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Hand Function pp 211-225 | Cite as

Functional Assessment in Geriatric Hand

  • Nurgül Arıncı İncel
Chapter

Abstract

Prolonged longevity with an increase in the numbers of elderly and disability-free life expectancy focused the impact on geriatric population. A larger geriatric population is expected to result in an increase in old hand therapy patients.

Aging has been reported to have a negative effect on hand function. Studies on hand function in elderly population have reported increased difficulties in performing everyday tasks and a reduction in quality of life. The decline in hand function has been postulated to be due to deterioration in muscle coordination and strength, decline in finger dexterity and hand sensation, as well as the degeneration of the central nervous system. Some systemic pathologies common in the elderly population have marked impact on hand function. Parkinson’s disease with rigidity and tremor, type II DM with neuropathy and Dupuytren’s contracture, and stroke with flask or spastic extremities are the most recognized ones. Also in older people, conditions not directly related to the primary upper extremity problem but negatively affecting the patients’ general health status or the therapy period can be present, like a patient with flexor tendon repair accompanied by a severe dementia. These problems not only interfere with the evaluation and diagnostic process but seriously and negatively affect the therapy and rehabilitation period.

In this chapter along with impact of aging and age-related comorbid conditions on hand function, clinical examination and functional evaluation in the elderly population will be reviewed.

Keywords

Geriatrics Elderly Hand Aging Sarcopenia Functional evaluation Activities of daily living Laterality Dexterity Grip strength TEMPA GERI-AIMS 

References

  1. 1.
    Olshansky SJ, Goldman DP, Zheng Y, Rowe JW. Aging in America in the twenty-first century: demographic forecasts from the MacArthur Foundation Research Network on an Aging Society. Milbank Q. 2009;87(4):842–62.  https://doi.org/10.1111/j.1468-0009.2009.00581.x.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Maltais ML, Desroches J, Dionne IJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009;9(4):186–97.PubMedGoogle Scholar
  3. 3.
    Shiffman LM. Effects of aging on adult hand function. Am J Occup Ther. 1992;46(9):785–92.CrossRefGoogle Scholar
  4. 4.
    Ranganathan VK, Siemionow V, Sahgal V, Yue GH. Effects of aging on hand function. J Am Geriatr Soc. 2001;49(11):1478–84.CrossRefGoogle Scholar
  5. 5.
    Lam NW, Goh HT, Kamaruzzaman SB, Chin AV, Poi PJH, Tan MP. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population. Singap Med J. 2016;57(10):578–84.  https://doi.org/10.11622/smedj.2015164.CrossRefGoogle Scholar
  6. 6.
    Rosen SL, Reuben DB. Geriatric assessment tools. Mt Sinai J Med. 78(4):489–97.  https://doi.org/10.1002/msj.20277.CrossRefGoogle Scholar
  7. 7.
    Clark J, Loftus A, Hammond G. Age-related changes in short-interval intracortical facilitation and dexterity. Neuroreport. 2011;22(10):499–503.  https://doi.org/10.1097/WNR.0b013e3283487480.CrossRefPubMedGoogle Scholar
  8. 8.
    Garcia PA, Dias JMD, Dias RC, Santos P, Zampa CC. A study on the relationship between muscle function, functional mobility and level of physical activity in community-dwelling elderly. Rev Bras Fisioter. 2011;15(1):15–22.CrossRefGoogle Scholar
  9. 9.
    Marmon AR, Pascoe MA, Schwartz RS, Enoka RM. Associations among strength, steadiness, and hand function across the adult life span. Med Sci Sports Exerc. 2011;43(4):560–7.  https://doi.org/10.1249/MSS.0b013e3181f3f3ab.CrossRefPubMedGoogle Scholar
  10. 10.
    Liu CJ, Marie D, Fredrick A, Bertram J, Utley K, Fess EE. Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity. Aging Clin Exp Res. 2017;29(4):753–60.  https://doi.org/10.1007/s40520-016-0628-0.CrossRefPubMedGoogle Scholar
  11. 11.
    Kubota H, Demura S, Kawabata H. Laterality and age-level differences between young women and elderly women in controlled force exertion (CFE). Arch Gerontol Geriatr. 2012;54(2):e68–72.  https://doi.org/10.1016/j.archger.2011.06.027.CrossRefPubMedGoogle Scholar
  12. 12.
    Saimpont A, Pozzo T, Papaxanthis C. Aging affects the mental rotation of left and right hands. PLoS One. 2009;4(8):e6714.  https://doi.org/10.1371/journal.pone.0006714.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Petit A, Constans T, Mondon K, et al. Hemispheric lateralization in aging: interest of the verbal-manual concurrency paradigm. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2011;18(5):620–31.  https://doi.org/10.1080/13825585.2011.600752.CrossRefPubMedGoogle Scholar
  14. 14.
    Desrosiers J, Hébert R, Bravo G, Rochette A. Age-related changes in upper extremity performance of elderly people: a longitudinal study. Exp Gerontol. 1999;34(3):393–405.CrossRefGoogle Scholar
  15. 15.
    Warabi T, Noda H, Kato T. Effect of aging on sensorimotor functions of eye and hand movements. Exp Neurol. 1986;92(3):686–97.CrossRefGoogle Scholar
  16. 16.
    Pacala JT, Yueh B. Hearing deficits in the older patient: “I didn’t notice anything”. JAMA. 2012;307(11):1185–94.  https://doi.org/10.1001/jama.2012.305.CrossRefPubMedGoogle Scholar
  17. 17.
    Diermayr G, McIsaac TL, Gordon AM. Finger force coordination underlying object manipulation in the elderly – a mini-review. Gerontology. 2011;57(3):217–27.  https://doi.org/10.1159/000295921.CrossRefPubMedGoogle Scholar
  18. 18.
    Wickremaratchi MM, Llewelyn JG. Effects of ageing on touch. Postgrad Med J. 2006;82(967):301–4.  https://doi.org/10.1136/pgmj.2005.039651.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Krueger N, Luebberding S, Oltmer M, Streker M, Kerscher M. Age-related changes in skin mechanical properties: a quantitative evaluation of 120 female subjects. Skin Res Technol. 2011;17(2):141–8.  https://doi.org/10.1111/j.1600-0846.2010.00486.x.CrossRefPubMedGoogle Scholar
  20. 20.
    Salthouse T. Consequences of age-related cognitive declines. Annu Rev Psychol. 2012;63:201–26.  https://doi.org/10.1146/annurev-psych-120710-100328.CrossRefPubMedGoogle Scholar
  21. 21.
    Carmeli E, Patish H, Coleman R. The aging hand. J Gerontol A Biol Sci Med Sci. 2003;58(2):146–52. http://www.ncbi.nlm.nih.gov/pubmed/12586852. Accessed 15 Apr 2012CrossRefGoogle Scholar
  22. 22.
    Nicholls EE, van der Windt DAWM, Jordan JL, Dziedzic KS, Thomas E. Factors associated with the severity and progression of self-reported hand pain and functional difficulty in community-dwelling older adults: a systematic review. Musculoskeletal Care. 2012;10(1):51–62.  https://doi.org/10.1002/msc.1007.CrossRefGoogle Scholar
  23. 23.
    DJ S. Predicting the outcome of distal radius fractures. Hand Clin. 2005;21(3):289–94.CrossRefGoogle Scholar
  24. 24.
    Loeser RF. Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med. 2010;26(3):371–86.  https://doi.org/10.1016/j.cger.2010.03.002.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Kjeken I, Dagfinrud H, Slatkowsky-Christensen B, et al. Activity limitations and participation restrictions in women with hand osteoarthritis: patients’ descriptions and associations between dimensions of functioning. Ann Rheum Dis. 2005;64(11):1633–8.  https://doi.org/10.1136/ard.2004.034900.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Kroon FPB, Rubio R, Schoones JW, Kloppenburg M. Intra-articular therapies in the treatment of hand osteoarthritis: a systematic literature review. Drugs Aging. 2016;33(2):119–33.  https://doi.org/10.1007/s40266-015-0330-5.CrossRefPubMedGoogle Scholar
  27. 27.
    Smith LL, Burnet SP, McNeil JD. Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med. 2003;37(1):30–5.CrossRefGoogle Scholar
  28. 28.
    Cagliero E. Rheumatic manifestations of diabetes mellitus. Curr Rheumatol Rep. 2003;5(3):189–94. http://www.ncbi.nlm.nih.gov/pubmed/12744809. Accessed 29 Apr 2012CrossRefGoogle Scholar
  29. 29.
    Meijer JW, van Sonderen E, Blaauwwiekel EE, et al. Diabetic neuropathy examination: a hierarchical scoring system to diagnose distal polyneuropathy in diabetes. Diabetes Care. 2000;23(6):750–3.CrossRefGoogle Scholar
  30. 30.
    Kelly-Hayes M. Influence of age and health behaviors on stroke risk: lessons from longitudinal studies. J Am Geriatr Soc. 2010;58(Suppl 2):S325–8.  https://doi.org/10.1111/j.1532-5415.2010.02915.x.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Shuaib A, Boyle C. Stroke in the elderly. Curr Opin Neurol. 1994;7(1):41–7.CrossRefGoogle Scholar
  32. 32.
    Legg L, Drummond A, Leonardi-Bee J, et al. Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials. BMJ. 2007;335(7626):922.  https://doi.org/10.1136/bmj.39343.466863.55.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Bode C, Taal E, Westerhof GJ, van Gessel L, van de Laar MV. Experience of aging in patients with rheumatic disease: a comparison with the general population. Aging Ment Health. 2012;(April 2012):37–41.  https://doi.org/10.1080/13607863.2011.651438.CrossRefGoogle Scholar
  34. 34.
    Schmidt J, Warrington KJ. Polymyalgia rheumatica and giant cell arteritis in older patients: diagnosis and pharmacological management. Drugs Aging. 2011;28(8):651–66.  https://doi.org/10.2165/11592500-000000000-00000.CrossRefPubMedGoogle Scholar
  35. 35.
    Marttila RJ, Rinne UK. Progression and survival in Parkinson’s disease. Acta Neurol Scand Suppl. 1991;136:24–8. http://www.ncbi.nlm.nih.gov/pubmed/1801533. Accessed 29 Apr 2012.CrossRefGoogle Scholar
  36. 36.
    Treves TA, Korczyn AD. Modeling the dementia epidemic. CNS Neurosci Ther. 2012;18(2):175–81.  https://doi.org/10.1111/j.1755-5949.2011.00242.x.CrossRefPubMedGoogle Scholar
  37. 37.
    Palmer KT. Regional musculoskeletal conditions: pain in the forearm, wrist and hand. Best Pract Res Clin Rheumatol. 2003;17(1):113–35.CrossRefGoogle Scholar
  38. 38.
    Gagliese L. Pain and aging: the emergence of a new subfield of pain research. J Pain. 2009;10(4):343–53.  https://doi.org/10.1016/j.jpain.2008.10.013.CrossRefPubMedGoogle Scholar
  39. 39.
    Sosnoff JJ, Newell KM. Aging and motor variability: A test of the neural noise hypothesis. Exp Aging Res. 2011;37:377–97.CrossRefGoogle Scholar
  40. 40.
    Quinn TJ, McArthur K, Ellis G, Stott DJ. Functional assessment in older people. BMJ. 2011;343:d4681. http://www.ncbi.nlm.nih.gov/pubmed/21859792. Accessed 24 Apr 2012.CrossRefGoogle Scholar
  41. 41.
    Kamarul T, Ahmad T, Loh W. Hand grip strength in the adult Malaysian population. J Orthop Surg. 2006;14(2):172–7.  https://doi.org/10.1177/230949900601400213.CrossRefGoogle Scholar
  42. 42.
    Taekema DG, Gussekloo J, Maier AB, Westendorp RGJ, de Craen AJM. Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing. 2010;39(3):331–7.  https://doi.org/10.1093/ageing/afq022.CrossRefPubMedGoogle Scholar
  43. 43.
    Rice MS, Leonard C, Carter M. Grip strengths and required forces in accessing everyday containers in a normal population. Am J Occup Ther. 1998;52:621–6.CrossRefGoogle Scholar
  44. 44.
    Fritz NE, McCarthy CJ, Adamo DE. Handgrip strength as a means of monitoring progression of cognitive decline – a scoping review. Ageing Res Rev. 2017;35:112–23.  https://doi.org/10.1016/j.arr.2017.01.004.CrossRefPubMedGoogle Scholar
  45. 45.
    Spirduso WW, Clifford P. Replication of age and physical activity effects on reaction and movement time. J Gerontol. 1978;33(1):26–30.CrossRefGoogle Scholar
  46. 46.
    Incel NA, Sezgin M, As I, Cimen OB, Sahin G. The geriatric hand: correlation of hand-muscle function and activity restriction in elderly. Int J Rehabil Res. 2009;32(3):213–8.  https://doi.org/10.1097/MRR.0b013e3283298226.CrossRefPubMedGoogle Scholar
  47. 47.
    Dong R, Wang X, Guo Q, et al. Clinical relevance of different handgrip strength indexes and mobility limitation in the elderly adults. J Gerontol A Biol Sci Med Sci. 2015;71(1):96–102.  https://doi.org/10.1093/gerona/glv168.CrossRefPubMedGoogle Scholar
  48. 48.
    Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9(1):97–113. http://www.ncbi.nlm.nih.gov/pubmed/5146491. Accessed 8 Mar 2012.CrossRefGoogle Scholar
  49. 49.
    Hackel ME, Wolfe GA, Bang SM, Canfield JS. Changes in hand function in the aging adult as determined by the Jebsen Test of Hand Function. Phys Ther. 1992;72(5):373–7.CrossRefGoogle Scholar
  50. 50.
    Scherder E, Dekker W, Eggermont L. Higher-level hand motor function in aging and (preclinical) dementia: its relationship with (instrumental) activities of daily life – a mini-review. Gerontology. 2008;54(6):333–41.  https://doi.org/10.1159/000168203.CrossRefPubMedGoogle Scholar
  51. 51.
    Desrosiers J, Hébert R, Bravo G, Dutil E. Upper extremity performance test for the elderly (TEMPA): normative data and correlates with sensorimotor parameters. Test d’Evaluation des Membres Supérieurs de Personnes Agées. Arch Phys Med Rehabil. 1995;76(12):1125–9.CrossRefGoogle Scholar
  52. 52.
    Exner CE. The zone of proximal development in in-hand manipulation skills of nondysfunctional 3- and 4-year-old children. Am J Occup Ther. 1990;44(10):884–91.CrossRefGoogle Scholar
  53. 53.
    Desrosiers J, Hébert R, Bravo G, Dutil E. The Purdue Pegboard Test: normative data for people aged 60 and over. Disabil Rehabil. 1995;17(5):217–24.CrossRefGoogle Scholar
  54. 54.
    Krupp S, Kasper J, Balck F, Schnoor M, Eisemann N, Lohse K, Brunk J, Katalinic A, Willkomm M. Timed up and go test for fingers in the form of the 20 cents test. Psychometric criteria of a simple performance test of fine motor skills. Z Gerontol Geriatr. 2015;48(2):121–7.  https://doi.org/10.1007/s00391-014-0854-z; Epub 2015 Jan 14. German.CrossRefPubMedGoogle Scholar
  55. 55.
    Weiner DK, Duncan PW, Chandler J, Studenski SA. Functional reach: a marker of physical frailty. J Am Geriatr Soc. 1992;40(3):203–7.CrossRefGoogle Scholar
  56. 56.
    Michener LA, Leggin BG. A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 1991;14(2):68–76.CrossRefGoogle Scholar
  57. 57.
    Hughes SL, Edelman P, Chang RW, Singer RH, Schuette P. The GERI-AIMS. Reliability and validity of the arthritis impact measurement scales adapted for elderly respondents. Arthritis Rheum. 1991;34(7):856–65.CrossRefGoogle Scholar
  58. 58.
    Falconer J, Hughes SL, Naughton BJ, Singer R, Chang RW, Sinacore JM. Self report and performance-based hand function tests as correlates of dependency in the elderly. J Am Geriatr Soc. 1991;39(7):695–9.CrossRefGoogle Scholar
  59. 59.
    Duruoz MT, Poiraudeau S, Fermanian J, et al. Development and validation of a rheumatoid hand functional disability scale that assess functional handicap. J Rheumatol. 1996;23:1167–72.Google Scholar
  60. 60.
    Duruoz MT, Topcu E, Duruoz E, Ucar U. The validity of Duruöz Hand Index (DHI) in geriatric population. Ann Rheum Dis. 2012;71(Suppl 3):717.Google Scholar
  61. 61.
    Dziedzic KS, Thomas E, Hay EM. A systematic search and critical review of measures of disability for use in a population survey of hand osteoarthritis (OA). Osteoarthr Cartil. 2005;13(1):1–12.  https://doi.org/10.1016/j.joca.2004.09.010.CrossRefPubMedGoogle Scholar
  62. 62.
    Bellamy N, Campbell J, Haraoui B, et al. Dimensionality and clinical importance of pain and disability in hand osteoarthritis: development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index. Osteoarthr Cartil. 2002;10(11):855–62.CrossRefGoogle Scholar
  63. 63.
    Pransky G, Feuerstein M, Himmelstein J, Katz JN, Vickers-Lahti M. Measuring functional outcomes in work-related upper extremity disorders. Development and validation of the Upper Extremity Function Scale. J Occup Environ Med. 1997;39(12):1195–202.CrossRefGoogle Scholar
  64. 64.
    Seino S, Yabushita N, Kim M-J, et al. Comparison of a combination of upper extremity performance measures and usual gait speed alone for discriminating upper extremity functional limitation and disability in older women. Arch Gerontol Geriatr. 2011;  https://doi.org/10.1016/j.archger.2011.10.011.CrossRefGoogle Scholar
  65. 65.
    Rand D, Eng JJ. Arm-hand use in healthy older adults. Am J Occup Ther. 2010;64(6):877–85.  https://doi.org/10.5014/ajot.2010.09043.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.CrossRefGoogle Scholar
  67. 67.
    Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMedGoogle Scholar

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Authors and Affiliations

  • Nurgül Arıncı İncel
    • 1
  1. 1.Department of Physical Medicine and RehabilitationMersin University School of MedicineMersinTurkey

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