BACKGROUND

Hand grip strength (HGS) is a tool to measure muscle strength, which is an important component in sarcopenia and frailty. Grip strength (GS) in midlife can predict physical disability in senior years and help evaluate a patient's overall health.

The general purpose of this study is to validate the HGS using an aneroid sphygmomanometer and Jamar dynamometer as a diagnostic tool for sarcpenia. The specific aims of this study are (a) to determine the concurrent criterion validity, (b) to determine the reliability, and (c) to measure the inter-rater agreement of the aneroid sphygmomanometer against the Jamar dynamometer in measuring HGS.

This prospective validation study measures HGS using an aneroid sphygmomanometer and Jamar dynamometer obtained from seventy participants 50 years old and above. Statistical methods used in data analysis include Spearman Rho, univariate linear regression analyses, intra-class correlation, inter-rater reliability, intra-rater reliability, Bland-Altman plots, and Lin’s concordance.

There was a significant correlation of HGS with the Jamar dynamometer and aneroid sphygmomanometer regardless of the rater [Spearman Rho (rs=0.762 to 0.778, p=0.001)]. Jamar GS is comparable to GS using a sphygmomanometer with the formula of [Jamar = 0.54 x sphygmomanometer (mmHg) - 45.12].

Aneroid sphygmomanometer can be used as an option to measure GS and has a valid value to predict the Jamar GS value. Hence, it can be an alternate tool for diagnosing sarcopenia.

Background: An accurate, quantifiable assessment of hand grip strength (HGS) can predict overall strength and health with a good predictor for identifying populations at higher risk for any medical conditions like rheumatoid arthritis, neuromuscular diseases and stroke that helps clinicians establish realistic treatment goals and provides treatment outcome data. The purpose of the study is to determine the percentile scores of HGS of healthy adult individuals of various age groups using Jamar dynamometer and modified sphygmomanometer. Methods: This descriptive study measures HGS using Jamar dynamometer and modified sphygmomanometer obtained from one hundred twenty healthy participants 20 years old and above. Comparative analyses of the 2 apparatuses were conducted using One-Way ANOVA. The reference intervals at different percentiles were calculated using the Clinical and Laboratory Standard Institute (CLSI) guidelines. Results: Grip strength (GS) using Jamar dynamometer (JD) and modified sphygmomanometer (MS) among younger (20- 29 years old) participants, the 50th percentile (Q2) JD score was 28.29 kg with an equivalent MS score of 161.38 mmHg, were significantly higher compared to those across older age groups especially among the ≥70 years old with a JD Q2 score of 16.74 kg and MS Q2 score of 101.33 mmHg. These findings suggest that HGS decreases with increasing age. Conclusion Scores obtained from this study can serve as preliminary baseline values or guide for interpreting GS measurements.
Hand Strength ; Sphygmomanometers

Introduction: Soil-transmitted helminthiasis (STH) remains to be highly prevalent in the Philippines, despite the implementation of school-based bi-annual mass drug administration and other preventive measures under the Garantisadong Pambata Program by the Department of Health (DOH). Methods: This analytical cross-sectional study determined the association between the level of knowledge and the actual practices of family care givers in the prevention of STH among school-age children belonging to low-income families in an urban barangay. Results: Among 193 respondents, 97.93% had good level of knowledge of STH prevention and control, 83.42% had good hand hygiene practices, but only 39.90% adhered to the recommended bi-annual anti-helminthic prophylaxis for their school-aged children. A positive association was noted between level of knowledge and actual hand hygiene practices, but this was not statistically significant (i.e., prevalence odds ratio = 5.3, p = 0.129). Among those who did not comply with the bi-annual anti-helminthic administration, there was a prevalence odds ratio (POR) of 0.66 that the family care giver was knowledgeable on STH prevention and control, and this negative association was not statistically significant (i.e., p = 0.529). Conclusion Level of knowledge on STH prevention was positively associated with hand hygiene practices but was negatively associated with compliance with the bi-annual deworming prophylaxis. But these associations were not statistically significant.
Hand Hygiene

OBJECTIVE: To evaluate the clinical features, laboratory and imaging results, treatment and outcomes of eosinophilic fasciitis (EF) and assess the value of ultrasound in the diagnosis of EF. METHODS: We retrospectively analyzed the clinical data of 45 patients with EF treated in our center from January 1, 2006 to February 28, 2022. The consistency between the diagnoses of EF based on ultrasound and MRI findings was assessed. RESULTS: In the 45 EF patients (male/female ratio 3.5:1), the age of onset ranged from 16 to 64 years with a mean disease course of 22.6 months. The average time from symptom onset to diagnosis was 16 months. The most common possible trigger of the disease was vigorous exercise (10/45), causing symmetrical lesions in the limbs, most commonly in the forearms (86.7%) and lower legs (80%). Clinical features of EF included subcutaneous swelling and induration (95.6%), arthralgia and arthritis (55.6%), groove sign (42.2%), hand joint contractures (42.2%), skin pigmentation (37.8%), and peau d'orange appearance (13.3%). Eosinophilia was found in 31 patients (68.9%). Hypergammaglobulinemia was seen in 23/44 (52.3%) and positive antinuclear antibodies in 9 (20%) of the patients. Twentyone of the patients were treated with high-dose methylprednisolone (≥200 mg daily for 3 to 5 consecutive days), and compared with the patients who did not receive this treatment, these patients more frequently experienced relapse before admission, had more extensive involvement, and had a higher rate of hypergammaglobulinemia without fever, but these differences were not statistically significant. Of the 31 patients (68.9%) with follow-up data (for a median of 3.2 years [range 0.2-15.9]), complete remission was achieved in 12 (38.7%) patients, and the accumulative complete remission rate was 44.1% at 5.5 years. No specific baseline characteristics or immunosuppressants were found to correlate with the treatment response. A total of 26 patients underwent both ultrasound and MRI examination, and the Kappa value of the diagnostic results between ultrasound and MRI was 0.91. CONCLUSION EF is characterized by symmetrical subcutaneous swelling and induration in the limbs, accompanied by eosinophilia and hypergammaglobulinemia. Glucocorticoid is effective for treating EF. Ultrasound examination can identify thickening of subcutaneous fascia for an early diagnosis of EF.
Humans ; Female ; Male ; Infant ; Child, Preschool ; Retrospective Studies ; Hypergammaglobulinemia ; Eosinophilia ; Ultrasonography ; Hand ; Contracture ; Treatment Outcome

BACKGROUND: Treatment duration of wrist-ankle acupuncture (WAA) is uncertain for post-thyroidectomy pain relief. OBJECTIVE: This study evaluated the effect of different WAA treatment duration on post-operative pain relief and other discomforts associated with thyroidectomy. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This randomized controlled trial was conducted at a single research site in Guangzhou, China. A total of 132 patients receiving thyroidectomy were randomly divided into the control group (sham WAA, 30 min) and three intervention groups (group 1: WAA, 30 min; group 2: WAA, 45 min; group 3: WAA, 60 min), with group allocation ratio of 1:1:1:1. Acupuncture was administered within 1 hour of leaving the operating room. OUTCOMES AND MEASURES: Primary outcome was patients' pain at the surgical site assessed by visual analogue scale (VAS) at the moment after acupuncture treatment (post-intervention). Secondary outcomes included the patients' pain VAS scores at 6, 12, 24, 48 and 72 h after the thyroidectomy, the 40-item Quality of Recovery (QoR-40) score, the grade of post-operative nausea and vomiting (PONV), and the use of additional analgesic therapy. RESULTS: The adjusted mean difference (AMD) in VAS scores from baseline to post-intervention in group 1 was -0.89 (95% confidence interval [CI], -1.02 to -0.76). The decrease in VAS score at post-intervention was statistically significant in group 1 compared to the control group (AMD, -0.43; 95% CI, -0.58 to -0.28; P < 0.001), and in groups 2 and 3 compared to group 1 (group 2 vs group 1: AMD, -0.65; 95% CI, -0.81 to -0.48; P < 0.001; group 3 vs group 1: AMD, -0.66; 95% CI, -0.86 to -0.47; P < 0.001). The VAS scores in the four groups converged beyond 24 h after the operation. Fewer patients in group 2 and group 3 experienced PONV in the first 24 h after operation. No statistical differences were measured in QoR-40 score and the number of patients with additional analgesic therapy. CONCLUSION Compared with the 30 min intervention, WAA treatment with longer needle retention time (45 or 60 min) had an advantage in pain relief within 6 h after surgery. WAA's analgesic effect lasted for 6-12 h post-operatively. Please cite this article as: Han XR, Yue W, Chen HC, He W, Luo JH, Chen SX, Liu N, Yang M. Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial. J Integr Med. 2023; 21(2): 168-175.
Male ; Humans ; Ankle ; Wrist ; Duration of Therapy ; Thyroidectomy ; Postoperative Nausea and Vomiting/drug therapy* ; Acupuncture Therapy ; Analgesics/therapeutic use* ; Pain/drug therapy*

Objective: To understand the vaccination status of enterovirus type 71 (EV71) inactivated vaccines in China from 2017 to 2021 and provide evidence for making policy on immunization strategy against hand, foot and mouth disease (HFMD). Methods: Using the reported dose number of EV71 vaccination and birth cohort population data collected by the China immunizaiton program information system to estimate the cumulative coverage of EV71 vaccine by the end of 2021 among the birth cohorts since 2012 at national, provincial, and prefecture levels, and analyze the correlation between the vaccination coverage and the potential influencing factors. Results: As of 2021, the estimated cumulative vaccination coverage of the EV71 vaccine was 24.96% in birth cohorts since 2012. The cumulative vaccination coverage was between 3.09% and 56.59% in different provinces, between 0 and 88.17% in different prefectures. There was a statistically significant correlation between vaccination coverage in different regions and the region's previous HFMD prevalence and disposable income per capita. Conclusions: Since 2017, the EV71 vaccines have been widely used nationwide, but the coverage of EV71 vaccination varies greatly among regions. Vaccination coverage is higher in relatively developed regions, and the intensity of previous epidemic of HFMD may have a certain impact on the acceptance of the vaccine and the pattern of immunization service. The impact of EV71 vaccination on the epidemic of HFMD requires further studies.
Humans ; Enterovirus A, Human ; Hand, Foot and Mouth Disease/prevention & control* ; Vaccines, Inactivated ; Viral Vaccines ; Enterovirus ; Vaccination ; China/epidemiology*

Objective: To investigate the present situation of pelvic floor muscle strength, and to analyze the factors affecting pelvic floor muscle strength. Methods: The data of patients who were admitted into the general outpatient department of gynecology, Peking University People's Hospital from October 2021 to April 2022 were collected, and the patients who met the exclusion criteria were included in this cross sectional study. The patient's age, height, weight, education level, defecation way and defecation time, birth history, maximum newborn birth weight, occupational physical activity, sedentary time, menopause, family history and disease history were recorded by questionnaire. Morphological indexes such as waist circumference, abdomen circumference and hip circumference were measured with tape measure. Handgrip strength level was measured with grip strength instrument. After performing routine gynecological examinations, the pelvic floor muscle strength was evaluated by palpation with modified Oxford grading scale (MOS). MOS grade>3 was taken as normal group and ≤3 as decreased group. Binary logistic regression was used to investigate the related factors of deceased pelvic floor muscle strength. Results: A total of 929 patients were included in the study, and the average MOS grade was 2.8±1.2. By univariate analysis, birth history, menopausal time, defecation time, handgrip strength level, waist circumference and abdominal circumference were related to the decrease of pelvic floor muscle strength (all P<0.05). By binary logistic regression analysis, the level of handgrip strength (OR=0.913, 95%CI: 0.883-0.945; P<0.001) was correlated with normal pelvic floor muscle strength; waist circumference (OR=1.025, 95%CI: 1.005-1.046; P=0.016), birth history (OR=2.224, 95%CI: 1.570-3.149; P<0.001), sedentary time> 8 hours (OR=2.073, 95%CI: 1.198-3.587; P=0.009) were associated with the decrease of pelvic floor muscle strength. Conclusions: The level of handgrip strength is related to the normal pelvic floor muscle strength of females, while the waist circumference, birth history and sedentary time>8 hours are related to the decrease of pelvic floor muscle strength of females. In order to prevent the decrease of pelvic floor muscle strength, it is necessary to carry out relevant health education, enhance exercise, improve the overall strength level, reduce daily sedentary time, maintain symmetry, and carry out comprehensive overall intervention to improve pelvic floor muscle function.
Adult ; Female ; Humans ; Cross-Sectional Studies ; Gynecology ; Hand Strength ; Muscle Contraction/physiology* ; Muscle Strength/physiology* ; Outpatients ; Pelvic Floor/physiology*

In clinical practice, radiopharmaceutical dynamic imaging technology requires the bolus injection method to complete injection. Due to the failure rate and radiation damage of manual injection, even experienced technicians still bear a lot of psychological burden. This study combined the advantages and disadvantages of various manual injection modes to develop the radiopharmaceutical bolus injector, and explored the application of automatic injection in the field of bolus injection from four aspects: radiation protection, occlusion response, sterility of injection process and effect of bolus injection. Compared with the current mainstream manual injection method, the bolus manufactured by the radiopharmaceutical bolus injector based on the automatic hemostasis method had a narrower full width at half maximum and better repeatability. At the same time, radiopharmaceutical bolus injector had reduced the radiation dose of the technician's palm by 98.8%, and ensured more efficient vein occlusion recognition performance and sterility of the entire injection process. The radiopharmaceutical bolus injector based on automatic hemostasis has application potential in improving the effect and repeatability of bolus injection.
Radiopharmaceuticals ; Injections ; Hand

OBJECTIVE: To investigate the feasibility and effectiveness of absorbable anchor combined with Kirschner wire fixation in the reconstruction of extension function of old mallet finger. METHODS: Between January 2020 and January 2022, 23 cases of old mallet fingers were treated. There were 17 males and 6 females with an average age of 42 years (range, 18-70 years). The cause of injury included sports impact injury in 12 cases, sprain in 9 cases, and previous cut injury in 2 cases. The affected finger included index finger in 4 cases, middle finger in 5 cases, ring finger in 9 cases, and little finger in 5 cases. There were 18 patients of tendinous mallet fingers (Doyle type Ⅰ), 5 patients were only small bone fragments avulsion (Wehbe type ⅠA). The time from injury to operation was 45-120 days, with an average of 67 days. The patients were treated with Kirschner wire to fix the distal interphalangeal joint in a mild back extension position after joint release. The insertion of extensor tendon was reconstructed and fixed with absorbable anchors. After 6 weeks, the Kirschner wire was removed, and the patients started joint flexion and extension training. RESULTS: The postoperative follow-up ranged from 4 to 24 months (mean, 9 months). The wounds healed by first intention without complications such as skin necrosis, wound infection, and nail deformity. The distal interphalangeal joint was not stiff, the joint space was good, and there was no complication such as pain and osteoarthritis. At last follow-up, according to Crawford function evaluation standard, 12 cases were excellent, 9 cases were good, 2 cases were fair, and the good and excellent rate was 91.3%. CONCLUSION Absorbable anchor combined with Kirschner wire fixation can be used to reconstruct the extension function of old mallet finger, which has the advantages of simple operation and less complications.
Male ; Female ; Humans ; Adult ; Bone Wires ; Fracture Fixation, Internal ; Finger Injuries/surgery* ; Fractures, Bone/surgery* ; Tendon Injuries/surgery* ; Fingers ; Treatment Outcome ; Finger Joint/surgery*

OBJECTIVE: To summarize the clinical characteristics, differential diagnosis, and treatment methods of finger flexion contracture caused by three kinds of forearm flexor diseases. METHODS: Between December 2008 and August 2021, 17 patients with finger flexion contracture were treated, including 8 males and 9 females, aged 5-42 years, with a median of 16 years. The disease duration ranged from 1.5 months to 30 years, with a median of 13 years. The etiology included 6 cases of Volkmann's contracture, all of which were flexion deformity of the 2nd to 5th fingers, accompanied by limitation of thumb dorsiflexion in 3 cases and limitation of wrist dorsiflexion in 3 cases; 3 cases of pseudo-Volkmann's contracture, including 2 cases of flexion deformity of middle, ring, and little fingers, and 1 case of flexion deformity of ring and little fingers; 8 cases of ulnar finger flexion contracture caused by forearm flexor disease or anatomical variations, all of which were flexion deformity of middle, ring, and little fingers. Operations such as slide of flexor and pronator teres origin, excision of abnormal fibrous cord and bony prominence, and release of entrapped muscle (tendon) were performed. Hand function was evaluated according to WANG Haihua's hand function rating standard or modified Buck-Gramcko classification standard, and muscle strength was evaluated according to British Medical Research Council (MRC) muscle strength rating standard. RESULTS: All patients were followed up 1-10 years (median, 1.5 years). At last follow-up, 8 patients with contracture caused by forearm flexor disease or anatomical variations and 3 patients with pseudo-Volkmann's contracture achieved excellent hand function, with muscle strength of grade M5 in 6 cases and grade M4 in 5 cases. One patient with mild Volkmann's contracture and 3 patients with moderate Volkmann's contracture without severe nerve damage had excellent hand function in 2 cases and good in 2 cases, with muscle strength of grade M5 in 1 case and grade M4 in 3 cases. Two patients with moderate or severe Volkmann's contracture had poor hand function, with 1 case of muscle strength of grade M3 and 1 case of grade M2, which improved when compared with those before operation. The overall excellent and good rate of hand function and the proportion of patients with muscle strength of grade M4 and above were 88.2% (15/17), respectively. CONCLUSION The finger flexion contracture caused by different etiology can be differentiated by analyzing the history, physical examination, radiographs, and intraoperative findings. After different surgical treatments, such as resection of contracture band, release of compressed muscle (tendon), and downward movement of flexor origin, most patients have a good outcome.
Male ; Female ; Humans ; Forearm/surgery* ; Contracture/surgery* ; Ischemic Contracture/surgery* ; Fingers/surgery* ; Muscle, Skeletal/surgery*