Hand Function (eBook)

Preface from 1st Edition 6
Preface for 2nd Edition 7
Contents 8
Contributors 10
Section I: Basic Principles of Hand Function 13
1: Functional Anatomy and Biomechanics of the Hand 14
The Hand: A Beautiful but Complex Instrument 14
Introduction 14
Skin and Connective Tissue 15
Clinical Relevance: Example 15
Clinical Relevance: Example 16
Joints and Ligaments 16
Carpometacarpal (CMC) Joints 17
Clinical Relevance: Example 17
Metacarpophalangeal (MCP) Joints 17
Clinical Relevance: Example 18
Clinical Relevance: Example 18
Proximal Interphalangeal (PIP) Joint 18
Clinical Relevance: Example 18
PIP and DIP Move Interdependently 19
Clinical Relevance: Example 19
Thumb 19
Clinical Relevance: Example 20
Wrist Carpal Bones 20
Distal Radioulnar Joint (DRU) 20
Triangular Fibrocartilage Complex (TFCC) 20
Scapholunate (Interosseous) Ligament (SL) 21
The Dart-Throwing Motion (DTM) 21
Clinical Relevance: Example 21
Muscle and Tendons 21
Intrinsics of the Finger and Thumb 22
Clinical Relevance: Example 23
Clinical Relevance: Example 23
Intrinsic Tightness 23
Clinical Relevance: Example 24
Clinical Relevance: Example 24
Lumbrical Plus 24
Fingers Flexing: The Flexors and Pulleys 24
Pulleys 24
Clinical Relevance: Example 25
Flexor Digitorum Profundus (FDP) Quadriga: Linkage of Tendons 25
Clinical Relevance: Example 25
Flexor Digitorum Superficialis (FDS) 25
FDS Chinese Finger Trap: Tendon Locking Mechanism 25
Clinical Relevance: Example 26
Finger Extension: The Extensors 26
Extensor Tendons 26
Clinical Relevance: Example 26
Clinical Relevance: Example 26
Clinical Relevance: Example 28
EIP and EDC of Index Finger 28
Clinical Relevance: Example 28
Thumb Muscles 28
Extensor Pollicis Longus (EPL) 28
Clinical Relevance: Example 28
Extensor Pollicis Brevis (EPB) 28
Clinical Relevance: Example 28
Abductor Pollicis Longus (APL) 28
Clinical Relevance: Example 28
Nerves and Innervations 29
References 31
2: Physical Examination of the Hand 33
Introduction 33
Patient History 33
General Inspection 34
Palpation 34
Assessment of Range of Motion 37
Range of Motion of the Wrist 37
Range of Motion of Fingers 39
Thumb Motions 40
Neurological Examination 41
Muscle Strength Evaluation 41
Motor Functions of the Thumb 43
Pinch and Grip Strength 44
Sensory Function Evaluation 45
Evaluation of Vascular Supply of the Hand 47
Specific Tests 47
References 50
3: Assessment of Hand Function 52
Functional Components of the Hand 53
Grip (Prehension) 53
Dexterity 57
Assessment Methods 57
Which Assessment Method Is the Best? 60
References 60
Section II: Hand Function in Clinical Practice 63
4: Pain and Hand Function 64
Introduction 64
Understanding and Classifying Chronic Pain 64
Measuring Hand Pain and Function 67
Hand Pain and Function by Region 69
Main Causes of Chronic Hand Pain and Its Relations to Hand Function 72
Osteoarthritis 72
Systemic Rheumatic Diseases 72
Tendinitis, Tenosynovitis, and Trigger Finger 73
Benign Masses of Wrist 73
Trigger Points 73
Vascular Diseases 73
Posttraumatic Chronic Pain 75
Peripheral Nerve Syndromes 75
Complex Regional Pain Syndrome 75
Phantom Limb Pain 76
References 76
5: Hand Function in Rheumatoid Arthritis 80
Hand Impairment, Activity Limitations, and Participation (Functional Ability) 82
Assessment of Hand Function 83
Measures of Hand Function 84
Self-Reports of Hand Function 86
Summary 87
Summary 88
References 88
6: Hand Function in Osteoarthritis 90
Epidemiology 90
Clinical Presentation 90
Diagnostic and Classification Criteria 92
Imaging 92
Instruments for Measuring Impact of Hand OA 93
Studies Comparing Instruments on Impact of Hand OA 94
Conclusion 95
References 95
7: Hand Function in Scleroderma 98
Systemic Sclerosis 98
Causes of Hand Functional Impairment in Systemic Sclerosis 98
Skin 100
Subcutaneous Tissues 100
Articular and Periarticular Involvement 100
Bone Involvement 101
Tendon Involvement 102
Muscle Involvement 102
Vascular Involvement in SSc 102
Peripheral Nervous System 104
Hand Functional Impairment in Different Phases of Systemic Sclerosis 104
Correlations Between Hand Functional Disturbances and Other Clinical Parameters 105
Evaluation of Hand Function 106
Questionnaires Assessing SSc Global Disability 106
Questionnaires Assessing Hand Disability Not Adapted to SSc 107
Questionnaires Assessing Hand Disability Adapted to SSc 108
Questionnaires Assessing Hand Disability Specific for SSc 108
Anthropometric Measures of the Hands 109
Conclusions 110
References 110
8: Functional Assessment in Hand with Flexor and Extensor Tendon Injuries 115
Evaluation of Function in Flexor Tendon Injuries 115
Description and Functional Significance of Flexor Tendon Injuries (Fig. 8.1) 116
Zone I 116
Zone II 118
Zone III 118
Zone IV 118
Zone V 119
Extensor Tendons 119
Description and Functional Significance of Extensor Tendon Injuries 121
Zone I–II 121
Zone III and IV 121
Zone V 122
Zone VI 122
Zone VII 123
Impairment of Hand Function Due to Tendon Injuries 123
Disability After Tendon Injuries 124
Preoperative Evaluation (Boyes) 124
Examination of Range of Motion 124
Evaluation of Strength 126
Assessment of Disability and Patient Satisfaction 127
Assessment of Performance 127
Evaluation of Flexor Tendon Rehabilitation Restrictions 128
Evaluation of Hand Function by High Technology 128
Hand Therapy Outcomes and ICF (International Classification of Functioning) 128
References 129
9: Hand Function in Stroke 131
Introduction 131
Impairments in the Upper Extremity 131
Predictors of Recovery 132
Brunnstrom Stages of Stroke Recovery 132
Outcome Measures 132
Outcome Measures of Body Functions 132
Modified Ashworth Spasticity Scale 132
Modified Tardieu Scale (MTS) 133
Fugl-Meyer Assessment 133
Activity/Disability Outcome Measures 133
Box and Block Test 133
Nine-Hole Peg Test 133
Jebsen–Taylor Hand Function Test 134
Action Research Arm Test (ARAT) 134
Wolf Motor Function Test (WMFT) 134
Duruöz Hand Index (DHI) 134
Michigan Hand Outcomes Questionnaire 134
Adult Assisting Hand Assessment Stroke (Ad-AHA) 134
Treatment 135
Exercises Therapy 135
Neurophysiological Approaches/Bobath Therapy 135
Task-Specific Training 136
Constraint-Induced Movement Therapy (CIMT) 136
Bilateral Arm Training 136
Motor Imagery 136
Mirror Therapy 137
Robot-Aided Training 137
Virtual Reality Training and Videogaming 138
Electrical Stimulation 138
Noninvasive Brain Stimulation 138
Orthosis 139
References 139
10: Hand Function in Tetraplegia 142
Expected Functional Outcomes by Neurologic Level of Injury 143
C1–C4 Tetraplegia 143
C5 Tetraplegia 143
C6 Tetraplegia 143
C7 and C8 Tetraplegics 144
The Use of the International Classification of Functioning, Disability and Health and Outcome Measures in Tetraplegics 144
Upper Extremity Outcome Tools Categorized According to the ICF Domain “Body Function and Structure” 147
The International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI) 147
The Sensory Examination 148
The Motor Examination 148
International Classification for Surgery of the Hand in Tetraplegia 150
The Strength Tests 150
Manual Muscle Testing (MMT) 150
Handheld Dynamometry (HHD) 151
Grip and Pinch Strength Measurement 151
Isokinetic Dynamometry 151
Spasticity Assessment 151
Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) 152
Upper Extremity Outcome Tools Categorized According to the ICF Domain “Activities” 153
General Tests: Basic Activities 153
Action Research Arm Test (ARAT) 153
Sollerman Hand Function Test 153
General Tests: Complex Activities 153
Modified Barthel Index (MBI) 153
Functional Independence Measure (FIM) 154
Canadian Occupational Performance Measure (COPM) 154
Duruöz Hand Index (DHI) 155
Spinal Cord Independence Measure-III (SCIM-III) 155
Valutazione Funzionale Mielolesi (VFM) 156
Specific Tests: Basic Activities 156
Standardized Object Test (SOT) 156
Vanden Berghe Hand and Arm Function Test 156
Grasp and Release Test (GRT) 156
Capabilities of Upper Extremity (CUE) Instrument (Questionnaire) (CUE-Q) 157
Thorson’s Functional Test 157
Van Lieshout Test 158
Van Lieshout Test-Short Form (VLT-SF) 158
Motor Capacities Scale (MCS) 158
Capabilities of Upper Extremity-Test (CUE-T) 159
Toronto Rehabilitation Institute–Hand Function Test (TRI-HFT) 159
Specific Tests: Complex Activities 159
Rancho Los Amigos Hospital Functional Activities Test 159
Quadriplegia Index of Function (QIF) 160
Common Object Test (COT) 160
Quadriplegia Index of Function (QIF)-Short Form 160
Tetraplegia Hand Activity Questionnaire (THAQ) 161
References 162
11: Hand Function in Parkinson’s Disease 168
Physiology of Hand Function 168
Role of the Basal Ganglia in Grasp Function 168
Sensorimotor Deficits of Hand Control in PD 169
Grasping and Functional Hand Control 169
Pathophysiology of Motor Dysfunction in PD 171
Clinical Aspects of Hand Function 174
Tremor 174
Bradykinesia and Rigidity 175
Hand Function in Activities of Daily Living 176
Examination of the Hand and Arm 177
Sensory Symptoms 178
Dyskinesias Associated with Treatment 179
Future Directions 179
References 179
12: Hand Function in Cerebral Palsy 185
What Kind of Hand Functional Troubles Exist in Cerebral Palsy? 186
Pathophysiology of Impaired Hand Function in Cerebral Palsy 187
Assessments Tools and Classification Systems Evaluating Hand Function in Cerebral Palsy 188
References 190
13: Hand Function in Children with Congenital Disorders 193
Congenital Upper Limb Differences 193
Impact of Congenital Hand Differences on Hand Skills Development 194
Basic Hand Skills 195
Reaching 195
Grasping 195
Grasping in Children with a Transverse Arrest 196
Grasping in Children with a Longitudinal Arrest: Radial Dysplasia 196
Grasping in Children with Syndactyly 196
“Controlled Release” or Voluntary Release 196
Controlled Release in Children with a Longitudinal Arrest: Radial Dysplasia 197
Controlled Release in Children with Failure of Differentiation of Parts with Soft Tissue Involvement: Finger Flexion C 197
Complementary Two-Hand Use 197
Complementary Two-Hand Use in Children with a Transverse Arrest 198
Complementary Two-Hand Use in Children with a Longitudinal Arrest-Radial Dysplasia 198
Complementary Two Hand Use in Children with a Syndactyly: Apert Syndrome 198
In-hand Manipulation 198
In-hand Manipulation in Children with Congenital Hand Differences 199
Function-, Activity-, Participation-Reported Problems 199
Assessment of Function 200
History and Status Praesens 200
Outcome Measures at Function Level 200
Range of Motion 200
Strength 200
Sensibility 201
Dexterity 201
Outcome Measures at Activity Level 201
Outcome Measures at Participation Level 201
Aesthetics 202
Psychological Implications of a Congenital Hand Difference 202
References 202
14: Hand Involvement in Juvenile Idiopathic Arthritis 205
Physical Examination in the Differential Diagnosis of Rheumatic and Non-rheumatic Hand 205
Systemic Juvenile Idiopathic Arthritis 206
Polyarticular Juvenile Idiopathic Arthritis 207
Juvenile Psoriatic Arthritis 208
Interpretation of the Joint Involvement in JIA 209
The Wrist 209
Metacarpophalangeal (MCP) Joints 209
Interphalangeal Joints 210
The Role of Hand in Quality of Life and Functional Assessment of Hand in JIA 210
References 213
15: Functional Assessment in Geriatric Hand 215
Focus on Aging Hand 215
Changes Associated with Aging 216
Neuromuscular Changes 216
Changes in Special Senses 217
Skin and Wound Healing 218
Cognitive Changes 218
Frequent Problems to Deal with in Elderly Population 218
Fractures 219
Osteoarthritis 219
Diabetes Mellitus 219
Stroke 220
Rheumatic Diseases 220
Parkinson’s Disease 220
Dementia 220
Pain 220
Senile Tremor 221
Evaluation of the Geriatric Hand 221
Functional Evaluation 223
Jebsen Test of Hand Function 223
Upper Extremity Performance Test for the Elderly (Test d’Evaluation des Membres Supérieurs de Personnes Agées-TEMPA) 223
Pegboard Tests 224
Functional Reach (Maximal Safe Standing Forward Reach) 224
Finger-Nose Test 224
The 20 Cents Test (20-C-T) 225
Questionnaires 225
GERI-AIMS-Dexterity Scale 225
Duruöz Hand Index (DHI) 225
Australian Canadian Osteoarthritis Hand Index (AUSCAN) 225
Upper Extremity Function Scale (UEFS) 225
Activities of Daily Living (ADL) 226
References 226
16: Hand Function in Common Hand Problems 230
Introduction 230
Measurement 231
Carpal Tunnel Syndrome 231
Trigger Finger or “Stenosing Tenosynovitis” 235
The Froimson Grading System 236
The Quinnell Grading System 236
De Quervain’s Tenosynovitis 237
Dupuytren’s Disease 238
Complex Regional Pain Syndrome (CRPS) 240
The Assessment Tools for CRPS 241
Focal Hand Dystonia 242
References 243
17: Hand Function in Cancer 248
Breast Cancer 249
References 251
18: Function Assessment in Metabolic Disorders: Diabetes Mellitus, Hemodialysis, and Gout 254
Hemodialysis 254
Musculoskeletal Involvements of the Hand 254
Hand Function Assessment 255
Diabetes Mellitus 257
Musculoskeletal Involvements of the Hand 257
Hand Function Assessment 258
Gout 259
Hand Function Assessment 260
References 260
Section III: Hand Function with Robotics and Assistive Technology 263
19: Hand Function and Assistive Devices 264
Introduction 264
Principles of Therapy with Assistive Devices in Diseases with Hand Involvement 265
Categorization of Assistive Devices 267
Examples of Assistive Devices 268
Summary 277
References 277
20: Sports and Recreational Adaptations for Amputee Hand 279
References 288
21: The Functional Capacity of the Humanlike Robotic Hands 290
Introduction 290
Related Work 291
Prosthetic Hands 291
Dexterous/Anthropomorphic Hands 291
Human Hand Taxonomy 295
Development of a Low-Cost Humanlike Robotic Hand via 3D-Printing 298
Mechanical Design of the 3D-Printed Robotic Hand 299
Adaptable Tendon Routing 301
Tactile Sensing of the Robotic Hand 301
Actuation System 303
Performance Evaluation of the Robotic Hand 304
The Performance of the Tactile Sensing 304
The Force Behaviors and Speed of the Robotic Hand 305
The Cost of the Robotic Hand 307
Conclusion 308
Appendix 309
References 310
Section IV: Hand Function and Imaging Outcomes 312
22: Hand Function and Imaging Outcomes 313
Conventional Radiography (X-Rays) 313
Digital X-Ray Radiogrammetry 314
Dual-Energy X-Ray Absorptiometry (DXA) of the Hand 317
Musculoskeletal Ultrasonography 319
Magnetic Resonance Imaging (MRI) of Hand 321
Summary 324
References 325
Appendix 1: ABILHAND (Manual Ability Measure) 329
References 329
Appendix 2: Boston Questionnaire (Brigham and Women’s Carpal Tunnel Questionnaire/the Carpal Tunnel Syndrome Instrument) 330
Questionnaire for Assessment of Severity of Symptoms and Functional Status 330
Symptom Severity Scale 330
Functional Status Scale 331
Reference 331
Appendix 3: Duruöz Hand Index (DHI) 332
Reference 332
Appendix 4: Hand Mobility in Scleroderma (HAMIS) Test 333
Reference 334
Appendix 5: Hand Functional Index (HFI) 335
References 335
Appendix 6: Michigan Hand Outcomes Questionnaire (MHQ) 336
Reference 340
Appendix 7: Quick-DASH (The Disabilities of the Arm, Shoulder and Hand) 341
Reference 342
Index 343