Quantification of functional hand grip using electromyography and inertial sensor-derived accelerations: Clinical implications

Background Assessing hand injury is of great interest given the level of involvement of the hand with the environment. Knowing different assessment systems and their limitations generates new perspectives. The integration of digital systems (accelerometry and electromyography) as a tool to supplement functional assessment allows the clinician to know more about the motor component and its relation to movement. Therefore, the purpose of this study was the kinematic and electromyography analysis during functional hand movements. Method Ten subjects carried out six functional movements (terminal pinch, termino-lateral pinch, tripod pinch, power grip, extension grip and ball grip). Muscle activity (hand and forearm) was measured in real time using electromyograms, acquired with the Mega ME 6000, whilst acceleration was measured using the AcceleGlove. Results Electrical activity and acceleration variables were recorded simultaneously during the carrying out of the functional movements. The acceleration outcome variables were the modular vectors of each finger of the hand and the palm. In the electromyography, the main variables were normalized by the mean and by the maximum muscle activity of the thenar region, hypothenar, first interosseous dorsal, wrist flexors, carpal flexors and wrist extensors. Conclusions Knowing muscle behavior allows the clinician to take a more direct approach in the treatment. Based on the results, the tripod grip shows greater kinetic activity and the middle finger is the most relevant in this regard. Ball grip involves most muscle activity, with the thenar region playing a fundamental role in hand activity. Clinical relevance Relating muscle activation, movements, individual load and displacement offers the possibility to proceed with rehabilitation by individual component.

Uptight citizens in the grip of an evil spell

Review of 'The Crucible', Queensland Theatre Company, published in The Australian, 2 November 2009.

Engineering the surface of a sugarcane roller mill roll for grip and durability

Roller mills are typically used to crush sugarcane to express the juice from which sugar is manufactured. The mill rolls need to provide sufficient grip to ensure minimal sliding of the sugarcane along the roll surface. The rolls are subject to pressures up to 55 MPa from the sugarcane bagasse (as the sugarcane is called after first being crushed between a pair of rolls). The insoluble component of sugarcane includes typically 10% ash that largely originates from soil that is harvested with the cane. The sugarcane juice is acidic with pH typically between 5.0 and 5.5. As a result of ash and juice, the mill rolls are subjected to a range of abrasive and corrosive wear mechanisms. Solutions to provide grip and resist wear involve the selection of an appropriate roll shell material and compatible hard facing to provide the desired grip and wear characteristics. This paper reviews the various solutions that have been adopted for grip and durability for mill rolls and highlights the advantages and disadvantages of each method.

The association of early life supplemental nutrition with lean body mass and grip strength in adulthood : evidence from APCAPS

In the present study, we examined the associations of early nutrition with adult lean body mass (LBM) and muscle strength in a birth cohort that was established to assess the long-term impact of a nutrition program. Participants (n = 1,446, 32% female) were born near Hyderabad, India, in 29 villages from 1987 to 1990, during which time only intervention villages (n = 15) had a government program that offered balanced protein-calorie supplementation to pregnant women and children. Participants’ LBM and appendicular skeletal muscle mass were measured using dual energy x-ray absorptiometry; grip strength and information on lifestyle indicators, including diet and physical activity level, were also obtained. Ages (mean = 20.3 years) and body mass indexes (weight (kg)/height (m)2; mean = 19.5) of participants in 2 groups were similar. Current dietary energy intake was higher in the intervention group. Unadjusted LBM and grip strength were similar in 2 groups. After adjustment for potential confounders, the intervention group had lower LBM (β = −0.75; P = 0.03), appendicular skeletal muscle mass, and grip strength than did controls, but these differences were small in magnitude (<0.1 standard deviation). Multivariable regression analyses showed that current socioeconomic position, energy intake, and physical activity level had a positive association with adult LBM and muscle strength. This study could not detect a “programming” effect of early nutrition supplementation on adult LBM and muscle strength.

A biomechanical study of spherical grip

Use of the hand is vital in working life due to the grabbing and pinching it performs. Spherical grip is the most commonly used, due to similarity to the gripping of a computer mouse. Knowledge of its execution and the involved elements is essential. Analysis of this exertion with surface electromyography devices (to register muscular activity) and accelerometer devices (to register movement values ) can provide multiple variables. Six subjects performed ball gripping and registered real-time electromyography (thenar region, hypothenar region, first dorsal interosseous, flexors of the wrist, flexor carpi ulnaris and extensors of the wrist muscles) and accelerometer (thumb, index, middle, ring, pinky and palm) values. The obtained data was resampled “R software” and processed “Matlab Script” based on an automatic numerical sequence recognition program. Electromyography values were normalized on the basis of maximum voluntary contraction, whilst modular values were calculated for the acceleration vector. After processing and analysing the obtained data and signal, it was possible to identify five stages of movement in accordance with the module vector from the palm. The statistical analysis of the variables was descriptive: average and standard deviations. The outcome variables focus on the variations of the modules of the vector (between the maximum and minimum values of each module and phase) and the maximum values of the standardized electromyography of each muscle. Analysis of movement through accelerometer and electromyography variables can give us an insight into the operation of spherical grip. The protocol and treatment data can be used as a system to complement existing assessments in the hand.

Contribución de la fuerza y el dolor en la función del paciente con artrosis trapecio metacarpiana. Estudio transversal

Objetivo Establecer una posible relación entre la fuerza (Jamar), el dolor (EVA) y la capacidad funcional referida por el paciente (DASH) determinando en qué grado influyen unas en otras. Estudio observacional transversal analítico. Participantes Muestra de 72 pacientes que presentaban una artrosis trapecio metacarpiana grado 2-3 de Eaton. Los pacientes fueron reclutados cuando acudían a la Unidad de Cirugía de mano. Método Se realizaron mediciones de fuerza de agarre, pinza, valoración del dolor y funcionalidad, y se establecieron las correlaciones entre cada una de ellas. Resultados El modelo más significativo para la función (R2 =0.83) incluye la variable dolor y la fuerza. Pero es la fuerza punta contra punta la que presenta una mayor correlación con el cuestionario DASH (B-estandarizado: –57). Respecto al dolor, influye en todas las mediciones de fuerza realizadas con el dinamómetro, siendo también la fuerza de la pinza punta contra punta la que presenta una mayor correlación. Conclusiones Los hallazgos corroboran que existe una correlación significativa entre la función referida por el paciente y variables que podemos medir en consulta, como la fuerza del puño y la pinza. Pero también esta correlación es significativa entre las variables función y dolor entre sí, pero es la pinza punta contra punta la que presenta una mayor asociación con el cuestionario DASH. Abstract in English Objective To assess the relationship between muscle strength (Jama), and pain (VAS) levels with hand function (DASH) in patients with trapeziometarcapal osteoarthritis. Cross-sectional study. Participants Sample of 72 patients with osteoarthritis stage 2-3 (Eaton) and trapeziometacarpal osteoarthritis. Patients were recruited when they came to the Hand Surgery Unit. Method Grip strength, pinch, pain and hand function were measured, and correlation and regression coefficients between them were obtained. Results For function, the most significant model (R2 = 0.83) included pain and strength. But it is tip to tip pinch force which has a stronger relationship with DASH (Standardized B: –57) questionnaire. Pain also influenced strength measured with the dynamometer but it was tip to tip pinch force that was the most affected. Conclusions Findings confirm that there is a significant correlation between function referred by the patient and variables that can be measured in the clinic such as grip strength and pinch. The correlation between pain intensity and function was also significant, but tip to tip pinch strength had the greatest impact on the function.

A kinematic analysis of the hand function

Background The evaluation of the hand function is an essential element within the clinical practice. The usual assessments are focus on the ability to perform activities of daily life. The inclusion of instruments to measure kinematic variables provides a new approach to the assessment. Inertial sensors adapted to the hand could be used as a complementary instrument to the traditional assessment. Material: clinimetric assessment (Upper Limb Functional Index, Quick Dash), antrophometric variables (eight and weight), dynamometry (palm preasure) was taken. Functional analysis was made with Acceleglove system for the right hand and computer system. The glove has six acceleration sensor, one on each finger and another one on the reverse palm. Method Analytic, transversal approach. Ten healthy subject made six task on evaluation table (tripod pinch, lateral pinch and tip pinch, extension grip, spherical grip and power grip). Each task was made and measure three times, the second one was analyze for the results section. A Matlab script was created for the analysis of each movement and detection phase based on module vector. Results The module acceleration vector offers useful information of the hand function. The data analysis obtained during the performance of functional gestures allows to identify five different phases within the movement, three static phase and tow dynamic, each module vector was allied to one task. Conclusion Module vector variables could be used for the analysis of the different task made by the hand. Inertial sensor could be use as a complement for the traditional assessment system.

A kinematic and electromyographic study of grip force

Background The hand is an element of great importance to humans, as it enables us to have different grips. Its analysis, based on an accelerometer and electromyography, is critical in order to determine its operation. The processing and analysis of variables obtained by these devices offer a different approach in functional assessment. Therefore, knowledge of the muscles and elements of the hand in the grip force will offer a better approach for different interventions. Method The functionality of the hand of seven healthy subjects was parameterized and synchronized in real time based on grip force. The AcceleGlove was used to register accelerometric (fingers and palm) values and the Mega ME6000 was used for the surface electromyography and maximum voluntary contraction for the hand and forearm muscles. A computer script based on “R” and MATLAB software was developed to enable the correct interpretation of the main variables (variation of acceleration and maximum peak value of electromyography). Results The muscles of greater activity in grip was found in the hypothenar region (0.313 ± 0.148%) and the flexor ulnaris carpi (0.360 ± 0.118%), based on maximum voluntary contraction. Reference values in the module vector of the palm have proved an essential element for the identification of the movement phases. The ring and index fingers were the elements with the greatest variation of acceleration in the movement phases. Conclusion: Parameterization of the force grip and fragmentation of the registered data has been made possible due to the development of a technical procedure.

Application of K-tree to document clustering

Digital collections are growing exponentially in size as the information age takes a firm grip on all aspects of society. As a result Information Retrieval (IR) has become an increasingly important area of research. It promises to provide new and more effective ways for users to find information relevant to their search intentions. Document clustering is one of the many tools in the IR toolbox and is far from being perfected. It groups documents that share common features. This grouping allows a user to quickly identify relevant information. If these groups are misleading then valuable information can accidentally be ignored. There- fore, the study and analysis of the quality of document clustering is important. With more and more digital information available, the performance of these algorithms is also of interest. An algorithm with a time complexity of O(n2) can quickly become impractical when clustering a corpus containing millions of documents. Therefore, the investigation of algorithms and data structures to perform clustering in an efficient manner is vital to its success as an IR tool. Document classification is another tool frequently used in the IR field. It predicts categories of new documents based on an existing database of (doc- ument, category) pairs. Support Vector Machines (SVM) have been found to be effective when classifying text documents. As the algorithms for classifica- tion are both efficient and of high quality, the largest gains can be made from improvements to representation. Document representations are vital for both clustering and classification. Representations exploit the content and structure of documents. Dimensionality reduction can improve the effectiveness of existing representations in terms of quality and run-time performance. Research into these areas is another way to improve the efficiency and quality of clustering and classification results. Evaluating document clustering is a difficult task. Intrinsic measures of quality such as distortion only indicate how well an algorithm minimised a sim- ilarity function in a particular vector space. Intrinsic comparisons are inherently limited by the given representation and are not comparable between different representations. Extrinsic measures of quality compare a clustering solution to a “ground truth” solution. This allows comparison between different approaches. As the “ground truth” is created by humans it can suffer from the fact that not every human interprets a topic in the same manner. Whether a document belongs to a particular topic or not can be subjective.

A further step in the modelling of the mechanical behaviour of bagasse

A better understanding of the behaviour of prepared cane and bagasse during the crushing process is believed to be an essential prerequisite for further improvements to the crushing process. Improvements could be made, for example, in throughput, sugar extraction, and bagasse moisture. The ability to model the mechanical behaviour of bagasse as it is squeezed in a milling unit to extract juice would help identify how to improve the current process to reduce final bagasse moisture. However an adequate mechanical model for bagasse is currently not available. Previous investigations have proven with certainty that juice flow through bagasse obeys Darcy’s permeability law, that the grip of the rough surface of the grooves on the bagasse can be represented by the Mohr- Coulomb failure criterion for soils, and that the internal mechanical behaviour of the bagasse is critical state behaviour similar to that for sand and clay. Current Finite Element Models (FEM) available in commercial software have adequate permeability models. However, the same commercial software do not contain an adequate mechanical model for bagasse. Progress has been made in the last ten years towards implementing a mechanical model for bagasse in finite element software code. This paper builds on that progress and carries out a further step towards obtaining an adequate material model.

Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis

Summary This systematic review demonstrates that vitamin D supplementation does not have a significant effect on muscle strength in vitamin D replete adults. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency. Introduction The purpose of this study is to systematically review the evidence on the effect of vitamin D supplementation on muscle strength in adults. Methods A comprehensive systematic database search was performed. Inclusion criteria included randomised controlled trials (RCTs) involving adult human participants. All forms and doses of vitamin D supplementation with or without calcium supplementation were included compared with placebo or standard care. Outcome measures included evaluation of strength. Outcomes were compared by calculating standardised mean difference (SMD) and 95% confidence intervals. Results Of 52 identified studies, 17 RCTs involving 5,072 participants met the inclusion criteria. Meta-analysis showed no significant effect of vitamin D supplementation on grip strength (SMD −0.02, 95%CI −0.15,0.11) or proximal lower limb strength (SMD 0.1, 95%CI −0.01,0.22) in adults with 25(OH)D levels >25 nmol/L. Pooled data from two studies in vitamin D deficient participants (25(OH)D <25 nmol/L) demonstrated a large effect of vitamin D supplementation on hip muscle strength (SMD 3.52, 95%CI 2.18, 4.85). Conclusion Based on studies included in this systematic review, vitamin D supplementation does not have a significant effect on muscle strength in adults with baseline 25(OH)D >25 nmol/L. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency. Keywords Muscle – Muscle fibre – Strength – Vitamin D

An additional step towards modelling the mechanical behaviour of sugar cane bagasse

A better understanding of the behaviour of prepared cane and bagasse, especially the ability to model the mechanical behaviour of bagasse as it is squeezed in a milling unit to extract juice, would help identify how to improve the current milling process; for example to reduce final bagasse moisture. Previous investigations have proven with certainty that juice flow through bagasse obeys Darcy’s permeability law, that the grip of the rough surface of the grooves on the bagasse can be represented by the Mohr- Coulomb failure criterion for soils, and that the internal mechanical behaviour of the bagasse can be represented by critical state behaviour similar to that of sand and clay. Current Finite Element Models (FEM) available in commercial software have adequate permeability models. However, commercial software does not contain an adequate mechanical model for bagasse. Progress has been made in the last ten years towards implementing a mechanical model for bagasse in finite element software code. This paper builds on that progress and carries out a further step towards obtaining an adequate material model. In particular, the prediction of volume change during shearing of normally consolidated final bagasse is addressed.

Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis

BACKGROUND: The efficacy of nutritional support in the management of malnutrition in chronic obstructive pulmonary disease (COPD) is controversial. Previous meta-analyses, based on only cross-sectional analysis at the end of intervention trials, found no evidence of improved outcomes. OBJECTIVE: The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD. DESIGN: Literature databases were searched to identify RCTs comparing nutritional support with controls in stable COPD. RESULTS: Thirteen RCTs (n = 439) of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 11 RCTs), and enteral tube feeding (1 RCT)] with a control comparison were identified. An analysis of the changes induced by nutritional support and those obtained only at the end of the intervention showed significantly greater increases in mean total protein and energy intakes with nutritional support of 14.8 g and 236 kcal daily. Meta-analyses also showed greater mean (±SE) improvements in favor of nutritional support for body weight (1.94 ± 0.26 kg, P < 0.001; 11 studies, n = 308) and grip strength (5.3%, P < 0.050; 4 studies, n = 156), which was not shown by ANOVA at the end of the intervention, largely because of bias associated with baseline imbalance between groups. CONCLUSION: This systematic review and meta-analysis showed that nutritional support, mainly in the form of ONS, improves total intake, anthropometric measures, and grip strength in COPD. These results contrast with the results of previous analyses that were based on only cross-sectional measures at the end of intervention trials.