Identification of key pinch forces required to complete functional tasks.

Reconstructive hand surgeries restore key pinch to individuals with pinch force deficits caused by tetraplegia. Data that define the magnitudes of force necessary to complete functional key pinch tasks are limited. This study aims to establish target pinch forces for completing selected tasks that represent a range of useful functional activities. A robot arm instrumented with a force sensor completed the tasks and simultaneously measured the forces applied to the task objects. Lateral pinch force requirements were calculated from these measured object forces. Pinch force requirements ranged from 1.4 N to push a button on a remote to 31.4 N to insert a plug into an outlet. Of the tasks studied, 9 of 12 required less than 10.5 N. These pinch force requirements, when compared to pinch forces produced by 14 individuals with spinal cord injuries (with and without surgical reconstruction of pinch), accurately predicted success or failure in 81% of subject trials. The prediction errors indicate a need to measure other factors such as pinch opening, force location, force direction, and proximal joint control.

[1]  R. H. Jebsen,et al.  An objective and standardized test of hand function. , 1969, Archives of physical medicine and rehabilitation.

[2]  E. Moberg Upper limb surgery in tetraplegia. , 1977, The Hand.

[3]  J. Keller,et al.  Surgical rehabilitation of the upper limb in tetraplegia , 1981 .

[4]  J. House,et al.  Reconstruction of the thumb in tetraplegia following spinal cord injury. , 1985, Clinical orthopaedics and related research.

[5]  P. Helm Clinical mechanics of the hand , 1986 .

[6]  T J Armstrong,et al.  An investigation of human palmar skin friction and the effects of materials, pinch force and moisture. , 1988, Ergonomics.

[7]  R. Waters,et al.  Electromyographic analysis of brachioradialis to flexor pollicis longus tendon transfer in quadriplegia. , 1990, The Journal of hand surgery.

[8]  E. Moberg,et al.  Surgical Rehabilitation of the Upper Limb in Tetraplegia , 1980, Paraplegia.

[9]  M. Laere,et al.  Reconstruction of the upper extremity in tetraplegia: functional assessment, surgical procedures and rehabilitation , 1991, Paraplegia.

[10]  A. Freehafer Tendon transfers in patients with cervical spinal cord injury. , 1991, The Journal of hand surgery.

[11]  W. C. Randall,et al.  Spinal mediation of thermally induced sweating. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[12]  J. House,et al.  One-stage key pinch and release with thumb carpal-metacarpal fusion in tetraplegia. , 1992, The Journal of hand surgery.

[13]  M. Keith,et al.  Development of a quantitative hand grasp and release test for patients with tetraplegia using a hand neuroprosthesis. , 1994, The Journal of hand surgery.

[14]  A. Rothwell,et al.  Single-stage reconstruction of key pinch and extension of the elbow in the tetraplegic patients. , 1995, The Journal of bone and joint surgery. American volume.

[15]  C. Sollerman,et al.  Sollerman hand function test. A standardised method and its use in tetraplegic patients. , 1995, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[16]  K. Kilgore,et al.  Tendon transfers and functional electrical stimulation for restoration of hand function in spinal cord injury. , 1996, The Journal of hand surgery.

[17]  R. Waters,et al.  Functional hand surgery following tetraplegia. , 1996, Archives of physical medicine and rehabilitation.

[18]  J. House,et al.  Intrinsic balancing in reconstruction of the tetraplegic hand. , 1997, The Journal of hand surgery.

[19]  M. Rice,et al.  Grip strengths and required forces in accessing everyday containers in a normal population. , 1998, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[20]  F J Valero-Cuevas,et al.  Activation patterns of the thumb muscles during stable and unstable pinch tasks. , 2001, The Journal of hand surgery.

[21]  K. Kilgore,et al.  The Influence of Elbow Position on the Range of Motion of the Wrist Following Transfer of the Brachioradialis to the Extensor Carpi Radialis Brevis Tendon , 2002, The Journal of bone and joint surgery. American volume.