Thesis (M.S.)--Marquette University, 2009. / Scott A. Beardsley, Robert A. Scheidt, Brian D. Schmit, Advisors. Available for download on December 08, 2010.

Thesis (M.E.)--University of Canterbury, 2006. / Typescript (photocopy). Includes bibliographical references (leaves 99-101). Also available via the World Wide Web.

M. Tech. / The aim of this study was to determine whether using the Powerball™ as a form of resistance training for the hand and wrist, had the effect of increasing grip strength. In the study there were 20 male and 20 female participants. The participants had to be between the ages of 20 and 30 years to participate in the study. There was a Wrist and Hand Regional performed on all the participants to ensure there were no wrist or hand pathologies which would exclude them from the study. Participants trained with the Powerball™ three times a week for four weeks. Each training session with the Powerball™ lasted five minutes for each hand and was done under the supervision of the researcher. Grip strength measurements were taken with the Jamar grip strength dynamometer. Grip strength readings were taken prior to the 1st training session with the Powerball™ while a further two readings were taken prior to the 7th training session and after the 12th training session with the Powerball™. The results for the 40 participants showed a grip strength improvement of 4.77kg for the right hand and 4.03kg for the left hand. The 20 male participants had a grip strength improvement of 4.85kg for the right hand and 4.55kg for the left hand while the 20 female participants improved by 4.68kg for the right hand and 3.5kg for the left hand overall. It was concluded that participants using the Powerball™ showed an overall increase in grip strength and that it may have possible benefits as a strengthening and rehabilitative tool for the wrist and hand.

The purpose of this study was to explore the effectiveness of chiropractic manipulative therapy on the wrist, in treating lateral epicondylitis. It also aimed to determine the effectiveness of Mills’ manipulation applied to elbow, and whether adjusting both the elbow and the wrist would be more effective than simply adjusting the elbow or the wrist in isolation. Thirty patients suffering from lateral epicondylitis who conformed to specific diagnostic criteria were accepted for the trial. The patients were stratified according to age and sex and placed into three groups of ten. The first group received chiropractic manipulative therapy directed to the wrist. The second group received chiropractic manipulative therapy directed to the elbow complex, and the third group received chiropractic manipulative therapy directed at both areas. The treatment consisted of four sessions over a period of 2 weeks. The groups were assessed and compared in terms of objective and subjective measurements to determine the most beneficial treatment. The data was collected at the beginning of each treatment session. Subjective data consisted of the Numerical Pain Rating Scale 101 (Vernon in Liebenson, 1996:61) and the short form Mc Gill Pain Questionnaire (Melzack, 1987:192), which assessed patients’ discomfort levels. Objective data was collected by means of the Jamar Grip Strength Dynamometer (Kaufman, 2000:619) and the Pressure Algometer (Fischer, 1987:213), which measured the grip strength and pressure pain threshold respectively. The results showed that both wrist and Mills’ manipulation in isolation as well as in combination are beneficial in treating lateral epicondylitis, in that they all showed subjective and objective improvements. The Mills’ manipulation alone and in combination with wrist manipulations had superior clinical effects compared to the wrist manipulations in isolation. The statistical results of the inter-group analysis revealed that there was no significant difference between the outcomes of the wrist manipulation, Mills’ manipulation and combined treatment protocols and therefore none are expressly recommended above the other. / Dr. C. Yelverton Dr. C. Lyons

No description available.

[Truncated abstract] The aim of the research was to explore the association between wrist guard use and wrist fracture risk in snowboarders in Australia. During the study, the opportunity was also taken to examine the relationship between wearing wrist guards and the severity of wrist and elbow injury. A case-control study was conducted at the Mount Buller Medical Centre, Victoria, Australia. A total of 494 participants was recruited during the 2004 and 2005 ski seasons. Cases were defined as any snowboarder seen at the Clinic with a fractured wrist (N = 119), and controls as any snowboarder seen at the clinic for any reasons other than a fractured wrist (N = 375). Severity of forearm injuries were defined and analysed separately. Study participants completed a questionnaire consisting of: basic demographics (age and sex only); wrist guard use on the day of presentation; normal use of protective equipment; the number of days spent snowboarding that season; the ability of the snowboarder; and ski run difficulty. Risk taking behaviour was assessed by a history of any previous fracture or joint injury and psychometric questions. Clinic medical staff recorded site and severity of fractures and soft tissue injuries. Logistic regression was used to obtain adjusted odds ratios for these risk factors against the main outcome measure. Presence of wrist fracture and injury in snowboarders with and without wrist guards. ... There was a significant association between wrist guard use and soft tissue elbow injuries (adjusted odds ratio = 17.6, p = 0.011, 95% CI: 1.93 – 160.2), but no significant association with elbow fractures (adjusted odds ratio = 1.84, p = 0.385, 95% CI: 0.46 – 7.30). There was thus no evidence in this study that wrist guards increase the occurrence of other severe injuries in the forearm by transferring the impact force away from the protected wrist up the arm. No evidence was found for compensatory risk taking behaviour in participants wearing protective equipment. A local injury prevention strategy was implemented in schools in the Mt Buller district during the course of this study. Education about the protective effects of wrist guards enabled a policy change in the local secondary college so that wrist guard use is now mandatory for all snowboarders in the school ski programme: That policy states:

Distal radius fracture is a common injury. The majority of people recover well but a proportion have ongoing pain, stiffness, deformity and functional limitation. Associations between these outcomes, injury characteristics and treatment methods are inconsistent, for example a deformed wrist is not always painful, stiff and functionally limiting. The psychological response to fracture and the role that psychological factors play in recovery are complex and poorly understood. Identification and treatment of those psychological factors that might influence disability and symptom intensity could improve outcomes in this large group of patients. The aim of this thesis is to explore the influence of psychological factors on outcome following fracture of the distal radius. To investigate these relationships further a literature review was carried out looking at the association between psychological factors and outcomes in distal radius fracture patients. Prospective studies were then performed in order to identify associations between demographic factors, injury severity, treatment and psychosocial factors and symptom intensity and disability after fracture and to identify predictors of psychological response to injury. A prospective randomised controlled trail (RCT) was then carried out to compare the impact of an additional psychological workbook intervention versus an information workbook in the otherwise routine management of distal radius fracture. The literature review identified evidence to support the association between psychological factors and outcome after acute injury in general but limited evidence specifically pertaining to distal radius fracture. The first prospective study of 216 patients found psychosocial factors to be more strongly associated with disability (Disability of Arm Shoulder and Hand score, DASH) and pain intensity after distal radius fracture than any injury or treatment factor. The second prospective study of 153 patients found that psychological traits are relatively stable in this cohort and that no demographic, injury or treatment factors were associated with the small changes in psychological scores up to 10 weeks following injury. The RCT demonstrated that use of a psychological workbook did not significantly improve disability six weeks after injury compared to an information workbook in a cohort of patients with distal radius fracture (DASH 38 vs 35, p = 0.949). The importance of psychosocial factors in recovery from distal radius fracture has been demonstrated. Following this injury, psychological factors remain stable over time or fluctuate to a small degree with distinct trends. In cohorts with stable psychological responses to fracture, the individual psychological response cannot be reliably predicted by demographic, injury or treatment factors. Use of a psychological workbook intervention does not improve outcomes in patients with a good initial psychological response to injury. Future work should investigate less psychologically stable and well adapted cohorts, establish how best to identify patients at risk of poor outcome and whether, indeed, these specific groups are amenable to treatment and if so what form this intervention should take. It should address limitations identified in this work, primarily, reduce questionnaire fatigue with more focused psychological questionnaires. Ultimately, it should work towards creating a structure where patients can be screened with a recognised psychological scoring system at initial presentation to fracture clinic and allow a sub-group of psychologically mal-adpted patients to be referred on to a dedicated psychology service, that would work to optimise the psychological conditions for recovery.

Three experiments compared wrist and arm performance in a cyclical Fitts’ target task. The purpose of Experiment I was to determine if movement kinematics differed for wrist/elbow flexion/extension movements to targets of varying difficulty. Participants were asked to flex/extend a manipulandum in the horizontal plane at the wrist and elbow joint in an attempt to move back and forth between two targets. Online knowledge of effector position was displayed as a visual trace on a projector screen. Target widths were manipulated with amplitude constant (16 degrees) in order to create Indexes of Difficulty of 1.5, 3, 4.5, and 6. Results failed to detect differences in elbow and wrist movements either in terms of movement time, movement accuracy, or kinematic characteristics of the movement. In studies that have reported difference in wrist and arm performance in Fitts’ target tasks, experimenters have typically utilized visual amplification to counterbalance the small resulting wrist movements. The purpose of Experiments II and III was to investigate how changes in task parameters and visual gain play a role in providing a performance advantage for the wrist. In these experiments arm movement amplitude was increased to 32 degrees and wrist amplitude was decreased to 8 degrees. Results found similar overall movement times for arm and wrist movements. However, kinematic analysis of the movement revealed relatively large dwell times for wrist movements at IDs of 4.5 and 6. Removal of dwell time resulted in faster movement times for the wrist compared to arm. The results of these three experiments add to the limited literature examining how different effectors perform a Fitts’ target task. These findings suggest that performance differences in past literature may be due to the visual amplification often used when arm, wrist, and finger movements are studied.

The purpose of this thesis was to create a computational wrist model that predicts carpal bone motion in order to investigate the complex kinematics of the human wrist. The tuning of this model was primarily based on in vitro, kinematic measurements of the carpal bones obtained from the same cadaver arm as the geometry for the model was generated. A rigid body spring model of the wrist was built using the kinematic simulation software RecurDynTM 6.1. Surface models of the eight carpal bones, the bases of the five metacarpal bones, and the distal parts of the ulna and radius, all obtained from computed tomography (CT) scans of a cadaver upper limb, were utilized as the geometry for this model. Elastic contact conditions between the rigid bodies modeled the influence of the cartilage layers, and ligamentous structures were constructed using nonlinear, tension-only spring elements. Motion of the wrist was simulated by applying forces to the tendons of the five main wrist muscles modeled. Three wrist motions were simulated: extension, ulnar deviation and radial deviation. The model was mainly tuned by comparing the simulated displacement and orientation of the carpal bones with previously obtained CT-scans of the same cadaver arm in deviated (45 deg ulnar and 15 deg radial), and extended (57 deg) wrist positions. Simulation results for the scaphoid, lunate, capitate, hamate and triquetrum are presented here and provide credible prediction of carpal bone movement. The impact of certain model parameters on simulation results has been investigated by performing sensitivity analyses, and their severity has been documented. The results of the first simulations indicate that this model may assist in future wrist kinematics investigations. However, further optimization and validation are required to define and guarantee the reliability of this model. It is suggested that this rigid body spring model may be part of an interacting framework between in vitro and in vivo investigations, as well as other computational models, in order to improve and complement each biomechanical investigation method. / Thesis (Master, Mechanical and Materials Engineering) -- Queen's University, 2007-08-30 16:30:32.543

Thesis (PhD)--University of South Australia, 2002.