• Anatomy and Cell Biology
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• v.56 no.1
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• pp.46-53
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• 2023

It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively. We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30-40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint. The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants' movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.

• Journal of the Korean Society of Safety
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• v.31 no.4
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• pp.111-119
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• 2016

This study aimed to analyze postures that were frequently conducted in manufacturing industry. To find grip strength and muscle activities of each posture, Maximum Voluntary Contraction (MVC) and ElectroMyoGraphy (EMG) were measured. Based on the results of this study, the most appropriate posture could be suggested and used as a basic information for preventing musculoskeletal disorders. Most work-related musculoskeletal disorders have been occurred in the fields of manufacturing industry. According to previous studies, it was reported that the rate of musculoskeletal diseases of upper extremity was higher than that of other body parts. Accordingly, there were many studies about discomfort and grip strength of upper extremity. However, these studies dealt with single selection of wrist, elbow and shoulder. So, it was insufficient for comprehensive studies about upper extremity. And in order to improve the work posture, the physiological changes being generated by the combination of wrist, elbow and shoulder postures should be observed and analyzed. In order to conduct this study, thirty university students who had no records of MSDs involved were recruited. Independent variables were postures of wrist(pronation, neutral, supination), postures of elbow(flexion $45^{\circ}$, $90^{\circ}$) and postures of shoulder(flexion $0^{\circ}$, $90^{\circ}$). And dependent variables were MVC values and EMG values. Jamar dynamometer and TeleMyo 2400T G2 was used to measure MVC and EMG. MVC and EMG for 12 postures were measured for three second and for three times. Experiment was performed randomly. A 10 minutes rest period was provided after each t. To measure muscle load, the EMG signals of eight muscles (Biceps, Medial triceps, Lateral triceps, Brachioradialis, Extensor carpi ulnaris, Extensor carpi radialis, Flexor carpi ulnaris and Flexor carpi radialis) were evaluated. MVC values and EMG values were analyzed using Minitab ver. 14. The results showed that MVC value was the highest at shoulder $0^{\circ}$, elbow $45^{\circ}$ and wrist supination. In case of wrist postures, MVC of supination is the highest. In case of elbow and shoulder postures, MVC of flexion $45^{\circ}$ and $0^{\circ}$ was the highest. It was found that there were interaction between wrist and elbow posture under shoulder flexion and between shoulder and wrist under elbow flexion $45^{\circ}$. In case of the angle of shoulder $0^{\circ}$, elbow $45^{\circ}$ and wrist supination, the EMG values of four muscles(Medial Triceps, Extensor carpi ulnaris, Extensor carpi radialis, Flexor carpi ulnaris) were the highest. Based on this study, it is worth to note that the combination postures of upper extremity have a large impact on the MVC and EMG. The optimal condition upper extremity was shoulder flexion $0^{\circ}$, elbow flexion $45^{\circ}$ and wrist supination for preventing work-related musculoskeletal disease.

• Physical Therapy Korea
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• v.27 no.3
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• pp.163-170
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• 2020

Background: The characteristics of lateral epicondylitis (LE) are muscle strength weakness and increased common extensor tendon (CET) thickness. Ultrasonography has recently been used to evaluate tendinopathy. Diamond taping (DT) is commonly used to manage patients with LE. However, no previous studies have investigated the effects of DT on CET thickness. Objects: The aim of this study was to investigate the effects of DT applied around the lateral elbow on CET thickness, grip strength, and wrist extension force in healthy subjects. Methods: The subjects were 26 adults (13 male) in their twenties. First, the CET thickness was measured at rest. The CET thickness was measured by using ultrasonography at two points. The subjects were then instructed to perform maximal grip activities or maximal wrist extension activities before and after DT around the lateral elbow. The DT technique was applied using non-elastic tape. While the subjects performed maximal grip activities, the investigator measured the maximum grip strength (MGS) and CET thickness. Likewise, while the subjects performed maximal wrist extension activities, the investigator measured the maximum wrist extension force (MWEF) and CET thickness. Results: The MGS showed a statistically significant improvement after DT taping application in men (p < 0.05). The MWEF showed a statistically significant improvement after DT application in male (p < 0.01) and female (p < 0.05). When performing the activities, the CET thickness increased compared to that at rest. However, CET thickness didn't show a statistically significant improvement before and after DT. Conclusion: This study shows that DT applied around the lateral elbow is effective in improving MGS and MWEF. However, it does not affect CET thickness.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.163-169
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• 2016

Objective: The purpose of this study was to investigate the effects of vibration resistance exercise (VRE) in patients with tennis elbow on strength, range of motion (ROM), function, pain and quality of life (QOL). Design: Randomized controlled trial. Methods: Twenty-seven participants were randomly assigned to either the VRE group (n=9), weight resistance exercise (WRE) group (n=9) or control group (n=9). Each group underwent hot compress for 15 minutes and electrotherapy for 15 minutes. The VRE group underwent exercises using a vibrating ball for 5 minutes. The WRE group underwent exercises using dumbbells for 5 minutes. All participants were evaluated on wrist extension strength using a hand-held dynamometer, grip strength level through an electric dynamometer, and ROM through a smartphone goniometer application before and after intervention. Patient-rated tennis elbow evaluation, Visual Analogue Scale and Short Form 8 were measured by questionnaires. Results: There were showed significant differences among the VRE, WRE and control group in wrist extensor muscle and hand grip strength, ROM, elbow function, pain and QOL after intervention (p<0.05). The VRE group showed a greater significant improvement in wrist extensor muscle strength and elbow function compared with the others (p<0.05). The VRE and the WRE groups had a more significant improvement in wrist extensor muscle and hand grip strength, ROM and pain compared with the control group (p<0.05). However, there were no significant differences in QOL among the three groups. Conclusions: Combining VRE with thermotherapy and electrotherapy appears to be more effective in improving wrist extension strength, ROM, elbow function, QOL in tennis elbow patients.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.1
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• pp.75-81
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• 2018

Purpose : The aim of this study was to compare the muscle activities of thumb and wrist during unimanual, bimanual symmetric and bimanual reciprocal movements using surface electromyography. Method : Thirty-six participants were involved in this study. Two blocks were used to perform unimanual, bimanual symmetric and bimanual reciprocal movements of thumb and wrist. Muscle activities in the flexor pollicis brevis, abductor pollicis brevis, extensor carpi radialis and flexor carpi radialis were measured using an surface EMG system. Result : For the flexor pollicis brevis and abductor pollicis brevis, significant difference in the muscle activity were found among the unimanual, bimanual symmetric and bimanual reciprocal movement. For the extensor carpi radialis and flexor carpi radialis, the unimanual movement significantly different from the bimanual symmetric and reciprocal movements. Conclusion : Both the thumb and wrist, bimanual symmetric and reciprocal movements were more efficient than the unimanual movement. Moreover, with regard to the thumb, the bimanual reciprocal movement was more efficient than the bimanual symmetric movement.

• Proceedings of the KSMRM Conference
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• 2000.11a
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• pp.44-44
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• 2000

• Physical Therapy Korea
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• v.27 no.2
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• pp.118-125
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• 2020

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal pain condition of the upper extremities. LE is often related to forceful grip activities that require isometric contraction of the wrist extensors. A previous study evaluated the effect of the diamond taping technique on grip strength and pain; however, there has been no report on the change in the electromyography (EMG) findings of wrist extensors. Objects: The aim of this study was to investigate the effect of diamond taping technique, using a rigid tape, on the EMG activities of the extensor carpi radialis (ECR) during grip activities. Methods: Twenty-four healthy subjects (mean age = 21.50 ± 2.76 years) volunteered to participate in this study. The subjects were instructed to perform forceful grip activities with and without diamond-type taping on the origin area of the ECR. Grip strength tests were performed at 100%, 75%, 50%, and 25% for maximal isometric contraction force. EMG data were collected from the ECR. Repeated measure analysis of variance was used to analyze the effect of grip force and taping (with and without). Statistical significance levels were set at α = 0.05. Comparison of the results with and without taping at different grip force were analyzed using independent t-test. Statistical significance levels were set at α = 0.01. Results: Statistically significant association was observed between the taping application and forceful grip activity as revealed by the EMG data of the ECR (p < 0.05). EMG of the ECR significantly reduced for all muscle strength levels (p < 0.01) after taping. Conclusion: This study shows an impressive effect of the diamond taping technique, using rigid tape, on wrist extensors during grip activities. Decreasing muscle activity via this taping approach could be utilized to enhance pain-free grip force and reduce pain in patients with LE. Our study suggested that this taping technique could be considered as an effective management strategy of LE.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.127-133
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• 2017

Objective: The purpose of this study was to explore the effect of repetitive wrist extension task training with electromyography (EMG)-triggered neuromuscular electrical stimulation (NMES) for wrist extensor muscle recovery in patients with stroke. Design: Randomized controlled trial. Methods: Fifteen subjects who had suffered a stroke were randomly assigned to an EMG-triggered NMES group (n=8) or control group (n=7); subjects in both groups received conventional therapy as usual. Subjects in the experimental group received application of EMG-triggered NMES to the wrist extensor muscles for 20 minutes, twice per day, five days per week, for a period of four weeks, and were given a task to make a touch alarm go off by activity involving extension of their wrist. In the control group, subjects performed wrist self-exercises for the same duration and frequency as those in the experimental group. Outcome measures included muscle reaction time and spectrum analysis. Assessments were performed during the pre- and post-treatment periods. Results: In the EMG-triggered NMES group, faster muscle reaction time was observed, and median frequency also showed improvement, from 68.2 to 75.3 Hz, after training (p<0.05). Muscle reaction time was significantly faster, and median frequency was significantly higher in the experimental group than in the experimental group after training. Conclusions: EMG-triggered NMES is beneficial for patients with hemiparetic stroke in recovery of upper extremity function.

• PNF and Movement
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• v.19 no.3
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• pp.391-399
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• 2021

Purpose: As laptop use increases throughout the COVID-19 pandemic and its use outside of traditional workstations proliferates, it is imperative to expand the limited research available regarding ergonomic exposure. This study aimed to identify the effects of a laptop supporter on biomechanical characteristics in the wrist joint muscles of healthy young adults. Methods: This was a cross-sectional observational study design with thirty-four healthy young adults as participants. They conducted a typing exercise performed under two different conditions, which were with and without a notebook computer supporter. This study measured the biomechanical characteristics of the muscles of the wrist joints including the flexor carpi ulnaris (FCU), the flexor carpi radialis (FCR), the extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU). Measurements were taken three times: before typing, immediately after typing for 30 minutes with a supporter, and immediately after typing for 30 minutes without a supporter. The statistical method to compare the three different measurement conditions was the repeated measures ANOVA. Results: The participants showed significantly different levels of dynamic stiffness in both the FCU before typing and immediately after 30 minutes of typing with a supporter, and showed significantly different levels of dynamic stiffness in the FCR before typing and immediately after 30 minutes of typing with a supporter. The dynamic stiffness level immediately after 30 minutes of typing without a supporter was significantly different than that immediately after 30 minutes of typing with a supporter. However, the muscle tone was not significantly different among the three different conditions. Conclusion: The results of this study revealed that a laptop supporter used to correct the eye level of the electronic screen increases the dynamic stiffness of the wrist joint flexors, so it is necessary to consider the neutral position of the wrist joint during typing.