title: Load distribution of the hand during cylinder grip analyzed by Manugraphy.
abstract: METHODS
  Clinical measurement and basic research.
  
  
  BACKGROUND
  Manugraphy allows assessing dynamically all forces applied perpendicular to a cylinder surface by the whole contact area of the hand with a high spatial resolution.
  
  
  OBJECTIVE
  To identify the physiological load distribution of the whole contact area of the hand during cylinder grip.
  
  
  METHODS
  A sample of 152 healthy volunteers performed grip force tests with 3 cylinder sizes of the Manugraphy system (novel, Munich, Germany) on 3 different days. The whole contact area of the hand was sectioned into 7 anatomic areas, and the percent contribution of each area in relation to the total load applied was calculated. The load distribution of the dominant and nondominant hands and with different cylinder sizes was compared. Furthermore, the load distribution between the finger phalanges of each finger was analyzed.
  
  
  RESULTS
  The results for the dominant and nondominant hands were in all 7 areas of the hand similar with the percent contribution differing within a range of 1%-4% (P > .138). Load distribution changed significantly with different cylinder sizes: all 7 areas differed between 1% and 7% with P < .001, most pronounced for the thumb. The load distribution of the phalanges showed that the contribution of the distal phalanges increased with ascending cylinder size, whereas the contribution of the proximal phalanges decreased. The interindividual variability of the load distribution pattern was noticeable.
  
  
  CONCLUSIONS
  For the clinical practice, Manugraphy might be a useful supplement to traditional grip force measurement for identifying the individual characteristics of a patient's dysfunction and monitoring the progress of hand rehabilitation.
  
  
  CONCLUSIONS
  There is no universal or typical load distribution pattern of the hand but only an individual pattern. To evaluate a compromised hand, it is permissible to compare it with the healthy opposite hand as a reference. Several cylinder sizes should be used for load distribution testing. Using smaller handles in the daily life can help to compensate impairment of the thumb and fingertips.
  
  
  METHODS
  2.
authors.affiliation: Clinic for Hand Surgery, Rhön Klinikum AG, Bad Neustadt an der Saale, Germany. Electronic address: muehldorfer3@gmx.de.
authors.forename: Marion
authors.initials: M
authors.lastname: Mühldorfer-Fodor
authors.affiliation: Clinic for Hand Surgery, Rhön Klinikum AG, Bad Neustadt an der Saale, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Ziegler
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, Rostock University Medical Center, Rostock, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Harms
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, Rostock University Medical Center, Rostock, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Neumann
authors.affiliation: Institute of Biostatistics and Informatics in Medicine and Ageing Research, University of Rostock, Rostock, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Kundt
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, Rostock University Medical Center, Rostock, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mittlmeier
authors.affiliation: Clinic for Hand Surgery, Rhön Klinikum AG, Bad Neustadt an der Saale, Germany.
authors.forename: Karl Josef
authors.initials: KJ
authors.lastname: Prommersberger
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005384:Finger Joint / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D053581:Muscle Strength Dynamometer; D012016:Reference Values; D016474:Weight-Bearing / Q000502:physiology
keywords: Cylinder grip; Hand dominance; Handle size; Load distribution; Manugraphy system