Carpal tunnel syndrome impairs sustained precision pinch performance

Li, Ké; Evans, Peter; Seitz, William H.; Li, Zong Ming

doi:10.1016/j.clinph.2014.05.004

Cited by 34 publications

(21 citation statements)

References 46 publications

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“…The result that the index finger generated more force than the thumb during submaximal precision pinch is consistent with a previous study [13]. Force discrepancy has been postulated as a consequence of anatomical structure and neural control.…”

Section: Discussionsupporting

confidence: 92%

“…In the current study, the precision pinch was performed on a stabilized object and visual feedback of force application was provided. It is possible that the sensorimotor deficits associated with CTS were compensated by the visual information to generate accurate pinch force [13]. In addition, 10% of the maximum pinch force was set as the target force in this study to minimize fatigue and discomfort for CTS patients, especially at the flexed posture.…”

Section: Discussionmentioning

confidence: 99%

“…To quantify the force matching accuracy, the root mean square error (RMSE) between the measured force and the target force [13] was calculated as:

RMSE = \sqrt{\frac{1}{n - 1} \sum_{i = 1}^{n} {(x_{i} - x_{t})}^{2}}

where n is the number of force samples, x i is the instant mean of the thumb and index finger normal forces, and x t is the target force (i.e. 10% of the averaged maximum pinch force).…”

Section: Methodsmentioning

confidence: 99%

“…As a potential compensatory strategy to overcome sensorimotor deficits and prevent objects from unintentionally slipping, patients with CTS apply excessive pinch force while lifting objects [10-12]. CTS also impairs digit force accuracy and stability during precision pinch, especially when the force application lacks accompanying visual feedback [13]. …”

Section: Introductionmentioning

confidence: 99%

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Effects of Carpal Tunnel Syndrome on Force Coordination and Muscle Coherence during Precision Pinch

Xiu

et al. 2017

J. Med. Biol. Eng.

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Carpal tunnel syndrome (CTS), caused by entrapment of the median nerve in the carpal tunnel, impairs hand function including dexterous manipulation. The purpose of this study was to investigate the effects of CTS on force coordination and muscle coherence during low-intensity sustained precision pinch while the wrist assumed different postures. Twenty subjects (10 CTS patients and 10 asymptomatic controls) participated in this study. An instrumented pinch device was used to measure the thumb and index finger forces while simultaneously collecting surface electromyographic activities of the abductor pollicis brevis (APB) and first dorsal interosseous (FDI) muscles. Subjects performed a sustained precision pinch at 10% maximum pinch force for 15 sec with the wrist stabilized at 30° extension, neutral, or 30° flexion using customized splints. The force discrepancy and the force coordination angle between the thumb and index finger forces were calculated, as well as the β-band (15-30 Hz) coherence between APB and FDI. The index finger applied greater force than the thumb (p < 0.05); this force discrepancy was increased with wrist flexion (p < 0.05), but was not affected by CTS (p > 0.05). The directional force coordination was not significantly affected by wrist posture or CTS (p > 0.05). In general, digit force coordination during precision pinch seems to be sensitive to wrist flexion, but is not affected by CTS. The β-band muscular coherence was increased by wrist flexion for CTS patients (p < 0.05), which could be a compensatory mechanism for the flexion-induced exacerbation of CTS symptoms. This study demonstrates that wrist flexion negatively influences muscle and force coordination in CTS patients supporting the avoidance of flexion posture for symptom exacerbation and functional performance.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

“…To quantify the force matching accuracy, the root mean square error (RMSE) between the measured force and the target force [13] was calculated as:

RMSE = \sqrt{\frac{1}{n - 1} \sum_{i = 1}^{n} {(x_{i} - x_{t})}^{2}}

where n is the number of force samples, x i is the instant mean of the thumb and index finger normal forces, and x t is the target force (i.e. 10% of the averaged maximum pinch force).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Carpal Tunnel Syndrome on Force Coordination and Muscle Coherence during Precision Pinch

Xiu

et al. 2017

J. Med. Biol. Eng.

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“…A functional grip force control is critical in everyday life. Therefore, the role of the median nerve in precision grip control has been also specified in clinical studies including patients suffering from chronic entrapment of the median nerve at the wrist, also known as carpal tunnel syndrome 2,[15][16][17][18] . Additionally, active median nerve self-mobilizations or passive mobilizations are frequently prescribed or executed by orthopaedic manual physical therapists with the aim of restoring the physiological function of the nerve.…”

Section: Introductionmentioning

confidence: 99%

Fine adaptive control of precision grip without maximum pinch strength changes after median nerve mobilization

Dierick

Brismée

White

et al. 2020

Preprint

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Fine dexterity critically depends on information conveyed by the median nerve. While the effects of its compression and vibration are well characterized, little is known about longitudinal tension and excursion. Using a force-sensitive manipulandum, a numeric dynamometer and Semmes Weinstein monofilaments, we examined the adaptations of precision grip control, maximum pinch strength and fingertips pressure sensation threshold before and immediately after the application of longitudinal tension and excursion mobilizations applied on the median nerve. Grip (GF ) and load (LF ) forces applied by the thumb, index and major fingers were collected in 40 healthy young participants during three different grip precision tasks along the direction of gravity. For grip-lift-drop task, maximum GF and LF and their first time derivatives were computed. For up-down oscillations, means of GF and LF and their variability were computed. For oscillations with up and down collisions, peaks of GF and LF , time delay between GF peak and contact, and values of GF and LF at contact were collected. Our findings show that median nerve mobilizations induce significant fine adaptations of precision grip control in the three different tasks but mainly during grip-lift drop and oscillations with collisions. Fingertips pressure sensation thresholds at index and thumb were significantly reduced after the mobilizations. No significant changes were observed for maximum pinch strength. We conclude that precision grip adaptations observed after median mobilizations could be partly explained by changes in cutaneous median-nerve mechanoreceptive afferents from the thumb and index fingertips.

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Coordination of digit force variability during dominant and non-dominant sustained precision pinch

Wei

Yue

et al. 2015

Exp Brain Res

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This study examined the effects of handedness on the inter-digit coordination of force variability with and without concurrent visual feedback during sustained precision pinch. Twenty-four right-handed subjects were instructed to pinch an instrumented apparatus with their dominant and non-dominant hands, separately. During the pinch, the subjects were required to maintain a stable force output at 5 N for 1 min. Visual feedback was given for the first 30 s and removed for the second 30 s. Coefficient of variation and detrended fluctuation analysis were employed to examine the amount and structural variability of the thumb and index finger forces. Similarly, correlation coefficient and detrended cross-correlation analysis were applied to quantify the inter-digit correlation of force amount and structural variability. Results showed that, compared to the non-dominant hand, the dominant hand had higher inter-digit difference in the amount of digit force variability. Without visual feedback, the dominant hand exhibited lower digit force structural variability but higher inter-digit force structural correlation than the non-dominant hand. These results implied that the dominant hand would be more independent, less flexible and with lower dynamic degrees of freedom than the non-dominant hand in coordination of the thumb and index finger forces during sustained precision pinch. The effects of handedness on inter-digit force coordination were dependent on sensory condition, which shed light on higher-level sensorimotor mechanisms that may be responsible for the asymmetries in coordination of digit force variability.

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Carpal tunnel syndrome impairs sustained precision pinch performance

Cited by 34 publications

References 46 publications

Effects of Carpal Tunnel Syndrome on Force Coordination and Muscle Coherence during Precision Pinch

Effects of Carpal Tunnel Syndrome on Force Coordination and Muscle Coherence during Precision Pinch

Fine adaptive control of precision grip without maximum pinch strength changes after median nerve mobilization

Coordination of digit force variability during dominant and non-dominant sustained precision pinch

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