Muscle Strength Measurements of the Hand

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.

• View at Worldcat

Free Full Text ( Final Version , 8mb )