Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?

Po Tsun Chen, I. Ming Jou, Chien Ju Lin, Hsiao Feng Chieh, Li-Chieh Kuo, Fong-chin Su

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. Questions/purposes: We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? Methods: We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (F r ) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. Results: The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2–7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1–5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2–3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2–2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035–0.050 for thumb and 0.016–0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3–1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9–2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039–0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6–0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3–0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6–0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3–0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20–0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16–0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05–0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04–0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04–0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02–0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20–0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02–0.02 N], p = 0.01). Conclusions: Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. Clinical Relevance: The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.

Original languageEnglish
Pages (from-to)2371-2382
Number of pages12
JournalClinical Orthopaedics and Related Research
Volume473
Issue number7
DOIs
Publication statusPublished - 2015 Jul 8

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Carpal Tunnel Syndrome
Fingers
Thumb
Hand
Hand Strength

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{a668ad2c19554f949e34a0745e2c83ce,
title = "Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?",
abstract = "Background: The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. Questions/purposes: We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? Methods: We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (F r ) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. Results: The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95{\%} CI, 7.2–7.4 N) versus control subjects (5 ± 0.8 N; 95{\%} CI, 5.1–5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95{\%} CI, 3.2–3.3 N) versus control subjects (2 ± 0.3 N; 95{\%} CI, 2.2–2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035–0.050 for thumb and 0.016–0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95{\%} CI, 1.3–1.4 N) versus the control subjects (2 ± 0.2 N; 95{\%} CI, 1.9–2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039–0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95{\%} CI, 0.6–0.9) versus the control subjects (0.9 ± 0.1; 95{\%} CI, 0.8–1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95{\%} CI, 0.3–0.7) versus the control subjects (0.8 ± 0.2; 95{\%} CI, 0.6–0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95{\%} CI, 0.3–0.8) versus the control subjects (0.9 ± 0.1; 95{\%} CI, 0.8–1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95{\%} CI, 0.20–0.32 N] versus [0.19 ± 0.06 N; 95{\%} CI, 0.16–0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95{\%} CI, 0.05–0.13 N] versus [0.05 ± 0.03 N; 95{\%} CI, 0.04–0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95{\%} CI, 0.04–0.08 N] versus [0.03 ± 0.01 N; 95{\%} CI, 0.02–0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95{\%} CI, 0.20–0.06 N] versus [0.02 ± 0.01 N; 95{\%} CI, 0.02–0.02 N], p = 0.01). Conclusions: Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. Clinical Relevance: The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.",
author = "Chen, {Po Tsun} and Jou, {I. Ming} and Lin, {Chien Ju} and Chieh, {Hsiao Feng} and Li-Chieh Kuo and Fong-chin Su",
year = "2015",
month = "7",
day = "8",
doi = "10.1007/s11999-015-4189-x",
language = "English",
volume = "473",
pages = "2371--2382",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "7",

}

Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome? / Chen, Po Tsun; Jou, I. Ming; Lin, Chien Ju; Chieh, Hsiao Feng; Kuo, Li-Chieh; Su, Fong-chin.

In: Clinical Orthopaedics and Related Research, Vol. 473, No. 7, 08.07.2015, p. 2371-2382.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?

AU - Chen, Po Tsun

AU - Jou, I. Ming

AU - Lin, Chien Ju

AU - Chieh, Hsiao Feng

AU - Kuo, Li-Chieh

AU - Su, Fong-chin

PY - 2015/7/8

Y1 - 2015/7/8

N2 - Background: The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. Questions/purposes: We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? Methods: We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (F r ) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. Results: The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2–7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1–5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2–3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2–2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035–0.050 for thumb and 0.016–0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3–1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9–2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039–0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6–0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3–0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6–0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3–0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20–0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16–0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05–0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04–0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04–0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02–0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20–0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02–0.02 N], p = 0.01). Conclusions: Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. Clinical Relevance: The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.

AB - Background: The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. Questions/purposes: We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? Methods: We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (F r ) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. Results: The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2–7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1–5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2–3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2–2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035–0.050 for thumb and 0.016–0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3–1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9–2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039–0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6–0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3–0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6–0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3–0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8–1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20–0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16–0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05–0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04–0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04–0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02–0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20–0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02–0.02 N], p = 0.01). Conclusions: Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. Clinical Relevance: The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.

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