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Finite element analysis of the wrist in stroke patients: the effects of hand grip

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Abstract

The provision of the most suitable rehabilitation treatment for stroke patient remains an ongoing challenge for clinicians. Fully understanding the pathomechanics of the upper limb will allow doctors to assist patients with physiotherapy treatment that will aid in full arm recovery. A biomechanical study was therefore conducted using the finite element (FE) method. A three-dimensional (3D) model of the human wrist was reconstructed using computed tomography (CT)-scanned images. A stroke model was constructed based on pathological problems, i.e. bone density reductions, cartilage wane, and spasticity. The cartilages were reconstructed as per the articulation shapes in the joint, while the ligaments were modelled using linear links. The hand grip condition was mimicked, and the resulting biomechanical characteristics of the stroke and healthy models were compared. Due to the lower thickness of the cartilages, the stroke model reported a higher contact pressure (305 MPa), specifically at the MC1-trapezium. Contrarily, a healthy model reported a contact pressure of 228 MPa. In the context of wrist extension and displacement, the stroke model (0.68° and 5.54 mm, respectively) reported a lower magnitude than the healthy model (0.98° and 9.43 mm, respectively), which agrees with previously reported works. It was therefore concluded that clinicians should take extra care in rehabilitation treatment of wrist movement in order to prevent the occurrence of other complications.

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Funding

The work has been supported by research funding from Centre of Research and Instrumentation Management (CRIM), Arus Perdana Research University Grant (AP-2014-014) under Universiti Kebangsaan Malaysia (UKM), Potential Academic Staff (Grant No.: Q.J130000.2745.02K78) under Universiti Teknologi Malaysia (UTM) and Fundamental Research Grant Scheme (FRGS) (Grant No.: FRGS/1/2016/TK04/UKM/02/5) by Ministry of High Education of Malaysia.

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  1. Medical Devices and Technology Group (MEDITEG), Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia (UTM), 81310, Johor Bahru, Malaysia

    Muhammad Hanif Ramlee, Nazri Bajuri & Mohammed Rafiq Abdul Kadir

  2. Sport Innovation and Technology Centre (SITC), Institute of Human Centered Engineering (IHCE), Universiti Teknologi Malaysia (UTM), 81310, Johor Bahru, Malaysia

    Muhammad Hanif Ramlee & Mohammed Rafiq Abdul Kadir

  3. Department of Electrical, Electronic and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia (UKM), 43600, Bangi, Selangor, Malaysia

    Gan Kok Beng

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The research and computed tomography (CT) dataset obtained institutional approval from Hospital Tengku Ampuan Afzan Kuantan, Pahang, Malaysia, as per the reference number Versi2.0Tarikh15Feb2008. An informed consent form was completed and approved by the Director of Clinical Research Centre, Hospital Tengku Ampuan Afzan Kuantan.

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Ramlee, M.H., Beng, G.K., Bajuri, N. et al. Finite element analysis of the wrist in stroke patients: the effects of hand grip. Med Biol Eng Comput 56, 1161–1171 (2018). https://doi.org/10.1007/s11517-017-1762-3

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