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Objectives: To explore the effects of different test positions on quantitative muscle strength of wrist and finger flexor muscle groups and to establish a standardized muscle strength test protocol for each muscle group., Methods: Forty healthy subjects (12 males and 28 females) were recruited. A portable digital quantitative muscle strength tester, Micro FET2 TM , was used to measure the flexor muscle strength of each finger and the wrist joint at the 30° extension, 0° neutral, and 30° flexion, respectively. Palmar abduction strength of the thumb was measured at 30° and 60°, respectively. Ten subjects were randomly selected from the 40 subjects, and the quantitative muscle strength of each muscle group was tested again by the same operator after an interval of 10 to 15 days., Results: Except for the fact that in males, there was no significant difference in flexor muscle strength of thumb and wrist joint between 30° of wrist extension and neutral 0° position, the muscle strength of the other fingers flexion and wrist palmar flexor showed the following characteristics：30° of wrist extension > neutral 0° position > 30° of flexion, and the PAST was 30°>60°; The flexor muscle strength of all the subjects was thumb > index finger > middle finger > ring finger > little finger; All muscle strength values of male were greater than those of female, and the difference was statistically significant ( P <0.05); There was no significant difference between the left and right side muscle strength values of all subjects ( P >0.05). The reliability of muscle strength values measured at different times in 10 subjects was good., Conclusions: The quantitative muscle strength of each muscle group of the hand and wrist is affected by the test position, and a standardized and uniformed test position should be adopted in the actual identification. Micro FET2 TM has good reliability for hand and wrist quantitative muscle strength testing. The 30° extension of the wrist can be used as the best standardized test position for the flexion muscle strength of each finger and wrist joint. The 30° position can be used as the best standardized test position for PAST.

In order to stimulate the patients' active participation in the process of robot-assisted rehabilitation training of stroke patients, the rehabilitation robots should provide assistant torque to patients according to their rehabilitation needs. This paper proposed an assist-as-needed control strategy for wrist rehabilitation robots. Firstly, the ability evaluation rules were formulated and the patient's ability was evaluated according to the rules. Then the controller was designed. Based on the evaluation results, the controller can calculate the assistant torque needed by the patient to complete the rehabilitation training task and send commands to motor. Finally, the motor is controlled to output the commanded value, which assists the patient to complete the rehabilitation training task. The control strategy was implemented to the wrist function rehabilitation robot, which could achieve the training effect of assist-as-needed and could avoid the surge of assistance torque. In addition, therapists can adjust multiple parameters in the ability evaluation rules online to customize the difficulty of tasks for patients with different rehabilitation status. The method proposed in this paper does not rely on the information from force sensor, which reduces development costs and is easy to implement.

It is the functional connectivity between motor cortex and muscle that directly relates to the rehabilitation of the dysfunction in upper limbs and neuromuscular activity status, which can be detected by electroencephalogram-electromyography (EEG-EMG) coherence analysis. In this study, based on coherence analysis method, we process the acquisition signals which consist of 9 channel EEG signal from motor cortex and 4 channel EMG signal from forearm, by using 4 groups of hand motions in the healthy subjects, including flexor digitorum, extensor digitorum, wrist flexion, and wrist extension. The results showed that in the β-band, the coherence coefficients between C3 and flexor digitorum (FD) was greater than extensor digitorum (ED) in the right hand flexor digitorum movement; the coherence coefficients between C3 and ED was greater than FD in the right hand extensor digitorum movement; the coherence coefficients between C3 and flexor carpi ulnaris (FCU) was greater than extensor carpi radialis (ECR) in the right hand wrist flexion movement; the coherence coefficients between C3 and ECR was greater than FCU in the right hand wrist extension movement. This analysis provides experimental basis to explore the information decoding of hand motion based on corticomuscular coherence (CMC).

Objective: To investigate the effectiveness and surgical skills of microsurgical repair of radial nerve deep branch injury., Methods: Between March 2001 and February 2011, 49 cases of radial nerve deep branch injury were treated by microsurgical technique. There were 40 males and 9 females with an average age of 32 years (range, 19-58 years), including 13 cases of knife-cut injury, 9 cases of electric-saw injury, 7 cases of dagger-stab injury, 6 cases of glass-cut injury, 5 cases of iatrogenic injury, 4 cases of Monteggia fracture, 3 cases of nailgun injury, and 2 cases of crush injury of the forearm complicated by fracture of the proximal radius. The disease duration ranged from 3 hours to 3 years and 8 months (mean, 4.9 months). The sites of injury were at front of supinator tube in 15 cases, in the supinator tube in 23 cases, and at back of supinator tube in 11 cases. One-stage repair was performed by end-to-end suture in 21 cases, including 9 cases of epineurial neurorrhaphy and 12 cases of perineurial neurorrhaphy; two-stage repair was performed in 28 cases, including 26 cases of sural nerve graft and 2 cases of neurolysis., Results: Postoperative wounds primarily healed. All patients were followed up 21.5 months on average (range, 12-39 months). At last follow-up, in 21 cases of one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 13 cases, and level 4 in 8 cases; in 28 cases of two-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 2 cases, level 4 in 21 cases, level 3 in 4 cases, and level 2 in 1 case; and significant difference was found (Z=-5.340, P=0.000). In 9 cases undergoing epineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 3 cases, and level 4 in 6 cases; in 12 cases undergoing perineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 10 cases, and level 4 in 2 cases; and significant difference was found (Z=-2.279, P=0.023). In 26 cases undergoing nerve graft at two-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 2 cases, level 4 in 20 cases, level 3 in 3 cases, and level 2 in 1 case; in 2 cases undergoing neurolysis at two-stage repair, the muscle strength of the extensor pollicis longus was level 4 in 1 case and level 3 in 1 case; and no significant difference was found (Z=-1.117, P=0.264). According to the upper arm function assessment criterion issued by Hand Surgery Association of Chinese Medicine Association, the results were excellent in 18 cases, good in 3 cases in one-stage repair patients; excellent in 2 cases, good in 21 cases, fair in 4 cases, and poor in 1 case in two-stage repair patients; and there was significant difference (Z=-5.340, P=0.000)., Conclusion: Microsurgical one-stage repair of radial nerve deep branch injury can obtain better effectiveness than two-stage repair by nerve graft, and perineurial neurorrhaphy is significantly better than epineurial neurorrhaphy.

Objective: To evaluate the results of thumb opposition function by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons., Methods: Between March 2006 and August 2009, 35 patients with dysfunction of thumb opposition were treated and the thumb opposition function was reconstructed by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons. There were 25 males and 10 females with an average age of 33.5 years (range, 20-53 years); 20 had median nerve injury in the wrist and 15 had median nerve injury with ulnar nerve injury. The causes were sharp instrument injury in 24 cases, blunt injury in 9 cases, and hot crush injury in 2 cases. Six cases complicated by shaft fractures of radius and ulna. All the patients underwent an operation of nerve repair at 1 to 3 hours after injury (mean, 2 hours). The time from injury to reconstructing operation was 6-14 months (mean, 7.5 months). Two cases was able to abduct thumb slightly, the others had no functions of thumb abduct and thumb opposition., Results: All the wounds gained the primary healing. The patients were followed up 12-18 months (mean, 14 months). The wrist joint angle and thumb dorsal extension were satisfactory. Thumb abduct and thumb opposition function returned to normal in 20 patients with simple median nerve injury; in 15 patients with median nerve injury and ulnar nerve injury, thumb abduct and thumb opposition function returned to normal in 15 and 13, respectively. According to ZHAO Shuqiang's standard, the results of thumb opposition function were normal in all patients at 12 months after operation., Conclusion: It is a convenient and efficient procedure to reconstruct thumb opposition function by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons.