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      Grip Force Measurement as a Complement to High-Resolution Ultrasound in the Diagnosis and Follow-Up of A2 and A4 Finger Pulley Injuries

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          Abstract

          The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was to determine if an injured annular pulley implies a finger flexor force decrease, as well as its relation to clinical and sonographic changes. We performed an observational study in 39 rock climbers with A2 or A4 pulley injuries to the 3rd or 4th fingers. The variables considered were pain upon palpation, ultrasound tendon–bone distance, and finger grip strength decrease. Three rock climbing grip types were considered: the one finger crimp, open crimp, and close crimp. Injured rock climbers presented a decrease in finger grip strength compared to non-injured controls when performing a one finger crimp ( p < 0.001). There exists a significant correlation between a tendon–bone distance at the level of the injured pulley and a decreased finger grip strength measured by performing a one finger crimp ( p = 0.006). A decrease in finger grip strength could be considered in the diagnostic and follow-up process of A2 and A4 pulley injuries to the 3rd and 4th fingers.

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          Most cited references30

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          Inhibition of maximal voluntary contraction force by experimental muscle pain: a centrally mediated mechanism.

          Muscle weakness frequently accompanies conditions with musculoskeletal pain. It is not clear if this attenuation of force is due to peripheral or central processes. The effect of experimental muscle pain on maximal voluntary contraction torque and peripheral contractile properties was therefore assessed. Experimental muscle pain reduced the torque produced by isometric knee extension, but the contractile properties assessed by twitch interpolation were not affected. This indicates that force inhibition by muscle pain is centrally mediated. This has clinical implications for rehabilitation and training of patients with musculoskeletal pain. Copyright 2002 Wiley-Liss, Inc. Muscle Nerve 26: 708-712, 2002
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            Physiological determinants of climbing-specific finger endurance and sport rock climbing performance.

            The aim of the study was to examine several physiological responses to a climbing-specific task to identify determinants of endurance in sport rock climbing. Finger strength and endurance of intermediate rock climbers (n = 11) and non-climbers (n = 9) were compared using climbing-specific apparatus. After maximum voluntary contraction (MVC) trials, two isometric endurance tests were performed at 40% (s = 2.5%) MVC until volitional exhaustion (continuous contractions and intermittent contractions of 10 s, with 3 s rest between contractions). Changes in muscle blood oxygenation and muscle blood volume were recorded in the flexor digitorum superficialis using near infra-red spectroscopy. Statistical significance was set at P < 0.05. Climbers had a higher mean MVC (climbers: 485 N, s = 65; non-climbers 375 N, s = 91) (P = 0.009). The group mean endurance test times were similar. The force-time integral, used as a measure of climbing-specific endurance, was greater for climbers in the intermittent test (climbers: 51,769 N x s, s = 12,229; non-climbers: 35,325 N x s, s = 9724) but not in the continuous test (climbers: 21,043 N x s, s = 4474; non-climbers: 15,816 N x s, s = 6263). Recovery of forearm oxygenation during rest phases (intermittent test) explained 41.1% of the variability in the force-time integral. Change in total haemoglobin was significantly greater in non-climbers (continuous test) than climbers (P = 0.023--40% test timepoint, P = 0.014--60% test timepoint). Pressor responses were similar between groups and not related to the force-time integral for either test. We conclude that muscle re-oxygenation during rest phases is a predictor of endurance performance.
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              Injury Trends in Rock Climbers: Evaluation of a Case Series of 911 Injuries Between 2009 and 2012

              Rock climbing is a widely performed sport. This prospective single-institution study evaluated the demographics of climbing-related injuries to improve our comprehension of current injury characteristics.
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                Author and article information

                Journal
                Diagnostics (Basel)
                Diagnostics (Basel)
                diagnostics
                Diagnostics
                MDPI
                2075-4418
                08 April 2020
                April 2020
                : 10
                : 4
                : 206
                Affiliations
                [1 ]Department of Physical Therapy, Universidad Camilo José Cela, 28692 Madrid, Spain; iruretagoiena.xeber@ 123456gmail.com
                [2 ]Eskura Osasun Zentroa, 20200 Beasain, Spain
                [3 ]Orthopedics Department, Clínica Pakea-Mutualia, 20018 San Sebastián, Spain; jdelafuente@ 123456mutualia.eus
                [4 ]Plastic Surgery Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona (Barcelona), Spain; marcblasibrugue@ 123456gmail.com
                [5 ]Faculty of Health Sciences, Universitat Pompeu Fabra, 08002 Mataró, Spain; fobrado@ 123456tecnocampus.cat
                [6 ]Ekin Fisioterapia Zentroa, 20550 Arechavaleta, Spain; a.ormazabal@ 123456hotmail.com
                Author notes
                [* ]Correspondence: esrodriguez@ 123456ucjc.edu
                Author information
                https://orcid.org/0000-0003-4289-9299
                Article
                diagnostics-10-00206
                10.3390/diagnostics10040206
                7235872
                32276341
                2b104d92-6974-4b9e-bdd0-1783ee6abc13
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 March 2020
                : 06 April 2020
                Categories
                Article

                annular pulley,ultrasound,strength,diagnosis,tendon–bone distance,rupture,grip,climber

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