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Importance: Occupational therapists need dependable and accurate instruments for remote assessments and monitoring of hand functionality. These assessments monitor progress, evaluate interventions, and guide independence goals. Objective: To assess the interinstrument reliability and concurrent validity of the Squegg® Smart Dynamometer and Hand Grip Trainer and the Jamar® Hydraulic Hand Dynamometer. Design: Repeated-measures design. Setting: Individual clinic in Bucharest, Romania. Participants: Forty middle-age and older adult volunteers, healthy and free from any neuromuscular, orthopedic dysfunction that affected hand strength. Outcomes and Measures: Participants' maximal grip strength (MGS) for both their dominant and nondominant hands was measured with both devices. Participants with odd-numbered IDs were measured with the Squegg first and the Jamar second, and those with even-numbered IDs were measured in opposite sequence. Results: Paired-samples t tests on overall mean MGS and mean MGS (three measures on each hand) showed no statistically significant differences between the two devices. Intraclass correlation analysis showed good to excellent interinstrument agreement. Pearson correlations between measurements across all participants, and hands, indicated strong agreement. Conclusions and Relevance: The Squegg shows promise for health care professionals, including occupational therapists, for grip strength assessment in clinical contexts. What This Article Adds: These results offer initial psychometric data for a new remote MGS measurement device. MGS is crucial for assessing the physical function of aging adults. Reliable measurements from such a device are vital for occupational therapists to guide treatment interventions and assess hand function's impact on daily activities. The study results offer initial psychometric data for a new remote measurement device for maximal grip strength (MGS). Reliable MGS measurements are vital for occupational therapists to guide treatment interventions and to assess the impact of hand function on the daily activities of aging adults. [ABSTRACT FROM AUTHOR]

Objectives. Exposure to hand-transmitted shocks is a widespread phenomenon in the workplace. Separate risk assessments for shocks do not exist in current international hand–arm vibration regulations, leading to potential underestimation of associated health risks. Methods. In a pilot study approach, eight healthy males were exposed to sets of 3 × 5 min of repetitive shocks and 1 × 5 min of random vibration, controlled at a weighted vibration total value of 10 m/s2. Baseline and post-exposure measurements of vibration perception thresholds, finger skin temperature, maximal grip/pinch force and the Purdue pegboard test were conducted. Muscle activity was monitored continuously by surface electromyography. Results. Shock exposures evoked a temporary increase of vibration perception thresholds with high examination frequencies. A decrease of skin temperature was hinted for shocks of 1 and 20 s–1. Electromyographical findings indicated an additional load on two forearm muscles during shock transmission. Maximum grip force and manual dexterity were not affected, and pinch force only partially reduced after the exposures. Conclusion. Physiological effects from shock exposure conform to those described for hand–arm vibration exposure in principle, although some divergence can be hypothesized. Randomized designs are required to conclusively assess the need of occupational health concepts specifically for hand-transmitted shocks. [ABSTRACT FROM AUTHOR]

The study aimed to assess the functional and aesthetic outcomes of abdominal full‐thickness skin grafts (FTSGs) in paediatric postburn digital and palmar flexion contractures. The digital and palmar functions and aesthetics of 50 children who met the criteria were evaluated at pre‐operation, the 3rd‐ and 12th‐month post‐operation, respectively. In the evaluation, the Vancouver Scar Scale (VSS), total active movement (TAM), and Jebsen–Taylor Hand Function Test (JHFT) were used. The contralateral, unaffected hand served as the criteria for functional recovery. The complications of donor sites were observed, and the take rate of skin grafts was calculated. The VSS scores at the 3rd and 12th months post‐operation were lower than those before the operation. The TAM of each finger was improved at the 3rd and 12th months post‐operation, compared with that before the operation. There was a significant difference in the time to complete the JHFT between the affected hand and the unaffected at the 3rd month post‐operation, but no significant difference between them at the 12th month post‐operation. The excellent and good take rate of the skin grafts was 90.00%.No donor site complications were observed. The abdominal FTSGs are effective in repairing paediatric digital and palmar scar contractures, with satisfying functional and aesthetic results, especially in large defects after scar release and resection. [ABSTRACT FROM AUTHOR]

Dermatopathia pigmentosa reticularis is a rare ectodermal dysplasia characterized by a triad of generalized reticulate hyperpigmentation, noncicatricial alopecia, and onychodystrophy. We report a case of a 22-year-old male with characteristic features of the diagnostic triad and adermatoglyphia of palm and soles. On dermoscopic examination reticulated hyperpigmented spots, reticulated pigmented spots, monotonous pigmented spots, reticulated hypopigmented spots, with perifollicular hypopigmentation were observed. Dermoscopic findings of palm and soles showed hyperpigmented reticular pattern with dots and adermatoglyphia. Onychoscopy and trichoscopy are also discussed. Histopathology revealed orthokeratosis, epidermal atrophy, increase in melanin pigment in basal layers with vacuolization, and dermal pigmentary incontinence. Other inherited reticulate dermatoses such as Naegeli-Franceschetti-Jadassohn syndrome, dyschromatosis symmetrica hereditaria, and dyskeratosis congenita were considered in differential diagnosis and are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the relationship between selected anthropometric, physiological, and upper-body strength measures and 15-km handcycling time-trial (TT) performance. Methods: Thirteen trained H3/H4 male handcyclists performed a 15-km TT, graded exercise test, 15-second all-out sprint, and 1-repetition-maximum assessment of bench press and prone bench pull strength. Relationship between all variables was assessed using a Pearson correlation coefficient matrix with mean TT velocity representing the principal performance outcome. Results: Power at a fixed blood lactate concentration of 4 mmol·L−1 (r =.927; P <.01) showed an extremely large correlation with TT performance, whereas relative V ˙ O 2 peak (peak oxygen uptake) (r =.879; P <.01), power-to-mass ratio (r =.879; P <.01), peak aerobic power (r =.851; P <.01), gross mechanical efficiency (r = 733; P <.01), relative prone bench pull strength (r =.770; P =.03) relative bench press strength (r =.703; P =.11), and maximum anaerobic power (r =.678; P =.15) all demonstrated a very large correlation with performance outcomes. Conclusion: Findings of this study indicate that power at a fixed blood lactate concentration of 4 mmol·L−1, relative V ˙ O 2 peak , power-to-mass ratio, peak aerobic power, gross mechanical efficiency, relative upper-body strength, and maximum anaerobic power are all significant determinants of 15-km TT performance in H3/H4 handcyclists. [ABSTRACT FROM AUTHOR]

The ability to coordinate different body parts under different constraints that are imposed by organism, environment, and tasks during motor development might be different in children. The aim of this study was to examine whether children with different motor development levels are different with regard to multijoint coordination during two-hand catching. Eighty-four children (age: 6.05 ±0.67 years) who were assessed on object control skills were recruited voluntarily. The biomechanical model was defined from 20 movements of seven segments (shoulders, elbows, wrists, and torso), and the principal component analysis was used to quantify the multijoint coordination and kinematic synergies during catching. The results showed that the redundancy of joints in two-hand catching is controlled by three kinematic synergies that defined the majority of the variance. The participants who were grouped based on their development levels did not show differences in the number and strength of synergies; however, they were different in the utilization of the kinematic synergies for successful catching. In conclusion, the number and the strength of the kinematic synergies during two-hand catching are not affected by the developmental levels and are related to the nature of the task. [ABSTRACT FROM AUTHOR]

This study aims toward an investigation and comparison of the digital force control and the brain activities of older adults and young groups during digital pressing tasks. A total of 15 young and 15 older adults were asked to perform force ramp tasks at different force levels with a custom pressing system. Near-infrared spectroscopy was used to collect the brain activities in the prefrontal cortex and primary motor area. The results showed that the force independence and hand function of the older adults were worse than that of the young adults. The cortical activations in the older adults were higher than those in the young group during the tasks. A significant hemodynamic between-group response and mild negative correlations between brain activation and force independence ability were found. Older adults showed poor force independence ability and manual dexterity and required additional brain activity to compensate for the degeneration. [ABSTRACT FROM AUTHOR]

Holding an object has been found to reduce postural sway during quiet standing. However, people normally stand to accomplish suprapostural goals, such as fitting a key into a lock. Postural control should therefore be assessed by examining postural outcomes in the context of suprapostural task performance. This study assessed whether holding an object increased standing postural stability and improved the performance of a concurrent precision manual task. A total of 15 young adults performed a precision manual task with their dominant hand while holding or not holding an object in their nondominant hand. Postural stability was assessed using measures of postural sway and time to boundary. Suprapostural task performance was assessed as an error count. Holding did not influence postural sway or suprapostural task performance. Discrepancies among previous studies coupled with the present findings suggest that the effects of holding an object on standing posture are highly sensitive to the experimental context. The authors provide several explanations for their findings and discuss the limitations of previous suggestions that holding an object may have clinical relevance for balance-compromised populations. [ABSTRACT FROM AUTHOR]

Background: Although global longitudinal strain (GLS) is recognized as a sensitive marker of intrinsic left ventricular (LV) dysfunction, its afterload dependency has also been pointed. We hypothesized that decrease in GLS during handgrip exercise could be more sensitive marker of intrinsic myocardial dysfunction. Methods: Handgrip exercise‐stress echocardiography was performed in 90 cardiovascular disease patients with preserved LV ejection fraction. LV diastolic function was graded according to the guidelines. Diastolic wall stress (DWS) and ratio of left atrial (LA) volume index to late‐diastolic mitral annular velocity (LAVI/a′) were measured at rest as LV stiffness. As well, LA strains were measured to assess LA function. GLS was expressed as absolute value and significant changes in GLS by handgrip exercise was defined as changes over prespecified mean absolute test‐retest variability (2.65%). Results: While mean value of GLS did not change by the exercise, substantial patients showed significant changes in GLS: decreased (group I, n = 28), unchanged (group II, n = 34), and increased (group III, n = 28). Unexpectedly, patients in group I did not show any clinical and echocardiographic characteristics, while those in group III were characterized by elevated natriuretic peptide levels, blunted heart rate response to handgrip exercise, and advanced LV diastolic dysfunction. Multivariable analyses revealed that DWS, left atrial booster strain, and grade II or more diastolic dysfunction determined the increase in GLS even after adjustment for elevated natriuretic peptides and the changes in heart rate by the exercise. Conclusion: In contrast to our hypothesis, paradoxical increase in GLS by handgrip exercise could be associated with advanced LV diastolic dysfunction in cardiovascular patients with preserved LV ejection fraction. Our findings suggest that HG exercise for heart failure patients does not enhance the afterload straightforward, resulting in variable changes of GLS according to the individual conditions. [ABSTRACT FROM AUTHOR]

In this study, we determined whether information in eye–hand/hand–eye cross-modal memory is maintained by the input modality used for encoding, the output modality used for testing, or both. In experiments, two categories of effect were examined: facilitatory, produced by rehearsal work with eyes or hands corresponding to the movement of the stimulus to be memorized after its presentation, and interference, formed through the performance of a noncorresponding movement. The results indicated that both the eye and hand facilitated the eye–hand cross-modal memory tasks (Experiment 1A), confirming that both serve a rehearsal function. Subsequently, we conducted an interference effect experiment (Experiment 1B) using the same memory task as that used in Experiment 1A and found that neither modality produced interference effects. This result indicates that information was preserved via output-modality-specific representations when the eye-interference task interfered with the information retention of input-modality-specific representations and via input-modality-specific representations when the hand-interference task interfered with the information retention of output-modality-specific representations. We observed the same facilitation and disappearance of interference effects for the hand–eye cross-modal memory task (Experiments 2A and 2B). In the eye–hand/hand–eye cross-modal memory tasks, the effects of eye and hand rehearsals were found to be comparable, which indicated that the two types of representations functioned together during encoding and testing. From the disappearance of interference effects, the possibility that modality-specific representations have functional aspects arises. [ABSTRACT FROM AUTHOR]

To describe hand function, and investigate adherence to a rehabilitation protocol and factors associated with upper extremity disability in non-surgically treated proximal phalangeal fractures. In a prospective cohort study, 86 patients (58 women, mean age of 49 years) were assessed at cast removal and 6 weeks follow-up. Adherence was registered in a diary. Factors potentially associated with disability were assessed in a logistic regression model. At 6 weeks, the mean total active range of motion in the injured finger was 84% of the uninjured finger and median pain intensity levels were low (VAS <20). Mean grip strength was 66% of the uninjured hand and 28% perceived high upper extremity disability (QuickDASH score ≥30). Most patients adhered to exercise and night splint regime. The strongest associated factors with high upper extremity disability were more days in cast (Odds ratio 1.429, 95% CI 1.110–1.840) and fear of movement (Odds ratio 1.119, 95% CI 0.990–1.256) in the final regression model (Nagelkerke R Square 0.46). Most patients regain early satisfactory hand function, but a quarter still perceives high upper extremity disability. Longer immobilisation time in particular and fear of movement are important factors that may negatively affect the early outcome. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between combinations of sarcopenia criteria by the Asian Working Group of Sarcopenia (AWGS) 2019 guideline and incident adverse health outcomes. Longitudinal analyses of a cohort study. We conducted prospective 2-year follow-up analyses (N = 1959) among community-dwelling older adults enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS). From the KFACS, 1959 older adults (52.8% women; mean age = 75.9 ± 3.9 years) who underwent assessments for appendicular skeletal mass using dual-energy X-ray absorptiometry, handgrip strength, usual gait speed, 5-times sit-to-stand test, and Short Physical Performance Battery (SPPB) at baseline were included. Participants with each adverse health outcome [mobility disability, falls, and instrumental activities of daily living (IADL) disabilities] at baseline were excluded for each corresponding analysis. Multivariable logistic regression was performed to examine whether sarcopenia defined by different diagnostic criteria was associated with incident adverse health outcomes after 2 years. A total of 444 participants (22.7%) were diagnosed with sarcopenia as defined by AWGS 2019. In the multivariable analysis, sarcopenia defined as both low muscle mass and low physical performance increased the risk of mobility disability (OR 2.14, 95% CI 1.35-3.38) and falls (1.74, 95% CI 1.21-2.49). Only the criterion defined as both low muscle mass and physical performance using the SPPB increased the risk of falls with fracture (2.53, 95% CI 1.01-6.35) and IADL disabilities (2.77, 95% CI 1.21-6.33). However, sarcopenia defined as both low muscle mass and low hand grip strength showed no associations with the incidence of any of the adverse health outcomes. Our study suggests that the predictive value of adverse health outcomes for community-dwelling older adults is better when diagnosed with sarcopenia based on low muscle mass and physical performance. Furthermore, using the SPPB as a diagnostic tool for low physical performance may improve the predictive validity for falls with fracture and IADL disability. Our findings may be helpful for the early detection of individuals with sarcopenia who have a higher risk of adverse health outcomes. [ABSTRACT FROM AUTHOR]

To evaluate the perceived usability and utility of using a soft robotic glove to rehabilitate hand function following a stroke. A convergent parallel mixed-methods design was used to consult a convenience sample of 14 experienced occupational therapists (OTs) practicing within a specialised stroke rehabilitation program. All OTs participated in one 60-to-90-minute individual consultation during which the attributes of a recently-developed soft robotic glove (ExoGlove) were presented before they could test it on themselves. After this consultation, OTs completed the System Usability Scale (SUS) questionnaire and answered open-ended questions focussing on the usability and utility of soft robotic gloves framed according to the Unified Theory of Acceptance and Use of Technology (UTAUT). The OTs perceived the glove's usability as being moderate-to-good on the SUS (median score= 63.75 on a scale of 100). Thematic analysis revealed the importance of specifically considering elements such as ease of use (e.g. simplicity and speed), cost, movement precision, durability, and safety, when developing soft robotic gloves such as the ExoGlove. Engagement in a continuous improvement process is essential to maximise the perceived usability and utility of soft robotic gloves, particularly of the ExoGlove, through their final development phase before pilot testing their effects and effectiveness for post-stroke hand rehabilitation. All occupational therapists anticipate that a soft robotic glove such as the ExoGlove will allow them to increase treatment intensity and best aligns with principles of neuroplasticity. The clinical judgement and guidance of OTs, developed through practice, experience, and knowledge, remain essential to safely and efficiently exercise with a soft robotic glove. Achieving a balance between effort and performance expectancies is essential in developing and improving the functionality of soft robotic gloves, as with each additional functionality comes new challenges that impact its successful transition to a clinical setting. [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]

Observer, manual single-frame video, and automated computer vision measures of the Hand Activity Level (HAL) were compared. HAL can be measured three ways: (1) observer rating (HALO), (2) calculated from single-frame multimedia video task analysis for measuring frequency (F) and duty cycle (D) (HALF), or (3) from automated computer vision (HALC). This study analysed videos collected from three prospective cohort studies to ascertain HALO, HALF, and HALC for 419 industrial videos. Although the differences for the three methods were relatively small on average (<1), they were statistically significant (p <.001). A difference between the HALC and HALF ratings within ±1 point on the HAL scale was the most consistent, where more than two thirds (68%) of all the cases were within that range and had a linear regression through the mean coefficient of 1.03 (R2 = 0.89). The results suggest that the computer vision methodology yields comparable results as single-frame video analysis. Practitioner summary: The ACGIH Hand Activity Level (HAL) was obtained for 419 industrial tasks using three methods: observation, calculated using single-frame video analysis and computer vision. The computer vision methodology produced results that were comparable to single-frame video analysis. [ABSTRACT FROM AUTHOR]

Pure motor isolated hand palsy (PMIHP) following infarction of the "hand knob" area is a rare entity in stroke. PMIHP usually recovers within the first few days, but there are rare cases where patients do not recover rapidly. Herein, we report a case of residual PMIHP in which repetitive facilitative exercise under concurrent low-amplitude continuous neuromuscular electrical stimulation ("RFE-under-cNMES") was introduced to improve hand function. A 65-year-old man with PMIHP (30 days after onset) participated in a rehabilitation program involving RFE-under-cNMES. This protocol followed an A1-B1-A2-B2 schedule, where the "A"-period consisted of RFE-under-cNMES ("A1," 2 weeks; "A2," 1 week), and the "B"-period consisted of 1-week conventional rehabilitation. The 5-week intervention promoted not only recovery from paralysis (8 points by the Fugl-Meyer Assessment), but also the ability to manipulate objects (13 points by the Action Research Arm test) and increased the subjective use of the affected upper limb during activities of daily living (2.88 points by the Motor Activity Log). Changes that exceeded the minimal clinically important difference occurred only in the RFE-under-cNMES period. The patient had improved outcomes. Further studies are required to determine the possibility of RFE-under-cNMES relieving motor paralysis in patients with PMIHP who do not recover rapidly. [ABSTRACT FROM AUTHOR]

To understand the role of affected upper extremity (UE) self-efficacy for explaining daily-hand-use in individuals post-stroke. Specifically, to describe UE self-efficacy and to assess the associations between UE self-efficacy to UE motor and functional capacity and daily hand-use. This cross-sectional study included individuals post-stroke receiving rehabilitation with high UE functional capacity [Action Research Arm Test (ARAT) > 50]. The Rating of Everyday Arm-Use in the Community and Home (REACH) assessed perceived UE daily use and the Confidence in Arm and Hand Movement scale (CAHM) assessed UE self-efficacy. Functional capacity was assessed by the ARAT and the Fugl-Meyer-motor-assessment assessed motor impairment. Correlations between measures were assessed. Twenty-two individuals, aged 19–80, with high UE functional capacity [median (IQR) ARAT-56.5 (54–57)] and varying UE self-efficacy [median (IQR) CAHM-76.7 (58–84.4)], were included. UE self-efficacy was significantly correlated with the ARAT (rs = 0.53, p < 0.01) and REACH (rs = 0.51, p < 0.01) but ARAT was not significantly correlated with REACH. UE self-efficacy is correlated with perceived daily hand-use in individuals with high functional capacity. Further research and a deeper understanding of the clinical implications of UE self-efficacy are warranted. UE self-efficacy should perhaps be assessed during rehabilitation. Individuals with stroke with high affected upper extremity functional capacity do not necessarily use this hand for daily living. Upper extremity self-efficacy is correlated with perceived daily hand-use in individuals with high functional capacity; participants with higher upper extremity self-efficacy also reported more daily hand-use. Upper extremity self-efficacy seems to be upper extremity task or situation-specific. Upper extremity self-efficacy should be assessed during rehabilitation and the clinical implications of (low) upper extremity self-efficacy should be further researched. [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]

Objective Many patients with coronavirus disease 2019 (COVID-19) infections were admitted to an intensive care unit (ICU). Physical impairments are common after ICU stays and are associated with clinical and patient characteristics. To date, it is unknown if physical functioning and health status are comparable between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 3 months after ICU discharge. The primary objective of this study was to compare handgrip strength, physical functioning, and health status between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 3 months after ICU discharge. The second objective was to identify factors associated with physical functioning and health status in patients in the ICU with COVID-19. Methods In this observational, retrospective chart review study, handgrip strength (handheld dynamometer), physical functioning (Patient-Reported Outcomes Measurement Information System Physical Function), and health status (EuroQol 5 Dimension 5 Level) were compared between patients in the ICU with COVID-19 and patients in the ICU without COVID-19 using linear regression. Multilinear regression analyses were used to investigate whether age, sex, body mass index, comorbidities in medical history (Charlson Comorbidity Index), and premorbid function illness (Identification of Seniors At Risk-Hospitalized Patients) were associated with these parameters in patients in the ICU with COVID-19. Results In total, 183 patients (N  = 92 with COVID-19) were included. No significant between-group differences were found in handgrip strength, physical functioning, and health status 3 months after ICU discharge. The multilinear regression analyses showed a significant association between sex and physical functioning in the COVID-19 group, with better physical functioning in men compared with women. Conclusion Current findings suggest that handgrip strength, physical functioning, and health status are comparable for patients who were in the ICU with COVID-19 and patients who were in the ICU without COVID-19 3 months after ICU discharge. Impact Aftercare in primary or secondary care in the physical domain of postintensive care syndrome after ICU discharge in patients with COVID-19 and in patients without COVID-19 who had an ICU length of stay >48 hours is recommended. Lay Summary Patients who were in the ICU with and without COVID-19 had a lower physical status and health status than healthy people, thus requiring personalized physical rehabilitation. Outpatient aftercare is recommended for patients with an ICU length of stay >48 hours, and functional assessment is recommended 3 months after hospital discharge. [ABSTRACT FROM AUTHOR]

• A standardized illustrated manual in Portuguese was provided. • The Brazilian version of the Jebsen Taylor Hand Function test is reliable. • Normative values for a Brazilian sample are now available for further comparison, both in clinical practice and research. This is an observational cross-sectional study. To assess dexterity and hand function, it is important to use validated performance-based outcome measures, such as the Jebsen Taylor Hand Function test (JTHFT). There is no previous study that has used this test in asymptomatic individuals to establish normal values for the Brazilian population, or to assess its reliability. The first aim of the study was to provide a standardized illustrated manual of the Brazilian version of the JTHFT. The second aim was to evaluate JTHFT test-retest reliability in asymptomatic adults, and the third aim was to determine normative values. This study consists of 236 individuals aged 18-60 years, of both sexes, asymptomatic for pain or injury in the upper limbs. An illustrated manual of instructions was developed in Portuguese, test-retest reliability was assessed by determining the intraclass correlation coefficient (ICC), and to evaluate the average of the correlations between the items, the Cronbach Alpha coefficient was used. The standard error of measurements of the test and retest of the JTHFT subtasks was also performed. The Cronbach Alpha coefficient, resulted in acceptable average values 0.75 for the dominant hand and 0.76 for the nondominant hand. JTHFT subtests reveal moderate to excellent test-retest reliability, varying from 0.53, 95% CI: 0.39-0.64; to 0.93, 95% CI: 0.91-0.95 for the dominant hand, and for the nondominant hand 0.66, 95%: 0.57-0.74; to 0.92, 95% CI: 0.90-0.94. JTHFT is reliable for a Brazilian sample in terms of test-retest measures and can be used both in research and in clinical practice. A standardized illustrated manual of application was provided. [ABSTRACT FROM AUTHOR]

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The use of both hands is often required for force/torque exertions, particularly when using hand tools. This study investigated the effects of handle diameter (3–5 cm), between-handle distance (0.5–1.5 shoulder span (SS), workpiece orientation (horizontal/frontal), working height (shoulder/elbow/knuckle), and exertion direction (clockwise/counter-clockwise) on maximum two-handed torque strength, usability and comfort/discomfort while using T-shaped handles. Participants (n = 20) performed 36 experimental conditions. The handle diameter had no significant main effect on torque strength. The 3 cm diameter handle was associated with better usability and comfort compared to other options. Higher torque values were recorded with between-handle distance of 1.0 and 1.5 SS, in frontal plane, in shoulder and knuckle heights, and in counter-clockwise direction. The between-handle distance of 1.0 SS had better comfort and higher usability than other conditions. Interactions between the between-handle distance and working height, between-handle distance and workpiece orientation, and workpiece orientation and working height were also significant. Practitioner summary: Effects of handle diameter, between-handle distance, workpiece orientation, working height, and exertion direction on torque exertions, and subjective measures when using T-shaped handles were evaluated. Higher levels of strength were measured with between-handle distance of 1.0–1.5 shoulder span, and in frontal plane, in shoulder/knuckle heights, and in counter-clockwise direction. [ABSTRACT FROM AUTHOR]

Background: Hand dexterity a measure of hand flexibility and coordination can be affected by many factors including hand grip strength. However, there are limited studies and data about the association between hand dexterity and grip strength in Asian population. Hence, we aim to investigate the relationship between hand dexterity and hand grip strength in healthy males aged between 18 to 25 years old in Asian population. Methods: Fiftyhealthy adult male participants between 18-25 years were recruited by advertisement.Hand grip strength and hand dexterity test by using a handheld dynamometer and Purdue pegboard test, respectively was measured. Purdue pegboard test consisted of two main parts: 1. Inserting pins into the pegboard holes using left, right, and both hands in 30 seconds. 2. Assembly using pins, collars, and washers in one minute. Pearson correlation coefficient and regression analysis was used to study the association between hand dexterity and hand grip strength. Results: The results showed no correlation between left, right and combined hand dexterity with hand grip strength (p value = 0.481 and r = 0.099, p value = 0.181 and r value = 0.188, and p value= 0.945 and r value= 0.009) respectively. Moreover, the results also showed no statistically significant association between number of assemblies built and grip strength (p value = 0.430 and r value=0.111). Conclusion: Our results suggest that there is no statistically significant relationship between hand dexterity and hand grip strength in young males aged between 18 to 25 years old. Thus, it can be concluded that hand grip strength is not a factor that affects hand dexterity in young adult males of Asian population. [ABSTRACT FROM AUTHOR]

A case is described where baseline transcranial electrical motor evoked potentials (TcMEP) and somatosensory evoked potentials (SSEP) results were unilaterally absent in a patient with previous hemispheric stroke undergoing a right-sided carotid endarterectomy. SSEP data confirmed right cortical pathology and excluded a technical rationale for absent motor evoked responses. Attempts at generating left-hand (contralateral) TcMEP from right cortical anodal stimulation failed despite high stimulus intensities. However, TcMEP responses from anodal stimulation of the right cortex were recorded from the right-hand (ipsilateral) which were attributed to "crossover." Ipsilateral TcMEP onset latencies derived from the stimulus-response data supports the idea that crossover is a product of cathodal stimulation initially acting on pericortical motor pathways. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is the second most commonly diagnosed cancer among women. Novel breast cancer screening techniques are necessary to improve early detection and increase the chances of successful treatment. This study investigates the presence of specific volatile organic compounds in the sweat of breast cancer patients, which could serve as biomarkers for non-invasive screening. Sweat samples were collected from 21 breast cancer patients before and after tumor removal surgery and analyzed using thermal desorption coupled with gas chromatography and mass spectrometry. This work demonstrates that volatile organic compounds in sweat differ between pre-and post-surgery status in breast cancer patients, suggesting the possibility to use these compounds as novel breast cancer biomarkers and opening the way to new screening tools. Breast cancer (BC) remains one of the most commonly diagnosed malignancies in women. There is increasing interest in the development of non-invasive screening methods. Volatile organic compounds (VOCs) emitted through the metabolism of cancer cells are possible novel cancer biomarkers. This study aims to identify the existence of BC-specific VOCs in the sweat of BC patients. Sweat samples from the breast and hand area were collected from 21 BC participants before and after breast tumor ablation. Thermal desorption coupled with two-dimensional gas chromatography and mass spectrometry was used to analyze VOCs. A total of 761 volatiles from a homemade human odor library were screened on each chromatogram. From those 761 VOCs, a minimum of 77 VOCs were detected within the BC samples. Principal component analysis showed that VOCs differ between the pre- and post-surgery status of the BC patients. The Tree-based Pipeline Optimization Tool identified logistic regression as the best-performing machine learning model. Logistic regression modeling identified VOCs that distinguish the pre-and post-surgery state in BC patients on both the breast and hand area with sensitivities close to 1. Further, Shapley additive explanations and the probe variable method identified the most important and pertinent VOCs distinguishing pre- and post-operative status which are mostly of distinct origin for the hand and breast region. Results suggest the possibility to identify endogenous metabolites linked to BC, hence proposing this innovative pipeline as a stepstone to discovering potential BC biomarkers. Large-scale studies in a multi-centered VOC analysis setting must be carried out to validate obtained findings. [ABSTRACT FROM AUTHOR]

In the psychotherapeutic treatment of social phobia, the hand movement behaviour exhibited during the interaction provides information about the success of the therapy. In particular, the degree of mutual somatosensory stimulation of the hands (hands moving on each other, as a unit, apart) appears to be relevant regarding the patient's mental state. To test this hypothesis, the present study investigates hand coordination in the course of psychotherapy in patients with and without symptom improvement and in the corresponding therapeutic dyads. Forty‐two videos of patient–therapist dyads consisting of 21 patients (n = 11 non‐improved; n = 10 improved; according to Liebowitz Social Anxiety Scale self‐assessment) from the Social Phobia Research Network project were investigated in early psychotherapy sessions and in pre‐last sessions. Hand movements of four randomised video sequences per dyad were analysed with NEUROGES®‐ELAN. Patients with non‐improved symptoms displayed shorter act apart coordination and more act on each other coordination than patients with improved symptoms. Patients displayed more act apart and act on each other and less act as a unit coordination than therapists. In therapeutic dyads, act on each other coordination in early sessions, as well as short act apart coordination, was significantly related to non‐improvement. Patients with non‐improved symptoms are characterised by more hand coordination associated with a high degree of somatosensory stimulation serving self‐regulation (act on each other), as well as short complex gestural expressions (act apart). Thus, hand coordination constitutes a progression and outcome parameter informing on somatosensory stimulation. [ABSTRACT FROM AUTHOR]

Objectives: A proper function of hands is critical for doing daily activities and work, especially when using electronic devices. This study determined the effect of mirror therapy on individuals with asymmetrical hand function. Methods: Forty-two men with asymmetrical hand function were recruited. All participants were randomly divided into sham control (n=21) and mirror therapy (n=21) groups. Both groups were tested before and after training using the 9-hole peg test (9HPT). The sham control group received pegboard training, and the mirror therapy group received mirror therapy using the pegboard. During training, hand muscle activities were recorded using surface electromyography. The obtained data were analyzed using the t-test and Mann-Whitney U test. Results: Non-dominant hand function on the 9HPT showed significant improvement in the mirror therapy group compared with the sham control group (P=0.021). The asymmetric hand function was also improved in the mirror therapy group. Muscle activities of the non-dominant hand were not significantly different between groups. Discussion: Mirror therapy using the pegboard had an immediate effect on improving non-dominant hand function. This finding has implications for possible preventive strategies against common hand problems and improving the efficient use of both hands. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the clinical outcome of patients treated with a functional Lucerne Cast (LuCa) for different types of hand fractures. Static casting has traditionally been the preferred treatment for hand fractures. However, functional casting may lead to good functional outcomes, less stiffness, and earlier return to work. Methods: A retrospective case series of all consecutive patients with a metacarpal or proximal phalangeal fracture treated with a LuCa between 2018 and 2019 was conducted. A total of 90 patients were included. Clinical data were collected directly from the patient's medical records. Functional outcome was assessed with the Michigan Hand Outcomes Questionnaire (MHQ). Results: The median MHQ score was 95 (IQR 83–100) with a median follow-up of 23 months. Complications occurred in 7 of 90 patients (8%). Functional impairment occurred in two (2%) patients. Functional impairment was defined as stiffness, persisting rotational deformity, a boutonnière or swanneck deformity. Persisting pain or CRPS occurred in six (7%) patients. Conclusion: The LuCa shows to be effective in the functional treatment of both metacarpal and proximal phalangeal fractures with excellent patient-reported outcomes but at a relatively high rate of persisting pain. [ABSTRACT FROM AUTHOR]

Background: Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. Method: The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/nondominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. Result: A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [b = -0.67, 95% confidence interval (CI): -1.26 ~ -0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(b = -0.60, 95% CI: -1.35 ~ 0.15, P = 0.115) and asymmetric non-dominant HGS (b = -0.56, 95% CI: -1.42 ~ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric nondominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ~ 1.74; OR per5 kgdecrease = 1.10, 95% CI: 1.01 ~ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ~ 1.78; OR per5 kgdecrease = 1.10, 95% CI: 1.02 ~ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ~ 1.67) and lower HGS (OR per5 kgdecrease = 1.21, 95% CI: 1.10 ~ 1.32) were associated with impairment of visuoperception. Conclusion: HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups [ABSTRACT FROM AUTHOR]

Background: C-terminal Agrin Fragment (CAF) has emerged as a potent biomarker for identifying sarcopenia. However, the effect of interventions on CAF concentration and the association of CAF with sarcopenia components are unclear. Objective: To review the association between CAF concentration and muscle mass, muscle strength, and physical performance among individuals with primary and secondary sarcopenia and to synthesize the effect of interventions on the change in the level of CAF concentration. Methods: A systematic literature search was conducted in six electronic databases, and studies were included if they met the selection criteria decided a priori. The data extraction sheet was prepared, validated, and extracted relevant data. Results: A total of 5,158 records were found, of which 16 were included. Among studies conducted on individuals with primary sarcopenia, muscle mass was significantly associated with CAF levels, followed by hand grip strength (HGS) and physical performance, with more consistent findings in males. While in secondary sarcopenics, the strongest association was found for HGS and CAF levels, followed by physical performance and muscle mass. CAF concentration was reduced in trials that used functional, dual task, and power training, whereas resistance training and physical activity raised CAF levels. Hormonal therapy did not affect serum CAF concentration. Conclusion(s): The association between CAF and sarcopenic assessment parameters varies in primary and secondary sarcopenics. The findings would help practitioners and researchers choose the best training mode/parameters/exercises to reduce CAF levels and, eventually, manage sarcopenia. [ABSTRACT FROM AUTHOR]

Body mass index (BMI) is one of the most commonly used anthropometric measurements. BMI is measured by dividing an individual's weight by their height. In the elderly, the aging process causes physiological changes to organ systems as well as body composition. The most noticeable changes occur in the musculoskeletal system--that is, of decreased muscle strength. Handgrip strength is one of the most commonly considered criteria to measure muscle strength. Various factors, including age, gender and anthropometric measurements such as BMI, are known to affect a person's muscle strength. In addition, weight and height affect the handgrip strength of an elderly person. However, whether BMI directly affects handgrip strength in the elderly is still debated. Several studies have stated that BMI has a relationship with handgrip strength in the elderly, while other studies have found no relationship between BMI and handgrip strength. BMI and handgrip strength is still controversial and requires further research. [ABSTRACT FROM AUTHOR]

In this study, the feasibility of Action Observation Training (AOT) in combination with sensor-based measurements in infants at high risk of Unilateral Spastic Cerebral Palsy (UCP) were evaluated. Over a four-week period, eight infants at high risk of UCP performed AOT at home while wearing sensors with assistance of caregivers. Sensor data were compared to clinical assessments of upper limb function, the Hand Assessment for Infants (HAI) and the Mini-Assisting Hand Assessment (Mini-AHA). AOT training time and acceptance by the caregivers were considered as indicators for feasibility. The excellent training adherence and positive feedback of the caregivers showed that the AOT was feasible in this patient group and setting. Sensor measurements were accepted and displayed significant correlations with hand function. These preliminary results indicate the potential of wearable sensors to record upper limb function over the course of AOT for infants at high risk of UCP. Thus, AOT in combination with sensor measurements are proposed as a feasible training tool to complement usual care. [ABSTRACT FROM AUTHOR]

Background/Aim: Lateral epicondylitis (LE), commonly known as "tennis elbow", is a painful inflammatory condition affecting wrist extensor tendons. Various treatments, such as extracorporeal shockwave therapy (ESWT) and neural therapy injections, have been used to alleviate symptoms of LE. However, there is a limited number of comparative studies available. This study aims to compare the effectiveness of sequential neural therapy injections and ESWT in reducing pain and improving functionality in patients with LE. Methods: A retrospective cohort study analyzed data from 128 LE patients. Among them, 30 patients underwent neural therapy, while 30 underwent ESWT, following the exclusion criteria. Pain levels were measured using the visual analog scale (VAS), and functionality was assessed using the Duruöz hand index (DHI) before and after treatment. Results: Both neural therapy injections and ESWT led to substantial reductions in pain and improvements in functionality, with no notable differences observed between the two treatment methods. Additionally, no significant variations were found based on age, body mass index, gender, or the side of the elbow treated. Conclusion: The findings suggest that both neural therapy injections and ESWT are equally effective in managing symptoms of LE. Treatment choice may depend on patient preference, cost, availability, or other factors. Further research is necessary to examine long-term outcomes, potential side effects, and factors predicting a better response to one treatment. [ABSTRACT FROM AUTHOR]

To explore patients' experiences of early active motion flexor tendon rehabilitation in relation to adherence to restrictions and outcome of rehabilitation. Seventeen patients with a flexor tendon injury in one or several fingers participated in qualitative interviews performed between 74 and 111 days after surgery. Data were analysed using directed content analysis with the Health Belief Model (HBM) as a theoretical framework. Perceived severity of hand function and susceptibility to loss of hand function affected the participants' behaviour. A higher perceived threat increased motivation to exercise and be cautious in activities. During rehabilitation, the perceived benefits or efficacy of doing exercise and following restrictions were compared to the cost of doing so, leading to adherence or non-adherence behaviour. Perceived self-efficacy was affected by previous knowledge and varied through the rehabilitation period. External factors and interaction with therapists influenced the perception of the severity of the injury and the cost and benefits of adhering to rehabilitation. Patient's perception of the injury, the effectiveness of exercises, context and social support to manage daily life affected adherence to restriction, motivation and commitment to rehabilitation. The HBM as a theoretical framework can be beneficial for understanding factors that influence patients' adherence. Information regarding the injury and consequences for the patient should be presented at different time points and in different ways, tailored to the patient. It' is important to aid patients to perceive the small gradual improvements in hand function to create motivation to adhere to exercise. Strategies to reduce the cost of adherence in terms of managing everyday life should be addressed by individually based strategies. Instructions regarding exercise and restrictions should be less complex and consider the patient's individual needs. [ABSTRACT FROM AUTHOR]

To identify the impact of kinematic limitations on hand osteoarthritis patients' ability to perform daily living activities. An experiment was performed on 33 patients and 32 healthy subjects. Active ranges of motion (AROM) of 16 hand joint angles were measured, together with scores of different hand tests of dexterity (Box and Block, Nine Hole Peg, Kapandji) and function (Sollerman Hand Function Test, SHFT). Functional ranges of motion (FROM) were recorded during SHFT tasks. Results by task are also reported. Patients' AROM is limited in flexion of thumb carpometacarpal and interphalangeal, and finger metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and in palmar arch. Patients scored worse in gross dexterity and opposition, but only Kapandji score was correlated with AROM limitations. Pain is mostly reported in patients with limited extension of finger MCP and PIP joints. Patients used significantly different FROM in almost all the joints, and needed more time to accomplish the SHFT tasks. AROM measurements can be used as indicators for early diagnosis. Patients use specific strategies to accomplish each task, arising from AROM limitations; some tasks with very extreme postures. The tasks where precision or force are required for thumb are the most affected ones. Active range of motion is an indicator for early hand osteoarthritis diagnosis. Patients' functional ranges are reduced, and thumb opposition and gross dexterity are hindered. Rehabilitation should focus especially on tasks requiring precision and thumb strength. Rehabilitation should favor the improvement of task completion times. [ABSTRACT FROM AUTHOR]

To describe hand use development in children with unilateral cerebral palsy who did/did not participate in constraint-induced movement therapy (CIMT) before 7 years of age. The study included 334 participants (18 months–12 years) who were assessed with 1,565 Assisting Hand Assessments (AHAs) and categorized into no intensive training (NIT), CIMT (18 months–7 years), and Baby-CIMT (<18 months) groups. AHA performance at 18 months (AHA-18) was positively associated with development regardless of training. The CIMT group had lower AHA-18 performance than the NIT group (p =.028), but higher stable limit (p =.076). The age when 90% of development was reached was highest in the CIMT group (p =.014). Although non-significant, the Baby-CIMT group had higher mean curve than NIT and CIMT combined (AHA-18 p =.459, limit p =.477). The CIMT group improved more over time than the NIT group. Intensive training extended the window of development, and Baby-CIMT might promote early development. [ABSTRACT FROM AUTHOR]

Background Stroke is a major ailment that results from hypoxia, ischemia, blockage, or hemorrhage. The recovery of hand functions is an essential goal in stroke patients' recovery. Aim This study aimed to analyze the outcomes of rhythmic auditory stimulation (RAS) and mirror therapy on hand functions, as well as grip strength, in stroke patients. Materials and Methods A quasiexperimental study has been used based on criteria of inclusion, 30 patients were enrolled. The participants were assigned to two groups, 15 patients each. Group A (control group) underwent traditional physiotherapy. Group B (experimental group) underwent RAS and mirror therapy. Both the groups received 20 minutes of treatment, 20 sessions in 1 month. The Action Research Arm Test (ARAT) and hand-held dynamometer were used to evaluate results. Paired t -test has been used to analyze the data with the SPSS software tool. Results The paired t -test results showed that notable distinctions in ARAT mean pretest scores between two groups were not found. A notable change in ARAT results was present between the two groups with mean posttest score and difference in pretest to posttest. No notable distinctions in grip strength results were seen with mean pretest results. But a notable change was found in grip strength results among two groups with mean posttest scores. Conclusion Combining RAS and mirror therapy programs has shown beneficial effects on hand functions, as well as grip strength of stroke patients and can be used as adjunct interventions along with conventional physiotherapy to encourage restoration of hand functions in hemiparetic patients. [ABSTRACT FROM AUTHOR]

Introduction: Carpal tunnel syndrome (CTS) usually occurs bilaterally and in the dominant hand. This study aims to compare the patients with electrophysiologically more advanced CTS in their nondominant hand with patients with more advanced CTS in their dominant hand. Methods: The files of patients with a diagnosis of CTS, verified with electromyography (EMG), registered to EMG laboratory which is a third-level health institute, were scanned retrospectively between October 2021 and December 2021. Missing data were completed by contacting the patients on the phone. The patients included in the study were separated into two groups according to their electrophysiological findings the ones with more advanced CTS in the nondominant hand forming Group 1 and the ones with more advanced CTS in the dominant hand forming Group 2. Results: 124 CTS patients (105 female patients, Group 1 n=58 and Group 2 n=66 patients) were included in the study. The average ages of the patients were 50.7±12 (27-78) in Group 1 and 50.4±10.3 (22-69) in Group 2 (p=0.86). No differences were detected between Group 1 and Group 2 in terms of sex, occupation, smoking, body mass index, and CTS provocation test results. The disease duration was longer in Group 1 CTS patients than in Group 2 (p=0.037). CTS complaints were observed more in the dominant hand in Group 1 patients and were detected more bilaterally in Group 2 patients (p=0.001). Drug use frequency was detected as being higher in Group 1 CTS patients due to hyperlipidemia (p=0.039). Discussion and Conclusion: The reason of visiting a doctor to take longer despite the electrophysiologically more advanced CTS of the nondominant hand might be due to the fact that the complaints with the nondominant hand have a lesser effect in daily lives. Investigation of local reasons with more advanced electrophysiological CTS in the nondominant hand is extremely crucial and therefore, physicians should be vigilant to seek for local reasons. As a result of there is a need for more detailed studies of the local, regional, and systemic causes, with a larger number of patients. [ABSTRACT FROM AUTHOR]

Stress exposure and reactivity may show differential associations with handedness, but shallow phenotyping may influence the current knowledge. Importantly, different handedness measures do not necessarily show high correlations with each other and should not be used interchangeably as they may reflect different dimensions of laterality. Here, data on handedness from 599 participants in the population-based, longitudinal Dortmund Vital Study was used to determine various asymmetry indices. Hand preference was assessed with the Edinburgh Handedness Inventory (EHI) and the lateral preference inventory (LPI) measuring handedness, footedness, earedness, and eyedness. Hand performance was determined using the pegboard test. In addition, data on several dimensions of stress exposure and reactivity, including hair cortisol, and mental well-being was analysed to determine associations with handedness. All handedness measures correlated significantly with each other, with the strongest correlation between the EHI and the LPI handedness score. The EHI and LPI hand measures resulted in the highest effect sizes and most consistent correlations with stress or mental well-being. In contrast, the pegboard test only showed very little association with the stress and mental well-being measures. This highlights the importance of handedness phenotyping. Including preference measures is recommended to disentangle the link between handedness and mental health. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a single session of botulinum toxin type A (BTA) injections into both hands more effectively decreases the frequency of systemic sclerosis–associated Raynaud's phenomenon (SSc‐RP) episodes than placebo. Methods: This multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group phase III trial in patients with SSc‐RP assessed the effect of 50‐unit BTA or placebo injections into the palms of both hands around each neurovascular bundle during 1 session in winter. The primary end point was the between‐group difference in the median change in the number of RP episodes from baseline (day 0) to 4 weeks postinjection. Values between the groups were compared with the Wilcoxon rank‐sum test. Results: The intent‐to‐treat analysis included 46 BTA‐treated patients and 44 placebo recipients. At 4 weeks after assigned treatment injections, the median number of daily RP episodes decreased comparably in the BTA and placebo groups (median change –1 episode/day [interquartile range (IQR) –1.5, 0 episodes/day] and –1 episode/day [IQR –2.5, 0 episodes/day], respectively) (P = 0.77 versus placebo). Moreover, change in Raynaud's Condition Score, quality of life assessed by Health Assessment Questionnaire disability index, and hand function assessed by shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Cochin Hand Function Scale from baseline to follow‐up weeks 4, 12, and 24 did not differ significantly between groups. The BTA group experienced transient hand muscle weakness significantly more frequently (P = 0.003). Conclusion: Neither the primary nor secondary end points were reached, and our results do not support any beneficial effect of palmar BTA injections to treat SSc‐RP. [ABSTRACT FROM AUTHOR]

The results of easily performed, commonly available clinical tests reflect self-reported neurosensory symptoms in victims years after electrical accidents. Objective: Electrical accidents cause both acute and long-term injuries. The care of acute injuries is somewhat standardized, but currently recommendations or assessment tools are not available for assessing the long-term effects of an accident on hand function. Methods: A case-control study of 24 healthy controls and 24 cases, 1 to 5 years after an electrical accident and with self-reported neurosensory symptoms, was performed using three hand-function tests: the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Purdue Pegboard test, and the Shape and Texture Identification test. Results: Compared with the control group, patients received statistically significantly lower scores for the Disabilities of the Arm, Shoulder, and Hand outcome measure and the Purdue Pegboard and for one finger on the Shape and Texture Identification test. Conclusion: Hand function is affected after an electrical accident in individuals with self-reported neurosensory symptoms. [ABSTRACT FROM AUTHOR]

The hand is involved very deeply in our lives in daily activities. When a person loses some hand function, their life can be greatly affected. The use of robotic rehabilitation to assist patients in performing daily actions might help alleviate this problem. However, how to meet individual needs is a major problem in the application of robotic rehabilitation. A biomimetic system (artificial neuromolecular system, ANM) implemented on a digital machine is proposed to deal with the above problems. Two important biological features (structure–function relationship and evolutionary friendliness) are incorporated into this system. With these two important features, the ANM system can be shaped to meet the specific needs of each individual. In this study, the ANM system is used to help patients with different needs perform 8 actions similar to those that people use in everyday life. The data source of this study is our previous research results (data of 30 healthy people and 4 hand patients performing 8 activities of daily life). The results show that while each patient's hand problem is different, the ANM can successfully translate each patient's hand posture into normal human motion. In addition, the system can respond to this difference smoothly rather than dramatically when the patient's hand motions vary both temporally (finger motion sequence) and spatially (finger curvature). [ABSTRACT FROM AUTHOR]

BACKGROUND: Recent initiatives, such as earlier diagnosis and treatment, have enhanced the survival of patients with systemic sclerosis (SSc). Despite these initiatives, there is extreme variability in rehabilitation strategies for these patients. In 2006, the Glittre-ADL test (TGlittre) was developed to evaluate functional capacity using multiple tasks similar to the activities of daily living (ADLs). OBJECTIVES: To evaluate the impact of therapist-oriented home rehabilitation (TOHR) on functional capacity using TGlittre and to examine the effects of TOHR on physical function, hand function, and quality of life (QoL) among women with SSc. METHODS: This quasi-experimental and longitudinal study included 12 women with SSc who underwent TOHR 3 times per week for 12 weeks. Before and after TOHR, functional capacity was assessed using TGlittre, physical function was examined by the Health Assessment Questionnaire Disability Index (HAQ-DI), hand function was evaluated using the Cochin Hand Functional Scale (CHFS) and handgrip strength (HGS), and QoL was evaluated using the Short Form-36 Health Survey Questionnaire (SF-36). RESULTS: When comparing the pre- and post-TOHR values of TGlittre, a significant reduction was found in total time (p = 0.002) and manual time (p = 0.010). There was a nonsignificant decrease in HAQ-DI scores between pre- and post-TOHR (p = 0.07). Regarding hand function, there was a significant reduction in the CHFS between pre- and post-TOHR (p = 0.036), although no significant difference was observed in HGS between pre- and post-TOHR (p = 0.08). Regarding QoL, there was an increase in all SF-36 categories, although physical function was the only category that was significantly increased (p = 0.008). CONCLUSION: After TOHR, patients with SSc are able to more quickly perform TGlittre tasks when considering both total and manual times. TOHR also positively affects manual skills and QoL. [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]

Context: Studies developed the frail elderly handgrip strength (HGS) diagnostic criteria using multiple types of handgrip dynamometers. If different handgrip dynamometers report different values, then this would have the potential to misclassify people into the wrong diagnostic category. Objective: To examine the characteristics of HGS measured by 2 standard handgrip dynamometers and to investigate the influence of hand size on HGS. Setting: University research laboratory. Participants: A total of 87 young and middle-aged adults between the ages of 20 and 60 years participated in this study. Main Outcome Measures: Standard methods of HGS measurements were used for hydraulic and Smedley spring-type dynamometers, although the participants were instructed to maintain an upright standing position in both tests. Results: Test–retest reliability of hydraulic and Smedley dynamometers provided comparable results to that observed with previous studies. However, the difference in HGS between the 2 dynamometers (Hydraulic–Smedley difference) was positively associated (r =.670, P <.001) with the mean of the 2 dynamometers. The participants who had relatively low HGS (at least <35 kg) produced similar HGS values when the 2 dynamometers were compared, whereas persons who had relatively higher HGS (at least >45 kg) produced greater strength values with the hydraulic compared with the Smedley. The hand and palm lengths were weakly correlated (r =.349 and r =.358, respectively, both Ps <.001) with the difference in HGS between the 2 dynamometers. Conclusions: Test–retest reliability of hydraulic and Smedley dynamometers provides comparable results to previous studies. However, the difference in HGS between the 2 dynamometers was positively associated with the mean of the 2 dynamometers. This Hydraulic–Smedley difference would not affect persons who have relatively low HGS (at least <35 kg), while when HGS is relatively high, the comparison between dynamometers should be done with caution. [ABSTRACT FROM AUTHOR]

Introduction: Free flaps are routinely used in head and neck surgery for reconstruction after major ablative procedures. Among these, radial forearm free flap (RFFF) still represents a workhorse. Regarding its harvesting, donor site complications are described, with acute hand ischemia as the most feared one. To evaluate residual hand perfusion through the ulnar axis, several methods are commonly used in clinical practice, such as the modified Allen's test (MAT) and Doppler ultrasound. Nevertheless, contradictory results are not uncommon. Indocyanine green (ICG) fluorescence video-angiography (ICG-VA) is a technique recently introduced in flap surgery to evaluate tissue perfusion, which may be employed during RFFF harvesting to enhance the accuracy of the traditional tests. Patients and Methods: To assess the dual blood supply in the donor site prior to harvesting a RFFF, we performed MAT, Doppler ultrasound, and ICG-VA in a patient suffering from oropharyngeal cancer who underwent major ablative and reconstructive surgery. The technique is described in the Video. Results: Clinical MAT was judged as "positive," highlighting an adequate dual blood supply to the hand, and the upper limb Doppler ultrasound showed a normal blood flow. Similarly, also ICG-VA pointed out a good hand perfusion pattern with a thenar-to-hypothenar ICG ratio of over 25%. Thus, we proceeded with RFFF harvesting without evidence of ischemic complications at the donor site in the postoperative course. Conclusions: ICG-VA represents a safe and useful procedure to reduce donor site morbidity during RFFF harvesting, enhancing the sensitivity of the clinical MAT, and potentially detecting its (rare) false positive results. Level of Evidence: Level V. [ABSTRACT FROM AUTHOR]

Popular topics for upper-body resistance training involve the differences between hand positions, open versus closed chain exercises, and movement variations for the novice to the advanced. It was hypothesized that there will be no difference between closed (push-up) versus open (bench press) chain exercises for the primary muscle group activity nor would there be a difference between push-ups on the toes versus knees with respect to the percent contribution of each muscle. Surface muscle activity was measured for 8 upper-body and core muscles during a sequence of push-up and bench press variations with a normalized weight for 12 active men. Each participant completed push-ups and bench press exercises at each of 3 hand positions. The results demonstrated that there were few differences between closed versus open chain exercises for the primary muscle groups with the exception of core activation. In addition, in general, narrow hand positions yielded greater activation, and there were no significant differences between push-ups on the toes versus knees with respect to the percent contribution for the primary muscle groups. In conclusion, closed chain exercises may be preferred for functional training, and knee push-ups may be ideal as a novice push-up variation. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) can affect hand function since the beginning of the motor symptoms. To compare the ability of different hand function tests to: 1) distinguish individuals with PD from healthy controls; 2) differentiate stages of the disease; and 3) indicate changes over time due to disease progression. Twenty-four individuals with PD (Hoehn and Yahr: I–III) and 24 age- and sex-matched controls performed the Jebsen-Taylor Hand Function Test (JTHFT), the Nine-Hole Peg Test (9HPT), and the maximum grip and the maximum pinch strength tests using their right and left hands. Eight individuals with PD (six females and two males) were reassessed after 18 months. The ROC analyses and Mann–Whitney U tests (for disease progression) using the average performance of the hands were done. Individuals with PD presented worse test performances than controls, except for the writing subtest of the JTHFT and the grip strength test. The JTHFT without the writing subtest (JTHFTnoW) was the most accurate to discriminate PD from controls (AUC = 0.899; sensitivity 75% and specificity 95.8%). The 9HPT and the simulated feeding and moving large, light objects JTHFT subtests were sensitive to distinguish stages, while the 9HPT, the moving small, common objects JTHFT subtest, and the grip strength were sensitive to changes with disease progression. The JTHFTnoW was highly discriminative of the hand function impairments in PD. TwoJTHFT subtests were the most sensitives to distinguish PD stages (i.e. simulated feeding JTHFT subtest) and disease progression (i.e. moving small, common objects JTHFT subtest). [ABSTRACT FROM AUTHOR]

BACKGROUND: Handgrip strength is considered an important interpreter of general health, and hand functions in children. It is mainly influenced by anthropometric determinants and hand dimensions. OBJECTIVE: To assess the handgrip strength and their association with anthropometric determinants, hand circumference, hand span, and hand length among school children in both the dominant and non-dominant hand. METHODS: Anthropometric measurements, hand circumference, hand span, hand length, and grip strength measurements were obtained from 133 school children of both genders aged 6–12 years. A Jamar hand-held dynamometer was used to measure handgrip strength and the hand dimensions with a tape measure in cm. RESULTS: Significant differences were found between the handgrip strength among boys and girls. The dominant hand was found to be sturdier than the non-dominant hand in both genders. We also found a significant correlation of anthropometric determinants and hand dimensions with handgrip strength. Age, BMI, hand circumference, hand span, and hand length had a strong correlation with grip strength (p < 0.01). CONCLUSIONS: The study revealed the reference values and concluded its correlations with hand dimensions among school children aged 6–12 years and this information can serve as a manual for interpretation of handgrip strength measurements in children. [ABSTRACT FROM AUTHOR]

In this paper, we present an unified framework for understanding hand action from the first-person video. The proposed framework composes two main components. The first component estimates three-dimensional (3D) hand joints from RGB images. Two network structures derived from the baseline HopeNet network are proposed: convolutional neural networks (CNNs) which are traditional multi-layer CNN and CNN combining with GraphCNN to perform 3D hand pose estimation, without the use of GraphUNet as in baseline HopeNet method. The second component of the framework recognizes hand action from skeleton stream. We first deploy two recent advanced neuronal networks that are PA-ResGCN and Double-feature Double-motion (DDNet). To focus more on the hand pose changes, we improve DDNet with two normalization strategies of the hand joints. Finally, we fuse PA-ResGCN with our improved DDNet to still boost the recognition performance. We evaluate our proposed methods on First-Person Hand Action Benchmark dataset. Experiments show that our model for 3D hand joints estimation achieves the best precision (36.6 mm). Our hand joint normalization strategies improve the original DDNet from 0.71% to 4.05% of accuracy with the ground-truth hand pose while the improvement is significantly larger (from 2.96% to 10.98%) with the estimated hand pose. The late fusion schemes outperform different state-of-the-art methods for the hand action recognition with the highest accuracy of 86.67%. These experimental results show potential and extendable possibilities for developing practical first-person vision applications. [ABSTRACT FROM AUTHOR]