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Patients with Dupuytren's disease use excessive grip force when lifting and holding small objects, independent of the degree of contracture

Published:March 07, 2023DOI:https://doi.org/10.1016/j.apmr.2023.02.010
Patients with Dupuytren's disease use excessive grip force when lifting and holding small objects, independent of the degree of contracture
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      Abstract

      Objective

      To identify the extent and quality of fine motor skill alteration in patients with Dupuytren's disease (DD) utilizing an instrumented device measuring grip forces, beyond the commonly used measurement of contracture.

      Design

      Case-Control Study.

      Setting

      University Outpatient Clinic.

      Participants

      Patients with DD (N = 27) and a contracture >45° (Tubiana Stadium II, III and IV) were included and compared to age-matched healthy controls (N = 27).

      Interventions

      Not applicable.

      Main Outcome Measures(s)

      All individuals were subjected to a set of specific tests using a new instrumented device (“manipulandum”). These included lifting, grasping, and then holding the “manipulandum” with 4 different object characteristics (light and heavy weight, rough and smooth surface) along with a measurement of the precision grip strength. Standard measurements including the Nine-Hole Peg Test (9-HPT), a Two-Point Discrimination (2PD) and the DASH Score were evaluated in comparison.

      Results

      While the measurements of precision grip, 2PD, 9-HPT and DASH showed no statistically significant differences between both groups, patients with DD applied significantly higher forces when tested with the different subtests using the “manipulandum”. Analysis of the 2-phase movement (lifting and holding the “manipulandum”) revealed highly significant differences between the groups.

      Conclusion

      Patients with DD use excessive grip forces when lifting and holding the “manipulandum” when compared to healthy controls, independent of the degree of contracture. As no differences in precision grip strength were seen, the presented approach is useful to obtain additional important information about fine motor function in diseased hands.

      keywords

      List of abbreviations:

      Dupuytren's disease patients (DD), Nine-Hole Peg Test (9-HPT), range of motion (ROM), Disability of Arm (Shoulder and Hand, DASH), Patient-Related Outcome Measurement (PROM), first phase (P1), second phase (P2), two-point discrimination analysis (2PD), peak grip force during lifting (GFlift), static grip force during holding (GFhold), group (Dupuytren patients and healthy control), condition (Four different modalities of the “manipulandum” (light, heavy, rough, smooth)), phase (P1 and P2)
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      Article info

      Publication history

      Accepted: February 14, 2023
      Received in revised form: February 9, 2023
      Received: August 4, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Dupuytren's Disease - grip force - Hand strength - Motor skills - Fine motor control

      The work took place at the Division of Hand-, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany

      Financial Disclosure Statement: Dr. Haas-Lützenberger has nothing to disclose. No funding was received for this article.

      All of authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted and (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

      The authors declare no conflict of interest.

      Identification

      DOI: https://doi.org/10.1016/j.apmr.2023.02.010

      Copyright

      © 2023 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine

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