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Chrzan AJ, Arnold ND, Chan K, Hess DE, Duquette SP, Hinkelman LL, Kelpin J, Bush TR. Kinematic Investigation of Healthy, Arthritic, and Postsurgery Thumbs: Is the Metacarpophalangeal Joint the Gateway to Carpometacarpal Arthritis? J Biomech Eng 2024; 146:071006. [PMID: 38456821 DOI: 10.1115/1.4065006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
The thumb carpometacarpal (CMC) joint is one of the most likely joints to develop osteoarthritis (OA). If conservative treatments fail to alleviate symptoms, surgery may be pursued. Kinematic outcomes of CMC surgery techniques have been described, but current tools have limitations in capturing motion abilities. The goals of this study were (1) develop a new and robust set of kinematic outcome measures, and apply them to (2) a cohort of younger and older control individuals without CMC OA to determine age and sex-related changes, and (3) a cohort of participants with CMC OA before, 3 months, and 6 months after undergoing thumb ligament reconstruction with tendon interposition surgery to detect the impacts of surgery. 52 (26 males, 26 females) control and 18 (3 males, 15 females) surgical participants were tested. Kinematics were investigated using motion capture by mapping the three-dimensional motion space of the whole thumb, and two-dimensional motion boundaries of the metacarpal (MC) and proximal phalange (PP). Visual analog pain score was recorded. Older control participants had shifted regions of motion compared to younger participants (p ≤ 0.027), suggesting asymptomatic CMC wear. Control females had 31% more metacarpophalangeal (MCP) motion than control males (p = 0.013), which could alter loading paths through the CMC joint and increase OA risk. Pain at 6 months postsurgery was 72% less than presurgery (p < 0.001), but motion abilities were 20-28% less than presurgery (p ≤ 0.074) and 24-40% less than control participants (p ≤ 0.066). These techniques have the possibility of identifying presymptomatic motion changes, including those at the metacarpophalangeal joint in CMC OA progression.
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Affiliation(s)
- Adam J Chrzan
- Mechanical Engineering, Michigan State University, East Lansing, MI 48824-4403
| | - Nicole D Arnold
- Mechanical Engineering, Michigan State University, East Lansing, MI 48824-4403
| | - Kevin Chan
- Orthopedic Hand and Upper Extremity Surgery, Corewell Health West, Grand Rapids, MI 49546
| | - Daniel E Hess
- Orthopedic Hand and Upper Extremity Surgery, Corewell Health West, Grand Rapids, MI 49546
| | - Stephen P Duquette
- Orthopedic Hand and Upper Extremity Surgery, Corewell Health West, Grand Rapids, MI 49546
| | - Levi L Hinkelman
- Orthopedic Hand and Upper Extremity Surgery, Corewell Health West, Grand Rapids, MI 49546
| | - John Kelpin
- Orthopedic Hand and Upper Extremity Surgery, Corewell Health West, Grand Rapids, MI 49546
| | - Tamara Reid Bush
- Mechanical Engineering Department, Michigan State University, 428 S. Shaw Lane, 2555, East Lansing, MI 48824
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Moraes VH, Vargas CD, Ramalho BL, Matsuda RH, Souza VH, Imbiriba LA, Garcia MAC. Effect of muscle length in a handgrip task on corticomotor excitability of extrinsic and intrinsic hand muscles under resting and submaximal contraction conditions. Scand J Med Sci Sports 2023; 33:2524-2533. [PMID: 37642219 DOI: 10.1111/sms.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 07/10/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
The neurophysiological mechanisms underlying muscle force control for different wrist postures still need to be better understood. To further elucidate these mechanisms, the present study aimed to investigate the effects of wrist posture on the corticospinal excitability by transcranial magnetic stimulation (TMS) of extrinsic (flexor [FCR] and extensor carpi radialis [ECR]) and intrinsic (flexor pollicis brevis (FPB)) muscles at rest and during a submaximal handgrip strength task. Fourteen subjects (24.06 ± 2.28 years) without neurological or motor disorders were included. We assessed how the wrist posture (neutral: 0°; flexed: +45°; extended: -45°) affects maximal handgrip strength (HGSmax ) and the motor evoked potentials (MEP) amplitudes during rest and active muscle contractions. HGSmax was higher at 0° (133%) than at -45° (93.6%; p < 0.001) and +45° (73.9%; p < 0.001). MEP amplitudes were higher for the FCR at +45° (83.6%) than at -45° (45.2%; p = 0.019) and at +45° (156%; p < 0.001) and 0° (146%; p = 0.014) than at -45° (106%) at rest and active condition, respectively. Regarding the ECR, the MEP amplitudes were higher at -45° (113%) than at +45° (60.8%; p < 0.001) and 0° (72.6%; p = 0.008), and at -45° (138%) than +45° (96.7%; p = 0.007) also at rest and active conditions, respectively. In contrast, the FPB did not reveal any difference among wrist postures and conditions. Although extrinsic and intrinsic hand muscles exhibit overlapping cortical representations and partially share the same innervation, they can be modulated differently depending on the biomechanical constraints.
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Affiliation(s)
- Victor Hugo Moraes
- Laboratório de Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratório de Neurobiologia do Movimento do Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Biociências e Atividades Físicas, Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudia D Vargas
- Laboratório de Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratório de Neurobiologia do Movimento do Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bia L Ramalho
- Laboratório de Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Pesquisa, Inovação e Difusão em Neuromatemática (NeuroMat), Instituto de Matemática e Estatística, Universidade de São Paulo, São Paulo, Brazil
| | - Renan H Matsuda
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Luis Aureliano Imbiriba
- Departamento de Biociências e Atividades Físicas, Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Antonio C Garcia
- Laboratório de Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
- Grupo de Estudos em Neuro Biomecânica, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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Jeong SH, Kim KS, Kim S. Designing Anthropomorphic Robot Hand With Active Dual-Mode Twisted String Actuation Mechanism and Tiny Tension Sensors. IEEE Robot Autom Lett 2017. [DOI: 10.1109/lra.2017.2647800] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Crisco JJ, Patel T, Halilaj E, Moore DC. The Envelope of Physiological Motion of the First Carpometacarpal Joint. J Biomech Eng 2016. [PMID: 26201612 DOI: 10.1115/1.4031117] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Much of the hand's functional capacity is due to the versatility of the motions at the thumb carpometacarpal (CMC) joint, which are presently incompletely defined. The aim of this study was to develop a mathematical model to completely describe the envelope of physiological motion of the thumb CMC joint and then to examine if there were differences in the kinematic envelope between women and men. In vivo kinematics of the first metacarpal with respect to the trapezium were computed from computed tomography (CT) volume images of 44 subjects (20M, 24F, 40.3 ± 17.7 yr) with no signs of CMC joint pathology. Kinematics of the first metacarpal were described with respect to the trapezium using helical axis of motion (HAM) variables and then modeled with discrete Fourier analysis. Each HAM variable was fit in a cyclic domain as a function of screw axis orientation in the trapezial articular plane; the RMSE of the fits was 14.5 deg, 1.4 mm, and 0.8 mm for the elevation, location, and translation, respectively. After normalizing for the larger bone size in men, no differences in the kinematic variables between sexes could be identified. Analysis of the kinematic data also revealed notable coupling of the primary rotations of the thumb with translation and internal and external rotations. This study advances our basic understanding of thumb CMC joint function and provides a complete description of the CMC joint for incorporation into future models of hand function. From a clinical perspective, our findings provide a basis for evaluating CMC pathology, especially the mechanically mediated aspects of osteoarthritis (OA), and should be used to inform artificial joint design, where accurate replication of kinematics is essential for long-term success.
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Dourthe B, D'Agostino P, Stockmans F, Kerkhof F, Vereecke E. In vivo contact biomechanics in the trapeziometacarpal joint using finite deformation biphasic theory and mathematical modelling. Med Eng Phys 2015; 38:108-14. [PMID: 26654104 DOI: 10.1016/j.medengphy.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 09/11/2015] [Accepted: 11/03/2015] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Benjamin Dourthe
- KU Leuven, Department of Development & Regeneration @ Kulak, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium.
| | - Priscilla D'Agostino
- KU Leuven, Department of Development & Regeneration @ Kulak, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Filip Stockmans
- KU Leuven, Department of Development & Regeneration @ Kulak, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium; AZ Groeninge, Campus Loofstraat, Loofstraat 43, 8500 Kortrijk, Belgium
| | - Faes Kerkhof
- KU Leuven, Department of Development & Regeneration @ Kulak, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Evie Vereecke
- KU Leuven, Department of Development & Regeneration @ Kulak, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
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Crisco JJ, Halilaj E, Moore DC, Patel T, Weiss APC, Ladd AL. In Vivo kinematics of the trapeziometacarpal joint during thumb extension-flexion and abduction-adduction. J Hand Surg Am 2015; 40:289-96. [PMID: 25542440 PMCID: PMC4306611 DOI: 10.1016/j.jhsa.2014.10.062] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE The primary aim of this study was to determine whether the in vivo kinematics of the trapeziometacarpal (TMC) joint differ as a function of age and sex during thumb extension-flexion (Ex-Fl) and abduction-adduction (Ab-Ad) motions. METHODS The hands and wrists of 44 subjects (10 men and 11 women with ages 18-35 y and 10 men and 13 women with ages 40-75 y) with no symptoms or signs of TMC joint pathology were imaged with computed tomography during thumb extension, flexion, abduction, and adduction. The kinematics of the TMC joint were computed and compared across direction, age, and sex. RESULTS We found no significant effects of age or sex, after normalizing for size, in any of the kinematic parameters. The Ex-Fl and Ab-Ad rotation axes did not intersect, and both were oriented obliquely to the saddle-shaped anatomy of the TMC articulation. The Ex-Fl axis was located in the trapezium and the Ab-Ad axis was located in the metacarpal. Metacarpal translation and internal rotation occurred primarily during Ex-Fl. CONCLUSIONS Our findings indicate that normal TMC joint kinematics are similar in males and females, regardless of age, and that the primary rotation axes are nonorthogonal and nonintersecting. In contrast to previous studies, we found Ex-Fl and Ab-Ad to be coupled with internal-external rotation and translation. Specifically, internal rotation and ulnar translation were coupled with flexion, indicating a potential stabilizing screw-home mechanism. CLINICAL RELEVANCE The treatment of TMC pathology and arthroplasty design require a detailed and accurate understanding of TMC function. This study confirms the complexity of TMC kinematics and describes metacarpal translation coupled with internal rotation during Ex-Fl, which may explain some of the limitations of current treatment strategies and should help improve implant designs.
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Affiliation(s)
- Joseph J. Crisco
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Eni Halilaj
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Douglas C. Moore
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Tarpit Patel
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903
| | - Arnold-Peter C. Weiss
- Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics 2 Dudley Street, Suite 200, Providence, RI 02905
| | - Amy L. Ladd
- Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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A thumb carpometacarpal joint coordinate system based on articular surface geometry. J Biomech 2013; 46:1031-4. [PMID: 23357698 DOI: 10.1016/j.jbiomech.2012.12.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 11/27/2012] [Accepted: 12/06/2012] [Indexed: 11/23/2022]
Abstract
The thumb carpometacarpal (CMC) joint is a saddle-shaped articulation whose in vivo kinematics can be explored more accurately with computed tomography (CT) imaging methods than with previously used skin-based marker systems. These CT-based methods permit a detailed analysis of the morphology of the joint, and thus the prominent saddle geometry can be used to define a coordinate system that is inherently aligned with the primary directions of motion at the joint. The purpose of this study was to develop a CMC joint coordinate systems that is based on the computed principal directions of curvature on the trapezium and the first metacarpal. We evaluated the new coordinate system using bone surface models segmented from the CT scans of 24 healthy subjects. An analysis of sensitivity to the manual selection of articular surfaces resulted in mean orientation differences of 0.7±0.7° and mean location differences of 0.2±0.1mm. Inter-subject variability, which mostly emanates from anatomical differences, was evaluated with whole bone registration and resulted in mean orientation differences of 3.1±2.7° and mean location differences of 0.9±0.5mm. The proposed joint coordinate system addresses concerns of repeatability associated with bony landmark identification and provides a robust platform for describing the complex kinematics of the CMC joint.
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