1
|
Arnold ND, Chrzan AJ, Chan K, Bush TR. The Female Thumb Carpometacarpal Joint: Motion and Force Changes Due to Arthritis and Surgical Intervention. J Biomech Eng 2024; 146:060902. [PMID: 38270931 DOI: 10.1115/1.4064551] [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: 03/01/2023] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
Thumb carpometacarpal (CMC) osteoarthritis (OA) has been one of the most common locations of hand OA. CMC OA disproportionately occurs in females over males. In severe cases, surgical intervention may be needed. However, to determine the effects of surgical treatment, normative, pre-, and postsurgery function must be understood. The goals of this work were to compare the thumb motion and force abilities of older healthy (OH) females without CMC OA to those of females with CMC OA and who received ligament reconstruction with tendon interposition (LRTI) surgery at time points presurgery, 3- and 6-months postsurgery. On average, CMC OA participants 3- and 6-months postsurgery showed 35.6% and 32.9% less overall metacarpal motion compared to presurgery, 31.9% and 29.1% less than OH, and exhibited altered motion. Metacarpal flexion/extension and abduction/adduction ranges were 51.9 deg and 43.4 deg for OH, 52.9 deg and 40.3 deg presurgery, 39.9 deg and 33.5 deg at 3-months, and 42.6 deg and 32.7 deg at 6-months postsurgery. On average, participants had increased force generation at 6-months postsurgery compared to presurgery, and 20% of participants returned to the level of OH females. These data sets highlight changes in thumb metacarpal movement and thumb force generation due to disease and surgical intervention. This work has the ability to support both surgeons and patients through improved outcome assessments as well as additional data to inform the decision process on intervention.
Collapse
Affiliation(s)
- Nicole D Arnold
- Mechanical Engineering, Michigan State University, East Lansing, MI 48824
| | - Adam J Chrzan
- Mechanical Engineering, Michigan State University, East Lansing, MI 48824
| | - Kevin Chan
- Orthopedic Hand and Upper Extremity Surgery, Spectrum Health, Grand Rapids, MI 49546
| | - Tamara Reid Bush
- Mechanical Engineering, Michigan State University, 428 S. Shaw Lane, 2555, East Lansing, MI 48824
| |
Collapse
|
2
|
Inaba N, Oki S, Nagura T, Sato K, Jinzaki M, Iwamoto T, Nakamura M. In-vivo kinematics of the trapeziometacarpal joint in dynamic pinch motion using four-dimensional computed tomography imaging. Skeletal Radiol 2024; 53:129-140. [PMID: 37306769 DOI: 10.1007/s00256-023-04387-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/03/2023] [Accepted: 06/04/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE CT imaging precisely and quantitatively analyzes the kinematics of the carpal bones to evaluate the etiology of related osteoarthritis. Previous studies have investigated the kinematics of the trapeziometacarpal joint using static CT scans of various postures including the pinch position. This study analyzed the in-vivo kinematics of the trapeziometacarpal joint during dynamic pinch motion in young healthy volunteers using four-dimensional CT. MATERIALS AND METHODS Twelve healthy young volunteers participated in this study. Each participant held the pinch meter between their thumb and index finger and pinched it with maximum force for a period of 6 s. This series of movement was recorded using a four-dimensional CT. The surface data of the trapezium and first metacarpal of all frames were reconstructed, and bone movement at the trapeziometacarpal joint was calculated using sequential three-dimensional registration. The instantaneous pinch force of each frame was measured using a pointer on a pinch meter that was reconstructed from the CT data. RESULTS The first metacarpal was abducted (15.9 ± 8.3°) and flexed (12.2 ± 7.1°) relative to the trapezium, and significantly translated to the volar (0.8 ± 0.6 mm) and ulnar directions (0.9 ± 0.8 mm) with maximum pinch force. This movement consistently increased with the pinch force. CONCLUSION This study successfully employed 4D-CT to precisely demonstrate changes in rotation and translation at the trapeziometacarpal joint during pinch motion for various instantaneous forces.
Collapse
Affiliation(s)
- Naoto Inaba
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Satoshi Oki
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Takeo Nagura
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Takuji Iwamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, Japan
| |
Collapse
|
3
|
Optimization of Thumb Prosthesis Design by Using Five Performance Criteria. Appl Bionics Biomech 2022; 2022:9647956. [PMID: 36106138 PMCID: PMC9467796 DOI: 10.1155/2022/9647956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/17/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Abstract
The thumb prosthesis mechanism is optimally designed by using five performance criteria including the following: least square structural error, mechanical manufacturing imprecision error, driving optimal torque, mechanical strength reliability, and production cost of the thumb mechanism. This paper was devoted to the optimization of the thumb prosthesis's mechanism by taking into consideration the manufacturing cost model based on machining cost theory which took into detail the shape of the workpieces and the strength reliability of all the parts composing the entire mechanism. Every optimization problem displays a particular set of an independent vector of optimal parameters, showing the impact of each objective function on the configuration of the prosthetic device. The multiobjective optimization showed that the mechanical reliability and the production cost included in any combination of the simultaneous optimization enabled the achievement of the same optimum variables design, though with some exceptions. With the inclusion of the labor charges, the depreciation rate of the equipment, and production assets in the mathematical's manufacturing cost model, the optimal manufacturing cost generated from the numerical simulation was 501.0021 USD. Therefore, the global manufacturing cost and the mechanical strength reliability of the whole prosthesis mechanism have a real impact on the customization of the structure, due to the stochastic nature of the trajectory of the cutting tools during the manufacturing processes.
Collapse
|
4
|
Gur Kabul E, Unver F, Alptekin A, Korkmaz H, Calık BB, Taşçı M, Çobankara V. The effect of rheumatoid arthritis on upper extremity functions: A kinematic perspective. Int J Rheum Dis 2022; 25:1279-1287. [PMID: 35965381 DOI: 10.1111/1756-185x.14421] [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: 03/02/2022] [Revised: 07/23/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
AIM To examine the global upper extremity kinematics in 3D while performing "jar opening motion" in Rheumatoid Arthritis (RA) and to compare these with healthy individuals. METHOD Twenty-four women (12 healthy, 12 RA) were included. Evaluations were made with a JAMAR dynamometer, Health Assessment Questionnaire, and 3D kinematic analysis of global upper extremity during "jar opening motion." The time taken during "jar opening motion" was analyzed in 2 parts (Part 1, Part 2), with total time: part 1 + part 2. In addition, shoulder-to-table distance; elbow flexion angle; wrist extension angle; the area scanned and angular rotation by arm, forearm and hand were used in the analysis. RESULTS Between groups, there was a statistical difference in: bilateral hand grip strength; part 1, part 2, total time; shoulder-to-table distance; elbow flexion angle; the area scanned by hand; angular rotation of arm and hand in favor of the healthy group (P < .05). In stepwise multiple regression analysis, the most predictive variable for disability was elbow flexion, explaining 53.9% of disability. CONCLUSION Compared to healthy individuals, individuals with RA have slower motion, more elbow flexion, less hand grip strength, circular pattern in hand, rotation in arm and hand. Increased disability may result in greater load on elbow flexion.
Collapse
Affiliation(s)
- Elif Gur Kabul
- Institute of Health Sciences, Physiotherapy and Rehabilitation, Usak University, Usak, Turkey
| | - Fatma Unver
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ahmet Alptekin
- Faculty of Sport Sciences, Pamukkale University, Denizli, Turkey
| | - Halil Korkmaz
- Sport Sciences Faculty, Istanbul Gedik University, Istanbul, Turkey
| | - Bilge Basakcı Calık
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Murat Taşçı
- Department of Rheumatology, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Veli Çobankara
- Department of Rheumatology, Medical Faculty, Pamukkale University, Denizli, Turkey
| |
Collapse
|
5
|
Kodama A, Kurumadani H, Tanaka T, Shinomiya R, Sunagawa T, Adachi N. Three-dimensional analysis of thumb motion recovery after carpal tunnel release. J Hand Surg Eur Vol 2021; 46:743-748. [PMID: 33969737 DOI: 10.1177/17531934211014700] [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: 02/03/2023]
Abstract
This study quantified recovery of thumb motion in patients with carpal tunnel syndrome after carpal tunnel release using three-dimensional motion analysis with a retroreflective surface-based marker method. Eighteen hands from 14 patients who underwent carpal tunnel release for idiopathic carpal tunnel syndrome were included. The angular movements of the three joints of the thumb, the path length of the thumb tip and the area enclosed by the perimeter path of the thumb tip were measured during circumduction. The range of joint movement, including abduction/adduction of the trapeziometacarpal joint, and flexion/extension of the interphalangeal and metacarpophalangeal joints and the path length of the thumb tips, improved significantly 1 year after surgery. The quantification of thumb kinematics helps to better understand motor dysfunction in carpal tunnel syndrome, assess the severity of the condition and decide on treatment.Level of evidence: IV.
Collapse
Affiliation(s)
- Akira Kodama
- Department of Orthopedic Surgery, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hiroshi Kurumadani
- Analysis and Control of Upper Extremity Function, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Teruyasu Tanaka
- Department of Orthopedic Surgery, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Rikuo Shinomiya
- Department of Orthopedic Surgery, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Toru Sunagawa
- Analysis and Control of Upper Extremity Function, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Hiroshima University, Minami-ku, Hiroshima, Japan
| |
Collapse
|
6
|
Fontaine C, D'Agostino P, Maes-Clavier C, Boutan M, Sturbois-Nachef N. Anatomy and biomechanics of healthy and arthritic trapeziometacarpal joints. HAND SURGERY & REHABILITATION 2021; 40S:S3-S14. [PMID: 34118467 DOI: 10.1016/j.hansur.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 10/21/2022]
Abstract
Understanding the biomechanics of the trapeziometacarpal (TMC) or first carpometacarpal (CMC1) joint, the pathophysiology of basal thumb arthritis, the design and performance of surgical procedures require a solid anatomical basis. This review of literature summarizes the most recent data on the descriptive, functional, and comparative anatomy of healthy and arthritic TMC joints.
Collapse
Affiliation(s)
- C Fontaine
- Laboratoire d'Anatomie et Organogenèse, Faculté de Médecine Henri Warembourg, Université de Lille, Rue Michel Polonovski, 59045 Lille cedex, France; Laboratoire d'Automatique, de Mécanique et d'Informatique Industrielle et Humaine LAMIH, Université de Valenciennes et du Hainaut-Cambrésis, Le Mont Houy, 59313 Valenciennes cedex, France; Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France.
| | - P D'Agostino
- Clinique de la Main, Bruxelles et Brabant-Wallon, Avenue Louise 284, 1050 Bruxelles, Belgique
| | - C Maes-Clavier
- Service de Chirurgie Orthopédique et Traumatologique, CHU Amiens-Picardie, Site sud Route départementale 408, 80054 Amiens cedex 1, France
| | - M Boutan
- Résidence Dryades, Bâtiment A1, 1, rue du 11 novembre, 40990 Saint-Paul-les-Dax, France
| | - N Sturbois-Nachef
- Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France
| |
Collapse
|
7
|
Curran PF, Bagley AM, Sison-Williamson M, James MA. Three-dimensional functional workspace of thumb prehension. Clin Biomech (Bristol, Avon) 2019; 63:63-72. [PMID: 30849647 DOI: 10.1016/j.clinbiomech.2019.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Clinical assessment of thumb motion is challenging, due to the complex anatomy and motion of the thumb. It is especially difficult to measure hand movement during activity, and to measure the effects of surgery that changes the morphology of the thumb. A three-dimensional model of the hand may enable clinicians to better assess prehension and thumb motion at baseline, and following surgical intervention. METHODS A kinematic model of the hand was developed to measure thumb and finger position during functional tasks, enabling the calculation of the volume of space in which prehension could occur. This method was validated by application to a mechanical model of the hand, and then applied to ten adult participants, using three-dimensional motion analysis with a marker array developed for the purpose of this study. FINDINGS This method can be used to accurately measure three-dimensional thumb joint range of motion (RoM) and predicted functional workspace during functional activities. The thumb carpometacarpal joint was predominantly responsible for thumb position during functional tasks. Predicted functional workspace is proportional to hand morphometric measurements. INTERPRETATION A kinematic model of the hand measures thumb RoM and predicts functional workspace during functional activities.
Collapse
Affiliation(s)
- Patrick F Curran
- Shriners Hospitals for Children Northern California, Sacramento, CA, United States; Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Anita M Bagley
- Shriners Hospitals for Children Northern California, Sacramento, CA, United States
| | | | - Michelle A James
- Shriners Hospitals for Children Northern California, Sacramento, CA, United States; Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, United States.
| |
Collapse
|
8
|
Hu MT, Hsu AT, Su FC. Kinematic Analyses of the Thumb during Simulated Posteroanterior Glide Mobilization. PLoS One 2016; 11:e0161624. [PMID: 27583407 PMCID: PMC5008622 DOI: 10.1371/journal.pone.0161624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 08/09/2016] [Indexed: 11/20/2022] Open
Abstract
Objective Thumb problems are common in some health professionals such as physical therapists. The purpose of this case-control study is to investigate the influence of clinical experience and different mobilization techniques on the kinematics of the thumb. Methods Twenty-three participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopedic experience (the Experienced Group) participated. The kinematics of the thumb while performing 3 different simulated posteroanterior (PA) glide mobilization techniques on a load cell was monitored. These 3 techniques were: 1) unsupported, 2) with digital support and 3) with thumb interphalangeal joint supported by the index finger. The amount of forces exerted were 25% to 100% of maximum effort at 25% increments. The main effects of experience and technique on thumb kinematics were assessed. Results Both experience and technique had main effects on the flexion/extension angles of the thumb joints. Experienced participants assumed a more flexed position at the carpometacarpal (CMC) joint, and the novice participants performed with angles closer to the neutral position (F = 7.593, p = 0.010). Participants’ metacarpophalangeal (MCP) joints were in a more flexed position while performing PA glide with thumb interphalangeal (IP) joint supported by the index as compared to the other two techniques (p < .001). Conclusions Negative correlations were generally obtained between the sagittal plane angles of adjacent thumb joints during mobilization/manipulation. Therapists are recommended to treat patient with more stable PA glide mobilization techniques, such as PA glide with thumb interphalangeal joint supported by the index finger, to prevent potential mobilization-related thumb disorders.
Collapse
Affiliation(s)
- Meng-Tzu Hu
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, Tzu Hui Institute of Technology, Ping Tung, Taiwan
| | - Ar-Tyan Hsu
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
- * E-mail:
| |
Collapse
|
9
|
Tsai CL, Lin CF, Lin HT, Liu MF, Chiu HY, Hsu HY, Kuo LC. How kinematic disturbance in the deformed rheumatoid thumb impacts on hand function: a biomechanical and functional perspective. Disabil Rehabil 2016; 39:338-345. [PMID: 26883482 DOI: 10.3109/09638288.2016.1141244] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose This study investigates the effects of kinematic disturbances in rheumatoid thumb on patient's hand functions via objective and patient-perceived measurements. Method Twenty-one patients with rheumatoid arthritis (RA) and 21 healthy age- and gender-matched individuals were recruited to receive the objective evaluations, including the Purdue Pegboard Test, Jamar dynamometer, pinch-meter, Permanent Impairment Scale and self-administrated measurements, including the Health Assessment Questionnaire (HAQ) and Manual Ability Measure-36 (MAM-36). An electromagnetic tracking system was used to measure thumb kinematics. The differences in the measures between the RA and control groups and the dominant and non-dominant hands of the RA group were examined. The relationships between the thumb kinematics and hand functional capabilities, as well as impairment levels, were also explored. Results The RA group showed significantly smaller thumb movement capabilities and hand strength, as well as worse scores in hand dexterity, MAM-36 and HAQ than healthy controls. The movement workspace of the RA thumb showed moderate correlations with the factors of hand strength, dexterity, impairment scale, MAM-36 and HAQ scores. Conclusions The findings indicate deficits related to the movement capability of the RA thumb may negatively influence hand dexterity and functional hand performance, as well as life quality, for the patients with RA. Implications for Rehabilitation A deformed rheumatoid thumb might limit the movement workspace of the thumb and consequently impair the hand performance as well as the life quality. The dominant thumb of the RA patients might have greater structural and functional deterioration than the non-dominant side. Suitable joint protection strategies, exercises and orthotics should be early applied to the RA patients for preserving hand functions.
Collapse
Affiliation(s)
- Chin-Liang Tsai
- a Department of Physical Medicine and Rehabilitation , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Cheng-Feng Lin
- b Department of Physical Therapy , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Hwai-Ting Lin
- c Department of Sports Medicine , College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Ming-Fei Liu
- d Department of Rheumatology , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Haw-Yen Chiu
- e Section of Plastic Surgery, Department of Surgery , Chi-Mei Medical Center , Tainan , Taiwan
| | - Hsiu-Yun Hsu
- a Department of Physical Medicine and Rehabilitation , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,f Department of Occupational Therapy , College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Li-Chieh Kuo
- f Department of Occupational Therapy , College of Medicine, National Cheng Kung University , Tainan , Taiwan.,g Medical Device Innovation Center, National Cheng Kung University , Tainan , Taiwan
| |
Collapse
|
10
|
Leitkam ST, Reid Bush T. Comparison Between Healthy and Reduced Hand Function Using Ranges of Motion and a Weighted Fingertip Space Model. J Biomech Eng 2015; 137:041003. [DOI: 10.1115/1.4029215] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Indexed: 11/08/2022]
Abstract
Detection and quantification of changes in hand function are important for patients with loss of function and clinicians who are treating them. A recently developed model, the weighted fingertip space (WFS) quantifies the hand function of individuals in three-dimensional space and applies kinematic weighting parameters to identify regions of reachable space with high and low hand function. The goal of this research was to use the WFS model to compare and contrast the functional abilities of healthy individuals with the abilities of individuals with reduced functionality due to arthritis (RFA). Twenty two individuals with no reported issues with hand function and 21 individuals with arthritis affecting the hand were included in the research. Functional models were calculated from the ranges of motion and hand dimension data for each individual. Each model showed the volume of reachable space for each fingertip of each hand, the number of ways to reach a point in space, the range of fingertip orientations possible at each point, and the range of possible force application directions (FADs) at each point. In addition, two group models were developed that showed how many individuals in both the healthy and RFA groups were able to reach the same points in space. The results showed differences between the two groups for the range of motion (ROM) measurements, the individual model calculations, and the group models. The ROM measurements showed significant differences for the joints of the thumb, extension of the nonthumb metacarpophalangeal (MCP) joints, and flexion of the distal interphalangeal (DIP) joints. Comparing the models, the two groups qualitatively showed similar patterns of functional measures in space, but with the RFA group able to reach a smaller volume of space. Quantitatively, the RFA group showed trends of smaller values for all of the calculated functional weighting parameters and significantly smaller reachable volume for all of the fingers. The group models showed that all healthy individuals were able to reach an overlapping space, while 18 of 21 RFA individuals were able to reach similar spaces. Combined, the results showed that the WFS model presents the abilities of the hand in ways that can be quantitatively and qualitatively compared. Thus, the potential of this hand model is that it could be used to assess and document the changes that occur in hand function due to rehabilitation or surgery, or as a guide to determine areas most accessible by various populations.
Collapse
Affiliation(s)
- Samuel T. Leitkam
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824
| | - Tamara Reid Bush
- Department of Mechanical Engineering, Michigan State University, 428 S. Shaw Lane, Rm. 2555 Engineering Building, East Lansing, MI 48824-1226 e-mail:
| |
Collapse
|
11
|
Endo H. Application of robotic manipulability indices to evaluate thumb performance during smartphone touch operations. ERGONOMICS 2014; 58:736-747. [PMID: 25434697 DOI: 10.1080/00140139.2014.986222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined whether manipulability during smartphone thumb-based touch operations could be predicted by the following robotic manipulability indices: the volume and direction of the 'manipulability ellipsoid' (MEd), both of which evaluate the influence of kinematics on manipulability. Limits of the thumb's range of motion were considered in the MEd to improve predictability. Thumb postures at 25 key target locations were measured in 16 subjects. Though there was no correlation between subjective evaluation and the volume of the MEd, high correlation was obtained when motion range limits were taken into account. These limits changed the size of the MEd and improved the accuracy of the manipulability evaluation. Movement directions associated with higher performance could also be predicted. In conclusion, robotic manipulability indices with motion range limits were considered to be useful measures for quantitatively evaluating human hand operations.
Collapse
Affiliation(s)
- Hiroshi Endo
- a Human Technology Research Institute , National Institute of Advanced Industrial Science and Technology (AIST) , Tsukuba , Japan
| |
Collapse
|
12
|
In vivo analysis of trapeziometacarpal joint arthrokinematics during multi-directional thumb motions. Clin Biomech (Bristol, Avon) 2014; 29:1009-15. [PMID: 25200884 DOI: 10.1016/j.clinbiomech.2014.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 06/24/2014] [Accepted: 08/11/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The investigation of the joint arthrokinematics of the trapeziometacarpal joint is critical to comprehend the causative mechanism underlying this common form of osteoarthritis. Therefore, the purpose of this study is to evaluate the arthrokinematics of the trapeziometacarpal joint during thumb postures in vivo. METHODS Fifteen healthy participants were enrolled in this study. Static computed tomography images of the 1st metacarpal bone and trapezium were taken at specific thumb postures during thumb flexion-extension, abduction-adduction, and circumduction motions. Images were analyzed to examine the joint gliding, expressed as displacement of the centroid of the articular surface of the 1st metacarpal bone, relative to the trapezium. The gliding ratio, defined as joint gliding in each direction normalized to the dimension of the trapezium joint surface in the given direction, was computed and compared between different thumb motions. FINDINGS The results indicate that thumb motions influenced joint gliding. The centroids of the articular surface of the 1st metacarpal bone were primarily located at the central and dorsal-radial regions while executing these motions. The maximum joint gliding of the 1st metacarpal bone occurred in the radial-ulnar direction when performing abduction-adduction, and in the dorsal-volar direction while performing flexion-extension and circumduction, with the gliding ratio values of 42.35%, 51.65%, and 51.85%, respectively. INTERPRETATION Activities that involved abduction-adduction in the trapeziometacarpal joint caused greater joint gliding in the ulnar-radial direction, while flexion-extension resulted in greater joint gliding in the dorsal-volar and distal-proximal directions. Understanding normal joint kinematics in vivo may provide insights into the possible mechanism leading to osteoarthritis of the trapeziometacarpal joint, and help to improve the design of implants.
Collapse
|
13
|
Marquardt TL, Nataraj R, Evans PJ, Seitz WH, Li ZM. Carpal tunnel syndrome impairs thumb opposition and circumduction motion. Clin Orthop Relat Res 2014; 472:2526-33. [PMID: 24777728 PMCID: PMC4079857 DOI: 10.1007/s11999-014-3651-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/11/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Carpal tunnel syndrome is associated with sensory and motor impairments resulting from the compressed and malfunctioning median nerve. The thumb is critical to hand function, yet the pathokinematics of the thumb associated with carpal tunnel syndrome are not well understood. QUESTIONS/PURPOSES The purpose of this study was to evaluate thumb motion abnormalities associated with carpal tunnel syndrome. We hypothesized that the ranges of translational and angular motion of the thumb would be reduced as a result of carpal tunnel syndrome. METHODS Eleven patients with carpal tunnel syndrome and 11 healthy control subjects voluntarily participated in this study. Translational and angular kinematics of the thumb were obtained using marker-based video motion analysis during thumb opposition and circumduction movements. RESULTS Motion deficits were observed for patients with carpal tunnel syndrome even though maximum pinch strength was similar. The path length, normalized by palm width of the thumb tip for the patients with carpal tunnel syndrome was less than for control participants (opposition: 2.2 palm width [95% CI, 1.8-2.6 palm width] versus 3.1 palm width [95% CI, 2.8-3.4 palm width], p < 0.001; circumduction: 2.2 palm width [95% CI, 1.9-2.5 palm width] versus 2.9 palm width [95% CI, 2.7-3.2 palm width], p < 0.001). Specifically, patients with carpal tunnel syndrome had a deficit of 0.3 palm width (95% CI, 0.04-0.52 palm width; p = 0.022) in the maximum position of their thumb tip ulnarly across the palm during opposition relative to control participants. The angular ROM also was reduced for the patients with carpal tunnel syndrome compared with the control participants in extension/flexion for the metacarpophalangeal (opposition: 34° versus 58°, p = .004; circumduction: 33° versus 58°, p < 0.001) and interphalangeal (opposition: 37° versus 62°, p = .028; circumduction: 41° versus 63°, p = .025) joints. CONCLUSIONS Carpal tunnel syndrome disrupts kinematics of the thumb during opposition and circumduction despite normal pinch strength. CLINICAL RELEVANCE Improving understanding of thumb pathokinematics associated with carpal tunnel syndrome may help clarify hand function impairment associated with the syndrome given the critical role of the thumb in dexterous manipulation.
Collapse
Affiliation(s)
- Tamara L. Marquardt
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195 USA
| | - Raviraj Nataraj
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195 USA
| | - Peter J. Evans
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH USA
| | - William H. Seitz
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH USA
| | - Zong-Ming Li
- Hand Research Laboratory, Department of Biomedical Engineering, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195 USA ,Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH USA ,Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH USA
| |
Collapse
|
14
|
Abstract
BACKGROUND The thumb carpometacarpal (CMC) joint is often affected by osteoarthritis--a mechanically mediated disease. Pathomechanics of the CMC joint, however, are not thoroughly understood due to a paucity of in vivo data. QUESTIONS/PURPOSES We documented normal, in vivo CMC joint kinematics during isometric functional tasks. We hypothesized there would be motion of the CMC joint during these tasks and that this motion would differ with sex and age group. We also sought to determine whether the rotations at the CMC joint were coupled and whether the trapezium moved with respect to the third metacarpal. METHODS Forty-six asymptomatic subjects were CT-scanned in a neutral position and during three functional tasks (key pinch, jar grasp, jar twist), in an unloaded and a loaded position. Kinematics of the first metacarpal, third metacarpal, and the trapezium were then computed. RESULTS Significant motion was identified in the CMC joint during all tasks. Sex did not have an effect on CMC joint kinematics. Motion patterns differed with age group, but these differences were not systematic across the tasks. Rotation at the CMC joint was generally coupled and posture of the trapezium relative to the third metacarpal changed significantly with thumb position. CONCLUSIONS The healthy CMC joint is relatively stable during key pinch, jar grasp, and jar twist tasks, despite sex and age group. CLINICAL RELEVANCE Our findings indicate that directionally coupled motion patterns in the CMC joint, which lead to a specific loading profile, are similar in men and women. These patterns, in addition to other, nonkinematic influences, especially in the female population, may contribute to the pathomechanics of the osteoarthritic joint.
Collapse
|
15
|
Leitkam ST, Bush TR, Bix L. Determining Functional Finger Capabilities of Healthy Adults: Comparing Experimental Data to a Biomechanical Model. J Biomech Eng 2014; 136:021022. [DOI: 10.1115/1.4026255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 12/16/2013] [Indexed: 11/08/2022]
Abstract
The human hand has a wide range of possible functional abilities that can change with age, disease, and injury, and can vary from individual to individual and subsequently can affect a person's quality of life. The objective of this work was to develop a theoretical model of the space that is reachable by the hand, weighted to represent three types of functionality, and to compare this model to an experimental data set obtained from a healthy hand population. A theoretical model, termed the Weighted Fingertip Space, was developed using 50th percentile published hand data and ranges of finger motion. The functional abilities calculated in the model were the abilities to position the fingertip pad, orient the fingertip pad, and apply directional forces through the fingertip pad at all the reachable points in space with respect to the palm. Following the development of this theoretical model, experimental data sets from nine individuals with healthy hands were obtained through motion capture techniques. The experimental data were then compared to the theoretical model. Comparisons between a 50th percentile theoretical model and a subject with a similar sized hand showed good agreement in weighting parameters and overall size and shape of the model spaces. The experimental data set from the entire sample, which ranged from the 2nd to 95th percentile hand sizes, showed resultant models that, on average, reached smaller volumes of space, but yielded higher values of the functional measures within those volumes. Additionally, in comparison to the theoretical model, the variability of the experimental models showed that small changes in hand dimensions and ranges of motion of the finger joints had a large influence in the functional measures of the model. Combined, these results suggest that the modeling technique can calculate functional ability of the hand, but should be used on an individualized basis for evaluating changes in function (e.g., rehabilitation). Further, scaling to hand size has the potential to yield “average” models for larger population samples.
Collapse
Affiliation(s)
- Samuel T. Leitkam
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824
| | - Tamara Reid Bush
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824 e-mail:
| | - Laura Bix
- School of Packaging, Michigan State University, East Lansing, MI 48824
| |
Collapse
|
16
|
The three-dimensional analysis of three thumb joints coordination in activities of daily living. Clin Biomech (Bristol, Avon) 2011; 26:371-6. [PMID: 21146265 DOI: 10.1016/j.clinbiomech.2010.11.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 11/16/2010] [Accepted: 11/16/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND Presently, the angular movements of the three thumb joints during activities of daily living are limited as a result of their static position and lack of the required thumb range of motion information during motion. The purpose of this study was to investigate the three thumb joints' motion required in activities of daily living. METHODS Sixteen healthy subjects were recruited for this study. A three-dimensional motion analysis system was used, with 14 retroreflective markers attached to each subject's thumb for motion data collection. Three joints including interphalangeal joint, metacarpophalangeal joint and carpometacarpal joint of the thumb were analyzed. The distal segment orientation relative to the proximal segment was defined the joint angle. The styloid process of radial bone orientation when quantifying the carpometacarpal joint movement was indirectly calculated from the third metacarpal bone. FINDINGS The results showed that each type of activity involved significant interphalangeal flexion. The metacarpophalangeal joint mainly showed abduction motion, cylinder grip and spherical grip with the largest angle. For the carpometacarpal joint, the cylinder grip and spherical grip showed a relatively larger rotational range of motion. The interphalangeal joint in the three thumb joints was primary in flexion. INTERPRETATION These results may provide more information to precisely describe the thumb function in daily life activities and also provide a reference when assessing thumb impairment or for constructing an index used for evaluating the recovery of an injured thumb in clinic. It also could help in designing hand-related instruments for use in activities of daily life.
Collapse
|
17
|
Jonsson P, Johnson PW, Hagberg M, Forsman M. Thumb joint movement and muscular activity during mobile phone texting - A methodological study. J Electromyogr Kinesiol 2010; 21:363-70. [PMID: 21123082 DOI: 10.1016/j.jelekin.2010.10.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 08/18/2010] [Accepted: 10/11/2010] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The extended intensive use of mobile phones and other devices for Information and Communication Technology (ICT) could expose the thumbs and fingers to operational stresses beyond their intended function which may generate pain and musculoskeletal disorders in the thumbs and the associated joints. Studies characterizing biomechanical exposures associated with mobile phone use are limited to date and the use of electrogoniometry and EMG was assessed for characterizing thumb-based activities. SCOPE The purpose was to investigate whether there were associations between thumb-based exposures registered with relatively easy-to-use electrogoniometric methods and more complicated EMG methods. Our hypothesis was that some outcome measures from the simpler electrogoniometric methods are related/correlated to and may be used as surrogate measure for the more complicated EMG methods. CONCLUSIONS Due to low associations and the complementary nature of exposures collected with electrogoniometry and EMG, the results indicated both measures are necessary for characterizing thumb exposure during mobile phone text messaging. Only in a few, selected abduction/adduction activities, could electrogoniometry be used in lieu of EMG for assessing thumb exposures.
Collapse
Affiliation(s)
- Per Jonsson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, Göteborg University, Box 414, SE-40530 Göteborg, Sweden.
| | | | | | | |
Collapse
|