forward-and-backward movement was employed to produce a distinctive waveform that was different from general movements. A detection algorithm was developed to generate a command signal by identifying this distinctive waveform through the detection of peaks and valleys in the sensor's signals. This command signal was used to control different FES hand grasp patterns. With a specificity of 0.9, the sensors had a success rate of 85-100% on healthy subjects and 82-97% on spinal cord injured subjects. In terms of sensor placement, the gyroscope was better as a control source than the accelerometer for wrist and hand positions, but the reverse was true for the shoulder.

[Hand management in recessive dystrophic bullous epydermolysis].

PubMed

Pajardi, G; Novelli, C; Parolo, C; Proserpio, G; Tegon, M; Vecchi, S

2011-01-01

Recessive distrofic epidermolysis bullosa creates severe hand deformities with disabling functional limitations. Hand surgeon should perform surgery when deformity inibits function, in order to restore the pinch. We present our experience on 44 patients and 58 operated hands, with the following schema: hand degloving, grafting of the first web and intraoperative dynamic splinting. In 30 patient with an 8 years follow up, 25 had had good or excellent results, and the 5 remaining shows early recurrence. Association of a correct surgical approach and adequate intra and post-operative rehabilitation improve hand function and a slow down inevitable recurrence.

A rehabilitation device to improve the hand grasp function of stroke patients using a patient-driven approach.

PubMed

Park, Wanjoo; Jeong, Wookjin; Kwon, Gyu-Hyun; Kim, Yun-Hee; Kim, Laehyun

2013-06-01

This paper proposes a robotic hand rehabilitation device for grasp training. The device is designed for stroke patients to train and recover their hand grasp function in order to undertake activities of daily living (ADL). The device consists of a control unit, two small actuators, an infrared (IR) sensor, and pressure sensors in the grasp handle. The advantages of this device are that it is small in size, inexpensive, and available for use at home without specialist's supervision. In addition, a novel patient-driven strategy based on the patient's movement intention detected by the pressure sensors without bio-signals is introduced. Once the system detects a patient's movement intention, it triggers the robotic device to move the patient's hand to form the normal grasping behavior. This strategy may encourage stroke patients to participate in rehabilitation training to recover their hand grasp function and it may also enhance neural plasticity. A user study was conducted in order to investigate the usability, acceptability, satisfaction, and suggestions for improvement of the proposed device. The results of this survey included positive reviews from therapists and a stroke patient. In particular, therapists expected that the proposed patient-driven mode can motivate patients for their rehabilitation training and it can be effective to prevent a compensational strategy in active movements. It is expected that the proposed device will assist stroke patients in restoring their grasp function efficiently.

A hospital-based observational cohort study exploring pain and biomarkers in patients with hand osteoarthritis in Norway: The Nor-Hand protocol

PubMed Central

Gløersen, Marthe; Mulrooney, Elisabeth; Hammer, Hilde Berner; Slatkowsky-Christensen, Barbara; Faraj, Karwan; Isaksen, Thore; Neogi, Tuhina; Kvien, Tore K; Magnusson, Karin; Haugen, Ida Kristin

2017-01-01

Introduction We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms. Methods and analysis The Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes. Ethics and dissemination The protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals. Trial registration number NCT03083548; Pre

Towards NIRS-based hand movement recognition.

PubMed

Paleari, Marco; Luciani, Riccardo; Ariano, Paolo

2017-07-01

This work reports on preliminary results about on hand movement recognition with Near InfraRed Spectroscopy (NIRS) and surface ElectroMyoGraphy (sEMG). Either basing on physical contact (touchscreens, data-gloves, etc.), vision techniques (Microsoft Kinect, Sony PlayStation Move, etc.), or other modalities, hand movement recognition is a pervasive function in today environment and it is at the base of many gaming, social, and medical applications. Albeit, in recent years, the use of muscle information extracted by sEMG has spread out from the medical applications to contaminate the consumer world, this technique still falls short when dealing with movements of the hand. We tested NIRS as a technique to get another point of view on the muscle phenomena and proved that, within a specific movements selection, NIRS can be used to recognize movements and return information regarding muscles at different depths. Furthermore, we propose here three different multimodal movement recognition approaches and compare their performances.

Fundamentals of endoscopic surgery: creation and validation of the hands-on test.

PubMed

Vassiliou, Melina C; Dunkin, Brian J; Fried, Gerald M; Mellinger, John D; Trus, Thadeus; Kaneva, Pepa; Lyons, Calvin; Korndorffer, James R; Ujiki, Michael; Velanovich, Vic; Kochman, Michael L; Tsuda, Shawn; Martinez, Jose; Scott, Daniel J; Korus, Gary; Park, Adrian; Marks, Jeffrey M

2014-03-01

The Fundamentals of Endoscopic Surgery™ (FES) program consists of online materials and didactic and skills-based tests. All components were designed to measure the skills and knowledge required to perform safe flexible endoscopy. The purpose of this multicenter study was to evaluate the reliability and validity of the hands-on component of the FES examination, and to establish the pass score. Expert endoscopists identified the critical skill set required for flexible endoscopy. They were then modeled in a virtual reality simulator (GI Mentor™ II, Simbionix™ Ltd., Airport City, Israel) to create five tasks and metrics. Scores were designed to measure both speed and precision. Validity evidence was assessed by correlating performance with self-reported endoscopic experience (surgeons and gastroenterologists [GIs]). Internal consistency of each test task was assessed using Cronbach's alpha. Test-retest reliability was determined by having the same participant perform the test a second time and comparing their scores. Passing scores were determined by a contrasting groups methodology and use of receiver operating characteristic curves. A total of 160 participants (17 % GIs) performed the simulator test. Scores on the five tasks showed good internal consistency reliability and all had significant correlations with endoscopic experience. Total FES scores correlated 0.73, with participants' level of endoscopic experience providing evidence of their validity, and their internal consistency reliability (Cronbach's alpha) was 0.82. Test-retest reliability was assessed in 11 participants, and the intraclass correlation was 0.85. The passing score was determined and is estimated to have a sensitivity (true positive rate) of 0.81 and a 1-specificity (false positive rate) of 0.21. The FES hands-on skills test examines the basic procedural components required to perform safe flexible endoscopy. It meets rigorous standards of reliability and validity required for high

Priming Hand Motor Training with Repetitive Stimulation of the Fingertips; Performance Gain and Functional Imaging of Training Effects.

PubMed

Lotze, Martin; Ladda, Aija Marie; Roschka, Sybille; Platz, Thomas; Dinse, Hubert R

Application of repetitive electrical stimulation (rES) of the fingers has been shown to improve tactile perception and sensorimotor performance in healthy individuals. To increase motor performance by priming the effects of active motor training (arm ability training; AAT) using rES. We compared the performance gain for the training increase of the averaged AAT tasks of both hands in two groups of strongly right-handed healthy volunteers. Functional Magnetic Resonance Imaging (fMRI) before and after AAT was assessed using three tasks for each hand separately: finger sequence tapping, visually guided grip force modulation, and writing. Performance during fMRI was controlled for preciseness and frequency. A total of 30 participants underwent a two-week unilateral left hand AAT, 15 participants with 20 minutes of rES priming of all fingertips of the trained hand, and 15 participants without rES priming. rES-primed AAT improved the trained left-hand performance across all training tasks on average by 32.9%, non-primed AAT improved by 29.5%. This gain in AAT performance with rES priming was predominantly driven by an increased finger tapping velocity. Functional imaging showed comparable changes for both training groups over time. Across all participants, improved AAT performance was associated with a higher contralateral primary somatosensory cortex (S1) fMRI activation magnitude during the grip force modulation task. This study highlights the importance of S1 for hand motor training gain. In addition, it suggests the usage of rES of the fingertips for priming active hand motor training. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and Application of a Tendon Prosthesis for Early Functional Restoration of the Hand.

DTIC Science & Technology

1975-09-01

AD-ARSA 323 JEFFERSON MEDICAL COLL PHILADELP HIA PA F/6 6/5 DEVELOFHNT AND APPLICATION OF A TENDON PROSTHESIS FOR EARLY FU--ETCU, SEP 75 .1 M HUNTER...THIS SHEET S LEVELINETR S DEVELOPEN AND APPLICATION OF A TENDON PROSTESIS FOR EARLY FUNCTIONAL RTORATION OF THE HAND DOCUMENT IDENTIFICATION...OF A TENDON PROSTHESIS * (B.l FOR EARLY FUNCTIONAL RESTORATION OF THE HArD ANNUAL REPORT by James M. Hunter, M.D. September 1975 (For the period 1 July

Tool making, hand morphology and fossil hominins

PubMed Central

Marzke, Mary W.

2013-01-01

Was stone tool making a factor in the evolution of human hand morphology? Is it possible to find evidence in fossil hominin hands for this capability? These questions are being addressed with increasingly sophisticated studies that are testing two hypotheses; (i) that humans have unique patterns of grip and hand movement capabilities compatible with effective stone tool making and use of the tools and, if this is the case, (ii) that there exist unique patterns of morphology in human hands that are consistent with these capabilities. Comparative analyses of human stone tool behaviours and chimpanzee feeding behaviours have revealed a distinctive set of forceful pinch grips by humans that are effective in the control of stones by one hand during manufacture and use of the tools. Comparative dissections, kinematic analyses and biomechanical studies indicate that humans do have a unique pattern of muscle architecture and joint surface form and functions consistent with the derived capabilities. A major remaining challenge is to identify skeletal features that reflect the full morphological pattern, and therefore may serve as clues to fossil hominin manipulative capabilities. Hominin fossils are evaluated for evidence of patterns of derived human grip and stress-accommodation features. PMID:24101624

Tool making, hand morphology and fossil hominins.

PubMed

Marzke, Mary W

2013-11-19

Was stone tool making a factor in the evolution of human hand morphology? Is it possible to find evidence in fossil hominin hands for this capability? These questions are being addressed with increasingly sophisticated studies that are testing two hypotheses; (i) that humans have unique patterns of grip and hand movement capabilities compatible with effective stone tool making and use of the tools and, if this is the case, (ii) that there exist unique patterns of morphology in human hands that are consistent with these capabilities. Comparative analyses of human stone tool behaviours and chimpanzee feeding behaviours have revealed a distinctive set of forceful pinch grips by humans that are effective in the control of stones by one hand during manufacture and use of the tools. Comparative dissections, kinematic analyses and biomechanical studies indicate that humans do have a unique pattern of muscle architecture and joint surface form and functions consistent with the derived capabilities. A major remaining challenge is to identify skeletal features that reflect the full morphological pattern, and therefore may serve as clues to fossil hominin manipulative capabilities. Hominin fossils are evaluated for evidence of patterns of derived human grip and stress-accommodation features.

Breath alcohol of anesthesiologists using alcohol hand gel and the "five moments for hand hygiene" in routine practice.

PubMed

Lindsay, Helen A; Hannam, Jacqueline A; Bradfield, Charles N; Mitchell, Simon J

2016-08-01

Appropriate hand hygiene reduces hospital-acquired infections. Anesthesiologists work in environments with numerous hand hygiene opportunities (HHOs). In a prospective observational study, we investigated the potential for an anesthesiologist to return a positive alcohol breath test during routine practice when using alcohol hand gel. We observed ten volunteer anesthesiologists over four hours while they implemented the World Health Organization (WHO) "five moments for hand hygiene" using our hospital's adopted standard 70% ethanol hand gel. We measured the expired alcohol concentration at shift start and every fifteen minutes thereafter with a fuel cell breathalyzer calibrated to measure the percentage of blood alcohol concentration (BAC). Blood alcohol specimens (analyzed with gas chromatography) were collected at shift start and, when possible, immediately after a participant's first positive breathalyzer test. Of the 130 breathalyzer tests obtained, there were eight (6.2%) positive breath alcohol results from six of the ten participants, all within two minutes of a HHO. The highest value breathalyzer BAC recorded was 0.064%, with an overall mean (SD) of 0.023 (0.017)%. Five (62.5%) of the positive breathalyzer tests returned to zero in less than seven minutes. All of three blood specimens obtained immediately after a positive breathalyzer reading tested negative for alcohol. Anesthesia practitioners using alcohol hand gel in a manner that conforms with recommended hand hygiene can test positive for alcohol on a breathalyzer assay. Positive tests probably arose from inhalation of alcohol vapour into the respiratory dead space following gel application. If workplace breath testing for alcohol is implemented, it should be completed more than 15 min after applying alcohol hand gel. Positive results should be verified with a BAC test.

Hand controller commonality evaluation process

NASA Technical Reports Server (NTRS)

Stuart, Mark A.; Bierschwale, John M.; Wilmington, Robert P.; Adam, Susan C.; Diaz, Manuel F.; Jensen, Dean G.

1990-01-01

A hand controller evaluation process has been developed to determine the appropriate hand controller configurations for supporting remotely controlled devices. These devices include remote manipulator systems (RMS), dexterous robots, and remotely-piloted free flyers. Standard interfaces were developed to evaluate six different hand controllers in three test facilities including dynamic computer simulations, kinematic computer simulations, and physical simulations. The hand controllers under consideration were six degree-of-freedom (DOF) position and rate minimaster and joystick controllers, and three-DOF rate controllers. Task performance data, subjective comments, and anthropometric data obtained during tests were used for controller configuration recommendations to the SSF Program.

Identifying factors of comfort in using hand tools.

PubMed

Kuijt-Evers, L F M; Groenesteijn, L; de Looze, M P; Vink, P

2004-09-01

To design comfortable hand tools, knowledge about comfort/discomfort in using hand tools is required. We investigated which factors determine comfort/discomfort in using hand tools according to users. Therefore, descriptors of comfort/discomfort in using hand tools were collected from literature and interviews. After that, the relatedness of a selection of the descriptors to comfort in using hand tools was investigated. Six comfort factors could be distinguished (functionality, posture and muscles, irritation and pain of hand and fingers, irritation of hand surface, handle characteristics, aesthetics). These six factors can be classified into three meaningful groups: functionality, physical interaction and appearance. The main conclusions were that (1) the same descriptors were related to comfort and discomfort in using hand tools, (2) descriptors of functionality are most related to comfort in using hand tools followed by descriptors of physical interaction and (3) descriptors of appearance become secondary in comfort in using hand tools.

Eye-hand laterality and right thoracic idiopathic scoliosis.

PubMed

Catanzariti, Jean-François; Guyot, Marc-Alexandre; Agnani, Olivier; Demaille, Samantha; Kolanowski, Elisabeth; Donze, Cécile

2014-06-01

The adolescent idiopathic scoliosis (AIS) pathogenesis remains unknown. Certain studies have shown that there is a correlation between manual laterality and scoliotic deviation. A full study of manual laterality needs to be paired with one for visual dominance. With the aim of physiopathological research, we have evaluated the manual and visual laterality in AIS. A retrospective study from prospective data collection is used to evaluate the distribution of eye-hand laterality (homogeneous or crossed) of 65 right thoracic AIS (mean age 14.8 ± 1.8 years; mean Cobb angle: 32.8°) and a control group of 65 sex and age-matched (mean age 14.6 ± 1.8 years). The manual laterality was defined by the modified Edinburgh Handedness Inventory. The evaluation of the visual laterality is done using three tests (kaleidoscope test, hole-in-the-card test, distance-hole-in-the-card test). The group of right thoracic AIS presents a significantly higher frequency of crossed eye-hand laterality (63 %) than the control group (63 vs. 29.2 %; p < 0.001). In the AIS group, the most frequent association, within crossed laterality is "right hand dominant-left eye dominant" (82.9 %). There is no relationship with the Cobb angle. Those with right thoracic AIS show a higher occurrence of crossed eye-hand laterality. This could point physiopathological research of AIS towards functional abnormality of the optic chiasma through underuse of cross visual pathways, and in particular accessory optic pathways. It would be useful to explore this by carrying out research on AISs through neuroimaging and neurofunctional exploration.

Association of activity changes in the primary sensory cortex with successful motor rehabilitation of the hand following stroke.

PubMed

Laible, Mona; Grieshammer, Steven; Seidel, Gundula; Rijntjes, Michel; Weiller, Cornelius; Hamzei, Farsin

2012-09-01

Previous studies demonstrated a posterior shift of activation toward the primary sensory cortex (S1) following stroke; however, any relationship between this posterior shift and clinical outcome measures for the affected hand function were unclear. The authors investigated the possible role of S1 in motor recovery. Assuming that previous studies examined inhomogeneous groups of patients, the authors selected participants with chronic stroke who had moderate hand paresis, normal sensory examination and somatosensory-evoked potentials, and no lesion within the S1, thalamus, or brain stem. Constraint-induced movement therapy (CIMT) was used to train the impaired hand. To relate fMRI (functional MRI) activation changes from baseline to post-CIMT, a correlation analysis was performed with changes of the Wolf Motor Function Test (WMFT) as a test for the hand function. A close relationship was found between increases in hand function and peak changes in activation within the ipsilesional S1. With a better outcome, greater increases in activation within the S1 were evident (P < .03; r = 0.73). In selected patients, the sensory network influences training-induced motor gains. This predictive knowledge of plasticity when applying CIMT may suggest strategies to enhance the effect of therapy, such as the addition of electrical stimulation to enhance S1 excitability.

RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

PubMed

Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

2017-06-01

The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

Test-retest reliability of functional connectivity networks during naturalistic fMRI paradigms.

PubMed

Wang, Jiahui; Ren, Yudan; Hu, Xintao; Nguyen, Vinh Thai; Guo, Lei; Han, Junwei; Guo, Christine Cong

2017-04-01

Functional connectivity analysis has become a powerful tool for probing the human brain function and its breakdown in neuropsychiatry disorders. So far, most studies adopted resting-state paradigm to examine functional connectivity networks in the brain, thanks to its low demand and high tolerance that are essential for clinical studies. However, the test-retest reliability of resting-state connectivity measures is moderate, potentially due to its low behavioral constraint. On the other hand, naturalistic neuroimaging paradigms, an emerging approach for cognitive neuroscience with high ecological validity, could potentially improve the reliability of functional connectivity measures. To test this hypothesis, we characterized the test-retest reliability of functional connectivity measures during a natural viewing condition, and benchmarked it against resting-state connectivity measures acquired within the same functional magnetic resonance imaging (fMRI) session. We found that the reliability of connectivity and graph theoretical measures of brain networks is significantly improved during natural viewing conditions over resting-state conditions, with an average increase of almost 50% across various connectivity measures. Not only sensory networks for audio-visual processing become more reliable, higher order brain networks, such as default mode and attention networks, but also appear to show higher reliability during natural viewing. Our results support the use of natural viewing paradigms in estimating functional connectivity of brain networks, and have important implications for clinical application of fMRI. Hum Brain Mapp 38:2226-2241, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Single treatment with ethanol hand rub is ineffective against human rhinovirus--hand washing with soap and water removes the virus efficiently.

PubMed

Savolainen-Kopra, Carita; Korpela, Terttu; Simonen-Tikka, Marja-Leena; Amiryousefi, Ali; Ziegler, Thedi; Roivainen, Merja; Hovi, Tapani

2012-03-01

Ethanol-containing hand rubs are used frequently as a substitute for hand washing with water and soap. However, not all viruses are inactivated by a short term rubbing with alcohol. The capacity of a single round of instructed and controlled hand cleaning with water and soap or ethanol-containing hand rub, respectively, was tested for removal of human rhinovirus administered onto the skin of healthy volunteers on the back of the hands. Hand washing with soap and water appeared to be much more efficient for removing rhinoviruses from skin than rubbing hands with an ethanol-containing disinfectant. After washing with soap and water the virus was detected in 3/9 (33.3%) test persons from the left hand and 1/9 (11.1%) cases from the right hand, whereas the virus was detected invariably by real-time RT-PCR from both hands after cleaning with alcohol hand rub (P-value <0.01). Both substances evaluated clinically were also tested in vitro for virucidal efficacy against Human rhinovirus2 (HRV2) using a standardized assay. Both tested substances were poor within the contact time used in the hand-cleaning test. In conclusion, thorough and conventional hand washing with water and soap can clean efficiently hands contaminated with the virus responsible for an extensive share of common cold episodes. Copyright © 2012 Wiley Periodicals, Inc.

Item and scale differential functioning of the Mini-Mental State Exam assessed using the Differential Item and Test Functioning (DFIT) Framework.

PubMed

Morales, Leo S; Flowers, Claudia; Gutierrez, Peter; Kleinman, Marjorie; Teresi, Jeanne A

2006-11-01

To illustrate the application of the Differential Item and Test Functioning (DFIT) method using English and Spanish versions of the Mini-Mental State Examination (MMSE). Study participants were 65 years of age or older and lived in North Manhattan, New York. Of the 1578 study participants who were administered the MMSE 665 completed it in Spanish. : The MMSE contains 20 items that measure the degree of cognitive impairment in the areas of orientation, attention and calculation, registration, recall and language, as well as the ability to follow verbal and written commands. After assessing the dimensionality of the MMSE scale, item response theory person and item parameters were estimated separately for the English and Spanish sample using Samejima's 2-parameter graded response model. Then the DFIT framework was used to assess differential item functioning (DIF) and differential test functioning (DTF). Nine items were found to show DIF; these were items that ask the respondent to name the correct season, day of the month, city, state, and 2 nearby streets, recall 3 objects, repeat the phrase no ifs, no ands, no buts, follow the command, "close your eyes," and the command, "take the paper in your right hand, fold the paper in half with both hands, and put the paper down in your lap." At the scale level, however, the MMSE did not show differential functioning. Respondents to the English and Spanish versions of the MMSE are comparable on the basis of scale scores. However, assessments based on individual MMSE items may be misleading.

Are human hands and feet affected by climate? A test of Allen's rule.

PubMed

Betti, Lia; Lycett, Stephen J; von Cramon-Taubadel, Noreen; Pearson, Osbjorn M

2015-09-01

In recent years, several studies have shown that populations from cold, high-latitude regions tend to have relatively shorter limbs than populations from tropical regions, with most of the difference due to the relative length of the zeugopods (i.e., radius, ulna, tibia, fibula). This pattern has been explained either as the consequence of long-term climatic selection or of phenotypic plasticity, with temperature having a direct effect on bone growth during development. The aims of this study were to test whether this pattern of intra-limb proportions extended to the bones of the hands and feet, and to determine whether the pattern remained significant after taking into account the effects of neutral evolutionary processes related to population history. Measurements of the limb bones, including the first metatarsal and metacarpal, were collected for 393 individuals from 10 globally distributed human populations. The relationship between intra-limb indices and minimum temperature was tested using generalized least squares regression, correcting for spatial autocorrelation. The results confirmed previous observations of a temperature-related gradient in intra-limb proportions, even accounting for population history. This pattern extends to the hands, with populations from cold regions displaying a relatively shorter and stockier first metacarpal; however, the first metatarsal appears to be wider but not shorter in cold-adapted populations. The results suggest that climatic adaptation played a role in shaping variation in limb proportions between human populations. The different patterns shown by the hands and feet might be due to the presence of evolutionary constraints on the foot to maintain efficient bipedal locomotion. © 2015 Wiley Periodicals, Inc.

Effect of Transcranial Direct Current Stimulation on Severely Affected Arm-Hand Motor Function in Patients After an Acute Ischemic Stroke: A Pilot Randomized Control Trial.

PubMed

Rabadi, Meheroz H; Aston, Christopher E

2017-10-01

The aim of this article was to determine whether cathodal transcranial direct current stimulation (c-tDCS) to unaffected primary motor cortex (PMC) plus conventional occupational therapy (OT) improves functional motor recovery of the affected arm hand in patients after an acute ischemic stroke compared with sham transcranial direct current stimulation plus conventional OT. In this prospective, randomized, double-blinded, sham-controlled trial of 16 severe, acute ischemic stroke patients with severe arm-hand weakness were randomly assigned to either experimental (c-tDCS plus OT; n = 8) or control (sham transcranial direct current stimulation plus OT; n = 8) groups. All patients received a standard 3-hr in-patient rehabilitation therapy, plus an additional ten 30-min sessions of tDCS. During each session, 1 mA of cathodal stimulation to the unaffected PMC is performed followed by the patient's scheduled OT. The primary outcome measure was change in Action Research Arm Test (ARAT) total and subscores on discharge. Application of c-tDCS to unaffected PMC resulted in a clinically relevant 10-point improvement in the affected arm-hand function based on ARAT total score compared with a 2-point improvement in the control group. Application of 30-min of c-tDCS to the unaffected PMC showed a 10-point improvement in the ARAT score. This corresponds to a large effect size in improvement of affected arm-hand function in patients with severe, acute ischemic stroke. Although not statistically significant, this suggests that larger studies, enrolling at least 25 patients in each group, and with a longer follow-up are warranted.

Hand function is altered in individuals with a history of illicit stimulant use.

PubMed

Pearson-Dennett, Verity; Flavel, Stanley C; Wilcox, Robert A; Thewlis, Dominic; Vogel, Adam P; White, Jason M; Todd, Gabrielle

2014-01-01

Use of illicit stimulant drugs such as methamphetamine, cocaine, and ecstasy are a significant worldwide problem. However, little is known about the effect of these drugs on movement. The aim of the current study was to investigate hand function in adults with a history of illicit stimulant use. We hypothesized that prior use of illicit stimulant drugs is associated with abnormal manipulation of objects. The study involved 22 subjects with a history of illicit stimulant use (aged 29±8 yrs; time since last use: 1.8±4.0 yrs) and two control groups comprising 27 non-drug users (aged 25±8 yrs) and 17 cannabis users with no history of stimulant use (aged 22±5 yrs). Each subject completed screening tests (neuropsychological assessment, medical history questionnaire, lifetime drug history questionnaire, and urine drug screen) prior to gripping and lifting a light-weight object with the dominant right hand. Horizontal grip force, vertical lift force, acceleration, and first dorsal interosseus electromyographic (EMG) activity were recorded during three trials. In trial one, peak grip force was significantly greater in the stimulant group (12.8±3.9 N) than in the control groups (non-drug: 10.3±4.6 N; cannabis: 9.4±2.9 N, P<0.022). However, peak grip force did not differ between groups in trials two and three. The results suggest that individuals with a history of stimulant use overestimate the grip force required to manipulate a novel object but, are able to adapt grip force in subsequent lifts. The results suggest that movement dysfunction may be an unrecognized consequence of illicit stimulant use.

Hand Function is Altered in Individuals with a History of Illicit Stimulant Use

PubMed Central

Pearson-Dennett, Verity; Flavel, Stanley C.; Wilcox, Robert A.; Thewlis, Dominic; Vogel, Adam P.; White, Jason M.; Todd, Gabrielle

2014-01-01

Use of illicit stimulant drugs such as methamphetamine, cocaine, and ecstasy are a significant worldwide problem. However, little is known about the effect of these drugs on movement. The aim of the current study was to investigate hand function in adults with a history of illicit stimulant use. We hypothesized that prior use of illicit stimulant drugs is associated with abnormal manipulation of objects. The study involved 22 subjects with a history of illicit stimulant use (aged 29±8 yrs; time since last use: 1.8±4.0 yrs) and two control groups comprising 27 non-drug users (aged 25±8 yrs) and 17 cannabis users with no history of stimulant use (aged 22±5 yrs). Each subject completed screening tests (neuropsychological assessment, medical history questionnaire, lifetime drug history questionnaire, and urine drug screen) prior to gripping and lifting a light-weight object with the dominant right hand. Horizontal grip force, vertical lift force, acceleration, and first dorsal interosseus electromyographic (EMG) activity were recorded during three trials. In trial one, peak grip force was significantly greater in the stimulant group (12.8±3.9 N) than in the control groups (non-drug: 10.3±4.6 N; cannabis: 9.4±2.9 N, P<0.022). However, peak grip force did not differ between groups in trials two and three. The results suggest that individuals with a history of stimulant use overestimate the grip force required to manipulate a novel object but, are able to adapt grip force in subsequent lifts. The results suggest that movement dysfunction may be an unrecognized consequence of illicit stimulant use. PMID:25545892

Associations between results of post-stroke NDT-Bobath rehabilitation in gait parameters, ADL and hand functions.

PubMed

Mikołajewska, Emilia

2013-01-01

In patients after a stroke there are variable disorders. These patients often need rehabilitation in more than one area beceause of multiple limitations of the ability to perform everyday activities. The aim of the study was to assess correlations - statistical relationships between observed gait parameters, ADL and hand functions - results of rehabilitation of patients after ischaemic stroke according to the NDTBobath method for adults. The investigated group consisted of 60 patients after ischaemic stroke, who participated in the rehabilitation programme. 10 sessions of the NDT-Bobath therapy were provided in 2 weeks (10 days of the therapy). The calculation of correlations was made based on changes of parameters: Bobath Scale (to assess hand functions), Barthel Index (to assess ADL), gait velocity, cadence and stride lenght. Measurements were performed in every patient twice: on admission (before the therapy) and after last session of the therapy to assess rehabilitation effects. The main statistically relevant corellations observed in the study were as follows: in the whole group of patients: poor and moderate (negative) correlation between changes of gait parameters and Bobath Scale and Barthel Index, moderate and severe (negative) correlation between changes of gait parameters and Bobath Scale and Barthel Index in the group of women, correlation between changes in Bobath Scale and Barthel Index in the group of patients with left side of paresis, (negative) correlation between changes of gait parameters and Bobath Scale in group of patients younger than 68 years, moderate, high and very high correlations between changes in gait parameters in groups of women, men, younger than 68 years and older than 68 years. There have been observed statistically significant and favourable changes in the health status of patients, described by gait parameters, changes in hand functions and ADL. Based on the presented correlations there is an assumption that it is hard to

Individual left-hand and right-hand intra-digit representations in human primary somatosensory cortex.

PubMed

Schweisfurth, Meike A; Frahm, Jens; Schweizer, Renate

2015-09-01

Individual intra-digit somatotopy of all phalanges of the middle and little finger of the right and left hand was studied by functional magnetic resonance imaging in 12 healthy subjects. Phalanges were tactilely stimulated and activation in BA 3b of the human primary somatosensory cortex could be observed for each individual phalanx. Activation peaks were further analysed using the Direction/Order (DiOr) method, which identifies somatotopy, if a significantly high number of subjects exhibit ordered distal-to-proximal phalanx representions along a similar direction. Based on DiOr, ordered and similar-direction-aligned intra-digit maps across subjects were found at the left hand for the little and middle finger and at the right hand for the little finger. In these digits the proximal phalanges were represented more medially along the course of the central sulcus than the distal phalanges. This is contrasted by the intra-digit maps for the middle finger of the right hand, which showed larger inter-subject variations of phalanx alignments without a similar within-digit representation across subjects. As all subjects were right-handed and as the middle finger of the dominant hand probably plays a more individual role in everyday tactile performance than the little finger of the right hand and all left-hand digits, the observed variation might reflect a functional somatotopy based on individual use of that particular digit at the dominant hand. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Handle grip span for optimising finger-specific force capability as a function of hand size.

PubMed

Lee, Soo-Jin; Kong, Yong-Ku; Lowe, Brian D; Song, Seongho

2009-05-01

Five grip spans (45 to 65 mm) were tested to evaluate the effects of handle grip span and user's hand size on maximum grip strength, individual finger force and subjective ratings of comfort using a computerised digital dynamometer with independent finger force sensors. Forty-six males participated and were assigned into three hand size groups (small, medium, large) according to their hands' length. In general, results showed the 55- and 50-mm grip spans were rated as the most comfortable sizes and showed the largest grip strength (433.6 N and 430.8 N, respectively), whereas the 65-mm grip span handle was rated as the least comfortable size and the least grip strength. With regard to the interaction effect of grip span and hand size, small and medium-hand participants rated the best preference for the 50- to 55-mm grip spans and the least for the 65-mm grip span, whereas large-hand participants rated the 55- to 60-mm grip spans as the most preferred and the 45-mm grip span as the least preferred. Normalised grip span (NGS) ratios (29% and 27%) are the ratios of user's hand length to handle grip span. The NGS ratios were obtained and applied for suggesting handle grip spans in order to maximise subjective comfort as well as gripping force according to the users' hand sizes. In the analysis of individual finger force, the middle finger force showed the highest contribution (37.5%) to the total finger force, followed by the ring (28.7%), index (20.2%) and little (13.6%) finger. In addition, each finger was observed to have a different optimal grip span for exerting the maximum force, resulting in a bow-contoured shaped handle (the grip span of the handle at the centre is larger than the handle at the end) for two-handle hand tools. Thus, the grip spans for two-handle hand tools may be designed according to the users' hand/finger anthropometrics to maximise subjective ratings and performance based on this study. Results obtained in this study will provide guidelines

Electromyography data for non-invasive naturally-controlled robotic hand prostheses

PubMed Central

Atzori, Manfredo; Gijsberts, Arjan; Castellini, Claudio; Caputo, Barbara; Hager, Anne-Gabrielle Mittaz; Elsig, Simone; Giatsidis, Giorgio; Bassetto, Franco; Müller, Henning

2014-01-01

Recent advances in rehabilitation robotics suggest that it may be possible for hand-amputated subjects to recover at least a significant part of the lost hand functionality. The control of robotic prosthetic hands using non-invasive techniques is still a challenge in real life: myoelectric prostheses give limited control capabilities, the control is often unnatural and must be learned through long training times. Meanwhile, scientific literature results are promising but they are still far from fulfilling real-life needs. This work aims to close this gap by allowing worldwide research groups to develop and test movement recognition and force control algorithms on a benchmark scientific database. The database is targeted at studying the relationship between surface electromyography, hand kinematics and hand forces, with the final goal of developing non-invasive, naturally controlled, robotic hand prostheses. The validation section verifies that the data are similar to data acquired in real-life conditions, and that recognition of different hand tasks by applying state-of-the-art signal features and machine-learning algorithms is possible. PMID:25977804

A hospital-based observational cohort study exploring pain and biomarkers in patients with hand osteoarthritis in Norway: The Nor-Hand protocol.

PubMed

Gløersen, Marthe; Mulrooney, Elisabeth; Mathiessen, Alexander; Hammer, Hilde Berner; Slatkowsky-Christensen, Barbara; Faraj, Karwan; Isaksen, Thore; Neogi, Tuhina; Kvien, Tore K; Magnusson, Karin; Haugen, Ida Kristin

2017-09-24

We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms. The Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes. The protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals. NCT03083548; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Hand-arm Vibration Effects on Performance, Tactile Acuity, and Temperature of Hand

PubMed Central

Forouharmajd, Farhad; Yadegari, Mehrdad; Ahmadvand, Masoumeh; Forouharmajd, Farshad; Pourabdian, Siamak

2017-01-01

Effects of vibration appear as mechanical and psychological disorders, including stress reactions, cognitive and movement disorders, problem in concentration and paying attention to the assigned duties. The common signs and symptoms of hand-arm vibration (HAV) in the fingers and hands may appear as pins and needles feeling, tingling, numbness, and also the loss of finger sensation and dexterity. Laboratory Virtual Instrument Engineering Workbench programming software designed for occupational vibrations measurement was used to calculate HAV acceleration. Hole steadiness test is designed to measure involuntary movement of people. V-Pieron test is designed for one of the other aspects of the psycho motor phenomena of steadiness by moving the stylus across a V-form ruler. The two points test was an experiment of touch acuity, which used a caliper by placing the two styli very close on the pad of finger knuckles. The temperature of finger skin is also measured simultaneous to the above tests. Wilcoxon test indicated that a significant decrement in hand steadiness occurred after gripping a vibrating handle for 2 min (P ≤ 0.003). Wilcoxon test also represented a significant change in errors after gripping a grinder vibratory handle (P ≤ 0.003). The differences at all of the knuckles were significant with a confidence interval percentage of 99%. There was a significant reduction in finger skin temperature before and after exposure to vibration (mean = 0.45°C, based on paired sample test). The obtained results considerably demonstrated the relation between hand performance and vibrations due to gripping a grinder. It can be concluded that an injury or accident may happen after exposure to vibrations for the fine duties, in fast actions. PMID:29204383

Hand-arm Vibration Effects on Performance, Tactile Acuity, and Temperature of Hand.

PubMed

Forouharmajd, Farhad; Yadegari, Mehrdad; Ahmadvand, Masoumeh; Forouharmajd, Farshad; Pourabdian, Siamak

2017-01-01

Effects of vibration appear as mechanical and psychological disorders, including stress reactions, cognitive and movement disorders, problem in concentration and paying attention to the assigned duties. The common signs and symptoms of hand-arm vibration (HAV) in the fingers and hands may appear as pins and needles feeling, tingling, numbness, and also the loss of finger sensation and dexterity. Laboratory Virtual Instrument Engineering Workbench programming software designed for occupational vibrations measurement was used to calculate HAV acceleration. Hole steadiness test is designed to measure involuntary movement of people. V-Pieron test is designed for one of the other aspects of the psycho motor phenomena of steadiness by moving the stylus across a V-form ruler. The two points test was an experiment of touch acuity, which used a caliper by placing the two styli very close on the pad of finger knuckles. The temperature of finger skin is also measured simultaneous to the above tests. Wilcoxon test indicated that a significant decrement in hand steadiness occurred after gripping a vibrating handle for 2 min ( P ≤ 0.003). Wilcoxon test also represented a significant change in errors after gripping a grinder vibratory handle ( P ≤ 0.003). The differences at all of the knuckles were significant with a confidence interval percentage of 99%. There was a significant reduction in finger skin temperature before and after exposure to vibration (mean = 0.45°C, based on paired sample test). The obtained results considerably demonstrated the relation between hand performance and vibrations due to gripping a grinder. It can be concluded that an injury or accident may happen after exposure to vibrations for the fine duties, in fast actions.

Different distal-proximal movement balances in right- and left-hand writing may hint at differential premotor cortex involvement.

PubMed

Potgieser, A R E; de Jong, B M

2011-12-01

Right-handed people generally write with their right hand. Language expressed in script is thus performed with the hand also preferred for skilled motor tasks. This may suggest an efficient functional interaction between the language area of Broca and the adjacent ventral premotor cortex (PMv) in the left (dominant) hemisphere. Pilot observations suggested that distal movements are particularly implicated in cursive writing with the right hand and proximal movements in left-hand writing, which generated ideas concerning hemisphere-specific roles of PMv and dorsal premotor cortex (PMd). Now we examined upper-limb movements in 30 right-handed participants during right- and left-hand writing, respectively. Quantitative description of distal and proximal movements demonstrated a significant difference between movements in right- and left-hand writing (p<.001, Wilcoxon signed-rank test). A Distal Movement Excess (DME) characterized writing with the right hand, while proximal and distal movements similarly contributed to left-hand writing. Although differences between non-language drawings were not tested, we propose that the DME in right-hand writing may reflect functional dominance of PMv in the left hemisphere. More proximal movements in left-hand writing might be related to PMd dominance in right-hemisphere motor control, logically implicated in spatial visuomotor transformations as seen in reaching. Copyright © 2011 Elsevier B.V. All rights reserved.

An Automated Test of Rat Forelimb Supination Quantifies Motor Function Loss and Recovery After Corticospinal Injury.

PubMed

Sindhurakar, Anil; Butensky, Samuel D; Meyers, Eric; Santos, Joshua; Bethea, Thelma; Khalili, Ashley; Sloan, Andrew P; Rennaker, Robert L; Carmel, Jason B

2017-02-01

Rodents are the primary animal model of corticospinal injury and repair, yet current behavioral tests do not show the large deficits after injury observed in humans. Forearm supination is critical for hand function and is highly impaired by corticospinal injury in both humans and rats. Current tests of rodent forelimb function do not measure this movement. To determine if quantification of forelimb supination in rats reveals large-scale functional loss and partial recovery after corticospinal injury. We developed a knob supination device that quantifies supination using automated and objective methods. Rats in a reaching box have to grasp and turn a knob in supination in order to receive a food reward. Performance on this task and the single pellet reaching task were measured before and after 2 manipulations of the pyramidal tract: a cut lesion of 1 pyramid and inactivation of motor cortex using 2 different drug doses. A cut lesion of the corticospinal tract produced a large deficit in supination. In contrast, there was no change in pellet retrieval success. Supination function recovered partially over 6 weeks after injury, and a large deficit remained. Motor cortex inactivation produced a dose-dependent loss of knob supination; the effect on pellet reaching was more subtle. The knob supination task reveals in rodents 3 signature hand function changes observed in humans with corticospinal injury: (1) large-scale loss with injury, (2) partial recovery in the weeks after injury, and (3) loss proportional to degree of dysfunction.

Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: A retrospective study.

PubMed

Nordstrand, Linda; Holmefur, Marie; Kits, Annika; Eliasson, Ann-Christin

2015-01-01

The common assumption that early-onset intensive intervention positively affects motor development has rarely been investigated for hand function in children with unilateral cerebral palsy (CP). This retrospective study explored the possible impact of baby constraint-induced movement therapy (baby-CIMT) on hand function at two years of age. We hypothesized that baby-CIMT in the first year of life would lead to better bimanual hand use at two years of age than would not receiving baby-CIMT. The Assisting Hand Assessment (AHA) was administered at age 21 months (SD 2.4 months) in 72 children with unilateral CP, 31 of who received baby-CIMT. When dividing the children into four functional levels based on AHA, the proportional distribution differed between the groups in favour of baby-CIMT. Logistic regression analysis indicated that children in the baby-CIMT group were more likely than were children in the no baby-CIMT group to have a high functional level, even when controlling for the effect of brain lesion type (OR 5.83, 95% CI 1.44-23.56, p = 0.001). However, no difference was found between groups in the odds of having a very low functional level (OR 0.31, 95% CI 0.08-1.17, p = 0.084). The result shows that baby-CIMT at early age can have a positive effect. Children who received baby-CIMT were six times more likely to have a high functional level at two years of age than were children in the no baby-CIMT group. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hand-arm vibration syndrome: clinical characteristics, conventional electrophysiology and quantitative sensory testing.

PubMed

Rolke, Roman; Rolke, Silke; Vogt, Thomas; Birklein, Frank; Geber, Christian; Treede, Rolf-Detlef; Letzel, Stephan; Voelter-Mahlknecht, Susanne

2013-08-01

Workers exposed to vibrating tools may develop hand-arm vibration syndrome (HAVS). We assessed the somatosensory phenotype using quantitative sensory testing (QST) in comparison to electrophysiology to characterize (1) the most sensitive QST parameter for detecting sensory loss, (2) the correlation of QST and electrophysiology, and (3) the frequency of a carpal tunnel syndrome (CTS) in HAVS. QST, cold provocation tests, fine motor skills, and median nerve neurography were used. QST included thermal and mechanical detection and pain thresholds. Thirty-two patients were examined (54 ± 11 years, 91% men) at the more affected hand compared to 16 matched controls. Vibration detection threshold was the most sensitive parameter to detect sensory loss that was more pronounced in the sensitivity range of Pacinian (150 Hz, x12) than Meissner's corpuscles (20 Hz, x3). QST (84% abnormal) was more sensitive to detect neural dysfunction than conventional electrophysiology (37% abnormal). Motor (34%) and sensory neurography (25%) were abnormal in HAVS. CTS frequency was not increased (9.4%). Findings are consistent with a mechanically-induced, distally pronounced motor and sensory neuropathy independent of CTS. HAVS involves a neuropathy predominantly affecting large fibers with a sensory damage related to resonance frequencies of vibrating tools. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

New possibilities of improving the function of the hand of patients with spastic hemiplegia.

PubMed

Kiwerski, J

1984-01-01

The report presents a therapeutic proposal aiming at the improvement of the functions of the paretic hand in spastic hemiplegics. To achieve this aim the author suggests a combination of phenolization of the medial and ulnar nerves and the stimulation training of the wrist and fingers extensors. An implanted stimulator is used; the stimulator electrodes are fixed to the radial nerve. The strengthening of the extensors during the period of increased muscular tension of the flexors makes it possible to improve the functions of the paretic upper extremity.

Treatment of fourth-degree hand burns.

PubMed

Nuchtern, J G; Engrav, L H; Nakamura, D Y; Dutcher, K A; Heimbach, D M; Vedder, N B

1995-01-01

Fourth-degree hand burns are rare but devastating injuries. They cannot be grafted readily but often require flaps and amputation, and impairment is significant. We report our 10-year experience (1981 to 1990) with deep hand burns to characterize our treatment and outcome. A total of 25 patients (35 hands) were treated. Eight local flaps, nine distant flaps, and two free-tissue transfers were performed. Eleven hands were treated with K-wire immobilization and grafting. Thirty-three amputations were done. Postburn function was evaluated in 25 salvaged hands. Eleven hands had good outcomes, whereas seven had moderate sequelae and seven were severely affected. Patients who were treated with flap coverage of exposed tendons and joints had better functional outcomes than those treated with delayed closure with immobilization and grafting. The excellent outcomes in the flap coverage group justifies the added commitment of technical and therapeutic resources that this treatment requires.

Lateralized ultradian rhythms: evidence from tactile discrimination of either hand.

PubMed

Meier-Koll, A

1998-12-01

Endogenous ultradian rhythms with periods of one or a few hours affect not only on physiological and behavioural functions but also perception and cognition. In particular, lateralized ultradian rhythms which seem to operate separately in the right and left hemispheres of the brain can be monitored by testing the tactile discrimination of the contralateral hand. The present paper is based on two subsequent studies: First, ultradian rhythms in tactile discrimination of either hand were examined in German subjects under laboratory conditions. Considerably different ultradian periods of right and left-handed tactile error rate were found in men but not in women. In a second study, a group of Kenyan Masai shepherds were tested while the subjects were leading herds on daily feeding routes through a savanna habitat. They showed ultradian periods of about 2 hours in tactile discrimination of either hand. Since the right hemisphere is specialized for visuospatial, the left for verbal processing lateralized ultradian rhythms may serve for a long-scale timing of neural processes underlying spatial and semantic mapping of the environment. Sex difference in German subjects and lateral differences found in left-handed (right-hemispheric) ultradian rhythms of German and Masai subjects are discussed from this point of view.

Classification of right-hand grasp movement based on EMOTIV Epoc+

NASA Astrophysics Data System (ADS)

Tobing, T. A. M. L.; Prawito, Wijaya, S. K.

2017-07-01

Combinations of BCT elements for right-hand grasp movement have been obtained, providing the average value of their classification accuracy. The aim of this study is to find a suitable combination for best classification accuracy of right-hand grasp movement based on EEG headset, EMOTIV Epoc+. There are three movement classifications: grasping hand, relax, and opening hand. These classifications take advantage of Event-Related Desynchronization (ERD) phenomenon that makes it possible to differ relaxation, imagery, and movement state from each other. The combinations of elements are the usage of Independent Component Analysis (ICA), spectrum analysis by Fast Fourier Transform (FFT), maximum mu and beta power with their frequency as features, and also classifier Probabilistic Neural Network (PNN) and Radial Basis Function (RBF). The average values of classification accuracy are ± 83% for training and ± 57% for testing. To have a better understanding of the signal quality recorded by EMOTIV Epoc+, the result of classification accuracy of left or right-hand grasping movement EEG signal (provided by Physionet) also be given, i.e.± 85% for training and ± 70% for testing. The comparison of accuracy value from each combination, experiment condition, and external EEG data are provided for the purpose of value analysis of classification accuracy.

Common hand sanitizer may distort readings of breathalyzer tests in the absence of acute intoxication.

PubMed

Ali, Syed S; Wilson, Michael P; Castillo, Edward M; Witucki, Peter; Simmons, Todd T; Vilke, Gary M

2013-02-01

The use of alcohol-based hand sanitizers has recently become widespread. To the authors' knowledge, no previous study has examined whether application of ethanol-based hand sanitizers by the person operating a common breathalyzer machine will affect the accuracy of the readings. This was a prospective study investigating whether the use of hand sanitizer applied according to manufacturer's recommendations (Group I), applied improperly at standard doses (Group II), or applied improperly at high doses (Group III) had an effect on breathalyzer readings of individuals who had not ingested alcohol. The participants of the prospective study were divided into three groups to assess the effect of hand sanitizer on breathalyzer readings. Group I used one pump (1.5 mL) of hand sanitizer (Purell), allowing the hands to dry per manufacturer's recommendations; Group II used one pump (1.5 mL), without allowing the hands to dry; and Group III used two pumps (3 mL), without allowing the hands to dry. Breathalyzer measures for each group are presented as medians with interquartile ranges (IQR) and ranges. Differences between each sequential group (I vs. II and II vs. III) were assessed using a Mann-Whitney U-test (p < 0.05 significant). There were 25 study participants in each group for a total of 75 participants. The initial breathalyzer readings of all study participants were 0.000 g/dL. The median breathalyzer reading was 0.004 g/dL in Group I (IQR = 0.001 to 0.008 g/dL), 0.051 g/dL in Group II (IQR = 0.043 to 0.064 g/dL), and 0.119 g/dL in Group III (IQR = 0.089 to 0.134 g/dL). Measures between each subsequent group were all statistically different (p < 0.001). The use of common alcohol-based hand sanitizer may cause false-positive readings with a standard hospital breathalyzer when the operator uses the hand sanitizer correctly. The breathalyzer readings are further elevated if more sanitizer is used or if it is not allowed to dry appropriately. © 2013 by the Society for

Feasibility of a Novel Functional Sensibility Test as an Assisted Examination for Determining Precision Pinch Performance in Patients with Carpal Tunnel Syndrome

PubMed Central

Hsu, Hsiu-Yun; Kuo, Li-Chieh; Kuo, Yao-Lung; Chiu, Haw-Yen; Jou, I-Ming; Wu, Po-Ting; Su, Fong-Chin

2013-01-01

To understand the feasibility of a novel functional sensibility test for determining precision pinch performance in patients with carpal tunnel syndrome, this study investigates the validity, sensitivity and specificity of functional sensibility derived from a pinch-holding-up activity (PHUA) test. Participants include 70 clinically defined carpal tunnel syndrome (CTS) patients with 119 involved hands and 70 age- and gender-matched controls. To examine the discriminating ability of the functional sensibility test, the differences in the ability of pinch force adjustments to the inertial load of handling object between CTS and control subjects are analyzed. The results of functional sensibility are correlated with the severity of CTS to establish concurrent validity. The receiver operating characteristic (ROC) curve is constructed to demonstrate the accuracy of the proposed test. The functional sensibility score significantly discriminates the patients and control groups (respectively, 12.94±1.72 vs. 11.51±1.15N in peak pinch force (FPPeak), p<0.001; 2.92±0.41 vs. 2.52±0.24 in force ratio, p<0.001) and is moderately correlated (r = 0.42–0.54, p<0.001) with the results of traditional sensibility tests (touch-pressure threshold and two-point discrimination test). In addition, there is a statistical difference in the results of functional sensibility (p<0.001) among the subgroups of CTS severity based on electrophysiological study. The sensitivity and specificity are 0.79 and 0.76, respectively, for the functional sensibility test. The areas under the ROC curve are 0.85 and 0.80 for the force ratio and FPPeak, respectively. In conclusion, the functional sensibility test could be feasibly used as a clinical tool for determining both the sensibility and precision pinch performance of hands for the patients with CTS. PMID:23977209

Functional Task Test (FTT)

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob J.; Mulavara, Ajitkumar; Peters, Brian T.; Rescheke, Millard F.; Wood, Scott; Lawrence, Emily; Koffman, Igor; Ploutz-Snyder, Lori; Spiering, Barry A.; Feeback, Daniel L.;

Measurement properties of the Patient-Rated Wrist and Hand Evaluation: Rasch analysis of responses from a traumatic hand injury population.

PubMed

Packham, Tara; MacDermid, Joy C

2013-01-01

The Patient-Rated Wrist and Hand Evaluation (PRWHE) is a self-reported assessment of pain and disability to evaluate outcome after hand injuries. Rasch analysis is an alternative strategy for examining the psychometric properties of a measurement scale based in item response theory, rather than classical test theory. This study used Rasch analysis to examine the content, scoring and measurement properties of the PRWHE. PRWHE scores (n = 264) from persons with a traumatic injury or reconstructive surgery to one hand were collected from an outpatient hand rehabilitation facility. Rasch analysis was conducted to assess how the PRWHE fit the Rasch model, confirms the scaling structure of the pain and disability subscales, and identifies any areas of bias from differential item functioning. Rasch analysis of the PRWHE supports internal consistency of the scale (α = 0.96) and reliability (as measured by the person separation index) of 0.95. While gender, age, diagnosis, and duration since injury all systematically influenced how people scored the PRWHE, hand dominance and affected side did not. Rasch analysis supported a 3 subscale structure (pain, specific activities and usual activities) rather than the current divisions of pain and disability. Initial examination of the PRWHE indicates the psychometric properties of consistency, reliability and responsiveness previously tested by classical methods are further supported by Rasch analysis. It also suggests the scale structure may be best considered as 3 subscales rather than simply pain and disability. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

[Circulatory Function Tests for Home & Community Use.

PubMed

Shimetani, Naoto

2016-05-01

Currently, the main circulatory function-testing tools for home use are blood pressure monitors and elec- trocardiography devices. Just like blood pressure monitors that are already widespread for home use, some devices with an electrocardiographic function have recently become available for purchase for personal use by the general public. On the other hand, clinic equipment on loan from doctors to patients in need can perform circulatory function tests like 24-hour ambulatory blood pressure monitoring (ABPM), Holter monitoring, and real-time electrocardiography. We introduce the actual clinical usage of ABPM and real-time electro- cardiography, and discuss the usefulness of these procedures. ABPM uses a blood pressure measurement device worn on the body for 24 hours a day to measure blood pressure at regular intervals. This makes it possible to check blood pressure changes throughout the day in a way in which conventional home-use blood pressure monitors cannot, like during sleep. This method al- lows the identification of masked hypertension like early-morning and nocturnal hypertension, stress hyper- tension including workplace hypertension, and white coat hypertension that only occurs in the doctor's office. Under routine care, there are few opportunities to perform electrocardiography at the time a patient is experiencing symptoms. Now, real-time electrocardiography has begun to be used in routine care, and pa- tients can record an electrocardiogram by themselves anytime, anywhere, and send the data by telephone or the Internet for analysis and diagnosis. Transmission-capable electrocardiography devices can play an im- portant role in the event of dangerous symptoms like arrhythmia, angina, or acute myocardial infarction. The spread of ABPM and event heart monitors is likely to make the early treatment and prevention of stroke and heart disease possible. We are expecting rapid development in this field in the future.

Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

ERIC Educational Resources Information Center

Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

2010-01-01

Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability…

Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial.

PubMed

Nijenhuis, Sharon M; Prange-Lasonder, Gerdienke B; Stienen, Arno Ha; Rietman, Johan S; Buurke, Jaap H

2017-02-01

To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes. A randomised controlled trial. Training at home, evaluation at research institute. Twenty chronic stroke patients with severely to mildly impaired arm and hand function. Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group). Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength. The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001). Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.

Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants.

PubMed

Marini, Francesco; Tagliabue, Chiara F; Sposito, Ambra V; Hernandez-Arieta, Alejandro; Brugger, Peter; Estévez, Natalia; Maravita, Angelo

2014-01-01

The way in which humans represent their own bodies is critical in guiding their interactions with the environment. To achieve successful body-space interactions, the body representation is strictly connected with that of the space immediately surrounding it through efficient visuo-tactile crossmodal integration. Such a body-space integrated representation is not fixed, but can be dynamically modulated by the use of external tools. Our study aims to explore the effect of using a complex tool, namely a functional prosthesis, on crossmodal visuo-tactile spatial interactions in healthy participants. By using the crossmodal visuo-tactile congruency paradigm, we found that prolonged training with a mechanical hand capable of distal hand movements and providing sensory feedback induces a pattern of interference, which is not observed after a brief training, between visual stimuli close to the prosthesis and touches on the body. These results suggest that after extensive, but not short, training the functional prosthesis acquires a visuo-tactile crossmodal representation akin to real limbs. This finding adds to previous evidence for the embodiment of functional prostheses in amputees, and shows that their use may also improve the crossmodal combination of somatosensory feedback delivered by the prosthesis with visual stimuli in the space around it, thus effectively augmenting the patients' visuomotor abilities. © 2013 Published by Elsevier Ltd.

"Like the palm of my hands": Motor imagery enhances implicit and explicit visual recognition of one's own hands.

PubMed

Conson, Massimiliano; Volpicella, Francesco; De Bellis, Francesco; Orefice, Agnese; Trojano, Luigi

2017-10-01

A key point in motor imagery literature is that judging hands in palm view recruits sensory-motor information to a higher extent than judging hands in back view, due to the greater biomechanical complexity implied in rotating hands depicted from palm than from back. We took advantage from this solid evidence to test the nature of a phenomenon known as self-advantage, i.e. the advantage in implicitly recognizing self vs. others' hand images. The self-advantage has been actually found when implicitly but not explicitly judging self-hands, likely due to dissociation between implicit and explicit body representations. However, such a finding might be related to the extent to which motor imagery is recruited during implicit and explicit processing of hand images. We tested this hypothesis in two behavioural experiments. In Experiment 1, right-handed participants judged laterality of either self or others' hands, whereas in Experiment 2, an explicit recognition of one's own hands was required. Crucially, in both experiments participants were randomly presented with hand images viewed from back or from palm. The main result of both experiments was the self-advantage when participants judged hands from palm view. This novel finding demonstrate that increasing the "motor imagery load" during processing of self vs. others' hands can elicit a self-advantage in explicit recognition tasks as well. Future studies testing the possible dissociation between implicit and explicit visual body representations should take into account the modulatory effect of motor imagery load on self-hand processing. Copyright © 2017. Published by Elsevier B.V.

Quantitative electroencephalographic and neuropsychological investigation of an alternative measure of frontal lobe executive functions: the Figure Trail Making Test.

PubMed

Foster, Paul S; Drago, Valeria; Ferguson, Brad J; Harrison, Patti Kelly; Harrison, David W

2015-12-01

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. Relatively little is known about right frontal lobe contributions to executive functioning given the paucity of measures sensitive to right frontal functioning. The present investigation reports the development and initial validation of a new measure designed to be sensitive to right frontal lobe functioning, the Figure Trail Making Test (FTMT). The FTMT, the classic Trial Making Test, and the Ruff Figural Fluency Test (RFFT) were administered to 42 right-handed men. The results indicated a significant relationship between the FTMT and both the TMT and the RFFT. Performance on the FTMT was also related to high beta EEG over the right frontal lobe. Thus, the FTMT appears to be an equivalent measure of executive functioning that may be sensitive to right frontal lobe functioning. Applications for use in frontotemporal dementia, Alzheimer's disease, and other patient populations are discussed.

Scar Management of the Burned Hand

PubMed Central

Sorkin, Michael; Cholok, David; Levi, Benjamin

2017-01-01

Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars. PMID:28363297

13C Methacetin Breath Test for Assessment of Microsomal Liver Function: Methodology and Clinical Application.

PubMed

Gorowska-Kowolik, Katarzyna; Chobot, Agata; Kwiecien, Jaroslaw

2017-01-01

Assessment of the liver function, and the need of constant monitoring of the organ's capacity, concerns not only patients with primary liver diseases, but also those at risk of hepatopathies secondary to other chronic diseases. Most commonly, the diagnostics is based on measurements of static biochemical parameters, which allow us to draw conclusions only indirectly about the function and the degree of damage of the organ. On the other hand, liver biopsy is an invasive procedure and therefore it is associated with a considerable risk of complications. Dynamic tests enable us to assess quantitatively the organ's functional reserve by analyzing the kinetics of the metabolization of the substrate by the liver. In practice applied are breath tests using substances such as aminopyrine, caffeine, methacetin, erythromycin (for assessment of the microsomal function); phenylalanine, galactose (for assessment of the cytosolic function); methionine, octanoate, ketoisocaproic acid (for assessment of the mitochondrial function). The test with 13 C methacetin belongs to the best described and most widely applied methods in noninvasive liver function assessment. Due to the rising availability of this method, knowledge concerning its limitations and controversies regarding the methodology, as well as its usefulness in chosen groups of patients, seems to be vital.

Classical Testing in Functional Linear Models.

PubMed

Kong, Dehan; Staicu, Ana-Maria; Maity, Arnab

2016-01-01

We extend four tests common in classical regression - Wald, score, likelihood ratio and F tests - to functional linear regression, for testing the null hypothesis, that there is no association between a scalar response and a functional covariate. Using functional principal component analysis, we re-express the functional linear model as a standard linear model, where the effect of the functional covariate can be approximated by a finite linear combination of the functional principal component scores. In this setting, we consider application of the four traditional tests. The proposed testing procedures are investigated theoretically for densely observed functional covariates when the number of principal components diverges. Using the theoretical distribution of the tests under the alternative hypothesis, we develop a procedure for sample size calculation in the context of functional linear regression. The four tests are further compared numerically for both densely and sparsely observed noisy functional data in simulation experiments and using two real data applications.

Classical Testing in Functional Linear Models

PubMed Central

Kong, Dehan; Staicu, Ana-Maria; Maity, Arnab

2016-01-01

We extend four tests common in classical regression - Wald, score, likelihood ratio and F tests - to functional linear regression, for testing the null hypothesis, that there is no association between a scalar response and a functional covariate. Using functional principal component analysis, we re-express the functional linear model as a standard linear model, where the effect of the functional covariate can be approximated by a finite linear combination of the functional principal component scores. In this setting, we consider application of the four traditional tests. The proposed testing procedures are investigated theoretically for densely observed functional covariates when the number of principal components diverges. Using the theoretical distribution of the tests under the alternative hypothesis, we develop a procedure for sample size calculation in the context of functional linear regression. The four tests are further compared numerically for both densely and sparsely observed noisy functional data in simulation experiments and using two real data applications. PMID:28955155

Left, right, left, right, eyes to the front! Müller-Lyer bias in grasping is not a function of hand used, hand preferred or visual hemifield, but foveation does matter.

PubMed

van der Kamp, John; de Wit, Matthieu M; Masters, Rich S W

2012-04-01

We investigated whether the control of movement of the left hand is more likely to involve the use of allocentric information than movements performed with the right hand. Previous studies (Gonzalez et al. in J Neurophys 95:3496-3501, 2006; De Grave et al. in Exp Br Res 193:421-427, 2009) have reported contradictory findings in this respect. In the present study, right-handed participants (N = 12) and left-handed participants (N = 12) made right- and left-handed grasps to foveated objects and peripheral, non-foveated objects that were located in the right or left visual hemifield and embedded within a Müller-Lyer illusion. They were also asked to judge the size of the object by matching their hand aperture to its length. Hand apertures did not show significant differences in illusory bias as a function of hand used, handedness or visual hemifield. However, the illusory effect was significantly larger for perception than for action, and for the non-foveated compared to foveated objects. No significant illusory biases were found for reach movement times. These findings are consistent with the two-visual system model that holds that the use of allocentric information is more prominent in perception than in movement control. We propose that the increased involvement of allocentric information in movements toward peripheral, non-foveated objects may be a consequence of more awkward, less automatized grasps of nonfoveated than foveated objects. The current study does not support the conjecture that the control of left-handed and right-handed grasps is predicated on different sources of information.

Management of post burn hand deformities

PubMed Central

Sabapathy, S. Raja; Bajantri, Babu; Bharathi, R. Ravindra

2010-01-01

The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor. PMID:21321661

Cross-cultural adaptation, reliability, internal consistency and validation of the Hand Function Sort (HFS©) for French speaking patients with upper limb complaints.

PubMed

Konzelmann, M; Burrus, C; Hilfiker, R; Rivier, G; Deriaz, O; Luthi, F

2015-03-01

Functional evaluation of upper limb is not only based on clinical findings but requires self-administered questionnaires to address patients' perspective. The Hand Function Sort (HFS©) was only validated in English. The aim of this study was the French cross cultural adaptation and validation of the HFS© (HFS-F). 150 patients with various upper limbs impairments were recruited in a rehabilitation center. Translation and cross-cultural adaptation were made according to international guidelines. Construct validity was estimated through correlations with Disabilities Arm Shoulder and Hand (DASH) questionnaire, SF-36 mental component summary (MCS),SF-36 physical component summary (PCS) and pain intensity. Internal consistency was assessed by Cronbach's α and test-retest reliability by intraclass correlation. Cronbach's α was 0.98, test-retest reliability was excellent at 0.921 (95 % CI 0.871-0.971) same as original HFS©. Correlations with DASH were-0.779 (95 % CI -0.847 to -0.685); with SF 36 PCS 0.452 (95 % CI 0.276-0.599); with pain -0.247 (95 % CI -0.429 to -0.041); with SF 36 MCS 0.242 (95 % CI 0.042-0.422). There were no floor or ceiling effects. The HFS-F has the same good psychometric properties as the original HFS© (internal consistency, test retest reliability, convergent validity with DASH, divergent validity with SF-36 MCS, and no floor or ceiling effects). The convergent validity with SF-36 PCS was poor; we found no correlation with pain. The HFS-F could be used with confidence in a population of working patients. Other studies are necessary to study its psychometric properties in other populations.

The influence of cooling forearm/hand and gender on estimation of handgrip strength.

PubMed

Cheng, Chih-Chan; Shih, Yuh-Chuan; Tsai, Yue-Jin; Chi, Chia-Fen

2014-01-01

Handgrip strength is essential in manual operations and activities of daily life, but the influence of forearm/hand skin temperature on estimation of handgrip strength is not well documented. Therefore, the present study intended to investigate the effect of local cooling of the forearm/hand on estimation of handgrip strength at various target force levels (TFLs, in percentage of MVC) for both genders. A cold pressor test was used to lower and maintain the hand skin temperature at 14°C for comparison with the uncooled condition. A total of 10 male and 10 female participants were recruited. The results indicated that females had greater absolute estimation deviations. In addition, both genders had greater absolute deviations in the middle range of TFLs. Cooling caused an underestimation of grip strength. Furthermore, a power function is recommended for establishing the relationship between actual and estimated handgrip force. Statement of relevance: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Practitioner Summary: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Task-Oriented Mirror Therapy Training on Hand Rehabilitation of Acute Stroke Patients.

PubMed

Kim, Jinhong; Yim, Jongeun

2018-02-06

BACKGROUND Impairments of hand function make it difficult to perform daily life activities and to return to work. The aim of this study was to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with task-oriented mirror therapy (TOMT) on hand rehabilitation in acute stroke patients. MATERIAL AND METHODS Twenty subacute stroke patients in the initial stages (<3 months) participated in the study. Subjects were allocated to 2 groups: the experimental group received HF-rTMS + TOMT and the control group received HF-rTMS. TOMT training was conducted in 10 sessions over 2 weeks for 30 min. rTMS was applied at a 20 Hz frequency over the hand motor area in the cortex of the affected hemisphere for 15 min. Outcomes, including motor-evoked potential (MEP), pinch grip, hand grip, and box and block test, were measured before and after training. RESULTS Significant improvements in the MEP and hand function variables were observed in both groups (p<0.05). In particular, hand functions (pinch grip and box and block test) were significantly different between the 2 groups (p<0.05). CONCLUSIONS HF-rTMS combined with TOMT had a positive effect on hand function and can be used for the rehabilitation of precise hand movements in acute stroke patients.

Changes in cortical, cerebellar and basal ganglia representation after comprehensive long term unilateral hand motor training.

PubMed

Walz, A D; Doppl, K; Kaza, E; Roschka, S; Platz, T; Lotze, M

2015-02-01

We were interested in motor performance gain after unilateral hand motor training and associated changes of cerebral and cerebellar movement representation tested with functional magnetic resonance imaging (fMRI) before and after training. Therefore, we trained the left hand of strongly right-handed healthy participants with a comprehensive training (arm ability training, AAT) over two weeks. Motor performance was tested for the trained and non-trained hand before and after the training period. Functional imaging was performed for the trained and the non-trained hand separately and comprised force modulation with the fist, sequential finger movements and a fast writing task. After the training period the performance gain of tapping movements was comparable for both hand sides, whereas the motor performance for writing showed a higher training effect for the trained hand. fMRI showed a reduction of activation in supplementary motor, dorsolateral prefrontal cortex, parietal cortical areas and lateral cerebellar areas during sequential finger movements over time. During left hand writing lateral cerebellar hemisphere also showed reduced activation, while activation of the anterior cerebellar hemisphere was increased. An initially high anterior cerebellar activation magnitude was a predictive value for high training outcome of finger tapping and visual guided movements. During the force modulation task we found increased activation in the striate. Overall, a comprehensive long-term training of the less skillful hand in healthy participants resulted in relevant motor performance improvements, as well as an intermanual learning transfer differently pronounced for the type of movement tested. Whereas cortical motor area activation decreased over time, cerebellar anterior hemisphere and striatum activity seem to represent increasing resources after long-term motor training. Copyright © 2014 Elsevier B.V. All rights reserved.

A Combined fMRI and DTI Examination of Functional Language Lateralization and Arcuate Fasciculus Structure: Effects of Degree versus Direction of Hand Preference

ERIC Educational Resources Information Center

Propper, Ruthe E.; O'Donnell, Lauren J.; Whalen, Stephen; Tie, Yanmei; Norton, Isaiah H.; Suarez, Ralph O.; Zollei, Lilla; Radmanesh, Alireza; Golby, Alexandra J.

2010-01-01

The present study examined the relationship between hand preference degree and direction, functional language lateralization in Broca's and Wernicke's areas, and structural measures of the arcuate fasciculus. Results revealed an effect of degree of hand preference on arcuate fasciculus structure, such that consistently-handed individuals,…

Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study.

PubMed

Widrig, Reto; Suter, Andy; Saller, Reinhard; Melzer, Jörg

2007-04-01

The use of topical preparations for symptom relief is common in osteoarthritis. The effects of ibuprofen (5%) and arnica (50 g tincture/100 g, DER 1:20), as gel preparations in patients with radiologically confirmed and symptomatically active osteoarthritis of interphalangeal joints of hands, were evaluated in a randomised, double-blind study in 204 patients, to ascertain differences in pain relief and hand function after 21 days' treatment. Diagnosis was according to established criteria; primary endpoints were pain intensity and hand function; statistical design was as per current regulatory guidelines for testing topical preparations. There were no differences between the two groups in pain and hand function improvements, or in any secondary end points evaluated. Adverse events were reported by six patients (6.1%) on ibuprofen and by five patients (4.8%) on arnica. Our results confirm that this preparation of arnica is not inferior to ibuprofen when treating osteoarthritis of hands.

Functional source separation and hand cortical representation for a brain–computer interface feature extraction

PubMed Central

Tecchio, Franca; Porcaro, Camillo; Barbati, Giulia; Zappasodi, Filippo

2007-01-01

A brain–computer interface (BCI) can be defined as any system that can track the person's intent which is embedded in his/her brain activity and, from it alone, translate the intention into commands of a computer. Among the brain signal monitoring systems best suited for this challenging task, electroencephalography (EEG) and magnetoencephalography (MEG) are the most realistic, since both are non-invasive, EEG is portable and MEG could provide more specific information that could be later exploited also through EEG signals. The first two BCI steps require set up of the appropriate experimental protocol while recording the brain signal and then to extract interesting features from the recorded cerebral activity. To provide information useful in these BCI stages, our aim is to provide an overview of a new procedure we recently developed, named functional source separation (FSS). As it comes from the blind source separation algorithms, it exploits the most valuable information provided by the electrophysiological techniques, i.e. the waveform signal properties, remaining blind to the biophysical nature of the signal sources. FSS returns the single trial source activity, estimates the time course of a neuronal pool along different experimental states on the basis of a specific functional requirement in a specific time period, and uses the simulated annealing as the optimization procedure allowing the exploit of functional constraints non-differentiable. Moreover, a minor section is included, devoted to information acquired by MEG in stroke patients, to guide BCI applications aiming at sustaining motor behaviour in these patients. Relevant BCI features – spatial and time-frequency properties – are in fact altered by a stroke in the regions devoted to hand control. Moreover, a method to investigate the relationship between sensory and motor hand cortical network activities is described, providing information useful to develop BCI feedback control systems. This

[The International Classification of Functioning, Disability and Health (ICF) : The implementation of the ICF Core Sets for Hand Conditions in clinical routine as an example of application].

PubMed

Coenen, Michaela; Rudolf, Klaus-Dieter; Kus, Sandra; Dereskewitz, Caroline

2018-05-24

The International Classification of Functioning, Disability and Health (ICF) provides a standardized language of almost 1500 ICF categories for coding information about functioning and contextual factors. Short lists (ICF Core Sets) are helpful tools to support the implementation of the ICF in clinical routine. In this paper we report on the implementation of ICF Core Sets in clinical routine using the "ICF Core Sets for Hand Conditions" and the "Lighthouse Project Hand" as an example. Based on the ICF categories of the "Brief ICF Core Set for Hand Conditions", the ICF-based assessment tool (ICF Hand A ) was developed aiming to guide the assessment and treatment of patients with injuries and diseases located at the hand. The ICF Hand A facilitates the standardized assessment of functioning - taking into consideration of a holistic view of the patients - along the continuum of care ranging from acute care to rehabilitation and return to work. Reference points for the assessment of the ICF Hand A are determined in treatment guidelines for selected injuries and diseases of the hand along with recommendations for acute treatment and care, procedures and interventions of subsequent treatment and rehabilitation. The assessment of the ICF Hand A according to the defined reference points can be done using electronic clinical assessment tools and allows for an automatic generation of a timely medical report of a patient's functioning. In the future, the ICF Hand A can be used to inform the coding of functioning in ICD-11.

AUTOMATIC HAND COUNTER

DOEpatents

Mann J.R.; Wainwright, A.E.

1963-06-11

An automatic, personnel-operated, alpha-particle hand monitor is described which functions as a qualitative instrument to indicate to the person using it whether his hands are cold'' or hot.'' The monitor is activated by a push button and includes several capacitor-triggered thyratron tubes. Upon release of the push button, the monitor starts the counting of the radiation present on the hands of the person. If the count of the radiation exceeds a predetermined level within a predetermined time, then a capacitor will trigger a first thyratron tube to light a hot'' lamp. If, however, the count is below such level during this time period, another capacitor will fire a second thyratron to light a safe'' lamp. (AEC)

Near-infrared spectroscopic study and the Wada test for presurgical evaluation of expressive and receptive language functions in glioma patients: with a case report of dissociated language functions.

PubMed

Sato, Yosuke; Uzuka, Takeo; Aoki, Hiroshi; Natsumeda, Manabu; Oishi, Makoto; Fukuda, Masafumi; Fujii, Yukihiko

2012-02-29

Near-infrared spectroscopy (NIRS) has proven to be useful for the evaluation of language lateralization in healthy subjects, infants, and epileptic patients. This study for the first time investigated the expressive and receptive language functions separately, using NIRS in presurgical glioma patients. We also describe a special case with dissociated pattern of language functions. Ten glioma patients were examined. Using NIRS, the hemodynamic changes during a verb generation task or story listening task were measured in the cerebral hemisphere on either side covering the language areas. Following the NIRS study, the Wada test was performed in all the patients. The NIRS study revealed increases of oxyhemoglobin and decreases of deoxyhemoglobin in the language areas elicited by both tasks. In 9 patients, who were all right-handed, the expressive and receptive language functions were lateralized to the left hemisphere. The results of the NIRS study were completely consistent with those of the Wada test. In the remaining 1 patient with a right sided insular glioma, who was right-handed, the NIRS study revealed stronger activation of the right inferior frontal region during the verb generation task, and stronger activation of the left superior temporal region during the story listening task. This dissociated language function was validated by the Wada test and the postoperative neurological course. These results demonstrate that a NIRS study using our technique is extremely valuable for preoperative assessment of the language functions and exemplifies how a preoperative NIRS study can allow detection of unforeseen language lateralization. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Antimicrobial efficacy of alcohol-based hand gels.

PubMed

Guilhermetti, M; Marques Wiirzler, L A; Castanheira Facio, B; da Silva Furlan, M; Campo Meschial, W; Bronharo Tognim, M C; Botelho Garcia, L; Luiz Cardoso, C

2010-03-01

In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers. Copyright 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Adapting a Robot Hand to Specialized Functions

NASA Technical Reports Server (NTRS)

Clark, Keith H.

1987-01-01

Adaptor enables mechanical and electrical connections made easily between special-purpose end effector and arm of robot or remote mainpulator. Use in prosthetic devices also contemplatd. With adaptor, hand changed quickly from device designed to grasp objects of various sizes and shapes to device intended to do specific task efficiently.

The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot.

PubMed

Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

2013-10-01

Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p<0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p<0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p<0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p<0.05) and a significant decrease of ED and FD co-contraction during the training (p<0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p<0.05). Copyright © 2013 Elsevier Ltd. All rights reserved.

Pure associative tactile agnosia for the left hand: clinical and anatomo-functional correlations.

PubMed

Veronelli, Laura; Ginex, Valeria; Dinacci, Daria; Cappa, Stefano F; Corbo, Massimo

2014-09-01

Associative tactile agnosia (TA) is defined as the inability to associate information about object sensory properties derived through tactile modality with previously acquired knowledge about object identity. The impairment is often described after a lesion involving the parietal cortex (Caselli, 1997; Platz, 1996). We report the case of SA, a right-handed 61-year-old man affected by first ever right hemispheric hemorrhagic stroke. The neurological examination was normal, excluding major somaesthetic and motor impairment; a brain magnetic resonance imaging (MRI) confirmed the presence of a right subacute hemorrhagic lesion limited to the post-central and supra-marginal gyri. A comprehensive neuropsychological evaluation detected a selective inability to name objects when handled with the left hand in the absence of other cognitive deficits. A series of experiments were conducted in order to assess each stage of tactile recognition processing using the same stimulus sets: materials, 3D geometrical shapes, real objects and letters. SA and seven matched controls underwent the same experimental tasks during four sessions in consecutive days. Tactile discrimination, recognition, pantomime, drawing after haptic exploration out of vision and tactile-visual matching abilities were assessed. In addition, we looked for the presence of a supra-modal impairment of spatial perception and of specific difficulties in programming exploratory movements during recognition. Tactile discrimination was intact for all the stimuli tested. In contrast, SA was able neither to recognize nor to pantomime real objects manipulated with the left hand out of vision, while he identified them with the right hand without hesitations. Tactile-visual matching was intact. Furthermore, SA was able to grossly reproduce the global shape in drawings but failed to extract details of objects after left-hand manipulation, and he could not identify objects after looking at his own drawings. This case

Transfer of motor skill learning from the healthy hand to the paretic hand in stroke patients: a randomized controlled trial.

PubMed

Ausenda, C; Carnovali, M

2011-09-01

Bilateral transfer of a motor skill is a phenomenon based on the observation that the performance of a skill with one hand can "teach" the same skill to the other hand. In this study the ability of bilateral transfer to facilitate the motor skill of the paretic hand in patients that suffered a stroke was tested. In a randomized controlled trial subjects were randomly assigned to either the test group or the control group. The experiment was performed in a general hospital rehabilitation facility for inpatients and outpatients. We studied 20 outpatients, who had their first stroke episode characterized by a brain lesion to a single hemisphere, at the end of their rehabilitation treatment. The criteria used for the selection were based on a physical examination, the time elapsed from the stroke and cognitive requirements. The experiment consisted in training the healthy hand of each patient from the test group to execute the nine hole peg test 10 times a day, for three consecutive days, and then test the paretic hand with the same test and with bimanual tasks. The control group was not trained but went through the same analysis. The homogeneity of the two groups has been proven. In the test group we found that the execution speed of the nine hole peg test with the paretic hand, after training the healthy hand, was on average 22.6% faster than the value recorded at baseline. The training had a positive effect on the execution of bimanual tasks. Meanwhile, no significant difference was found in the control group. This is the first evidence that bilateral transfer of motor skills is present in patients that suffered a stroke, and that it improves the ability of the affected hand. This observation could open the way to the development of a new approach for the rehabilitation of stroke patients.

Re-calibration of the magnetic compass in hand-raised European robins (Erithacus rubecula)

PubMed Central

Alert, Bianca; Michalik, Andreas; Thiele, Nadine; Bottesch, Michael; Mouritsen, Henrik

2015-01-01

Migratory birds can use a variety of environmental cues for orientation. A primary calibration between the celestial and magnetic compasses seems to be fundamental prior to a bird’s first autumn migration. Releasing hand-raised or rescued young birds back into the wild might therefore be a problem because they might not have established a functional orientation system during their first calendar year. Here, we test whether hand-raised European robins that did not develop any functional compass before or during their first autumn migration could relearn to orient if they were exposed to natural celestial cues during the subsequent winter and spring. When tested in the geomagnetic field without access to celestial cues, these birds could orient in their species-specific spring migratory direction. In contrast, control birds that were deprived of any natural celestial cues throughout remained unable to orient. Our experiments suggest that European robins are still capable of establishing a functional orientation system after their first autumn. Although the external reference remains speculative, most likely, natural celestial cues enabled our birds to calibrate their magnetic compass. Our data suggest that avian compass systems are more flexible than previously believed and have implications for the release of hand-reared migratory birds. PMID:26388258

An effective 3-fingered augmenting exoskeleton for the human hand.

PubMed

Gearhart, C J; Varone, B; Stella, M H; BuSha, B F

2016-08-01

Every year, thousands of Americans suffer from pathological and traumatic events that result in loss of dexterity and strength of the hand. Although many supportive devices have been designed to restore functional hand movement, most are very complex and expensive. The goal of this project was to design and implement a cost-effective, electrically powered exoskeleton for the human hand that could improve grasping strength. A 3-D printed thermoplastic exoskeleton that allowed independent and enhanced movement of the index, middle and ring fingers was constructed. In addition, a 3-D printed structure was designed to house three linear actuators, an Arduino-based control system, and a power supply. A single force sensing resistor was located on the lower inner-surface of the index fingertip which was used to proportionally activate the three motors, one motor per finger, as a function of finger force applied to the sensor. The device was tested on 4 normal human subjects. Results showed that the activation of the motor control system significantly reduced the muscle effort needed to maintain a sub-maximal grasp effort.

Hands-On Science: Is It an Acid or a Base? These Colorful Tests Tell All!

ERIC Educational Resources Information Center

VanCleave, Janice

1998-01-01

Two hands-on science activities for K-6 students teach them how to determine if something is an acid or a base. The activities require acid/base indicator juice, testing strips, and a base solution. A recipe for making them in the classroom using red cabbage and baking soda is provided. (SM)

Drug induced increases in CNS dopamine alter monocyte, macrophage and T cell functions: implications for HAND

PubMed Central

Gaskill, Peter J.; Calderon, Tina M.; Coley, Jacqueline S.; Berman, Joan W.

2013-01-01

Central nervous system (CNS) complications resulting from HIV infection remain a major public health problem as individuals live longer due to the success of combined antiretroviral therapy (cART). As many as 70% of HIV infected people have HIV associated neurocognitive disorders (HAND). Many HIV infected individuals abuse drugs, such as cocaine, heroin or methamphetamine, that may be important cofactors in the development of HIV CNS disease. Despite different mechanisms of action, all drugs of abuse increase extracellular dopamine in the CNS. The effects of dopamine on HIV neuropathogenesis are not well understood, and drug induced increases in CNS dopamine may be a common mechanism by which different types of drugs of abuse impact the development of HAND. Monocytes and macrophages are central to HIV infection of the CNS and to HAND. While T cells have not been shown to be a major factor in HIV-associated neuropathogenesis, studies indicate that T cells may play a larger role in the development of HAND in HIV infected drug abusers. Drug induced increases in CNS dopamine may dysregulate functions of, or increase HIV infection in, monocytes, macrophages and T cells in the brain. Thus, characterizing the effects of dopamine on these cells is important for understanding the mechanisms that mediate the development of HAND in drug abusers. PMID:23456305

Effectiveness of functional hand splinting and the cognitive orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols

PubMed Central

2014-01-01

Background Cerebral palsy (CP) and brain injury (BI) are common conditions that have devastating effects on a child’s ability to use their hands. Hand splinting and task-specific training are two interventions that are often used to address deficits in upper limb skills, both in isolation or concurrently. The aim of this paper is to describe the method to be used to conduct two randomised controlled trials (RCT) investigating (a) the immediate effect of functional hand splints, and (b) the effect of functional hand splints used concurrently with task-specific training compared to functional hand splints alone, and to task-specific training alone in children with CP and BI. The Cognitive Orientation to Occupational Performance (CO-OP) approach will be the task-specific training approach used. Methods/Design Two concurrent trials; a two group, parallel design, RCT with a sample size of 30 participants (15 per group); and a three group, parallel design, assessor blinded, RCT with a sample size of 45 participants (15 per group). Inclusion criteria: age 4-15 years; diagnosis of CP or BI; Manual Abilities Classification System (MACS) level I – IV; hand function goals; impaired hand function; the cognitive, language and behavioural ability to participate in CO-OP. Participants will be randomly allocated to one of 3 groups; (1) functional hand splint only (n=15); (2) functional hand splint combined with task-specific training (n=15); (3) task-specific training only (n=15). Allocation concealment will be achieved using sequentially numbered, sealed opaque envelopes opened by an off-site officer after baseline measures. Treatment will be provided for a period of 2 weeks, with outcome measures taken at baseline, 1 hour after randomisation, 2 weeks and 10 weeks. The functional hand splint will be a wrist cock-up splint (+/- thumb support or supination strap). Task-specific training will involve 10 sessions of CO-OP provided in a group of 2-4 children. Primary outcome

Deep learning-based artificial vision for grasp classification in myoelectric hands

NASA Astrophysics Data System (ADS)

Ghazaei, Ghazal; Alameer, Ali; Degenaar, Patrick; Morgan, Graham; Nazarpour, Kianoush

2017-06-01

Objective. Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand. Approach. We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at {{5}\\circ} intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set. Main results. The classification accuracy in the offline tests reached 85 % for the seen and 75 % for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of 84 % in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb UltraTM prosthetic hand and a motion controlTM prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to 88 % . In addition, we show that with training, subjects’ performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback. Significance. The proposed design constitutes a substantial

[The plexal hand (involvement of the hand in traumatic lesions of the brachial plexus in adults)].

PubMed

Alnot, J Y; Salon, A

1993-01-01

After spontaneous recovery following brachial plexus injuries, or after nerve regeneration following nervous surgery on traumatic brachial plexus, there usually is a variable residual distal deficit involving the hand and wrist. This deficit is defined by both a functional approach, and its anatomical nervous correspondence, in order to predict which motor muscles will be available for palliative surgery, and to establish the most reasonable therapeutic plan. Total palsy of the hand will only be mentioned, whereas three main presentations of the "plexic hand" are of a greater surgical interest and will be detailed: the "wrist drop", due to C5 C6 +/- C7 supra-clavicular lesions, the hand presenting with a deficit of digit flexion, pinch and intrinsic functions, due to C8 T1 +/- C7 supra-clavicular lesions, non-standardized deficits due to infra- and retro-clavicular lesions, whose therapeutic indications and prognosis are closer to more classical trunk palsies. The review of 44 "plexic hands" after distal palliative surgery indicates the need to modify the fundamental rules of tendinous transfer surgery, and suggests new principles properly adapted to the surgery of plexic hand palsies.

Cooperative hand movements in post-stroke subjects: Neural reorganization.

PubMed

Schrafl-Altermatt, Miriam; Dietz, Volker

2016-01-01

Recent research indicates a task-specific neural coupling controlling cooperative hand movements reflected in bilateral electromyographic reflex responses in arm muscles following unilateral nerve stimulation. Reorganization of this mechanism was explored in post-stroke patients in this study. Electromyographic reflex responses in forearm muscles to unilateral electrical ulnar nerve stimulation were examined during cooperative and non-cooperative hand movements. Stimulation of the unaffected arm during cooperative hand movements led to electromyographic responses in bilateral forearm muscles, similar to those seen in healthy subjects, while stimulation of the affected side was followed only by ipsilateral responses. No contralateral reflex responses could be evoked in severely affected patients. The presence of contralateral responses correlated with the clinical motor impairment as assessed by the Fugl-Meyer test. The observations suggest that after stroke an impaired processing of afferent input from the affected side leads to a defective neural coupling and is associated with a greater involvement of fiber tracts from the unaffected hemisphere during cooperative hand movements. The mechanism of neural coupling underlying cooperative hand movements is shown to be defective in post-stroke patients. The neural re-organizations observed have consequences for the rehabilitation of hand function. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

14 CFR 35.40 - Functional test.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Functional test. 35.40 Section 35.40... STANDARDS: PROPELLERS Tests and Inspections § 35.40 Functional test. The variable-pitch propeller system must be subjected to the applicable functional tests of this section. The same propeller system used in...

14 CFR 35.40 - Functional test.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Functional test. 35.40 Section 35.40... STANDARDS: PROPELLERS Tests and Inspections § 35.40 Functional test. The variable-pitch propeller system must be subjected to the applicable functional tests of this section. The same propeller system used in...

14 CFR 35.40 - Functional test.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Functional test. 35.40 Section 35.40... STANDARDS: PROPELLERS Tests and Inspections § 35.40 Functional test. The variable-pitch propeller system must be subjected to the applicable functional tests of this section. The same propeller system used in...

The tropical diabetic hand syndrome: a surgical perspective.

PubMed

Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

2013-01-01

Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population.

PubMed

Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin

2016-10-01

Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. 362 subjects aged 60-93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = -0.227, p = 0.009) and JTHFT (r = -0.927, p < 0.001). This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. Copyright: © Singapore Medical Association

Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population

PubMed Central

Lam, Ngee Wei; Goh, Hui Ting; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip Jun Hua; Tan, Maw Pin

2016-01-01

INTRODUCTION Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability. METHODS Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded. RESULTS 362 subjects aged 60–93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = −0.227, p = 0.009) and JTHFT (r = −0.927, p < 0.001). CONCLUSION This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength. PMID:26768064

Fine finger motor skill training with exoskeleton robotic hand in chronic stroke: stroke rehabilitation.

PubMed

Ockenfeld, Corinna; Tong, Raymond K Y; Susanto, Evan A; Ho, Sze-Kit; Hu, Xiao-ling

2013-06-01

Background and Purpose. Stroke survivors often show a limited recovery in the hand function to perform delicate motions, such as full hand grasping, finger pinching and individual finger movement. The purpose of this study is to describe the implementation of an exoskeleton robotic hand together with fine finger motor skill training on 2 chronic stroke patients. Case Descriptions. Two post-stroke patients participated in a 20-session training program by integrating 10 minutes physical therapy, 20 minutes robotic hand training and 15 minutes functional training tasks with delicate objects(card, pen and coin). These two patients (A and B) had cerebrovascular accident at 6 months and 11 months respectively when enrolled in this study. Outcomes. The results showed that both patients had improvements in Fugl-Meyer assessment (FM), Action Research Arm Test (ARAT). Patients had better isolation of the individual finger flexion and extension based on the reduced muscle co-contraction from the electromyographic(EMG) signals and finger extension force after 20 sessions of training. Discussion. This preliminary study showed that by focusing on the fine finger motor skills together with the exoskeleton robotic hand, it could improve the motor recovery of the upper extremity in the fingers and hand function, which were showed in the ARAT. Future randomized controlled trials are needed to evaluate the clinical effectiveness.

Differences on the projective hand test among chronic pain patients reporting three different pain experiences.

PubMed

Panek, Paul E; Skowronski, John J; Wagner, Edwin E

2002-10-01

This study examined personality differences among individuals experiencing 3 different types of pain. The projective Hand Test was administered to 90 individuals who were seeking treatment at a pain clinic in an urban area of the southeast United States. These people were seeking treatment for either arthritis (n = 31), fibromyalgia (n = 29), or migraine headaches (n = 30). A 2 (gender) x 3 (pain group) x Age Group multivariate analysis of variance was conducted using the quantitative Hand Test scoring variables as dependent measures. Results indicated that individuals who were seeking treatment for migraine headaches had a higher production rate of responses involving exhibitionistic displays (EXH) than individuals in the other 2 groups. Individuals who were seeking treatment for fibromyalgia had a higher production rate of responses indicating fear and phobic concerns (FEAR) than individuals in the other 2 groups. Individuals who were seeking treatment for arthritis had a higher production rate of Active (ACT) responses than individuals in the other 2 groups. Possible causes and consequences of these effects are discussed.

Development of the Hand Assessment for Infants: evidence of internal scale validity.

PubMed

Krumlinde-Sundholm, Lena; Ek, Linda; Sicola, Elisa; Sjöstrand, Lena; Guzzetta, Andrea; Sgandurra, Giuseppina; Cioni, Giovanni; Eliasson, Ann-Christin

2017-12-01

The aim of this study was to develop a descriptive and evaluative assessment of upper limb function for infants aged 3 to 12 months and to investigate its internal scale validity for use with infants at risk of unilateral cerebral palsy. The concepts of the test items and scoring criteria were developed. Internal scale validity and aspects of reliability were investigated on the basis of 156 assessments of infants at 3 to 12 months corrected age (mean 7.2mo, SD 2.5) with signs of asymmetric hand use. Rasch measurement model analysis and non-parametric statistics were used. The new test, the Hand Assessment for Infants (HAI), consists of 12 unimanual and five bimanual items, each scored on a 3-point rating scale. It demonstrated a unidimensional construct and good fit to the Rasch model requirements. The excellent person reliability enabled person separation to six significant ability strata. The HAI produced an interval-level measure of bilateral hand use as well as unimanual scores of each hand, allowing a quantification of possible asymmetry expressed as an asymmetry index. The HAI can be considered a valid assessment tool for measuring bilateral hand use and quantifying side difference between hands among infants at risk of developing unilateral cerebral palsy. The Hand Assessment for Infants (HAI) measures the use of both hands and quantifies a possible asymmetry of hand use. HAI is valid for infants at 3 to 12 months corrected age at risk of unilateral cerebral palsy. © 2017 Mac Keith Press.

Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

PubMed Central

Sheridan, R L; Baryza, M J; Pessina, M A; O'Neill, K M; Cipullo, H M; Donelan, M B; Ryan, C M; Schulz, J T; Schnitzer, J J; Tompkins, R G

1999-01-01

OBJECTIVE: To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA: Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-term outcomes associated with such a plan of care have not been previously reported. METHODS: Over a 10-year period, 495 children with 698 acutely burned hands were managed at a regional pediatric burn facility; 219 children with 395 injured hands were followed in the authors' outpatient clinic for at least 1 year and an average of >5 years. The authors' approach to the acutely burned hand emphasizes ranging and splinting throughout the hospital stay, prompt sheet autograft wound closure as soon as practical, and the selective use of axial pin fixation and flaps. Long-term follow-up, hand therapy, and reconstructive surgery are emphasized. RESULTS: Normal functional results were seen in 97% of second-degree and 85% of third-degree injuries; in children with burns involving underlying tendon and bone, 70% could perform activities of daily living and 20% had normal function. Reconstructive hand surgery was required in 4.4% of second-degree burns, 32% of third-degree burns, and 65% of those with injuries involving underlying bone and tendon. CONCLUSIONS: When managed in a coordinated long-term program, the large majority of children with serious hand burns can be expected to have excellent functional results. Images Figure 1. Figure 2. PMID:10203090

Fine motor skills of the hands in Polish and Czech female senior citizens from different backgrounds.

PubMed

Skrzek, Anna; Přidalová, Miroslava; Sebastjan, Anna; Harásková, Dominika; Fugiel, Jaroslaw; Ignasiak, Zofia; Slawinska, Teresa; Rozek, Krystyna

2015-08-01

The aim of the present study was an in-depth analysis of fine motor skills of the hands in elderly women from different socio-cultural backgrounds. The research also included analysis of the associations of age with the variables assessing right- and left-hand motor skills and its effect on hand performance asymmetry. The study examined 486 women over the age of 60. The study measured dominant and non-dominant hand performance using the motor performance series test battery (aiming, line tracking, inserting pins, tapping) from the Vienna test system. The best results in the tests assessing coordinated hand movements were achieved by the group of elderly women attending a University of the Third Age in Poland. This may be the result of a larger variety of physical activity programs offered at this type of institution. However, due to the cross-sectional design of the study, additional research of a longitudinal nature needs to be performed using the same sample of individuals to draw any definitive conclusions. Additionally, a decrease in the differences between dominant and non-dominant hand function with age was observed.

The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands.

PubMed

Heydorn, S; Menné, T; Andersen, K E; Bruze, M; Svedman, C; Basketter, D; Johansen, J D

2003-06-01

Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p.p.m.), whilst during the following 2 weeks, the concentration was relatively high (approximately 250 p.p.m.), imitating real-life exposure to a household product like dishwashing liquid diluted in water and the undiluted product, respectively. Evaluation was made using a clinical scale and laser Doppler flow meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger in a solution containing fragrance and development of clinically visible eczema on the finger in 15 participants previously diagnosed with hand eczema and with a positive patch test to the fragrance in question.

[Microsurgical 2nd toe transfer for catastrophic hand reconstruction].

PubMed

Placer, A; Lozano, Ja

2007-01-01

The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

[Hand motor dysfunctions in computer users].

PubMed

Shavlovskaia, O A; Shvarkov, S B; Posokhov, S I

2010-01-01

It were studied 239 female typists aged from 16 to 62 years (mean age 20,1±7,8 years) using author's questionnaire for computer typists to assess hand function and develop preventive measures of disturbances revealed. Indirect signs of tunnel hand neuropathy (27,2%), focal hand dystonia (21,4%) and muscular-tonic syndromes of different localization (18%) have been found. Typists are a risk group of fine hand motor dysfunctions. As preventive measures, authors recommend to use computer auxiliary devices, to change a motor stereotype during the day, to make hand "motor holidays", to organize working place.

Unilateral Cleft Hand with Cleft Foot

PubMed Central

Baba, Asif Nazir; Bhat, Yasmeen J.; Ahmed, Sheikh Mushtaq; Nazir, Abid

2009-01-01

Congenital anomalies of the hand form an important class of congenital malformations. They have a huge functional importance because of the part played by the hand in the daily activities of a person. The deformities also have significant cosmetic significance and may also be associated with other anomalies. Amongst the congenital anomalies, central deficiency or cleft hand is relatively rare. The association of cleft foot with cleft hand is an even more rare occurance. We present a case report of a 6 year old child, born of a non-consanginous marriage, having congenital central deficiency of ipsilateral hand and foot. PMID:21475543

Assessment of isometric muscle strength and rate of torque development with hand-held dynamometry: Test-retest reliability and relationship with gait velocity after stroke.

PubMed

Mentiplay, Benjamin F; Tan, Dawn; Williams, Gavin; Adair, Brooke; Pua, Yong-Hao; Bower, Kelly J; Clark, Ross A

2018-04-27

Isometric rate of torque development examines how quickly force can be exerted and may resemble everyday task demands more closely than isometric strength. Rate of torque development may provide further insight into the relationship between muscle function and gait following stroke. Aims of this study were to examine the test-retest reliability of hand-held dynamometry to measure isometric rate of torque development following stroke, to examine associations between strength and rate of torque development, and to compare the relationships of strength and rate of torque development to gait velocity. Sixty-three post-stroke adults participated (60 years, 34 male). Gait velocity was assessed using the fast-paced 10 m walk test. Isometric strength and rate of torque development of seven lower-limb muscle groups were assessed with hand-held dynamometry. Intraclass correlation coefficients were calculated for reliability and Spearman's rho correlations were calculated for associations. Regression analyses using partial F-tests were used to compare strength and rate of torque development in their relationship with gait velocity. Good to excellent reliability was shown for strength and rate of torque development (0.82-0.97). Strong associations were found between strength and rate of torque development (0.71-0.94). Despite high correlations between strength and rate of torque development, rate of torque development failed to provide significant value to regression models that already contained strength. Assessment of isometric rate of torque development with hand-held dynamometry is reliable following stroke, however isometric strength demonstrated greater relationships with gait velocity. Further research should examine the relationship between dynamic measures of muscle strength/torque and gait after stroke. Copyright © 2018 Elsevier Ltd. All rights reserved.

Normalisation of brain connectivity through compensatory behaviour, despite congenital hand absence.

PubMed

Hahamy, Avital; Sotiropoulos, Stamatios N; Henderson Slater, David; Malach, Rafael; Johansen-Berg, Heidi; Makin, Tamar R

2015-01-06

Previously we showed, using task-evoked fMRI, that compensatory intact hand usage after amputation facilitates remapping of limb representations in the cortical territory of the missing hand (Makin et al., 2013a). Here we show that compensatory arm usage in individuals born without a hand (one-handers) reflects functional connectivity of spontaneous brain activity in the cortical hand region. Compared with two-handed controls, one-handers showed reduced symmetry of hand region inter-hemispheric resting-state functional connectivity and corticospinal white matter microstructure. Nevertheless, those one-handers who more frequently use their residual (handless) arm for typically bimanual daily tasks also showed more symmetrical functional connectivity of the hand region, demonstrating that adaptive behaviour drives long-range brain organisation. We therefore suggest that compensatory arm usage maintains symmetrical sensorimotor functional connectivity in one-handers. Since variability in spontaneous functional connectivity in our study reflects ecological behaviour, we propose that inter-hemispheric symmetry, typically observed in resting sensorimotor networks, depends on coordinated motor behaviour in daily life.

Engineers test STS-37 CETA electrical hand pedal cart in JSC MAIL Bldg 9A

NASA Technical Reports Server (NTRS)

1990-01-01

McDonnell Douglas engineers Noland Talley (left) and Gary Peters (center) and ILC-Dover engineer Richard Richard Smallcombe prepare test setup for the evaluation of the crew and equipment translation aid (CETA) electrical hand pedal cart in JSC's Mockup and Integration Laboratory (MAIL) Bldg 9A. Peters, wearing extravehicular mobility unit (EMU) boots and positioned in portable foot restraint (PFR), is suspended above CETA cart and track via harness to simulate weightlessness. CETA will be tested in orbit in the payload bay of Atlantis, Orbiter Vehicle (OV) 104, during STS-37.

Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting.

PubMed

Carey, Leeanne M; Matyas, Thomas A

2011-02-01

Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase. Prospective cohort study of stroke survivors presenting for rehabilitation. Fifty-one consecutive patients admitted to a metropolitan rehabilitation centre over a continuous 12-month period who met selection criteria. Quantitative measures of touch discrimination and limb position sense, with high re-test reliability, good discriminative test properties and objective criteria of abnormality, were employed. Both upper limbs were tested, in counterbalanced order. Impaired touch discrimination was identified in the hand contralateral to the lesion in 47% of patients, and in the ipsilesional hand in 16%. Forty-nine percent showed impaired limb position sense in the contralesional limb and 20% in the ipsilesional limb. Sixty-seven percent demonstrated impairment of at least one modality in the contralesional limb. Ipsilesional impairment was less severe. Discriminative sensory impairment was quantified in the contralesional hand in approximately half of stroke patients presenting for rehabilitation. A clinically significant number also experienced impairment in the ipsilesional "unaffected" hand.

Effectiveness of the graded motor imagery to improve hand function in patients with distal radius fracture: A randomized controlled trial.

PubMed

Dilek, Burcu; Ayhan, Cigdem; Yagci, Gozde; Yakut, Yavuz

Single-blinded randomized controlled trial. Pain management is essential in the early stages of the rehabilitation of distal radius fractures (DRFx). Pain intensity at the acute stage is considered important for determining the individual recovery process, given that higher pain intensity and persistent pain duration negatively affect the function and cortical activity of pain response. Graded motor imagery (GMI) and its components are recent pain management strategies, established on a neuroscience basis. To investigate the effectiveness of GMI in hand function in patients with DRFx. Thirty-six participants were randomly allocated to either GMI (n = 17; 52.59 [9.8] years) or control (n = 19; 47.16 [10.5] years) groups. The GMI group received imagery treatment in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 8 weeks. The assessments included pain at rest and during activity using the visual analog scale, wrist and forearm active range of motion (ROM) with universal goniometer, grip strength with the hydraulic dynamometer (Jamar; Bolingbrook, IL), and upper extremity functional status using the Disability of the Arm, Shoulder and Hand Questionnaire, and the Michigan Hand Questionnaire. Assessments were performed twice at baseline and at the end of the eighth week. The GMI group showed greater improvement in pain intensity (during rest, 2.24; activity, 6.18 points), wrist ROM (flexion, -40.59; extension, -45.59; radial deviation, -25.59; and ulnar deviation, -26.77 points) and forearm ROM (supination, -43.82 points), and functional status (Disability of the Arm, Shoulder and Hand Questionnaire, 38.00; Michigan Hand Questionnaire, -32.53 points) when compared with the control group (for all, P < .05). The cortical model of pathological pain suggests new strategies established on a neuroscience basis. These strategies aim to normalize the cortical proprioceptive representation and reduce pain. One of

Hands beat machines for collecting native seed

Treesearch

Mary Ann Davies; Scott Jensen

2008-01-01

A hedge trimmer (Garden Groom Pro) and a hand-held vacuum (Euro-Pro Shark) were tested to determine whether they might be more effective for collecting the seed of native plants than common hand methods. The common hand methods worked best.

Track/train dynamics test procedure transfer function test

NASA Technical Reports Server (NTRS)

Vigil, R. A.

1975-01-01

A transfer function vibration test was made on an 80 ton open hopper freight car in an effort to obtain validation data on the car's nonlinear elastic model. Test configuration, handling, test facilities, test operations, and data acquisition/reduction activities necessary to meet the conditions of test requirements are given.

14 CFR 35.40 - Functional test.

Code of Federal Regulations, 2012 CFR

2012-01-01

... representative engine on a test stand or on an airplane. The propeller must complete these tests without evidence... STANDARDS: PROPELLERS Tests and Inspections § 35.40 Functional test. The variable-pitch propeller system must be subjected to the applicable functional tests of this section. The same propeller system used in...

14 CFR 35.40 - Functional test.

Code of Federal Regulations, 2011 CFR

2011-01-01

... representative engine on a test stand or on an airplane. The propeller must complete these tests without evidence... STANDARDS: PROPELLERS Tests and Inspections § 35.40 Functional test. The variable-pitch propeller system must be subjected to the applicable functional tests of this section. The same propeller system used in...

Reconstructive hand surgery for quadriplegic persons.

PubMed

Ainsley, J; Voorhees, C; Drake, E

1985-11-01

Reconstructive hand surgery is one approach to restoring lost hand function in quadriplegic patients. This paper describes Craig Hospital's experience with the two-stage procedure for achieving active grasp and pinch for C7 spinal cord-injured patients. It describes the hand clinic, patient selection and education, the surgery itself, and postsurgical occupational therapy. It also includes follow-up results on all patients treated since the program's inception.

Functional Task Test: 2. Spaceflight-Induced Cardiovascular Change and Recovery During NASA's Functional Task Test

NASA Technical Reports Server (NTRS)

Phillips, Tiffany; Arzeno, Natalia M.; Stenger, Michael; Lee, Stuart M. C.; Bloomberg, Jacob J.; Platts, Steven H.

2011-01-01

The overall objective of the functional task test (FTT) is to correlate spaceflight-induced physiological adaptations with changes in performance of high priority exploration mission-critical tasks. This presentation will focus on the recovery from fall/stand test (RFST), which measures the cardiovascular response to the transition from the prone posture (simulated fall) to standing in normal gravity, as well as heart rate (HR) during 11 functional tasks. As such, this test describes some aspects of spaceflight-induced cardiovascular deconditioning and the course of recovery in Space Shuttle and International Space Station (ISS) astronauts. The sensorimotor and neuromuscular components of the FTT are described in two separate abstracts: Functional Task Test 1 and 3.

Kinematic parameters of hand movement during a disparate bimanual movement task in children with unilateral Cerebral Palsy.

PubMed

Rudisch, Julian; Butler, Jenny; Izadi, Hooshang; Zielinski, Ingar Marie; Aarts, Pauline; Birtles, Deirdre; Green, Dido

2016-04-01

Children with unilateral Cerebral Palsy (uCP) experience problems performing tasks requiring the coordinated use of both hands (bimanual coordination; BC). Additionally, some children with uCP display involuntary symmetrical activation of the opposing hand (mirrored movements). Measures, used to investigate therapy-related improvements focus on the functionality of the affected hand during unimanual or bimanual tasks. None however specifically address spatiotemporal integration of both hands. We explored the kinematics of hand movements during a bimanual task to identify parameters of BC. Thirty-seven children (aged 10.9±2.6years, 20 male) diagnosed with uCP participated. 3D kinematic motion analysis was performed during the task requiring opening of a box with their affected- (AH) or less-affected hand (LAH), and pressing a button inside with the opposite hand. Temporal and spatial components of data were extracted and related to measures of hand function and level of impairment. Total task duration was correlated with the Jebsen-Taylor Test of Hand Function in both conditions (either hand leading with the lid-opening). Spatial accuracy of the LAH when the box was opened with their AH was correlated with outcomes on the Children's Hand Use Experience Questionnaire. Additionally, we found a subgroup of children displaying non-symmetrical movement interference associated with greater movement overlap when their affected hand opened the box. This subgroup also demonstrated decreased use of the affected hand during bimanual tasks. Further investigation of bimanual interference, which goes beyond small scaled symmetrical mirrored movements, is needed to consider its impact on bimanual task performance following early unilateral brain injury. Copyright © 2016 Elsevier B.V. All rights reserved.

Does Surgical Management of the Hand in Children with Spastic Unilateral Cerebral Palsy Affect Functional Outcome?

ERIC Educational Resources Information Center

van Munster, Judith C.; Maathuis, Karel G. B.; Haga, Nienke; Verheij, Nienke P.; Nicolai, Jean-Philippe A.; Hadders-Algra, Mijna

2007-01-01

The aim of this review was to examine the literature on the effects of surgery of the spastic hand in children with cerebral palsy on functional outcome and muscle coordination. We performed a search of the relevant literature in Medline, Embase, and Biological Abstracts from 1966 to June 2006. The search resulted in eight studies on the effect of…

Hand preferences for bimanual coordination in 29 bonobos (Pan paniscus).

PubMed

Chapelain, Amandine S; Hogervorst, Eef

2009-01-03

Brain lateralization has long been thought to be unique to humans. To investigate the origins and functions of this feature, researchers study behavioural laterality in other animals. Despite a substantial database, manual laterality in non-human primates remains a controversial topic. We give here a review of the main findings on manual preference in great apes. This article presents data on hand preferences for a bimanual coordination in 29 bonobos (Pan paniscus). The study aims to provide data on manual laterality for a complex bimanual task in this very interesting and rarely studied species. Hand preferences were assessed using the 'tube task'. This task has been used with other species, which allows reliable data comparisons. The task requires a bimanual coordinated precise action: the subject holds the tube with one hand while reaching for food inside with the other hand. As a complex task, this measure has been shown to be efficient in revealing hand preferences. It has revealed group-level right bias in chimpanzees. Bonobos had never been tested. We recorded both independent bouts (counting only the first pattern of a sequence of identical actions) and frequency (counting every action). The bonobos exhibited strong hand preferences. With frequency, 11 bonobos were classified as right-handed, 15 were left-handed and 3 had no preference. With bouts, 8 bonobos were right-handed, 9 were left-handed and 12 had no preference. No group-level bias appeared. The results are discussed in relation with previous findings and theories on brain lateralization.

Writing and drawing with both hands as indicators of hemispheric dominance.

PubMed

Labak, Irena; Snajder, Darija; Srzentić, Mirna Kostović; Bensić, Mirta; Nist, Marina; Ilakovac, Vesna; Heffer, Marija

2011-01-01

Brain lateralization is a common term used to describe dominance of one brain hemisphere over another for a specific function. The right hand dominance in writing, controlled by the left hemisphere, is preceded by development of communicative gesticulation and followed by development of speech in the same hemisphere. We assumed that some people are not aware of their own capability of using the other hand for tasks involving fine motor sequential movements. To prove this hypothesis, the participants were asked to perform one trained task (writing) and one less-trained task (drawing) with a dominant and a non-dominant hand. The final sample was comprised of 1189 children from 14 elementary schools and 8 high schools in the Osijek area, of which 685 elementary school children were attending 1st to 4th grade and 504 high school children were attending 3rd and 4th grade. The participants were asked to write two words, draw a specific object (a vase with flowers) and fill out a questionnaire with 10 questions concerning the classification of handedness and cerebral hemisphere dominance. The self-reported cerebral lateralization assessed in the questionnaire was compared with the drawing and the writing performance. The self-reported and objectively measured hand dominance deviated in the cases of the ambidextrous who consider themselves right-handers. Given the fact that the number of ambidextrous persons was greater in elementary schools than in high schools, we concluded how training of the right hand decreases the ability of using both hands equally for either of the tested functions - writing and drawing.

Hand controller commonality evaluation process

NASA Technical Reports Server (NTRS)

Stuart, Mark A.; Bierschwale, John M.; Wilmington, Robert P.; Adam, Susan C.; Diaz, Manuel F.; Jensen, Dean G.

1993-01-01

Hand controller selection for NASA's Orbiter and Space Station Freedom is an important area of human-telerobot interface design and evaluation. These input devices will control remotely operated systems that include large crane-like manipulators (e.g., Remote Manipulator System or RMS), smaller, more dexterous manipulators (e.g., Flight Telerobotic Servicer or FTS), and free flyers (e.g., Orbital Maneuvering Vehicle or OMV). Candidate hand controller configurations for these systems vary in many ways: shape, size, number of degrees-of-freedom (DOF), operating modes, provision of force reflection, range of movement, and 'naturalness' of use. Unresolved design implementation issues remain, including such topics as how the current Orbiter RMS rotational and translational rate hand controllers compare with the proposed Space Station Freedom hand controllers, the advantages that position hand controllers offer for these applications, and whether separate hand controller configurations are required for each application. Since previous studies contain little empirical hand controller task performance data, a controlled study is needed that tests Space Station Freedom candidate hand controllers during representative tasks. This study also needs to include anthropometric and biomechanical considerations.

[Arm Motor Function Recovery during Rehabilitation with the Use of Hand Exoskeleton Controlled by Brain-Computer Interface: a Patient with Severe Brain Damage].

PubMed

Biryukova, E V; Pavlova, O G; Kurganskaya, M E; Bobrov, P D; Turbina, L G; Frolov, A A; Davydov, V I; Sil'tchenko, A V; Mokienko, O A

2016-01-01

We studied the dynamics of motor function recovery in a patient with severe brain damage in the course of neurorehabilitation using hand exoskeleton controlled by brain-computer interface. For estimating the motor function of paretic arm, we used the biomechanical analysis of movements registered during the course of rehabilitation. After 15 weekly sessions of hand exoskeleton control, the following results were obtained: a) the velocity profile of goal-directed movements of paretic hand became bell-shaped, b) the patient began to extend and abduct the hand which was flexed and adducted in the beginning of rehabilitation, and c) the patient began to supinate the forearm which was pronated in the beginning of rehabilitation. The first result is an evidence of the general improvement of the quality of motor control, while the second and third results prove that the spasticity of paretic arm has decreased.

Assessing the manipulative potentials of monkeys, apes and humans from hand proportions: implications for hand evolution.

PubMed

Liu, Ming-Jin; Xiong, Cai-Hua; Hu, Di

2016-11-30

The hand structure possesses a greater potential for performing manipulative skills than is typically observed, whether in humans or non-human anthropoids. However, a precise assessment of the potential manipulative skills of hands has been challenging, which hampers our understanding of the evolution of manipulative abilities in anthropoid hands. Here, we establish a functional model to quantitatively infer the manipulative potentials of anthropoid hands based on hand proportions. Our results reveal a large disparity of manipulative potentials among anthropoid hands. From the aspect of hand proportions, the human hand has the best manipulative potential among anthropoids. However, the species with a manipulative potential closer to that of humans are not our nearest relatives, chimpanzees, but rather, are certain monkey species. In combination with the phylogenetically informed morphometric analyses, our results suggest that the morphological changes of non-human anthropoid hands did not coevolve with the brain to facilitate the manipulative ability during the evolutionary process, although the manipulative ability is a survival skill. The changes in non-human anthropoid hands may have more likely evolved under selective pressure for locomotion than manipulation. © 2016 The Author(s).

Do Comorbidities Play a Role in Hand Osteoarthritis Disease Burden? Data from the Hand Osteoarthritis in Secondary Care Cohort.

PubMed

Damman, Wendy; Liu, Rani; Kroon, Féline P B; Reijnierse, Monique; Huizinga, Tom W J; Rosendaal, Frits R; Kloppenburg, Margreet

2017-11-01

Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m 2 ). Mean differences were estimated between patients with versus without comorbidities, adjusted for age and sex: for general disease burden [health-related quality of life (HRQOL), Medical Outcomes Study Short Form-36 physical component scale (0-100)] and disease-specific burden [self-reported hand function (0-36), pain (0-20; Australian/Canadian Hand OA Index), and tender joint count (TJC, 0-30)]. Differences above a minimal clinically important improvement/difference were considered clinically relevant. The study included 538 patients (mean age 61 yrs, 86% women, 88% fulfilled American College of Rheumatology classification criteria). Mean (SD) HRQOL, function, pain, and TJC were 44.7 (8), 15.6 (9), 9.3 (4), and 4.8 (5), respectively. Any comorbidity was present in 54% (287/531) of patients and this was unfavorable [adjusted mean difference presence/absence any comorbidity (95% CI): HRQOL -4.4 (-5.8 to -3.0), function 1.9 (0.4-3.3), pain 1.4 (0.6-2.1), TJC 1.3 (0.4-2.2)]. Number of comorbidities and both musculoskeletal (e.g., connective tissue disease) and nonmusculoskeletal comorbidities (e.g., pulmonary and cardiovascular disease) were associated with disease burden. Associations with HRQOL and function were clinically relevant. Comorbidities showed clinically relevant associations with disease burden. Therefore, the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management.

Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting

PubMed Central

Babeluk, Rita; Jutz, Sabrina; Mertlitz, Sarah; Matiasek, Johannes; Klaus, Christoph

2014-01-01

Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid), desderman pure gel (odorless, gel) and Lavit (perfumed, spray). Sterillium and desderman are EN1500 (hygienic hand rub) certified products (available in pharmacy) and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group. PMID:25379773

A mechatronics platform to study prosthetic hand control using EMG signals.

PubMed

Geethanjali, P

2016-09-01

In this paper, a low-cost mechatronics platform for the design and development of robotic hands as well as a surface electromyogram (EMG) pattern recognition system is proposed. This paper also explores various EMG classification techniques using a low-cost electronics system in prosthetic hand applications. The proposed platform involves the development of a four channel EMG signal acquisition system; pattern recognition of acquired EMG signals; and development of a digital controller for a robotic hand. Four-channel surface EMG signals, acquired from ten healthy subjects for six different movements of the hand, were used to analyse pattern recognition in prosthetic hand control. Various time domain features were extracted and grouped into five ensembles to compare the influence of features in feature-selective classifiers (SLR) with widely considered non-feature-selective classifiers, such as neural networks (NN), linear discriminant analysis (LDA) and support vector machines (SVM) applied with different kernels. The results divulged that the average classification accuracy of the SVM, with a linear kernel function, outperforms other classifiers with feature ensembles, Hudgin's feature set and auto regression (AR) coefficients. However, the slight improvement in classification accuracy of SVM incurs more processing time and memory space in the low-level controller. The Kruskal-Wallis (KW) test also shows that there is no significant difference in the classification performance of SLR with Hudgin's feature set to that of SVM with Hudgin's features along with AR coefficients. In addition, the KW test shows that SLR was found to be better in respect to computation time and memory space, which is vital in a low-level controller. Similar to SVM, with a linear kernel function, other non-feature selective LDA and NN classifiers also show a slight improvement in performance using twice the features but with the drawback of increased memory space requirement and time

Specialization of the left supramarginal gyrus for hand-independent praxis representation is not related to hand dominance.

PubMed

Króliczak, Gregory; Piper, Brian J; Frey, Scott H

2016-12-01

Data from focal brain injury and functional neuroimaging studies implicate a distributed network of parieto-fronto-temporal areas in the human left cerebral hemisphere as playing distinct roles in the representation of meaningful actions (praxis). Because these data come primarily from right-handed individuals, the relationship between left cerebral specialization for praxis representation and hand dominance remains unclear. We used functional magnetic resonance imaging (fMRI) to evaluate the hypothesis that strongly left-handed (right hemisphere motor dominant) adults also exhibit this left cerebral specialization. Participants planned familiar actions for subsequent performance with the left or right hand in response to transitive (e.g., "pounding") or intransitive (e.g. "waving") action words. In linguistic control trials, cues denoted non-physical actions (e.g., "believing"). Action planning was associated with significant, exclusively left-lateralized and extensive increases of activity in the supramarginal gyrus (SMg), and more focal modulations in the left caudal middle temporal gyrus (cMTg). This activity was hand- and gesture-independent, i.e., unaffected by the hand involved in subsequent action performance, and the type of gesture (i.e., transitive or intransitive). Compared directly with right-handers, left-handers exhibited greater involvement of the right angular gyrus (ANg) and dorsal premotor cortex (dPMC), which is indicative of a less asymmetric functional architecture for praxis representation. We therefore conclude that the organization of mechanisms involved in planning familiar actions is influenced by one's motor dominance. However, independent of hand dominance, the left SMg and cMTg are specialized for ideomotor transformations-the integration of conceptual knowledge and motor representations into meaningful actions. These findings support the view that higher-order praxis representation and lower-level motor dominance rely on dissociable

Specialization of the left supramarginal gyrus for hand-independent praxis representation is not related to hand dominance

PubMed Central

Króliczak, Gregory; Piper, Brian J.; Frey, Scott H.

2016-01-01

Data from focal brain injury and functional neuroimaging studies implicate a distributed network of parieto-fronto-temporal areas in the human left cerebral hemisphere as playing distinct roles in the representation of meaningful actions (praxis). Because these data come primarily from right-handed individuals, the relationship between left cerebral specialization for praxis representation and hand dominance remains unclear. We used functional magnetic resonance imaging (fMRI) to evaluate the hypothesis that strongly left-handed (right hemisphere motor dominant) adults also exhibit this left cerebral specialization. Participants planned familiar actions for subsequent performance with the left or right hand in response to transitive (e.g., “pounding”) or intransitive (e.g. “waving”) action words. In linguistic control trials, cues denoted non-physical actions (e.g., “believing”). Action planning was associated with significant, exclusively left-lateralized and extensive increases of activity in the supramarginal gyrus (SMg), and more focal modulations in the left caudal middle temporal gyrus (cMTg). This activity was hand- and gesture-independent, i.e., unaffected by the hand involved in subsequent action performance, and the type of gesture (i.e., transitive or intransitive). Compared directly with right-handers, left-handers exhibited greater involvement of the right angular gyrus (ANg) and dorsal premotor cortex (dPMC), which is indicative of a less asymmetric functional architecture for praxis representation. We therefore conclude that the organization of mechanisms involved in planning familiar actions is influenced by one’s motor dominance. However, independent of hand dominance, the left SMg and cMTg are specialized for ideomotor transformations—the integration of conceptual knowledge and motor representations into meaningful actions. These findings support the view that higher-order praxis representation and lower-level motor dominance rely

[The surgeon as a hand patient: the clinical and psychological impact of hand and wrist fractures].

PubMed

Chin, K R; Lonner, J H; Jupiter, B S; Jupiter, J B

2010-03-01

To gain insight into the management of patients with hand and wrist injuries, a series of clinical and psychological analyses was performed on 9 surgeons, each of whom underwent operative fixation of a hand or wrist fracture. The results of these analyses suggest that the functional outcome after hand surgery was affected by the surgeons' personality, motivation, and ability to accept and adapt to the injury, the nature of the injury, and the importance of the hand to the surgeons' careers. Surgeons are highly motivated and compulsive individuals who consider their career involvement a major source of identity and self-worth. Most returned to their operative duties ahead of the schedule set by their hand surgeons (average, 25 days after surgery), regarded their injuries as a positive challenge, and changed their lifestyles after injury to protect their hands.

Hand-arm vibration in tropical rain forestry workers.

PubMed

Futatsuka, M; Inaoka, T; Ohtsuka, R; Sakurai, T; Moji, K; Igarashi, T

1995-01-01

Working conditions and health hazards including vibration syndrome related to forestry work using chain-saws were studied in Papua New Guinea and Indonesia. The subjects comprised 291 workers including 97 chain-saw operators. The health examination consisted of peripheral circulatory and sensory tests in the upper extremities. The vibration spectrum measured at the handle of the chain-saw indicated that these acceleration levels would lead to a moderately high risk of hand-arm vibration syndrome (HAVS). The peripheral circulatory function tests revealed dysfunction after more than five years vibration exposure. However, in general, the results of the function tests and subjective complaints showed fewer health problems compared to those of Japanese forestry workers. The reason of such differences of vibration effects seem to be the following: (1) warmer climate (more than 25 degrees C throughout the year), (2) young workers and short work experience. (3) short time vibration exposures on working days in the natural forests, (4) seasonal changes in logging work (5) healthy workers effects. Thus, we found no clear evidence that the workers of our study suffered from HAVS. A principal component analysis was applied. The factor score of the components of the reactive dynamics of peripheral circulation differed significantly after more than five years' exposure. On the other hand, we cannot deny the possibility that subclinical dysfunction of peripheral circulation may be caused by chain-saw operation in the tropics in future. Further investigations on the HAVS among forestry workers in the tropic environment are needed.

Hand-transmitted vibration and biodynamic response of the human hand-arm: a critical review.

PubMed

Dong, R G; Rakheja, S; Schopper, A W; Han, B; Smutz, W P

2001-01-01

Hand-arm vibration syndrome (HAVS) has been associated with prolonged exposure to vibration transmitted to the human hand-arm system from hand-held power tools, vibrating machines, or hand-held vibrating workpieces. The biodynamic response of the human hand and arm to hand transmitted vibration (HTV) forms an essential basis for effective evaluations of exposures, vibration-attenuation mechanisms, and potential injury mechanisms. The biodynamic response to HTV and its relationship to HAVS are critically reviewed and discussed to highlight the advances and the need for further research. In view of its strong dependence on the nature of HTV and the lack of general agreement on the characteristics of HTV, the reported studies are first reviewed to enhance an understanding of HTV and related issues. The characteristics of HTV and relevant unresolved issues are discussed on the basis of measured data, proposed standards, and measurement methods, while the need for further developments in measurement systems is emphasized. The studies on biodynamic response and their findings are grouped into four categories based on the methodology used and the objective. These include studies on (1) through-the-hand-arm response, expressed in terms of vibration transmissibility; (2) to-the-hand response, expressed in terms of the force-motion relationship of the hand-arm system; (3) to-the-hand biodynamic response function, expressed in terms of vibration energy absorption; and (4) computer modeling of the biodynamic response characteristics.

Deep learning-based artificial vision for grasp classification in myoelectric hands.

PubMed

Ghazaei, Ghazal; Alameer, Ali; Degenaar, Patrick; Morgan, Graham; Nazarpour, Kianoush

2017-06-01

Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand. We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at [Formula: see text] intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set. The classification accuracy in the offline tests reached [Formula: see text] for the seen and [Formula: see text] for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of [Formula: see text] in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb Ultra TM prosthetic hand and a motion control TM prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to [Formula: see text]. In addition, we show that with training, subjects' performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback. The proposed design constitutes a

Does an Eye-Hand Coordination Test Have Added Value as Part of Talent Identification in Table Tennis? A Validity and Reproducibility Study

PubMed Central

Faber, Irene R.; Oosterveld, Frits G. J.; Nijhuis-Van der Sanden, Maria W. G.

2014-01-01

This study investigated the added value, i.e. discriminative and concurrent validity and reproducibility, of an eye-hand coordination test relevant to table tennis as part of talent identification. Forty-three table tennis players (7–12 years) from national (n = 13), regional (n = 11) and local training centres (n = 19) participated. During the eye-hand coordination test, children needed to throw a ball against a vertical positioned table tennis table with one hand and to catch the ball correctly with the other hand as frequently as possible in 30 seconds. Four different test versions were assessed varying the distance to the table (1 or 2 meter) and using a tennis or table tennis ball. ‘Within session’ reproducibility was estimated for the two attempts of the initial tests and ten youngsters were retested after 4 weeks to estimate ‘between sessions’ reproducibility. Validity analyses using age as covariate showed that players from the national and regional centres scored significantly higher than players from the local centre in all test versions (p<0.05). The tests at 1 meter demonstrated better discriminative ability than those at 2 meter. While all tests but one had a positive significant association with competition outcome, which were corrected for age influences, the version with a table tennis ball at 1 meter showed the highest association (r = 0.54; p = 0.001). Differences between the first and second attempts were comparable for all test versions (between −8 and +7 repetitions) with ICC's ranging from 0.72 to 0.87. The smallest differences were found for the test with a table tennis ball at 1 meter (between −3 and +3 repetitions). Best test version as part of talent identification appears to be the version with a table tennis ball at 1 meter regarding the psychometric characteristics evaluated. Longitudinal studies are necessary to evaluate the predictive value of this test. PMID:24465638

Does an eye-hand coordination test have added value as part of talent identification in table tennis? A validity and reproducibility study.

PubMed

Faber, Irene R; Oosterveld, Frits G J; Nijhuis-Van der Sanden, Maria W G

2014-01-01

This study investigated the added value, i.e. discriminative and concurrent validity and reproducibility, of an eye-hand coordination test relevant to table tennis as part of talent identification. Forty-three table tennis players (7-12 years) from national (n = 13), regional (n = 11) and local training centres (n = 19) participated. During the eye-hand coordination test, children needed to throw a ball against a vertical positioned table tennis table with one hand and to catch the ball correctly with the other hand as frequently as possible in 30 seconds. Four different test versions were assessed varying the distance to the table (1 or 2 meter) and using a tennis or table tennis ball. 'Within session' reproducibility was estimated for the two attempts of the initial tests and ten youngsters were retested after 4 weeks to estimate 'between sessions' reproducibility. Validity analyses using age as covariate showed that players from the national and regional centres scored significantly higher than players from the local centre in all test versions (p<0.05). The tests at 1 meter demonstrated better discriminative ability than those at 2 meter. While all tests but one had a positive significant association with competition outcome, which were corrected for age influences, the version with a table tennis ball at 1 meter showed the highest association (r = 0.54; p = 0.001). Differences between the first and second attempts were comparable for all test versions (between -8 and +7 repetitions) with ICC's ranging from 0.72 to 0.87. The smallest differences were found for the test with a table tennis ball at 1 meter (between -3 and +3 repetitions). Best test version as part of talent identification appears to be the version with a table tennis ball at 1 meter regarding the psychometric characteristics evaluated. Longitudinal studies are necessary to evaluate the predictive value of this test.

A qualitative analysis of the experience and impact of killing in hand-to-hand combat.

PubMed

Jensen, Peter R; Simpson, Duncan

2014-08-01

A growing body of research suggests that killing during military combat is closely associated with posttraumatic stress disorder (PTSD), as well as a number of other adverse mental health related conditions (e.g., dissociative experiences, violent behavior, functional impairment). This article provides first-person perspectives on the experiences and impact of killing by service members with the goal of expanding our understanding of the impact of taking a life during war. In audio-recorded phenomenological interviews, 9 service members described their experiences and the subsequent impact of killing during hand-to-hand combat. A description, supported by participant quotations, was constructed to represent the participants' experiences. Results suggest the experience and aftermath of taking a life in hand-to-hand combat was disturbing, psychologically stressful, and necessitated some form of coping after the event. Service members who killed in hand-to-hand combat viewed their actions as necessary to preserve their life and that killing in hand-to-hand combat was more emotionally taxing than killing by shooting. Our findings may help to improve providers' understanding of service members' first-person experiences of killing in hand-to-hand combat and thus provide the basis for the development of a connected and genuine relationship with such military clients. Copyright © 2014 International Society for Traumatic Stress Studies.

The Performance of Left-Handed Participants on a Preferential Reaching Test

ERIC Educational Resources Information Center

Mamolo, Carla M.; Roy, Eric A.; Bryden, Pamela J.; Rohr, Linda E.

2005-01-01

Previous research in our laboratory has examined the distribution of preferred hand (PH) reaches in working space with right-handed participants. In one study, we examined the effects of tool position and task demands on the frequency of PH reaches with right-handers (Mamolo, Roy, Bryden, & Rohr, 2004). We found that PH reaches were at a maximum…

Liver Function Tests

MedlinePlus