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PubMedDate not supplied

Dependence of intermanual difference in hand skill on right or left cerebral motor control in right-handed male and female subjects.

The relations of the mean differences in right and left hand skills (L-R) to the mean right and left hand skills were studied in right-handed male and female subjects with and without familial sinistrality (FS+, FS-). Hand skill was measured by the peg moving task. In FS+ males, there was a significant negative linear correlation between L-R and right hand peg moving times (PMTs). In FS+ females, there was a significant positive linear correlation between L-R and left hand PMTs. There were no significant correlations between L-R and left hand PMTs in FS+ males, and right hand PMTs in FS+ females. FS- subjects could be described as follows. In males and females with right eye and right foot preference, L-R PMTs were found to be positively linearly correlated with left hand PMTs (no correlation between L-R and right hand PMTs). In subjects with left eye and right foot preference, the correlations were found to be similar to those for FS+ subjects. In subjects with mixed eye and right foot preference, there was a negative linear correlation between L-R and right hand PMTs in females; a positive linear correlation between L-R and left hand PMTs in males. There were no significant correlations between L-R and right hand PMTs in males, and left hand PMTs in females. These results indicated that left brain in FS+ males, and right brain in FS+ females would produce the L-R difference between hands in PMTs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Regular use of a hand cream can attenuate skin dryness and roughness caused by frequent hand washing.

BACKGROUND: Aim of the study was to determine the effect of the regular use of a hand cream after washing hands on skin hydration and skin roughness. METHODS: Twenty-five subjects washed hands and forearms with a neutral soap four times per day, for 2 minutes each time, for a total of two weeks. One part of them used a hand cream after each hand wash, the others did not (cross over design after a wash out period of two weeks). Skin roughness and skin hydration were determined on the forearms on days 2, 7, 9 and 14. For skin roughness, twelve silicon imprint per subject and time point were taken from the stratum corneum and assessed with a 3D skin analyzer for depth of the skin relief. For skin hydration, five measurements per subject and time point were taken with a corneometer. RESULTS: Washing hands lead to a gradual increase of skin roughness from 100 (baseline) to a maximum of 108.5 after 9 days. Use of a hand cream after each hand wash entailed a decrease of skin roughness which the lowest means after 2 (94.5) and 14 days (94.8). Skin hydration was gradually decreased after washing hands from 79 (baseline) to 65.5 after 14 days. The hand wash, followed by use of a hand cream, still decreased skin hydration after 2 days (76.1). Over the next 12 days, however, skin hydration did not change significantly (75.6 after 14 days). CONCLUSION: Repetitive and frequent hand washing increases skin dryness and roughness. Use of a hand cream immediately after each hand wash can confine both skin dryness and skin roughness. Regular use of skin care preparations should therefore help to prevent both dry and rough skin among healthcare workers in clinical practice.

Cross-Over Studies↗
PubMed1980

Bilateral asymmetry in bone measurements of the hand and lateral hand dominance.

Two hundred thirty-five (235) normal male participants of the Baltimore Longitudinal Study were classified as right handed, left handed, and ambidextrous on the basis of their grip-strength performance. Their left and right hands were also radiographed and the measurements of the second metacarpal bones were evaluated on the basis of hand dominance. The results indicated that, as a rule, the right hand measurements are higher than those of the left hand, regardless of hand dominance. The bilateral differences in total width, length, total area and cortical area are significant among the right hand dominant and nonsignificant among the left hand dominant. Regardless of hand dominance the bilateral differences in medullary width are nonsignificant. These results suggest an inherent tendency of the right second metacarpal to have more bone than the left regardless of hand dominance. Differential stress due to hand dominance will increase the bilateral difference in the right handed and reduce it in the left handed.

Adult↗
PubMed2004

Utility of digital photographs of the hand for assessing the presence of hand osteoarthritis.

OBJECTIVES: Nodal osteoarthritis of the hand (hand OA) is a subset of OA with a strong heritable component. Multiple genetic analyses of this condition have been performed and are underway. Highest yield from any genetic study depends upon a clear clinical phenotype for case definition. Radiographs may provide the most detail about the nature of the lesion. Physical examination is an imperfect means of evaluating each patient, particularly when hundreds or thousands of patients are required for study. Our study evaluated the accuracy, relative to a radiograph, of a digital photograph of the hands for the presence of OA in a particular joint, as well as for the diagnosis of nodal hand OA. METHODS: Consecutive patients were evaluated as part of the I-NODAL study (Investigation of Nodal Osteoarthritis to Detect an Association with Loci encoding Interleukin-1 [IL-1]). Evaluation included a physical examination by a trained rheumatologist, a postero-anterior radiograph of the hands, and a digital photograph of each hand. Radiographs were read by one trained observer using the Kellgren-Lawrence scale. Photographs were taken by one individual and were analyzed by an experienced rheumatologist. Kappa statistics were determined for each modality and accuracy was assessed using radiographic readings as a gold standard. RESULTS: Intra-reader reliability for radiograph interpretation was good for the overall diagnosis of hand OA (kappa0.76 [0.45,1.07]), but varied widely for the presence or absence of K-L grades 2-4 in individual joints (median kappa0.70, range 0.49-0.87 for ACR index joints). Distal interphalangeal joint (DIP) nodes on physical examination were sensitive (median 96.27, 93.94-100), but not specific for radiographic hand OA in the corresponding joint (median 33.0, 17.24-42.86). Physical examination evidence of OA in the 1st carpo-metacarpal (CMC) and proximal interphalangeal (PIP) joints provided only moderate sensitivity and specificity. However, the negative predictive value of the examination of individual joints was good (median negative predictive value was 82.58 for IP joints with a range 68.29-100.00), particularly in the DIP joints. Specificity of a node visualized on hand photograph was variable (median for all IP joints and 1st CMC 83.77, range 53.37-96.97), with greatest specificity for radiographic OA in the corresponding joint found in the 1st CMC and the PIP joints. Clinical hand OA was sensitive, but not specific for the radiographic diagnosis of hand OA; while, photographic OA was moderately specific, but insensitive. CONCLUSION: The visualization of a node on a digital photograph of the hand provides fair to moderate specificity for radiographic hand OA in the corresponding joint, with generally poor sensitivity. A photograph has limited value as a screening tool for the diagnosis of radiographic hand OA.

Aged↗
PubMed2004

[The cleft hand. Proposal of a classification based on 279 cleft hands].

PURPOSE: We propose a new classification of cleft hand based on the analysis of our own cases and a literature search. METHODS: We analysed clinical data and radiographs of 31 patients with 54 cleft hands in addition to 225 cleft hands from the literature, and classified them with the help of schematic drawings of radiographs in extension of the proposals of Blauth and Schneider-Sickert. RESULTS: Classification of cleft hand: 1. Median cleft hands without involvement of thumb and small finger. 2. Medioradial cleft hands with thumb affected but with detectable residuals preserved. 3. Radial cleft hands with thumb aplasia. Medioulnar cleft hands with small finger affected but detectable residuals preserved. 5. Ulnar cleft hands with small finger aplasia. Median cleft hands more frequently appear unilateral and are more seldom combined with cleft feet as medioradial and radial cleft hands. In radiographs, aplasia predominate in radial cleft hands while synostoses often appear in median cleft hands. CONCLUSIONS: The new classification enables us to arrange the great diversity of this malformation and takes medioulnar and ulnar cleft hands into account.

Abnormalities, Multiple↗
PubMed2000

Replace hand washing with use of a waterless alcohol hand rub?

Hand hygiene is one of the basic components of any infection control program and is frequently considered synonymous with hand washing. However, health care workers frequently do not wash their hands, and compliance rarely exceeds 40%. Hand rubbing with a waterless, alcohol-based rub-in cleanser is commonly used in many European countries instead of hand washing. Scientific evidence and ease of use support employment of a hand rub for routine hand hygiene. It is microbiologically more effective in vitro and in vivo, it saves time, and preliminary data demonstrate better compliance than with hand washing. Therefore, a task force comprising experts from the Centers for Disease Control and Prevention and from professional societies is designing guidelines for the use of a hand rub in the United States. Today, most countries of Northern Europe recommend a hand rub for hand hygiene unless the hands are visibly soiled. Side effects are rare and are mainly related to dryness of the skin. This review evaluates the scientific and clinical evidence that support the use of alcohol-based hand rubs in health care facilities as a new option for hand hygiene.

Alcohols↗
PubMed2000

Natural history of the growth of the hand: part II--hand length as a treatment guide in the pediatric trauma patient.

BACKGROUND: In a previous study, we defined the natural history of the growth of the hand. In particular, we demonstrated that the palmar aspect of the hand is approximately 0.78% of body surface area (BSA). We also demonstrated a relationship between the area of the palmar surface of the hand and the total BSA as growth proceeds. Seeking to improve the usefulness of hand size as a guide to predicting body size, we examined the length of the hand as a predictor of body mass and BSA. METHODS: Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The hand tracings were measured, and the length and width of the hands were determined. The height and weight of each individual were measured, and his or her BSA was calculated. The data was subjected to statistical and graphical analyses. RESULTS: Hand length is an excellent predictor of BSA and body mass. Hand length as a predictor of body size is independent of the gender of the subject and most accurate for ages 2 to 17 years. The correlation is so highly predictive that it is possible to derive a treatment guide based on hand length. The length of the hand predicts body weight and BSA and can be used to predict baseline intravenous fluid requirements and the volume of packed red blood cells to be transfused to raise the hematocrit 3%. CONCLUSIONS: Hand length is a simple measurement that may be used as a treatment guide. Hand length will predict body weight and body surface area independently of the gender of the subject.

Adolescent↗
PubMed2003

Surgical management of the rheumatoid hand: consensus and controversy among rheumatologists and hand surgeons.

OBJECTIVE: Rheumatoid arthritis (RA) is a common cause of debilitating hand deformities, but management of these deformities is controversial, characterized by large variations in the surgical rates of common RA hand procedures. We conducted a national survey evaluating potential differences in physicians' management of RA hand deformities. METHODS: We mailed a survey instrument to a random national sample of 500 rheumatologists and 500 hand surgeons in the US. We evaluated physicians' attitudes toward the other specialties' management of common RA hand deformities and toward the indications for performing rheumatoid hand surgery. RESULTS: We found 70% of rheumatologists consider hand surgeons deficient in understanding the medical options available for RA, while 73.6% of surgeons believe rheumatologists have insufficient knowledge of the surgical options for RA hand diseases. However, 66.9% of surgeons and 79.5% of rheumatologists had no exposure to the other specialty during training. The 2 physician groups disagree significantly on the indications for commonly performed RA hand procedures such as metacarpophalangeal joint arthroplasty (p < 0.001), small joint synovectomy (p < 0.001), and distal ulna resection (p = 0.001). When physicians do not agree with others' management of RA hand deformities, only 62.4% of surgeons and 61.9% of rheumatologists relay their concern to the other specialty. CONCLUSION: Rheumatologists and hand surgeons have minimal interdisciplinary training, communicate with each other infrequently, and significantly disagree on the indications for RA hand surgery. Research must focus on the surgical outcomes of RA hand procedures and on improving communication between rheumatologists and hand surgeons.

Arthritis, Rheumatoid↗
PubMed1993

Same-hand and different-hand finger pairings in two-choice reaction time: presence or absence of response competition?

Several two-choice reaction time experiments have compared conditions in which the two possible responses were from the same hand (same-hand pairing) or from different hands (different-hand pairing). Studies that used only the two relevant fingers on response keys reported shorter reaction times for the different-hand pairing. In other studies, two additional but irrelevant fingers were also in contact with response keys. These fingers were irrelevant in the sense that they never were required to respond. With this procedure, equivalent reaction times were found between same-hand and different-hand pairings. Reeve and Proctor (1988) recently have argued that using only two fingers results in response competition between the two fingers from the same hand, yielding shorter reaction times for the different-hand pairing condition. In contrast, when four fingers are placed on response keys, response competition should be absent for both the same-hand and the different-hand pairing conditions, resulting in equivalent reaction times. In the present work, reaction times associated with the same-hand pairing condition remained unchanged, irrespective of the number of fingers positioned on keys. In the different-hand pairing condition, reaction times were found to be longer when four fingers were used than when only two fingers rested on response keys. Thus, when four fingers are placed on keys, response competition appears to be present rather than absent. Other results showed that the response competition found in the different-hand pairing condition decreases with practice.

Journal Article↗
PubMed1990

An evaluation of volumes delivered by selected adult disposable resuscitators: the effects of hand size, number of hands used, and use of disposable medical gloves.

UNLABELLED: Due to increasing concern over potential cross-infection during cardiopulmonary resuscitation (CPR), a number of disposable resuscitators have become commercially available. The wearing of disposable medical gloves by persons performing CPR has also become commonplace. In this study, we evaluated the effects of hand size, use of disposable medical gloves, and number of hands used (one versus two) on the volumes delivered by five adult disposable resuscitators. METHOD: Persons familiar with bag-valve ventilation were recruited to participate in the study--eight with small hands, eight with medium hands, and eight with large hands. Ventilation was delivered to one side of a Vent-Aid training test lung (TTL), and volumes were measured with a BEAR VM-90. In random order, each participant ventilated the TTL with all combinations of one hand/two hands, gloves/no gloves, and each of the following resuscitators: Code Blue, Hospitak, Pulmanex, Mercury, and Ambu SPUR. The participants were instructed to ventilate the TTL as they would ventilate a patient. RESULTS: The mean =/- SD volumes (in liters) were small hands = 0.68 +/- 0.15, medium hands = 0.71 +/- 0.18, large hands = 0.81 +/- 0.19 (p=0.006); gloves = 0.73 +/- 0.19, no gloves = 0.73 +/- 0.18 (p=0.80); one hand = 0.62 +/- 0.12, two hands = 0.84 +/- 0.17 (p less than 0.0001); Code Blue = 0.79 +/- 0.14, Hospitak = 0.56 +/- 0.11, Pulmanex = 0.71 +/- 0.15, Mercury = 0.77 +/- 0.18, SPUR = 0.83 +/- 0.2 (p less than 0.0001). CONCLUSIONS: The use of gloves did not significantly affect volume delivery. Delivered volumes did increase significantly as hand size increased and as number of hands used to squeeze the bag increased, and observed differences in volume delivery between brands of resuscitators may be clinically important in some cases. This study emphasizes the importance of squeezing the resuscitator with two hands during bag-valve ventilation.

Adult↗
PubMed1998

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

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

Activities of Daily Living↗
PubMed2004

Comparison of pressure pain threshold, grip strength,dexterity and touch pressure of dominant and non-dominant hands within and between right-and left-handed subjects.

This study was done to evaluate differences in pressure pain threshold, grip strength, manual dexterity and touch pressure threshold in the dominant and non-dominant hands of right- and left-handed subjects, and to compare findings within and between these groups. Thirty-nine right-handed and twenty-one left-handed subjects participated in the study. Pressure pain threshold was assessed using a dolorimeter, grip strength was assessed with a hand-grip dynamometer, manual dexterity was evaluated using the VALPAR Component Work Sample-4 system, and touch pressure threshold was determined using Semmes Weinstein monofilaments. Results for the dominant and non-dominant hands were compared within and between the groups. In the right-handed subjects, the dominant hand was significantly faster with the VALPAR Component Work Sample-4, showed significantly greater grip strength, and had a significantly higher pressure pain threshold than the non-dominant hand. The corresponding results for the two hands were similar in the left-handed subjects. The study revealed asymmetrical manual performance in grip strength, manual dexterity and pressure pain threshold in right-handed subjects, but no such asymmetries in left-handed subjects.

Adult↗
PubMed1997

Mechanism and computer simulation of a new robot hand for potential use as an artificial hand.

A prosthetic hand is essential to provide rehabilitation for individuals who lose a hand. A prosthetic hand serves two purposes: cosmetic and functional. In this paper, a prototype of the artificial hand with an emphasis on the functionality purpose is presented. A new mechanism, the NTU-Hand (NTU-Hand, patent number 107115, Taiwan, R.O.C.), which has 5 fingers with 17 degrees of freedom, has been designed and fabricated in our laboratory. Due to the special design of the mechanism, the hand has an uncoupled configuration in which each finger and joint are all individually driven. The size of the hand is almost the same as a human hand. All actuators, mechanical parts, and sensors are on the hand. The compact design makes it feasible to adapt the hand to the injured wrist. A computer simulation with three-dimensional graphics was also built to evaluate the manipulative range of the artificial hand. From the results of this simulation, the relationship between the hand and the grasped object in a specific viewpoint can be obtained.

Artificial Limbs↗
PubMed2006

[The levels of recognition and hand functions of patients with Alzheimer's disease: a pilot study based on the simple test for evaluating hand function].

AIM: The purpose of this study was to analyze the levels of recognition and hand functions of the patients with Alzheimer's disease (AD) based on the Simple Test for Evaluating Hand Function (STEF). METHODS: Forty subjects with AD (AD group) and 20 without AD (control group) in a facility for elderly health care services participated in this study. The AD group consisted of 20 subjects with Clinical Dementia Rating (CDR) 1 and 20 other subjects with CDR2. RESULTS: The results were as follows: Time required for full motion of right hand dexterity was significantly longer in both the CDR1 and CDR2 groups compared to the control group (p < 0.05, p < 0.01). Time required for the control group and CDR1 group were significantly shorter for motion of right hand dexterity compared to the left hand. No significant difference was observed between the times of right and left hand dexterity among subjects of CDR2. The disparity of right-left hand dexterity decreased in the order of control, CDR1 and CDR2. The correlations between the sub-items for CDR scale and the right-left hand disparity were significant in "memory" and "judgment". The right-left hand disparity decreased with the shortened time for left hand motion, as the "memory" or "judgment" scores increased. CONCLUSION: These findings suggest that right hand dexterity speed in patients in the mild AD stage was low when their dominant hand superiority declined. Moreover the decline of dominant hand superiority correlated with the recognition of memory and judgment.

Aged↗
PubMed1993

Comparison of tidal volumes obtained by one-handed and two-handed ventilation techniques.

OBJECTIVES: To compare tidal volumes delivered by one- vs two-handed compressions of a manual resuscitation bag and assess the effects of subject characteristics on those tidal volumes. DESIGN: Subjects (108 healthcare providers from a 500-bed teaching hospital) were assigned randomly to one of two procedures: one- followed by two-handed compression or two- followed by one-handed compression. A 1-liter resuscitation bag, lung performance analyzer and Wright spirometer were used to measure tidal volume. Data collection occurred in a simulated situation. RESULTS: There was a significant difference in tidal volume delivered by one-handed (mean = 694 mL, SD = 111) vs two-handed compressions (mean = 827 mL, SD = 113). Hand size, grip strength, height and weight were correlated with tidal volumes generated by one-handed and two-handed procedures. No other subject characteristics were correlated with tidal volumes. CONCLUSIONS: Tidal volumes delivered by healthcare providers using one- vs two-handed compressions were found to be significantly different, with those delivered by two hands significantly greater than those delivered by one hand. Strength of hand grip was the best predictor of volume delivered and was more strongly correlated with volumes delivered by one rather than two hands.

Female↗
PubMed1999

Conversions of the left-handed form and the protonated form of DNA back to the bound right-handed form by sanguinarine and ethidium: a comparative study.

The interaction of sanguinarine and ethidium with right-handed (B-form), left-handed (Z-form) and left-handed protonated (designated as H(L)-form) structures of poly(dG-dC).poly(dG-dC) and poly(dG-me5dC).poly(dG-me5dC) was investigated by measuring the circular dichroism and UV absorption spectral analysis. Both sanguinarine and ethidium bind strongly to the B-form DNA and convert the Z-form and the H(L)-form back to the bound right-handed form. Circular dichroic data also show that the conformation at the binding site is right-handed, even though adjacent regions of the polymer have a left-handed conformation either in Z-form or in H(L)-form. Both the rate and extent of B-form to Z-form transition were decreased by sanguinarine and ethidium under ionic conditions that otherwise favour the left-handed conformation of the polynucleotides. The rate of decrease is faster in the case of ethidium as compared to that of sanguinarine. Scatchard analysis of the spectrophotometric data shows that sanguinarine binds strongly to both the polynucleotides in a non-cooperative manner under B-form conditions, in sharp contrast to the highly-cooperative binding under Z-form and H(L)-form conditions. Correlation of binding isotherms with circular dichroism data indicates that the cooperative binding of sanguinarine under the Z-form and the H(L)-form conditions is associated with a sequential conversion of the polymer from a left-handed to a bound right-handed conformation. Determination of bound alkaloid concentration by spectroscopic titration technique and the measurement of circular dichroic spectra have enabled us to calculate the number of base pairs of Z-form and H(L)-form that adopt a right-handed conformation for each bound alkaloid. Analysis reveals that 2-3 base pairs (bp) of Z-form of poly(dG-dC).poly(dG-dC) and poly(dG-me5dC).poly(dG-me5dC) switch to the right-handed form for each bound sanguinarine, while approximately same number of base pairs switch to the bound right-handed form in complexes with H(L)-form of these polynucleotides. Comparative binding analysis shows that ethidium also converts approximately 2 bp of Z-form or H(L)-form to bound right-handed form under same experimental conditions. Since sanguinarine binds preferentially to alternating GC sequences, which are capable of undergoing the B to Z or B to H(L) transition, these effects may be an important part in understanding its extensive biological activities.

Journal Article↗
PubMedDate not supplied

Characteristics in addition to size of the contralateral hand predict hand volume but are not clinically useful.

Traditionally, therapists who treat hand edema have used the volume of the contralateral hand to estimate normal or pre-injury hand volume. This presupposes that for the average person the difference in volumes between the two hands is so small that it is clinically insignificant. Left and right hand volumes, as well as a number of other hand characteristics, and health history were collected for a sample of 512 persons. Over 15% of the subjects had a measured volume difference of 30 ml or more. The difference in absolute and relative volumes between hands was minimally affected by gender, age, lifestyle, hand dominance, size of the largest hand, health problems, or previous hand injuries. Regression analysis uncovered a number of characteristics, including gender, handedness, and age, that predicted hand volume over and above the contralateral hand, but they boosted the proportion of variance explained only from 0.968 to 0.973, a clinically insignificant increase. It was concluded that the traditional methods of estimating pre-injury volume are still useful.

Adolescent↗