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The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.

Purpose Cerebellar connectivity is thought to be abnormal in cervical dystonia (CD) and other dystonia subtypes, based on evidence from imaging studies and animal work. The authors investigated whether transcranial magnetic stimulation-induced cerebellar brain inhibition (CBI), a measure of cerebellar efficiency at inhibiting motor outflow, is abnormal in patients with CD and/or is associated with clinical features of CD. Because of methodological heterogeneity in CBI reporting, the authors deployed additional controls to reduce potential sources of variability in this study. Methods Cerebellar brain inhibition was applied in 20 CD patients and 14 healthy control subjects. Cerebellar brain inhibition consisted of a cerebellar conditioning stimulus delivered at four different interstimulus intervals (ISIs) before a test stimulus delivered to hand muscle representation in the motor cortex. The average ratio of conditioned to unconditioned motor evoked potential was computed for each ISI. Cervical dystonia clinical severity was measured using the Toronto Western Spasmodic Torticollis Rating Scale. Control experiments involved neuronavigated transcranial magnetic stimulation, neck postural control in patients, and careful screening for noncerebellar pathway inhibition via cervicomedullary evoked potentials. Results There was no difference between CBI measured in healthy control subjects and CD patients at any of the four ISIs; however, CBI efficiency was significantly correlated with worsening CD clinical severity at the 5 ms ISI. Conclusions Cerebellar brain inhibition is a variable measure in both healthy control subjects and CD patients; much of this variability may be attributed to experimental methodology. Yet, CD severity is significantly associated with reduced CBI at the 5 ms ISI, suggestive of cerebello-thalamo-cortical tract dysfunction in this disorder.

We call a hemiparetic hand with paralyzed finger extensors and volitional but spastic flexors a "spastic combination hand." Anecdotally, patients report hand-as-a-holder function with objects like pill bottles, motivating us to formally study spastic combination hand holding capacity using cylinders with different diameters. Nine participants with spastic hemiparesis and spastic combination hand more than 24 mos performed a standardized motor task with 10 cylinder diameters ranging between 1.3 and 9.5 cm and weighing 0.8 and 8.4 oz. Using the unaffected hand, participants attempted to insert a given cylinder into their spastic combination hand, holding it independently for 5 secs. Successful holds were counted during two sessions before and one session after botulinum toxin intervention of Ashworth 3 hand muscles. Findings revealed that a median capacity of six different cylinder diameters was successfully inserted into spastic combination hand at least once before block and a median capacity of 10 cylinders was inserted after block. A mixed-effect statistical model using fixed effects of cylinder diameter and session revealed that total number of successful holds was 43% higher after botulinum. We conclude that this proof-of-concept study does support the idea that spastic combination hand has holding capacity for cylindrical objects of specified diameter and weight and that botulinum neurotoxin offers potential for enlarging spastic combination hand capacity.

STUDY DESIGN This is a cross-sectional descriptive study. OBJECTIVES To quantify differences in hand muscle morphology between persons with cervical spinal cord injury (SCI) and uninjured adults. SETTING The study was performed at the Guangdong Work Injury Rehabilitation Hospital. METHODS We quantified hand muscle cross-sectional area (CSA), thickness, and echo intensity (EI) in 18 persons with subacute to chronic SCI and 23 controls using ultrasound imaging. RESULTS Mean SCI abductor pollicis brevis (APB), abductor digiti minimi (ADM), and first dorsal interosseous (FDI) CSA were ~26%, 43%, and 37% smaller than the control means, the deficit in the APB being less than the ADM (P

Background: Literature shows that intensive Functional Electrical Stimulation facilitates upper limb motor recovery after Stroke. Aim: To assess the effects of 4 weeks of FES therapy on right upper limb motor functions in patient with Chronic Stroke. Materials and Methods: The participant was thirty year old male Right Hemiparesis who had experienced Chronic Ischemic Stroke. FES therapy was given for forty five minutes per session, three sessions a week for complete four weeks. The pre and post intervention score were measured with Fugl Meyer Assessment, Voluntary Control Grading and MAS. Results: The Fugl Meyer Assessment score for right upper limb showed improvement with progression in stage of VCG for right upper limb and hand. Also improved MAS score was noted for right shoulder, elbow and hand muscles. Conclusion: The current study confirms that application of FES therapy improves upper limb motor functions in Chronic stage of Stroke after 4 weeks.

Individuals with stroke show distinct differences in hand function impairment when the shoulder is in adduction, within the workspace compared to when the shoulder is abducted, away from the body. To better understand how shoulder position affects hand control, we tested the corticomotor excitability and intracortical control of intrinsic and extrinsic hand muscles important for grasp in twelve healthy individuals. Motor evoked potentials (MEP) using single and paired-pulse transcranial magnetic stimulation were elicited in extensor digitorum communis (EDC), flexor digitorum superficialis (FDS), first dorsal interosseous (FDI), and abductor pollicis brevis (APB). The shoulder was fully supported in horizontal adduction (ADD) or abduction (ABD). Separate mixed-effect models were fit to the MEP parameters using shoulder position (or upper-extremity [UE] side) as fixed and participants as random effects. In the non-dominant UE, EDC showed significantly greater MEPs in shoulder ABD than ADD. In contrast, the dominant side EDC showed significantly greater MEPs in ADD compared to ABD; %facilitation of EDC on dominant side showed significant stimulus intensity x position interaction, EDC excitability was significantly greater in ADD at 150% of the resting threshold. Intrinsic hand muscles of the dominant UE received significantly more intracortical inhibition (SICI) when the shoulder was in ADD compared to ABD; there was no position-dependent modulation of SICI on the non-dominant side. Our findings suggest that these resting-state changes in hand muscle excitabilities reflect the natural statistics of UE movements, which in turn may arise from as well as shape the nature of shoulder-hand coupling underlying UE behaviors.

Background: The manual muscle test (MMT) is the traditional method to assess the intrinsic hand muscle test. However, this test is qualitative and subjective. A device capable of rapidly measuring motor output along a linear scale may be of value in the evaluation of hand recovery from any neurological impairment. Objective: To demonstrate inter-rater reliability of the Peg Restrained Intrinsic Muscle Evaluator (PRIME) device for measuring intrinsic hand muscle strength in adults with impaired hand functions. Methods: 16 subjects (2 female, 14 male, mean age=47±15 years) with cervical spinal cord injury were enrolled. Intrinsic hand muscle strength of adults were performed by two-tester with use of PRIME device and manual muscle testing, within the same session. Inter-tester correlation was tested by Pearson's correlation and Intraclass correlation coefficient (ICC). Results: Intraclass correlation coefficients for hypothenar, first dorsal interosseous, abductor pollicis brevis and opponence pollicis muscles ranged from 0.7 to 0.8 with hypothenar muscle test being lowest ICC=0.7 and thumb opposition highest, ICC=0.81. Conclusion: Results from this study suggest that PRIME device demonstrates good reliability within testers for quantified measuring of intrinsic hand muscle strength. Further use of PRIME in clinic will aid in diagnostics, medical decision making and evaluation of rehabilitation progress in patients with cervical spinal cord injury.

A dynamic splint is superior to traditional static splint, offering more benefits such as reduced spasticity, allowing comfortable stretch, repositioning fingers in extension positions, and increasing hand performance. This paper suggested the development of a dynamic splint based on a pulley rotation with a locking system as a home rehabilitation device to reduce hand spasticity in stroke patients. Moreover, this study consisted of two main activities: simulation using finite element analysis and clinical experimental trials. Eight stroke patients participated in 4 weeks of intervention using the proposed dynamic splint for a combined total of least 3 hours per day at home. Outcome measures included Fugl-Meyer Assessment (FMA) and Modified Modified Ashworth Scale (MMAS) at baseline, 2 weeks, and 4 weeks. After 4 weeks of wearing, participants were also asked to fill out a satisfaction questionnaire. The results showed that wearing this proposed dynamic splint over 4 weeks, the hand function of participants increased significantly(p < 0.05), and the spasticity of the hand muscles decreased significantly(p < 0.05). With an overall rating of 8 out of 10 points, stroke participants had a high level of satisfaction with this home-use dynamic splint. The findings indicated that stroke patients who used this proposed splint showed substantial changes in hand function and reduced hand spasticity.

Objective. There is a debate over the relevance of ultrasound abnormalities to the pain, functional impairment, and radiologic severity in hand osteoarthritis (OA). This study aims to determine the association between ultrasound abnormalities and clinical, functional, and radiographic measures in hand OA. Methods. A total of 66 patients was consecutively enrolled. All patients with gray-scale synovitis, joint effusion, and osteophytes were examined by ultrasound for 20 hand joints. Radiographic changes in both hands were evaluated by the Kellgren-Lawrence (K-L) grading system and were described as total radiographic severity score and number of affected joints. Other measures were also assessed, including each patient’s visual analogue scale for pain, the Functional Index for Hand Osteoarthritis for functional disability, and grip and pinch strength for hand muscle strength. Results. In total, 10 patients with gray-scale synovitis, 35 with joint effusion, and 66 with osteophytes were detected in hand OA scans on ultrasound. Osteophytes on ultrasound were significantly associated with total radiographic severity score and number of affected joint (r=0.293, p=0.003 and r=0.336, p＜0.001, respectively). In addition, there were weak associations of synovitis and joint effusion with radiographic changes. Patients with higher total radiographic severity score showed larger number of ultrasound-detected abnormalities, such as synovitis, joint effusion, and osteophytes (p=0.011, p=0.002, and p＜0.001, respectively). Conclusion. This study shows that ultrasound findings, especially osteophytes, were associated with radiographic changes based on K-L grade, but not clinical and functional status in hand OA. (J Rheum Dis 2021;28:17-24)

Introduction: the aim of this study was to assess the relationship between ultrasonographic hand muscle thickness measurements and hand muscle strength in patients who underwent median or ulnar nerve reconstruction. Methods: in this prospective, cross-sectional study, intrinsic hand muscle thicknesses were measured using ultrasound with a 4- to 13-MHz linear-array probe. Measurements of hand strength were performed using a dynamometer and a pinchmeter. Results: in the median nerve group (n = 11), a moderate correlation (r = 0.694; P =.018) was observed between lateral pinch strength and transverse thenar thickness. In the ulnar nerve group (n = 11), longitudinal thenar thickness below the flexor pollicis longus tendon was moderate to highly correlated with pinch and handgrip strengths (r = 0.726-0.893; P, NA

Study Design Case report. Introduction A severe wrist fracture can cause permanent physical disabilities and deformities, leading to limit patients in their occupation and social environment. Purpose of the Study We aim at presenting a treatment protocol and the functional outcome of a patient with severe clinical state after a rare wrist fracture. Methods We provided physical therapy intervention associated with serious games for muscle strengthening. Results and Discussion There was an increase in strengthening and a decrease in Disability of the Arm, Shoulder and Hand score and Patient Rated Wrist Evaluation scores. The International Classification of Functioning scores have changed from severe to light or to absent in many of the domains. Conclusion The use of serious games combined with a conventional physical therapy intervention played a fundamental role in recovery and return to work activities, and there was also an important recovery of general health condition.

Purpose Targeted muscle reinnervation (TMR) has emerged as a treatment for, and prevention of, symptomatic neuromas and has been reported to be of benefit in the hand. Anatomical studies establishing landmarks for consistent identification of the motor entry points (MEPs) to the intrinsic muscles have not been performed. The purpose of this study was to provide details regarding the MEPs to the intrinsic muscles, determine which MEPs are identifiable dorsally, and develop recommended sensory to MEP nerve coaptations for prophylactic TMR at the time of ray amputation or for management of symptomatic neuromas. Methods Motor entry points to the intrinsic hand muscles were dissected in 5 fresh latex-injected cadavers. Number of MEPs, diameter, surface of entry, and distance from dorsal (Lister tubercle) and volar (hamate hook) landmarks were recorded for each target muscle. The digital sensory nerve diameters were measured for size comparison. Results Motor entry points were identified to all 19 intrinsic muscles through a volar approach and 12 through a dorsal approach. For all fingers, at least 2 MEPs were consistently identified dorsally at the base of each amputation site innervating expendable muscles. Motor entry points to the thenar muscles were only reliably identified through a volar approach. Two recommended nerve coaptations for each digit amputation were identified. All had a favorable sensory-to-MEP diameter ratio less than 2:1. Conclusions The intrinsic hand muscles have MEPs at consistent distances from bony landmarks both dorsally and volarly. Clinical relevance These results can be applied clinically to assist surgeons in identifying the locations of MEPs to the intrinsic muscles when performing TMR in the hand for both neuroma treatment and prevention.

Objective To explore the diagnostic accuracy of the split-hand index (SHI) for amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA) using sonographic assessment of muscle thickness. Methods We performed a prospective sonographic assessment of hand muscle thickness in 59 controls, 87 patients with ALS, and 33 patients with SMA. We determined the diagnostic accuracy of SHI for differentiating patients with ALS and SMA from controls. Results Patients with ALS and SMA had significantly lower muscle thickness and SHI values compared with controls. SHI showed excellent diagnostic accuracy for differentiating ALS from controls, and good diagnostic accuracy for differentiating SMA from controls. Conclusions SHI determined by sonographic measurement of hand muscle thickness seems to be a promising tool for the diagnosis of ALS and may be added easily when performing neuromuscular ultrasound. Significance SHI determined by sonographic measurement of hand muscle thickness can differentiate between healthy subjects and patients with ALS and SMA.

It is believed that exposure to whole-body vibration (WBV) may increase seated occupant drowsiness and seated. The purpose of this paper is to investigate the strength of the hand grip among the young adults in Malaysia. Also, to examine the correlation between anthropometry factors such as hand length (HL), hand breadth (HB), wrist circumference (WC) and body mass index (BMI) with average full hand grip strength of young adults. 40 Malaysian young adults with equal females and males and the range age of 23 to 28 years old voluntarily basis participated in this study. Three experiments were conducted in sitting position according to American Standard Hand Therapist (ASHT) with 45º, 90o and 135o of hand flexion using dynamometer. The results show the significant different full hand grip strength between Malaysian young adult females and females, the difference full hand grip strength for different hand flexion angles in sitting position and difference correlations between anthropometry factors and full hand grip strength for both young adult males and females.

Background: The sawmill or lumber mill industry is mainly known as important small-scale industries in India, where thousands of sawmillers suffered from musculoskeletal pain and other health-related problems. The primary aim of the current study is to find out the subjective assessment of musculoskeletal disorders (MSDs) and occupational related health disorders among sawmill workers in India. Materials and Methods: The current descriptive study was direct on 135 sawmillers and 130 control subjects from different region of the Hooghly district, in India. To this end, the Nordic Musculoskeletal Questionnaire (NMQ) was administered to estimate the subjective discomfort feeling and Handgrip Strength were also measured to estimate the power of the hand muscle among the sawmillers and compare with control groups. Posture adopted frequently during working of the sawmillers were also analyzed by the Ovako Working Analysis System (OWAS). Results: The data indicated that the sawmill workers complained of discomfort (pain) felt maximum in low back part of the body (91) followed by hands (80), shoulders (76), knees (64), and the upper back (58). This study indicated that the sawmillers had less handgrip strength than the control subjects due to performing more hand intensive jobs. Conclusions: The results of current study indicate that the sawmill workers suffered from MSD due to working in a stooped, squatting posture for a long duration, which adversely affected their health.

Introduction: The number of older people in Indonesia continues to rise. Aging process will cause changes in organ systems, one of which is changes in the musculoskeletal system. One of the significant weakening of function in the elderly is the degrading strength of the handheld muscles, which resulted in a decrease of functional abilities. One method which can be used to increase hand muscle grip strength is by doing rubber ball exercise. Aim: To analyze the difference of hand muscle grip strength on pre- and post- performing rubber ball exercises in elderlies at St. Joseph Nursing Home in Surabaya. Method: This study is a pre-experimental analytic research with one group pretest – posttest design approach. The sampling technique used consecutive sampling, with a total sample of 48 elderlies. The interventions for rubber ball exercises were carried out three times a week for one month. Instruments used for this study were the MMSE and MNA-SF questionnaires. The hand muscle grip strength was measured using the Handgrip Dynamometer. data analysis was done using the SPSS program and the Chi-Square test. Results: The mean total value of the muscle grip strength pre-exercises was 10,8 ± 3,9 kg. The mean total value of the hand muscle grip strength post exercises was 11,97 ± 4,08 kg. The data analysis results show that there was a significant difference between pre- and postperforming rubber ball exercises on the elderly at St. Joseph nursing home in Surabaya. (p=0,025). Conclusion: There is a significant contrast between pre and post-performing rubber ball exercises on the elderly at St. Joseph nursing home in Surabaya.

Voluntary force declines during sustained, maximal voluntary contractions (MVC) due to changes in muscle and central nervous system properties. Central fatigue, an exercise-induced reduction in voluntary activation, is influenced by multiple processes. Some may occur independently of descending voluntary drive. To differentiate the effects associated with voluntary drive from other central and peripheral influences, we measured voluntary activation and motoneuron excitability following fatiguing contractions produced voluntarily or by electrical stimulation. On two separate days, participants performed either a 2-min MVC of adductor pollicis muscle or received 2-min continuous supramaximal electrical stimulation of the ulnar nerve. In study 1 (n = 14), the superimposed twitch elicited by ulnar nerve stimulation during brief MVCs was increased, and, hence, voluntary activation was reduced, up to 240 s after the 2-min MVC [−20 ± 12% (SD), P = 0.002] but not the 2-min stimulated contraction (−4 ± 7%), despite large reductions in MVC force (voluntary, −54 ± 18%; stimulated, −46 ± 16%). In study 2 (n = 12), F-waves recorded from the adductor pollicis were reduced in area for 150 s following the 2-min MVC (−21 ± 16%, P = 0.007) but not after the stimulated contraction (5 ± 27%). Therefore, voluntary activation and motoneuron excitability decreased only when descending voluntary drive was present during the fatiguing task. The findings do not exclude a cortical or brain stem contribution to the reduced voluntary activation but suggest that neither sensory feedback from the fatigued muscle nor repetitive activation of motoneurons underlie the changes, whereas they are consistent with motoneuronal inhibition by released factors linked to voluntary drive. NEW & NOTEWORTHY We demonstrate that reductions in voluntary activation and motoneuron excitability following 2-min isometric maximal contractions in humans occur only when fatigue is produced through voluntary contractions and not through electrically stimulated contractions. This is contrary to studies that suggest that changes in the superimposed twitch and therefore voluntary activation are explained by changes in peripheral factors alone. Thus, the interpolated twitch technique remains a viable tool to assess voluntary activation and central fatigue.

Background: Functional abnormalities in multiple sclerosis may be due to a decrease in the level of physical activity of MS patients compared to healthy People. Exercise activity as a non-pharmacological method can have beneficial effects on the rehabilitation of these patients. Therefore, the purpose of present study was to investigate the effect of eight weeks of combined training on some indicators of physical and mental function in women with multiple sclerosis. Methods: Twenty women with multiple sclerosis were randomly divided into experimental and control group that only 16 subjects (8 in the training group and 8 in the control group) were able to complete all stages of this study. The training group participated in eight weeks and three days per week in combined training program (contains rhythmic aerobic and resistance training by bodyweight, Theraband, and TRX). Muscles strength, endurance and speed of walking, and psychological induces were evaluated in pre- test and post-test. Independent and paired samples T-test were used for data analysis. Results: Combined training resulted in a significant increase in quadriceps and hand muscles strength, endurance and speed of walking, and also significant decrease in depression and anxiety levels (P˂0.05). However, no significant difference was observed in the fingers strength (P˃0.05). Conclusion: It seems that combined training used in present study can be effective in increasing muscle strength, motor function, and decreasing depression and anxiety in women with multiple sclerosis. Therefore, the use of this training method at the club and home is recommended for these patients.

In this study, we address the issue of whether vibrotactile feedback can enhance the motor cortex excitability translated into the plastic changes in local cortical areas during motor imagery (MI) BCI-based training. For this purpose, we focused on two of the most notable neurophysiological effects of MI – the event-related-desynchronization (ERD) level and the increase in cortical excitability assessed with navigated transcranial magnetic stimulation (nTMS). For TMS navigation, we used individual high-resolution 3D brain MRIs. Ten BCI-naive and healthy adults participated in this study. The MI (rest or left/right hand imagery using Graz-BCI paradigm) tasks were performed separately in the presence and absence of feedback. To investigate how much the presence/absence of vibrotactile feedback in MI BCI-based training could contribute to the sensorimotor cortical activations, we compared the MEPs amplitude during MI after training with and without feedback. In addition, the ERD levels during MI BCI-based training were investigated. Our findings provide evidence that applying vibrotactile feedback during MI training leads to (i) an enhancement of the desynchronization level of mu-rhythm EEG patterns over the contralateral motor cortex area corresponding to the MI of the non-dominant hand; (ii) an increase in motor cortical excitability in hand muscle representation corresponding to a muscle engaged by the MI.

Hand movement is controlled by a large number of muscles acting on multiple joints in the hand and forearm. In a forearm amputee the control of a hand prosthesis is traditionally depending on electromyography from the remaining forearm muscles. Technical improvements have made it possible to safely and routinely implant electrodes inside the muscles and record high-quality signals from individual muscles. In this study, we present a database of intramuscular EMG signals recorded with fine-wire electrodes alongside recordings of hand forces in an isometric setup and with the addition of spike-sorted metadata. Six forearm muscles were recorded from twelve able-bodied subjects and nine forearm muscles from two subjects. The fully automated recording protocol, based on command cues, comprised a variety of hand movements, including some requiring slowly increasing/decreasing force. The recorded data can be used to develop and test algorithms for control of a prosthetic hand. Assessment of the signals was done in both quantitative and qualitative manners., Measurement(s)muscle electrophysiology trait • muscle contractionTechnology Type(s)micro electrode • strain gaugesFactor Type(s)age • muscleSample Characteristic - OrganismHomo sapiens Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.11310011

The first aim of this study was to compare an incidence of sarcopenia in patients with chronic obstructive pulmonary disease (COPD) when using updated (2018) the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm compared to the previous version (2010). The second aim was to determine relationships between clinical and functional parameters of COPD and parameters of sarcopenia. Methods . The study involved 86 stable COPD patients (68 males; mean age, 66.6 ± 8.7 years). The diagnosis of COPD was made according to GINA 2019. Sarcopenia was diagnosed according to EWGSOP guidelines 2010 and 2018. Muscle mass was assessed using dual-energy Xray absorptiometry (DXA). Results . Walking speed was measured in all patients according to EWGSOP guideline 2010. Additionally, hand muscle strength was measured in patients with walking speed > 0.8 m/s (n = 25). DXA was required to 72% of patients to confirm the diagnosis of sarcopenia. Sarcopenia was defined in 38 (44.1%) patients including severe sarcopenia in 20 (23.3%). According to results of SARC-F questionnaire, further hand muscle strength measurement was required to 64 patients and DXA was required to 51 (59.3%) patients. As a result, sarcopenia was confirmed in 38 (44.1%) patients including severe sarcopenia in 34 (39.5%) patients. The incidence of sarcopenia was higher in patients with more severe symptoms of COPD and more severe bronchial obstruction ( р = 0.001), and in patients with emphysema ( р < 0.03). Conclusion . The incidence of sarcopenia in COPD patients did not differ when used different diagnostic algorithms (EWGSOP, 2010 vs 2018) and was 44.1%. The need in additional tests, including expensive tests, was lower and the incidence of sarcopenia was higher (39.5% vs 23.3%) following the EWGSOP algorithm, 2018, compared to that of 2010. The incidence of sarcopenia increased in more severe COPD, in patients with emphysema, severe clinical symptoms, severe and very severe bronchial obstruction. The incidence of sarcopenia was not related to the patient’s age.

Background: Parkinson’s disease (PD) is the third most common neurodegenerative disease in the central nervous system. It is a degenerative and slowly progressive disease. PD patients have difficulty at the beginning of the movement, at the path of movement, and at the end of the movement. PD consists of 5 main stages. Methods: The purpose of this study was to diagnose PD type 1 and 2 on the electrical activity of shoulder muscle during isometric contraction with and without intellectual activity. In the same way, the electrical activity of the 2 right anterior deltoid muscles and the right upper trapezium by electromyographic apparatus in 4 conditions: (1) Resting, (2) Resting with intellectual activity, (3) performing an isometric movement in the hands, and (4) performing a movement Isometric in hand with an intellectual activity evaluated. The statistical population of the study consisted of 20 patients as experimental group (10 patients in the first stage and 10 patients in the second stage of PD) and ten healthy subjects as the control group as the statistical population. Shapiro-Wilk test was used to determine the normal distribution of data. Averages of variables were compared using the ANOVA test at a significant level of 5%. All statistical methods were performed using SPSS software. Results: The results of this study showed that the electrical activity of the shoulder belt muscles is significantly different during and after the isometric contraction with and without mental activity in PD type I and II. Conclusion: As a result, a non-invasive approach to assessing the electrical activity of shoulder muscle can be used to determine the first and second stages of PD. Research shows that PD is a chronic and progressive complication that most affects older people. Also, according to the results, Parkinson’s patients have weaker performance in cognitive functions than healthy people.

Introduction. Coexistent involvement of upper and lower motor neurons is a characteristic feature of amyotrophyc lateral syndrome (ALS) necessary for the diagnosis. Diagnosis of upper motor neuron involvement in ALS is based solely on clinical features, which may not be detected at the disease onset and in rare forms manifesting clinically as the local lower motor neuron syndrome (LLMNS). The main method of assessment of the functional state of the upper motor neuron in ALS is transcranial magnetic stimulation (TMS). It allows assessing the excitability of motor cortex, corticospinal path function, and mapping of cortical representation of the muscles. In patients with ALS changes of various indicators demonstrating hyperexcitability as well as degenerative lesions of the motor cortex and the corticospinal tracts are recorded on TMS. Objective: to discuss changes in the TMS in patients with LAS, pathophysiological mechanisms of their formation and possible diagnostic value. Results. In 22 patients with LLMNS, navigation TMS revealed disturbances of intracortical suppression on paired stimulation with recording period of silence, increase of motor threshold in dominant hemisphere, decrease of the weighted square and reorganization of cortical representations of the hand muscles. Conclusion. The data obtained allow to consider navigation TMS as a promising technology for identifying upper motor neuron involvement in patients with ALS., №2 (2018)

PubMedID: 31033455 BACKGROUND AND OBJECTIVE: This study determined the hand muscle strength parameters and reference values in healthy subjects using the Nicholas Manual Muscle Tester (NMMT) and Manual Muscle Test (MMT) and compared these methods. METHODS: The study was carried out with 200 (102 males, 98 females) healthy adults aged between 18-25 years. Muscle strength evaluations of the hand were performed to determine hand motor ability using both NMMT and MMT. RESULTS: The mean values of age, weight, height and body mass index (BMI) were 19.48 ± 0.95 years, 60.66 ± 8.82 kg, 165.30 ± 7.95 cm and 22.14 ± 2.25 kg/m2, respectively, in females, whereas the same values were found as 20.40 ± 1.34 years, 72.53 ± 9.45 kg, 176.20 ± 6.29 cm and 23.25 ± 2.90 kg/m2, respectively, in males. There was a statistically significant difference in all demographic data between genders (p< 0.05). Furthermore, correlation coefficient in NMMT was found to be between 0.503 and 0.954. However, there was no correlation between the MMT and NMMT results. CONCLUSION: The observations presented need to be taken into consideration for evaluate musculoskeletal problems and also can be used as reference values for evaluating treatment outcomes. © 2019 - IOS Press and the authors. All rights reserved.

Objective There is still insufficient knowledge about natural history in adult spinal muscular atrophy, thus valid markers for treatment and disease monitoring are urgently needed. Methods We studied hand muscle innervation pattern of 38 adult genetically confirmed 5q spinal muscular atrophy (SMA) patients by the motor unit number index (MUNIX) method. Data were compared to healthy controls and amyotrophic lateral sclerosis (ALS) patients and systematically correlated to typical disease-relevant scores and other clinical as well as demographic characteristics. Results Denervation of hand muscles in adult SMA was not evenly distributed. By calculation of the MUNIX ratios, we identified a specific hand muscle wasting pattern for SMA which is different to the split hand in ALS. Furthermore, MUNIX parameters strongly correlated with established disease course parameters independent of disease stages. Conclusion We found a pathophysiological remarkable denervation pattern of hand muscles, a ‘reversed split hand’. MUNIX of single hand muscles correlated well with disease severity and thus represents an easily available biomarker for adult SMA. Significance Our data show the power of the MUNIX method as a biomarker for upcoming questions in adult SMA.

Intrinsic hand muscles are densely located in the hand, and the myoelectric observation from the surface is sometimes unreliable because of some outside influences that may interfere with the signals. In the present study, we evaluated the activities of multiple interosseous hand-muscles which densely located in the hand, through analyzing the surface electromyographic signals during finger-oriented tasks using univariate and multivariate logistic regression models. Ten healthy subjects participated in our experiment, and isometrically exercised each finger one by one in flexed form. The result of a univariate analysis with the power and amplitude domain predictor variables of the surface electromyographic signals showed significant consistency between the activated finger and the inserted finger of the dorsal interosseous muscles to the proximal phalanx (P < 0.001). Meanwhile, the results of a multivariate analysis showed a higher correlation of the regression model of the fourth dorsal interosseous muscle during the action of the ring finger using frequency-domain variables (the Nagelkerke R2 = 0.716 when the median frequency was used), compared to the model without the frequency-domain variables (the Nagelkerke R2 = 0.583). Our result showed that the logistic regression models have a particular possibility for the analysis of the surface electromyographic signals of densely located hand-muscle activities related to the finger-oriented tasks.

The spatial accuracy of transcranial magnetic stimulation (TMS) may be as small as a few millimeters. Despite such great potential, navigated TMS (nTMS) mapping is still underused for the assessment of motor plasticity, particularly in clinical settings. Here, we investigate the within‐limb somatotopy gradient as well as absolute and relative reliability of three hand muscle cortical representations (MCRs) using a comprehensive grid‐based sulcus‐informed nTMS motor mapping. We enrolled 22 young healthy male volunteers. Two nTMS mapping sessions were separated by 5–10 days. Motor evoked potentials were obtained from abductor pollicis brevis (APB), abductor digiti minimi, and extensor digitorum communis. In addition to individual MRI‐based analysis, we studied normalized MNI MCRs. For the reliability assessment, we calculated intraclass correlation and the smallest detectable change. Our results revealed a somatotopy gradient reflected by APB MCR having the most lateral location. Reliability analysis showed that the commonly used metrics of MCRs, such as areas, volumes, centers of gravity (COGs), and hotspots had a high relative and low absolute reliability for all three muscles. For within‐limb TMS somatotopy, the most common metrics such as the shifts between MCR COGs and hotspots had poor relative reliability. However, overlaps between different muscle MCRs were highly reliable. We, thus, provide novel evidence that inter‐muscle MCR interaction can be reliably traced using MCR overlaps while shifts between the COGs and hotspots of different MCRs are not suitable for this purpose. Our results have implications for the interpretation of nTMS motor mapping results in healthy subjects and patients with neurological conditions.

Machine learning is widely used in the medical applications. Parkinson’s disease is a nervous system disorder which commonly causes tremors, but the disorder also commonly causes stiffness or slowing of movement. These symptoms are not only caused by Parkinson’s disease but also the other movement disorder sickness. The doctors who are specialist in the Parkinson’s disease can simply diagnose the tremors, which usually be hand muscle tremor of the patient. But conversely, the out-patient-department doctors find that it is difficult to diagnose those symptoms. This work proposes the use of machine learning for the Parkinson’s disease data to assist the physician diagnosis. The Long Short-Term memory network is suitable for the data collected by a specialist. The result shows that the proposed method has 73% accuracy in early identifying the patient with Parkinson’s disease.

Unduly tight plaster hand casts may narrow the metacarpal joint space, hindering rehabilitation. This study investigated how metacarpal narrowing affects grip strength. Forty-two adult volunteers with no other pathology were included. Dominant and non-dominant hand grip strength was measured with a digital hand dynamometer (Jamar plus, China). Metacarpal width was measured with a metal caliper, and the caliper was then fixed at 10% narrowing of the joint space, and a second measurement of grip strength was taken. The measurements were thus taken twice each in the dominant and non-dominant hand, and the average of the two was recorded. A total 336 measurements were taken in the dominant and non-dominant hands of 42 individuals at two time points. There was no significant difference in grip strength between dominant and non-dominant hands (p = 0.183). After 10% narrowing, both the dominant and the non-dominant hand showed a mean 33.4% reduction in grip strength: i.e., squeezing the metacarpus with a caliper significantly reduced grip strength in both dominant and non-dominant hands (p = 0.01). The study thus showed that grip strength will decrease significantly when the metacarpus is squeezed by a tight cast. Although the patient does not feel the 10% narrowing of the metacarpus, it is clear that hand muscle mass may be adversely affected in the long term.

Acute exercise can modulate the excitability of the non-exercised upper-limb representation in the primary motor cortex (M1). Accumulating evidence demonstrates acute exercise affects measures of M1 intracortical excitability, with some studies also showing altered corticospinal excitability. However, the influence of distinct M1 interneuron populations on the modulation of intracortical and corticospinal excitability following acute exercise is currently unknown. We assessed the impact of an acute bout of leg cycling exercise on unique M1 interneuron excitability of a non-exercised intrinsic hand muscle using transcranial magnetic stimulation (TMS) in young adults. Specifically, posterior-to-anterior (PA) and anterior-to-posterior (AP) TMS current directions were used to measure the excitability of distinct populations of interneurons before and after an acute bout of exercise or rest. Motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) were measured in the PA and AP current directions in M1 at two time points separated by 25 minutes of rest, as well as immediately and 30 minutes after a 25-minute bout of moderate-intensity cycling exercise. Thirty minutes after exercise, MEP amplitudes were significantly larger than other timepoints when measured with AP current, whereas MEP amplitudes derived from PA current did not show this effect. Similarly, SICI was significantly decreased immediately following acute exercise measured with AP but not PA current. Our findings suggest that the excitability of unique M1 interneurons are differentially modulated by acute exercise. These results indicate that M1 interneurons preferentially activated by AP current may play an important role in the exercise-induced modulation of intracortical and corticospinal excitability.

Dissociated muscle atrophy is an established clinical phenomenon of amyotrophic lateral sclerosis (ALS), heralded by the split-hand sign which is clinically characterised by preferential wasting of thenar group of intrinsic hand muscles (abductor pollicis brevis (APB) and first dorsal interosseous (FDI)), when compared with the hypothenar group.1–3 The specificity of the split-hand phenomenon in ALS was further established by the split-hand index, a neurophysiological biomarker utilising motor amplitudes.4 Additionally, dissociated patterns of muscle atrophy in ALS may also be characterised by the split-hand plus (preferential dysfunction of thenar muscles compared with flexor pollicis longus),4 split-elbow (preferential weakness of biceps brachii compared with triceps muscle)5 and split-leg signs (preferential dysfunction of ankle plantar flexor compared with the dorsiflexor muscles). …

© 2020 International Federation of Clinical Neurophysiology Objective: Decomposition-based quantitative electromyography (DQEMG) is one method of measuring neuromuscular physiology in human muscles. The objective of the current study is to compare the neuromuscular physiology of a typical aging population in the intrinsic hand muscles. Methods: Measurements of DQEMG were detected with a standard concentric needle and surface EMG from the intrinsic hand muscles. DQEMG was obtained from the first dorsal interosseous (FDI), the abductor digiti minimi (ADM) and fourth dorsal interosseous (4DI). Multivariate analysis of variance (MANOVA) were performed for the surface and intramuscular EMG measures to identify age differences in motor unit properties. Results: Large differences were observed between the age groups for the canonical intramuscular and surface EMG variables. Older adults demonstrated a large decrease in motor unit number estimation in the ADM and FDI. Likewise, medium to large decreases in motor unit stability were observed in the FDI, ADM and 4DI. Conclusions: With aging, there are decreases in motor unit number estimation and stability in the intrinsic hand muscles. Using a multivariate approach allows for age-related differences and the relationship between the variables to be further elucidated. Significance: Multivariate analysis of DQEMG may be useful for identifying patterns of change in neuromuscular physiology with age-related changes to hand musculature. This may potentially lead to future prognostic biomarkers of age-related changes to hand muscles.

Electromyography (EMG) based interfaces have been used in various robotics studies ranging from teleoperation and telemanipulation applications to the EMG based control of prosthetic, assistive, or robotic rehabilitation devices. But most of these studies have focused on the decoding of user’s motion or on the control of the robotic devices in the execution of simple tasks (e.g., grasping tasks). In this work, we present a learning scheme that employs High Density Electromyography (HD-EMG) sensors to decode a set of dexterous, in-hand manipulation motions (in the object space) based on the myoelectric activations of human forearm and hand muscles. To do that, the subjects were asked to perform roll, pitch, and yaw motions manipulating two different cubes. The first cube was designed to have a center of mass coinciding with the geometric center of the cube, while for the second cube the center of mass was shifted 14 mm to the right (off-centered design). Regarding the acquisition of the myoelectric data, custom HD-EMG electrode arrays were designed and fabricated. Using these arrays, a total of 89 EMG signals were extracted. The object motion decoding was formulated as a regression problem using the Random Forests (RF) technique and the muscle importances were studied using the inherent feature variables importance calculation procedure of the RF. The muscle importance results show that different subjects use different strategies to execute the same motions on same object when the weight is off-centered. Finally, the decoded motions were used to control a five fingered robotic hand in a proof-of-concept application.

Research background. Autism is one of the most difficult wide spectrum developmental disorders. Recently, striking increase in the number of autistic children is observed. Physical activation is important for the development and physical fitness of children with autism disorder. Research object – children’s balance, muscle strength and endurance. The aim was to evaluate physical capacity and impact of physiotherapy on balance, muscle strength and endurance in 7–11-yearold children with autism disorder. Methods. The study group consisted of 10 children with autism disorder (8 boys and 2 girls), the control group consisted of 18 healthy children (15 boys and 3 girls). The average age of the study group was 8.90 ± 1.4 years; in the control group 8.94 ± 1.0 years. Balance of children was assessed by Berg Balance Scale, hand grip – by dynamometry, leg muscle strength – by long jump test and squat test, and endurance of abdominal muscle – by sit up test. The results showed that physical condition of children with autism disorder was significantly poorer compared to healthy children: the balance – 43.9 ± 7.82 v. s. 55.4 ± 0.9 points; right hand muscle strength of 5.9 ± 2.06 kg v. s. 12.2 ± 3.43 kg; left – 5.3 ± 1.87 kg v. s 12.1 ± 3.43; long jump 43.0 ± 25.25 cm v. s 132.6 ± 31.87 cm; endurance of abdominal muscles 7.3 ± 2.01 v. s 19.6 ± 4.06 times per 30 s; squats 9.1 ± 4.36 v. s 27.6 ± 7.07 times per 30 s. After applying physical therapy results of all performed tests in children with autism improved significantly: balance to 49.9 ± by 5.45 points, right hand muscle strength to 7.9 ± 2.49 kg, left – 7.5 ± 2.31 kg, long jump to 79.2 ± 39.87 cm, crunches to 11.8 ± 4.54 times, squats to 14.8 ± 4.83 times, but they did not reach the results of healthy children. Conclusion. Balance, muscle strength and endurance of children with autism disorder were significantly lower than those in healthy children. Physical therapy significantly improved physical capacity of autistic children, but the level of healthy children was not reached.Keywords: autism, children, physiotherapy.

In this study, we investigated the electrophysiologic recovery of the abductor pollicis brevis (APB) muscle after contralateral seventh cervical (cC7) nerve transfer for the treatment of global brachial plexus avulsion (GBPA). We retrospectively analyzed the electromyography records of 95 patients with GBPA, comprising 81 men and 14 women, focusing on the motor unit potential (MUP) recovery of the APB. All patients underwent cC7-median nerve (MN) transfer. The cC7 nerve was transferred to the MN alone in 58 patients (One-Nerve Group), whereas 37 patients underwent cC7 transfer to the MN and another nerve (Two-Nerve Group). Fifty-three patients (MUP Group) exhibited MUP recovery of the APB, whereas 42 patients did not (No-MUP Group). The MUP Group comprised 32 patients from the One-Nerve Group and 21 patients from the Two-Nerve Group. The mean age of the MUP Group was significantly lower than that of the No-MUP Group. In summary, electrophysiologic recovery of the APB was common in patients with GBPA after cC7-MN transfer, indicating that it may be possible to restore the function of the intrinsic muscles of the hand after GBPA. The rehabilitation strategy for patients with GBPA, which overlooks the restoration of intrinsic hand muscle function, may require amendment.

To design comfortable and efficient hand tools, an objective measurement such as using surface electromyography (sEMG) is required, where the ergonomic design tries to find the most optimal and most fit design of hand-tool that doesn't cause stress on the hand muscles. The hand tool design optimization will be demonstrated in this study on designing shampoo bottles, where the design of bottle and its compatibility with the slippery watery area, in addition to the aesthetic considerations are important issues that must be taking by the manufacturers concerned with such industries. Six different designs of shampoo bottles, as outcomes of industrial design graduation project in the department of Industrial design at our university, were used in this study. The new designs, together with other traditionally bottle designs, were evaluated in simulated shampoo pouring task in the laboratory. Several important parameters extracted from the sEMG signal in both temporal domain and frequency domain provide useful information about the tested designs. Twenty healthy university students (10 males and 10 females; mean age of 21 ± 2 years) were included in this study. Each subject was asked to handle the bottle and simulate the shampoo pouring activity in gentle and delicate manner using the grasp pattern that is found most comfort for him/her. Muscular behavior during bottle holding and shampoo pouring tasks show that male and female have different preferences in dealing with different bottle design, where male have less hand stress with designs that achieve the best fit of their full hand, while female have less hand stress with designs that achieve the best fit of their fingertips, and therefore, the end-user gender must be considered in designs of such industries. Keywords: Surface electromyography, Ergonomic design, Hand-tools, Hand stress, Mean frequency, Euclidean distance, Root mean square, Gender considerations

ObjectiveThe objective of this study was to investigate the usefulness of muscle ultrasound in evaluating dissociated small hand muscle atrophy, termed ‘split hand’, and its feasibility in the diagnosis of amyotrophic lateral sclerosis (ALS).MethodsForty-four patients with ALS, 18 normal subjects and 9 patients with other neuromuscular disorders were included in this study. The hand muscles were divided into three regions, the median-innervated lateral hand muscle group (ML), the ulnar-innervated lateral hand muscle (UL) and the ulnar-innervated medial hand muscle (UM), and the muscle echo intensity (EI) and compound muscle action potential (CMAP) were measured. We calculated the split hand index (SHI) using muscle EI (SHImEI) and CMAP (SHICMAP) for comparison among groups. The SHI was derived by dividing muscle EI (or CMAP) measured at the ML and UL by that measured at the UM.ResultsThe SHImEI was significantly higher in patients with ALS (51.7±28.3) than in normal controls (29.7±9.9) and disease controls with other neuromuscular disorders (36.5±7.3; PmEI had significantly better diagnostic accuracy than the SHICMAP.ConclusionsThe SHImEI was more sensitive in evaluating dissociated small hand muscle atrophy compared with the SHICMAP and may be a reliable diagnostic marker for differentiating ALS from other neuromuscular disorders and healthy controls.

Limb amputation injuries and their subsequent replantation is a time-critical exercise if function is to be restored. The exact time limit to functional replantation is still poorly defined in the literature owing to the multitude of factors that influence functional recovery. The relative metabolic activity of a tissue is lower under hypothermic conditions, and subsequently, moderate delays in restoring circulation can still achieve good functional outcomes if the amputated part is transported appropriately. Some surgeons have adopted the practice of, in cases where the delay to replantation is beyond 8–10 h, resecting skeletal muscle from the amputated part to avoid the sequelae of its ischaemic period. We report the case of a traumatic trans-carpal hand amputation in a 40-year-old male, with a second-level injury more distally at the metacarpal heads, who was replanted with a total ischaemic time of 19 h and 25 min. The decision was made to retain his intrinsic hand muscles in contradiction to common practice. At 2.5 years follow-up, he has regained a remarkable level of function of his hand including activation of his intrinsic hand muscles. His Semmes Weinstein testing has also shown good sensory recovery of his repaired nerves and he enjoys little, if any, disability as a result of his injury (despite a double-level injury on the dorsal ulna aspect of his forearm). This suggests, in cases of hand amputation with appropriate hypothermic transportation of the amputated part, ischaemia times up to 20 h may be compatible with restoration of intrinsic hand function. Level of Evidence: Level V, risk / prognostic study.

The aim of this study was to test the effects of kilohertz frequency alternating current (KHFAC) surface stimulation applied to the ulnar nerve on force and myoelectrical activity of the abductor digiti minimi (ADM) muscle. Eighteen healthy volunteers (age: 27.6 ± 7.9 years; 10 males, 8 females) were included in the study. Each subject participated in one session during which a biphasic 7 kHz rectangular pulse was delivered above the medial epicondyle of the humerus to induce ulnar nerve blocking. ADM electromyographic (EMG) activity and contraction force were measured before (Pre), immediately after, and following 5 and 10 min post stimulation (post 1, post 2). The results showed that EMG activity decreased immediately after stimulation compared to prestimulation, it returned to the level of prestimulation at 5 min (post 1), and decreased again at 10 min (post 2). Furthermore, analysis of compound adjusted z-score indicated significant decrease of force and myoelectrical activity immediately, and 10 min post stimulation. The findings, which demonstrate that KHFAC surface stimulation of the ulnar nerve may decrease the motor activity of intrinsic hand muscle, can help to develop future methods of neuromodulation to treat hand spasticity.

The object of this study was to clarify how the motor imagery of foot muscle relaxation influences corticospinal excitability for the ipsilateral hand. Twelve participants volitionally relaxed their right foot from a dorsiflexed position (actual relaxation), or imaged the same movement (imagery relaxation) in response to an auditory cue. Transcranial magnetic stimulation (TMS) was delivered to the hand area of the left primary motor cortex at different time intervals after an auditory cue. Motor evoked potentials (MEPs) were recorded from the right extensor carpi radialis (ECR) and flexor carpi radialis (FCR). MEP amplitudes of ECR and FCR caused by single-pulse TMS temporarily decreased during both actual relaxation and imagery relaxation as compared with those of the resting control. A correlation of MEP amplitude between actual relaxation and imagery relaxation was observed. Our findings indicate that motor imagery of muscle relaxation of the foot induced a reduction of corticospinal excitability in the ipsilateral hand muscles. This effect is likely produced via the same mechanism that functions during actual muscle relaxation.

The hand knob area is the cortical representation of motor hand function. The current study aimed to investigate the effects of eloquent area gliomas on the morphometry of the hand motor cortex and preoperative hand motor function. A retrospective study of 320 glioma patients was conducted. Seventy-eight patients with gliomas involving motor functional area were finally enrolled. Using axial T2-weight magnetic resonance images, the width and height of the hand knob were measured in both hemispheres, and differences were compared between the affected and unaffected hemispheres. Receiver operating characteristic (ROC) curve and logistic regression analysis were used to estimate the degree of correlation between distance measurements and motor impairment. The width and height of the hand knob in the affected and unaffected hemispheres were significantly different (p

Experimental muscle pain inhibits corticomotor excitability (CE) of upper limb muscles. It is unknown if this inhibition affects overlapping muscle representations within the primary motor cortex to the same degree. This study explored CE changes of the first dorsal interosseus (FDI) and extensor carpi radialis (ECR) muscles in response to muscle pain. Participants (n=13) attended two sessions (≥48 hours in-between). Hypertonic saline was injected in the ECR (session one) or the FDI (session two) muscle. CE, assessed by transcranial magnetic stimulation (TMS) motor-evoked potentials (MEPs), was recorded at baseline, during pain, and twenty minutes postinjection together with pain intensity ratings. Pain intensity ratings did not differ between the two pain sites (p=0.19). In response to FDI muscle pain, the MEPs of the FDI muscle were reduced at 2 and 4 min postinjection (p≤0.03), but not after ECR muscle pain. No significant MEP change was detected for the ECR muscle (p=0.62). No associations between MEPs and pain intensity were found (p>0.2). The present results indicate that the output from overlapping cortical representations of two muscles differentially adapts to acute muscle pain.

This study aimed to investigate the effect of smartphone size and use on fatigue of the extensor pollicis longus and abductor digiti minimi, and digiti minimi deformity. The 40 people assigned to the experimental group spent at least 6 hours using the smartphone and used the digiti minimi for support. The control group spent at least 3 hours using the smartphone, however did not use digiti mini for support. Questionnaires were used to measure smartphone usage, daily use duration, and method of holding the smartphone device. X-rays of distal interphalangeal joint angle deformity of the digiti minimi were assessed. Surface electromyography was used to analyze muscle fatigue. The angle deformity was significantly different between the experimental group and the control group, and fatigue of the extensor pollicis longus and abductor digiti minimi of the large smartphone users were high. The muscle fatigue was reduced when the smartphone size fit well with the user's hand. This study suggests that the size of the smartphone influence the fatigue of the hand muscles.

The objective is to determine the age peculiarities of higher education students’ functional and motor preparedness.Materials and methods. The participants in the study were male students of the 1st year (n = 98), 2nd year (n = 69), 3rd year (n = 56), 4th year (n = 32), and 5th year (n = 46) of training.The following research methods were used to solve the tasks set within the study: analysis of scientific literature, pedagogical observation, pedagogical testing; the index method and biomedical methods. The pedagogical methods were used to study the peculiarities of the functional state of the organism and the motor abilities in higher education students of the 1st-5th years of trtaining; methods of mathematical statistics were used to processing the data.Results. The first and second-year students demonstrated statistically reliable dynamics in the indicators of their functional and motor preparedness. Thus, at the age of 19, the students show a decrease in the Ruffier index (9.7 – “good heart”), the static equilibrium (12 sec. – “satisfactory”), and the standing long jump (Р

This study was to apply the newly developed electrical impedance myography (EIM) technique to examine hand muscles in patients with an incomplete cervical spinal cord injury (SCI).EIM was performed on the thenar, hypothenar, and first dorsal interosseous (FDI) muscles of SCI (n=16) and age-matched healthy control (n=18) subjects. By sending low intensity and high frequency current through the skin and measuring the consequent voltage, EIM estimates the major impedance parameters, which include resistance (R), reactance (X) and phase angle (θ).The SCI group had lower reactance and phase angle (p0.0001) as compared to the control group in all three muscles, and lower resistance in the thenar muscle (p0.05). The SCI group also demonstrated a smaller anisotropy in resistance (p0.0001) and larger anisotropy in phase angle (p0.05) compared to those from healthy controls.The reduced reactance and phase angle of paralyzed muscles could be due tochanges of membrane integrity and fat infiltration, whereas the change in the anisotropy may reflect the rearrangement of muscle fiber geometry.The EIM provides a quick and convenient tool for examination of muscle alterations after SCI.