Mühldorfer-Fodor Marion, Ziegler Steffen, Harms Christoph, Neumann Julia, Kundt Günther, Mittlmeier Thomas, Prommersberger Karl Josef
Clinic for Hand Surgery, Rhön Klinikum AG, Bad Neustadt an der Saale, Germany.
Clinic for Hand Surgery, Rhön Klinikum AG, Bad Neustadt an der Saale, Germany.
J Hand Ther. 2017 Oct-Dec;30(4):529-537. doi: 10.1016/j.jht.2016.10.009. Epub 2017 Feb 28.
Clinical measurement and basic research.
Manugraphy allows assessing dynamically all forces applied perpendicular to a cylinder surface by the whole contact area of the hand with a high spatial resolution.
To identify the physiological load distribution of the whole contact area of the hand during cylinder grip.
A sample of 152 healthy volunteers performed grip force tests with 3 cylinder sizes of the Manugraphy system (novel, Munich, Germany) on 3 different days. The whole contact area of the hand was sectioned into 7 anatomic areas, and the percent contribution of each area in relation to the total load applied was calculated. The load distribution of the dominant and nondominant hands and with different cylinder sizes was compared. Furthermore, the load distribution between the finger phalanges of each finger was analyzed.
The results for the dominant and nondominant hands were in all 7 areas of the hand similar with the percent contribution differing within a range of 1%-4% (P > .138). Load distribution changed significantly with different cylinder sizes: all 7 areas differed between 1% and 7% with P < .001, most pronounced for the thumb. The load distribution of the phalanges showed that the contribution of the distal phalanges increased with ascending cylinder size, whereas the contribution of the proximal phalanges decreased. The interindividual variability of the load distribution pattern was noticeable.
For the clinical practice, Manugraphy might be a useful supplement to traditional grip force measurement for identifying the individual characteristics of a patient's dysfunction and monitoring the progress of hand rehabilitation.
There is no universal or typical load distribution pattern of the hand but only an individual pattern. To evaluate a compromised hand, it is permissible to compare it with the healthy opposite hand as a reference. Several cylinder sizes should be used for load distribution testing. Using smaller handles in the daily life can help to compensate impairment of the thumb and fingertips.
临床测量与基础研究。
手部动态力学测量法能够以高空间分辨率动态评估手部整个接触区域垂直作用于圆柱表面的所有力。
确定抓握圆柱体时手部整个接触区域的生理负荷分布。
152名健康志愿者在3个不同日期使用手部动态力学测量系统（新型，德国慕尼黑）的3种圆柱体尺寸进行握力测试。将手部整个接触区域划分为7个解剖区域，并计算每个区域相对于总施加负荷的贡献百分比。比较优势手和非优势手以及不同圆柱体尺寸下的负荷分布。此外，还分析了每个手指指骨之间的负荷分布。
优势手和非优势手在手部所有7个区域的结果相似，贡献百分比差异在1% - 4%范围内（P > 0.138）。负荷分布随圆柱体尺寸不同而有显著变化：所有7个区域差异在1%至7%之间，P < 0.001，拇指最为明显。指骨的负荷分布表明，随着圆柱体尺寸增大，远节指骨的贡献增加，而近节指骨的贡献减少。负荷分布模式的个体间变异性明显。
对于临床实践，手部动态力学测量法可能是传统握力测量的有用补充，有助于识别患者功能障碍的个体特征并监测手部康复进展。
手部不存在通用或典型的负荷分布模式，但只有个体模式。评估受损手部时，可将其与健康对侧手作为参考进行比较。应使用多种圆柱体尺寸进行负荷分布测试。在日常生活中使用较小的手柄有助于补偿拇指和指尖的损伤。
2级。
