Assessment of Handgrip Strength and Hand Dexterity of Preschool Age Children

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  Assessment of Handgrip Strength and Hand Dexterity of PreschoolAge Egyptian ChildrenAmaal HM Ebrahim* Reda Sarhan**Assistant professor. asic Science Department. Physical !herapyCollege. Cairo ni#ersityAbstract$ntrod%ction !he h%man hand is capable of complex and precise f%nctions &hichcan be di#ided into grasping abilities meas%red by the strength andman%al dexterity. !he hand is a receptor of m%ch information fromthe en#ironment and in e#eryday life all 'inds of grips are of #italimportance for ordinary acti#ities of daily life. Handgrip strength is agood parameter not only in e#al%ation of hand as a predictor of hand f%nction( b%t also to explore the stat%s of general health )(+, .As children gro& %p the hand f%nction de#elops )-(, &ith contrib%tionof the increased hand anthropometry. Many st%dies fo%nd a relationbet&een increasing age( anthropometry and handgrip strength )-/0, .1rip strength testing are commonly %sed to e#al%ate hand strengthfor disability ratings as 2 after s%rgery for tra%ma( correction of congenital anomaly or in case of impaired hand f%nctions d%e tobrain lesions( peripheral ne%ropathies or other ca%ses. $t isimperati#e that hand strength and dexterity be e#al%ated in order todetermine the se#erity of hand dysf%nction and determining thee3ect of treatment strategies or e3ects of di3erent proced%res.4imet al )5, ( pro#ide normati#e data of hand f%nction incl%ding dexterityfor the 6orean elementary school children. Semproli et al+770 )8, in#estigate the relationship bet&een hand grip and pinchstrength #al%es &ith basic body )body height( body mass index( M$,and &ith speci9c hand anthropometric parameters )9nger span(lengths and perimeter,in : pre/p%bertal children ages from : to7 years. !hey fo%nd that the relation bet&een anthropometry andhandgrip strength is stronger in boys compared &ith girls and lo&relation bet&een hand anthropometry and tip and 'ey pinchstrength. Crosby et al 88 )7,  st%died normal hand strength De9citsin motor f%nctions in the de#elop and the di3erence bet&eendominant and nondominant hands. !he ma;ority of right/handeds%b;ects &ere 7< stronger in grip strength on the dominant side.De Smet and =ercammen +77 ), ( st%died the grip strength of 50healthy children aged bet&een > and > years. !hey fo%nd a clearcorrelation bet&een age and grip strength %p to age of + years.?rom the age of - years( boys de#eloped a +>< stronger grip forcethan girls. !he di3erence bet&een the dominant and non/dominanthand grip &as not signi9cant( b%t &as constantly stronger in theright hand for right/hand dominant children.  Dexterity is a motor man%al s'ill associated &ith the hands re@%iringcoordination of 9ne and gross mo#ement. abies cannot controltheir hands b%t as they de#elop( the dexterity increases &ith age as&ell as hand/eye coordination. ith re#ie&ing the literat%res( handdexterity of children has not been &idely st%died %ntil no& )+, .6amieniarB et al )-, ( %sed ne& comp%ter tests of man%al dexterityand ine Hole Peg !ests in t&o gro%ps of children aged from 0 to >years. !hey fo%nd that the hand grip strength meas%rement sho&edthe highest test/retest reliability. Also the ine/Hole Peg !est isreliable for the dominant hand b%t lo&er than the comp%ter tests.Smith et al +777 ),  e#al%ated norms for motor dexterity s'ills on5+: elementary school children of ages > thro%gh 7 %tiliBing theine/hole Peg test. !heir 9ndings s%pported the ine/hole Peg !estas an e3ecti#e screening tool for 9ne motor dexterity of school/agechildren.    !he p%rpose of this st%dy &as to establish normati#e data of handgrip strength and hand dexterity in pre/school children )-/: years,and examine if there is a relation bet&een dominant and non/dominant hands. Material and Methods   Subjects  !his st%dy &as performed after an appro#al from the director of El/ !a'&a and Dar Al/Eman 'indergartens. !he researchers ga#e the'indergartens administration a consent letter to the parents of children containing the proced%re of the experiment and itsimportance to the children health. !he st%dy incl%ded 50 healthychildren( )7 girls and 0 boys, from El/!a'&a and Dar Al/Eman'indergarten( aged from - to : years old &ith mean age ).-.5,.Children &ere di#ided according to their age into fo%r gro%ps( gro%pA )- years F : months, +- children )> boys and 5 girls,( gro%p )years : months, +5 children )+ boys and : girls,( gro%p C)>years  : months, +- children )- boys and 7 girls,( and gro%p D): years : months, - children )0 boys and : girls,. !he s%b;ectcharacteristics( age( sex( &eight and height incl%ded in table ),. Allchildren &ere right handed. Handedness &as identi9ed by as' thechild to dra& or &rite any thin' and notice the hand %sed andcon9rmed o%r obser#ation by as'ing the teacher &hich hand thechild %sed in dra&ing or &riting. !he excl%sion criteria &ere lefthandedness( pre#io%s s%rgery in %pper limb( and any disorder thata3ected %pper limb performance.  !able . S%b;ect characteristicsG n%mber( age( &eight and height.Age%mberboys1irlseightHeight1ro%p )A, -4 F :mo+->5:.-.>8>.1ro%p ),  4  :mo+5+:8.+.85.>:.+  51ro%p )C, > 4  : mo+--7+.-+.:7.-:.51ro%p )D, : 4  :mo-0:+.5-.0-.:5. Instruments Hand/held dynamometer %sed for meas%ring grip strength and aine/hole Peg oard )Sammons Preston( SA, &as %sed formeas%ring the hand dexterity. eight and height scale p%tted inclassroom on a at s%rface &ith infant des' and chair of appropriateheight to children. Stop &atch to meas%re dexterity time. Procedures  !he children &ere tested indi#id%ally by the researchers. ?irst&eighted the child and meas%re hisIher height. A calibrated hand-held dynamometer was used to measure the grip strength of dominant andnon-dominant hand. Before beginning the researcher ensured that thedynamometer was set at zero. The recommendations of the AmericanSociety of Hand Therapists (Richards  !almiter ##$% ( &% ' for astandardized position were followed the child was seated upright on astraight-bac)ed chair comfortably with the feet flat on the floor' shoulder adducted and neutrally rotated' elbow fle*ed at #+ degrees' forearm inneutral position' and the wrist between + and ,+ degree e*tension and between + and & degree ulnar deiation. The arm should not besupported by the e*aminer or by an armrest. The handgrip dynamometer  placed in childs right hand ertically and in line with the forearm tomaintain the standard forearm and wrist position' and as)ed him/her tos0ueeze the dynamometer as hard as he/she can . !he researchers inthis st%dy meas%re the hand grip strength once as %sed by Har)onen et al ##,a  ( $%  and Ashton 1++2 ( 3%  who recommended the useof single measurement as an accurate and time efficient way. The same procedure was repeated for the (non dominant%. The measurementrecorded for each child as dominant hand and non-dominant hand score. To test the hand de*terity the nine-hole peg board was used tomeasure the time the child too) to place nine headless pegs in holes on a&-inch s0uare peg board using one hand only. The 4ine-hole !eg Boardwas centered in front of the child with the container side on the same sideas the hand being tested. The right dominant hand was tested first. Thechild completed one practice trial followed by the actual timed test for   each hand. The child was told that the holes might be filled in any order'and he/she must pic) up one peg at a time' using one hand only' and to put them in the holes until all nine holes were filled. The child shouldta)e the pegs out again from the holes one by one (5% . The child completedone practice trial followed by the actual timed test for each hand. The performance of each child was recorded in seconds' and the test was performed once with each hand.Statistical AnalysisThe mean and standard deiation to age height' weight' and grip strengthand de*terity time for both dominant and non-dominant hand werecalculated. The paired-sample t-test was used to compare differences between right dominant and left non-dominant hands within each group.6inear regression correlation coefficient test performed to find therelation between hand grip strength and hand de*terity was done to allgroups. A p alue 7+.+& was accepted as significant. All statisticalanalysis was performed using a statistical !ac)age for the Social Sciences $.+(S!SS% computer software' he graphs done by using 8ffice 9*cel1++,.ResultsHand grip strength of all groups showed a highly significant difference instrength between right (dominant% and left hand (non-dominant% p7+.+++ . :n de*terity test' group A (age from , ;$ months% recorded nosignificant difference between right and left hand de*terity (p<+. ,55%'the other three groups (B' =' and >% reported ery significant differences between right and left hand de*terity (p7+.++ #' 7+.++&3' +.++,$%respectiely (table 1' figure 1',% . Table 1. The paired t-test of hand grip strength and hand de*terity of all groups. ?easurementHand grip strength (@g%Hand de*terity (sec%groupHandCS>S9?t! alueCS>S9?t! alue %A(RT2.$,C . $ $+.12,5.3&$<+.+++ 2,.$ C ,.5 &1.553 .&+57+. ,55
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