Hand Function - A Practical Guide to Assessment

Preface from 1st Edition

Preface for 2nd Edition

Contents

Contributors

Section I: Basic Principles of Hand Function

1: Functional Anatomy and Biomechanics of the Hand

The Hand: A Beautiful but Complex Instrument

Introduction

Skin and Connective Tissue

Clinical Relevance: Example

Clinical Relevance: Example

Joints and Ligaments

Carpometacarpal (CMC) Joints

Clinical Relevance: Example

Metacarpophalangeal (MCP) Joints

Clinical Relevance: Example

Clinical Relevance: Example

Proximal Interphalangeal (PIP) Joint

Clinical Relevance: Example

PIP and DIP Move Interdependently

Clinical Relevance: Example

Thumb

Clinical Relevance: Example

Wrist Carpal Bones

Distal Radioulnar Joint (DRU)

Triangular Fibrocartilage Complex (TFCC)

Scapholunate (Interosseous) Ligament (SL)

The Dart-Throwing Motion (DTM)

Clinical Relevance: Example

Muscle and Tendons

Intrinsics of the Finger and Thumb

Clinical Relevance: Example

Clinical Relevance: Example

Intrinsic Tightness

Clinical Relevance: Example

Clinical Relevance: Example

Lumbrical Plus

Fingers Flexing: The Flexors and Pulleys

Pulleys

Clinical Relevance: Example

Flexor Digitorum Profundus (FDP) Quadriga: Linkage of Tendons

Clinical Relevance: Example

Flexor Digitorum Superficialis (FDS)

FDS Chinese Finger Trap: Tendon Locking Mechanism

Clinical Relevance: Example

Finger Extension: The Extensors

Extensor Tendons

Clinical Relevance: Example

Clinical Relevance: Example

Clinical Relevance: Example

EIP and EDC of Index Finger

Clinical Relevance: Example

Thumb Muscles

Extensor Pollicis Longus (EPL)

Clinical Relevance: Example

Extensor Pollicis Brevis (EPB)

Clinical Relevance: Example

Abductor Pollicis Longus (APL)

Clinical Relevance: Example

Nerves and Innervations

References

2: Physical Examination of the Hand

Introduction

Patient History

General Inspection

Palpation

Assessment of Range of Motion

Range of Motion of the Wrist

Range of Motion of Fingers

Thumb Motions

Neurological Examination

Muscle Strength Evaluation

Motor Functions of the Thumb

Pinch and Grip Strength

Sensory Function Evaluation

Evaluation of Vascular Supply of the Hand

Specific Tests

References

3: Assessment of Hand Function

Functional Components of the Hand

Grip (Prehension)

Dexterity

Assessment Methods

Which Assessment Method Is the Best?

References

Section II: Hand Function in Clinical Practice

4: Pain and Hand Function

Introduction

Understanding and Classifying Chronic Pain

Measuring Hand Pain and Function

Hand Pain and Function by Region

Main Causes of Chronic Hand Pain and Its Relations to Hand Function

Osteoarthritis

Systemic Rheumatic Diseases

Tendinitis, Tenosynovitis, and Trigger Finger

Benign Masses of Wrist

Trigger Points

Vascular Diseases

Posttraumatic Chronic Pain

Peripheral Nerve Syndromes

Complex Regional Pain Syndrome

Phantom Limb Pain

References

5: Hand Function in Rheumatoid Arthritis

Hand Impairment, Activity Limitations, and Participation (Functional Ability)

Assessment of Hand Function

Measures of Hand Function

Self-Reports of Hand Function

Summary

Summary

References

6: Hand Function in Osteoarthritis

Epidemiology

Clinical Presentation

Diagnostic and Classification Criteria

Imaging

Instruments for Measuring Impact of Hand OA

Studies Comparing Instruments on Impact of Hand OA

Conclusion

References

7: Hand Function in Scleroderma

Systemic Sclerosis

Causes of Hand Functional Impairment in Systemic Sclerosis

Skin

Subcutaneous Tissues

Articular and Periarticular Involvement

Bone Involvement

Tendon Involvement

Muscle Involvement

Vascular Involvement in SSc

Peripheral Nervous System

Hand Functional Impairment in Different Phases of Systemic Sclerosis

Correlations Between Hand Functional Disturbances and Other Clinical Parameters

Evaluation of Hand Function

Questionnaires Assessing SSc Global Disability

Questionnaires Assessing Hand Disability Not Adapted to SSc

Questionnaires Assessing Hand Disability Adapted to SSc

Questionnaires Assessing Hand Disability Specific for SSc

Anthropometric Measures of the Hands

Conclusions

References

8: Functional Assessment in Hand with Flexor and Extensor Tendon Injuries

Evaluation of Function in Flexor Tendon Injuries

Description and Functional Significance of Flexor Tendon Injuries (Fig. 8.1)

Zone I

Zone II

Zone III

Zone IV

Zone V

Extensor Tendons

Description and Functional Significance of Extensor Tendon Injuries

Zone I–II

Zone III and IV

Zone V

Zone VI

Zone VII

Impairment of Hand Function Due to Tendon Injuries

Disability After Tendon Injuries

Preoperative Evaluation (Boyes)

Examination of Range of Motion

Evaluation of Strength

Assessment of Disability and Patient Satisfaction

Assessment of Performance

Evaluation of Flexor Tendon Rehabilitation Restrictions

Evaluation of Hand Function by High Technology

Hand Therapy Outcomes and ICF (International Classification of Functioning)

References

9: Hand Function in Stroke

Introduction

Impairments in the Upper Extremity

Predictors of Recovery

Brunnstrom Stages of Stroke Recovery

Outcome Measures

Outcome Measures of Body Functions

Modified Ashworth Spasticity Scale

Modified Tardieu Scale (MTS)

Fugl-Meyer Assessment

Activity/Disability Outcome Measures

Box and Block Test

Nine-Hole Peg Test

Jebsen–Taylor Hand Function Test

Action Research Arm Test (ARAT)

Wolf Motor Function Test (WMFT)

Duruöz Hand Index (DHI)

Michigan Hand Outcomes Questionnaire

Adult Assisting Hand Assessment Stroke (Ad-AHA)

Treatment

Exercises Therapy

Neurophysiological Approaches/Bobath Therapy

Task-Specific Training

Constraint-Induced Movement Therapy (CIMT)

Bilateral Arm Training

Motor Imagery

Mirror Therapy

Robot-Aided Training

Virtual Reality Training and Videogaming

Electrical Stimulation

Noninvasive Brain Stimulation

Orthosis

References

10: Hand Function in Tetraplegia

Expected Functional Outcomes by Neurologic Level of Injury

C1–C4 Tetraplegia

C5 Tetraplegia

C6 Tetraplegia

C7 and C8 Tetraplegics

The Use of the International Classification of Functioning, Disability and Health and Outcome Measures in Tetraplegics

Upper Extremity Outcome Tools Categorized According to the ICF Domain “Body Function and Structure”

The International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI)

The Sensory Examination

The Motor Examination

International Classification for Surgery of the Hand in Tetraplegia

The Strength Tests

Manual Muscle Testing (MMT)

Handheld Dynamometry (HHD)

Grip and Pinch Strength Measurement

Isokinetic Dynamometry

Spasticity Assessment

Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP)

Upper Extremity Outcome Tools Categorized According to the ICF Domain “Activities”

General Tests: Basic Activities

Action Research Arm Test (ARAT)

Sollerman Hand Function Test

General Tests: Complex Activities

Modified Barthel Index (MBI)

Functional Independence Measure (FIM)

Canadian Occupational Performance Measure (COPM)

Duruöz Hand Index (DHI)

Spinal Cord Independence Measure-III (SCIM-III)

Valutazione Funzionale Mielolesi (VFM)

Specific Tests: Basic Activities

Standardized Object Test (SOT)

Vanden Berghe Hand and Arm Function Test

Grasp and Release Test (GRT)

Capabilities of Upper Extremity (CUE) Instrument (Questionnaire) (CUE-Q)

Thorson’s Functional Test

Van Lieshout Test

Van Lieshout Test-Short Form (VLT-SF)

Motor Capacities Scale (MCS)

Capabilities of Upper Extremity-Test (CUE-T)

Toronto Rehabilitation Institute–Hand Function Test (TRI-HFT)

Specific Tests: Complex Activities

Rancho Los Amigos Hospital Functional Activities Test

Quadriplegia Index of Function (QIF)

Common Object Test (COT)

Quadriplegia Index of Function (QIF)-Short Form

Tetraplegia Hand Activity Questionnaire (THAQ)

References

11: Hand Function in Parkinson’s Disease

Physiology of Hand Function

Role of the Basal Ganglia in Grasp Function

Sensorimotor Deficits of Hand Control in PD

Grasping and Functional Hand Control

Pathophysiology of Motor Dysfunction in PD

Clinical Aspects of Hand Function

Tremor

Bradykinesia and Rigidity

Hand Function in Activities of Daily Living

Examination of the Hand and Arm

Sensory Symptoms

Dyskinesias Associated with Treatment

Future Directions

References

12: Hand Function in Cerebral Palsy

What Kind of Hand Functional Troubles Exist in Cerebral Palsy?

Pathophysiology of Impaired Hand Function in Cerebral Palsy

Assessments Tools and Classification Systems Evaluating Hand Function in Cerebral Palsy

References

13: Hand Function in Children with Congenital Disorders

Congenital Upper Limb Differences

Impact of Congenital Hand Differences on Hand Skills Development

Basic Hand Skills

Reaching

Grasping

Grasping in Children with a Transverse Arrest

Grasping in Children with a Longitudinal Arrest: Radial Dysplasia

Grasping in Children with Syndactyly

“Controlled Release” or Voluntary Release

Controlled Release in Children with a Longitudinal Arrest: Radial Dysplasia

Controlled Release in Children with Failure of Differentiation of Parts with Soft Tissue Involvement: Finger Flexion C

Complementary Two-Hand Use

Complementary Two-Hand Use in Children with a Transverse Arrest

Complementary Two-Hand Use in Children with a Longitudinal Arrest-Radial Dysplasia

Complementary Two Hand Use in Children with a Syndactyly: Apert Syndrome

In-hand Manipulation

In-hand Manipulation in Children with Congenital Hand Differences

Function-, Activity-, Participation-Reported Problems

Assessment of Function

History and Status Praesens

Outcome Measures at Function Level

Range of Motion

Strength

Sensibility

Dexterity

Outcome Measures at Activity Level

Outcome Measures at Participation Level

Aesthetics

Psychological Implications of a Congenital Hand Difference

References

14: Hand Involvement in Juvenile Idiopathic Arthritis

Physical Examination in the Differential Diagnosis of Rheumatic and Non-rheumatic Hand

Systemic Juvenile Idiopathic Arthritis

Polyarticular Juvenile Idiopathic Arthritis

Juvenile Psoriatic Arthritis

Interpretation of the Joint Involvement in JIA

The Wrist

Metacarpophalangeal (MCP) Joints

Interphalangeal Joints

The Role of Hand in Quality of Life and Functional Assessment of Hand in JIA

References

15: Functional Assessment in Geriatric Hand

Focus on Aging Hand

Changes Associated with Aging

Neuromuscular Changes

Changes in Special Senses

Skin and Wound Healing

Cognitive Changes

Frequent Problems to Deal with in Elderly Population

Fractures

Osteoarthritis

Diabetes Mellitus

Stroke

Rheumatic Diseases

Parkinson’s Disease

Dementia

Pain

Senile Tremor

Evaluation of the Geriatric Hand

Functional Evaluation

Jebsen Test of Hand Function

Upper Extremity Performance Test for the Elderly (Test d’Evaluation des Membres Supérieurs de Personnes Agées-TEMPA)

Pegboard Tests

Functional Reach (Maximal Safe Standing Forward Reach)

Finger-Nose Test

The 20 Cents Test (20-C-T)

Questionnaires

GERI-AIMS-Dexterity Scale

Duruöz Hand Index (DHI)

Australian Canadian Osteoarthritis Hand Index (AUSCAN)

Upper Extremity Function Scale (UEFS)

Activities of Daily Living (ADL)

References

16: Hand Function in Common Hand Problems

Introduction

Measurement

Carpal Tunnel Syndrome

Trigger Finger or “Stenosing Tenosynovitis”

The Froimson Grading System

The Quinnell Grading System

De Quervain’s Tenosynovitis

Dupuytren’s Disease

Complex Regional Pain Syndrome (CRPS)

The Assessment Tools for CRPS

Focal Hand Dystonia

References

17: Hand Function in Cancer

Breast Cancer

References

18: Function Assessment in Metabolic Disorders: Diabetes Mellitus, Hemodialysis, and Gout

Hemodialysis

Musculoskeletal Involvements of the Hand

Hand Function Assessment

Diabetes Mellitus

Musculoskeletal Involvements of the Hand

Hand Function Assessment

Gout

Hand Function Assessment

References

Section III: Hand Function with Robotics and Assistive Technology

19: Hand Function and Assistive Devices

Introduction

Principles of Therapy with Assistive Devices in Diseases with Hand Involvement

Categorization of Assistive Devices

Examples of Assistive Devices

Summary

References

20: Sports and Recreational Adaptations for Amputee Hand

References

21: The Functional Capacity of the Humanlike Robotic Hands

Introduction

Related Work

Prosthetic Hands

Dexterous/Anthropomorphic Hands

Human Hand Taxonomy

Development of a Low-Cost Humanlike Robotic Hand via 3D-Printing

Mechanical Design of the 3D-Printed Robotic Hand

Adaptable Tendon Routing

Tactile Sensing of the Robotic Hand

Actuation System

Performance Evaluation of the Robotic Hand

The Performance of the Tactile Sensing

The Force Behaviors and Speed of the Robotic Hand

The Cost of the Robotic Hand

Conclusion

Appendix

References

Section IV: Hand Function and Imaging Outcomes

22: Hand Function and Imaging Outcomes

Conventional Radiography (X-Rays)

Digital X-Ray Radiogrammetry

Dual-Energy X-Ray Absorptiometry (DXA) of the Hand

Musculoskeletal Ultrasonography

Magnetic Resonance Imaging (MRI) of Hand

Summary

References

Appendix 1: ABILHAND (Manual Ability Measure)

References

Appendix 2: Boston Questionnaire (Brigham and Women’s Carpal Tunnel Questionnaire/the Carpal Tunnel Syndrome Instrument)

Questionnaire for Assessment of Severity of Symptoms and Functional Status

Symptom Severity Scale

Functional Status Scale

Reference

Appendix 3: Duruöz Hand Index (DHI)

Reference

Appendix 4: Hand Mobility in Scleroderma (HAMIS) Test

Reference

Appendix 5: Hand Functional Index (HFI)

References

Appendix 6: Michigan Hand Outcomes Questionnaire (MHQ)

Reference

Appendix 7: Quick-DASH (The Disabilities of the Arm, Shoulder and Hand)

Reference

Index