Concurrent validity of the Suitcase Packing Activity in the assessment of upper extremity function after burn injury.

Upper extremity strength and function are rarely assessed in routine multiple sclerosis (MS) care. This study aimed to evaluate hand muscle strength and functionality in individuals with MS and investigate correlations with upper extremity function, cognitive status, health-related quality of life (HRQOL), and balance. A cross-sectional study was conducted with 45 consecutive individuals with MS between the ages of 18 and 65. Upper limb motor strength was evaluated using a hand grip strength dynamometer. Upper limb functional capacity was assessed using the Nine-Hole Peg Test (9HPT) and the Duruoz Hand Index (DHI). Balance, coordination, and falls were measured with the Berg Balance Scale (BBS), Falls Efficacy Scale (FES), and the 30-Second Chair Stand Test (30CST). Cognitive function was evaluated using the Montreal Cognitive Assessment instrument and the Symbol Digit Modalities Test. Level of HRQOL was assessed using the self-reported 54-item MS Quality of Life-54 questionnaire. Out of the 45 participants (80% women, mean age 36.6 ± 8.6 years), higher hand grip dynamometer measures were strongly correlated with better DHI, 9HPT, BBS, FES, and 30CST scores. In the regression analysis, a 1-unit increase in dynamometer measures led to a 0.383 increase in overall HRQOL score. This study demonstrates that increased hand grip strength (HGS) is associated with better hand functionality, balance, and HRQOL in individuals with MS. It provides evidence to support more systematic measurement of HGS in the care of people with MS.

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.

Background: With the growing prevalence of smartphone use, concerns have emerged regarding its potential impact on musculoskeletal health. This study aims to investigate the effect of smartphone usage on hand grip strength, pinch strength, and upper extremity function among college students in Bengaluru. Although previous research has explored general musculoskeletal symptoms associated with smartphone use, specific effects on hand and upper extremity function remain underexplored, particularly within the context of young adults in India. Objectives: The primary objectives of this study were to assess hand grip strength, pinch strength, and upper extremity function among college students, to evaluate the correlation between smartphone usage and these measures, and to determine the impact of smartphone usage on hand grip strength specifically. Methods: A cross-sectional study was conducted involving 240 college students aged 18-25 years from Bengaluru. Participants were categorized based on age and gender and were assessed using a hand dynamometer for grip strength, a pinch gauge for pinch strength, and the Upper Extremity Functional Index (UEFI) questionnaire for overall upper extremity function. Smartphone usage was recorded through self-reported data. Descriptive statistics summarized demographic data and outcomes, while inferential statistics, including Pearson’s and Spearman’s correlations, were used to analyse relationships between smartphone usage and musculoskeletal parameters. Statistical analyses were performed using R Version 4.1.0, with Microsoft Excel 2016 and Word 2016 for data presentation. Results: The study found weak to negligible correlations between smartphone usage and hand grip strength (right hand: r = 0.248, left hand: r = 0.0120), and pinch strength (right pinch: r = 0.0403, left pinch: r = 0.0357). However, a high negative correlation was observed between smartphone usage and UEFI scores (r = -0.0847), suggesting that increased smartphone use may negatively affect overall upper extremity function. Despite these findings, the impact of smartphone usage on hand and pinch strength appeared minimal.

Background/Objectives: The impact of stroke on upper extremity function in the older adult population underscores the need for accurate recovery prediction. Motor evoked potential (MEP) has been explored as a predictor of upper extremity function recovery in patients with stroke. However, research specifically targeting the geriatric population remains limited. Therefore, this study focused specifically on patients aged 65 years and older to investigate correlations between MEP parameters and upper extremity function. This study investigates correlations between MEP parameters (amplitude and latency) and upper extremity function-related measures, including Medical Research Council (MRC) scale, the Korean version of the Modified Barthel Index (K-MBI), and the Hand Function Test (HFT), including grip strength, pinch strength, the Box and Block Test, and the 9-Hole Peg Test, in older adults with stroke. Methods: A multiple linear regression model predicts upper extremity outcomes using initial MEP parameters, time, and function. The dataset includes 90 patients with stroke categorized by timing of the first MEP assessment: ≤3 months (n = 42) or >3 months (n = 48). Results: MEP amplitude and latency were significantly correlated with upper extremity function in both groups. No significant correlations were found between MEP amplitude or latency and outcome measures. Regression analysis showed that initial MEP amplitude had a limited association with outcomes, whereas latency was significantly associated with grip strength (β: -10.205, 95% CI: -19.374~-1.036) and the Box and Block Test (β: -10.204, 95% CI: -20.254~-0.154). Initial upper extremity parameters were significantly associated with K-MBI and HFT follow-up results (p < 0.05). Conclusions: Larger MEP amplitude and faster initial MEP latency were associated with improved upper extremity function in patients with stroke. In older patients, MEP latency, rather than amplitude, demonstrated greater predictive value for upper extremity function recovery, possibly due to age-related muscle atrophy, a factor not fully addressed in existing prognostic frameworks such as PREP2. These findings support the integration of MEP latency assessment into geriatric stroke prognostication, complementing existing frameworks such as PREP2, and may guide personalized rehabilitation planning to optimize functional recovery and independence.

This study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p&lt;0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p&lt;0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients

Purpose/Aim: The aim of this study is to examine the relationship between cervical proprioception sense and balance, hand grip strength, cervical region muscle strength and upper extremity functionality in healthy young subjects. Methods: A total of 200 people with a mean age of 20.8 ± 1.8 participated in the study. Cervical proprioception sense of the participants was evaluated with Cervical Joint Position Error Test (CJPET), balance with Biodex Stability System, hand grip strength with hand dynamometer, and upper extremity functionality with Perdue Pegboard test. The relationship of variables with cervical proprioception was evaluated with Pearson Correlation analysis. Results: According to this study results, there was no significant relationship between CJPET (extension, left rotation, right rotation) and sub-parameters of dynamic balance (anteroposterior, mediolateral, overall), cervical muscle strength and hand grip strength (p > 0.05). There was a significant correlation between CJPET flexion and static balance variables (p < 0.05). Conclusion: According to this study, there is no relationship between cervical proprioception and balance, hand grip muscle strength, cervical region muscle strength and upper extremity functionality in healthy young subjects.

Background: The hand is the most active and important part of the upper extremity with complex functional biomechanics and anatomy. The decline in hand grip strength and dexterity with age can adversely affect functional activities. Task-oriented training (TOT) is a treatment approach focused on functional activities of daily life. Aim: To investigate the effect of TOT on hand dexterity, grip strength, and hand function in the geriatric population. Subjects and Methods: Sixteen institutionalized geriatric participants were recruited based on the inclusion and exclusion criteria and assigned to Group A experimental group (nine participants) who received TOT for 4 weeks, 3 days/week along with routine activities and Group B control group (seven participants) who were involved in routine activities only. Gross dexterity was assessed using the box and block test, fine dexterity with nine-hole peg board, hand grip strength with hand dynamometer, and hand function with the Michigan hand outcome questionnaire. The statistical analysis with Student's t-test was performed using the SPSS software. The significance level kept as P ≤ 0.05. Results: The analysis expressed significant improvement in gross and fine hand dexterity and grip strength among the experimental group. The hand function did not reveal a statistically significant change. Conclusion: A 4-week TOT program is an effective measure to improve gross and fine dexterity, and muscle grip strength in the geriatric population. For improvement in hand function, a longer training may be required.

One of the most prevalent clinical subtypes of cerebral palsy (CP) is diplegia. Most children with diplegia have weakness in axial muscles and spasticity in extremities which have adverse impacts on trunk control and manual coordination of upper extremities. To examine and compare between the effects of arm ergometer and stabilization exercises applied for duration of 12 weeks on upper extremity functioning, trunk control, and hand grip strength (HGS) in children with spastic diplegia. Forty-two children with spastic diplegia aged from 6 to 10 years were randomly assigned to either group A or B, (n = 21 each). Children in group A received a designed arm ergometer exercises for 30min while those in group B received trunk stabilization exercises for 30min. As well, children in both groups received 30min of a designed physical training for 30min. Treatment was delivered three times a week for 12 weeks in succession. The quality of upper extremity skill test (QUEST), hand held dynamometer (HHD) and Trunk control measuring scale (TCMS) were used to assess upper extremity functions, HGS and trunk control respectively before and after suggested treatment duration. In terms of all indicators measured at baseline, study groups were comparable (P > 0.05). Significant improvements in all outcome indicators were recorded in within-group comparison (P < 0.05). Further, between groups comparison showed significant higher improvements in upper extremity functions and HGS in favor of group A while trunk control scores showed no significant difference between the two groups (P > 0.05). Arm ergometer exercises have the capability to enhance upper extremity functions, HGS and trunk control. It is therefore beneficial for physical rehabilitation specialists to incorporate the arm ergometer exercises into the intervention plans for children with spastic diplegia.

(1) Background: The purpose of this study is to investigate the effect of virtual-reality-based hand motion training (VRT) in parallel with the Kinesio Taping (KT) technique on upper extremity function in stroke patients and to present a more effective therapeutic basis for virtual reality training intervention. (2) Methods: First, 43 stroke patients were randomly assigned to two groups: 21 experimental subjects and 22 controls. The experimental group performed Kinesio Taping (KT) on the dorsal part of the hand along with virtual-reality-based hand motion training, and the control group performed only virtual-reality-based hand motion training. The intervention was conducted for a total of 30 sessions over 6 weeks. To evaluate changes in upper extremity function, the Fugl–Meyer Assessment of the Upper Extremity (FMA-UE), the Wolf Motor Function Test (WMFT), and the Motor Activity Log (MAL) (including amount of use (AOU) and quality of movement (QOM)) were evaluated. In addition, the Self-Efficacy Scale (SEF) was evaluated to examine the change in the self-esteem of the study subjects. (3) Results: The experimental group who participated in the virtual reality training in parallel with the KT technique showed statistically significant improvement (** p &lt; 0.01) in the FMA-UE, WMFT, and MAL evaluations that investigate changes in upper extremity function. SEF evaluation also showed a statistically significant improvement (** p &lt; 0.01). A statistically significant difference between the two groups was observed in the evaluation of FMA-UE, WMFT, MAL-QOM, and SEF († p &lt; 0.05), showing that that combined intervention was more effective at improving upper extremity function than the existing VRT intervention. There was no statistical difference between the two groups in the MAL-AOU item, which is an evaluation of upper extremity function (p &gt; 0.05). There was a statistically significant difference between the two groups in the amount of change in upper limb function (†† p &lt; 0.01). (4) Conclusions: It was confirmed that virtual-reality-based hand motion training performed in parallel with the KT technique had a positive effect on the recovery of upper extremity function of stroke patients. The fact that the KT technique provided stability to the wrist by assisting the wrist extensor muscles appears to have improved the upper extremity function more effectively than VRT alone.

Hand grip strength is a critical indicator of upper extremity function, especially important in healthcare professions. Effective upper extremity function relies on proximal stability from the scapula and distal mobility from hand actions. This study aimed to examine the relationship between scapular dyskinesia and hand grip strength in healthcare students with smartphone addiction. A descriptive cross-sectional study was conducted with 63 students with smartphone addiction. Scapular dyskinesia was measured using Lateral Scapular Slide Test (LSST) at neutral, 45 and 90 degrees. Hand grip strength was measured using the Jamar Hydraulic hand dynamometer. The Short version of Smartphone Addiction Scale (SAS-SV) questionnaire assessed the severity of smartphone addiction, while the Disability of Arm, Shoulder and Hand (DASH) questionnaire evaluated the impact on upper extremity function. A negative correlation was found between LSST at 45degrees and hand grip strength. However, no significant correlation was observed between SAS-SV, DASH, and scapular dyskinesia. Findings of the present study report a negative association between scapular dyskinesia at 45 degrees of LSST and hand grip strength. This suggests greater the scapular dyskinesis, lower will be the hand grip strength.

Date Presented 4/7/2016 What is the correlation between muscle strength of the upper extremity and hand function in older adults? Our study shows that arm-curl strength, rather than grip strength, is correlated with hand function. An arm-curl strength test may be used to predict hand function performance in older clients. Primary Author and Speaker: Chiung-ju Liu Additional Authors and Speakers: Aaron Frederick, Elaine Fess, Kristen Utley, Jessica Bertram, Deana Schuman

Surviving a burn can dramatically alter a child's life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5-7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5- < 18 years) who were hospitalized or had burn surgery between 08/2011 and 09/2012 completed the Burn Outcomes Questionnaire (BOQ). Outcomes were compared between two subgroups: children with mild/intermediate burns (<10% total body surface area (TBSA) burned) versus severe burns ((1) aged <10 years old at the time of injury with >10% (TBSA) burned; (2) aged ≥10 years with >20% TBSA burned; or (3) >5% full-thickness burns). A total of 102 children were included (mean age at survey: 8.4 (3.0) years; mean former TBSA: 7.1%). At a mean of 5.7 years post-burn, many parents rated their child's health as excellent (46.1%) or very good (35.3%), with few reporting issues with 'pain' (2.3%), 'physical function and sports' (1.6%), and 'upper extremity function' (0.9%). Parents of children with severe burns indicated significantly more problems with 'appearance' (89.2% versus 71.5%; p = 0.014) and 'parental concern' (94.1% versus 84.8%; p = 0.021). Upper limb burns, facial burns, burn size, length of hospital stay, full-thickness burns, and the number of surgeries predicted poorer outcomes. In general, these findings indicate positive long-term HRQL, though especially children with full-thickness burns and/or surgical interventions face a higher risk of reduced HRQL. The results can be used to inform children and their families about the long-term implications. Furthermore, healthcare professionals can use these insights to identify children at higher risk of poorer long-term HRQL.

Effects of interactive robot-enhanced hand rehabilitation in treatment of paediatric hand-burns: A randomized, controlled trial with 3-months follow-up.

We aimed to investigate the effect of hand osteoarthritis (HOA) on hand strength, dexterity, and upper extremity functional scores, as well as to determine the relation of radiological severity of HOA with these parameters. Sixty patients and 40 controls were enrolled in the study. The presence of hand pain, nodes, and tenderness in hand joints was determined. Grip and pinch strengths were measured by Jamar dynamometer and pinch meter, dexterity was assessed by Purdue pegboard test, and upper extremity function was determined by disabilities of arm, shoulder and hand (DASH) test. Hand radiographs were evaluated according to the Kallman grading scale. The mean age of the patients and control subjects were 58.9 ± 4.8 and 56.6 ± 5.8years, respectively. The level of hand pain and tenderness, and the number of nodes were significantly higher in the patient group than in control subjects. The mean grip and pinch strengths were lower in the patient group,: however, the difference was significant only in left lateral and left three chuck pinch. In hand dexterity, all scores except Purdue 1 were significantly lower in the patient group. In the functional evaluation DASH outcome, questionnaire scores of the patient and control groups were 48.3 ± 26.3 and 39.5 ± 23.5, respectively (p > 0.05). In the patient group, Kallman scores indicating radiological severity were found to be correlated with age, DASH scores, grip and pinch strengths, and Purdue scores (except Purdue assembly). Pain by visual analog scale was significantly higher in the patient group and correlated significantly with DASH scores. In patients with HOA, using standardized tests for evaluations may not be adequate. The determination of grip-pinch strength, dexterity and functional disability will lead to a clearer definition of the needs of the patients and will likely increase the gains from the rehabilitation programs.

Objectives To investigate the relationship between scapular alignment and upper extremity function. Methods Eighty-five children (63 boys and 22 girls) with spastic hemiplegic cerebral palsy aged 3 to 6 years were included in the study. Scapular upward rotation was assessed using Postural Zone software, and upper extremity function was assessed using the Pediatric Arm Function Test. Results There was a significant difference (p = .0001) in the degree of upward scapular rotation between less affected and affected sides (−41.78 ± 4.87 and −26.42 ± 6.34, respectively). There was a significant difference (p = .0001) between the function of the upper extremity of the affected side and the less affected sides (48.15 ± 14.37, 62.1 ± 6.62, respectively). Pearson Correlation Coefficient (r) was calculated, and there was a strong negative significant correlation between the degree of scapular upward rotation of the affected side, a unilateral score of the affected side, and the total score of the Pediatric Arm Function Test (r = −0.976, p = .0001 and r = −0.973, p = .0001, respectively). The correlation between symmetry index and total score of the Pediatric Arm Function Test was a strong positive significant correlation (r = 0.946, p = .0001). Conclusion The degree of upward scapular rotation was less on the affected side. Scapular alignment and symmetry may contribute to upper extremity function in children with hemiplegic cerebral palsy. Clinically, correction of scapular deviations may be considered in the rehabilitation program for children with hemiplegic cerebral palsy. This study suggests further experimental studies to find the cause and effect.