The Effect of Proprioceptive Training on Hand Function and Activity Limitation After Open Carpal Tunnel Release Surgery: A Randomized Controlled Study.

OBJECTIVE: To investigate the effect of proprioceptive training on hand function and activity limitation in patients undergoing open carpal tunnel release surgery. DESIGN: Randomized controlled study. SETTING: A university hospital. PARTICIPANTS: Thirty patients were included in the study and randomized to proprioceptive training (PT) and conventional rehabilitation (CR) groups. INTERVENTION: One week after surgery, both groups received CR for 6 weeks. All participants were asked to perform home-based exercises daily in 3 sets with 10 repetitions. For the PT group, a 6-step PT program was conducted starting from Week 6. Both groups received face-to-face interventions twice a week for 12 weeks. MAIN OUTCOME MEASURES: The outcome measures included the Purdue Pegboard Test (PPT), the joint position sense test (JPST), the Boston Carpal Tunnel Questionnaire, and the Patient-Specific Functional Scale. In total, 3 assessments were performed (at 1, 6 and 12 weeks postoperatively). RESULTS: In the PT group, the results for PPT were statistically significant (P<.05). Although there was a greater decrease in the absolute angular error value (JPST) of the PT group compared to the CR group, the difference was nonsignificant (P>.05). Similar reductions in activity limitation were seen in both groups (PT: 176%, CR: 175%). Symptom severity decreased by 40% in the PT group vs 32% in the CR group. The effect sizes were larger for the changes between the second and third assessments in the PT group compared to the CR group in all parameters tested. CONCLUSION: When applied after carpal tunnel release surgery, PT may potentially to improve hand functions, reduce activity limitation, increase participation in activities of daily living, and thus improve quality of life.

Interrater Reliability and Precision of a Novel Hand Strength Assessment and Treatment Device: The GripAble.

IMPORTANCE: Occupational therapy practitioners need modern tools for the assessment of maximal grip strength in clinical and remote settings. OBJECTIVE: To establish the (1) interrater reliability and (2) precision of the GripAble among three raters with different expertise in occupational therapy when testing healthy participants, and to (3) evaluate the relative reliabilities of different approaches to estimating grip strength (i.e., one trial, mean of two trials, and the mean of three trials). DESIGN: Measurement study. SETTING: Minnesota Translational Musculoskeletal and Occupational Performance Research Lab, University of Minnesota, Minneapolis. PARTICIPANTS: Thirty volunteers, age ≥18 yr, without any hand problems. OUTCOMES AND MEASURES: Using GripAble, three occupational therapy raters with varied experience measured the maximal grip strength of the dominant and nondominant hands of all participants. Using the mean of three trials when testing grip strength with GripAble adds precision. RESULTS: GripAble has excellent interrater reliability (i.e., intraclass correlation coefficient > .75) and acceptable precision (minimal detectable change < 15%) among healthy adults. CONCLUSIONS AND RELEVANCE: GripAble allows occupational therapy practitioners with different experiences to assess grip strength in healthy hands quickly, precisely, and with excellent reliability. Additional research is needed on its psychometrics in clinical populations and capacities in remote monitoring and exergaming. Plain-Language Summary: The results of this study show that grip strength, an important biomarker and commonly assessed construct in occupational therapy, can be evaluated reliably, precisely, and rapidly with GripAble. The use of GripAble by occupational therapy practitioners in clinical settings may help to build an infrastructure for remote measurements and exergaming interventions in the future.

Evaluation of Load Distributions and Contact Areas in 4 Common Grip Types Used in Daily Living Activities.

PURPOSE: Grip analysis systems, with sensors quantifying load distributions and contact areas applied by the hand while grasping objects, are useful for collecting and recording instant data; these systems are popular in hand assessment. The purpose of this study was to determine the load distribution (LD) and contact area (CA) size of the palmar surface of the hand during 4 common grip types used in activities of daily living (standard, lateral, pinch, and tripod grips). METHODS: A convenience sample of 80 right-handed subjects were enrolled in this study. Participants wore special gloves equipped with sensors and grasped a variety of objects. Contact area size and LD were determined for the 4 grip types. RESULTS: The CA and the LD were different for each grip. For standard grip, although the largest CA occurred at the metacarpophalangeal joint level, the largest LD was over the middle finger pulp. For standard grip, index, middle, and ring fingers appear to be loaded with almost the same frequency as the thumb. Although CA on the thumb was maximum in the pinch, lateral and tripod grip types, the LD on the thumb was not. CONCLUSIONS: This study shows that the LD and CA patterns differ widely among standard, pinch, lateral, and tripod grips. The percentage of CA occurring on the thumb was maximum in all grip types. CLINICAL RELEVANCE: This information is important to optimize the design of artificial manipulators or assistive devices and to optimize the hand rehabilitation process. In addition, results of the study can be used to guide the design of prostheses and biomedical implants better.

Erratum: 404 Mechanisms of a Dynamic Stability Protocol for Persons with Thumb Osteoarthritis - CORRIGENDUM.

[This corrects the article DOI: 10.1017/cts.2024.351.].