Abstract
Study Design
Clinical measurement and basic research.
Introduction
Manugraphy allows assessing dynamically all forces applied perpendicular to a cylinder
surface by the whole contact area of the hand with a high spatial resolution.
Purpose of the Study
To identify the physiological load distribution of the whole contact area of the hand
during cylinder grip.
Methods
A sample of 152 healthy volunteers performed grip force tests with 3 cylinder sizes
of the Manugraphy system (novel, Munich, Germany) on 3 different days. The whole contact
area of the hand was sectioned into 7 anatomic areas, and the percent contribution
of each area in relation to the total load applied was calculated. The load distribution
of the dominant and nondominant hands and with different cylinder sizes was compared.
Furthermore, the load distribution between the finger phalanges of each finger was
analyzed.
Results
The results for the dominant and nondominant hands were in all 7 areas of the hand
similar with the percent contribution differing within a range of 1%-4% (P > .138). Load distribution changed significantly with different cylinder sizes: all
7 areas differed between 1% and 7% with P < .001, most pronounced for the thumb. The load distribution of the phalanges showed
that the contribution of the distal phalanges increased with ascending cylinder size,
whereas the contribution of the proximal phalanges decreased. The interindividual
variability of the load distribution pattern was noticeable.
Discussion
For the clinical practice, Manugraphy might be a useful supplement to traditional
grip force measurement for identifying the individual characteristics of a patient's
dysfunction and monitoring the progress of hand rehabilitation.
Conclusions
There is no universal or typical load distribution pattern of the hand but only an
individual pattern. To evaluate a compromised hand, it is permissible to compare it
with the healthy opposite hand as a reference. Several cylinder sizes should be used
for load distribution testing. Using smaller handles in the daily life can help to
compensate impairment of the thumb and fingertips.
Level of Evidence
2.
Keywords
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JHT Read for Credit
Quiz: #515
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The authors identified _______ different areas of the hand in assessing load distribution during gripping
- a.2
- b.7
- c.4
- d.6
- a.
- #2.The subject population was approximately
- a.50 healthy senior citizens
- b.100 physical therapy students
- c.150 patients with a history of hand injury
- d.150 healthy individuals
- a.
- #3.The load distribution____________________ as the cylinder size increased
- a.remained constant
- b.decreased across the palm
- c.increased at the distal phalanges
- d.increased at the MPs
- a.
- #4.With different cylinder sizes the load patterns shifted, most noticeably at the
- a.MPs
- b.thumb
- c.PIPs
- d.hypothenar eminence
- a.
- #5.Load patterns are individual, not universal
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: February 28, 2017
Accepted:
October 21,
2016
Received in revised form:
October 12,
2016
Received:
April 12,
2016
Identification
Copyright
© 2016 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
