Relevance of grasp types to assess functionality for personal autonomy

Abstract

Study Design: Cross-sectional research design.Introduction: Current assessment of hand function is not focused on evaluating the real abilities required for autonomy.Purpose of the Study: To quantify the relevance of grasp types for autonomy in order to guide hand recovery and its assessment.Methods: Representative tasks of the ICF-activities in which the hands are directly involved were recorded. The videos were analysed to identify the grasps used with each hand, and their relevance for autonomy was determined weighting time with the frequency of appearance of each activity in disability and dependency scales. Relevance is provided, globally and distinguishing by hand (right-left) and bimanual function. Significant differences in relevance are also checked.Results: The most relevant grasps are pad to pad pinch (31.9%), lumbrical (15.4%), cylindrical (12%), and special pinch (7.3%) together with the non-prehensile (18.6%) use of the hand. Lumbrical grasp has higher relevance for the left hand (19.9% vs. 12%) while cylindrical grasp for the right hand (15.3% vs. 7.7%). Relevancies are also different depending on bimanual function. Discussion: Different relative importance was obtained when considering dependency versus disability scales. Pad to pad pinch and non-prehensile grasp are the most relevant for both hands, while lumbrical grasp is more relevant for the left hand and cylindrical grasp for the right one. The most significant difference in bimanual function refers to pad to pad pinch (more relevant for unimanual actions of the left hand and bimanual actions of the right).

Transferring the Motor Branch of the Opponens Pollicis to the Terminal Division of the Deep Branch of the Ulnar Nerve for Pinch Reconstruction

“…In fact, thumb-toeindex finger pinch is the most commonly used pinch gesture in daily activities. 33 After harvesting the OPB, we observed no downgrade in thumb function according to the Kapandji score, 18 possibly because the APB can compensate for paralysis of the OPB. These 2 muscles have the same function and fire at the same time during thumb opposition.…”

Contribution to hand functional assessment based on its kinematics

“…Therefore, the 1 st experiment of the thesis was carried out with the goal of providing a rating of the relevancy of grasps types for the autonomy. Preliminary findings from this experiment were presented in a congress in Milan (Gracia-Ibáñez et al 2015), and final results are under revision in the Journal of Hand Therapy (Gracia-Ibáñez et al, 2016b). Having this rating at disposal may answer the question whether the most relevant grasps are the most frequently used, through comparison of results with those from our previous work .…”

Rhizarthrose erkennen

“…Gracia-Ibáñez et al [4] stellten in ihrer 2018 publizierten Arbeit fest, dass die im Alltag am häufigsten genutzten Greifformen nicht die wichtigsten Griffe für die Autonomie des Menschen sind. Spitz-, Lumbrikal-, Grob-und Dreipunktgriff haben demnach eine große Bedeutung für die Autonomie.…”

“…Der Spitz-, der Drei-Punkt-Griff und der "nonprehensile grasp" werden von beiden Händen ausgeführt. Die Autoren weisen darauf hin, dass dies in die Therapieplanung einfließen sollte, um so gezielt die Autonomie des Patienten zu trainieren und wiederherzustellen [4].…”