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Continuous exposure to hand-arm vibration integrated with poor posture and forceful movements are known causes of musculoskeletal disorders (MSD). In most related studies, force and vibration levels in experimental research is controlled. This study aims to determine how actual hand tractor field operation can affect the upper limb of users. It intends to characterize upper limb muscle activation applied during actual hand tractor usage. Lastly, it determines the immediate impacts on hand strength and perceived upper limb discomfort after the operation. We recruited 15 farm operators with a mean working experience of 20.1 ± 12.2 years. They were asked to operate a hand tractor on paddy fields for at most 8 minutes. Handle vibration was measured using a tri-axial accelerometer. The total unweighted vibration acceleration was computed and used to represent the handle vibration magnitude. Muscle activation was measured using surface electromyography (sEMG). Six sEMG sensors were attached to the dominant and non-dominant side of the extensor carpi radialis (ECR), bicep, and deltoid. Pre- and post-task hand strength and subjective discomfort rating were also taken. The total unweighted handle vibration acceleration is 17.45 ± 7.53 m/s2. This exceeds the allowable safe value. Meanwhile, the percentage of maximum voluntary contraction (% MVC) of the muscles ranged from 6% to 14% with the ECR having a significantly higher activation (p <.05) than the bicep and deltoid. The post-task grip strength of the dominant hand was lower than its pre-task value (p <.01) while that of the non-dominant side did not vary significantly. There is a modest trend of higher hand discomfort of the non-dominant side on post-task than pre-task rating (p <.10). Although, overall, the perceived discomfort ranged from none to mild discomfort. In conclusion, the study showed an indication that the effects of vibration on humans are evident even at mild muscle exertion, with the exertion predominantly concentrated on the distal arm area clearly affecting grip strength and hand discomfort. In such cases, future recommendations can revolve around the improvement of the hand tractor handle grip to impose grip comfort and ease. [ABSTRACT FROM AUTHOR]

Introduction: The assessment forms the basis of all hand therapy measures, although various barriers complicate this process. The MoKö was developed to overcome these challenges. It offers a clear selection and arrangement of different assessments and presents the results in a comprehensive visual manner. Method: To answer the research question of whether the MoKö represents a gain for hand assessment, two hypotheses were formed. The first hypothesis states that the MoKö facilitates hand assessment, and the second hypothesis states that it optimizes the planning of the occupational therapy process. For this purpose, an online questionnaire was completed by professionals. Furthermore, suggestions from an open question were analyzed to check for potential adjustments to the MoKö. Results: Out of 322 questionnaires, 215 were included in the analysis. A polarity profile was created to present the results. All defined characteristics of the MoKö received positive ratings. The pre-selection and arrangement of the assessments, as well as the visual presentation of results, were particularly highlighted. Constructive feedback gained from the open question was analyzed and systematically integrated into the MoKö. Results: The study confirms the benefits of the MoKö for hand assessment. Visualization and scoring provide a clear basis for therapy planning. Although a final evaluation with a larger sample is still necessary, the MoKö can be a viable option in the future possibly also in digital formats. [ABSTRACT FROM AUTHOR]

The risk of injury in archery is supposedly low. However, relations between pain, shooting phases and types of bow have not been studied. Understanding the biomechanical mechanisms of archery-related injuries. Online survey for archers from all types of bow. Variables were analyzed using contingency tables and chi-squared tests. 396 surveys were completed. 36.9% of the archers had practiced archery for more than 10 years, 23.3% between 5 and 10 years. Olympic recurve bow was the most commonly used (38.2%), followed by traditional (23.3%) and compound (22.0%). 57.3% of the archers suffered some kind of injury during archery practice. Drawing shoulder (28.2%) and neck/back injuries (19.9%) were the most prevalent, preventing 50.3% of those who suffered them from continuing archery practice. There was a moderate association between drawing arm injuries and symptomatology in the drawing phase, especially in the shoulder region (0.55), elbow (0.20), and hand (0.13), and to a lesser extent in the neck/back (0.28). Our results show that injury chronicity is frequent on archery. Correlations between types of bow, phases of the shoot and areas of pain could be a starting point for future studies on the repercussions of different types of injuries in archery practice. [ABSTRACT FROM AUTHOR]

Propose further indicators for helping to detect hand osteoarthritis (HOA) using either active or functional ranges of motion (AROM or FROM). Hand kinematics data of 16 hand joint angles from previous studies were used, taken from healthy participants and HOA patients with differently affected joints and distinct levels of compromise. Data consisted of: (i) AROM (extreme values and ranges); (ii) FROM while performing the Sollerman Hand Function Test (mean, extreme percentiles and ranges). Two linear discriminant analyses (stepwise method) were conducted, one per dataset (AROM and FROM), with condition (healthy/patient) as the grouping variable. The potential predictors were the data from the joints with significant differences between samples for each analysis (A-predictors and F-predictors). Good sensitivity-specificity values of 85.2–90.9% and 93.8–93.9% for F-predictors and A-predictors, respectively. Sets of predictors corresponded to the joints more commonly affected by HOA. F-predictors: lower maximal flexion of carpometacarpal and interphalangeal thumb joints, higher maximal flexion of thumb metacarpal joint, lower flexion/extension range of ring proximal interphalangeal joint and higher maximal little finger adduction. A-predictors: narrower flexion/extension range of the thumb carpometacarpal joint, lesser extension of the ring metacarpophalangeal joint; lower flexion of the middle finger proximal interphalangeal joint along with a narrower palmar arch range. Both sets of predictors provide discrimination capacity of HOA with good sensitivity-specificity, slightly better for A-predictors. The AROM measurement is technically less demanding and can be clinically applied even with manual goniometry. Range of motion is affected by hand osteoarthritis even before joint deformity is noticeable. Active (AROM) or functional (FROM) ranges of motion can help to identify potential hand osteoarthritis and opening up the possibility of applying rehabilitation treatments to improve quality of life. The AROM measurement is technically less demanding and can be clinically applied even with manual goniometry. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyse secular trend in handgrip strength (HGS) in adolescents using an allometric approach and identify the factors associated. The sample comprised 657 and 1004 adolescents (14 to 19 years) in 2007 and 2017/2018, respectively, of public schools in Florianópolis, Brazil. The dependent variable was HGS normalised to body mass and height. Covariance analysis was used to examine secular trends in HGS, and multiple linear regression was used to identify associated factors. The independent variables were sociodemographic, biological, and behavioural factors. Comparison of HGS between surveys indicated a negative secular trend in both sexes (p < 0.001). In boys, there was a positive association of HGS with age and FFM in both surveys. In 2017/18, there was a positive association with sexual maturation and a negative association with sitting time and fat percentage. In girls, FFM was positively associated with HGS in both surveys. In 2007, there were positive associations of HGS with age and vigorous physical activity, whereas, in 2017/18, negative associations were observed with economic level and sitting time. The findings of the present study show a decline in adolescent HGS. And behavioural changes appear to be contributing to declines in HGS. [ABSTRACT FROM AUTHOR]

Elderly individuals with neurodegenerative diseases, such as Parkinson's disease (PD), may experience difficulties when performing functional tasks. To analyze the handgrip strength, pulling force, and ground reaction forces (GRF) of individuals with and without PD when boarding a bus while performing both simple (ST) and dual tasks (DT). This case-control study addressed 31 individuals with PD (GPD) and 30 healthy individuals (GHI). Assessments were performed in ST and DT situations using a bus model (prototype). Handgrip strength and pulling force were measured in both upper limbs using a dynamometer, and GRF was measured using a force platform. The GPD's and GHI's performances were compared in both ST and DT, and the individuals were classified as fallers according to the Falls Efficacy Scale. In the inter-group comparison, the GPD presented significantly lower maximum force using their right hand, in handgrip strength (30.43 vs. 36.62, P =.022), and pulling force (10.77 vs 12.81, P =.037). The left hand's pulling force proved to be the most demanding for the GPD, during ST (6.35 vs. 4.76, P =.006) and DT (6.32 vs 4.74, P =.008). The GPD also took longer to perform ST (6.14 vs. 4.67, P <.001) and DT (6.08 vs. 4.81, P =.002). Additionally, the GPD was more afraid of falling compared to the GHI (34.74 vs. 24.77, P <.001). Boarding a bus is a complex task for individuals with PD because they present lower maximum strength in the upper limbs and more significant functional expenditure than their healthy counterparts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lumbar stabilization exercises (LSE) provide dynamic trunk stability, promote muscle strength and endurance, and improve low back pain rehabilitation and performance. OBJECTIVE: To clarify the differences in trunk muscle activity during LSEs on stable and different unstable surfaces. METHODS: Fifteen healthy males performed three exercises (elbow-toe, hand-knee, and side bridge) on stable (floor) and unstable surfaces. Muscle activity of the bilateral rectus abdominis, internal oblique, external oblique, and erector spinae were recorded. Data were compared using the Friedman test. Pairwise comparisons were performed using Wilcoxon's signed rank test if significant differences were observed. RESULTS: In the elbow-toe exercise, muscle activity of the rectus abdominis and right internal oblique increased in the following order: floor, low-difficulty, and high-difficulty unstable surface. In the hand-knee exercise, muscle activity of the internal oblique on the lower-extremity elevated side, external oblique, and erector spinae on the upper-extremity elevated side were greater on unstable surface exercise performance. In the side bridge exercise, rectus abdominis muscle activity was highest on a high-difficulty unstable surface. CONCLUSION: Trunk muscle activity increased during exercise on unstable surfaces. Since the effects of unstable surfaces vary depending on muscle and exercise types, exercise difficulty and surface stability must be considered accordingly. [ABSTRACT FROM AUTHOR]

Describing the outcomes of an exercise program on wrist and hand function for patients with midcarpal instability (MCI). This study has a prospective cohort design. Two hundred and thirteen patients with MCI were included. The intervention was a 3-month exercise program consisting of hand therapy and home exercises. The primary outcome was perceived wrist and hand function evaluated with the Patient-Rated Wrist/Hand Evaluation (PRWHE) three months after treatment onset. Secondary outcomes were conversion to surgery, pain, and satisfaction with treatment results. PRWHE total scores improved from 51 ± 19 (mean ± SD) to 33 ± 24 at 3 months (95% CI: 36–30, p < 0.001). All visual analog scales for pain demonstrated clinically relevant improvements at 6 weeks and 3 months (p < 0.001). At 3 months, 81% of the participants would undergo the treatment again. After a median follow-up of 2.8 years, 46 patients (22%) converted to surgery. We found clinically relevant improvements in hand and wrist function and pain. Most participants would undergo treatment again and 78% of the participants did not convert to surgery. Hence, non-invasive treatment should be the primary treatment choice for patients with MCI. Midcarpal instability (MCI) is a disabling condition and treatment options are limited. Patients with MCI can benefit from an exercise program aiming to improve the strength and coordination of the wrist muscles. Participants improved in hand/wrist function and 78% did not convert to surgery. Non-invasive treatment should be the primary treatment choice for these patients. [ABSTRACT FROM AUTHOR]

This study aimed to investigate inter- and intra-athlete technique variability in pre-elite and elite Australian fast bowlers delivering new ball conventional swing bowling. Ball grip angle and pelvis, torso, shoulder, elbow, wrist, upper arm, forearm, and hand kinematics were investigated at the point of ball release for inswing and outswing deliveries. Descriptive evaluations of group and individual data and k-means cluster analyses were used to assess inter- and intra-bowler technique variability. Inter-athlete technique and ball grip variability were identified, demonstrating that skilled bowlers use individualised strategies to generate swing. Functional movement variability was demonstrated by intra-athlete variability in successful swing bowling trials. Bowlers demonstrated stable technique parameters in large proximal body segments of the pelvis and torso, providing a level of repeatability to their bowling action. Greater variation was observed in bowling arm kinematics, allowing athletes to manipulate the finger and ball position to achieve the desired seam orientation at the point of ball release. This study demonstrates that skilled bowlers use individualised techniques and grips to generate swing and employ technique variations in successive deliveries. Coaches should employ individualised training strategies and use constraints-led approaches in training environments to encourage bowlers to seek adaptive movement solutions to generate swing. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hand/instrument motion-tracking in surgical simulation provides valuable data to improve psychomotor skills and can serve as a formative evaluation tool. Motion analysis has been well-studied in laparoscopic surgery; however, there are essentially no studies looking at motion-tracking for flexible ureteroscopy (fURS), a common surgical procedure requiring hand dexterity and 3D spatial awareness. We aimed to design a synchronized motion-tracking and video capture system for fURS capable of collecting objective metrics for use in surgical skills training. METHODS: Motion tracking of the ureteroscope was performed using a motion-tracking platform, inertial measurement units (IMUs), and an optical sensor. Position (x, y, z) and orientation (roll, pitch, yaw) of the ureteroscope handle, lever deflection, and translation of the scope insertion point were collected. Video capture of the operator's hands was collected with a Raspberry Pi camera. All peripherals were controlled on a Raspberry Pi 4 and synchronized to its system clock. RESULTS: Our system demonstrated good accuracy in detecting translation of the ureteroscope in the x- and y-axes, and yaw, pitch and roll of the ureteroscope at discrete orientations of 0, ±30, ±60, and ±90 degrees. Unique to fURS, deflection of the lever was captured by the difference in IMU static accelerations with good accuracy. The optical sensor detected translation of the ureteroscope at the insertion point with good precision and an average error of 5.51%. CONCLUSIONS: We successfully developed a motion-tracking and video-capture system capable of collecting motion-analysis parameters unique to fURS. Future studies will focus on establishing the construct validity of this tool. [ABSTRACT FROM AUTHOR]

Tuberculous dactylitis is infrequently seen after the age of 6 years. The index and middle fingers are the most common sites. Early diagnosis is essential to eradicate the infection. Delay in diagnosis and management leads to extensive involvement which may require surgical intervention. The current literature reveals conservative management gives satisfactory results in early stages. Though surgical intervention in Tuberculous dactylitis is seldom required, delay in diagnosis and management leads to extensive involvement of the bone and sequestration which does not respond to Anti Tubercular Therapy and needs staged surgical interventions. We report a case of an 11-year-old girl who presented to us after extensive involvement of 2nd and 3rd metacarpals and failed to respond to ATT even after 1.5 years of medication. She required staged surgeries to eradicate the infection which led to loss of 2nd and 3rd metacarpals. Complex reconstructive procedures of hand were required in stages and the bone loss was managed with non-vascularized Fibular strut graft. At 2 years of follow up, there is complete incorporation of the graft, and the patient has satisfactory functions of the hand and can carry out activities of daily living with ease. [ABSTRACT FROM AUTHOR]

Most stroke survivors have remaining upper limb impairment six months after stroke and require additional rehabilitation and help from family members to enhance their performance of daily activities. First-person (egocentric) video has been proposed to capture the activities of daily living (ADLs) of stroke survivors in order to assess their hand function at home. This study explored the experiences and expectations of stroke survivors regarding the use of egocentric cameras in daily life for rehabilitation applications. Twenty-one chronic stroke survivors recruited for the study were asked to record three sessions of 1.5 h of video of their ADLs at home over two weeks. Their experiences and expectations after completing the recordings were discussed using a structured questionnaire and a semi-structured interview. The questionnaire and interview data were analysed using descriptive statistics and content analysis, respectively. The results were further integrated using a mixed methods analysis for mutual explanation and elaboration. The themes generated were Camera Usability, Privacy Concerns Related to Home Recordings, Future Use of the Camera in Public, and Information Usefulness. The participants perceived that the camera was easy to use, the information obtained from the recordings was beneficial, and no major concerns about recording at home. A discreet camera and a solution to privacy issues were prerequisites to recording tasks in public. There was high acceptance among stroke survivors regarding the use of wearable cameras for rehabilitation purposes in the future. Concerns to be managed include discomfort, self-consciousness, and the privacy of others. The egocentric camera was easy for the stroke survivors to use at home. However, they expressed a preference for cameras to be less noticeable and lighter in the future to minimize self-consciousness and discomfort. Expectations for future use of an egocentric camera for upper limb rehabilitation at home from the perspectives of stroke survivors included receiving feedback on their hand function in daily life and guidance on how to improve function. Privacy concerns of stroke survivors regarding recording activities of daily living were mostly avoidable by planning in advance. However, some personal hygiene tasks and virtual meetings were recorded by accident. A checklist of common activities that may raise privacy issues can be provided along with the camera to serve as a reminder to avoid these issues. [ABSTRACT FROM AUTHOR]

Background: The objective was to investigate self-reported hand eczema, and skin complaints at other skin locations among workers exposed to particulate matter, especially ultrafine particles. Method: We conducted a cross-sectional study on workers from one ferro-silicon smelter plant, eight chimney sweeper stations and one firefighter station across Norway. Participants answered an extended version of the Nordic Occupational Skin Questionnaire (NOSQ-2022), with additional questions about whole-body skin complaints and visible dust deposition. Results are presented as descriptive data using firefighters as reference group. Odds ratio (OR) was calculated using logistic regression on lifetime prevalence of hand eczema adjusted for potential confounders and mediators. P-values were calculated using likelihood ratio test against the crude OR. Results: A total of 186 participants answered the questionnaire: 74 chimney sweepers, 52 firefighters and 60 smelter workers. Participation rate was 95.0, 94.5 and 63.6%, respectively. Lifetime prevalence of hand eczema was 9.5, 9.6, and 28.3%, respectively. The point prevalence of hand eczema was 1.4, 1.9 and 10.0%, respectively. We estimated OR for lifetime hand eczema in smelter workers to 4.36 [95% CI: 1.31–14.43, p = 0.016] and for lifetime skin complaints in other locations to 2.25 [95% CI: 0.98–5.18, p = 0.058]. The lifetime prevalence of skin complaints at other locations was 18.9, 23.1 and 40.0%, respectively. The point prevalence was 14.9, 9.6 and 16.7%, respectively. These estimates were not statistically significant but indicates that smelter workers have more skin complaints also at other locations. Conclusion: This study reports a more than four-fold increased risk of hand eczema in smelter workers, and possibly a higher risk of skin complaints in other body locations, compared to the other occupations. Longitudinal studies with larger population are needed to verify the marked increased risk of eczema among smelters and establish causation. [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]

Intellectual disability (ID) is a public health challenge affecting communities worldwide. ID is characterized by impaired physical and cognitive functioning and less engaged in physical activities. The objective of this study was to assess the impact of adaptive yoga practices on cognitive and motor abilities in the subjects with ID. Sixty-six subjects with mild and moderate IDs were purposively selected and randomly divided into experimental and control groups, with 33 subjects in each group. One month of adaptive yoga module was provided to the experimental group. To assess the impact of the yoga intervention, Functional Reach Test (FRT), Wall Toss Test (WTT), Finger Tapping Test (FTT), Sit-- Reach Test (SRT), and Six Letter Cancellation Test (SLCT) were administered. The experimental group showed a statistically significant improvement with P < 0.05 across all the parameters, whereas the control group could not observe a significant improvement. Based on the results, this study concludes that "one month of adaptive yoga module" delivered impact and helped to improve the dynamic balance, eye--hand coordination, neuro-motor function, spinal flexibility, and selective attention in ID-afflicted subjects. [ABSTRACT FROM AUTHOR]

To assess the feasibility and effects on manual dexterity and the quality of life (QoL) of a 12-week home calligraphic training program in patients with Parkinson's disease (PD). A pilot study with participants recruited from the Movement Disorders consultation at the Hospital 12 de Octubre (Madrid). The main outcome, manual dexterity, was assessed using the Purdue Pegboard Test (PPT). Secondary outcomes included clinical rating scales that contemplate aspects related to manual dexterity (DextQ-24, UPDRSII, UPDRSIII), and QoL (PDQ-39 and EuroQoL-5D). Thirty PD patients (57% males) with a mean age of 66.11 (9.76) years and 93% adherence rate. The PPT scores improved significantly (p < 0.0001) from T0 (start of the study) to T1 (after 24 weeks). No statistically significant change was found in DextQ-24, UPDRS-II and UPDRS-III, but a clear improvement was observed in the QoL measurement: EuroQoL-5D (p < 0.0001), PDQ-39 (p < 0.0001) and modified PDQ-39 (p = 0.022). This is the first study to demonstrate the feasibility and improvement in hand dexterity assessed by the PPT for patients diagnosed with PD after a 12-week home calligraphic training program. A significant improvement was noted in the QoL measurements, such as the PDQ-39, modified PDQ-39, and EuroQoL-5D. Most patients with Parkinson's disease suffer from impaired manual dexterity, making it difficult to perform activities of daily living such as eating, buttoning, or shaving. A 12-week home calligraphic training program could improve hand dexterity in these patients. The advantage of this home calligraphic trainingis is that it is an easy-to-perform, low-cost and no side effects. This training also improves their quality of life. [ABSTRACT FROM AUTHOR]

Background: This study evaluates the association between ICUC trauma and short-form Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) scores among patients who underwent surgery for distal radius fractures. Methods: This research gathered patient-reported outcomes (PROs) from patients registered in the ICUC database at a single trauma center. The study involved 76 adult patients who underwent surgical treatment for distal radius fractures before 2023. These patients received a volar locking plate for their distal radius fracture. The research utilized two different PROs to evaluate the patients' conditions. The ICUC trauma score measures functional impairment and pain through two 5-point scale questions, allowing patients to self-assess these aspects. The Quick DASH, comprising 11 questions, was used to evaluate symptoms and functionality of the upper extremity. Results: For patients aged 55.9 ± 15.3 years and 4.6 ± 3.9 years post-op follow-up, the ICUC trauma score was 0.70 ± 0.95, and Quick DASH was 6.07 ± 10.35. A strong correlation between ICUC and Quick DASH was identified (r = 0.71, P < 0.01). The interaction between the ICUC trauma score and age at the surgery to Quick DASH revealed a significant unstandardized partial regression coefficient of 0.19 (95% confidence interval 0.08–0.31; P < 0.01). Conclusion: This study demonstrated a strong correlation between the ICUC trauma score and the Quick DASH among patients, especially the elderly. It was noted that an elevation in the ICUC trauma score is linked to a more marked increase in the Quick DASH score, particularly in older patients. Given its simplicity and efficacy, the ICUC trauma score may be a viable alternative to the Quick DASH for assessing the patient's clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Preterm children with cerebral palsy (CP) often have varying hand dysfunction, while the specific brain injury with periventricular leukomalacia (PVL) cannot quite explain its mechanism. We aimed to investigate glymphatic activity using diffusion tensor image analysis along the perivascular space (DTI-ALPS) method and evaluate its association with brain lesion burden and hand dysfunction in children with CP secondary to PVL. Methods: We retrospectively enrolled 18 children with bilateral spastic CP due to PVL and 29 age- and sex-matched typically developing controls. The Manual Ability Classification System (MACS) was used to assess severity of hand dysfunction in CP. A mediation model was performed to explore the relationship among the DTI-ALPS index, brain lesion burden, and the MACS level in children with CP. Results: There were significant differences in the DTI-ALPS index between children with CP and their typically developing peers. The DTI-ALPS index of the children with CP was lower than that of the controls (1.448 vs. 1.625, P = 0.003). The mediation analysis showed that the DTI-ALPS index fully mediated the relationship between brain lesion burden and the MACS level (c′ = 0.061, P = 0.665), explaining 80% of the effect. Conclusion: This study provides new insights into the neural basis of hand dysfunction in children with CP, demonstrating an important role of glymphatic impairment in such patients. These results suggest that PVL might affect hand function in children with CP by disrupting glymphatic drainage. [ABSTRACT FROM AUTHOR]

Objective The objectives of this study were to establish the short-term feasibility and usability of wrist-worn wearable sensors for capturing the arm and hand activity of people with stroke and to explore the association between factors related to the use of the paretic arm and hand. Methods Thirty people with chronic stroke were monitored with wrist-worn wearable sensors for 12 hours per day for a 7-day period. Participants also completed standardized assessments to capture stroke severity, arm motor impairments, self-perceived arm use, and self-efficacy. The usability of the wearable sensors was assessed using the adapted System Usability Scale and an exit interview. Associations between motor performance and capacity (arm and hand impairments and activity limitations) were assessed using Spearman correlations. Results Minimal technical issues or lack of adherence to the wearing schedule occurred, with 87.6% of days procuring valid data from both sensors. The average sensor wear time was 12.6 (standard deviation [SD] = 0.2) hours per day. Three participants experienced discomfort with 1 of the wristbands, and 3 other participants had unrelated adverse events. There were positive self-reported usability scores (mean = 85.4/100) and high user satisfaction. Significant correlations were observed for measures of motor capacity and self-efficacy with paretic arm use in the home and the community (Spearman correlation coefficients = 0.44–0.71). Conclusions This work demonstrates the feasibility and usability of a consumer-grade wearable sensor for capturing paretic arm activity outside the laboratory. It provides early insight into the everyday arm use of people with stroke and related factors, such as motor capacity and self-efficacy. Impact The integration of wearable technologies into clinical practice offers new possibilities to complement in-person clinical assessments and to better understand how each person is moving outside of therapy and throughout the recovery and reintegration phase. Insight gained from monitoring the arm and hand use of people with stroke in the home and community is the first step toward informing future research with an emphasis on causal mechanisms with clinical relevance. [ABSTRACT FROM AUTHOR]

The aim of the study was to assess neuromuscular changes during an intermittent fatiguing task designed to replicate fundamental actions and ergonomics of road race motorcycling. Twenty-eight participants repeated a sequence of submaximal brake-pulling and gas throttle actions, interspaced by one maximal brake-pulling, until failure. During the submaximal brake-pulling actions performed at 30% MVC, force fluctuations, surface EMG, maximal M-wave (Mmax) and H-reflex were measured in the flexor digitorum superficialis. At the end of the task, the MVC force and associated EMG activity decreased (P <0.001) by 46% and 26%, respectively. During the task, force fluctuation and EMG activity increased gradually (106% and 61%, respectively) with respect to the pre-fatigue state (P ≤0.029). The Mmax first phase did not change (P ≥0.524), whereas the H-reflex amplitude, normalized to Mmax , increased (149%; P ≤0.039). Noteworthy, the relative increase in H-reflex amplitude was correlated with the increase in EMG activity during the task (r =0.63; P <0.001). During the 10-min recovery, MVC force and EMG activity remained depressed (P ≤0.05) whereas H-reflex amplitude and force fluctuation returned to pre-fatigue values. In conclusion, contrarily to other studies, our results bring forward that when mimicking motorcycling brake-pulling and gas throttle actions, supraspinal neural mechanisms primarily limit the duration of the performance. [ABSTRACT FROM AUTHOR]

Purpose: The reconstruction of medium-sized soft tissue defects of the fingertip remains a challenge for hand surgeons. The aim of this study was to compare the outcomes of modified triangular neurovascular unilateral advancement flap and digital artery dorsal perforator flap in the treatment of this injury. Methods: From May 2018 to May 2022, 70 patients with medium-sized volar soft tissue defects were enrolled. The patients were divided into two groups based on the flap type: modified triangular neurovascular unilateral advancement flap (Group A) and digital artery dorsal perforator flap (Group B). The debridement times, defect size, operation time, and flap survival rate were recorded. At follow-up, hand function, aesthetics, and complications were evaluated. Function was evaluated using the TAM score. The aesthetics of the reconstructed and donor sites were assessed using the vancouver scar scale (VSS). The static two-point discrimination of the finger pulp served as a measure of tactile agnosia. Results: A total of 10 patients were lost to follow-up for various reasons, resulting in 30 cases remaining in each group. The general information of the two groups showed no significant differences in age, sex, injury side, cause of injury, time from injury to surgery, and operation time (P > 0.05). Additionally, the debridement times and size of the defect were similar between the groups (P > 0.05). However, the operation time was significantly shorter in Group A compared to Group B (P = 0.001). With regard to complications, there was no significant difference between them. At one-month follow-up, TAM scores indicated that Group B performed significantly better than Group A. However, at the final follow-up period, there was no significant difference in TAM scores between the two groups. When considering the VSS, significant differences were observed between the two groups in both the reconstructed site and donor site. Conclusion: Both flaps can effectively repair medium-sized fingertip defects. Furthermore, the modified triangular neurovascular unilateral advancement flap offers anatomical reconstruction possibilities, ensuring satisfactory sensation and cosmetic contour. [ABSTRACT FROM AUTHOR]

Muscle strength decline and vitamin D deficiency are coexisting conditions associated with multiple adverse health outcomes. This prospective study aimed to investigate the multiplicative and additive interactions between handgrip strength (HS) and serum 25-hydroxyvitamin D [25(OH)D] on all-cause mortality in Chinese community-dwelling older adults. This is a population-based cohort study. 2635 older adults (85.15 ± 12.01 years) were recruited from the Chinese Longitudinal Healthy Longevity Survey (2012–2018). Low HS was defined according to the Asian Working Group for Sarcopenia 2019 updated consensus (<28 kg for men and <18 kg for women). Serum 25(OH)D < 50 nmol/L were defined as vitamin D deficiency. Cox proportional hazard models were used to examine the association of HS and 25(OH)D with all-cause mortality. Socio-demographics, health status, and clinical characteristics were included as covariates. 1715 (65.09 %) and 1885 (71.54 %) participants had low HS and vitamin D deficiency, respectively. During a median follow-up of 3.52 years, 1107 older people died. After multivariable adjustment, both HS and 25(OH)D levels were inversely associated with all-cause mortality risk (Ps < 0.001). The hazard ratios (HRs) of low HS and vitamin D deficiency for all-cause mortality were 1.73 (95 % CI: 1.41–2.13) and 1.61 (95 % CI: 1.32–1.93), respectively. Although significant multiplicative interactions were not found, the association between low HS and all-cause mortality was attenuated in the higher 25(OH)D subgroup than in the lower 25(OH)D subgroup (stratified by 50 nmol/L). The multiple-adjusted HR of mortality for combined low HS and vitamin D deficiency was 2.18 (95 % CI: 1.73–2.56), which was higher than that for these two conditions alone. Significant additive interactions between low HS and vitamin D deficiency on mortality were observed (relative excess risk due to interaction: 0.71, 95 % CI: 0.37–1.05). Low HS and low 25(OH)D levels synergistically increased the risk of all-cause mortality. Our results added new insights to the priority of early detection for older adults with comorbid muscle strength decline and vitamin D deficiency. [ABSTRACT FROM AUTHOR]

Objective: This study described the effects of applied force (grip) on vascular and sensorineural function in an animal model of hand-arm vibration syndrome (HAVS). Methods: Rat tails were exposed to 0, 2, or 4 N of applied force 4 hr/d for 10 days. Blood flow and sensitivity to transcutaneous electrical stimulation and pressure were measured. Results: Applied force increased blood flow but reduced measures of arterial plasticity. Animals exposed to force tended to be more sensitive to 250-Hz electrical stimulation and pressure applied to the tail. Conclusions Effects of applied force on blood flow and sensation are different than those of vibration. Studies examining co-exposures to force and vibration will provide data that can be used to determine how these factors affect risk of workers developing vascular and sensorineural dysfunction (ie, HAVS). [ABSTRACT FROM AUTHOR]

BACKGROUND: In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. OBJECTIVE: This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. METHODS: The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49–72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. RESULTS: The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. CONCLUSION: The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP. [ABSTRACT FROM AUTHOR]

Immersive Virtual Reality (VR) systems allow for highly repetitive tasks to be performed within a virtual environment that increases practice in home environments. VR can increase access to rehabilitation by reducing access barriers. However, rehabilitation outcomes between immersive VR systems and conventional physical rehabilitation are not well understood. The purpose of this case study was to assess the use of a custom clinically based VR simulation for testing gross hand dexterity with an individual with chronic stroke. The participant performed the box and blocks test (BBT) in an immersive VR environment and a physical environment. Three trials of the BBT were performed with their less-affected and affected hands each in both environments while measuring cortical activity using fNIRS. Rests were given between trials and environment conditions. Our results show that there was no statistical difference in the number of blocks moved between the physical and VR BBT for both the affected and less-affected hands. Furthermore, our results also indicate no statistically significant difference between the physical BBT and VR BBT conditions on contralateral motor cortex activation, suggesting that cortical involvement is comparable between physical and VR conditions. These results suggest that an immersive VR system may be able to elicit functional and motor cortex activations that are comparable to the conventional physical BBT. Importantly, these findings highlights the potential benefits of VR therapy as a remote therapy intervention and/or to increase the effectiveness and practicality of current in-person rehabilitation programs. These findings highlight the potential benefits of immersive virtual reality as a remote therapy intervention. Immersive virtual reality use has potential benefits to increase the effectiveness and practicality of current in-person rehabilitation programs. [ABSTRACT FROM AUTHOR]

Laterality is considered relevant to performance in combat sports with particular emphasis being placed on fighters' handedness and combat stance. Such approach, however, may fall too short to understand the role of laterality in sports where fighters are allowed to use their hands and feet standing and on the ground. Here, we referred to grappling sports (i) to estimate lateral preferences in selected combat situations and (ii) to test for an association between those preferences and common measures of hand and foot preference. Based on the responses of 135 experienced grapplers who participated in an online questionnaire lateral preference, at the group-level, was revealed in 12 out of 18 combat situations. At an item-level, common measures of lateral preference and grappling-specific lateral preference were related in three out of 36 conditions (footedness only, not handedness). Across items, scores in a grappling-specific laterality index were positively related with foot but not with hand preference scores. Implications for the assessment of lateral preference in combat sports and the use of item-specific terminology in this context are discussed. On a broader scale, we also elaborate on potential consequences of our findings with regard to evolutionary explanations of the maintenance of left-handedness in humans. [ABSTRACT FROM AUTHOR]

To examine whether accelerometry can quantitate asymmetry of upper limb activity in infants aged 3–12 months at risk for developing unilateral spastic cerebral palsy (USCP). A prospective study was performed in 50 infants with unilateral perinatal brain injury at high risk of developing USCP. Triaxial accelerometers were worn on the ipsilateral and contralesional upper limb during the Hand Assessment for Infants (HAI). Infants were grouped in three age intervals (3–5 months, 5–7.5 months and 7.5 until 12 months). Each age interval group was divided in a group with and without asymmetrical hand function based on HAI cutoff values suggestive of USCP. In a total of 82 assessments, the asymmetry index for mean upper limb activity was higher in infants with asymmetrical hand function compared to infants with symmetrical hand function in all three age groups (ranging from 41 to 51% versus − 2–6%, p < 0.01), while the total activity of both upper limbs did not differ. Upper limb accelerometry can identify asymmetrical hand function in the upper limbs in infants with unilateral perinatal brain injury from 3 months onwards and is complementary to the Hand Assessment for Infants. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the construct validity of the Both Hands Assessment (BoHA) using activity of the upper limbs as detected by accelerometry in children with bilateral cerebral palsy (CP). Observational study of children with CP (n = 44, n = 27 boys, aged 9.1 ± 1.6 years; Manual Ability Classification Scale I: n = 15, II: n = 22, III: n = 7) completing a BoHA assessment while wearing a triaxial accelerometer on each wrist. BoHA Each-Hand sub-scores, BoHA percentage difference between hands, BoHA Units, mean activity for each hand, mean activity asymmetry index and total mean activity were calculated. Linear regressions were used to analyze associations between measures. There were significant, positive associations between BoHA Units and total mean activity (B = 0.86, 95%CI: 0.32, 1.40), BoHA Percentage difference between hands and mean activity asymmetry index (B = 0.95, 95%CI: 0.75,1.15), and BoHA Each-Hand sub-score and mean activity for the non-dominant hand (B = 1.71, 95%CI: 1.16, 2.28), but not the dominant hand (B = 0.50, 95%CI: −0.45, 1.45). This study provides further evidence for the construct validity of the BoHA as a measure of upper limb performance. Wearable wrist sensors such as accelerometers capture and quantify gross upper limb movement in children with CP but cannot measure fine finger movements captured by the BoHA. Australian New Zealand Clinical Trials Registry (ACTRN12616001488493 and ACTRN12618000164291) [ABSTRACT FROM AUTHOR]

Aims: To describe self‐care capabilities among children with cerebral palsy (CP) and explore associations between self‐care and hand function for children with unilateral cerebral palsy (UCP) and children with bilateral cerebral palsy (BCP) separately. Method: Cross‐sectional data on self‐care capabilities (Pediatric Evaluation of Disability Inventory, PEDI), manual abilities (Manual Ability Classification System, MACS) and hand use during bimanual performance (Assisting Hand Assessment, AHA; Both Hands Assessment, BoHA) were retrieved from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP). Eighty‐seven children with CP (UCP, n = 61, mean age 4 years 1 month, SD 1 year 3 months, range 56) or BCP (n = 26, mean age 4 years 4 months, SD 1 year, range 41), classified at MACS level I (n = 26), II (n = 40) or III (n = 21), were included. Results: No significant differences in self‐care capabilities were found between children with UCP and children with BCP. Analysis of variance showed significant differences in self‐care between MACS levels for the whole group. No significant differences in self‐care between MACS levels were observed for children with UCP (p = 0.36), but significant differences were found for those with BCP (p < 0.001). Whereas a small correlation (r = 0.3) between PEDI and AHA scores was found for children with UCP, a large correlation (r = 0.6) was found for those with BCP. Children with BCP with symmetric hand use during bimanual performance (BoHA) had higher PEDI scores than children with asymmetric hand use. Conclusion: Though children with UCP and children with BCP who were classified at MACS I–III exhibited similar self‐care capabilities, the limited hand use seems to contribute differently between the two groups. The two different measures of hand use exhibit different associations with self‐care capabilities for young children with UCP and BCP, respectively, and illustrate the need to treat UCP and BCP as two distinct groups, each requiring tailored interventions according to their specific needs. [ABSTRACT FROM AUTHOR]

This study aimed to assess kinematic and kinetic changes in front crawl with various stroke frequency (SF) conditions to investigate why swimming velocity (SV) does not increase above a certain SF (SFmax). Eight male swimmers performed 20 m front crawl four times. The first trial involved maximal effort, whereas SF was controlled during the next three trials. The instructed SFs were 100 (T100%), 110 (T110%), and 120% (T120%) of the SFmax. Through pressure measurement and underwater motion analysis, hand propulsive force (calculated by the difference between the palm and dorsal pressure value and the hand area) and the angle of attack of the hand were quantified, and differences between trials were assessed by a repeated-measures ANOVA. There was no difference in SV between the conditions, while the angle of attack during the latter half of the underwater stroke at T120% was smaller by 25.7% compared with T100% (p = 0.007). The lower angle of attack induced a lower pressure value on the palm that consequently caused a smaller hand propulsive force at T120% than T100% (p = 0.026). Therefore, the decrease in the angle of attack must be minimised to maintain the hand propulsive force. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify how elite artistic (synchronised) swimmers generate fluid forces with their hands during two kinds of sculling motions: flat sculling in the back-layout position and support sculling in the vertical position. We used the pressure-distribution measuring method to estimate unsteady fluid forces acting on the hand during sculling motions performed by seven elite artistic swimmers. In addition, we simultaneously analysed sculling motions using three dimensional-direct linear transformation methods. We found that sculling motions continuously generated fluid forces that are large during the stroke phase and small during the transition phase. Lift force was efficiently generated, and a large upward propulsive force was obtained during the stroke phase in both flat and support sculling. During the outside transition from out- to in-sculling, the net vertical load (= gravitational force—buoyant force) was supported by the drag force. In both flat and support sculling, artistic swimmers generated an even fluid force in the upward direction during the in-sculling and out-sculling phases to maintain a stable position. [ABSTRACT FROM AUTHOR]

Purpose: Patients with scar contracture deformities caused by hand burns were treated with an exoskeleton manipulator system, which was equipped with games to explore its clinical application value. Methods: Twenty patients who were treated for post-burn scars of bilateral hands between October 2020 and June 2021 were selected (ChiCTR2000036232). The patients were divided into two groups: control, 10 patients (traditional outpatient treatment); and experimental, 10 patients (exoskeleton manipulator system treatment). We compared the change in the total active motion (TAM) value, grip strength, scar improvement, and postoperative pain improvement. Results: After 3 months of rehabilitation training, the improvement of thumb TAM was 33.80 ± 11.38 ° in the experimental group and 23.2 ± 6.13 ° in the control group. With respect to the index finger TAM, the improvement in the experimental and control groups was 84.50 ± 30.96 ° and 54.80 ± 15.89 °, respectively. The middle finger TAM of the experimental and control groups improved by 86.75 ± 32.85 ° and 60.25 ± 17.97 °, respectively. However, improvement of grip strength, scar score, and pain score were similar between the two groups. Conclusions: The exoskeleton manipulator system has excellent effects in improving burned hand joint movement, which is suitable for hand burn patients and has beneficial clinical effects. [ABSTRACT FROM AUTHOR]

Objective: The wrist is the second most commonly involved location for GCTB, while distal ulna is a relatively rare location and limited evidence exists on which surgical approaches and reconstruction techniques are optimal. We carried out a multicenter retrospective study to evaluate the recurrence rate of distal ulna GCTB and the long-term functional outcomes of different surgery options. Methods: All 28 patients received surgical treatment for distal ulna GCTB in one of three tertiary bone tumor centers between May 2007 and January 2021 with a minimum two-year follow-up. Surgical options included intralesional curettage or en bloc resection (one of 3 types). Functional outcomes were assessed by the MSTS score, the QuickDASH instrument, MWS, and MHQ according to the latest treatment. Results: Overall recurrence rate was 14.2%. The curettage group (N = 7) had a significantly higher recurrence rate compared to en bloc resection (N = 21) (42.9% vs 4.8%) (mean follow-up: 88.8 mo). Seven patients received the Darrach procedure, 5 received the original Sauvé–Kapandji procedure, and 9 received the modified Sauvé–Kapandji procedure with extensor carpi ulnaris (ECU) tenodesis. Of the 4 patients having a recurrence, 1 received the Darrach EBR, 2 received the modified Sauvé–Kapandji procedure, and 1 received resection for soft tissue recurrence. Only MWS and esthetics in the MHQ scores were different (curettage, Darrach, Sauvé–Kapandji, and Sauvé–Kapandji with ECU tenodesis [MWS: 96.5 ± 1.3 vs 91.5 ± 4.7 vs 90.8 ± 2.8 vs 91.5 ± 3.6; esthetics in MHQ: 98.5 ± 3.1 vs 89.9 ± 4.7 vs 93.8 ± 4.4 vs 92.6 ± 3.8], respectively). Conclusions: En bloc resection for distal ulna GCTB had a significantly lower recurrence rate compared with curettage and achieved favorable functional outcome scores. Given the higher recurrence rate after curettage, patients should be well informed of the potential benefits and risks of selecting the distal radioulnar joint-preserving procedure. Moreover, reconstructions after tumor resection of the ulna head do not appear to be necessary. [ABSTRACT FROM AUTHOR]

The initial stride down the mound is an important aspect of the baseball pitch. Understanding the implications of stride length is essential to appropriately coach baseball pitchers. The purpose of this study was to determine the association between normalised stride length and the elbow varus and glenohumeral internal rotation moments, ball velocity, trunk and pelvic rotation and forward trunk tilt. Motion analysis data collected from 99 collegiate pitchers were analysed for this study. A random intercept, mixed-effects regression model was used to determine if there were statistically significant associations between normalised stride length and the variables of interest. Secondary analyses were conducted to determine if an optimal stride length existed in this cohort. No significant associations were found between normalised stride length, ball velocity, or upper extremity joint moments. Additionally, no optimal stride length was identified; however, trends indicate that stride lengths between 131%–137% of a pitcher's leg length may be beneficial. Normalised stride length was associated with both trunk and pelvic rotation at foot contact (p < 0.001). Trunk and pelvic rotation has been previously shown to be associated with ball velocity and joint moments, indicating that stride length may have an indirect effect on ball velocity and joint moments. [ABSTRACT FROM AUTHOR]

Background: Caregivers are at a high risk of musculoskeletal injuries. Efficiency in handling and changing patients' absorbent incontinence products may reduce the burden of caring. Aims: This study aimed to compare various types of absorbent incontinence products from an ergonomic perspective and assess the length of time required for handling these products and the physical demand on caregivers' backs, hands and fingers. Methods: A within-subject design was selected for two studies involving 64 experienced nurses. The first study was conducted at a test centre in Germany, while the second was performed at a hospital in France. Objective data, such as the time required to apply or change a product and physical stress on the back and hands/wrists, as well as users' subjective assessment of product handling were investigated. Findings: Both objective and subjective assessments showed that elastic slips were superior to other slip products. The traditional and belted slips were the second-best products in the objective and subjective assessments respectively. Conclusion: Choice of incontinence product influences the time required and the physical demands associated with handling. Both aspects can be considerably reduced with the use of appropriate absorbent incontinence products. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To explore the causes and consequences of cortical visual impairment in people with learning disabilities • To understand better how to recognise visual perception issues in people with learning disabilities • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Sight issues, which can be eye-related or brain-related, are common among people with learning disabilities. Premature birth or subsequent developmental delays can cause damage to the areas of the brain that process vision, leading to cortical visual impairment. Eye-related and brain-related sight issues can manifest as impaired visual perception causing, for example, difficulties with light perception, colour perception, object perception or movement perception. People with learning disabilities may display behaviours indicative of visual perception issues, but such behaviours are often ignored or misinterpreted. This article explains the causes and consequences of cortical visual impairment, describes visual perception issues that commonly arise from ocular/retinal or cortical causes, and outlines how learning disability nurses can detect the presence of visual perception issues in service users. [ABSTRACT FROM AUTHOR]

Lateral epicondylitis, also known as tennis elbow, is a major health issue among tennis players. This musculo‐skeletal disorder affects hand extensor tendons, results in substantial pain and impairments for sporting and everyday activities and requires several weeks of recovery. Unfortunately, prevention remains limited by the lack of data regarding biomechanical risk factors, especially because in vivo evaluation of hand tendon forces remains challenging. Electromyography‐informed musculo‐skeletal modeling is a noninvasive approach to provide physiological estimation of tendon forces based on motion capture and electromyography but was never applied to study hand tendon loading during tennis playing. The objective of this study was to develop such electromyography‐informed musculo‐skeletal model to provide new insight into hand tendon loading in tennis players. The model was tested with three‐dimensional kinematics and electromyography data of two players performing forehand drives at two‐shot speeds and with three rackets. Muscle forces increased with shot speed but were moderately affected by racket properties. Wrist prime extensors withstood the highest forces, but their relative implication compared to flexors depended on the player‐specific grip force and racket motion strategy. When normalizing wrist extensor forces by shot speed and grip strength, up to threefold differences were observed between players, suggesting that gesture technique, for example, grip position or joint motion coordination, could play a role in the overloading of wrist extensor tendons. This study provided a new methodology for in situ analysis of hand biomechanical loadings during tennis gesture and shed a new light on lateral epicondylitis risk factors. [ABSTRACT FROM AUTHOR]

Volunteering is a popular activity among middle-aged and older adults as means to contribute to the society and to maintain personal health and wellbeing. While the benefits of volunteering have been well-documented in the current literature, it does not tend to distinguish between various types of volunteering activities. This cross-sectional study aims to compare the effects of instrumental (e.g. food preparation, fundraising) and cognitively demanding volunteering activities (e.g. befriending, mentoring) in a sample of 487 middle-aged and older Hong Kong Chinese adults. Participation in instrumental and cognitively demanding volunteering, life satisfaction, depressive symptoms, cognitive functioning and hand-grip strength were measured. The results of two-way between-subject robust analyses of variance demonstrated significant main effects of volunteering type and their interaction effect with age on life satisfaction and depressive symptoms. Comparisons among four volunteering groups (no volunteering, instrumental volunteering, cognitively demanding volunteering and both types) revealed that individuals engaging in instrumental volunteering exhibited lower life satisfaction and more depressive symptoms compared to those who engaged in cognitively demanding volunteering and those who did not volunteer at all. This detrimental pattern of instrumental volunteering was only seen in middle-aged adults, but not in older adults. Findings of this study revealed distinctive effects of two volunteering types, and provide valuable directions for designing future volunteering programmes. [ABSTRACT FROM AUTHOR]

Purpose The objective of this study was to compare the effects of ten commercially available instrument handle designs' mass and diameter on forearm muscle activity during a simulated periodontal scaling experience. Methods A convenience sample of 25 registered dental hygienists were recruited for this IRB-approved study. Ten commercially available instruments were categorized into four groups based on their masses and diameters: large diameter/light mass, small diameter/light mass, large diameter/heavy mass, and small diameter/heavy mass. Participants were randomized to four instruments with one from each group. Participants scaled with each instrument in a simulated oral environment while muscle activity was collected using surface electromyography. Muscle activity was compared among the four instrument group types. Results Muscle activity of the flexor digitorum superficialis was not significantly influenced by instrument mass (p=0.60) or diameter (p=0.15). Flexor pollicis longus muscle activity was not significantly influenced by instrument mass (p=0.81); diameter had a significant effect (p=0.001) with smaller diameter instruments producing more muscle activity. For the extensor digitorum communis and extensor carpi radialis brevis, instrument mass did not significantly affect muscle activity (p=0.64, p=0.43), while diameter narrowly failed to reach significance for both muscles (p=0.08, p=0.08); muscle activity for both muscles increased with smaller diameter instruments. Conclusion Results from this study indicate instrument diameter is more influential than mass on muscle activity generation; small diameter instruments increased muscle activity generation when compared to large diameter instruments. Future research in real-world settings is needed to determine the clinical impact of these findings. [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]

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]

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 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]

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]

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]

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]

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]