Elin Fonksiyonel Parametreleri Arasındaki İlişkiler: Kesitsel Bir Çalışma

Öz

Amaç: Kavrama/çimdikleme kuvvetleri, bilek fleksiyon-ekstansiyon kuvvetleri, el bileği aktif eklem pozisyon hissi (AEPH), el becerisi ve bimanuel koordinasyon arasındaki ilişkileri araştırmaktır. Gereç ve Yöntem: Bu kesitsel çalışma, 25 sağlıklı genç yetişkin katılımcıyla yapılmıştır. Bilek fleksiyon-ekstansiyon kuvvetleri ve AEPH, izokinetik dinamometre kullanılarak değerlendirilmiştir. Ayrıca kaba kavrama, key kavrama, tip kavrama ve palmar kavrama kuvvetleri dinamometre ile değerlendirilmiştir. Elin becerisi ve bimanuel koordinasyonu değerlendirilmek için purdue pegboard testi kullanılmıştır. Bulgular: İstatistiksel analizler, bimanuel koordinasyon ile dominant ve nondominant bilek fleksiyon ve ekstansiyon kuvvetleri arasında negatif yönde anlamlı bir korelasyon bulmuştur (sırasıyla dominant: CC=-0,401; CC=-0,475. Nondominant: CC=-0,427; CC=-0,4). Bimanuel koordinasyon ile nondominant manuel beceri arasında ise pozitif yönde anlamlı bir korelasyon bulunmuştur (CC=0,472). Bilek fleksiyon gücü ile ekstansiyon, kavrama ve çimdikleme kuvvetleri arasında pozitif yönde anlamlı korelasyonlar saptanmıştır (Sırasıyla, CC=0,701; CC=0,435; CC=0,424; CC=0,404; CC=0,447). AEPH ile diğer parametreler arasında anlamlı bir korelasyon bulunmamıştır. Sonuç: Non-dominant el becerileri, bimanuel koordinasyonu geliştirmek için öncelikli odak noktası olabilir. Kavramaların veya bilek hareketlerinin kuvvetini artırmak, genel kuvveti artırabilir ancak manuel beceriyi veya bimanuel koordinasyonu geliştirmeyebilir. Çalışmamızın bulguları, tek başına AEPH’nin fonksiyonel parametreleri öngörmede yeterli olmayabileceğini ve klinik ortamlarda propriyosepsiyon için multifaktöriyel bir yaklaşım gerektiğini göstermektedir.

Anahtar Kelimeler

• El Kavrama Kuvveti
• Motor Beceri
• Parmak Kavrama Kuvveti
• Pozisyon Duyusu
• Üst Uzuv

Relationships Between Hand Functional Parameters: A Cross-Sectional Study

Öz

Objective: To investigate the relationships between grip/pinch strengths, wrist flexion-extension strengths, wrist active joint position sense (AJPS), manual dexterity, and bimanual coordination. Material and Methods: This cross-sectional study was conducted with 25 healthy young adult participants. The AJPS and flexion-extension strengths of the wrist were assessed using an isokinetic dynamometer. Additionally, grip strength, key pinch, tip pinch, and palmar pinch strengths were evaluated using a dynamometer. The Purdue Pegboard Test was used to assess manual dexterity and bimanual coordination. Results: Statistical analyses revealed a significant negative correlation between bimanual coordination and wrist flexion and extension strengths of both the dominant and nondominant wrists (respectively: Dominant: CC=-0.401; CC=-0.475. Nondominant: CC =-0.427; CC=-0.4). A significant positive correlation was found between bimanual coordination and nondominant manual dexterity (CC=0.472). Wrist flexion strength showed significant positive correlations with extension, grip and pinch strengths (respectively: CC=0.701; CC=0.435; CC=0.424; CC=0.404; CC=0.447). No significant correlations were found between AJPS and other parameters. Conclusion: Non-dominant manual dexterity may play a key role in improving bimanual coordination. Strengthening grip/pinch or wrist movements may increase overall strength but may not improve manual dexterity or bimanual coordination. AJPS alone may not predict functional parameters, suggesting the need for a multifactorial approach to proprioception in clinical settings.

Anahtar Kelimeler

• Hand Strength
• Motor Skill
• Pinch Strength
• Proprioception
• Upper Extremity.

Kaynakça

1. Woytowicz E, Whitall J, Westlake KP. Age-related changes in bilateral upper extremity coordination. Curr Geriatr Rep. 2016 Sep;5(3):191-9. DOI: 10.1007/s13670-016-0184-7.
2. Shizuka Y, Murata S, Goda A, Sawai S, Fujikawa S, Yamamoto R, et al. Aging-related changes in bimanual coordination as a screening tool for healthy aging. medRxiv. 2025:2025.01. 06.25320094.
3. Golubovic S, Slavkovic S. Manual ability and manual dexterity in children with cerebral palsy. Hippokratia. 2014 Oct-Dec;18(4):310-4.
4. Wang YC, Wickstrom R, Yen SC, Kapellusch J, Grogan KA. Assessing manual dexterity: Comparing the WorkAbility Rate of Manipulation Test with the Minnesota Manual Dexterity Test. J Hand Ther. 2018 Jul-Sep;31(3):339-47. DOI: 10.1016/j.jht.2017.03.009.
5. Gerloff C, Andres FG. Bimanual coordination and interhemispheric interaction. Acta Psychol (Amst). 2002 Jun;110(2-3):161-86. DOI: 10.1016/s0001-6918(02)00032-x.
6. José J, Iturri G. Proprioception and coordination. Rehabilitation of Sports Injuries: Scientific Basis. 2003:274-87.
7. Amiri Arimi S, Ghamkhar L, Kahlaee AH. The Relevance of proprioception to chronic neck pain: a correlational analysis of flexor muscle size and endurance, clinical neck pain characteristics, and proprioception. Pain Med. 2018 Oct 1;19(10):2077-88. DOI: 10.1093/pm/pnx331.
8. Rothwell JC, Traub MM, Day BL, Obeso JA, Thomas PK, Marsden CD. Manual motor performance in a deafferented man. Brain. 1982 Sep;105 (Pt 3)(3):515-42. DOI: 10.1093/brain/105.3.515.

9. Jones L. Proprioception and its contribution to manual dexterity. In: Hand and Brain: Elsevier; 1996. p. 349-62.
10. Morrison S, Hong SL, Newell KM. Upper frequency limits of bilateral coordination patterns. Neurosci Lett. 2009 May 1;454(3):233-8. DOI: 10.1016/j.neulet.2009.03.036.
11. Hughes SL, Gibbs J, Edelman P, Singer R, Chang RW. Joint impairment and hand function in the elderly. J Am Geriatr Soc. 1992 Sep;40(9):871-7. DOI: 10.1111/j.1532-5415.1992.tb01982.x.
12. Videler AJ, Beelen A, van Schaik IN, Verhamme C, van den Berg LH, de Visser M, et al. Tripod pinch strength and thumb opposition are the major determinants of manual dexterity in Charcot-Marie-Tooth disease type 1A. J Neurol Neurosurg Psychiatry. 2010 Aug;81(8):828-33. DOI: 10.1136/jnnp.2009.187302.
13. Sequeira G, Keogh JW, Kavanagh JJ. Resistance training can improve fine manual dexterity in essential tremor patients: a preliminary study. Archives of physical medicine and rehabilitation. 2012;93(8):1466-8.
14. Price RC. Determinants of manual dexterity in young adults [dissertation]: University of Colorado at Boulder; 2014.
15. Candiri B, Talu B, Demirtas Karaoba D, Ozaltin GE, Yolbas S. Effect of psoriatic arthritis on the strength, proprioception, skill, coordination, and functional condition of the hand. Int J Rheum Dis. 2022 Jan;25(1):47-55. DOI: 10.1111/1756-185X.14241.
16. Seven B, Cobanoglu G, Oskay D, Atalay-Guzel N. Test-retest reliability of isokinetic wrist strength and proprioception measurements. J Sport Rehabil. 2019 Sep 1;28(7). DOI: 10.1123/jsr.2018-0341.
17. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984 Mar;9(2):222-6. DOI: 10.1016/s0363-5023(84)80146-x.
18. Fess E. Clinical assessment recommendations. American society of hand therapists. 1981:6-8.
19. Tiffin J, Asher EJ. The Purdue pegboard; norms and studies of reliability and validity. J Appl Psychol. 1948 Jun;32(3):234-47. DOI: 10.1037/h0061266.
20. Lyle KB, Dombroski BA, Faul L, Hopkins RF, Naaz F, Switala AE, et al. Bimanual coordination positively predicts episodic memory: A combined behavioral and MRI investigation. Brain Cogn. 2017 Nov;118:71-9. DOI: 10.1016/j.bandc.2017.07.009.
21. DeLacoste-Utamsing C, Holloway RL. Sexual dimorphism in the human corpus callosum. Science. 1982 Jun 25;216(4553):1431-2. DOI: 10.1126/science.7089533.
22. Crisomia S. Effects of single-task and dual-task demands on force control during bimanual coordination in healthy young adults: University of Delaware; 2024.
23. Kuypers H, Brinkman J. Precentral projections to different parts of the spinal intermediate zone in the rhesus monkey. Brain research. 1970;24(1):29-48.
24. Wiesendanger M, Wicki U, Rouiller E. Are there unifying structures in the brain responsible for interlimb coordination? In: Interlimb coordination: Elsevier; 1994. p. 179-207.
25. Byblow WD, Lewis GN, Stinear JW, Austin NJ, Lynch M. The subdominant hand increases in the efficacy of voluntary alterations in bimanual coordination. Exp Brain Res. 2000 Apr;131(3):366-74. DOI: 10.1007/s002219900271.
26. Carson RG, Thomas J, Summers JJ, Walters MR, Semjen A. The dynamics of bimanual circle drawing. Q J Exp Psychol A. 1997 Aug;50(3):664-83. DOI: 10.1080/713755721.
27. Manelis A, Hu H, Satz S. The relationship between reduced hand dexterity and brain structure abnormality in older adults. Geriatrics. 2024;9(6):165.
28. Martin JA, Ramsay J, Hughes C, Peters DM, Edwards MG. Age and grip strength predict hand dexterity in adults. PLoS One. 2015;10(2):e0117598. DOI: 10.1371/journal.pone.0117598.
29. Duran G, Bayraktar D, Kalkan AC, Turkucar S, Makay B, Unsal SE, et al. Investigating wrist joint position sense and hand functions in children with polyarticular juvenile idiopathic arthritis with wrist involvement. Clin Pediatr (Phila). 2023 Jul;62(7):786-95. DOI: 10.1177/00099228221147175.
30. Seven B, Zorlular A, Oskay D. Comparison of the validity and reliability of three different methods used for wrist proprioception measurement. J Bodyw Mov Ther. 2024 Jan;37:170-6. DOI: 10.1016/j.jbmt.2023.11.018.
31. Sobinov AR, Bensmaia SJ. The neural mechanisms of manual dexterity. Nat Rev Neurosci. 2021 Dec;22(12):741-57. DOI: 10.1038/s41583-021-00528-7.
32. Zelic G, Mottet D, Lagarde J. Perceptuo-motor compatibility governs multisensory integration in bimanual coordination dynamics. Exp Brain Res. 2016 Feb;234(2):463-74. DOI: 10.1007/s00221-015-4476-5.
33. Ronsse R, Miall RC, Swinnen SP. Multisensory integration in dynamical behaviors: maximum likelihood estimation across bimanual skill learning. J Neurosci. 2009 Jul 1;29(26):8419-28. DOI: 10.1523/JNEUROSCI.5734-08.2009.
34. Lu CC, Yao HI, Fan TY, Lin YC, Lin HT, Chou PP. Twelve weeks of a staged balance and strength training program improves muscle strength, proprioception, and clinical function in patients with isolated posterior cruciate ligament injuries. Int J Environ Res Public Health. 2021 Dec 6;18(23):12849. DOI: 10.3390/ijerph182312849.
35. Oksuz C, Oskay D, Huri G. Proprioception after hand and wrist injury, surgery, and rehabilitation. Proprioception in Orthopaedics, Sports Medicine and Rehabilitation. 2018:57-64.
36. Shang XD, Zhang EM, Chen ZL, Zhang L, Qian JH. Correlation analysis of national elite Chinese male table tennis players' shoulder proprioception and muscle strength. World J Clin Cases. 2022 Aug 26;10(24):8514-24. DOI: 10.12998/wjcc.v10.i24.8514.
37. Neumann DA. Neumann's kinesiology of the musculoskeletal System. 4 ed: Elsevier Health Sciences; 2024. 172-94 p.