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At least 1,207 records · Page 67Linked to original sources
PubMed2006

Hand span influences optimal grip span in male and female teenagers.

PURPOSE: To determine if there is an optimal grip span for determining the maximum handgrip strength in male and female teenagers, and if the optimal grip span was related to hand span. If they are related then the second aim was to derive a mathematic equation relating hand span and optimal grip span. METHODS: One hundred healthy teenage boys (15.1 +/- 1.1 y) and 106 girls (15.4 +/- 1.3 y) were evaluated (age range, 13-18 y). Each hand was randomly tested on 10 occasions using 5 different grip spans, allowing a 1-minute rest between attempts. The hand span was measured from the tip of the thumb to the tip of the small finger with the hand opened as wide as possible. RESULTS: The results showed that an optimal grip span to determine the maximum handgrip strength was identified for both genders, and the optimal grip span and hand span correlated in both genders. CONCLUSIONS: The results suggest that there is an optimal grip span to which the dynamometer should be adjusted when measuring handgrip strength in teenagers. The optimal grip span was influenced by hand span in both genders. For males the optimal grip span can be derived from the equation y = x/7.2 + 3.1 cm, and for females from the equation y = x/4 + 1.1 cm. where y is the optimal grip span and x is the hand-span. These equations may improve the reliability and accuracy of the results and may guide clinicians and researchers in selecting the optimal grip span on the hand dynamometer when measuring handgrip strength in teenagers.

Adolescent↗
PubMed1998

Testing a new alcohol-free hand sanitizer to combat infection.

Universal precautions require that perioperative health care personnel wash their hand before and after all patient contact. Time constraints, however, can make adhering to universal precautions, including proper hand washing, difficult. Some perioperative health care workers, therefore, routinely use rise-free hand sanitizers to supplement normal hand washing. This study evaluated immediate and persistent antimicrobial effectiveness of two alcohol--containing hand sanitizers and a novel surfactant, allantoin, benzalkonium chloride (SAB) hand sanitizer using a federally approved effectiveness protocol. Results indicate that all three products were equally effective after a single application. After repeated use, the alcohol-containing sanitizers did not meet federal performance standards, and the alcohol-free sanitizer did. These properties and others illustrated in this article indicate that the nonflammable, alcohol-free SAB hand sanitizer is the most favorable of the rise-free hand sanitizer formulas for normal hand washing.

Adolescent↗
PubMed2001

Functional and biomechanical assessment of the normal and rheumatoid hand.

OBJECTIVE: To assess hand function in accordance with its accepted definition and to compare the results of three different assessment techniques. DESIGN: A clinical-type assessment was used together with measurement of pinch grip and three-dimensional biomechanical trials. BACKGROUND: Traditional clinical assessment may not relate to a patient's actual hand function. If hand function is defined as "the ability to use the hand in daily activities" then it is more appropriate to measure the forces available for performing everyday tasks using biomechanical tests. METHODS: Eight female patients with rheumatoid arthritis and eight control subjects were recruited for the study. Volunteers underwent a clinical-type assessment using a six-task activity board. Lateral pinch grip of both hands was measured using a custom-built transducer. Biomechanical trials were conducted using a 6 degree-of-freedom transducer and 6-camera motion analysis. RESULTS: Functional differences between the two subject groups were apparent using all three methods of assessment. Pinch strength correlated well with the biomechanical trial data but results from the clinical-type assessment provided only a weak correlation. CONCLUSIONS: Clinical-type assessments do not give an accurate measure of hand function. Pinch strength measurements can provide a cost-effective alternative to full biomechanical analysis. RELEVANCE: Traditional functional assessment uses measurements of grip or pinch strength and range of motion together with a subjective assessment of activities of daily living. This study demonstrates that pinch strength measurements can provide an accurate measure of hand function. The results from activity-board trials do not reflect hand ability and are of limited use for hand evaluation.

Adult↗
PubMed2006

Evidence-based model for hand transmission during patient care and the role of improved practices.

Hand cleansing is the primary action to reduce health-care-associated infection and cross-transmission of antimicrobial-resistant pathogens. Patient-to-patient transmission of pathogens via health-care workers' hands requires five sequential steps: (1) organisms are present on the patient's skin or have been shed onto fomites in the patient's immediate environment; (2) organisms must be transferred to health-care workers' hands; (3) organisms must be capable of surviving on health-care workers' hands for at least several minutes; (4) handwashing or hand antisepsis by the health-care worker must be inadequate or omitted entirely, or the agent used for hand hygiene inappropriate; and (5) the caregiver's contaminated hand(s) must come into direct contact with another patient or with a fomite in direct contact with the patient. We review the evidence supporting each of these steps and propose a dynamic model for hand hygiene research and education strategies, together with corresponding indications for hand hygiene during patient care.

Education↗
PubMed1998

Asymmetry correction equations for hand volume, grip and pinch strengths in healthy working people.

Assessments of oedema and decrease in hand strength are useful for patients with a hand lesion. This study examined the asymmetry of the arms and determined the estimates of the unknown prior to lesion values for hand volume, grip strengths assessed with a Jamar dynamometer (GS[J]) and a Collins dynamometer (GS[C]), and pinch strength with a Jamar pinch gauge (PS) in 100 healthy working people. Hand volume, GS(J), GS(C) and PS of the dominant hand were respectively 3.6 +/- 4.1%, 6.6 +/- 9.2%, 11.7 +/- 11.2%, and 8.0 +/- 13.2% higher than those of the non-dominant hand (p < 0.001). Very good estimates were obtained with the values of the contralateral arm for all the indices studied. The correlation coefficient equalled 0.95 for hand volume, 0.91 for GS(J), 0.83 for GS(C), and 0.72 for PS. These estimates allow us to evaluate the evolution of oedema and hand strengths in patients with hand injury, especially to determine whether they could return to work as they are mostly manual workers with demanding jobs.

Adolescent↗
PubMed2000

[The musician's hand: aspects of music physiology and performing arts medicine].

Musicians are particularly demanding hand patients. Increased expectancy towards the hand surgeon as well as principle aversion to any kind of operative treatment of the musician's hand impede the relationship between hand surgeon and patient. Knowledge and experience of the specific demands towards the musician's hand--including the background of basics in physiology of music making and instrumental techniques--facilitate history taking, examinations, diagnosing as well as the selection of therapy. Besides tendinitis and tendovaginitis, pathologies of the musician's hand are not more frequent compared to the entire population. Still several pathologies reach a significantly pronounced importance through the specific professional requirements. This is true especially for peripheral nerve compression syndromes, arthritis, ganglia, contractures, joint laxity and focal dystonias. The treatment of these disorders and hand trauma require, besides an utmost of hand surgical care, creativity and the implementation of the professional musical surroundings in therapy and rehabilitation, including also the musical instruments. The indication for surgery might be restrained in certain cases, although there are, without doubt, situations, when a professional musician should be operated on at an early stage. This should enhance a rapid return to play the musical instrument and to exercise delicate and demanding skilled movement patterns of his hand.

Adult↗
PubMed2005

Estimation of hand force in ergonomic job evaluations.

The aims of the present study were: (1) to collect normative data of pinch and power grip strength with a newer digital dynamometer; (2) to study the ability of hand grip force matching using a hand dynamometer where the validity and reliability issues were studied; and (3) to study the relationship between hand grip force matching and muscle activities of three forearm and hand muscles. This study consisted of two experiments. One hundred and twenty subjects volunteered in the first experiment, where hand grip strength and hand force estimation data were collected. The second experiment had 14 volunteers, where muscle activities of the hand and forearm were collected during the tests of hand grip strength and hand force matching estimations. Results showed that the power grip and pinch grip strengths collected with a newer digital dynamometer were comparable to similar studies using older equipment. At the group level, the force matching method was largely accurate and consistent. Instructions to the subjects about force matching estimation were important to the accuracy and consistency of the estimated forces. Estimation in force matching might depend on perceptions of several major muscle activities.

Adult↗
PubMedDate not supplied

Hand function in women and men with early rheumatoid arthritis. A prospective study over three years (the Swedish TIRA project).

OBJECTIVE: To describe the course of hand function in women and men during the first 3 years after diagnosis of recent-onset rheumatoid arthritis (RA), to investigate sex differences in hand function, and to study correlations between and within hand function assessments. METHODS: A total of 276 patients (69% women) with RA of a maximal duration of 12 months were recruited to the study. Hand function was assessed by the Grip Ability Test (GAT) and Signals of Functional Impairment (SOFI). Peak and average grip force over 10 s in the right and left hand was measured by an electronic device. RESULTS: Hand function was affected at diagnosis, but had improved significantly at the 3-months' follow-up and then remained stable (but still affected) in both women and men. As assessed by SOFI, hand function was worse in men than in women, whereas women had significantly lower grip force. GAT, grip force, and SOFI correlated weakly. The average and peak values of grip force correlated strongly, as did the grip force in the right and the left hand. CONCLUSION: Hand function was profoundly affected at diagnosis of RA, but improved significantly within 3 months and remained stable (but still affected) over 3 years. As expected, women on average had significantly lower grip force than men.

Arthritis, Rheumatoid↗
PubMed2003

Nasal and hand carriage of Staphylococcus aureus in staff at a Department for Thoracic and Cardiovascular Surgery: endogenous or exogenous source?

OBJECTIVE: To investigate the rates of Staphylococcus aureus carriage on the hands and in the noses of healthcare workers (HCWs) and the relatedness of S. aureus isolates found in the two sites. DESIGN: Point-prevalence study. SETTING: Department for Thoracic and Cardiovascular Surgery at the University Hospital of Uppsala, Uppsala, Sweden. SUBJECTS AND METHODS: Samples were obtained from 133 individuals, 18 men and 115 women, using imprints of each hand on blood agar and a swab from the nose. S. aureus isolates were identified by standard methods and typed by pulsed-field gel electrophoresis. RESULTS: S. aureus was found on the hands of 16.7% of the men and 9.6% of the women, and in the noses of 33.3% of the men and 17.4% of the women. The risk ratio for S. aureus carriage on the hands with nasal carriage was 7.4 (95% confidence interval, 2.7 to 20.2; P < .001). Among the 14 HCWs carrying S. aureus on their hands, strain likeness to the nasal isolate was documented for 7 (50%). CONCLUSIONS: Half of the HCWs acquired S. aureus on the hands from patients or the environment and half did so by apparent self-inoculation from the nose. Regardless of the source of contamination, good compliance with hand hygiene is needed from all HCWs to protect patients from nosocomial infections. The moderate rate of S. aureus carriage on hands in this setting could be the result of the routine use of alcoholic hand antisepsis.

Adult↗
PubMed1991

Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral catheters.

OBJECTIVE: The study was designed to compare the efficacies of bland soap handwash and isopropyl alcohol hand rinse in preventing transfer of aerobic gram-negative bacilli to urinary catheters via transient hand colonization acquired from direct patient contact. Glove juice recovery of gram-negative bacteria was considered transient colonization; catheter recovery was considered transfer colonization. DESIGN: The contact source for gram-negative bacteria was a single "high burden" groin skin carrier (greater than or equal to 10(4)/ml cup scrub fluid). Using a two-period cross-over design, 6 healthcare workers had 2 15-second contacts for each hand followed by either soap handwash or alcohol hand rinse (12 experiments with each treatment). Between 4 to 5 minutes after contact, each hand manipulated a catheter; the catheter was then cultured and the hand was glove juice tested. RESULTS: Soap handwash failed to prevent gram-negative bacteria transfer to the catheter in 11 of 12 (92%) experiments; alcohol hand rinse in 2 of 12 (17%) (p less than .001). Soap handwash failed to prevent transient colonization in 12 of 12 (100%) experiments; alcohol in 5 of 12 (42%) (risk ratio 2.4, 95% confidence interval 1.2-4.7). Single gram-negative bacteria species carried at source levels greater than or equal to 5.5 x 10(3)/ml (heavy contamination) established transient colonization in 23 of 30 (77%) exposures following soap handwash; single gram-negative bacteria species carried at levels less than or equal to 3.5 x 10(3)/ml established colonization in 1 of 22 (5%) similar exposures (p less than .001). CONCLUSIONS: Bland soap handwash was generally ineffective in preventing hand transfer of gram-negative bacteria to catheters following brief contact with a heavy-contamination patient source; alcohol hand rinse was generally effective.

Adult↗
PubMed2002

Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study.

Osteoarthritis is one of the most common joint disorders in the elderly, yet few studies have targeted symptomatic osteoarthritis, especially symptomatic hand osteoarthritis. The authors conducted a survey in 1992-1993 among an elderly population to estimate the prevalence of symptomatic hand osteoarthritis and to assess its impact on grip strength and functional activities. Framingham Study subjects received hand radiographs and answered queries on joint symptoms. Functional activities were assessed using an interviewer-administered questionnaire. Grip strength and observed functional performance were evaluated using standard procedures. A hand joint was defined as having symptomatic osteoarthritis if both symptoms and radiographic evidence of osteoarthritis were present. Of 1,041 subjects aged 71-100 years (36% men), the prevalence of symptomatic hand osteoarthritis was higher in women (26.2%) than in men (13.4%). Compared with those without symptomatic hand osteoarthritis, subjects with the disease had 10% reduced maximal grip strength, reported more difficulty writing, handling, or fingering small objects (odds ratio = 3.4), and showed more self-reported and observed difficulty carrying a 10-pound (4.5-kg) bundle (odds ratio = 1.7 and 1.6, respectively). In conclusion, in the context of a remarkable paucity of data on the epidemiology of symptomatic hand osteoarthritis, this study suggests that symptomatic hand osteoarthritis is a common disease among elders and frequently impairs hand function.

Activities of Daily Living↗
PubMed1997

Prospective outcome analysis of a protocol for the surgical and rehabilitative management of burns to the hands.

Treatment protocols for the management of burned hands are essential for integrating team efforts and achieving optimal functional results. Standard protocols are especially useful during mass casualty incidents, when the admission of multiple patients with large burns and/or associated injuries may reduce the priority usually accorded the hands. We prospectively evaluated a surgical and rehabilitative treatment protocol for burned hands during a mass casualty incident, after which 43 burn patients with 82 burned hands were admitted to one burn center. Soft-tissue management was individualized to achieve, if possible, wound closure within 14 days, and included the use of topical antimicrobials, cutaneous debridement and/or tangential excision, biologic dressings, and split-thickness autografts. Range of motion therapy was based on daily measurement of active motion of the metacarpophalangealjoints. Static splinting alternating with continuous passive motion every 4 hours was utilized for sedated patients. Continuous passive motion alternating with active ranging and night splinting was utilized for metacarpophalangeal flexion <70 degrees. Active ranging and progressive resistance was utilized for metacarpophalangeal flexion > or =70 degrees. Sixty-four hands required excision and grafting, with 89 percent having at least one autografting procedure completed by postburn day 16. Total active motion of the hands treated averaged 220.6 degrees on discharge and 229.9 degrees at 3 months after injury. Mean hand grip strength was 60.8 pounds at discharge and 66.0 pounds at 3 months after injury. Adherence to a standard hand burn protocol resulted in timely wound coverage and recovery of hand function for a large group of patients treated at a single burn facility after a mass casualty incident.

Accidents, Aviation↗
PubMed1996

Projection of the point of force application onto a palmar plane of the hand during wheelchair propulsion.

The objective of this study was to develop and test a method for projecting the pushrim point of force application (PFA) onto a palmar plane model of the hand. Repetitive wheelchair use often leads to hand and wrist pain or injury. The manner by which the hands grasp the pushrim and how the forces and moments applied to the pushrim are directed may contribute to the high incidence of pain and injury. The projections of the PFA onto the palmar surface model of the hand reside primarily within zone II. These results are in agreement with previous studies which have assumed the PFA to be coincident with one of the metacarpophalangeal (MP) joints. However, the results from three subjects show different PFA patterns within the palmar surface of the hand which can be related to each subject's propulsion pattern, and the PFA is not focused at a single MP joint. Projection of the world coordinates of the four hand marker system onto the palmar plane show the resolution to be within 3 mm, or one half the diameter of the passive reflective markers. The errors in the planar model assumption were greatest for the second and fifth MP markers. This was expected because as the hand grasp changes these markers do not remain coplanar. The results of this study indicate that new knowledge about how forces are applied by the hand onto the pushrim can be obtained using this method. This technical note provides insight into understanding the details within the kinetics of wheelchair propulsion and describes a technique for estimation of the PFA on the palmar surface of the hand. This technical note provides initial results from three different wheelchair users.

Adult↗
PubMed2005

Age-related differences in corticospinal control during functional isometric contractions in left and right hands.

The purpose of the study was to examine age-related differences in electromyographic (EMG) responses to transcranial magnetic stimulation (TMS) during functional isometric contractions in left and right hands. EMG responses were recorded from the first dorsal interosseus muscle following TMS in 10 young (26.6 +/- 1.3 yr) and 10 old (67.6 +/- 2.3 yr) right-handed subjects. Muscle evoked potentials (MEPs) and silent-period durations were obtained in the left and right hands during index finger abduction, a precision grip, a power grip, and a scissor grip, while EMG was held constant at 5% of maximum. For all tasks, MEP area was 30% (P < 0.001) lower in the left hand of old compared with young subjects, whereas there was no age difference in the right hand. The duration of the EMG silent period was 14% (P < 0.001) shorter in old (150.3 +/- 2.9 ms) compared with young (173.9 +/- 3.0 ms) subjects, and the age differences were accentuated in the left hand (19% shorter, P < 0.001). For all subjects, the largest MEP area (10-12% larger) and longest EMG silent period (8-19 ms longer) were observed for the scissor grip compared with the other three tasks, and the largest task-dependent change in these variables was observed in the right hand of older adults. These differences in corticospinal control in the left and right hands of older adults may reflect neural adaptations that occur throughout a lifetime of preferential hand use for skilled (dominant) and unskilled (nondominant) motor tasks.

Adult↗
PubMed2004

Muscular and postural synergies of the human hand.

Because humans have limited ability to independently control the many joints of the hand, a wide variety of hand shapes can be characterized as a weighted combination of just two or three main patterns of covariation in joint rotations, or "postural synergies." The present study sought to align muscle synergies with these main postural synergies and to describe the form of membership of motor units in these postural/muscle synergies. Seventeen joint angles and the electromyographic (EMG) activities of several hand muscles (both intrinsic and extrinsic muscles) were recorded while human subjects held the hand statically in 52 specific shapes (i.e., shaping the hand around 26 commonly grasped objects or forming the 26 letter shapes of a manual alphabet). Principal-components analysis revealed several patterns of muscle synergy, some of which represented either coactivation of all hand muscles, or reciprocal patterns of activity (above and below average levels) in the intrinsic index finger and thumb muscles or (to a lesser extent) in the extrinsic four-tendoned extensor and flexor muscles. Single- and multiunit activity was generally a multimodal function of whole hand shape. This implies that motor-unit activation does not align with a single synergy; instead, motor units participate in multiple muscle synergies. Thus it appears that the organization of the global pattern of hand muscle activation is highly distributed. This organization mirrors the highly fractured somatotopy of cortical hand representations and may provide an ideal substrate for motor learning and recovery from injury.

Electromyography↗
PubMed1998

Gradual molding of the hand to object contours.

Subjects were asked to reach to and to grasp 15 similarly sized objects with the four fingers opposed to the thumb. The objects' contours differed: some presented a concave surface to the fingers, others a flat one, and yet others a convex surface. Flexion/extension at the metacarpal-phalangeal and proximal interphalangeal joints of the fingers was recorded during the reaching movement. We used discriminant analysis, cluster analysis, and information theory to determine the extent to which the shape of the hand was affected by the objects' shapes along a convexity/concavity gradient. Maximum aperture of the hand was reached about midway in the reaching movement. At that time, the hand's posture was influenced by the shape of the object to be grasped but imperfectly. The information transmitted by hand posture about object shape increased gradually and monotonically as the hand approached the object, reaching a maximum at the time the object was in the grasp of the hand. We also asked subjects to shape the hand so as to grasp the object without moving the arm. Their performance was poorer on this task in the sense that hand shape discriminated among fewer objects and that trial-to-trial variability was greater than when the distal and proximal components of the motion were linked. The results indicate that the hand is molded only gradually to the contours of an object to be grasped. Because other parameters of the motion, such as movement direction, for example, already are specified fully early on in a movement, the results also suggest that the specification of diverse aspects of a movement does not evolve at a uniform rate.

Arm↗
PubMed2005

Are sterile water and brushes necessary for hand washing before surgery in Japan?

PURPOSE: To examine whether sterile water and brushes are necessary for hand washing before surgery. METHOD: Twenty-two operating room nurses were randomly divided into two groups as follows: 11 nurses who used 7.5% povidone iodine (PVI group) and another 11 nurses who used 4% chlorhexidine gluconate (CHG group) to wash their hands using the rubbing method. All the nurses were examined for bacterial contamination of their hands before and after surgical hand rubbing. We used tap water to wash the hands at the sink used for washing surgical instruments in the operating room and non sterilized plastic brushes. RESULTS: No bacteria were detected in the tap water. Before washing the hands, the number of bacteria detected was 5.0 x 10(3) cfu/H in the PVI group and 4.0 x 10(3) cfu/H in the CHG group, which were similar in both groups. After washing the hands, the median value of the bacteria decreased to 8.7 x 10(2) cfu/H in the PVI group and 0 cfu/H in the CHG group. CONCLUSIONS: Sterile water and brushes are not necessary for preoperative scrubbing up. When using tap water for surgical hand washing, 1) the hand-rubbing method should be used; 2) a quick-alcohol-based disinfectant scrub should be used; 3) the concentration of free chloride in the water should be maintained at over 0.1 PPM; 4) the bacterial contamination of the water should be checked; and 5) the faucet should be routinely cleaned and sterilized.

Anti-Infective Agents, Local↗
PubMed2005

Common encoding of novel dynamic loads applied to the hand and arm.

In manual action, the relationship between a given motor command and the ensuing movement depends on the dynamics of both the arm and hand-held objects. Skilled performance relies on the brain learning both these dynamics, and previous studies have examined how people adapt to novel loads applied to either the hand or the arm. In this study, we ask whether these different kinds of load are represented independently as a result of changes in cutaneous feedback and hand-arm coordination. We used a robotic apparatus that could either apply forces to an object held in the subject's hand or directly to the segments of the arm. We tested whether subjects could retain learning of a force field applied to the hand after subsequently experiencing the opposing field applied to the arm (or vice versa), or whether retrograde interference would be observed. In separate experiments, we used force fields and torque fields that were linearly related to either hand or joint velocities, respectively. Our finding of complete interference between opposing fields suggests that loads applied to the arm and hand are not represented independently by the sensorimotor system. This interference occurred despite markedly different cutaneous inputs that were directly related to the movement task. This result suggests that the brain represents dynamics independently of these sensory inputs. In addition, we found that the rate at which subjects adapted to a given force field, specified either in hand or joint coordinates, was independent of whether the forces were applied to the hand or arm segments.

Adult↗