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Muscle Strength Measurements of the Hand
- Publication date
- 24 November 2004
- Publisher
- The hand has been called an extension of the brain, and the sensory
and motor performance of the hand is based on adequate function of
components in both the peripheral nerves as well as the central
nervous systems. Damage to the nerves (e.g., injury, compression,
infection [e.g. leprosy]) causes a loss of sensation and strength
that may result in serious loss of hand function. According to
Lundborg (2000) peripheral nerve lesions constitute one major reason
for severe and longstanding impairment of hand function. He called
the situation of nerve repair after injury frustrating because,
although a nerve suture may be technically perfect and the
rehabilitation carried out meticulously, the outcome is
unpredictable and often disappointing.
The evaluation of muscle strength is, in combination with the
assessment of sensibility, an important clinical method to determine
ulnar and median nerve function. This information is valuable in
decision-making concerning surgery (e.g. tendon transfers), therapy
(e.g. splints), advice in work-related issues (e.g. safety to work
with machines) and research issues (e.g. nerve repair technique).
Concerning this latter topic, Trumble et al. (1995) noted that
without extremely sensitive methods for monitoring the functional
outcome of nerve regeneration, it will be difficult to identify
those factors that may have small but additive beneficial effects
and those that may have negative effects on nerve regeneration.
The main objective of the work presented in this thesis was to
investigate the methods currently used to evaluate the motor domain
of nerve function, i.e. manual muscle strength testing, and grip and
pinch strength measurements. We questioned whether these methods
give appropriate and sufficient information about the intrinsic
muscle strength of the hand. Our hypothesis was that a dynamometer
that provides quantitative data on the intrinsic muscle strength
would provide more valuable information when monitoring the muscle
strength of patients who have suffered nerve injuries of their arm.