Hand function in children is very important in the development of skills needed for daily childhood activities; therefore, preserving this function warrants special attention. One of the interventions aiming to preserve functionis splinting of the affected wrist joint. The rationale for the use of splinting is to balance rest and activity, therebypreserving wrist function. However, the evidence-based knowledge to support this rationale is scarce. To determine the validity of “balancing rest and activity of the affected wrists to preserve function,” we reviewed ourown data, data in the literature regarding rheumatic wrist problems in children, and data from a 15-year followup study of rheumatic wrist problems in an adult cohort of our adult rheumatology counterpart within the medicalcenter.
Force transmission across the wrist during a grasping maneuver of the hand was simulated for three children with juvenile idiopathic arthritis (JIA) and for one healthy age-matched child. Joint reaction forces were estimated using a series of springs between articulating bones. This method (i.e., rigid body spring modeling) has proven useful for examining loading profiles for normally aligned wrists. A novel method (i.e., sliding rigid body spring modeling) designed specifically for studying joint reaction forces of the malaligned JIA wrist is presented in this paper. Loading profiles across the wrist for the unimpaired child were similar using both spring modeling methods. However, the traditional fixed-end method failed to converge to a solution for one of the JIA subjects indicating the sliding model may be more suitable for investigating loading profiles of the malaligned wrist. The results of this study suggest that a larger proportion of force is transferred through the ulno-carpal joint of the JIA wrist than for healthy subjects, with a less than normal proportion of force transferred through the radio-carpal joint. In addition, the ulnar directed forces along the shear axis defined in this study were greater for all three JIA children compared to values for the healthy child. These observations are what were hypothesized for an individual with JIA of the wrist.
Het lectoraat Armoede Interventies van de Hogeschool van Amsterdam (HvA) deed vijf jaar lang onderzoek onder 85 projecten die zich richten op het bevorderen van financiële zelfredzaamheid van mensen met schulden of dreigende schulden. De projecten én het onderzoek werden gefinancierd door Nationale Nederlanden en Aegon. De inzichten uit het onderzoek zijn gebundeld in het boek ‘Van Schulden naar Kansen: Weten Wat Werkt’. Senior onderzoeker en projectleider Jodi Mak, die het onderzoek met haar team uitvoerde onder supervisie van lector Roeland van Geuns, maakt het onderzoek én de uitkomsten voor Tijdschrift Schuldsanering inzichtelijk.
