RESUMEN
BACKGROUND: Down Syndrome (DS) is a genetic condition. Physical characteristics like short stature, hypotonia, small, and thick hands result in decreased grip and pinch strength and quality of fine motor tasks. PURPOSE: The purpose of this review is to summarize the evidence of upper extremity physical characteristics and its influence on hand function in DS population. STUDY DESIGN: A scoping review. METHODOLOGY: A comprehensive electronic literature search was conducted through PubMed, CINAHL, Cochrane Library. The search was limited to articles written in English and published between 2010 to 2021. Additionally, books were referred for a better understanding of the hand function in DS. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) was adopted to develop the protocol. RESULTS: Following a detailed review of 28 articles meeting the inclusion criteria, fetuses with a diagnosis of DS are reported to have shortening of humerus on sonographic markers wherein 9% of fetuses had below 5th percentile shortening. Additionally, literature reports that during reaching there was increased trunk rotation (effect size = 0.88). DS population had 60% less grip strength, 33% less palmar pinch strength ,20% less key pinch strength and poor manual dexterity (CI = 4.5-5.5). CONCLUSION: Findings of this review concludes that physical characteristics of the upper extremity have an influence on hand function performance in children and adolescents with DS.However, only arm length and hand span have been quantified and correlated with grip strength. Further work must focus on correlation of upper extremity anthropometry and overall hand function in children and adolscents with DS.
RESUMEN
Carpal tunnel syndrome (CTS) is one of the reasons for labor abandonment due to inability and pain. The aim of this study was to evaluate the effectiveness of gabapentin and exercise training in the treatment of CTS and compare their effects. This single-blind clinical trial was conducted on patients referred to the Imam Hossein hospital's electrodiagnostic (EDX) unit. The patients randomly assigned into four groups: using nocturnal splint as an approved treatment in the control group; taking 300-mg gabapentin per night and using nocturnal splint; nerve and tendon gliding exercises and using nocturnal splint; and taking 300-mg gabapentin per night, performing same exercise as group 3 and using nocturnal splint. At baseline, four indicators were assessed in all patients, including the Boston carpal tunnel questionnaire, visual analogue scale (VAS), pinch and grip strength of the affected hand. One month after the beginning of intervention, participants were reassessed and compared for each of the four indicators. Using nocturnal splint along with exercise and gabapentin significantly improved VAS, pinch and grip strength in moderate CTS compared to control group that only used nocturnal splint. However in mild CTS, grip strength was not significantly higher compared to control group (P=0.048). Results of this study showed that use of splint alone in mild CTS is an appropriate and sufficient treatment; however, in moderate CTS, receiving gabapentin along with exercise and splinting showed better treatment results compared to splinting alone.
RESUMEN
The Association between myofascial pain syndrome and some tests was assessed in a cross-sectional study of 904 female telephone operators using video display terminals(VDTs). 105 cases were diagnosed as Myofascial pain syndrome with symptom questionnaire, laboratory examination and physician's physical examination and 550 controls were defined to show only musculoskeletal symptoms using NIOSH symptom criteria. Data on demographics, musculoskeletal symptom and visual analogue scale(VAS) were obtained by questionnaire. Anthropometric measurements, pressure pain threshold, Grip and Pinch strength and laboratory test were conducted. No significant difference between case and control at comparing of demographics, occupational history and body measurements were observed. But, Grip strength, pressure pain threshold and VAS showed the statistical difference between case and control. Age, pressure pain threshold of Rt. Upper trapezius and VAS were associated with myofascial pain syndrome in multivariate logistic regression analysis. This results suggest that, to diagnose of myofascial pain syndrome, the consideration of the objective aspects among patients' subjective symptom complaints through the VAS and pressure pain threshold is required.