Original Research|Articles in Press

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:



      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.


      Case-Control Study.


      University Outpatient Clinic.


      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).


      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.


      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.


      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.


      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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