Hand grip strength measurement is a recognized part of hand function assessment. The standard measurement using the Jamar dynamometer and comparing these results to the recommended normal values suggested by the manufacturers of the Jamar was questioned as these values were based on Western population. A study comparing a novel method of predicting grip strength using our software was conducted on 25 normal subjects using the LIDO kinetic workset (Group A and B ). These results were then compared against our predictive software (Group A) and the expected values supplied together with the Jamar Dynamometer (Group B). In another group, 22 normal subjects were tested using the Jamar (Group C and D) and then matched against the predicted values using their recommended chart (Group C). The last group (Group D) was tested using the Jamar but the values attained were compared to the results from our software. In group A, the predictability of our predictive method was 100% (both R & L) as compared to (R = 64%, L = 68%) in group B, (R = 27.3%, L = 59.1%) in group C and (R = 81.8%, L = 86.4%) in group D. The differences between the predictability of both methods were statistically significant. The data collected using both the Jamar and the LIDO kinetic workset correlated well to the data from our software but not to the values suggested by the manufacturers of Jamar. We conclude that our method of predicting hand grip values are superior to that suggested by the manufacturers of dynamometers. The standard reference for hand grip strength provided by the manufacturers is less accurate in predicting the grip strength of our local population.
A tick in the ear is a very painful condition and removal is difficult because it grips firmly to the external auditory canal or tympanic membrane. Facial paralysis is a rarely reported localised neurological complication of an intra-aural tick infestation. The pathophysiology of localised paralysis is discussed, together with the safe way of handling patients with an intra-aural tick infestation.
Ninety two male brickfield workers and sixty sedentary individuals of 25-45 years were randomly selected from brickfields of West Bengal, India, to evaluate the body composition and hand grip strength among male brickfield workers and to compare the data with their sedentary counterparts. Assessment of body composition by skinfold measurements and determination of hand grip strength (HGS) by hand grip dynamometer indicated significantly higher (p<0.001) fatness, skinfold values and body mass index (BMI) among the sedentary individuals though HGS and hand grip endurance were significantly higher (p<0.001) among brickfield workers. BMI and %fat values indicated that the subjects were non-obese and non-overweight and regression norms for prediction of %fat from BMI in both the groups were computed as follows : Control Group : Y = 1.647 X - 22.789 (r = 0.92, p<0.001, SEE = 1.01), Brick-field Workers : Y = 0.747 X - 8.398 (r = 0.78, p<0.001, SEE = 1.34). Percentage of lean body mass (%LBM) was significantly higher (p<0.001) among brickfield workers whereas absolute LBM value had insignificant variation because of significant difference (p<0.001) in body mass between the groups. The present investigation revealed that the daily labour of the brick-field workers hindered the accumulation of body fat and extensive use of their hand and finger muscles enabled them to achieve greater arm strength. The proposed norms for prediction of %fat from BMI will also provide a first-hand impression about the body composition in the studied population.
The longlegged ant, Anoplolepis gracilipes (Fr. Smith) (Hymenoptera: Formicidae), is a highly invasive species that can aggressively displace other ant species. We conducted laboratory assays to examine interspecies aggression of A. gracilipes versus 15 sympatric ant species found in the urban environment and disturbed habitat in Malaysia: Monomorium pharaonis (L.), Monomorium floricola (Jerdon), Monomorium orientale Mayr, Monomorium destructor (Jerdon), Pheidole parva Mayr, Crematogaster sp., Solenopsis geminata (F.), Tapinoma indicum (Forel), Tapinoma melanocephalum (F.), Technomyrmnex butteli Forel, Dolichoderus thoracicus (Smith), Paratrechina longicornis (Latrielle), Oecophylla smaragdina (F), Camponotus sp., and Tetraponera rufonigra (Jerdon). A. gracilipes showed aggressive behavior toward all opponent species, except the smallest M. orientale. Opponent species size (body size, head width, and mandible width) was significantly correlated with A. gracilipes aggression level and mortality rate. We also found a significant positive relationship between A. gracilipes aggression level and the mortality of the opponent species. The results suggest that invasive populations of A. gracilipes would have the greatest impact on larger ant species. In addition, we examined the intraspecific aggression of A. gracilipes. We found that A. gracilipes from different localities in Malaysia showed intraspecific aggression toward one another. This finding differs from the results of studies conducted in Christmas Island earlier. Differences in the genetic variability among populations may explain these differing results.
The physical strength of the elderly aged above 60 years is typically 10 to 30% less than the young adult population of ages between 25 to 35 years. This reduction of strength has a strong impact on the activity of the daily living (ADL) of the elderly population. There has been little research done studying on the physical strength of the elderly population in Malaysia. The objective of this study was to determine the static strength of the elderly population in Malaysia. In particular, the grip and pinch strength were investigated as these two static strengths are extensively used in their instrumental activity of daily living (IADL). The results were then compared to the strength of the university students. A total of 30 subjects (15 males and 15 females) participated in the study. Their age ranged between 60 to 83 years, with the mean of age of 67.1 years. The comparison group comprised a total of 30 university students (20 male, 10 female) aged between 23 to 24 years, with the mean of age of 23.2 years. Grip and pinch strengths of both groups were measured and analysed using a descriptive statistics. It was found that the elderly male subjects are stronger in both strength measurements than their female counterpart. The 95th percentile of the female grip strength was slightly lower than that of the male while the male pinch strength was 31.07% higher. It was also found that the male students had higher strengths compared to the females. The grip strength of the elderly was 30.66% lower than the university student, while their pinch strength was 13.42% lower. Both static strengths of the elderly were found to be lower than those of the university students. This supported the research hypotheses postulating that the static strength had a negative correlation with age. In terms of gender differences, the male subjects were found to be stronger than the females.
Grip strength is an important measure used to monitor the progression of a condition, and to evaluate outcomes of treatment. We assessed how various physical and social factors predict normal grip strength in an adult Malaysian population of mixed Asian ethnicity (254 men, 246 women). Grip strength was recorded using the Jamar dynamometer. The mean grip strength for the dominant hand was 29.8 kg for men and 17.6 kg for women. Multiple regression analysis demonstrated that the dominant hand grip strength was positively associated with height and body mass index, and negatively associated with age for both sexes. Dominant hand grip strength was related to work status for men (p strength among ethnic groups.
We compared the effectiveness of physiotherapy and corticosteroid injection treatment in the management of mild trigger fingers. Mild trigger fingers are those with mild crepitus, uneven finger movements and actively correctable triggering. This is a single-centred, prospective, block randomized study with 74 patients; 39 patients for steroid injection and 35 patients for physiotherapy. The study duration was from Jun 2009 until August 2010. Evaluation was done at 6 weeks, 3 months and 6 months post-treatment. At 3 months, the success rate (absence of pain and triggering) for those receiving steroid injection was 97.4% and physiotherapy 68.6%. The group receiving steroid injection also had lower pain score, higher rate of satisfaction, stronger grip strength and early recovery to near normal function (findings were all significant, p Hand clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
The wrist is the most complex joint for virtual three-dimensional simulations, and the complexity is even more pronounced when dealing with skeletal disorders of the joint such, as rheumatoid arthritis (RA). In order to analyse the biomechanical difference between healthy and diseased joints, three-dimensional models of these two wrist conditions were developed from computed tomography images. These images consist of eight carpal bones, five metacarpal bones, the distal radius and ulna. The cartilages were developed based on the shape of the available articulations and ligaments were simulated via mechanical links. The RA model was developed accurately by simulating all ten common criteria of the disease related to the wrist. Results from the finite element (FE) analyses showed that the RA model produced three times higher contact pressure at the articulations compared to the healthy model. Normal physiological load transfer also changed from predominantly through the radial side to an increased load transfer approximately 5% towards the ulnar. Based on an extensive literature search, this is the first ever reported work that simulates the pathological conditions of the rheumatoid arthritis of the wrist joint.
A 'green tyre' concept has the advantage of low rolling resistance, improved wet grip and enhanced handling. It has been reported that 3% decrease in rolling resistance is equivalent to 1% fuel saving, thus giving the 'green tyre' economic benefits and customer satisfaction. In this study, epoxidised natural rubber (ENR) compounds containing various loading of silica filler were prepared. The processibility and viscoelastic properties were investigated using the rubber processing analyser and Mooney viscometer. Results showed that the properties were adversely affected by the poor dispersion of silica as supported by the bound rubber measurement. In addition, a reversion in the cure behaviour was also observed as the curing temperature was increased to 170ºC.
The purpose of this study was to investigate the relationship between anthropometric and motor performance and to determine the contribution of combined anthropometric dimensions on motor performance. A total of 225 male (n = 138) and female (n = 87) Malaysian university athletes aged
between 18 and 28 years (M = 22.1, SD = 1.8) from 18 different team related sports and individual sports participated in this study. The subjects underwent anthropometric measurements (height, weight, BMI,% body fat, waist-hip ratio) and motor performance tests (grip strength - GS, back
strength - BS, 7 level sit-up - SU7, 10m sprint - S10, 30m sprint - S30, sit and reach - SR, trunk extension test - TE, SEMO agility test - SEMO, vertical jump - VJ, standing long jump - SLJ, reaction time (audio) - RTa, reaction time (visual) - RTv, bleep test - Bleep, leg strength - LS, stork test– ST, and push-ups - PU). Descriptive analysis showed that anthropometric and performance difference between sports reflected the needs and requirements of the sports. Multivariate Analysis of Covariance (MANCOVA) and multiple regression analysis showed that height, weight, BMI, % body fat, waist-hip ratio contributed positively or negatively on specific components of motor performance. Among male athletes, all anthropometric were found to be a significant contributor to strength, vertical jump, cardiovascular endurance, while among females, only % body fat and WHR contributed significantly to abdominal strength, vertical jump and trunk extension. Findings of the study suggested that anthropometric characteristics that contributed to motor performance should provide a scientific rationale in selecting and training of athletes.
Grip strength is a marker of sarcopenia, the age-related decline in muscle mass and function, and has been little researched in Asian populations. We aimed to describe the feasibility and acceptability of measuring grip strength in hospitalized, older people in Malaysia and to explore its range, determinants and association with length of stay. Patients admitted acutely to the geriatrics ward of a teaching hospital were consecutively recruited. Inability to consent or use the dynamometer led to exclusion. Maximum grip strength, anthropometric data, length of hospital stay, discharge destination, 3-point Barthel score, mini-mental state examination, falls history and number of co-morbidities and medications on admission were recorded. 80/153 (52%) eligible patients were recruited (52 women; age range 64-100 years). 9/153 (6%) refused to participate and 64/153 (42%) were excluded (34 too unwell, 24 unable to consent, 4 unable to use the dynamometer, 2 other reasons). 76/80 patients (95%) reported that they would undergo grip strength measurement again. Determinants were similar to those of Caucasian populations but grip strength values were lower. After adjustment for sex, age and height, stronger grip strength was associated with shorter length of stay [hazard ratio 1.05 (95% CI 1.00, 1.09; P=0.03)]. This is the first report of grip strength measurement in hospitalized older people in Malaysia. It was feasible, acceptable to participants and associated with length of stay. Further research is warranted to elucidate the normative range in different ethnic groups and explore its potential use in clinical practice in Malaysia.
This study was conducted to investigate i) while the shoulder was in 180° of flexion and the elbow extended, which of the forearm position (supination, pronation and neutral) can generate the greatest handgrip strength, ii) is there any correlation of the handgrip strength between the dominant hand (right hand) and non-dominant hand (left hand) in each forearm position, and iii) will the dominant hand possessed 10% higher handgrip strength than the non-dominant hand. 100 right handed sedentary active students age 22.20 years old (± 1.03), height 172.83 cm (± 6.37), body mass 68.87 (± 11.52) and grip position 3.77 (± 0.77) were recruited in this study. The result indicated that for both the dominant and non-dominant hand, when the shoulder is in 180˚ flexion of the body with the elbow extended, the greatest grip strength was obtained when the forearm was in neutral position followed by pronation and supination position. Post Hoc analysis showed that for both dominant hand and non-dominant hand, pronation and supination forearm position produced greater strength score compared to supination forearm position (p0.05). In all forearm position, participants were shown to produced significantly greater strength in their dominant hand and all the scores were more than 10% greater compared to when using non-dominant hand. Positive relationships were also found for the strength score between dominant hand and non-dominant hand. As the conclusion, different shoulder, elbow and forearm position can affect handgrip strength.
BACKGROUND/OBJECTIVES: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status.
SUBJECTS/METHODS: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn's disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS).
RESULTS: Children with CD had lower BMI z-scores than controls (median (IQR): -0.3 (-0.9:0.4) vs 0.3 (-0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score strength measurement between groups. Except for CD children, the proportion of patients with suboptimal micronutrient intake was similar to that of controls and the cohort of children from the latest NDNS. A higher proportion of children with CD had suboptimal intake for riboflavin, vitamin B6 and calcium and consumed significantly more meat products, juices (including carbonated drinks), spreads/jams and crisps and savoury snacks and significantly fewer portions of dairy, fish, fruits and vegetables compared with healthy controls.
CONCLUSIONS: GastroD affect children's body composition, growth, strength, dietary intake and eating habits, particularly CD, but to a lesser extent than expected.
Study site: Gastroenterology clinic, Royal Hospital for Sick Children. Glasgow, United Kingdom
Normally, surface electromyography electrodes are used to evaluate the activity of superficial muscles during various kinds of voluntary contractions of muscle fiber. The objective of the present study was to investigate the effect of repetitive isometric contractions on the three heads of the triceps brachii muscle during handgrip force exercise.
This study aimed: i) to examine the relationship between the magnitude of cross-talk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles with the sub-maximal to maximal isometric grip force, and with the anthropometric parameters of the forearm, and ii) to quantify the distribution of the cross-talk in the MMG signal to determine if it appears due to the signal component of intramuscular pressure waves produced by the muscle fibers geometrical changes or due to the limb tremor.
Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate.
Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire.
Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score.
Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.
Handgrip strength is useful for screening the nutritional status of adult population as it is strongly associated with physical disabilities and mortality. Therefore, we aimed to determine the predictors of handgrip strength among adults of a rural community in Malaysia using a cross-sectional study design with multistage sampling. All adults aged 30 years and older from 1250 households were invited to our study. Structured questionnaire on sociodemographic characteristics, medical history, occupation history, lifestyle practices, and measurements, including anthropometry and handgrip strength were taken. There were 2199 respondents with 55.2% females and majority were of Malay ethnicity. Their mean (standard deviation) age was 53.4 (13.2) years. The response rate for handgrip strength was 94.2%. Females had significantly lower handgrip strength than males (P < .05). In the multiple linear regression models, significant predictors of handgrip strength for males were age, height, job groups, and diabetes, while for females, the significant predictors were age, weight, height, and diabetes.
Amputation of the thumb invariably causes marked functional impairment of the hand especially, pinch and grasp functions. In rural areas where highly skilled microvascular surgeries are not available, distraction osteogenesis provides an easy and safe alternative of thumb reconstruction. We report a case of crush injury of the right hand in a 37 year old gentleman in which the right thumb was amputated at the level of the proximal phalanx. Metacarpal lengthening of the thumb was performed by using distraction osteogenesis.
The objective of the present study was to investigate the time to fatigue and compare the fatiguing condition among the three heads of the triceps brachii muscle using surface electromyography during an isometric contraction of a controlled forceful hand grip task with full elbow extension. Eighteen healthy subjects concurrently performed a single 90 s isometric contraction of a controlled forceful hand grip task and full elbow extension. Surface electromyographic signals from the lateral, long and medial heads of the triceps brachii muscle were recorded during the task for each subject. The changes in muscle activity among the three heads of triceps brachii were measured by the root mean square values for every 5 s period throughout the total contraction period. The root mean square values were then analysed to determine the fatiguing condition for the heads of triceps brachii muscle. Muscle fatigue in the long, lateral, and medial heads of the triceps brachii started at 40 s, 50 s, and 65 s during the prolonged contraction, respectively. The highest fatiguing rate was observed in the long head (slope = -2.863), followed by the medial head (slope = -2.412) and the lateral head (slope = -1.877) of the triceps brachii muscle. The results of the present study concurs with previous findings that the three heads of the triceps brachii muscle do not work as a single unit, and the fiber type/composition is different among the three heads.