Evaluation of the Association Between Carrying Angle, Hand Grip Strength, Lateral Pinch Strength, and Hand Functional Index in Nursing Students / Evaluación de la Asociación entre el Ángulo de Carga, la Fuerza de Agarre de la Mano, la Fuerza de Pellizco Lateral y el Índice Funcional de la Mano en Estudiantes de Enfermería

SUMMARY: Health professionals especially nurses have ongoing contact with patients and they may have a high incidence of musculoskeletal problems. For this reason, grip strength and carrying angle are important parameters for all health professionals to succeed in their job and avoid injuries. It was aimed to determine the effects of the hand grip, and pinch strength, carrying angle of dominant, and non-dominant hands as well as the association of the hand functional index with morphometric measurements in 193 nursing students. The means of the carrying angle of dominant and non-dominant sides were 169.11±4.21° and 168.16±4.30°, respectively. The means of the dominant and, non-dominant sides of hand grip strength were 45.99±11.24 kg and 45.89±11.34 kg, respectively. The lateral pinch strength means were measured as 19.55±3.75 kg and 19.31±3.45 kg, respectively. This paper's findings may be important for some experts such as anatomists, clinicians, surgeons, forensic scientists, anthropologists, and nurses- healthcare professionals keep in touch with patients. Also, we believe that appropriate and effective knowledge of carrying angle, hand grip and lateral pinch strength has created an opportunity to research in terms of reducing work-related risk factors.

Los profesionales de la salud, especialmente las enfermeras, se mantienen en contacto con los pacientes y pueden tener una alta incidencia de problemas musculo-esqueléticos. En consecuencia, la fuerza de agarre y el ángulo de carga son parámetros importantes para que todos los profesionales de la salud tengan éxito en su trabajo y eviten las lesiones. El objetivo de este estudio fue determinar los efectos de la fuerza de prensión y pinzamiento de la mano, el ángulo de carga de las manos dominantes y no dominantes, así como la asociación del índice funcional de la mano con medidas morfométricas en 193 estudiantes de enfermería. Las medias del ángulo de carga de los lados dominante y no dominante fueron 169,11±4,21° y 168,16±4,30°, respectivamente. Las medias de los lados dominante y no dominante de la fuerza de prensión manual fueron 45,99 ± 11,24 kg y 45,89 ± 11,34 kg, respectivamente. La media de la fuerza de pellizco lateral se midió como 19,55 ± 3,75 kg y 19,31 ± 3,45 kg, respectivamente. Los hallazgos de este artículo pueden ser importantes para algunos expertos, como anatomistas, médicos clínicos, cirujanos, científicos forenses, antropólogos y enfermeras y profesionales de la salud que se mantienen en contacto con los pacientes. Además, creemos que el conocimiento apropiado y efectivo del ángulo de carga, el agarre de la mano y la fuerza de pellizco lateral ha creado una oportunidad para investigar en términos de reducción de los factores de riesgo relacionados con el trabajo.

Fractura de catéter implantable con reservorio por síndrome de pinch-off / Totally implantable venous access device fracture due to pinch-off syndrome

RESUMEN La fractura y embolización de un catéter implantable con reservorio es una complicación infrecuente, pero potencialmente grave. El síndrome pinch-off fue descripto en los accesos venosos subclavios, cuando la sección del catéter se produce por la compresión intermitente entre la primera costilla y la clavícula. Informamos el caso de una paciente oncológica a quien se le colocó un catéter implantable con reservorio por acceso percutáneo ecoguiado y control radioscópico en la vena subclavia. Luego de varias sesiones de quimioterapia comenzó con mal funcionamiento del catéter; la radiografía de tórax evidenció la fractura completa del catéter a nivel del espacio costoclavicular con embolia de un fragmento a las cavidades cardíacas. Se realizó la extracción endovascular del catéter fracturado me diante lazo de nitinol por acceso percutáneo femoral, sin complicaciones. Se analizan la incidencia, los factores de riesgo y las medidas para prevenir el síndrome de pinch- off en los catéteres implantables con reservorio.

ABSTRACT Fracture and migration of totally implantable venous access devices is a rare but potentially serious complication. Pinch-off syndrome was described in subclavian venous accesses when the intermittent compression of the catheter between the first rib and the clavicle produces catheter fracture. The report the case of a patient with cancer who underwent implantation of a totally implantable venous access device through the subclavian vein under ultrasound and radioscopy guidance. After several cycles of chemotherapy, the patient started with malfunctioning of the device. The chest X-ray showed a complete fracture of the catheter at the level of the costoclavicular space with migration of a fragment of the catheter to the right cardiac chambers. The fractured catheter was percutaneously removed via the right femoral vein using nitinol gooseneck snare without complications. The incidence of the pinch-off syndrome, risk factors and prevention measures in totally implantable venous access devices are analyzed.

Application of three fingers to pinching needle method in infusion port / 中国实用护理杂志

Objective To explore the advantages of the three-finger method of pinching the needle infusion port. Methods A total of forty three patients who underwent intracranial vein infusion port implantation between January 2018 and June 2018 were enrolled. The self-control method was divided into the test group and the control group, and both groups of patients used a safe butterfly wing non-destructive needle. The control group used the traditional needle insertion method from July 1st to July 31st. The experimental group used the three-finger needle-to-needle method from August 1st to August 31st to compare the two groups of patients in one-time injection. Different results in terms of local skin bleeding and patient satisfaction. Results The one-time injection rate and non-bleed rate of the control group were both 25.6%(11/43) and the satisfaction rate was 20.9%(9/43). There was one case of pedicle turnover, one case of clipping syndrome, and one case of local infection; no other complications. The one-time injection rate and non-bleed rate of the test group were both 90.7%(39/43) and the satisfaction rate was 90.7%(39/43); there was one case of clipping syndrome; no other complications. The difference of one-time injection rate, local non-bleed rate and satisfaction rate between the two groups was statistically significant (χ2=37.45, 37.45,42.43, both P<0.05). Conclusions The three-finger method of pinching the needle can improve the one-time injection rate of the nurse, improve the patient's satisfaction and reduce the complications. This aspect deserves to be promoted in the clinic.

Application of three fingers to pinching needle method in infusion port / 中国实用护理杂志

Objective@#To explore the advantages of the three-finger method of pinching the needle infusion port.@*Methods@#A total of forty three patients who underwent intracranial vein infusion port implantation between January 2018 and June 2018 were enrolled. The self-control method was divided into the test group and the control group, and both groups of patients used a safe butterfly wing non-destructive needle. The control group used the traditional needle insertion method from July 1st to July 31st. The experimental group used the three-finger needle-to-needle method from August 1st to August 31st to compare the two groups of patients in one-time injection. Different results in terms of local skin bleeding and patient satisfaction.@*Results@#The one-time injection rate and non-bleed rate of the control group were both 25.6%(11/43) and the satisfaction rate was 20.9%(9/43). There was one case of pedicle turnover, one case of clipping syndrome, and one case of local infection; no other complications. The one-time injection rate and non-bleed rate of the test group were both 90.7%(39/43) and the satisfaction rate was 90.7%(39/43); there was one case of clipping syndrome; no other complications. The difference of one-time injection rate, local non-bleed rate and satisfaction rate between the two groups was statistically significant (χ2=37.45, 37.45,42.43, both P<0.05).@*Conclusions@#The three-finger method of pinching the needle can improve the one-time injection rate of the nurse, improve the patient's satisfaction and reduce the complications. This aspect deserves to be promoted in the clinic.

Peripheral device to quantify grip and pinch capacity of children

Abstract Introduction Grip and pinch movements are important to perform daily activities and to manipulate objects. In this paper we describe the development and evaluation of a peripheral device to quantify cylindrical grip, pulp-to-pulp pinch, pulp-to-side pinch strength and range of motion of children. Methods Three objects were selected: a door handle, a switch, and a key, which were instrumented with force sensing resistors to analyse the strength. Potentiometers were used to verify the range of motion and micro switches to assure the correct position of the fingers during the movement execution. Thirty volunteers (8.77 ± 1.28), both male and female, were selected to test the peripheral device functionality. Results The results determined the minimum necessary strength values for the object activation and maximum displacement, in which the values are 2.5N, 40°; 2.7N, 55°; and 2.8N, 100%, for door handle object, key object, and switch object, respectively. In the functionally tests, volunteers have shown a superior strength for activating each object and 73.33% of them have completed the range movement in the key object, 86.67% in the switch object, and 93.33% in the door handle object. Conclusion The developed peripheral device enabled the measurement of range and static and dynamic strength of grip and pinch movements of children.

Perspectives on the integration of a supercritical fluid extraction plant to a sugarcane biorefinery: thermo-economical evaluation of CO2 recycle systems

Abstract In the present study, the software Aspen Plus® was used to analyse two different systems for CO2 recycle in a SFE process for extraction of more polar compounds using ethanol as co-solvent, the most common co-solvent used due to its environment-friendly nature. The extraction process of β-ecdysone from Brazilian ginseng roots was considered as example in the computational simulations. The first CO2 recycle system, named Recycle A, considered the compression of the CO2 separated in the second flash to the recycle pressure assumed at the first flash tank, its cooling to 25 °C and recirculation, while the second recycle system, named Recycle B, considered the cooling and pumping of the CO2 separated in the second flash, its heating to 25 °C and recirculation. The best techno-economic condition to operate the recycling step would be using Recycle A at 40 bar and 30 °C considering a stand-alone SFE process; and using Recycle B at 40 bar and 40 °C, considering this process in close proximity of a hypothetical sugarcane biorefinery. Therefore, these results suggest that the selection where would be located the SFE plant should be taken into account during the first steps of the process design.

Pinch-Off Syndrome, a Rare Complication of Totally Implantable Venous Access Device Implantation: A Case Series and Literature Review

BACKGROUND: Pinch-off syndrome (POS) is a rare complication after totally implantable venous access device (TIVAD) implantation. In cancer patients, it is important to prevent this rare complication and to recognize it early if it does occur. We present a case series of POS after TIVAD implantation and the results of a literature search about this complication. METHODS: From July 2006 to December 2015, 924 permanent implantable central venous catheter implantation procedures were performed. The most common indication was vascular access for chemotherapy. RESULTS: POS occurred in 5 patients in our clinic. Two patients experienced POS within 2 weeks, and the other 3 patients were admitted to department of surgery, Istanbul Faculty of Medicine at 6 to 14 months following implantation. The catheters were found to be occluded during medication administration, and all patients complained of serious pain. The transected fragments of the catheters had migrated to the heart. They were successfully removed under angiography with a single-loop snare. CONCLUSION: POS is a serious complication after TIVAD implantation. It is important to be aware of this possibility and to make an early diagnosis in order to prevent complications such as drug extravasation and occlusion events.

Fadiga dos músculos extensores do punho diminui a força de preensão palmar / La fatiga de los músculos extensores de muñeca disminuye la fuerza de prensión palmar / Fatigue of the wrist extensor muscles decreases palmar grip strength

RESUMO O objetivo deste estudo foi avaliar os efeitos de um protocolo de fadiga dos músculos extensores de punho na força de preensão e da pinça lateral através da dinamometria e eletromiografia de superfície (EMG). Foram selecionados 40 indivíduos do sexo masculino, divididos em dois grupos: preensão ou pinça lateral. O protocolo de fadiga foi baseado no teste de 1 Repetição Máxima (1-RM), seguido da realização do movimento de extensão de punho repetidas vezes com carga de 75% da 1-RM. Os voluntários realizaram as tarefas de preensão ou pinça lateral associadas à dinamometria. A EMG foi realizada para ambos os grupos, analisando o comportamento, segundo o protocolo, pela frequência mediana (FM) do extensor radial do carpo (ERC), do extensor ulnar do carpo (EUC) e do flexor superficial dos dedos (FD). A dinamometria de preensão ou pinça lateral e a EMG foram realizadas antes e após o protocolo de fadiga para ambos os grupos. O protocolo de fadiga foi eficaz na diminuição da força de preensão palmar (43,5±3,85 kgf inicial e 36,50±5,1 kgf final) e da pinça lateral (10,26±1,01 kgf inicial e 8,54±0,86 kgf final), bem como na diminuição da FM, sugerindo uma condição de fadiga do EUC no grupo preensão. Os achados do presente estudo possibilitam relacionar a fadiga dos extensores de punho à diminuição de força em atividades funcionais, como a preensão, o que pode implicar em disfunções musculoesqueléticas do membro superior.

RESUMEN En este estudio se evalúa los resultados de un protocolo de fatiga de los músculos extensores de muñeca en la fuerza de presión y de pinza empleando la dinamometría y la electromiografía de superficie (EMG). Se eligieron a cuarenta hombres, los cuales fueron divididos en dos grupos: el de presión y el de pinza lateral. Se basó el protocolo de fatiga en la prueba de 1 Repetición Máxima (1RM), y se realizó el movimiento de extensión de muñeca muchas veces con carga del 75% de la 1RM. Los participantes realizaron la tarea de prensión o de pinza lateral asociada a la de dinamometría. La EMG fue realizada por ambos grupos, en los que se evaluó el comportamiento ante el protocolo de la frecuencia mediana (Fm) del extensor radial del carpo (ERC), del extensor cubital del carpo (ECC) y del flexor superficial de los dedos (FD). Se realizaron la dinamometría de presión o de pinza lateral y la EMG antes y después del protocolo de fatiga en ambos grupos. El protocolo de fatiga fue eficaz en la disminución de la fuerza de presión palmar (43,5±3,85 kgf inicial y 36,50±5,1 kgffinal) y de pinza lateral (10,26±1,01 kgf inicial y 8,54±0,86 kgf final), así como en la disminución de la Fm, lo que demuestra una condición de fatiga del ECC en el grupo de presión. Los resultados de este estudio permiten relacionar la fatiga de los extensores de muñeca a la disminución de fuerza en las actividades funcionales, lo que puede causar trastornos musculoesqueléticos del miembro superior.

ABSTRACT The objective of this study was to evaluate the effects of a wrist extensor muscles fatigue protocol at the handgrip and lateral pinch strength through dynamometry and surface electromyography (EMG). Forty male individuals were divided into two groups: handgrip and lateral pinch group. The fatigue protocol was based on the 1 Maximal Repetition (1-MR) test, followed by wrist extension movement repeated multiple times with a load of 75% of 1-MR. The volunteers performed hand grip and lateral pinch with a dynamometer. Surface EMG was performed by both groups to analyze the behavior of median frequency (MF) during a fatigue protocol. The muscles extensor carpi radialis longus and brevis, extensor carpi ulnaris, extensor digitorum and flexor digitorum superficialis were analyzed. The strength and EMG evaluations were carried out before and after the fatigue protocol in both groups. The fatigue protocol was effective on hand grip strength reduction (43.5±3.85 kgf in baseline and 36.50±5.1 kgf final) and lateral pinch strength reduction (10.26±1.01 kgf in baseline and 8.54±0.86 kgf final) (p<0.05, 95% CI). At the EMG analysis, using median frequency, an ulnaris carpal extensor muscle fatigue at the handgrip group was evidenced. The findings indicate that wrist extensors fatigue can decrease the strength in functional activities such as handgrip, resulting in upper limb dysfunctions.

Prevention of pinch-off syndrome in postoperative complications of totally implantable central venous access ports / 国际外科学杂志

Objective To evaluate the occurrence and prevention of pinch-off syndrome in post-operative complications of totally implantable central venous port.Methods From October 2003 to September 2016,628 cases underwent implantable central venous port via the subclavian vein using the landmark venipuncture technique.From February 2014 to September 2016,106 cases underwent implantable central venous port gaining subclavian venous access.Retrospective analysis of two groups of pinch-off syndrome after totally implantable central venous port.Results pinch-off syndromne were not found in the uhrasound-guided group,pinch-off syndrome occurred in 9 patients of 628 cases underwent implantable central venous port via the subclavian vein using the landmark venipuncture technique during follow-up period.Conclusions Subclavian venous access cannulation on the lateral side of mid-clavicular line by ultrasound guidance was found to be associated with absence of pinch-off syndrome.This method appears to reduce or prevent pinch-off syndrome occurrence after implantable central venous port,therefore improving the safety of the long-term management of implantable central venous port.

Conjuctivochalasis - a review.

Conjunctivochalasis is an ocular condition that is usually missed, unless specifically looked for. It is defined as a redundant loose non edematous inferior bulbar conjunctiva. Though generally asymptomatic, It may also present as dryness and foreign body sensation. Various grading systems like Mirmura ((based on Lid-parallel conjunctival folds), Mellers (based on lid-parallel conjunctival folds, punctual occlusion and conjunctival fold changes during down gaze and digital pressure) and Zhang’s based on conjunctival folds, dryness, foreign body sensations, epiphora symptoms, punctual occlusion, tear meniscus height, tear film break-up time (BUT), and conjunctival fold changes during down gaze) system has been outlined. Various etiological aspects like dissolution of the Tenon’s Capsule and role of expression of matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-3 (MMP-3) has been dealt in detail. Different surgical approaches like pastepinch- cut conjunctivoplasty and their steps are specified. Conjunctivochalasis has to be understood in a wider depth and more research work is required to understand CCh in better detail so that preventive steps can be implemented with regard to secondary causes.

Short-Term Strength Deficit Following Zone 1 Replantations

BACKGROUND: Hand strength deficit following digital replantation is usually attributed to the mechanical deficiency of the replanted digit. Zone 1 replantation, however, should not be associated with any mechanical deficit, as the joint and tendon are intact. We evaluate short-term motor functions in patients who have undergone single-digit zone 1 replantation. METHODS: A single-institution retrospective review was performed for all patients who underwent zone 1 replantation. Hand and pinch strengths were evaluated using standard dynamometers. Each set of measurements was pooled according to follow-up periods (within 1 month, 1 to 2 months, 2 to 3 months, and after 3 months). The uninjured hand was used as reference for measurements. RESULTS: The review identified 53 patients who had undergone zone 1 replantation and presented for follow-up visits. Compared to the uninjured hand, dynamometer measurements revealed significantly less strength for the hand with replanted digit at one month. The relative mean grip, pulp, and key pinch strength were 31%, 46%, and 48% of the uninjured hand. These three strength measurements gradually increased, with relative strength measurements of 59%, 70%, and 78% for 4-month follow up. CONCLUSIONS: Despite the lack of joint or tendon injury, strength of the injured hand was significantly lower than that of the uninjured hand during the 4 months following replantation. Improved rehabilitation strategies are needed to diminish the short-term negative impact that an isolated zone 1 replantation has on the overall hand strength.

Relationship Between Grip and Pinch Strength and Activities of Daily Living in Stroke Patients

OBJECTIVE: To investigate the relationship between grip and pinch strength and independence in activities of daily living (ADL) in stroke patients. METHODS: Medical records of 577 stroke patients from January 2010 to February 2013 were retrospectively reviewed. Patients' grip and pinch strength of both hemiplegic and non-hemiplegic hands and the Korean version of Modified Barthel Index (K-MBI) score were collected. These patients were divided into three groups: group A (onset duration: 3 months and or =2 years). The correlation between grip and pinch strength and the K-MBI score was analyzed. RESULTS: In group A (95 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of both hands in patients with right hemiplegia. Significant (p<0.05) correlation between the K-MBI score and the grip and pinch strength of the hemiplegic hand was shown in patients with left hemiplegia. In group B (69 patients) and group C (73 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of the hemiplegic hand. CONCLUSION: Stroke patients in subacute stage mainly performed activities of daily living using their dominant hand. However, independence in ADL was associated with the strength of the affected dominant hand. For stroke patients in chronic and late chronic stages, their hand power of the affected hand was associated with independence in ADL regardless whether the dominant hand was affected.

Pinch-off syndrome / 대한외과학회지

Subclavian venous catheterization was previously frequently performed, but because of life-threatening complications such as hemothorax, pneumothorax, mediastinal hematoma, and myocardial injury, its use has become less common. However, this practice has some advantages in patient mobility, secured dressing, and rapidity and adequacy of vascular access. In some situations where patient comfort is an especially important consideration, such as with totally implantable venous port insertion for chemotherapy, the subclavian route can be a good choice if an experienced and well-trained faculty is available. The authors have had recent experience with pinch-off syndrome-in other words, spontaneous catheter fracture-in 3 patients who had undergone venous port implantation through the right subclavian route. Through these cases, we intend to review the dangers of subclavian venous catheterization, the causes of pinch-off syndrome, and its clinical presentation, progress, treatments, and prevention.

Normative Measurements of Grip and Pinch Strengths of 21st Century Korean Population

BACKGROUND: Measuring grip and pinch strength is an important part of hand injury evaluation. Currently, there are no standardized values of normal grip and pinch strength among the Korean population, and lack of such data prevents objective evaluation of post-surgical recovery in strength. This study was designed to establish the normal values of grip and pinch strength among the healthy Korean population and to identify any dependent variables affecting grip and pinch strength. METHODS: A cross-sectional study was carried out. The inclusion criterion was being a healthy Korean person without a previous history of hand trauma. The grip strength was measured using a Jamar dynamometer. Pulp and key pinch strength were measured with a hydraulic pinch gauge. Intra-individual and inter-individual variations in these variables were analyzed in a standardized statistical manner. RESULTS: There were a total of 336 healthy participants between 13 and 77 years of age. As would be expected in any given population, the mean grip and pinch strength was greater in the right hand than the left. Male participants (137) showed mean strengths greater than female participants (199) when adjusted for age. Among the male participants, anthropometric variables correlated positively with grip strength, but no such correlations were identifiable in female participants in a statistically significant way. CONCLUSIONS: Objective measurements of hand strength are an important component of hand injury evaluation, and population-specific normative data are essential for clinical and research purposes. This study reports updated normative hand strengths of the South Korean population in the 21st century.

Reliability of the Pinch Strength with Digitalized Pinch Dynamometer

OBJECTIVE: To examine the intra-rater, inter-rater, and inter-instrumental reliability of the digitalized pinch muscle strength dynamometer. METHOD: Thirty normal subjects were examined for pinch strength, using both the Preston pinch gauge and the digitalized pinch dynamometer. The participants performed all pinch strength tests in the seated position as recommended by the American Society of Hand Therapists (ASHT). Three successive measurements were taken for each hand. The mean of the three trials was used for data analysis. The pinch strength tests performed used a repeated measure design and measurements were taken by each rater. RESULTS: The relationship between the Preston pinch gauge and the digitalized pinch dynamometer in pinch strength was reliable (the ICC were 0.821 and 0.785 in rater 1 and rater 2 respectively). The relationship between the first session and second session in pinch strength using the digitalized pinch dynamometer was reliable (the ICC were 0.872 and 0.886 in rater A and rater B respectively). The relationship between rater A and rater B in pinch strength using the digitalized pinch dynamometer was reliable (the ICC was 0.754). CONCLUSION: The pinch strength measurement using the digitalized pinch dynamometer is reliable within the rater and between raters. Thus, the Preston pinch gauge and the digitalized dynamometer measure grip strength equivalently, and can be used interchangeably.

Elastic bandage vs. neoprene thumb stabilizer splint in acute De Quervain’s tenosynovitis.

Background: De Quervain’s tenosynovitis is a common disease among the patients who performed unaccustomed repetitive movement of the thumb side of the wrist. A neoprene thumb stabilizer splint is often used to restrict thumb movement. However, because of its cost, usage of an elastic bandage made of cheaper materials is proposed. Objective: Compare the effectiveness between the elastic bandage and the neoprene thumb stabilizer splint in acute De Quervain’s tenosynovitis. Methods: Forty participants with acute De Quervain’s tenosynovitis were divided into two groups (20 participants each). The first group used the elastic bandage, and the second group used the neoprene thumb stabilizer splint. Visual Analog Scale (VAS) pain, lateral and palmar pinch strength were measured before and after using the bandage and the splint for one or two weeks. Results: The average ages in the bandage and the splint group were 53.15±10.42 and 48±11.7 years, respectively. The VAS pain score of the bandage and splint group over week 0, 1, and 2 were 58.50, 33.90 and 19.55, and 51.60, 35.85 and 25.20, respectively. The bandage and splint group had the lateral pinch strength over the time of 9.40, 10.70 and 11.25 lbs, and 8.90, 9.88 and 10.57 lbs, respectively. Furthermore, they had the palmar pinch strength of 3.63, 4.68 and 5.28 lbs, and 3.07, 3.92 and 4.29 lbs, respectively. Conclusion: The pain and strength were not significantly different between the bandage and the splint group in acute De Quervain tenosynovitis. Using the bandage may be more cost-effectiveness than using the splint.

Força de preensão palmar e pinças em indivíduos sadios entre 6 e 19 anos / Grip and pinch strength in healthy children and adolescents

OBJETIVO: Determinar e comparar os valores das forças isométricas de preensão palmar e pinças em indivíduos sadios de 6 a 19 anos através da dinamometria, considerando as variáveis sexo, dominância e faixa etária. MÉTODOS: Foram avaliados 199 indivíduos utilizando os dinamômetro Jamar® para a mensuração da preensão palmar e Preston Pinch Gauge® para as pinças, realizando três mensurações consecutivas,, utilizando a média. A análise estatística foi realizada pela regressão linear com efeitos mistos. RESULTADOS: Os valores em kgf encontrados foram 24,51, 3,64, 5,37 e 6,78, respectivamente para preensão palmar, pinça polpa-a-polpa, trípode e lateral, independente das variáveis. Houve diferença significativa em todas as forças mensuradas analisando sexo e dominância independentemente, sendo a mão dominante e o sexo masculino os que obtiveram valores maiores. Entre as faixas etárias foi verificado que as forças variaram conforme a idade, com diferença significativa na maioria das comparações. CONCLUSÃO: Concluímos que a força de preensão palmar e das pinças apresentou diferença significativa no sexo, na dominância e na maioria dos subgrupos etários estudados, devendo ser considerados na dinamometria. Este estudo se mostrou relevante como referência de normalidade para avaliações das forças de preensão e pinças das mãos em crianças e jovens.

OBJECTIVE: This study aimed to determine and compare the values of maximum isometric palmar grip and pinch forces in healthy children between 6 and 19 years old using dynamometry, considering gender, dominance and age. METHODS: 199 subjects were evaluated using Jamar® dynamometer to measure palmar grip strength and Preston Pinch Gauge® dynamometer to evaluate pulp to pulp, lateral and three points pinch strength in a standardization testing protocol. The mean of three consecutive grip tests was recorded. Linear regression with mixed effects was used to statistically analyze the differences between data. RESULTS: Mean values found for palmar grip, pulp to pulp, three points and lateral pinch were 24,51kgf, 3,64kgf, 5,37kgf and 6,78kgf, respectively, regardless of the variables. There was statistical difference in all measures by gender and dominance, and the dominant hand and the males had higher grip forces. It was verified that mean values varied with age, with significant difference in most of comparisons between the age groups. CONCLUSION: We concluded that pinch and palmar grip strength demonstrated significant differences in gender, dominance and in most of age subgroups studied, being important to consider them on dynamometry. This study was relevant as reference of normality of hand strength in children and adolescents.

Changes in the Hand Strength and Related Factors after Carpal Tunnel Decompression / 대한정형외과학회잡지

PURPOSE: Our goal was to investigate an improvement in hand strength and its associated factors after carpal tunnel decompression in patients with carpal tunnel syndrome. MATERIALS AND METHODS: Between January 2008 and January 2009, a total of 31 patients (50 hands) treated with carpal tunnel decompression for carpal tunnel syndrome were enrolled into the study. Hand-strength was assessed pre- and post-surgery. In the pre-operation evaluation, we assessed multiple factors and investigated the association between these factors and recovery of hand strength. RESULTS: All patients regained hand strength after surgery. On average, the grip strength was 14.8 kg preoperatively, 13.0 kg at 6 weeks, 16.2 kg at 3 months, 18.7 kg at 6 months, and 20.6 kg at 1year postoperatively. The tip-pinch strength was 3.4 kg preoperatively and improved to 3.9 kg at 6 weeks, 4.0 kg at 3 months, 4.4 kg at 6 months and 4.7 kg at 1 year postoperatively. The key-pinch strength showed same pattern of improvement. The recovery of grip strength was significantly slower in patients with longer duration of carpal tunnel syndrome, with diabetes, or with nocturnal pain. There was no factor affecting the recovery of tip-pinch strength. Recovery of key-pinch strength was slower in patients that had experienced a longer duration of symptoms. CONCLUSION: Grip strength and pinch strength were recovered within 3 months and 6 weeks, respectively, after carpal tunnel decompression; both improved gradually until 12 months after surgery. Disease duration, diabetes, and nocturnal pain were significant factors that impacted on post-surgery recovery.

Study on the expression of PINCH and vascular endothelial growth factor C in cervical squamous cell carcinoma / 中国综合临床

Objective To study the expression of PINCH and vascular endothelial growth factor C (VEGF-C) in cervical squamous cell carcinoma.Methods We detected the expression of PINCH and VEGF-C by immunohistochemistry SP in 58 cervical squamous cell carcinoma cases and 30 normal cervical epithelial tissue and analyzed their relationship to the clinical pathological features.Results The expression of PINCH and VEGF-C in 58 cervical squamous cell carcinoma(62.1％,36/58 ;67.2％,39/58 ) were higher than that in normal cervical epithelial tissue(0,0/30).The difference was significant( x2 =31.512,12.534,P ＜ 0.001 ).The expression of PINCH protein was not significantly associated with the age,tumor size and tumor differentiation grade ( P ＞ 0.05 ),but was associated with the lymph node metastasis and clinical stage ( x2 =9.090,8.236,P ＜ 0.001 ).The expression of VEGF-C had no significant correlationship with the age and tumor size( P ＞ 0.05 ) but had a correlationship with the lymph node metastasis,tumor differentiation grade and clinical stage( x2 =10.775,13.496,5.001,P ＜ 0.05 ).The expression of VEGF-C was correlated with the expression of PINCH protein( C =0.341,P ＜ 0.01 ).Conclusion It is possible that VEGF-C and PINCH take part in the development and progress of cervical squamous cell carcinoma and play an important role in the invasion and metastasis mechanism altogether.

Parámetros de normalidad en fuerzas de prensión de mano en sujetos de ambos sexos de 7 a 17 años de edad / Normal parameters in hand grasping strength in subjects of both genders, 7 to 17 years of age

Introduction: Determining normal parameters in hand grasping strength will allow to determine clinical conditions and treatment results in patients with changes in hand dexterity. Purpose: Establish ranges of normal strength in three types of grasp in subjects of both genders, ages 7 to 17. Materials and Methods: 753 random subjects selected from schools in the Metropolitan Region, two-stage sampling, 2.12 percent error. The following tests were performed: cylindrical palmar (dynamometer), spherical palmar (vigorimeter), and subterminolateral clasp prehension (clasp). Means tests with 95 percent confidence were calculated. Results: 96.1 percent women and 95.6 men were right hand dominant. For cylindrical test, strength increased from 10.3 to 25 kg average at 17 years of age in women, in men in increased slowly up to 12 years of age reaching 39 kg at the end of the study. Spherical prehension showed slow, gradual increase reaching 0.45 bar in women and 0.65 bar in men at 17 years of age. Clasp at 17 years of age was 6.9 and 9.5 kg for women and men respectively. Conclusions: When the right hand is dominant, it is at least 6 percent stronger in clasp than the left hand in women, 5 percent in fist and clasp in men, with a 95 percent confidence between gender between the ages of 7 and 17. These data could be used as reference in patients with pathology that compromises dexterity in urban areas.

Introducción: Determinar parámetros de normalidad de fuerzas de prensión, permitirá objetivar condiciones clínicas y resultados de tratamientos en pacientes con alteraciones de funcionalidad manual. Objetivo: Establecer rangos de normalidad de fuerza en tres tipos de prensión en sujetos de ambos sexos de 7-17 años cumplidos. Materiales y Método: 753 sujetos seleccionados aleatoriamente de colegios de Región Metropolitana, en muestreo bietápico con 2,12 por ciento de error. Se evaluó prensión palmar cilíndrica (dinamómetro), palmar esférica (vigorímetro) y pinza sub-terminolateral (pinzómetro); se probó normalidad estadística para establecer intervalos de confianza de 95 por ciento para las medias. Resultados: 96,1 por ciento de mujeres y 95,6 por ciento de varones declararon mano derecha como dominante. Para prensión cilíndrica, la fuerza creció desde 10,3 hasta 25 kg promedio a los 17 a±os en mujeres; en varones, aumentó lentamente hasta los 12 años, alcanzando 39 kg promedio a igual edad. Prensión esférica presentó crecimiento lento y gradual obteniendo 0,45 bar en mujeres y 0,65 bar en varones de 17 años. En pinza, los valores promedio a la edad máxima, alcanzaron 6,9 y 9,5 kg para mujeres y hombres respectivamente. Conclusión: la mano derecha cuando es considerada dominante, tiene a lo más, un 6 por ciento de fuerza en pinza mayor que la izquierda en mujeres y de 5 por ciento en fuerza de puño y pinza en hombres; los intervalos con 95 por ciento de confianza para las prensiones estudiadas según género de 7 a 17 años de edad, pueden constituirse en patrones de referencia al comparar las fuerzas de prensión en pacientes con patologías que comprometan función manual con la población normalmente desarrollada de áreas urbanas.