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The aim of this study was to evaluate tracking performance when an extra reference block is added to a basic block-matching method, where the two reference blocks originate from two consecutive ultrasound frames. The use of an extra reference block was evaluated for two putative benefits: (i) an increase in tracking performance while maintaining the size of the reference blocks, evaluated using in silico and phantom cine loops; (ii) a reduction in the size of the reference blocks while maintaining the tracking performance, evaluated using in vivo cine loops of the common carotid artery where the longitudinal movement of the wall was estimated. The results indicated that tracking accuracy improved (mean - 48%, p<0.005 [in silico]; mean - 43%, p<0.01 [phantom]), and there was a reduction in size of the reference blocks while maintaining tracking performance (mean - 19%, p<0.01 [in vivo]). This novel method will facilitate further exploration of the longitudinal movement of the arterial wall. 

Objective: The gluteus medius (GM) is a strong abductor and medial rotator of the thigh, and plays an important role in stabilizing the pelvis and controlling the knees during athletic activities.Weakness in the GM can have adverse effects onperformance and increase the risk of lower extremityinjuries. The aim of this study was to validate a newtraining device by comparing the activation of theGM when performing a squat with and without thedevice. Methods: Thirty-two female athletes (mean age 20 ± 3) performed body weight squats on and offthe device, while surface electromyography wasrecorded bilaterally on the GM. Results: All testsubjects were able to perform the squat and toactivate the GM. The activation of the GM was significantly higher when using the new device than when performing squats on the floor (Z=-4.9,P<0.001). Correlation tests between a complete sequence of three squats and one selected repetition revealed that activation was consistent throughout theexercise (right GM: rs=0.93, P<0.001, left GM:rp=0.92, P<0.001). No differences in activation were found between the right and left GM when squatting on the device. Conclusion: The newly developed training device increases muscle activity in the GM during squats. Moreover, the results showed thatsquatting on the device activates the left and rightside of the body equally, and that the GM was activated during the whole hip flexion exercise. This information and the new training device can be usedin training programs to improve stabilization of the pelvis and lower extremities during dynamic exercises.

Background: Hand grip force is a good indicator of general muscle strength and can also be used to predict multiple outcomes such as changes in activities of daily living (ADL), disability, mortality and general upper extremity strength. Hand grip force is often measured as the amount of static grip force a subject can produce when measured with a hydraulic dynamometer such as the Jamar or with an electronic device such as the Grippit. The Grippit device measures an average grip force, a peak grip force and force over a set time period. Grippit has shown good reliability for healthy subjects. Grippit, which was developed over 20 years ago in Gothenburg, Sweden is no longer manufactured. Therefore, the need for anewly developed and modernized measurement instrument for use in evaluating hand rehabilitation has arisen.

Objectives: The aim of this study was to evaluate the test-retest reliability of the newly developed instrument GRIP-it and to describe and validate the relationship between grip force measurements from GRIP-it and the original Grippit device.

Methods: Healthy controls (n=43) were included in the study. Two devices were used to evaluate grip force (Newton, N), (i) GRIP-it a newly developed device and (ii) Grippit. Both instruments were used to measure mean and maximal force over 10 seconds.

Results: GRIP-it displayed a mean measurement error of -1.7 ± 0.5% and the corresponding error for Grippit was -1.6 ± 1.9%. All subjects completed the grip force tests and the results for three attempts for each hand. The test-retest reliability was excellent for both pieces of equipment, with ICCs ranging from 0.963 to 0.947 (CI 95% between 0.103 and 0.041) for GRIP-it and from 0.979 to 0.968 (CI 95% between 0.087 and 0.042) for Grippit.

Relationships between Grippit and GRIP-it

There was a significant difference between the measured values derived from Grippit and GRIP-it for both the dominant hand (P < 0.001) and the non-dominant hand (P < 0.01). Grippit gives in general a higher grip force measurement than GRIP-it which is also indicated by the slope (β₁) of the regression lines that deviates from 1. However, there were no substantial differences in the grip force when comparing the measurements for the dominant hand with the non-dominant hand for either Grippit (P = 0.071) or GRIP-it (P = 0.404). Based on these non-significant differences between hands and the fact that the model estimates for the intercept (β₀) and the slope (β₁) are contained within the confidence intervals of the model estimates for the opposite hand, a combined model was derived. The linear regression analysis, with grip force measurements for both hands included, gives: GRIP-it = 49.0 + 0.779 · Grippit. This explains 89.6% of the variance in grip force analyzed by GRIP-it (P < 0.001) see Figure 2. To enable an estimation of grip force measured by Grippit based on GRIP-it values a regression analysis with Grippit as dependent variable gives: Grippit = -18.1 + 1.15 · GRIP-it, which explains 89.6% of the variance in grip force analyzed by Grippit (P < 0.001).

Conclusions: This study showed that GRIP-it has excellent test-retest reliability. Measurements of grip force with GRIP-it are strongly related to those from the original Grippit. The newly developed GRIP-it shows great potential for use in the assessment of hand function and the evaluation of hand rehabilitation.

OBJECTIVE: To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.

METHODS: Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme.

RESULTS: The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound.

CONCLUSION: A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.

OBJECTIVE:

Balance between flexor and extensor muscle activity is essential for optimal function. The purpose of this pilot study was to compare the relationship between maximum finger flexion force and maximum finger extension force in women with rheumatoid arthritis and healthy women.

METHODS:

Twenty healthy women (median age 61 years) and 20 women with rheumatoid arthritis (median age 59.5 years, median disease duration 16.5 years) were included in the study. Finger extension force was measured with an electronic device, EX-it, and finger flexion force using Grippit. The Grip Ability Test and the score from the patient-reported outcome Disability Arm Shoulder and Hand were used to evaluate activity limitations.

RESULTS:

Patients with rheumatoid arthritis showed significantly decreased hand function compared with healthy controls. A correlation was found between extension force and flexion force in the healthy group (r = 0.65, p = 0.002),but not in the rheumatoid arthritis group (r = 0.25, p = 0.289).

CONCLUSION:

Impaired hand function appears to influence the relationship between maximum finger flexion and extension force. This study showed a difference in the relationship between maximum finger flexion and extension force in healthy controls and those with rheumatoid arthritis.

Background. Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group.

Methods. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC.

Results. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and—for the EDC—also when writing with a pen and using a key (p < 0.02). The exercise “rolling dough with flat hands” required the lowest %MVIC and may be less effective in improving muscle strength.

Conclusions. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

Equipment used in sports is of great importance, especially when the equipment is in direct contact with the athlete or is important for safety. In the sport kitesurfing environmental factors and the equipment design are crucial for the comfort and safety. The participants' choice and opinion of equipment can show which factors are considered most important for the performance and to reduce risk for injury. This study has evaluated self-reported information from the participants about what equipment they use, comfort of the equipment and if the equipment has contributed to any injuries. The methods used were questionnaires (n=206) and interviews (n=17), which in combination allows to assess the problem both quantitatively and qualitatively. The results showed that supported leading edge kites are most frequently used, with a waist harness and foot straps to attach the feet. The choice of kite type was mainly based on the discipline of riding for the respondent. Some issues concerning comfort of riding and injury risk the respondents did relate to the design of harness and foot straps. The information from this study can be used for development strategies for industry manufacturers and for further studies in the area of equipment design and biomechanics.