Hand Size Measurements in Children Aged 1-15 Years to Help the Development of Pediatric Electromyography Sensors for Neuromuscular Monitoring.

Background/

Objectives

The aim of this observational study was to collect hand measurements and anthropometric data in children aged 1-15 years of age to help the design of a pediatric skin electrode for electromyography-based neuromuscular monitoring.

Methods

Data collection was performed at the Pediatric Department of the University of Debrecen Medical Centre between 1 December 2019 and 31 January 2021. After gaining written informed consent from the parents or legal representatives and verbal acceptance from age-appropriate (12-35 months) patients, a total of 153 children were enrolled. The following parameters were recorded: demographics (age, sex, weight, height, and hand dominance) and hand size parameters, defined as the distance between the following reference points: the ulnar groove and the midpoint of the hypothenar eminence (A); the midpoint of the hypothenar eminence and the first interphalangeal joint of the 5th finger (B); the ulnar groove and the midpoint of the thenar eminence (C); the midpoint of the thenar eminence and the interphalangeal joint of the thumb (D); the midpoint of the wrist crease and the tip of the third finger; wrist circumference (E); and forearm length. All measurements were made in centimeters (cm).

Results

The children were divided into 4 groups (12-23 months, 2-5 years, 6-11 years and 12+ years). The number of children in the groups ranged between 6 and 16. The hand size parameters increased according to the children's age (A: 4.3 ± 0.4, 5.0 ± 0.7, 6.3 ± 0.6, and 6.9 ± 1.0 cm; B: 3.2 ± 0.4, 4.1 ± 0.7, 5.0 ± 0.6, and 5.9 ± 0.6 cm; C: 3.0 ± 0.3, 3.6 ± 0.7, 4.1 ± 0.6, and 4.9 ± 0.6 cm; D: 4.1 ± 0.4, 4.8 ± 0.8, 6.2 ± 0.8, and 7.2 ± 0.9 cm; E: 10.1 ± 0.6, 12.0 ± 1.1, 15.3 ± 1.3, and 17.7 ± 1.7 cm, respectively, in the four groups, [mean ± SD]). The height of the children showed a closer correlation with hand size parameters (Pearson's correlation coefficients: 0.702-0.961) than with age (0.665-0.904) or weight (0.675-0.863). The correlation was weaker when data were examined in prespecified age groups.

Conclusions

The current pediatric hand size database provides previously unavailable information that was used in one manufacturer's design, which may help with the future design of pediatric electrodes of electromyography-based neuromuscular monitors; this information may facilitate adoption of quantitative neuromuscular monitoring in routine pediatric anesthesia practice.