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Biomechanical studies of finger extension function. Analysis with a new force measuring device and ultrasound examination in rheumatoid arthritis and healthy muscles
Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims:

The overall aim of this thesis was to further our understanding of extensor muscles and their role for hand function.

The aims of the studies were:

To develop and evaluate a new device for finger extensor force measurements. To evaluate ultrasound as a tool for assessment of muscle architecture. To determine the correlation between extensor muscle force and hand function. To evaluate the degree of impaired finger extensor force in rheumatoid arthritis (RA) and the correlation to impaired... mer hand function. To analyse the effect of hand exercise in RA patients and healthy subjects with ultrasound and finger extension force measurements.

Method:

A new finger extension force measuring device was developed and an ultrasound based method was used to be able to objectively measure the finger extension force and analyze the static and dynamic extensor muscle architectures. Measurements were made of healthy volunteers (n=127) and RA patients (n=77) during uninfluenced and experimental conditions. A hand exercise program was performed and evaluated with hand force measurements, hand function test, patient relevant questionnaires (DASH and SF-36) and ultrasound measurements.

Results:

The new finger extension force measurement device was developed and then validated with measurements of accuracy as well as test-retest reliability. The coefficient of variation was 1.8 % of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. Ultrasound examination on m. extensor digitorum communis (EDC) showed significant differences between healthy men and healthy women as well as between healthy women and RA patients. The extension and flexion force improved in both groups after six weeks of hand exercise (p<0.01). Hand function improved in both groups (p<0.01). The RA group showed improvement in the results of the DASH questionnaire (p<0.05). The cross-sectional area of the EDC increased significantly in both groups.

Conclusions:

A new finger extension force measuring device has been developed which provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and is sufficiently sensitive to evaluate the effects of hand exercise. US provide useful information about muscle architecture. A significant improvement of hand strength and hand function in RA patients was seen after six weeks of hand training, the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for RA patients, providing better strength and function.

Place, publisher, year, edition, pages
Göteborg: Göteborgs Universitet , 2008.
Keyword [en]
Muscles, Muscle rigity, Rheumatoid Arthritis, Exercise therapy
Identifiers
URN: urn:nbn:se:hh:diva-5972ISBN: 978-91-628-7602-9 OAI: oai:DiVA.org:hh-5972DiVA: diva2:352971
Public defence
2008-12-12, Aulan Sahlgrenska universitetssjukhuset/Sahlgrenska, Göteborg, 13:00 (English)
Opponent
Available from: 2010-09-23 Created: 2010-09-23 Last updated: 2011-04-05Bibliographically approved
List of papers
1. A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis
Open this publication in new window or tab >>A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis
2009 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 5, 338-342 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.

METHODS:

Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme.

RESULTS:

The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound.

CONCLUSION:

A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.

Place, publisher, year, edition, pages
Basingstoke: Taylor & Francis, 2009
Keyword
Hand exercise therapy, Rheumatoid arthritis, Extension force, Muscle architecture, Ultrasound, Hand strength, DASH, SF-36
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-2626 (URN)10.2340/16501977-0334 (DOI)000266097400007 ()19363566 (PubMedID)2-s2.0-64349122505 (Scopus ID)2082/3028 (Local ID)2082/3028 (Archive number)2082/3028 (OAI)
Available from: 2009-06-24 Created: 2009-06-24 Last updated: 2017-05-22Bibliographically approved
2. Extensor muscle force measurements and muscle architecture in rheumatoid arthritis patients
Open this publication in new window or tab >>Extensor muscle force measurements and muscle architecture in rheumatoid arthritis patients
(English)Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-5971 (URN)
Available from: 2010-09-23 Created: 2010-09-23 Last updated: 2012-09-28Bibliographically approved
3. A new force measurement device for evaluating finger extension function in the healthy and rheumatoid arthritis hand
Open this publication in new window or tab >>A new force measurement device for evaluating finger extension function in the healthy and rheumatoid arthritis hand
Show others...
2008 (English)In: Technology and Health Care, ISSN 0928-7329, E-ISSN 1878-7401, Vol. 16, no 4, 283-292 p.Article in journal (Refereed) Published
Abstract [en]

Although often neglected, finger extension force is of great importance for developing grip strength. This paper describes the design and evaluation of a new finger extension force measurement device (EX-it) based on the biomechanics of the hand. Measurement accuracy and test-retest reliability were analysed. The device allows measurements on single fingers as well as all the fingers (excluding the thumb) of both healthy and deformed hands. The coefficient of variation in the device was 1.8% of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. This study also provides reference values for finger extension force in healthy subjects and patients with rheumatoid arthritis (RA). Significant differences were found in extension strength between healthy subject and RA patients (men, p < 0.05 and women, p < 0.001). EX-it provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and can be used to evaluate the outcome of therapeutic interventions after hand trauma or disease

Place, publisher, year, edition, pages
Amsterdam: IOS Press, 2008
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-5970 (URN)18776605 (PubMedID)2-s2.0-52449125684 (Scopus ID)
Available from: 2010-09-23 Created: 2010-09-23 Last updated: 2017-05-22Bibliographically approved
4. Ultrasound evaluation in combination with finger extension force measurements of the forearm musculus extensor digitorum communis in healthy subjects
Open this publication in new window or tab >>Ultrasound evaluation in combination with finger extension force measurements of the forearm musculus extensor digitorum communis in healthy subjects
Show others...
2008 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 8, 6Article in journal (Refereed) Published
Abstract [en]

Background:

The aim of this study was to evaluate the usefulness of an ultrasound-based method of examining extensor muscle architecture, especially the parameters important for force development. This paper presents the combination of two non-invasive methods for studying the extensor muscle architecture using ultrasound simultaneously with finger extension force measurements.

Methods:

M. extensor digitorum communis (EDC) was examined in 40 healthy subjects, 20 women and 20 men, aged 35-73 years. Ultrasound measurements were made in a relaxed position of the hand as well as in full contraction. Muscle cross-sectional area (CSA), pennation angle and contraction patterns were measured with ultrasound, and muscle volume and fascicle length were also estimated. Finger extension force was measured using a newly developed finger force measurement device.

Results:

The following muscle parameters were determined: CSA, circumference, thickness, pennation angles and changes in shape of the muscle CSA. The mean EDC volume in men was 28.3 cm3 and in women 16.6 cm3. The mean CSA was 2.54 cm2 for men and 1.84 cm2 for women. The mean pennation angle for men was 6.5° and for women 5.5°. The mean muscle thickness for men was 1.2 cm and for women 0.76 cm. The mean fascicle length for men was 7.3 cm and for women 5.0 cm. Significant differences were found between men and women regarding EDC volume (p < 0.001), CSA (p < 0.001), pennation angle (p < 0.05), muscle thickness (p < 0.001), fascicle length (p < 0.001) and finger force (p < 0.001). Changes in the shape of muscle architecture during contraction were more pronounced in men than women (p < 0.01). The mean finger extension force for men was 96.7 N and for women 39.6 N. Muscle parameters related to the extension force differed between men and women. For men the muscle volume and muscle CSA were related to extension force, while for women muscle thickness was related to the extension force.

Conclusion:

Ultrasound is a useful tool for studying muscle architectures in EDC. Muscle parameters of importance for force development were identified. Knowledge concerning the correlation between muscle dynamics and force is of importance for the development of new hand training programmes and rehabilitation after surgery.

© 2008 Brorsson et al; licensee BioMed Central Ltd.

Place, publisher, year, edition, pages
London: BioMed Central, 2008
Keyword
adult, aged, arm muscle, article, controlled study, echography, extensor muscle, female, finger, human, human experiment, male, muscle contraction, muscle force, muscle mass, muscle strength, non invasive procedure, normal human, postoperative care, rehabilitation care, thickness, forearm, histology, middle aged, nonparametric test, physiology, skeletal muscle
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-1941 (URN)10.1186/1471-2342-8-6 (DOI)18312699 (PubMedID)2-s2.0-41149116277 (Scopus ID)2082/2336 (Local ID)2082/2336 (Archive number)2082/2336 (OAI)
Available from: 2008-09-22 Created: 2008-09-22 Last updated: 2017-05-22Bibliographically approved

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