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Kodama A, Kurumadani H, Tanaka T, Shinomiya R, Sunagawa T, Adachi N. Association between three-dimensional motion analysis of the thumb and clinical parameters in patients with carpal tunnel syndrome. J Hand Surg Eur Vol 2024; 49:452-457. [PMID: 37873759 DOI: 10.1177/17531934231203163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
We analysed the relationship between motor dysfunction of the thumb and the clinical parameters of carpal tunnel syndrome using three-dimensional motion analysis. This single-centred, prospective study included 65 hands in 51 patients with idiopathic carpal tunnel syndrome and 30 healthy hands. Three-dimensional thumb kinematics were acquired using a motion capture system with a retroreflective surface-based marker method. The trajectory area of thumb tip, adduction and abduction of the trapeziometacarpal joints and metacarpophalangeal joints were correlated with the clinical parameters. There was no significant correlation between the results of motion analysis values and patient-reported outcomes measures. Thumb movement disorder associated with carpal tunnel syndrome affected specific activities of daily living based on the pinching movements, such as 'writing' and 'buttoning clothes' among the patient-reported outcome measure items.Level of evidence: III.
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Affiliation(s)
- Akira Kodama
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Kurumadani
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Teruyasu Tanaka
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Rikuo Shinomiya
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toru Sunagawa
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Li L, Li Y, Jia P, Wang S, Wang W, Liu Y. Effect of pinch types on pinch force sense in healthy adults. Front Hum Neurosci 2022; 16:990431. [PMID: 36393992 PMCID: PMC9643592 DOI: 10.3389/fnhum.2022.990431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022] Open
Abstract
Pinch force sense plays an important role in the performance of daily finger movements, including tip, key, palmar pinch. The present study investigated the roles of pinch type in the sensation of pinch force among healthy participants in the ipsilateral force reproduction trial. This study instructed forty healthy adult subjects (20 women and 20 men) in producing reference forces at different levels [10, 30, 50% maximal voluntary isometric contraction (MVIC)] by adopting 3 pinch types (tip, key, and palmar pinches) and in reproducing the above force levels with the identical hand. Our study revealed that subjects are significantly more sensitive detecting alterations of pinching forces with tip pinch but not key or palmar pinch under high forces (30 and 50% MVIC) but not at lower force levels (10% MVIC).
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Affiliation(s)
- Lin Li
- Department of Physical Education, Renmin University of China, Beijing, China
| | - YanXia Li
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
- *Correspondence: YanXia Li,
| | - Peng Jia
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
| | - Shuyan Wang
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
| | - Wanpeng Wang
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
| | - Yuxiang Liu
- College of Physical Education, Langfang Normal University, Langfang, Hebei, China
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Reschechtko S, Wang H, Alendry K, Benson C, Hahn B, Zhang W. Effect of Sensory Deprivation on Maximal Force Abilities from Local to Non-local Digits. J Mot Behav 2019; 52:58-70. [PMID: 30848722 DOI: 10.1080/00222895.2019.1580670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present study investigates the effect of sensory deprivation of the index and middle finger on motor function of all digits during maximal voluntary force production tasks. A total of 27 subjects performed maximal isometric pressing tasks by using different instructed finger combinations. Subjects completed the same tasks in two visits: a control visit when they had normal sensory feedback in all fingers, and an anesthesia visit when digital nerve blocks were performed on their right index and middle fingers. We evaluated three aspects of motor adaptation on both local (anesthetized) and non-local (non-anesthetized) digits during maximal force production: (1) task-relevant and overall force magnitude, (2) force directional application, and (3) digital individuation and force sharing. Our results indicate that selective digital anesthesia resulted in decreased maximal force magnitude, changed direction of force production, and significant changes extended to non-local digits. The motor weakness and inefficiency revealed in the non-local digits implies that sensory information from each digit can be shared across the digits to assist motor execution within the same hand.
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Affiliation(s)
- Sasha Reschechtko
- Department of Physical Therapy, College of Staten Island, City University of New York, Staten Island, NY, USA.,Department of Kinesiology, The Pennsylvania State University, State College, PA, USA
| | - Hu Wang
- Department of Physical Therapy, College of Staten Island, City University of New York, Staten Island, NY, USA
| | - Kerlin Alendry
- Department of Physical Therapy, College of Staten Island, City University of New York, Staten Island, NY, USA
| | - Cynthia Benson
- Emergency Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Barry Hahn
- Emergency Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Wei Zhang
- Department of Physical Therapy, College of Staten Island, City University of New York, Staten Island, NY, USA.,Ph.D. Program in Biology, Graduate School and University Center, City University of New York, New York, NY, USA
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Grandy EL, Xiu K, Marquardt TL, Li C, Evans PJ, Li ZM. Carpal tunnel syndrome impairs index finger responses to unpredictable perturbations. J Electromyogr Kinesiol 2017; 38:197-202. [PMID: 28343885 DOI: 10.1016/j.jelekin.2017.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/15/2022] Open
Abstract
The fine-tuning of digit forces to object properties can be disrupted by carpal tunnel syndrome (CTS). CTS' effects on hand function have mainly been investigated using predictable manipulation tasks; however, unpredictable perturbations are commonly encountered during manual tasks, presenting situations which may be more challenging to CTS patients given their hand impairments. The purpose of this study was to investigate muscle and force responses of the index finger to unpredictable perturbations in patients with CTS. Nine CTS patients and nine asymptomatic controls were instructed to stop the movement of a sliding plate by increasing index finger force following an unexpected perturbation. The electrical activity of the first dorsal interosseous muscle and forces exerted by the index finger were recorded. CTS patients demonstrated 20.9% greater muscle response latency and 12.0% greater force response latency compared to controls (p<0.05). The duration of plate sliding was significantly different between groups (p<0.05); the CTS group's duration was 142.2±5.8ms compared to the control group's duration of 133.1±8.4ms. Although CTS patients had increased muscle and force response durations comparatively, these differences were not statistically significant. Findings from this study suggest CTS-induced sensorimotor deficits interfere with accurate detection, processing and response to unpredictable perturbations. These deficits could be accounted for at multiple levels of the peripheral and central nervous systems. Delayed and decreased responses may indicate inefficient object manipulation by CTS patients and may help to explain why CTS patients tend to drop objects.
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Affiliation(s)
- Emily L Grandy
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States.
| | - Kaihua Xiu
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States.
| | - Tamara L Marquardt
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States.
| | - Chengliu Li
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States.
| | - Peter J Evans
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, United States.
| | - Zong-Ming Li
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, United States; Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, United States.
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Carteron A, McPartlan K, Gioeli C, Reid E, Turturro M, Hahn B, Benson C, Zhang W. Temporary Nerve Block at Selected Digits Revealed Hand Motor Deficits in Grasping Tasks. Front Hum Neurosci 2016; 10:596. [PMID: 27932964 PMCID: PMC5122577 DOI: 10.3389/fnhum.2016.00596] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/09/2016] [Indexed: 01/04/2023] Open
Abstract
Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of peripheral deafferentation through digital nerve blocks at selective digits on motor performance and motor coordination in grasp control. Our results suggested that the absence of somatosensory information induced motor deficits in hand grasp control, as evidenced by reduced maximal force production ability in both local and non-local digits, impairment of force and moment control during object lift and hold, and attenuated motor synergies in stabilizing task performance variables, namely the tangential force and moment of force. These findings implied that individual sensory input is shared across all the digits and the disturbed signal from local sensory channel(s) has a more comprehensive impact on the process of the motor output execution in the sensorimotor integration process. Additionally, a feedback control mechanism with a sensation-based component resides in the formation process for the motor covariation structure.
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Affiliation(s)
- Aude Carteron
- Department of Physical Therapy, College of Staten Island, City University of New York Staten Island, NY, USA
| | - Kerry McPartlan
- Department of Physical Therapy, College of Staten Island, City University of New York Staten Island, NY, USA
| | - Christina Gioeli
- Department of Physical Therapy, College of Staten Island, City University of New York Staten Island, NY, USA
| | - Emily Reid
- Department of Physical Therapy, College of Staten Island, City University of New York Staten Island, NY, USA
| | - Matt Turturro
- Department of Physical Therapy, College of Staten Island, City University of New York Staten Island, NY, USA
| | - Barry Hahn
- Emergency Medicine, Staten Island University Hospital Staten Island, NY, USA
| | - Cynthia Benson
- Emergency Medicine, Staten Island University Hospital Staten Island, NY, USA
| | - Wei Zhang
- Department of Physical Therapy, College of Staten Island, City University of New YorkStaten Island, NY, USA; Ph.D. Program in Biology, Graduate School and University Center, City University of New YorkNew York, NY, USA
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Nataraj R, Evans PJ, Seitz WH, Li ZM. Pathokinematics of precision pinch movement associated with carpal tunnel syndrome. J Orthop Res 2014; 32:786-92. [PMID: 24536036 PMCID: PMC4010872 DOI: 10.1002/jor.22600] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/24/2014] [Indexed: 02/04/2023]
Abstract
Carpal tunnel syndrome (CTS) can adversely affect fine motor control of the hand. Precision pinch between the thumb and index finger requires coordinated movements of these digits for reliable task performance. We examined the impairment upon precision pinch function affected by CTS during digit movement and digit contact. Eleven CTS subjects and 11 able-bodied (ABL) controls donned markers for motion capture of the thumb and index finger during precision pinch movement (PPM). Subjects were instructed to repetitively execute the PPM task, and performance was assessed by range of movement, variability of the movement trajectory, and precision of digit contact. The CTS group demonstrated shorter path-length of digit endpoints and greater variability in inter-pad distance and most joint angles across the PPM movement. Subjects with CTS also showed lack of precision in contact points on the digit-pads and relative orientation of the digits at contact. Carpal tunnel syndrome impairs the ability to perform precision pinch across the movement and at digit-contact. The findings may serve to identify deficits in manual dexterity for functional evaluation of CTS.
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Affiliation(s)
- Raviraj Nataraj
- Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation; Cleveland Clinic; Cleveland Ohio
| | - Peter J. Evans
- Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation; Cleveland Clinic; Cleveland Ohio
| | - William H. Seitz
- Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation; Cleveland Clinic; Cleveland Ohio
| | - Zong-Ming Li
- Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation; Cleveland Clinic; Cleveland Ohio
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Kuo LC, Hsu HM, Wu PT, Lin SC, Hsu HY, Jou IM. Impact of distal median neuropathy on handwriting performance for patients with carpal tunnel syndrome in office and administrative support occupations. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:332-343. [PMID: 23934582 DOI: 10.1007/s10926-013-9471-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE This study investigates the handwriting performance of patients with carpal tunnel syndrome (CTS) and healthy controls in office and administrative support occupations, adopting both biomechanical and functional perspectives. This work also explores how surgical intervention altered the performance of the CTS patients. METHODS Fourteen CTS patients and 14 control subjects were recruited to complete a self-reported survey and participate in sensory tests, hand strength, dexterity and handwriting tasks using a custom force acquisition pen along with motion capture technology. Based on the results of these, the sensory measurements, along with functional and biomechanical parameters, were used to determine the differences between the groups and also reveal any improvements that occurred in the CTS group after surgical intervention. RESULTS The CTS patients showed significantly poorer hand sensibility and dexterity than the controls, as well as excessive force exertion of the digits and pen tip, and less efficient force adjustment ability during handwriting. After surgery and sensory recovery, the hand dexterity and pen tip force of the CTS patients improved significantly. The force adjustment abilities of the digits also increased, but these changes were not statistically significant. CONCLUSIONS This study provides the objective measurements and novel apparatus that can be used to determine impairments in the handwriting abilities of office or administrative workers with CTS. The results can also help clinicians or patients to better understand the sensory-related deficits in sensorimotor control of the hand related to CTS, and thus develop and implement more suitable training or adaptive protocols.
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Affiliation(s)
- Li-Chieh Kuo
- Department of Occupational Therapy, National Cheng Kung University, 1 University Rd., Tainan, 701, Taiwan,
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Jahn J, Janes WE, Saheb-Al-Zamani M, Burbank CM, Brown JM, Engsberg JR. Identification of three movement phases of the hand during lateral and pulp pinches using video motion capture. Hand (N Y) 2013; 8:123-31. [PMID: 24426908 PMCID: PMC3652995 DOI: 10.1007/s11552-013-9517-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hand injuries affect a person's ability to engage successfully in activities of daily living (ADLs). Video motion capture (VMC) facilitates measurement of dynamic movement. No study to date has used VMC as a means of quantifying the simultaneous movement patterns of all joints of all digits of the hand during active purposeful movement. METHOD The purpose of this study was to analyze all joints of all five digits during active completion of the lateral and pulp pinches. VMC data were collected from four participants during completion of two pinches. Joint angles were plotted to facilitate identification of movement patterns. RESULTS Range of motion recorded in all joints with VMC, excluding flexion of the thumb carpometacarpal of both pinches, coincided with the normative goniometric data. Three phases were observed: initiation, preshaping, and pinch phases. Patterns of movement in all digits were identified for the two pinches. CONCLUSION VMC is a feasible and valid method for objectively quantifying dynamic movement of multiple joints simultaneously. The results provide new insight to the dynamics of hand movement as well as a basis for subsequent evaluations of movement patterns performed in ADLs and instrumental ADLs.
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Affiliation(s)
- Johanna Jahn
- />Program in Occupational Therapy, Washington University School of Medicine, Campus Box 8505, 4444 Forest Park Avenue, St. Louis, MO 63108 USA
| | - William E. Janes
- />Program in Occupational Therapy, Washington University School of Medicine, Campus Box 8505, 4444 Forest Park Avenue, St. Louis, MO 63108 USA
| | - Maryam Saheb-Al-Zamani
- />Washington University School of Medicine, 660 South Euclid Street, St. Louis, MO 63108 USA
| | - Caitlin M. Burbank
- />Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 1101, St. Louis, MO 63108 USA
| | - Justin M. Brown
- />Department of Neurosurgery, University of California, San Diego, 3855 Health Sciences Drive MC 0987, La Jolla, CA 92093-0987 USA
| | - Jack R. Engsberg
- />Program in Occupational Therapy, Washington University School of Medicine, Campus Box 8505, 4444 Forest Park Avenue, St. Louis, MO 63108 USA
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Li K, Li ZM. Cross recurrence quantification analysis of precision grip following peripheral median nerve block. J Neuroeng Rehabil 2013; 10:28. [PMID: 23453041 PMCID: PMC3599398 DOI: 10.1186/1743-0003-10-28] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 02/21/2013] [Indexed: 11/23/2022] Open
Abstract
Background Precision grip by the thumb and index finger is vulnerable to sensorimotor deficits. Traditional biomechanical parameters offer limited insight into the dynamical coordination between digits during precision grip. In this study, the thumb and index finger were viewed as “coupled systems”, and a cross recurrence quantification analysis (CRQA) was used to examine the changes of interdigit dynamics and synchronization caused by peripheral median nerve block. Methods Seven subjects performed a precision grip by holding an instrumented handle before and after median nerve block at the wrist. The forces and the torques at each digit-handle interface were recorded with two six-component transducers. For CRQA, the percentage of recurrence rate (%RR), percentage of determinism (%DET), longest diagonal line (Lmax) and percentage of laminarity (%LAM) were computed for the force, torque and center of pressure (COP) signals. Phase synchronization of the thumb and index finger was examined based on the τ-recurrence rate. Paired t-tests and Wilcoxon signed-rank tests were used for statistical comparisons. The twin-surrogate hypothesis test was used to examine phase synchronization. Results Nerve block led to significant increases (p < 0.05) for %DET, Lmax and %LAM in all components of force, torque, and COP. Only the normal force met the conditions of phase synchronization for all successfully completed pre- and post-block grasping trials. The probability of synchronization with larger time lags (τ > 0.1 s) increased after nerve block. The percentage of trials that the thumb led the index finger increased from 52% (pre-block) to 86% (post-block). Conclusions Nerve block caused more deterministic structures in force, torque and COP when the thumb interacted with the index finger. A compensatory mechanism may be responsible for this change. Phase synchronization between the opposite normal forces exerted by the thumb and index finger would be an essential dynamical principle for a precision grip. The nerve block resulted in an increased interdigit phase delay and increased probability that the thumb leads the index finger. The CRQA provides an effective tool to examine interdigit coordination during precision grip and has the potential for clinical evaluation of hand dysfunction.
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Affiliation(s)
- Ke Li
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
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Shen ZL, Mondello TA, Nataraj R, Domalain MF, Li ZM. A digit alignment device for kinematic analysis of the thumb and index finger. Gait Posture 2012; 36:643-5. [PMID: 22633016 PMCID: PMC3597988 DOI: 10.1016/j.gaitpost.2012.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 04/13/2012] [Accepted: 04/22/2012] [Indexed: 02/02/2023]
Abstract
Kinematic analysis of the digits using optical motion capture systems relies on defining accurate coordinate systems for the individual segments. Limitations of previous digit kinematic protocols include marker placement errors, marker occlusion and superimposition, and skin movement artifact. The purpose of this study was to develop a protocol utilizing a digit alignment device (DAD) and nail marker clusters to overcome these limitations. Ten subjects underwent 10 static calibration trials for validation. The orientation of the thumb distal phalange relative to the index finger distal phalange was described using Euler angles of pitch(x), yaw(y'), and roll(z''). The digit calibration protocol demonstrated high accuracy (0.5°, 1.9° and 2.2° for x, y', z'') and precision (1.4°, 2.3° and 3.1° for x, y', z''). The developed protocol provided convenient identification of transformations that determine anatomically relevant coordinate systems for the distal phalanges of the digits. The potential of utilizing this protocol as a standardized tool for digit kinematics was demonstrated using a dynamic task of precision pinching.
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Affiliation(s)
- Zhilei Liu Shen
- Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - Tracy A. Mondello
- Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - Raviraj Nataraj
- Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | | | - Zong-Ming Li
- Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
,Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
,Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH
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Corresponding author: Clevel and Clinic 9500 Euclid Avenue, ND20 Cleveland, OH 44195 Phone: (216) 444-1211 Fax: (216) 444-9198
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Influence of index finger proximal interphalangeal joint arthrodesis on precision pinch kinematics. J Hand Surg Am 2011; 36:1944-9. [PMID: 22051227 PMCID: PMC3226898 DOI: 10.1016/j.jhsa.2011.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 09/03/2011] [Accepted: 09/12/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the impact of proximal interphalangeal (PIP) joint arthrodesis on the kinematics of precision pinch. METHODS Eleven healthy subjects performed index finger-thumb pinch motions under 4 conditions: unrestricted thumb and index finger (CONTROL) and fusion of the PIP joint of the index finger in flexion of 30° (PIP30), 40° (PIP40), and 50° (PIP50). Fusion was simulated with metallic splints. Kinematics of the thumb and index finger were recorded with a motion capture system. RESULTS Proximal interphalangeal joint fusion at 30°, 40°, and 50° restricted maximal pinch span between the thumb tip and index finger tip by 6%, 10%, and 14%, respectively. At the time of pulp contact, PIP fusion led to an increase in index metacarpophalangeal joint flexion angle for the PIP30 condition and an increase in variability of thumb tip location for the PIP50 condition. Furthermore, the dynamic coordination between joint angles throughout the movement was affected by PIP fusion. CONCLUSIONS This study reports impairment in the kinematics of precision pinch associated with index finger PIP joint fusion. A PIP joint fusion at 40° to 50° leads to a more natural precision pinch posture, but it restricts the aperture and reduces pinch precision.
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12
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Functional workspace for precision manipulation between thumb and fingers in normal hands. J Electromyogr Kinesiol 2009; 19:829-39. [DOI: 10.1016/j.jelekin.2008.07.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 07/25/2008] [Accepted: 07/28/2008] [Indexed: 01/29/2023] Open
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Li ZM, Tang J, Chakan M, Kaz R. Complex, multidimensional thumb movements generated by individual extrinsic muscles. J Orthop Res 2008; 26:1289-95. [PMID: 18404721 DOI: 10.1002/jor.20641] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this study was to investigate three-dimensional thumb joint movements produced by individual extrinsic thumb muscles. Ten cadaveric arms were dissected to expose the musculotendinous junctions of the flexor pollicis longus (FPL), abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). Each muscle/tendon was loaded to 10% of its maximal force capability whereas three-dimensional angular movements of the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints were obtained simultaneously. We found that each extrinsic muscle produced unique joint angular trajectories in multiple directions. The FPL, APL, EBP, and EPL generated two, two, three, and six movements, respectively. The extrinsic muscles all together generated eight movements among the multiple thumb joints. High interjoint coordination was shown between the MCP joint flexion and IP joint flexion by FPL loading, as well as between the MCP joint extension and IP joint extension by EPL loading. High intrajoint coordination was observed between extension and supination at the CMC joint by the APL, EPL, and EPB. We concluded that each muscle produces movements in multiple joints and/or in multiple anatomical directions. The findings provide a novel insight into the biomechanical roles of the extrinsic muscles of the thumb.
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Affiliation(s)
- Zong-Ming Li
- Hand Research Laboratory, Departments of Orthopaedic Surgery and Bioengineering, University of Pittsburgh, 210 Lothrop Street, E1641 BST, Pittsburgh, Pennsylvania 15213, USA.
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Gehrmann S, Tang J, Kaufmann RA, Goitz RJ, Windolf J, Li ZM. Variability of precision pinch movements caused by carpal tunnel syndrome. J Hand Surg Am 2008; 33:1069-75. [PMID: 18762099 DOI: 10.1016/j.jhsa.2008.02.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 02/20/2008] [Accepted: 02/22/2008] [Indexed: 02/02/2023]
Abstract
PURPOSE Carpal tunnel syndrome (CTS) impairs the performance of fine motor tasks of the hand, leading to clumsiness. Precision pinch by the thumb and index finger is a frequent task that requires the fine control of each digit as well as the coordination of the 2 digits. The purpose of this study was to examine the performance of precision pinch movements impaired by CTS. METHODS Sixteen CTS subjects and 16 gender- and age-matched control subjects were instructed to repetitively perform the precision pinch movement with the thumb and index finger. A marker-based motion analysis method was used to obtain the kinematic data of the thumb and index finger during the precision pinch movements. Pinch performance was quantified by the variability of tip positions, joint angles, and tip distance at the pinch closures in the repeated movements. RESULTS The CTS subjects performed the precision pinch movements less consistently compared with performance of the control subjects. The inconsistency was demonstrated by the increased variability of the tip positions of the 2 digits and the joint angles of the index finger. However, the variability of thumb joint angles was not significantly different between the 2 groups. The tip-to-tip distance, an indicator of thumb and index finger coordination, was relatively reproducible for both groups. Still, the CTS subjects showed a 50% greater variability of the tip distance compared with that of the control subjects. CONCLUSIONS Carpal tunnel syndrome impairs the performance of precision pinch movement as indicated by the increased variability. The results correlate with the observed clumsiness or lack of dexterity for patients with CTS.
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Affiliation(s)
- Sebastian Gehrmann
- Hand Research Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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