The aging hand

Hand Grip Strength and Its Sociodemographic and Health Correlates among Older Adult Men and Women (50 Years and Older) in Indonesia

Objective

There is lack of knowledge about the patterns and correlates of hand grip strength (HGS) of older adults in Indonesia. This study aims to assess sociodemographic and health determinants of HGS among older adult men and women in Indonesia.

Methods

Participants were 7097 individuals of 50 years and older (mean age 61.2 years, SD=9.4) that participated in the cross-sectional Indonesia Family Life Survey (IFLS-5) in 2014-15. The assessment measures included a questionnaire on sociodemographic characteristics and health variables and anthropometric and HGS measurements. Linear multivariable regression analysis was conducted to estimate the association of social and health variables and HGS.

Results

The mean HGS was 28.2 kgs for men and 17.2 kgs for women. In adjusted linear regression analysis among both men and women, height, being overweight or obese, and having a good self-rated health status were positively associated with HGS, while age, having underweight, low cognitive functioning, and functional disability were negatively associated with HGS. In addition, among men, higher education and medium economic background were positive and having two or more chronic conditions, having severe depressive symptoms, and having moderate sleep impairment were negatively associated with HGS.

Conclusion

The study contributed to a better understanding of patterns and correlates of HGS among older adults in Indonesia. Gender-specific and health related interventions may be needed so as to improve the physical functioning of the growing older populace in Indonesia.

Executive Functioning of Older Adults Correlates with Performance of Touchscreen App-Based Puzzles

BACKGROUND

The use of touchscreen tablets has become common in healthcare. This technology has the potential to be used as a motivational tool for cognitive training. Age-related decline in executive functioning (EF) and dexterity may lead to poor performance using tablet applications (apps), but the impact on performance of app-based puzzles has not been studied.

OBJECTIVES

(1) To characterize and compare the experience performance of playing tablet apps of older and younger adults, (2) To determine if EF and dexterity contribute to performance of app-based puzzles.

MATERIALS AND METHODS

We performed a cross-sectional study of community-dwelling healthy older (n = 35) and younger adults (n = 34). EF was measured by the Trail Making Test (part B) (TMT-B) and the Weekly Calendar Planning Activity. Dexterity was assessed using the Nine-Hole Peg Test. Participants played three unfamiliar app-based puzzles requiring EF and filled out the short feedback questionnaire.

RESULTS

All participants succeeded in playing the apps and reported enjoyment, however, older adults perceived less success and control. Significant differences in EF, dexterity, and performance were found between groups. EF of older adults (TMT-B) accounted for 17.7%-36.8% (P < 0.05) of the total variance of performance.

CONCLUSION

These findings have implications for the use of tablet apps for older adults. Longer instruction and training periods may be required for training EF among older adults.

Hand functions in patients with schizophrenia: A clinical comparison with bipolar disorder and healthy subjects

OBJECTIVE

Failure to achieve expected level of motor functioning may be a significant contributor to social withdrawal and further attenuation of life quality in patients with schizophrenia. Hand functioning is one of the most crucial entities in that manner. This study aimed to reveal this question by means of comparing patients with schizophrenia and bipolar disorder who are receiving similar antipsychotic psychopharmacological agents along with healthy control subjects.

METHODS

99 patients with schizophrenia were compared to 40 patients with bipolar disorder matched according to the received pharmacotherapy comprising similar antipsychotics and 81 medication-free socio-demographically matched healthy control subjects. The materials were Hand Functional Index (HFI), Duruoz Hand Index (DHI), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS) along with clinical characteristics.

RESULTS

Difference in total scores of DHI and HFI between schizophrenia, bipolar disorder and control groups were extremely significant (p < 0.001). Further post-hoc subgroup analysis revealed that patients with schizophrenia demonstrated higher scores of HFI indicating worse performance when compared to both bipolar disorder and control group. Significantly higher scores of DHI in patients with schizophrenia than healthy controls were noted.

CONCLUSION

Independent from the impact of the medication use, impairment in hand functions was found to be more frequently seen in schizophrenia when compared to patients with bipolar disorder and healthy subjects. It is evident that hand function impairment is seen independent from psychopharmacological side effect, and is recommended to be assessed as a possible preventable and retractable manifestation of schizophrenia.

Hand strength and dexterity in patients with Prader-Willi syndrome: a pilot intervention study

OBJECTIVE

The study aim was to examine the hand function (hand strength and dexterity) and intervention effects of training in adults with Prader-Willi syndrome (PWS).

METHODS

Six adults with PWS (two females; mean age 26.14 years) underwent hand muscle strength and dexterity training for 3 months (2 hours per week). The following hand function tests were performed pre- and post-intervention: (1) hand grip, lateral pinch, and tip pinch hand strength tests, (2) the Box and Block test (BBT) for gross manual dexterity and (3) the Purdue Pegboard test for finger dexterity.

RESULTS

Before treatment, all subjects showed lower hand grip, lateral pinch, tip pinch strength, and poorer manual/finger dexterity relative to healthy adults. After training, hand function scores improved on many test items, but only the left hand tip pinch and the right hand BBT performance showed significant improvements.

CONCLUSIONS

All subjects showed lower hand strength and poorer manual/finger dexterity compared with healthy adults; this should be considered during physical training programs. Owing to limitations in the intervention intensity and possible subject behavioral deficits, further research is needed to clarify the effects of this intervention on hand function in PWS patients.

Get a grip: individual variations in grip strength are a marker of brain health

Demonstrations that grip strength has predictive power in relation to a range of health conditions-even when these are assessed decades later-has motivated claims that hand-grip dynamometry has the potential to serve as a "vital sign" for middle-aged and older adults. Central to this belief has been the assumption that grip strength is a simple measure of physical performance that provides a marker of muscle status in general, and sarcopenia in particular. It is now evident that while differences in grip strength between individuals are influenced by musculoskeletal factors, "lifespan" changes in grip strength within individuals are exquisitely sensitive to integrity of neural systems that mediate the control of coordinated movement. The close and pervasive relationships between age-related declines in maximum grip strength and expressions of cognitive dysfunction can therefore be understood in terms of the convergent functional and structural mediation of cognitive and motor processes by the human brain. In the context of aging, maximum grip strength is a discriminating measure of neurological function and brain health.

How does ageing affect grasp adaptation to a visual-haptic size conflict?

Previous research suggests that the ability to adapt motor behaviour to sudden environmental changes may be impaired in older adults. Here, we investigated whether the adaptation of grasping behaviour in response to a visual-haptic size conflict is also affected by increasing age. 30 older and 18 young adults were instructed to grasp a hidden block whilst viewing a second block in a congruent position. Initially block sizes were equal, but after a set number of trials a sensory conflict was introduced by covertly changing the hidden block for a smaller or larger block. The scale and speed of maximum grasp aperture adaptation to the increase or decrease in the size of the hidden block was measured. Older adults successfully adapted to the visual-haptic size conflict in a similar manner to young adults, despite a tendency to adapt less when the hidden block increased in size. This finding is attributed to the physical capabilities of the grasping hand of older adults, rather than an effect of age-related sensory or cognitive decline. The speed of grasp adaptation did not differ between age groups; however, awareness of the visual-haptic conflict lead to faster adaptation. These findings suggest that sensorimotor adaptation for grasping is intact for cognitively healthy older adults.

The influence of digit size and proportions on dexterity during cold exposure

OBJECTIVES

The current study investigated whether size and proportions of the hands and digits affect dexterity during severe cold exposure. As wide hands are known to lose less heat than narrow hands, and narrow digits are associated with greater dexterity, this study aimed to test whether there was a direct trade-off between dexterity and thermoregulation that shapes hand morphology.

METHODS

Participants (25 women, 15 men) carried out the Purdue Pegboard test before and after a 3-min ice-water immersion of the hand. Their hand length, hand width, digit lengths, and digit widths were measured using standard anthropometric methods.

RESULTS

Wide first and third digits associated with significantly reduced dexterity after immersion relative to individuals with narrower first and third digits. Second digit width positively correlated with average digit temperature after immersion. Hand length and hand width did not influence dexterity.

CONCLUSION

The current study suggests that digit width influences dexterity in cold conditions, reflecting patterns found at room temperature. Hand and digit morphology may be the product of two significant constraints on the hand: dexterity and thermoregulation. In cold conditions, hand morphology appears to be predominantly constrained by thermal stress, at the expense of dexterity. This may have important implications for interpreting the morphology of extinct and extant hominins.

Mechanisms of tactile sensory deterioration amongst the elderly

It is known that roughness-smoothness, hardness-softness, stickiness-slipperiness and warm-cold are predominant perceptual dimensions in macro-, micro- and nano- texture perception. However, it is not clear to what extent active tactile texture discrimination remains intact with age. The general decrease in tactile ability induces physical and emotional dysfunction in elderly, and has increasing significance for an aging population. We report a method to quantify tactile acuity based on blinded active exploration of systematically varying micro-textured surfaces and a same-different paradigm. It reveals that elderly participants show significantly reduced fine texture discrimination ability. The elderly group also displays statistically lower finger friction coefficient, moisture and elasticity, suggesting a link. However, a subpopulation of the elderly retains discrimination ability irrespective of cutaneous condition and this can be related to a higher density of somatosensory receptors on the finger pads. Skin tribology is thus not the primary reason for decline of tactile discrimination with age. The remediation of cutaneous properties through rehydration, however leads to a significantly improved tactile acuity. This indicates unambiguously that neurological tactile loss can be temporarily compensated by restoring the cutaneous contact mechanics. Such mechanical restoration of tactile ability has the potential to increase the quality of life in elderly.

Oral curcumin supplementation improves fine motor function in the middle-aged rhesus monkey

Aged individuals experience decreased fine motor function of the hand and digits, which could result, in part, from the chronic, systemic state of inflammation that occurs with aging. Recent research for treating age-related inflammation has focused on the effects of nutraceuticals that have anti-inflammatory properties. One particular dietary polyphenol, curcumin, the principal curcuminoid of the spice turmeric, has been shown to have significant anti-inflammatory effects and there is mounting evidence that curcumin may serve to reduce systemic inflammation. Therefore, it could be useful for alleviating age-related impairments in fine motor function. To test this hypothesis we assessed the efficacy of a dietary intervention with a commercially available optimized curcumin to ameliorate or delay the effects of aging on fine motor function of the hand of rhesus monkeys. We administered oral daily doses of curcumin or a control vehicle to 11 monkeys over a 14- to 18-month period in which they completed two rounds of fine motor function testing. The monkeys receiving curcumin were significantly faster at retrieving a food reward by round 2 of testing than monkeys receiving a control vehicle. Further, the monkeys receiving curcumin demonstrated a greater degree of improvement in performance on our fine motor task by round 2 of testing than monkeys receiving a control vehicle. These findings reveal that fine motor function of the hand and digits is improved in middle-aged monkeys receiving chronic daily administration of curcumin.

The impact of finger position on pinch strength

Introduction

Pinch strength is a widely used measurement of hand function, but digit position on the pinch gauge has not been described in the literature. The aim of this study was to assess for differences in tip, lateral, and three-jaw-chuck pinch force when the digits are placed on the groove or bridge of a Bernadette and Linda pinch gauge.

Methods

Thirty-six healthy volunteers each pinched six times in random order: one for each type of pinch force with the digits placed in each position.

Results

There were no significant differences in pinch strength measurements based on digit position, except for three-jaw-chuck pinch which was slightly higher on the groove. Equivalence was found within one pound for tip and lateral pinch but not for three-jaw-chuck.

Conclusion

Variations in finger position may result in similar pinch strength measurements for tip and lateral pinch. Clinicians may reliably assess lateral and tip pinch using either position; however, standardized positioning is still recommended.

Supplementary motor area-primary motor cortex facilitation in younger but not older adults

Growing evidence implicates a decline in white matter integrity in the age-related decline in motor control. Functional neuroimaging studies show significant associations between functional connectivity in the cortical motor network, including the supplementary motor area (SMA), and motor performance. Dual-coil transcranial magnetic stimulation studies show facilitatory connections between SMA and the primary motor cortex (M1) in younger adults. Here, we investigated whether SMA-M1 facilitation is affected by age and whether the strength of SMA-M1 facilitation is associated with bilateral motor control. Dual-coil transcranial magnetic stimulation was used to measure SMA-M1 connectivity in younger (N = 20) and older adults (N = 18), and bilateral motor control was measured with the assembly subtest of the Purdue Pegboard and clinical measures of dynamic balance. SMA-M1 facilitation was seen in younger but not older adults, and a significant positive association was found between SMA-M1 facilitation and bimanual performance. These results show that SMA-M1 facilitation is reduced in older adults compared to younger adults and provide evidence of the functional importance of SMA-M1 facilitation.

The effects of age and sex on hand movement structure

The aim was to investigate the effects of age and sex on hand function and ascertain age-related changes (magnitude and rate) by assessing a broad range of functional tasks with the dominant and non-dominant hands. A representative sample of 635 adults (114 males and 491 females) aged 50 years and over completed motor performance series of the Vienna Test System Parametric and non-parametric analysis and simple linear regression was used to examine the relationships. Significant relationships were observed between task performance and age and sex, although the contributions of both factors differed by varying degree. Compared with males, the females performed significantly better than males in the majority of tests, particularly with the dominant hand, although greater age-related reductions were observed in performance. Among the skills quantifying hand function, age accounted for the most variance in hand and finger dexterity.

Upper-limb motor and sensory function in patients with hip fracture: Comparison with community-dwelling older adults

BACKGROUND

Upper-limb function is important in patients with hip fracture so they can perform activities of daily living and participate in leisure activities. Upper-limb function of these patients, however, has not been thoroughly investigated.

OBJECTIVE

The aim of this study was to evaluate the upper-limb motor and sensory functions in patients with hip fracture by comparing these functions with those of community-dwelling older adults (control group).

METHODS

We compared the results of motor and sensory function tests of upper-limb function - range of motion, strength, sensibility, finger dexterity, comprehensive hand function - between patients with hip fracture (n= 32) and the control group (n= 32).

RESULTS

Patients with hip fracture had significantly reduced grip strength, pinch strength, finger dexterity, and comprehensive hand function compared with the control group.

CONCLUSIONS

Most upper-limb functions are impaired in the patients with hip fracture. Thus, upper-limb function of patients with hip fracture should be considered during treatment.

Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors

BACKGROUND

Hand-grip strength (HGS) serves as a proxy measure for muscle function and physical health. Studies have shown that low HGS is associated with common age-related disorders including frailty and sarcopenia. The aim of the present study was to establish the normative values of HGS among older adults in Singapore and to compare it with data from Western and other Asian countries. The study also aimed to explore the sociodemographic and anthropometric correlates of HGS.

METHODS

Data were collected from 2043 men and women aged 60 years and above who took part in the Well-being of the Singapore Elderly study in 2013. HGS was obtained using a Jamar Plus + digital hand dynamometer. Normative data were stratified by; 5-year age groups, sex and ethnicity. Relationships between the HGS with various sociodemographic and anthropometric correlates were examined using multiple linear regression analysis.

RESULTS

The mean HGS demonstrate a decreasing trend with increased age across all ethnic groups and sexes. HGS among Singapore older adults were relatively low compared to Western and other Asian countries. Males in the youngest age group (60-64) and of Chinese ethnicity attained greater HGS values than their counterparts. When the regression analysis was stratified for sex, significant associations were found between height, upper arm circumference with HGS in the males sample, and between height, weight, waist circumference and HGS in the females sample.

CONCLUSIONS

Older adults in Singapore have a relatively weak HGS compared to other countries. Greater height and weight, and smaller waist circumference are independently associated with greater HGS in females but not males. These results facilitate the interpretation of HGS conducting using Jamar digital-type dynamometers among the older adults in Singapore.

Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity

BACKGROUND

Hand function is critical for independence in activities of daily living for older adults.

AIMS

The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults.

METHODS

Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively.

RESULTS

Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = -.25, p < .01) and manual dexterous coordination (β = -.52, p < .01) performed better on the time-based hand function test. In comparison, older adults with better grip strength (β = .40, p < .01), arm curl strength (β = .23, p < .05), and manual dexterous coordination (β = .23, p < .05) were associated with better self-report of upper extremity function.

CONCLUSIONS

The relationship between grip strength and hand function may be test-specific. Grip strength becomes a significant factor when the test requires grip strength to successfully complete the test tasks. Arm curl strength independently contributed to hand function in both time-based and self-report assessments, indicating that strength of extrinsic muscles of the hand are essential for hand function.

Age-related changes in hand dominance and functional asymmetry in older adults

The aim of the study was to investigate fine motor performance and ascertain age-related changes in laterality between the dominant and non-dominant hand. A representative sample of 635 adults (144 males and 491 females) aged 50 years and over completed a test battery MLS (Motor Performance Series) to assess a broad range of hand functions. Functional asymmetry was observed in all four motor tests (postural tremor, aiming, tapping, and inserting long pins). Significant differences between the dominant and non-dominant hand were obtained in both sexes across all age groups, except in the oldest female group (age >70) for the aiming (number of hits and errors) and postural tremor (number of errors) tasks. These differences in age-related changes may be attributed to hemispheric asymmetry, environmental factors, or use-dependent plasticity. Conflicting evidence in the literature warrants additional research to better explain age-related alterations of hand dominance and manual performance in old age.

Evaluation of the controlled grip force exertion tasks associated with age, gender, handedness and target force level

INTRODUCTION

Force control of the hand is an essential factor for operating tools and moving objects. Therefore, a method for quantifying hand functionality more accurately and objectively is very important.

METHODS

The present study included 60 healthy participants (30 elderly and 30 young adults) to evaluate the effects of age, gender and target force levels on tracking performance. Tracking performance was quantified by measuring the difference between target force levels and exerted force.

RESULTS

Females exerted 59.6% of the maximum grip strength of males and the elderly group exerted 70.5% of maximum grip strength compared with the young group. The elderly group showed 3.1 times larger tracking error than the young group. There was a significant difference in females between the young and elderly groups, indicating age-related decline in hand function is more pronounced in females. The difference in grip force control ability between the elderly and young groups was significant at the low target force level (5% maximum voluntary contraction).

CONCLUSIONS

The results of this study could be used for hand function evaluation guidelines. In addition, this study could be used as a tool for physiotherapy to improve hand function and prevent its decline in elderly people.

Cognitive Processing Speed across the Lifespan: Beyond the Influence of Motor Speed

Traditional neuropsychological measurement of cognitive processing speed with tasks such as the Symbol Search and Coding subsets of the WAIS-IV, consistently show decline with advancing age. This is potentially problematic with populations where deficits in motor performance are expected, i.e., in aging or stroke populations. Thus, the aim of the current study was to explore the contribution of hand motor speed to traditional paper-and-pencil measures of processing speed and to a simple computer-customized non-motor perception decision task, the Inspection Time (IT) task. Participants were 67 young university students aged between 18 and 29 (59 females), and 40 older adults aged between 40 and 81 (31 females) primarily with a similar education profile. As expected, results indicated that age group differences were highly significant on the motor dexterity, Symbol Search and Coding tasks. However, no significant differences or correlations were seen between age groups and the simple visual perception IT task. Furthermore, controlling for motor dexterity did not remove significant age-group differences on the paper-and-pencil measures. This demonstrates that although much of past research into cognitive decline with age is confounded by use of motor reaction times as the operational measure, significant age differences in cognitive processing also exist on more complex tasks. The implications of the results are crucial in the realm of aging research, and caution against the use of traditional WAIS tasks with a clinical population where motor speed may be compromised, as in stroke.

An Analysis of Human Dorsal Hand Skin Texture Using Hyperspectral Imaging Technique for Assessing the Skin Aging Process

Skin texture has become an important issue in recent research with applications in the cosmetic industry and medicine. In this paper, we analyzed the dependence of skin texture features on wavelength as well as on different parameters (age and gender) of human participants using grey-level co-occurrence matrix and hyperspectral imaging technique for a more accurate quantitative assessment of the aging process. A total of 42 healthy participants (men and women; age range, 20-70 years) was enrolled in this study. A region of interest was selected from the hyperspectral images. The results were analyzed in terms of texture using the gray-level co-occurrence matrix which generated four features (homogeneity, contrast, entropy, and correlation). The results showed that most of these features displayed variations with wavelength (the exception was entropy), with higher variations in women. Only correlation in both sexes and contrast in men proved to vary statistically significant with age, making them the targeted variables in future attempts to characterize aging skin using the complex method of hyperspectral imaging. In conclusion, by using hyperspectral imaging some measure of the degree of damage or the aging process of the hand skin can be obtained, mainly in terms of correlation values. At the present time, reasonable explanations that can link the process of skin aging and the above mentioned features could not be found, but deeper investigations are on the way.

Reference values of manual dexterity using Minnesota Rate of Manipulation Test for Indian adults

Introduction

Dexterity assessment is an integral component of hand function evaluation. The Minnesota Rate of Manipulation Test is a valid and reliable tool to evaluate manual dexterity and has been used to study prognosis of therapy. Information available on its reference values is limited. Reference values are required to interpret, set realistic treatment goals, and assess the ability to return to employment. Therefore, manual dexterity was studied in healthy Indian adults to generate reference values.

Methods

A descriptive study was conducted on 900 subjects divided into three groups: Group 1: 18–30 years ( n = 300): Group 2: 31–60 years (n = 300), and Group 3: ≥61 years ( n = 300). The Minnesota Rate of Manipulation Test was used to evaluate manual dexterity. All subjects performed three trials (one practice + two test trials) of the five subtests. The average of two test trials was used to compute the Minnesota Rate of Manipulation Test score.

Results

The total score of the Minnesota Rate of Manipulation Test in Groups 1, 2, and 3 was 275.7 ± 24.1 s, 299.3 ± 31.9 s, and 357.4 ± 48.6 s, respectively. Manual dexterity was moderately associated with age ( r = 0.707, p < 0.001); however, differences between males and females were nonsignificant ( p = 0.306).

Conclusion

Manual dexterity declined with advancing age; however, differences between genders were not significant. These reference values of manual hand dexterity for healthy adult Indian people will be relevant for clinical assessment of hand function.

A wearable soft-robotic glove enables hand support in ADL and rehabilitation: A feasibility study on the assistive functionality

Background

Elderly people frequently experience a decline in hand function, due to ageing or diseases. This leads to decreased independence in activities of daily living (ADL). Assistive technology may enhance independence.

Objectives

The objective of this paper was to explore user acceptance of an affordable wearable soft-robotic glove (ironHand (iH) system), that supports grip and hand opening in ADL. In addition, functional performance with the iH system was explored.

Methods

For this study 28 elderly people used the iH system across two sessions. During these sessions, participants performed six functional tasks with and without the iH system. Outcome measures were System Usability Scale (SUS), Intrinsic Motivation Inventory (IMI) and performance time of the functional tasks.

Results

User acceptance scored highly, with a mean SUS score of at least 63.4 (SD = 19.0) and a mean IMI score of 5.1 points (SD = 0.97 points). Functional task performance improved across repetitions both with and without the glove (p ≤ 0.017), but all functional tasks were performed faster without the glove (p ≤ 0.032).

Conclusion

Participants perceived the iH system as useful, pleasant and meaningful. The learning curve in functional performance time (improvements across repetitions) is promising, since it suggests there is room for improved performance when a longer acquaintance period is applied.

Integration of occupation based intervention in hand injury rehabilitation: A Randomized Controlled Trial

STUDY DESIGN

Randomized Controlled Trial (RCT).

INTRODUCTION

Engagement in daily occupations and day to day activities helps to restore function in individuals with injured hands and provides a platform to practise selected occupations.

PURPOSE

The purpose of this study was to investigate the effectiveness of a combination of Occupation Based Intervention (OBI) and Therapeutic Exercise (TE) compared to TE alone for the rehabilitation of hand injuries.

METHOD

A single center RCT, parallel group was conducted at the Kuala Lumpur General Hospital (KLGH), Malaysia. Forty-six adult clients with hand injuries who consented to participate were randomly allocated to either the OBI + TE group or to the TE group.

RESULTS

Following a ten week intervention program, statistical significance differences were found in DASH score (TE = 18.64 ± 14.84 vs OBI + TE = 9.50 ± 9.14, p = 0.02); total active motion (TE = 1035.85 ± 179.84 vs OBI + TE = 1203.65 ± 133.60, p = 0.01); neuropathic pain (TE = 2.90 ± 2.79 vs OBI + TE = 1.05 ± 2.01, p = 0.02); COPM performance (TE = 7.62 ± 2.03 vs OBI + TE = 9.53 ± 0.64, p < 0.001); and COPM satisfaction (TE = 7.60 ± 2.11 vs OBI + TE = 9.49 ± 0.76, p < 0.001) in favor of OBI + TE group.

CONCLUSION

This study highlighted the integration of OBI into hand injury rehabilitation improved outcomes for clients.

Hand impairment and functional ability: A matched case comparison study between people with rheumatoid arthritis and healthy controls

Introduction

The aim of this study was to compare hand impairment and function in a cohort of patients with rheumatoid arthritis and matched healthy participants.

Methods

A matched case comparison research design comparing hand impairment and functional ability between patients with rheumatoid arthritis and healthy participants (males or females, aged ≥ 50 years). Functional ability was assessed using the Michigan Hand Questionnaire, power and pinch grip strength and the nine-hole peg test.

Results

A total of 100 participants (50 patients with rheumatoid arthritis and 50 matched healthy participants) were recruited. Patients with rheumatoid arthritis reported significantly lower overall hand function, activities of daily living, work, aesthetics, satisfaction ( p < 0.001) and significantly higher pain scores when compared with healthy controls. The patients with rheumatoid arthritis had significantly lower maximum power and pinch grip strength in both left and right hands ( p < 0.001) when compared with healthy controls. The rheumatoid arthritis group took significantly longer to complete the nine-hole peg test using both right and left hands compared with healthy controls ( p < 0.001, respectively). Additionally, in rheumatoid arthritis patients, a significant moderate, positive correlation between power grip strength and activities of daily living (r = 0.584, n = 50, p < 0.01) and a weak-to-moderate, significant negative correlation between power grip strength and pain (r = −0.314, n = 50, p < 0.05) were reported.

Conclusion

Despite the recent substantial improvement of drug therapy and disease control, the functional impact of rheumatoid arthritis on hand pain and function remains significant.

Thumb performance of elderly users on smartphone touchscreen

This study investigated the relationship between thumb muscle activity and thumb operating tasks on a smartphone touchscreen in elderly users (right hand posture). Three thumb muscles were targeted in the experiment, namely, abductor pollicis brevis, abductor pollicis longus (APL) and first dorsal interosseous (FDI). The results showed that the elderly participants developed fatigue rapidly and tapped more slowly when operating on smaller buttons (diameter 3.0 mm compared with 9.0 mm) and moving in the flexion–extension (compared with adduction–abduction) orientation. Meanwhile, electromyography and perceived exertion evaluation revealed significant increases in FDI in the small button task, and results for APL were significantly greater in the flexion–extension task. This study suggests that the use of small touch-buttons and flexion–extension movement should be minimised in the handheld touchscreen interface design for elderly users.

The attraction of emotions: Irrelevant emotional information modulates motor actions

Emotional expressions are important cues that capture our attention automatically. Although a wide range of work has explored the role and influence of emotions on cognition and behavior, little is known about the way that emotions influence motor actions. Moreover, considering how critical detecting emotional facial expressions in the environment can be, it is important to understand their impact even when they are not directly relevant to the task being performed. Our novel approach was to explore this issue from the attention-and-action perspective, using a task-irrelevant distractor paradigm in which participants are asked to reach for a target while a nontarget stimulus is also presented. We tested whether the movement trajectory would be influenced by irrelevant stimuli-faces with or without emotional expressions. The results showed that reaching paths veered toward faces with emotional expressions, in particular happiness, but not toward neutral expressions. This reinforces the view of emotions as attention-capturing stimuli that are, however, also potential sources of distraction for motor actions.

Association Between Executive Functions, Working Memory, and Manual Dexterity in Young and Healthy Older Adults: An Exploratory Study

Aging is accompanied by declines in cognitive and sensorimotor functions. However, at present, the interrelation between attentional processes and dexterity in aging has not been thoroughly addressed. This study explored the relationship between executive function, working memory, and dexterity performance in 15 young and 15 healthy elderly, right-handed participants. A modified version of the Purdue Pegboard Test was used for dexterity assessment. Two subtasks were selected to calculate temporal and kinematic parameters of reaching, grasping, transport, and insertion of pegs. Evaluation of executive function and working memory was performed using neuropsychological tests. The relationship between dexterity and cognitive outcomes were also examined. Results showed that the prehensile movements involved in grasping and their speed significantly differed between groups and correlated with executive function in the young group. For elderly adults, variability of hand movements turned out to be associated with executive abilities.

Practical guidance for nurses caring for stoma patients with long-term conditions

As the population ages and the number of people living with a long-term condition grows, it is likely that community nurses may be presented with increasing numbers of people requiring assessment, support, and advice for complex needs. Many of the long-term conditions affect the patient's ability to live and manage aspects of daily life independently and may affect the ability to manage a stoma. The purpose of this article is to consider how long-term conditions affect daily living and stoma care, and make practical suggestions for stoma management. Sources of further help and information for people living with a stoma (ostomates) and a long-term condition have also been included. It is hoped that by reading this article, the nurse will become more familiar with the difficulties with dexterity associated with long-term conditions experienced by ostomates, and how they can be assisted in managing and living as independently as possible.

Evaluation of jar lid design characteristics by older women with hand use limitations

The study evaluated several lid design characteristics (diameter, height, top shape, side shape, and surface texture) by means of controlled laboratory testing with older women with hand function limitations. A subjective evaluation process was applied to examine main effects and interactions of lid design characteristics on usability, determined by participants' perceptions of effort and discomfort. Results showed that lid height was the most important design characteristic associated with usability. For 42 mm diameter lids, designs perceived as best were ones with taller height, hexagonal top shape, and convex side shape. For 28 mm diameter lids, the best designs were ones with taller height and hexagonal top shape. Additionally, when the smaller lid's side shape was flat, a serrate surface texture provided some advantages, particularly for subjects with more severe hand dysfunction. This information could be used by package designers to improve jar lid usability for a growing sector of consumers.

The Effects of Age, Gender, and Hand on Force Control Capabilities of Healthy Adults

OBJECTIVE

The present study examined the effects of age (20s to 70s), gender (male and female), and hand (dominant and nondominant) on force control capabilities (FCCs) in four force control phases (initiation, development, maintenance, and termination).

BACKGROUND

Normative data of FCCs by force control phase are needed for various populations in age and gender to identify a type of motor performance reduction and its severity.

METHOD

FCCs of 360 participants (30 for each combination of age group and gender) were measured using a finger dynamometer and quantified in terms of initiation time (IT), development time (DT), maintenance error (ME), and termination time (TT).

RESULTS

Although gradual increases (1%~28%) by age were shown in IT, DT, and TT, a dramatic increase in ME was observed among participants in their 50s (26%), 60s (68%), and 70s (160%) compared to those in their 20s~40s. The most distinctive interaction effect of age and gender was found in ME out of the four FCC measures. Lastly, hand and its related interactions were not found significant.

CONCLUSION

Normative FCC data were established for four age groups (20s~40s, 50s, 60s, and 70s) and gender.

APPLICATION

The normative FCC data can be used for evaluating an individual's motor performance, screening patients with brain disorders, and designing input devices triggered and/or operated by the finger.

Smartphone Text Input Method Performance, Usability, and Preference With Younger and Older Adults

OBJECTIVE

User performance, perceived usability, and preference for five smartphone text input methods were compared with younger and older novice adults.

BACKGROUND

Smartphones are used for a variety of functions other than phone calls, including text messaging, e-mail, and web browsing. Research comparing performance with methods of text input on smartphones reveals a high degree of variability in reported measures, procedures, and results. This study reports on a direct comparison of five of the most common input methods among a population of younger and older adults, who had no experience with any of the methods.

METHOD

Fifty adults (25 younger, 18-35 years; 25 older, 60-84 years) completed a text entry task using five text input methods (physical Qwerty, onscreen Qwerty, tracing, handwriting, and voice). Entry and error rates, perceived usability, and preference were recorded.

RESULTS

Both age groups input text equally fast using voice input, but older adults were slower than younger adults using all other methods. Both age groups had low error rates when using physical Qwerty and voice, but older adults committed more errors with the other three methods. Both younger and older adults preferred voice and physical Qwerty input to the remaining methods. Handwriting consistently performed the worst and was rated lowest by both groups.

CONCLUSION

Voice and physical Qwerty input methods proved to be the most effective for both younger and older adults, and handwriting input was the least effective overall.

APPLICATION

These findings have implications to the design of future smartphone text input methods and devices, particularly for older adults.