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Background: Head-down tackling has been associated with higher rates of head and neck injuries and less successful tackles compared with head-up tackling in American football. In rugby, head and neck injuries have been associated with tackling, with the tackler's head positioned in front of the ball carrier. Purpose: To assess the success and risks of tackling techniques used in the English Rugby Premiership matches. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Three reviewers analyzed 1000 consecutive solo defensive tackling attempts during the 2022 to 2023 season in 6 English Rugby Premiership matches. Slow-motion replays were used to analyze the success of the tackling attempt in terms of head angulation (head up vs head down), head position relative to the offensive player's waist at point of contact, and tackling method (inside shoulder, arm, head across the bow, and head-to-head). The chi-square test or Fisher exact test was used to analyze categorical data, and the 2-tailed Student t test or the Mann-Whitney U test was used to analyze continuous data. Results: The mean interrater reliabilities for analyzing the tackles were good across all groups (κ = 0.715). Head-up and head-down tackling occurred in 848 tackle attempts (84.8%) and 152 tackle attempts (15.2%), respectively. Head-up tackles were successful in 80.7% of the tackle attempts compared with 71.1% of the head-down tackle attempts (P =.0072). Tackles made at or above the waist were successful in 80.7% of the tackle attempts compared with 73.1% of tackles below the waist (P =.0193). The inside-shoulder technique had the highest successful tackle rate at 90.8%, compared with 44.2% with the arm technique (P <.0001) and 72.4% with the head-across-the-bow technique (P <.0001). The inside-shoulder technique resulted in head-up tackling in 84.8% of players compared with 59.8% with the head-across-the-bow technique (P <.0001) and 94.9% with arm tackling (P =.0001). There were 4 recorded injuries to the tackler: 2 neck injuries, 1 shoulder injury, and 1 wrist/hand injury. Conclusion: Head-up tackling, tackles made at or above the level of the offensive player's waist, and inside-shoulder tackling were found to be more efficient in producing successful tackles. The head-down, tackling below the waist, and head-across-the-bow techniques were associated with poor tackling and lower success rates. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists and physiotherapists routinely assess Hand grip Strength (HGS) to evaluate hand function. This study explored the experiences of clinicians who regularly assess and evaluate HGS including the testing protocol utilised, evaluation methods and the influence of various biological and functional factors. Method: This exploratory survey (n = 49) was distributed online to members of the Australian Hand Therapy Association. The questionnaire asked recipients to identify HGS testing protocols, evaluation methods, use of normative data, reasons for assessment and the influence of biological and functional factors on HGS. Demographic data was also collected. Results: Sixty-four percent of respondents were occupational therapists and 59% had over 10 years' experience assessing HGS. The standardised American Society of Hand Therapists (ASHT) testing protocol was consistently adopted by only 67% of respondents. Variations in contraction time, scoring and evaluation methods were identified. Gender, age, employment and lifestyle were considered the functional and biological factors which influence HGS. Conclusion: This study details how and why occupational therapists and physiotherapists in Australia assess and evaluate HGS. Use of the ASHT testing protocol is not universal. Clinicians rely on the reason for assessment, clinical experience and practice context to determine how they assess and evaluate HGS. [ABSTRACT FROM AUTHOR]

Eye–hand coordination is a visuomotor task that enables one to look, localize, and touch objects. Eye–hand coordination is known to be poor in children with developmental delay. In this study, we assessed the feasibility of measuring eye–hand coordination task in children with developmental delay using Sanet Vision Integrator (SVI), a commercially available device. Children (age: 3–16 years) with developmental delay and their age-similar typically developing peers were enrolled. White circles (5.5°) on a black background were presented on the SVI touch screen monitor. Participants popped these circles by touching it. Reaction time, accuracy, and an overall performance score were computed. Participants could perform the task from 4 years of age and with visual acuity 20/400 (6/120) or better. This resulted in 85% (17/20) of children with developmental delay and 95% (19/20) of typically developing children completing the task. Children with developmental delay were significantly (p <.001) less accurate (56%) and took longer (2.63 s) to complete the task when compared with their peers (accuracy = 93%, reaction time = 1.46 s). The overall performance score of children with developmental delay was also lower than their peers by a factor of 3.3. Eye–hand coordination performance can be measured and quantified with SVI. The quantification of speed and accuracy is possible and a unitary measure combining speed-accuracy can be computed. The task can be performed both by typically developing children and by children with developmental delay. Thus, it is feasible to measure eye–hand coordination using SVI. Such quantification will be useful for children undergoing interdisciplinary therapies for their medical conditions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the relationship between dietary zinc intakes and skeletal muscle mass and strength in children and adolescents. A retrospective study was conducted using data on United States adolescents aged 8 to 19 years. Data were extracted from the National Health and Nutrition Examination Survey 2011-2014 cycles. Subjects were divided into 3 groups based on the tertiles of dietary zinc intakes. The levels of appendicular skeletal muscle mass divided by weight (ASM/Wt, %) and grip in subjects with the highest tertile were higher than those in subjects with the middle and lowest tertiles (P <.05). Dietary zinc intakes were positively correlated with ASM/Wt (r =.221, P <.001) and grip (r = 0.169, P <.001). After a multivariate analysis, dietary zinc intakes were still significantly associated with ASM/Wt (β = 0.059, P <.001) and grip (β = 0.245, P <.001). The present study demonstrates that dietary zinc intakes were positively associated with skeletal muscle mass and strength in children and adolescents. [ABSTRACT FROM AUTHOR]

Despite rehabilitation, stroke patients continue to have impaired function and reduced health-related quality of life (HRQoL) even in a chronic stage. However, no clear information is available on long-term variations in HRQoL. In this study, we aimed to report the short- and long-term changes in HRQoL in a subacute stroke sample that was enrolled in a clinical trial on arm rehabilitation. Thirty-nine stroke survivors (62% male, mean age 68 years) were assessed using the Stroke Impact Scale Version 2.0 (SIS 2.0) pre and post rehabilitation and at 6 months and 6 years follow-up. Long-term changes in physical function were explored through clinically meaningful changes in the Stroke Impact Scale-16 (SIS-16). After rehabilitation (P <.001), an overall improvement was found in all SIS domains except the memory and thinking, emotions, and communication domains. The baseline SIS-16 score (P <.001), the presence of a sensory deficit, and rehabilitation setting (P <.05) were factors related to the SIS-16 domain scores at the end of rehabilitation and at 6 months follow-up. Patients showed the most deterioration in the mobility (P <.001), strength (P <.003), and hand function (P <.05) domains 6 years after stroke. Stroke severity, male gender, and age ⩾65 years are related with a long-term HRQoL reduction after stroke. [ABSTRACT FROM AUTHOR]

Background: Trapeziometacarpal osteoarthritis is the second most frequent degenerative hand disease and is the most functionally debilitating. The condition presents in 66% of women over 55. Motor imagery (MI) training post-surgery could help reduce rehabilitation times. Method: It is an experimental, prospective, longitudinal, parallel arm randomised clinical trial. Participants were women over 50 years old on the surgical waiting list. The experimental group will undergo MI training during the 3-week post-surgical immobilisation period. The control group will receive standard rehabilitation treatment. Outcomes will be assessed four times throughout the study using the Disabilities of the Arm, Shoulder and Hand questionnaire, the Cochin Hand Function Scale questionnaire, the Visual Analogue Scale, goniometry, baseline pinch gauge, circumferential measurement (cm), the Modified Kapandji Index and the Kinaesthetic and Visual Imagery questionnaire. Discussion: Early MI could improve hand function leading to improvements in recovery times. Trial registration: Clinical Trials registration: NCT03815734. Ethics Committee approval: 17155. Project funded in 2021. [ABSTRACT FROM AUTHOR]

Comparing the wrist joint position sense and hand functions between children with juvenile idiopathic arthritis (JIA) and healthy controls, and determining possible relationships between these parameters in children with JIA were the aims of this study. Twenty children with polyarticular JIA with wrist involvement (JIAWrist+), 20 children with other subtypes of JIA without wrist involvement (JIAWrist−), and 20 healthy controls were included. Wrist joint position sense was evaluated by measuring joint repositioning error. Hand functions were assessed by using the Purdue Pegboard test, hand grip strength, pinch strength, and Duruoz Hand Index. Joint position sense and hand functions were diminished in the JIAWrist+ group compared with healthy control group (P <.05). Few moderate relationships were detected between hand functions and wrist joint position sense (P <.05). Improving proprioceptive acuity by appropriate training methods may have a role in enhancing hand functions. [ABSTRACT FROM AUTHOR]

Introduction: Handgrip strength (HGS) is commonly measured to assess hand function, however, little is known about how and why occupational therapists assess and interpret HGS. This study aimed to explore the experiences of occupational therapists who work with HGS. Additionally, the study explored what biological and functional factors occupational therapists believe influence adult HGS. Method: A qualitative study design utilising purposive sampling identified occupational therapy clinicians within Queensland, Australia who assess HGS. Data were collected from 19 participants using a semi-structured interview process. The interviews were transcribed verbatim and analysed using thematic analysis. Results: Variations of the American Society of Hand Therapists HGS testing procedure were used by the participants based on experience. When evaluating HGS, comparison to normative data was not always completed or seen to be valuable. Biological and functional factors such as height, hand length, occupation and lifestyle factors were considered to influence HGS. Conclusion: The results of this study provide insight into the various ways occupational therapists assess and evaluate HGS according to experience and practice context. These variations in assessment and evaluation of HGS along with the influence of an individual's biological and functional factors need to be considered when interpreting HGS results. [ABSTRACT FROM AUTHOR]

Objective: Temporal bone simulation is now commonly used to augment cadaveric education. Assessment of these tools is ongoing, with haptic modeling illustrating dissimilar motion patterns compared to cadaveric opportunities. This has the potential to result in maladaptive skill development. It is hypothesized that trainee drill motion patterns during printed model dissection may likewise demonstrate dissimilar hand motion patterns. Methods: Resident surgeons dissected 3D-printed temporal bones generated from microCT data and cadaveric simulations. A magnetic position tracking system (TrakSTAR Ascension, Yarraville, Australia) captured drill position and orientation. Skill assessment included cortical mastoidectomy, thinning procedures (sigmoid sinus, dural plate, posterior canal wall) and facial recess development. Dissection was performed by 8 trainees (n = 5 < PGY3 > n = 3) using k-cos metrics to analyze drill strokes within position recordings. K-cos metrics define strokes by change in direction, providing metrics for stroke duration, curvature, and length. Results: T -tests between models showed no significant difference in drill stroke frequency (cadaveric = 1.36/s, printed = 1.50/s, P <.40) but demonstrate significantly shorter duration (cadaveric = 0.37 s, printed = 0.16 s, P <.01) and a higher percentage of curved strokes (cadaveric = 31, printed = 67, P <.01) employed in printed bone dissection. Junior staff used a higher number of short strokes (junior = 0.54, senior = 0.38, P <.01) and higher percentage of curved strokes (junior = 35%, senior = 21%, P <.01). Conclusions: Significant differences in hand motions were present between simulations, however the significance is unclear. This may indicate that printed bone is not best positioned to be the principal training schema. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between night-time sleep duration and hand grip strength (HGS) among patients with chronic obstructive pulmonary disease (COPD). Participants aged ≥45 years were included in a nationally representative investigation clinical study in 2015. HGS was measured using dynamometers. The data on night-time sleep duration, sociodemographic information, and health-related variables were systematically collected. For analysis, sleep duration was categorized as <5 h, 5–7 h, 7 h, 7–9 h, and >9 h. Multivariable linear regression models were used to determine the possible association between the night-time sleep duration and HGS. Our results indicated that the shortest (<5 h) or the longest sleep duration (>9 h) was relevant to high risk of weaker HGS in females. In males, the shortest (<5 h) sleep duration was correlated to lower HGS. Thus, our findings clearly suggest that health care providers should focus on the potential influence of sleep duration on HGS among COPD patients. [ABSTRACT FROM AUTHOR]

Although the importance of practice has been evidenced in early studies of cross-limb transfer, the association between cross-limb transfer and practice organization remains unknown. The two primary means of organizing practice are constant practice (CP) and variable practice (VP). When the same generalized motor program governs the motor responses, VP produces better transfer than CP. Thus, we hypothesized that VP would generate a higher cross-limb transfer level than CP. We assigned 40 participants to CP or VP groups and conducted an experiment consisting of three phases: pre-test, practice, and transfer test. At pre-test, all participants practiced eight trials of a sequence key-pressing task with the non-dominant hand (NDH). After the pre-test, all participants performed a practice phase of 72 trials with the dominant hand, but CP and VP groups underwent their different practice schedules (CP or VP) such that the CP group practiced a sequence key-pressing task in one sequence, and the VP group practiced four different sequences randomly. On the transfer test all partcipants completed eight trials with the NDH 24 hours after the practice phase. The CP group showed better performance than the VP group on the transfer test, and we concluded that the effects of practice organization in cross-limb transfer are distinct from intra- and inter-task transfer such that the specificity of practice explained the benefits of CG. [ABSTRACT FROM AUTHOR]

Introduction: Aging is associated with subtle cognitive decline in attention, memory, executive function, processing speed, and reasoning. Although lower brain-derived neurotrophic factor (BDNF) has been linked to cognitive decline among older adults, it is not known if the association differs among individuals with various BDNF Val66Met (rs6265) genotypes. In addition, it is not clear whether these associations vary by hand grip strength or physical activity (PA). Methods: A total of 2904 older adults were included in this study using data from the Health and Retirement Study. Associations between serum BDNF and measures of cognitive function were evaluated using multivariable linear regression models stratified by Met allele status. PA and hand grip strength were added to the model to evaluate whether including these variables altered associations between serum BDNF and cognition. Results: Mean age was 71.4 years old, and mean body mass index was 28.3 kg/m2. Serum BDNF levels were positively associated with higher total cognitive score (beta = 0.34, p =.07), mental status (beta = 0.16, p =.07), and word recall (beta = 0.22, p =.04) among Met carriers, while serum BDNF levels were negatively associated with mental status (beta = −0.09, p =.07) among non-Met carriers. Furthermore, associations changed when hand grip strength was added to the model but not when PA was added to the model. Conclusions: The BDNF Val66Met variant may moderate the association between serum BDNF levels and cognitive function in older adults. Furthermore, such associations differ according to hand grip strength but not PA. [ABSTRACT FROM AUTHOR]

Aim: Accurate assessment of in-hand manipulation is imperative when treating children with fine motor delays. A clinically suitable instrument for in-hand manipulation is required to inform the paediatric developmental and rehabilitation context. Critical evaluation of the available instrument is required to make an informed decision and direct future research. The aim of the study was to assess the available literature with a view to writing a scoping review on in-hand manipulation assessment instruments for children. Methods: The Arskey and O'Malley six-stage scoping review was applied. Fifteen databases were sourced for articles published between 1 January 1990 and 31 December 2020. After identifying 33 eligible articles that met the inclusion criteria, the data obtained from the articles were charted. Results: Eleven in-hand manipulation assessment instruments were identified and summarised according to (i) the constructs of in-hand manipulation included; (ii) clinical utility aspects of applicability and practicality and (iii) psychometric properties. Conclusion: At the time of the review, none of the instruments had comprehensively completed the instrument development process to the point of standardisation with evaluated psychometric properties. Further research is recommended for the development of a gold standard in-hand manipulation assessment instrument. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of Maitland's joint mobilization and therapeutic exercises on the functionality of the hands in patients with systemic sclerosis. Design: Randomized controlled trial. Setting: Tertiary university hospital. Subjects: Twenty-four patients diagnosed with systemic sclerosis according to ACR/EULAR 2013 criteria; age ⩾18 years and Cochin Hand Functional Scale (COCHIN) score ⩾10. They were randomized to physical therapy group (n = 12) or control group (n = 12). Interventions: The physical therapy group received joint mobilization and undertook therapeutic exercises, twice a week, for 12 weeks, and received a booklet with information about the disease. The control group only received the booklet about the disease. Main measures: The primary outcome measure was functionality of the hands (COCHIN). The secondary outcomes measures were disability (SHAQ), pain (visual analogic scale), range of motion (HAMIS and Delta finger-to-palm), grip strength (JAMAR dynamometer), and quality of life (SF12). Results: Twenty-two patients were female, with a mean age of 47.4 ± 11.1 years and 18 had limited cutaneous form. The physical therapy group showed a decrease of 11.33 points in the COCHIN in comparison with the control group (P = 0.09). There was a significant increase in range of motion by HAMIS (3.00 ± 1.48 vs 5.42 ± 2.64, P = 0.008), reduction in pain VAS (3.42 ± 2.78 vs 7.75 ± 2.53, P < 0.001), and increase in the physical component of SF12 (38.51 ± 9.60 vs 32.65 ± 9.10, P = 0.038). Conclusion: Maitland's joint mobilization and therapeutic exercises improved the functionality of the hands, reduced pain in the hands and wrists, increased range of motion, and improved quality of life in patients with systemic sclerosis. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the impact of self-reported sleep problems on post-stroke recovery. Design: Cross-sectional secondary analysis of longitudinal data from the Locomotor Experience Applied Post-Stroke (LEAPS) rehabilitation and recovery study (phase-III single-blind randomized controlled clinical trial). Group medians were compared for three sleep problem groups across three time points. Setting: Outpatient and in-home physical therapy. Subjects: Adults during the first year following stroke (n = 408, 380, 360 at 2, 6, 12 months, respectively). Interventions: The original study compared effects of locomotor training with body weight support in the year post-stroke. This analysis evaluated function in three sleep/functional-impact groups: no sleep problems, sleep problems with no-to-minimal-impact and sleep problems with moderate-to-quite-a-bit of impact. Main measures: Participants' responses regarding if they had "a sleep problem, such as insomnia" and, if so, what the impact was on their function. Stroke Impact Scale subscales for strength, hand function, mobility, ADLs, memory, communication, emotion, participation, and percent recovery. Results: About 25% of people with stroke reported sleep difficulty, 10% perceived sleep problems negatively impact function. Groups self-reporting worse sleep performed worse in all functional subscales (except self-perceived percent recovery) during the first year post-stroke. Conclusion: Self-reported poor sleep adversely effects post-stroke functional recovery. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the influence of holding the chair handles during the assessment of older women's knee flexion and extension isokinetic and isometric strength. Of 57 older women (≥60 years) selected from a convenience sample for this research, 23 were randomly chosen to perform the tests twice for reliability analyses. Each participant performed maximal isokinetic knee extension and flexion at 60°/s and 180°/s angular velocities and isometric tests under two conditions: (a) holding the lateral handle of the chair (HOLD) and (b) supporting the hands on the shoulders with the arms crossed (i.e., not holding the handle [NHOLD]). Participants performed significantly better in the HOLD compared with the NHOLD condition. Slightly lower intraclass correlation coefficients (ICC = 0.870–0.956) were noted for the HOLD than for the NHOLD condition (ICC = 0.900–0.981) so that the HOLD performance on Days 1 and 2 was different on some measures. Owing to the higher reliability coefficients in the NHOLD condition, results suggest that, when assessing knee strength in older women, the evaluee should place their hands over their shoulders with arms crossed in front of the chest (NHOLD) to maximize assessment reliability (reproducibility of performance). [ABSTRACT FROM AUTHOR]

This study investigated whether reduced visual attention to an observed action might account for altered imitation in autistic adults. A total of 22 autistic and 22 non-autistic adults observed and then imitated videos of a hand producing sequences of movements that differed in vertical elevation while their hand and eye movements were recorded. Participants first performed a block of imitation trials with general instructions to imitate the action. They then performed a second block with explicit instructions to attend closely to the characteristics of the movement. Imitation was quantified according to how much participants modulated their movement between the different heights of the observed movements. In the general instruction condition, the autistic group modulated their movements significantly less compared to the non-autistic group. However, following instructions to attend to the movement, the autistic group showed equivalent imitation modulation to the non-autistic group. Eye movement recording showed that the autistic group spent significantly less time looking at the hand movement for both instruction conditions. These findings show that visual attention contributes to altered voluntary imitation in autistic individuals and have implications for therapies involving imitation as well as for autistic people's ability to understand the actions of others. [ABSTRACT FROM AUTHOR]

This paper reflects on a slow-motion video clip of the hands of three young children as they play with toys in the sand tray. It foregrounds sand and toys that are handled, as well as hands that grasp and relinquish things. Through this movement of hands that tug and pull at things, it explores how things animate bodies, and how this produces the felt-sense of other desiring bodies. As hands tender things, they are animated by what they touch, and simultaneously things are animated through the give and take of pulls and pushes of desire expressed as kinetic force. The slowed film of hands in motion draws our attention from words, towards a (re)cognition of a sensed intelligence which is not pre-language, but is produced before language, as well as with language. Arguing that child development theories are inextricably bound up in narratives of human exceptionalism founded in language and moralism, I will make the case for reinstating sense as a mode of attention in order to counter a lack that is perceived until children learn language. By troubling the boundaries that we draw between the animal and the human, there is much to learn from very young children when we seriously attend to their capacity for sensory ways of knowing that are so often eclipsed by the dominance of language. [ABSTRACT FROM AUTHOR]

Although detailed descriptions of proper handshakes partly comprise many etiquette books, how a normal handshake can be described, its proper duration, and the consequences of violating handshake expectations remain empirically unexplored. This study measured the effect of temporal violations of the expected length of a handshake (less than three seconds according to previous studies) administered unobtrusively in a naturalistic experiment. We compared volunteer participants' (N = 34; 25 females; 9 males; M age = 23.76 years, SD = 6.85) nonverbal behavior before and after (a) a prolonged handshake (>3 seconds), (b) a normal length handshake (average length <3 seconds), and (c) a control encounter with no handshake. Frame-by-frame behavioral analyses revealed that, following a prolonged handshake (vs. a normal length or no handshake), participants showed less interactional enjoyment, as indicated by less laughing. They also showed evidence of anxiety and behavioral freezing, indicated by increased hands-on-hands movements, and they showed fewer hands-on-body movements. Normal length handshakes resulted in less subsequent smiling than did prolonged handshakes, but normal length handshakes were also followed by fewer hands-on-face movements than prolonged handshakes. No behavior changes were associated with the no-handshake control condition. We found no differences in participants' level of empathy or state/trait anxiety related to these conditions. In summary, participants reacted behaviorally to temporal manipulations of handshakes, with relevant implications for interactions in interviews, business, educational, and social settings and for assisting patients with social skills difficulties. [ABSTRACT FROM AUTHOR]

Background: Donor site complications secondary to radial forearm free flap (RFFF) reconstruction can limit recovery. Optimizing hand and wrist function in the post-operative period may allow more efficient self-care and return to activities of daily living. Negative pressure wound dressings (NPD) may increase blood flow and perfusion as compared to static pressure dressings (SPD) designed to minimize shear forces during the healing period. This study aims to compare subjective and objective hand and wrist functional outcomes following RFFF reconstruction with split thickness skin grafts (STSG) in patients treated with NPD and SPD. Methods: Adult patients undergoing RFFF with STSG were identified preoperatively and randomized to receive NPD or SPD following their RFFF reconstruction. NPD involved a single-use, portable device capable of applying 80 mmHg of negative pressure to the forearm donor site. SPD involved a volar splint. Dressings were left in place for seven days with subjective and objective function assessed at seven days, one month and three months postoperatively. The primary outcome was self-reported hand function as measured with the function subscale of the Michigan Hand Questionnaire (MHQ). Secondary outcomes included hand and wrist strength, range of motion, sensation, scar aesthetics, and skin graft complications. Results: Twenty-four patients undergoing RFFF were randomized to NPD or SPD. Patients treated with NPD had improved MHQ self-reported functional scores as compared to those treated with SPD at seven days postoperatively (P = 0.016). Flexion at seven days was improved in NPD group (P = 0.031); however, all other strength and range of motion outcomes were similar between groups. There were no differences in rates of graft complications, scar aesthetics, or sensation. Conclusions: In the immediate post-operative period, NPD was associated with improved patient-reported hand and wrist function. Wound care to optimize hand and wrist function could allow for improved patient outcomes in the immediate postoperative period. [ABSTRACT FROM AUTHOR]

The manifestation of muscle dysfunction associated with diabetes is commonly observed in skeletal muscles. The negative effect of hyperglycemia on muscle function is systemic and it may extend to abdominal muscles. Hence, the purpose of this study was to determine whether hand grip strength (HGS), an indicator of peripheral muscle strength, correlates with peak expiratory flow (PEF), which reflects the strength of abdominal muscles, among middle-aged and older Chinese individuals with diabetes. After controlling for all variables except for physical activity, 10 L/min increase in PEF was associated with 0.2 kg increase in HGS (β =.02, p <.0001). In the model additionally controlling for physical activity, the effect size of PEF on HGS did not change (β =.02, p <.0001). Our results suggest that among individuals with diabetes, PEF is positively related to HGS. The relationship may suggest a decline in PEF and a weakness of abdominal muscles. [ABSTRACT FROM AUTHOR]

The hands involve knowing, sensing, and intuition. In our use of them as qualitative researchers, we have the capacity to enrich our understanding through our tactile engagement with things and people. Drawing on Heidegger (2003) and Merleau-Ponty's (2014) phenomenology, this article examines the use of the hands in a qualitative study with a commercial aeroplane pilot, in which the hands were integral for understanding how to operate an aircraft simulator and fly a Cherokee aeroplane, used for training commercial pilots. By being there and engaging with things, we can attempt to acquire an optimal grasp of our research participant's worlds, thus providing insightful ways of knowing and making sense of our qualitative data. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of dry heat treatment (fluidotherapy) in improving hand function in patients with rheumatoid arthritis. Design: Prospective randomized controlled trial. Setting: Departments of Physical Medicine and Rehabilitation and Rheumatology in a university hospital. Subjects: Patients with rheumatoid arthritis. Interventions: All patients were randomly divided into two groups. Group 1 underwent dry heat treatment (fluidotherapy) and Group 2 was a control group. Patients in both groups participated in a joint protection and exercise program. Main measures: Primary outcome measures were Health Assessment Questionnaire and Duruoz Hand Index. Secondary outcome measures were pain and stiffness, Grip Ability Test, Disease Activity Score-28, and grip strength. These assessments were performed at the hospital at baseline, week 3, and week 12. Results: A total of 93 participants were allocated to Group 1 (n = 47) and Group 2 (n = 46). The mean age of these groups was 54.19 ± 11.15 years and 53.00 ± 10.15 years, respectively (P = 0.592). At baseline, there were no significant differences between the groups in any parameter except significantly poorer Health Assessment Questionnaire score in Group 1 (P = 0.007). At week 3, there were no significant differences between the groups in any of the parameters (P > 0.005). At week 12, Duruoz Hand Index scores were significantly better in Group 2 (P = 0.039). Conclusion: Dry heat treatment (fluidotherapy) was not effective in improving hand function in patients with rheumatoid arthritis. Moreover, no positive effect on any other clinical parameters was observed. [ABSTRACT FROM AUTHOR]

The advantage of simulation environments is that they present various insights into real situations, where experimental research opportunities are very limited-for example, in endoscopic surgery. These operations require simultaneous use of both hands. For this reason, surgical residents need to develop several motor skills, such as eye-hand coordination and left-right hand coordination. While performing these tasks, the hand condition (dominant, nondominant, both hands) creates different degrees of mental workload, which can be assessed through mental physiological measures-namely, pupil size. Studies show that pupil size grows in direct proportion to mental workload. However, in the literature, there are very limited studies exploring this workload through the pupil sizes of the surgical residents under different hand conditions. Therefore, in this study, we present a computer-based simulation of a surgical task using eye-tracking technology to better understand the influence of the hand condition on the performance of skill-based surgical tasks in a computer-based simulated environment. The results show that under the both-hand condition, the pupil size of the surgical residents is larger than the one under the dominant and nondominant hand conditions. This indicates that when the computer-simulated surgical task is performed with both hands, it is considered more difficult than in the dominant and nondominant hand conditions. In conclusion, this study shows that pupil size measurements are sufficiently feasible to estimate the mental workload of the participants while performing surgical tasks. The results of this study can be used as a guide by instructional system designers of skill-based training programs. [ABSTRACT FROM AUTHOR]

Objective We examined the impacts of pulling task (breakaway and pull-down tasks at different postures), glove use, and their interaction on achievable downward pull forces from a ladder rung. Background Posture, glove use, and the type of pulling task are known to affect the achievable forces. However, a gap in the literature exists regarding how these factors affect achievable downward pulling forces, which are relevant to recovery from a perturbation during ladder climbing. Methods Forty subjects completed four downward pulling tasks (breakaway force; pull force at maximum height, shoulder height, and a middle height), using three glove conditions with varying coefficient of friction (COF) levels (cotton glove, low COF; bare hand, moderate COF; and latex-coated glove, high COF) with their dominant and nondominant hand. The outcome variable was the maximum force normalized to body weight. Results The highest forces were observed for the highest hand postures (breakaway and maximum height). Increased COF led to higher forces and had a larger effect on breakaway force than the other tasks. The dominant hand was associated with higher forces than the nondominant hand. Male subjects generated greater forces than female subjects, particularly for higher hand positions. Conclusion This study suggests that a higher hand position on the ladder, while avoiding low-friction gloves, may be effective for improving recovery from ladder perturbations. Application This study may guide preferred climbing strategies (particularly those that lead to a higher hand position) for improving recovery from a perturbation during ladder climbing. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine maximum forces during syringe use for different grips found in the field.Background: Prolonged syringe use in chemotherapy drug delivery is associated with pain and injury in nurses and technicians.Method: Twenty healthy female hospital workers generated isometric maximum voluntary force using a 30 cc syringe with four pinch grips (chuck, chuck variation, thenar, two-handed). Both dominant and nondominant hands were used with the syringe plunger fixed in wide (8.3 cm) and narrow (2.5 cm) grip spans. Participants were encouraged to position the apparatus in the most comfortable position and exert a maximal effort for 5 seconds.Results: Significant interaction effects were found: Grip Span × Pinch Type, Hand × Pinch Type, and Grip Span × Hand × Pinch Type ( p < .05). The results demonstrated that the thenar (103.6 ± 22.9 N) and two-handed (104.7 ± 17.1 N) pinches produced the highest forces.Conclusion: Thenar and two-handed pinch grips may be the preferred pinch type to lower the relative efforts required to use a syringe and may be one strategy to assist with reduction of musculoskeletal disorder risk associated with syringe use.Application: Determining maximal syringe press forces allows workers and ergonomists to develop better strategies for managing the cumulative loads during drug delivery and mixing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of hand immersion duration on manipulative ability and tactile sensitivity.Background: Individuals in maritime settings often work with hands that have been immersed in water. Although research has shown that hand immersion duration differentially impacts skin adhesion and tactile sensitivity, the effect of hand immersion on manipulative ability has not been directly tested. Given how critical manipulative ability is for the safety and performance of those working at sea, the effect of hand immersion duration on manual performance was investigated.Method: Tests of manipulative ability (Purdue Pegboard, Grooved Pegboard, reef knot untying) and tactile sensitivity (Touch-Test) were completed following no-exposure, short-exposure, and long-exposure hand immersions in thermoneutral water.Results: Compared to the no immersion condition, the Purdue Pegboard performance was reduced in both immersion conditions (short exposure, -11%; long exposure, -8%). A performance decrement was only observed in the short exposure condition (+15% in time to complete task) for the reef knot untying task. There were no statistical differences in the Grooved Pegboard or Touch-Test scores between exposure conditions.Conclusion: Immersing the hands in water decreases manipulative ability except for when object properties reduce the slipperiness between the hand and object.Application: Manual performance in a wet environment may be conserved by designing tools and objects with edges and textures that can offset the slipperiness of wet hands. To maintain safety, the time requirements for working with wet hands needs to be considered. [ABSTRACT FROM AUTHOR]

It is important to obtain optimal grasping performance of a parallel hybrid hand in order to reduce the grasping impact force and power loss, to avoid the damage of object or human body during grasping operation or rescue missions. In this article, the coordinated grasping kinematics of the multi-fingers and the optimization of grasping force for a parallel hybrid hand are studied and analyzed systematically. First, the coordinated grasping condition is analyzed, and the formulae are derived for solving the displacement, the velocity, and the acceleration of the contact points between the object and the multi-fingertips of the parallel hybrid hand. Second, the formulae are derived for solving the contact forces at the contact points. Third, the frictional constraints between the multi-fingers and the object are analyzed during stable grasping, and the formulae are derived for solving the optimum contact forces. Finally, an analytic numerical example is given, the analytic solutions of the coordinated grasping kinematics and optimum contact forces are solved and verified by simulation solutions. [ABSTRACT FROM AUTHOR]

With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects. Four Novices, four Trainees, and three Experts performed a large vessel patch anastomosis on a phantom tissue. Path length, total number of movements, absolute velocity, and total time were analyzed between groups. Compared to the Novices, Expert subjects exhibited significantly decreased total number of movements, decreased instrument path length, and decreased total time to complete tasks. There were no significant differences found in absolute velocity between groups. In this pilot study, we have identified significant differences in patterns of motion between Novice and Expert subjects. These data warrant further analysis for its predictive value in larger cohorts at different levels of training and may be a useful tool in competence-based training paradigms in the future. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe arm and hand movement in children suspected of having autism spectrum disorder (ASD; age range 29–43 months). A videotaped retrospective review of five children with symptoms of ASD during Communication Temptation Tasks was completed at two time points (pre-testing and 6 weeks later). Categories of arm and hand movement were classified and examined. Findings revealed that mean proportional use of arm and hand movement types were generally stable between time points. Only 2 of 17 coded arm and hand movements significantly changed over the 6-week developmental period for appropriate actions on objects and the “give” meaningful communicative act. Appropriate actions on objects were represented at the highest proportion at each time point. Aided augmentative and alternative communication (AAC) was inconsistently used. The findings support the need to examine motor and language co-developments in children suspected of having ASD to inform clinical practice. [ABSTRACT FROM AUTHOR]

Objective: We examined interactions of overhead work location and direction of force application on shoulder muscular activity.Background: Overhead work tasks are common occupational stressors. Previous research has quantified influences of overhead work spatial placement and different force application directions but typically separately or exclusively for tasks done in the median plane.Method: Twenty female participants exerted 40 N of force in six directions (forward/backward, upward/downward, left/right) 150 cm off the floor while seated. An asymmetric pattern of 14 work locations spaced 15 cm centered directly overhead were evaluated.Results: Force direction and work location strongly influenced mean muscle activity (F = 559, p < .01). Interaction effects existed between force direction and hand location in the transverse plane (F = 21, p < .01), with increases as high as 49% in normalized mean muscle activity.Conclusion: Backward exertions produced the highest mean overall muscle activity across hand force directions, exceeding 30% maximum voluntary isometric exertion (MVE) across work locations, with higher activation of anterior deltoid, biceps, infraspinatus, supraspinatus, and upper and lower trapezius. Downward exertions had the lowest mean overall activity, with <10% MVE across work locations. Altered (up to 47%) muscular activity occurred as exertions moved laterally from the origin, and increasingly forward hand positions generally yielded decreased mean overall activity for most force directions.Application: This study provides previously unavailable submaximal shoulder muscular activity data for a wide range of overhead tasks. As such, it enables novel work design considerations that include modifying existing overhead elements to reduce or redistribute associated muscular demands. [ABSTRACT FROM AUTHOR]

Observers experience biases in visual processing for objects within easy reach of their hands; these biases may assist them in evaluating items that are candidates for action. I investigated the hypothesis that hand postures that afford different types of actions differentially bias vision. Across three experiments, participants performed global-motion-detection and global-form-perception tasks while their hands were positioned (a) near the display in a posture affording a power grasp, (b) near the display in a posture affording a precision grasp, or (c) in their laps. Although the power-grasp posture facilitated performance on the motion-detection task, the precision-grasp posture instead facilitated performance on the form-perception task. These results suggest that the visual system weights processing on the basis of an observer’s current affordances for specific actions: Fast and forceful power grasps enhance temporal sensitivity, whereas detail-oriented precision grasps enhance spatial sensitivity. [ABSTRACT FROM PUBLISHER]

The purposes of this study are to design and develop a computerized test to measure junior high school students' motor skills, specifically their abilities in hand-eye motor coordination and hand motor skills, using the Wii Remote. The hand motor skills computerized test, which is based on the operational examinations in the General Aptitude Test Battery, examines hand and finger dexterity (i.e., motion, rotation, fabrication, and disassembly tests). 55 students participated in the experiment to assess the reliability and validity of the computerized test, which were supported. Information literacy and experience in the use of Wii devices did not affect the reliability. [ABSTRACT FROM AUTHOR]

The article discusses a study which compared the repeatability, sensitivity, bias and limits of agreement of evoked electromyography in three muscles of the hand. Study authors examined the effect of evoked electromyography on abductor digiti minimi, adductor pollicis and first dorsal interosseous. They described the recovery of the muscles from on-depolarising neuromuscular blockade.

Objective: Clinical studies suggest resting thermoregulatory cutaneous vasomotor tone could be increased in schizophrenia, resulting in reduced hand blood flow. In animal models, atypical antipsychotics including clozapine potently inhibit sympathetic neural outflow to the thermoregulatory cutaneous vascular beds. We have now determined whether antipsychotic medication administration is associated with an acute increase in hand blood flow in patients with schizophrenia and schizoaffective disorder, and whether this increase correlates with clinical status. Method: Hand temperature was measured with an infrared camera in 12 patients with chronic schizophrenia or schizoaffective disorder 30 min prior to, then 30 and 60 min following medication. Clinical status was assessed via the Brief Psychiatric Rating Scale (BPRS). Results were compared using regression and repeated measures analysis of variance. Results: A robust and significant increase in hand temperature (p < 0.001) was observed following antipsychotic administration. The mean increase after 60 min was 4.1 ± 2.4°C. This increase was significantly associated with colder hand temperature prior to medication (p < 0.05; suggestive of increased resting vasoconstriction) and with more severe psychiatric symptoms (p < 0.05). Conclusions: Atypical antipsychotics were associated with increased hand blood flow, consistent with inhibition of thermoregulatory sympathetic outflow to the cutaneous vascular bed in patients with schizophrenia and schizoaffective disorder. This increase correlated with symptom severity. Hand temperature increase following antipsychotic medication may therefore be a simple and informative physiological marker of disease activity and potential response in patients with schizophreniform disorders. Given that antipsychotics also inhibit sympathetic outflow to brown adipose tissue, which normally converts energy to heat, future studies should examine whether antipsychotic-induced hand temperature increase is associated with antipsychotic-induced weight gain. [ABSTRACT FROM AUTHOR]

Objective: To compare a small cellular clamshell phone with a traditional office phone in the development of discomfort and muscle fatigue over time during phone use.Background: Phone use involves low-level static exertions that may be influenced by phone design. Phone design and its interactions with anthropometry may change shoulder and hand postures assumed during use, which in turn may modify the length-strength relationship and moment arms of the muscles.Method: Ten adults participated in a study that simulated phone use using a small clamshell and a traditional office phone. Discomfort information and electromyographic (EMG) muscle activity were monitored on four upper extremity muscles. Discomfort and fatigue data (EMG median frequency shifts) were analyzed to assess differences between phones as well as differing effects attributable to anthropometry.Results: Median frequency shifts supported discomfort claims and indicated muscle fatigue in the deltoid and thenar muscles. Biomechanical measures demonstrated that participants with short limb lengths developed more severe signs of thenar fatigue. Participants with longer arms developed greater discomfort in the neck, shoulder, and back. The deltoid confirmed this occurrence, showing signs of muscle fatigue.Conclusion: Phone design and anthropometry influenced the development of discomfort and fatigue during phone use. Phone design dictated grip style, resulting in differing discomfort and fatigue levels. Anthropometry influenced the severity of the discomfort and fatigue present in the shoulder and hand.Application: Use of small clamshell phones may contribute to a lack of rest and recovery from typical workday exposures. It should be explored from an ergonomic perspective. [ABSTRACT FROM AUTHOR]

Our aim was to study physiological response and acceptability of intermittent muscle contractions. Seven male subjects performed eight isometric handgrip exercises with altered contraction-relaxation periods but identical tension-time products. Local blood flow (BF), heart rate, blood pressure, electromyography, maximal voluntary handgrip contraction (MVC), and venous concentration of potassium and lactate of both forearms were followed during and up to 24 hours after the exercises. Wrist force response to electrical stimulation of a forearm muscle was used to investigate low-frequency fatigue (LFF). Ratings of perceived exertion were recorded during exercise. LFF was associated with a decreased functional capacity, which may be explained by a net potassium loss. Recovery BF was linearly related to mean contraction intensity of the experiments. Physiological criteria for acceptability of isometric exercise are suggested, based on the absence of fatigue during exercise and the return to baseline values within four hours of the recovery period. Based on these physiological criteria, intermittent handgrip contractions at (or higher than) a mean contraction intensity of 17% MVC and continuous handgrip contractions at (or higher than) 10% MVC were considered unacceptable. [ABSTRACT FROM AUTHOR]

Finger and palmar forces were measured during actual pneumatic nutrunner operation using a strain gauge dynamometer. Eighteen student subjects were assigned to one of three categories based on hand length. Two triggers and four handle spans were presented randomly. Handle span affected maximal and submaximal grip force. As span increased from 4 cm to 7 cm, average peak finger force increased 24%, peak palmar force increased 22%, and average finger and palmar tool-holding forces increased 20%. When an extended trigger was used, average peak finger force decreased 9%, peak palmar force decreased 8%, finger tool-holding force decreased 65%, and palmar tool-holding force decreased 48%. Hand size affected grip strength (MVC), grip force, and exertion level (force/MVC). Holding exertion level was maximum for large-handed subjects using a 4-cm handle and for small-handed subjects using a 7-cm handle. Subjective handle span preference increased as hand size increased. A similar experiment was performed using 11 factory workers. [ABSTRACT FROM AUTHOR]

The goal of this study was to collect anthropometric data that describe the geometry of the surface of the hand and to model this anthropometry as a function of gross external hand measurements. The depth and breadth of each segment of the hand were measured at points that were spaced at approximately equal distances between the joints of the hand. Linear models using hand breadth as the independent variable explained from 12% to 47% of the variation in segment breadths and from 6% to 74% in segment depths. Ellipsoids are used in biomechanical models as an efficient mathematical description of the shape of kinematic segments for use in the determination of contact with other objects. Therefore the primary objectives of this study were to approximate the semiaxis dimensions for these hand segment contact bodies using a linear model of the gross anthropometry and to evaluate the accuracy with which ellipsoids describe the geometry of the hand segments. Graphical comparisons showed that differences between the ellipsoidal approximations and the breadth and depth measurements were largest near the joints. Data collected in this study could be used to create a set of overlapping ellipsoids that would provide a more accurate representation of hand geometry, and this representation could be adapted to biomechanical models that use ellipsoids to define segment geometry. [ABSTRACT FROM AUTHOR]

This research investigated the range of wrist motion characteristics associated with the ergonomic principle of "bending the tool and not the wrist" as applied to the hammer. It is thought that bending the tool reduces angular wrist motion, which has been shown in the literature to be a risk factor in hand/wrist disorders such as carpal tunnel syndrome and tenosynovitis. Hammer handles angled at 0 (straight), 20, and 40 deg were investigated in this study. For novices, hammer handles bent at 20 and 40 deg resulted in less total ulnar deviation than straight hammers. However, there was a trade-off in beginning and ending positions of the wrist in that the angled hammers reduced ulnar deviation at the impact position but increased radial deviation at the starting position of a hammer stroke. Handle angle did not significantly affect hammering performance. Wrist motion was affected minimally by hammering orientation, but hammering performance was significantly worse in the wall orientation compared with the bench orientation. This research suggests that for novice users, hammers with handles bent in the range of 20 to 40 deg could possibly decrease the incidence of hand/wrist disorders caused by hammering. [ABSTRACT FROM AUTHOR]

The article presents a study which analyzes the potential difference in the electrical resistance between the acupuncture points (AP) and non-AP. Results of the study imply that there is no difference in the electrical resistance of APs and non-APs, based on the skin resistance measurements of the AP L14 and the adjacent skin site.

The authors discuss a study on the rate of cancellation of the second procedure in patients listed for staged bilateral carpal tunnel release (CTR) surgery. They mention the offer of staged CTR to patients with bilateral carpal tunnel syndrome (CTS) wherein each side is released separately. The most common reason given for CTR cancellation was that the original date for the second procedure was too soon after the first.