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Ergonomics

Ergonomics. Maximum Voluntary Effort By: Group 10 - Marcus, Allan, Matt, Andre, and Lance. JAMAR Hand Dynamometer. The JAMAR Hand Dynamometer is an indispensable tool, to generate accurate and objective data required for reimbursable hand and forearm rehabilitation services.

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Ergonomics

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  1. Ergonomics Maximum Voluntary Effort By: Group 10 - Marcus, Allan, Matt, Andre, and Lance

  2. JAMAR Hand Dynamometer The JAMAR Hand Dynamometer is an indispensable tool, to generate accurate and objective data required for reimbursable hand and forearm rehabilitation services. Ideal for routine screening of hand muscle function. The Dynamometer represents an excellent way to track the hand’s response and progress associated with therapy and has been used for over 35 years. Accommodates various hand sizes and has 5 positions which range form 1 3/8” to 3 3/8” Weighs: 3 lbs.Dimensions: 8" x 11" Price: Approx. $280

  3. Reliability and Validity • How reliable is the JAMAR Hand Dynamometer? • VERY!!!!! • The JAMAR is isometric in use, with almost no perceptible motion of the handles. • The hand grasp is both comfortable and effective • These features combine to ensure accurate and reproducible results • Full effort needed for less than 10% variation • If non-maximal effort given, than as much as 100% variation can occur. • Hamilton, et al.(1994) found that handle position 1 was the least reliable

  4. Coefficient of Variation • Used to determine whether the trials are in the permissible range • SD/mean = coefficient of variation • Compare this # to permitted max (found in table) • If CV is > the permissible CV then trial is inconsistent • If CV is < the permissible CV then trial consistent • Allowed to have 2/10 coefficients exceeding the cut points

  5. Normative Data Grip Strength Males – Right – 104.3 (SD – 28.3) Left – 93.1 (SD – 27.6) Females – Right – 62.8 (SD – 17.0) Left – 53.9 (SD – 15.7) *all values in lbs

  6. A standard position for testing recommended by the American Society of Hand Therapists requires that the patient: • Sit in a straight-backed chair • Feet flat on the floor • Shoulders adducted in neutrally rotated • Elbows flexed at 90 degrees • Forearm rotation neutral • Wrist 0-30 degrees dorsiflexion and 0-15 degrees ulnar deviated • Repeated 3X and take the average

  7. Alternate Tests • Tekdyne hand dynamometer • DynEx™ Electronic Hand Dynamometer

  8. JAMAR Hand Dynamometer Rapid Exchange Grip Test • Although grip strength is not a true measure of hand function it often aids in gauging impairment • It aids to better identify actual maximum grip strength in individuals with whom the evaluator is querying full effort. • Increases the validity of the maximal voluntary effort

  9. Used as alternate test, to confirm if the person is lacking full effort in Max Voluntary Grip Test Procedure - use setting at which person did his/her best • Switch hands rapidly from right to left, while giving max grip effort • Dynamometer held by evaluator, resetting gauge after each trial • Test completed after result of test determined as positive or negative • Positive – score greater than or equal to the static score • Negative – score less than (approx 15%) the static score

  10. JAMAR Hydraulic Pinch Gauge • designed for use in hand strength testing applications – ie. measurement of tip, key and palmar pinch. • used effectively as a diagnostic tool, or as a means of monitoring progress of rehab of the hand

  11. Reliability and Validity • The unique design of this gauge frees the client to perform a true pinch pattern because the therapist, supports the weight of the gauge. A highly accurate pinch-force measurement is the result. - Full effort needed for less than 10% variation - If non-maximal effort given, than as much as 100% variation can occur.

  12. Normative Data Palmar Pinch Males – Right - 23.4 (SD – 5.0) Left – 23.0 (SD – 5.3) Females – Right – 16.3 (SD – 3.8) Left – 15.7 (SD – 3.6) Key Pinch Males – Right - 24.5 (SD – 4.6) Left – 23.6 (SD – 4.6) Females – Right – 16.2 (SD – 3.0) Left – 15.3 (SD – 3.1)

  13. Normative Data Tip Pinch Males – Right - 17.0 (SD – 4.1) Left – 16.4 (SD – 4.0) Females – Right – 11.3 (SD – 2.6) Left – 10.8 (SD – 2.4) * All values are in lbs

  14. Procedure • 1. Patient should be seated • 2. Shoulders adducted and neutrally rotated • 3. Elbow flexed at 90 degrees • 4. Forearm and wrist in neutral position • Pinch Styles • 1. Tip Pinch – thumb tip to index fingertip • 2. Key Pinch - thumb pad to later aspect of middle phalanx of index finger • 3. Palmar Pinch - thumb pad to pads of index and middle finger

  15. Key Pinch

  16. Alternate Tests • Baseline Hydraulic Pinch Guage

  17. References • Hamilton, A., Balnave, R., & Adams,R. (1994). Grip strength testing reliability. Journal of Hand Therapy,7,163-170 • Niebuhr, B. R., & Marion, R., & Fike, M. L. (1994). Reliability of grip strength assessment with the computerised Jamar dynanometer. Occupational Therapy Journal of Research,14,3-18 Ev Innes : Handgrip strength testing: A review of the literature Australian Occupational Therapy Journal (1999) 46, 120-140. Internet Scientific Publications http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijs/vol5n2/strength.xml#e5

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