I manage and conduct integrative research using machine-learning, biomechanics, additive manufacturing and advanced medical imaging to drive the knowledge on hand (dys)function in ways that are clinically meaningful.

Honors & Awards

  • International Scholarship Award, Hand and Wrist Biomechanics International (June 2015)
  • Louis Bolk-Award for best presentation, Dutch/Flemish Anatomical Society (January 2017)

Professional Education

  • Doctor of Philosophy, Katholieke Universiteit Leuven (2017)
  • Bachelor (Undeclared), Unlisted School (2008)
  • Master of Science, Rijksuniversiteit Groningen (2018)

All Publications

  • The Role of the Flexor Carpi Radialis Groove in Trapeziometacarpal Osteoarthritis. Hand (New York, N.Y.) Mitchell, A. R., Kerkhof, F. D., Wadhwa, H., Ladd, A. L. 2022: 15589447221120844


    BACKGROUND: Thumb carpometacarpal (CMC) osteoarthritis (OA) is a common condition. The contribution of surrounding ligaments and tendons to the stability of the CMC joint is likely altered in OA. The flexor carpi radialis (FCR) tendon runs in the trapezial FCR groove and is often noted to be frayed during CMC arthroplasty. We hypothesized that decreased integrity of the FCR tendon is related to FCR groove morphology and is associated with increased severity of CMC OA.METHODS: We examined 3-dimensional surface models based on computed tomography (CT) scans of explanted trapezia from patients who underwent thumb CMC arthroplasty. Fraying of the FCR tendon was rated intraoperatively. Measurements were taken of the FCR groove to evaluate its morphology. Preoperative thumb CMC radiographs for each patient were scored using the modified Eaton classification system and the Thumb Osteoarthritis Index. Differences in the tendon groups were examined, and multivariable linear regression models were used to test the association between tendon group and FCR groove measurement.RESULTS: There were 136 patients who were categorized into 4 tendon groups: intact, minor fraying, fraying, and ruptured. There were no differences between the tendon groups on any measures.CONCLUSIONS: Our findings do not demonstrate a significant influence of FCR groove morphology on FCR tendon fraying in CMC arthroplasty patients. We also did not find a significant association between the FCR tendon state and degree of radiographic CMC OA. Further studies should investigate the in vivo FCR tendon to evaluate its tearing and inflammation in relation to basilar thumb pain.

    View details for DOI 10.1177/15589447221120844

    View details for PubMedID 36050929

  • In vivo quantification of the 3D kinematics and coupling of the thumb base joints MEDICAL ENGINEERING & PHYSICS Sciacca, D., D'Agostino, P., Vanneste, M., Kerkhof, F., Vereecke, E. E. 2022; 106
  • Characterization of Trapezial Pommel in Relation to Radiographic and Wear Patterns in Carpometacarpal Osteoarthritis. Hand (New York, N.Y.) Bourdillon, A. T., Shapiro, L., Kerkhof, F. D., Segovia, N. A., Weiss, A. P., Ladd, A. L. 2022: 15589447221093670


    Trapezial pommel, or ulnar osteophyte positioned at the vertex of the saddle-shaped facet, is a consistent structural appearance in osteoarthritis (OA) of the first carpometacarpal. This study investigates its relation to radiographic measures (modified Eaton staging and thumb OA [ThOA] index) and wear patterns (trapezial surface morphology and cartilaginous eburnation).In all, 137 whole trapezia were explanted from 116 patients and evaluated for Eaton staging, morphology (saddle, cirque, or dish), and eburnation (degree of cartilaginous effacement) of the articular surface of the trapezium. In total, 131 Robert's views and 126 stress views were reviewed by 2 blinded senior surgeons for ThOA index and pommel size. Statistical analyses included Spearman correlation and linear regression.Standardized pommel size achieved good intrarater reliability (correlation coefficient: 0.80-0.98) and moderate interrater reliability (correlation coefficient: 0.60-0.67). The ThOA index and pommel size were significantly correlated across Robert's (rs = 0.51) and stress views (rs = 0.64). The ThOA index better distinguished between stages compared with pommel size. All the radiographic measures inversely correlated with preserved cartilage and varied across morphologies. Pommel size differed significantly between dish and saddle, and the ThOA index was significantly different between all morphologies when using stress views.We reliably quantified the pommel feature and demonstrated significant correlations with other radiographic and topologic measures of arthritic disease. If future studies can demonstrate that the pommel is a pathogenic process in ThOA and its correction can curb disease progression, the identification of the pommel feature may help guide targeted intervention.

    View details for DOI 10.1177/15589447221093670

    View details for PubMedID 35642728

  • Ultrasound of Thumb Muscles and Grasp Strength in Early Thumb Carpometacarpal Osteoarthritis. The Journal of hand surgery Lai, C., Kenney, D., Kerkhof, F., Finlay, A., Ladd, A., Roh, E. 2021


    PURPOSE: The pathophysiology of thumb carpometacarpal (CMC) osteoarthritis (OA) involves complex interactions between the ligaments and muscles supporting the joint. Factors such as muscle volume and strength may be more relevant in early disease. We used ultrasound as a noninvasive method to explore differences in the intrinsic hand muscles of patients with early CMC OA, as determined using physical exam and radiographs, and healthy controls. We also assessed differences in grip strength.METHODS: A convenience sample of postmenopausal women with early CMC OA diagnosed using a physical examination or radiographs was recruited from an orthopedic clinic specializing in hand surgery. Healthy controls who were matched for age and hand dominance were recruited from the same clinic. We used ultrasound to determine the length of the first metacarpal and the muscle thickness of the abductor pollicis brevis, opponens pollicis (OPP), and first dorsal interosseous. Grip strength measurements were taken using a standard Jamar dynamometer and 2 custom-designed tools for cylindrical grasp and pinch strength.RESULTS: Twenty-three subjects were enrolled, with a total of 32 thumbs measured: 15 thumbs with arthritis and 17 healthy thumbs. Multivariable logistic regression models indicated that thumbs with thicker OPP had 0.85 lower odds (95% CI= 0.71-0.97) of early OA, adjusting for hand dominance and the first metacarpal length. Linear regression models indicated no association between early OA and grip strength.CONCLUSIONS: The size of OPP may have a weak association with the diagnosis of early OA.CLINICAL RELEVANCE: This study supports further exploration of the role of OPP in stabilizing the CMC joint, particularly with regard to minimizing joint subluxation. This may be clinically relevant to providers who treat patients with CMC OA early in the course of the disease, when nonsurgical treatment is the most relevant.

    View details for DOI 10.1016/j.jhsa.2021.07.021

    View details for PubMedID 34509311

  • Radiographic Progression of Thumb CMC Osteoarthritis: A Systematic Review. Journal of hand surgery global online Shapiro, L. M., McQuillan, T. J., Kerkhof, F. D., Ladd, A. 2020; 2 (6): 343-348


    Thumb carpometacarpal (CMC) osteoarthritis (OA) is a prevalent disease that causes pain and disability. Determining the progression of CMC OA is problematic given the lack of consensus for classifications and scoring systems. We performed a systematic review to (1) determine which imaging modalities or scoring systems are used to evaluate CMC OA progression, and (2) describe the progression of CMC OA through available metrics.This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An English language literature search was performed in July 2019 and included studies evaluating CMC OA progression with an imaging modality or radiographic scoring system, with a minimum 1-year follow-up. Studies were analyzed with respect to their methodology, scoring systems, and relevant findings.The initial search yielded 4,097 articles, 10 of which met inclusion criteria. Study size varied from 32 to 289 subjects; many subjects were included in multiple cohorts. Eight studies used radiography whereas 2 used scintigraphy. Estimates of progression varied from 20% to 70% (with large variation in follow-up time); the magnitude of progression varied from 3% to 48% (joint space narrowing) and from 0.6 to 1 points (Kellgren-Lawrence scale). The percentage of subjects who progressed and the progression degree varied widely and depended on follow-up length and the scoring system used.A paucity of literature exists to measure CMC OA progression; there is a lack of uniformly accepted imaging modality, scoring system, or follow-up interval. This absence provides the opportunity to determine consensus techniques and metrics to assess the natural history of thumb CMC OA.Diagnostic III.

    View details for DOI 10.1016/j.jhsg.2020.09.001

    View details for PubMedID 35415524

    View details for PubMedCentralID PMC8991744

  • Mobility and structural constraints of the bonobo trapeziometacarpal joint BIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY Van Leeuwen, T., Vanneste, M., Kerkhof, F. D., D'Agostino, P., Vanhoof, M. M., Stevens, J. G., Van Lenthe, G., Vereecke, E. E. 2019; 127 (3): 681–93
  • Relating Trapeziometacarpal Joint Morphology to Functional Capabilities in the Primate Thumb van Leeuwen, T., Vanneste, M., Kerkhof, F. D., Stevens, J. G., Vereecke, E. E. WILEY. 2019: S232
  • Trapeziometacarpal stabilization through dorsoradial ligament reconstruction: An early post-surgery in vivo biomechanical analyses JOURNAL OF ORTHOPAEDIC RESEARCH Kerkhof, F. D., Vereecke, E. E., Vanovermeire, O., Vanhaecke, J., Vanneste, M., Stockmans, F. 2018; 36 (11): 2851–64


    Ligament reconstruction can provide pain relief in patients with a painful, unstable, pre-arthritic trapeziometacarpal (TMC) joint. Imbrication of the dorsoradial ligament (DRL) has been proposed as a minimal invasive stabilization technique. It requires less invasive surgery than an Eaton-Littler technique and shows promising long-term clinical outcome. We used dynamic CT to objectively review the effects of the imbrication. Four patients with pain and laxity at the TMC joint, but without radiographic signs of osteoarthritis, were recruited. Dynamic CT scans were made during active thumb abduction-adduction, flexion-extension, and two functional grip tasks using a radiolucent jig. Scans of the patients were acquired before and 3 to 6 months after DRL reconstruction. Motion of each bone in the articular chain of the thumb was quantified. In addition, we mapped changes in the contact patterns between the articular facets during the entire thumb motion. After DRL imbrication, we found no overall decrease in MC1 movement in three out of four patients. Furthermore, no increase in TMC joint congruency, defined as proximity area size, was found for three out of four patients. Pre- and post-operative differences in congruency across different tasks were patient-dependent and relatively small. We demonstrated that, from a biomechanical perspective, there is high variability in post-operative outcome between patients that undergo identical surgical procedures performed by the same surgeon. A post-operative decrease in range of motion, increase in joint congruency or decrease in proximity area shift during thumb motion is not omnipresent. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2851-2864, 2018.

    View details for DOI 10.1002/jor.24103

    View details for Web of Science ID 000453696100004

    View details for PubMedID 29947128

  • The digital human forearm and hand JOURNAL OF ANATOMY Kerkhof, F. D., van Leeuwen, T., Vereecke, E. E. 2018; 233 (5): 557–66


    How changes in anatomy affect joint biomechanics can be studied using musculoskeletal modelling, making it a valuable tool to explore joint function in healthy and pathological joints. However, gathering the anatomical, geometrical and physiological data necessary to create a model can be challenging. Very few integrated datasets exist and even less raw data is openly available to create new models. Therefore, the goal of the present study is to create an integrated digital forearm and make the raw data available via an open-access database. An un-embalmed cadaveric arm was digitized using 7T MRI and CT scans. 3D geometrical models of bones, cartilage, muscle and muscle pathways were created. After MRI and CT scanning, physiological muscle parameters (e.g. muscle volume, mass, length, pennation angle, physiological cross-sectional area, tendon length) were obtained via detailed dissection. After dissection, muscle biopsies were fixated and confocal microscopy was used to visualize and measure sarcomere lengths. This study provides an integrated anatomical dataset on which complete and accurate musculoskeletal models of the hand can be based. By creating a 3D digital human forearm, including all relevant anatomical parameters, a more realistic musculoskeletal model can be created. Furthermore, open access to the anatomical dataset makes it possible for other researchers to use these data in the development of a musculoskeletal model of the hand.

    View details for DOI 10.1111/joa.12877

    View details for Web of Science ID 000447145700001

    View details for PubMedID 30225930

  • Insights into the musculature of the bonobo hand JOURNAL OF ANATOMY van Leeuwen, T., Vanhoof, M. M., Kerkhof, F. D., Stevens, J. G., Vereecke, E. E. 2018; 233 (3): 328–40


    The human hand is well known for its unique dexterity which is largely facilitated by a highly mobile, long and powerful thumb that enables both tool manufacturing and use, a key component of human evolution. The bonobo (Pan paniscus), the closest extant relative to modern humans together with the chimpanzee (Pan troglodytes), also possesses good manipulative capabilities but with a lower level of dexterity compared with modern humans. Despite the close phylogenetic relationship between bonobos and humans, detailed quantitative data of the bonobo forelimb musculature remains largely lacking. To understand how morphology may influence dexterity, we investigated the functional anatomy of the bonobo hand using a unique sample of eight bonobo cadavers, along with one chimpanzee and one human (Homo sapiens) cadaver. We performed detailed dissections of unembalmed specimens to collect quantitative datasets of the extrinsic and intrinsic hand musculature, in addition to qualitative descriptions of the forelimb muscle configurations, allowing estimation of force-generating capacities for each functional group. Furthermore, we used medical imaging to quantify the articular surface of the trapeziometacarpal joint to estimate the intra-articular pressure. Our results show that the force-generating capacity for most functional groups of the extrinsic and intrinsic hand muscles in bonobos is largely similar to that of humans, with differences in relative importance of the extensors and rotators. The bonobo thumb musculature has a lower force-generating capacity than observed in the human specimen, but the estimated maximal intra-articular pressure is higher in bonobos. Most importantly, bonobos show a higher degree of functional coupling between the muscles of the thumb, index and lateral fingers than observed in humans. It is conceivable that differentiation and individualization of the hand muscles rather than relative muscle development explain the higher level of dexterity of humans compared with that of bonobos.

    View details for DOI 10.1111/joa.12841

    View details for Web of Science ID 000440996700005

    View details for PubMedID 29938781

  • In vivo biomechanical behavior of the trapeziometacarpal joint in healthy and osteoarthritic subjects CLINICAL BIOMECHANICS D'Agostino, P., Dourthe, B., Kerkhof, F., Van Lenthe, G., Stockmans, F., Vereecke, E. E. 2017; 49: 119–27


    The contact biomechanics of the trapeziometacarpal joint have been investigated in several studies. However, these led to conflicting results and were mostly performed in vitro. The purpose of this study was to provide further insight on the contact biomechanics of the trapeziometacarpal joint by in vivo assessment of healthy and osteoarthritic subjects.The hands of 16 healthy women and 6 women with trapeziometacarpal osteoarthritis were scanned in positions of maximal thumb extension, flexion, abduction and adduction during three isometric tasks (lateral key pinch, power grasp and jar twist) and in thumb rest posture (relaxed neutral). Three-dimensional surface models of the trapezium and first metacarpal were created for each thumb configuration. The articular surface of each bone was measured in the neutral posture. A computed tomography-based proximity mapping algorithm was developed to calculate the distance between opposing joint surfaces, which was used as a surrogate for intra-articular stress.Distinct proximity patterns were observed across tasks with a recurrent pattern reported on the volar aspect of the first metacarpal. The comparison between healthy and arthritic subjects showed a significantly larger articular area, in parallel with a significant joint space narrowing and an increase in proximity area in arthritic subjects. We also observed severe articular deformations in subjects with late stage osteoarthritis.This study has increased our insight in the contact biomechanics of the trapeziometacarpal joint during tasks and positions of daily life in healthy and arthritic subjects, which might contribute to a better understanding of the occurrence mechanisms of degenerative diseases such as osteoarthritis.

    View details for DOI 10.1016/j.clinbiomech.2017.09.006

    View details for Web of Science ID 000416881700019

    View details for PubMedID 28934632

  • In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism JOURNAL OF ORTHOPAEDIC RESEARCH D'Agostino, P., Dourthe, B., Kerkhof, F., Stockmans, F., Vereecke, E. E. 2017; 35 (7): 1556–64


    The thumb plays a crucial role in basic hand function. However, the kinematics of its entire articular chain have not yet been quantified. Such investigation is essential to improve our understanding of thumb function and to develop better strategies to treat thumb joint pathologies. The primary objective of this study is to quantify the in vivo kinematics of the trapeziometacarpal (TMC) and scaphotrapezial (ST) joints during flexion and adduction of the thumb. In addition, we want to evaluate the potential coupling between the TMC and ST joints during these tasks. The hand of 16 asymptomatic women without signs of thumb osteoarthritis were CT scanned in positions of maximal thumb extension, flexion, abduction, and adduction. The CT images were segmented and three-dimensional surface models of the radius, scaphoid, trapezium, and the first metacarpal were created for each thumb motion. The corresponding rotations angles, translations, and helical axes were calculated for each sequence. The analysis shows that flexion and adduction of the thumb result in a three-dimensional rotation and translation of the entire articular chain, including the trapezium and scaphoid. A wider range of motion is observed for the first metacarpal, which displays a clear axial rotation. The coupling of axial rotation of the first metacarpal with flexion and abduction during thumb flexion supports the existence of a screw-home mechanism in the TMC joint. In addition, our results point to a potential motion coupling between the TMC and ST joints and underline the complexity of thumb kinematics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1556-1564, 2017.

    View details for DOI 10.1002/jor.23421

    View details for Web of Science ID 000404354200024

    View details for PubMedID 27606961

  • Subject-specific thumb muscle activity during functional tasks of daily life JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY Kerkhof, F. D., Deleu, G., D'Agostino, P., Vereecke, E. E. 2016; 30: 131–36


    The trapeziometacarpal joint is subjected to high compressive forces during powerful pinch and grasp tasks due to muscle loading. In addition, muscle contraction is important for stability of the joint. The aim of the present study is to explore if different muscle activation patterns can be found between three functional tasks.Isometric forces and fine-wire electromyographic (fEMG) activity produced by three intrinsic and four extrinsic thumb muscles were measured in 10 healthy female volunteers. The participants performed isometric contractions in a lateral key pinch, a power grasp and a jar twist task. The tasks were executed with and without EMG recording to verify if electrode placement influenced force production.A subject-specific muscle recruitment was found which remained largely unchanged across tasks. Extrinsic thumb muscles were significantly more active than intrinsic muscles in all tasks. Insertion of the fEMG electrodes decreased force production significantly in all tasks.The thumb muscles display a high variability in muscle activity during functional tasks of daily life. The results of this study suggest that to produce a substantial amount of force, a well-integrated, but subject-specific, co-contraction between the intrinsic and extrinsic thumb muscles is necessary.

    View details for DOI 10.1016/j.jelekin.2016.06.009

    View details for Web of Science ID 000389027400017

    View details for PubMedID 27403854

  • Quantifying thumb opposition kinematics using dynamic computed tomography JOURNAL OF BIOMECHANICS Kerkhof, F. D., Brugman, E., D'Agostino, P., Dourthe, B., van Lenthe, G. H., Stockmans, F., Jonkers, I., Vereecke, E. E. 2016; 49 (9): 1994–99


    Current motion capture techniques all have shortcomings when applied to the 3D quantitative evaluation of thumb base motion. Dynamic CT might overcome these shortcomings but, so far, robustness of this technique in more than one specimen has not yet been demonstrated. The aim of the current study is to further evaluate the use of dynamic CT for quantification of thumb motion in a larger cadaveric study using a protocol which is feasible in a clinical context. A dynamic CT scan was acquired from six cadaveric human forearms, while a motion simulator imposed thumb opposition. After image acquisition and segmentation, carpal bone motion was quantified using helical axes. To enable comparisons between specimens, intersection points of the instantaneous helical axis with an anatomically defined plane were determined. Precision of the dynamic CT method, measured as variation in distances between silicon nitride beads between frames of a dynamic scan, was 0.43mm (+/-0.09mm) when fixed to the skin and 0.13mm (+/-0.04mm) when embedded into the bone. Absolute deviation between known and measured distances were not larger than 0.34mm. We could demonstrate and quantify that thumb opposition is associated with motion at the trapeziometacarpal and scaphotrapezotrapezoidal joints. High consistency in motion patterns between specimen were found, while the radiation dose was limited. We conclude that dynamic CT can be used to visualize and quantify 3D thumb kinematics, making it a promising method to explore kinematics in vivo.

    View details for DOI 10.1016/j.jbiomech.2016.05.008

    View details for Web of Science ID 000377731200081

    View details for PubMedID 27198890

  • In vivo contact biomechanics in the trapeziometacarpal joint using finite deformation biphasic theory and mathematical modelling MEDICAL ENGINEERING & PHYSICS Dourthe, B., D'Agostino, P., Stockmans, F., Kerkhof, F., Vereecke, E. 2016; 38 (2): 108–14


    The assessment of the contact biomechanics in the trapeziometacarpal (TMC) joint during functional tasks represents a relevant way to obtain a better understanding of the onset of osteoarthritis (OA). CT scans of the hand region of 20 female volunteers were taken in relaxed neutral, lateral key pinch and power grasp configuration. 3D models of the first metacarpal (MC1) and the trapezium were created. The articular area of each bone was quantified and a mathematical model was developed in Matlab to evaluate the projected contact area and stress distribution of each bone. The articular areas of the MC1 and the trapezium presented no significant difference. A slightly smaller projected contact area was calculated for the trapezium compared to the MC1. Similar amounts of stress were reported in the neutral and lateral pinch configurations. The highest stress levels were observed during power grasp. Very consistent results for high stress location on the volar/radial articular sub-region were found in the neutral and power grasp configurations. More variation was reported during lateral pinch. The mathematical model presented in this paper offers the possibility to predict contact patterns within the TMC joint based on in vivo CT images.

    View details for DOI 10.1016/j.medengphy.2015.11.003

    View details for Web of Science ID 000371099900006

    View details for PubMedID 26654104

  • SEGMENTATION OF 4D CT BONE IMAGES BY SEQUENTIAL REGISTRATION Van Dijck, C., Kerkhof, F., Vereecke, E., Wirix-Speetjens, R., Vander Sloten, J., IEEE IEEE. 2015: 621–24
  • Comparison of the Anatomical Dimensions and Mechanical Properties of the Dorsoradial and Anterior Oblique Ligaments of the Trapeziometacarpal Joint JOURNAL OF HAND SURGERY-AMERICAN VOLUME D'Agostino, P., Kerkhof, F. D., Shahabpour, M., Moermans, J., Stockmans, F., Vereecke, E. E. 2014; 39 (6): 1098–1107


    The respective roles of the dorsoradial (DRL) and anterior oblique (AOL) ligaments in stability of the highly mobile trapeziometacarpal (TMC) joint remain disputed. Earlier publications have pointed to the AOL as the key stabilizing structure; yet, more recent publications have challenged the stabilizing role of the AOL, favoring the DRL as the main TMC joint stabilizer. We executed an anatomical study of the ligaments, including detailed dissection to quantify the length, width, and thickness of the AOL and DRL and tested the material properties of these ligaments.Thirteen fresh frozen cadaveric thumbs from 9 specimens were used. Length, width, and thickness of the AOL and DRL were measured on magnetic resonance imaging and/or after dissection. Next, the first metacarpal and trapezium were isolated together with both ligaments, and both bones were cut sagittally to isolate a first metacarpal-AOL-trapezium and first metacarpal-DRL-trapezium complex from each thumb. These samples were subjected to cyclic loading in displacement-controlled tests. The obtained force-displacement curves were used to calculate stiffness and hysteresis of each sample.Our results showed that the DRL is significantly shorter and thicker than the AOL, which is thin and ill-defined. Our results also indicate that the DRL has a higher stiffness than the AOL, making it a more likely candidate to provide joint stability.Although the AOL has been asserted to be the primary restraint to dorsoradial subluxation, this view has been challenged over the past 10 years by several studies. These studies have shown the AOL to be relatively weak and compliant compared with the intermetacarpal and dorsoradial ligaments and have demonstrated that the DRL is the strongest and stiffest ligament of the TMC joint. Our studies confirm these findings.This study indicates that the DRL is relatively stiff and thick, suggesting it should be repaired or reconstructed when disrupted to restore stability of the TMC joint.

    View details for DOI 10.1016/j.jhsa.2014.02.025

    View details for Web of Science ID 000337011000010

    View details for PubMedID 24810939

  • Physical strain of handcycling: An evaluation using training guidelines for a healthy lifestyle as defined by the American College of Sports Medicine JOURNAL OF SPINAL CORD MEDICINE Hettinga, F. J., de Groot, S., van Dijk, F., Kerkhof, F., Woldring, F., van der Woude, L. 2013; 36 (4): 376–82


    Developments in assistive technology such as handcycling provide attractive possibilities to pursue a healthy lifestyle for patients with spinal cord injury. The objective of the study is to evaluate physical stress and strain of handcycling against training guidelines as defined by the American College of Sports Medicine (ACSM).Seven able-bodied males conducted an incremental peak exercise handcycling test on a treadmill. In addition, two indoor treadmill (1.3 m/second with an inclination of 0.7% and 1.0 m/second with an inclination of 4.8%) and three outdoor over ground exercise bouts were performed (1.7, 3.3, and 5.0 m/second). One individual handcycled a representative 8-km-distance outdoors.Physical stress and strain were described in terms of absolute and relative power output, oxygen uptake (VO2), gross efficiency (GE), and heart rate (HR). Also, local perceived discomfort (LPD) was determined.Relative handcycling exercise intensities varied between 23.3 ± 4.2 (below the ACSM lower limit of 46%VO2peak) and 72.5 ± 15.1%VO2peak (well above the ACSM lower limit), with GE ranging from 6.0 ± 1.5% at the lower to 13.0 ± 2.6% at the higher exercise intensities. Exercise intensities were performed at 49.8 ± 4.2 to 80.1 ± 10.5%HRpeak. LPD scores were low to moderate (<27 ± 7).Handcycling is relatively efficient and exercise intensities > 46%VO2peak were elicited. However, exercise load seems to be underestimated using %HRpeak. LPD was not perceived as limiting. Physiological stress and strain in able-bodied individuals appear to be comparable to individuals with a paraplegia. To understand individualize and optimize upper-body training, different training programs must be evaluated.

    View details for DOI 10.1179/2045772313Y.0000000127

    View details for Web of Science ID 000321574200013

    View details for PubMedID 23820153

    View details for PubMedCentralID PMC3758534

  • Human hand function and dysfunction: what insights can be gained from comparative anatomy and musculoskeletal computer models? Vereecke, E. E., Kerkhof, F., Stockmans, F., Jonkers, I., Van Sint Jan, S. WILEY-BLACKWELL. 2012: 292