1
|
Guerra E, Licciardi L, Van Veenendaal P, Robinson LS. Reliability and clinical utility of a novel telehealth-based goniometry approach to measure range of motion of the digits of the hand. J Hand Ther 2024; 37:83-93. [PMID: 37591726 DOI: 10.1016/j.jht.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 03/21/2023] [Accepted: 05/01/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Range of motion (ROM) is an outcome measure commonly used when treating acute and chronic hand injuries and conditions. Increased adoption of telehealth service provision in hand therapy practice, influenced by the advent of COVID-19, has led to the need for a valid and reliable approach to measure the range of motion of the digits of the hand when providing hand therapy services using telehealth. PURPOSE To determine if performing manual goniometry during a livestream teleconsultation is reliable and clinically useful to measure the range of motion of the fifth digit when providing hand therapy services using telehealth. STUDY DESIGN Clinical measurement, repeated-measures study. METHODS According to a measurement protocol, 12 independent raters (who currently provide hand therapy services) each obtained several screen-based goniometric range of motion measurements of the fifth digit at 2-time points. Raters were surveyed on the clinical utility of the telehealth-based goniometry approach. Measures of relative and absolute reliability were calculated to evaluate test-retest and inter-rater reliability. Free-text responses were analyzed using content analysis. RESULTS Inter-rater reliability was excellent for all flexion and extension measures (intraclass correlation coefficient [ICC] ≥ 0.89) but poor for the arc of motion (ICC ≤ 0.67). Test-retest reliability was poor (ICC ≤ 0.43). No statistically significant differences between test and retest measurements were observed (P ≥ 0.24). The overall coefficient of variation indicated good precision (14.69%). Measurement error (≤6.07º) and limits of agreement (≤6.33) had acceptable levels to support clinical use. Content analysis revealed several practical considerations. CONCLUSIONS This study suggests that performing manual goniometry during a livestream teleconsultation is unreliable for measuring the range of motion of the fifth digit. However, when combined with patient-reported and functional outcomes, this approach may be suitable to facilitate a range of motion assessment for certain functions of telehealth service provision in hand therapy practice.
Collapse
Affiliation(s)
- Emiliana Guerra
- Department of Occupational Therapy, Monash University-Peninsula Campus, Frankston, Victoria, Australia.
| | - Lisa Licciardi
- Department of Occupational Therapy, Monash University-Peninsula Campus, Frankston, Victoria, Australia
| | - Penny Van Veenendaal
- Department of Occupational Therapy, Alfred Health, Melbourne, Victoria, Australia
| | - Luke Steven Robinson
- Department of Occupational Therapy, Monash University-Peninsula Campus, Frankston, Victoria, Australia
| |
Collapse
|
2
|
Avila FR, Carter RE, McLeod CJ, Bruce CJ, Giardi D, Guliyeva G, Forte AJ. Accuracy of Wearable Sensor Technology in Hand Goniometry: A Systematic Review. Hand (N Y) 2023; 18:340-348. [PMID: 34032154 PMCID: PMC10035090 DOI: 10.1177/15589447211014606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Wearable devices and sensor technology provide objective, unbiased range of motion measurements that help health care professionals overcome the hindrances of protractor-based goniometry. This review aims to analyze the accuracy of existing wearable sensor technologies for hand range of motion measurement and identify the most accurate one. METHODS We performed a systematic review by searching PubMed, CINAHL, and Embase for studies evaluating wearable sensor technology in hand range of motion assessment. Keywords used for the inquiry were related to wearable devices and hand goniometry. RESULTS Of the 71 studies, 11 met the inclusion criteria. Ten studies evaluated gloves and 1 evaluated a wristband. The most common types of sensors used were bend sensors, followed by inertial sensors, Hall effect sensors, and magnetometers. Most studies compared wearable devices with manual goniometry, achieving optimal accuracy. Although most of the devices reached adequate levels of measurement error, accuracy evaluation in the reviewed studies might be subject to bias owing to the use of poorly reliable measurement techniques for comparison of the devices. CONCLUSION Gloves using inertial sensors were the most accurate. Future studies should use different comparison techniques, such as infrared camera-based goniometry or virtual motion tracking, to evaluate the performance of wearable devices.
Collapse
Affiliation(s)
| | - Rickey E. Carter
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - Charles J. Bruce
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Davide Giardi
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Gunel Guliyeva
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | |
Collapse
|
3
|
Gu F, Fan J, Wang Z, Liu X, Yang J, Zhu Q. Automatic range of motion measurement via smartphone images for telemedicine examination of the hand. Sci Prog 2023; 106:368504231152740. [PMID: 36721870 PMCID: PMC10450288 DOI: 10.1177/00368504231152740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Telemedicine support virtual consultations and evaluations in hand surgery for patients in remote areas during the COVID-19 era. However, traditional physical examination is challenging in telemedicine and it is inconvenient to manually measure the hand range of motion (ROM) from images or videos. Here, we propose an automatic method using the hand pose estimation technique, aiming to measure the hand ROM from smartphone images. METHODS Twenty-eight healthy volunteers participated in the study. An eight-hand gestures measurement protocol and the Google MediaPipe Hands were used to analyze images and calculate the ROM automatically. Manual goniometry was also performed according to the guideline of the American Medical Association. The correlation between the automatic and manual methods was analyzed by the intraclass correlation coefficient and Pearson correlation coefficient. The clinical acceptance was testified using Bland-Altman plots. RESULTS A total of 32 parameters of each hand were measured by both methods, and 1792 measurement results were compared. The mean difference between automatic and manual methods is -2.21 ± 9.29° in the angle measurement and 0.48 ± 0.48 cm in the distance measurement. The intraclass correlation coefficient of 75% of parameters was higher than 0.75, the Pearson correlation coefficient of 84% of parameters was over 0.6, and 40.6% of parameters reached well-accepted clinical agreements. CONCLUSIONS The proposed method provides a helpful protocol for automatic hand ROM measurement based on smartphone images and the MediaPipe Hands pose estimation technique. The automatic measurement is acceptable and comparable with existing methods, showing a possible application in the telemedicine examination of hand surgery.
Collapse
Affiliation(s)
- Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhaoyang Wang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| |
Collapse
|
4
|
Boisvert-Plante V, Noutsios CD, Perez J, Ingelmo P. The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review. J Pain Res 2021; 14:3173-3192. [PMID: 34675645 PMCID: PMC8519790 DOI: 10.2147/jpr.s336168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
With the COVID-19 pandemic hastening the adoption of telemedicine into clinical practice, it has also prompted an abundance of new literature highlighting its capabilities and limitations. The purpose of this review is to summarize the current state of the literature on telemedicine applied in the context of a musculoskeletal examination of the neck and upper limbs for children 3 to 18 years old. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. General examination components including inspection, guided self-palpation, range of motion, sensory and motor examination, as well as special testing are described. Although the literature is focused mainly on adult populations, we describe how each component of the exam can be reliably incorporated into a virtual appointment specific to pediatric patients. Caregivers are generally needed for most consultations, but certain maneuvers can be self-performed by older children and adolescents alone. There is general feasibility, validity, and substantial reliability in performing most examination components of the upper limbs remotely, except for the shoulder exam. Compared to those made in person, clinical diagnoses established virtually were found to be either the same or similar in most cases, and management decisions also had high agreement. Despite this, there is evidence that some pediatric providers may not be able to collect all the information needed from a telemedicine visit to make a complete clinical assessment. Lastly, currently available smartphone applications measuring joint range of motion were found to have high reliability and validity. This narrative review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase physicians' confidence in incorporating telemedicine into their standard of care.
Collapse
Affiliation(s)
| | | | - Jordi Perez
- Alan Edwards Pain Management Unit, Montreal General Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Pablo Ingelmo
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
- Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
| |
Collapse
|
5
|
Means KR, Saunders RJ. Understanding and Measuring Long-Term Outcomes of Fingertip and Nail Bed Injuries and Treatments. Hand Clin 2021; 37:125-153. [PMID: 33198913 DOI: 10.1016/j.hcl.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There are many outcome measures to choose from when caring for or studying fingertip and nail bed trauma and treatments. This article outlines general outcome measures principles as well as guidelines on choosing, implementing, and interpreting specific tools for these injuries. It also presents recent results from the literature for many of these measures, which can help learners, educators, and researchers by providing a clinical knowledge base and aiding study design.
Collapse
Affiliation(s)
- Kenneth R Means
- The Curtis National Hand Center @ MedStar Union Memorial Hospital, Baltimore, MD, USA.
| | - Rebecca J Saunders
- The Curtis National Hand Center @ MedStar Union Memorial Hospital, Baltimore, MD, USA
| |
Collapse
|
6
|
A framework for automatic hand range of motion evaluation of rheumatoid arthritis patients. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
7
|
Korhonen L, Pokka T, Holappa A, Serlo W, Sinikumpu JJ. The Measurement Methods of Movement and Grip Strength in Children with a Previous Upper Extremity Fracture: A Comparative, Prospective Research. Scand J Surg 2019; 109:351-358. [PMID: 31238810 DOI: 10.1177/1457496919857261] [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: 11/16/2022]
Abstract
BACKGROUND AND AIMS Decreased range of motion of the elbow and forearm and decreased grip strength are potential findings following a childhood upper extremity fracture. Clinical follow-up is essential because spontaneous improvement is seen several months after the injury. Freehand measuring with a goniometer and hydraulic dynamometer is used to evaluate clinical result. The new methods are justified in avoiding human typewriting errors, thus improving patient safety. Nevertheless, their feasibility in child patients is unknown. This study aimed to evaluate congruence between the computer-assisted and the free-hand measuring methods. MATERIALS AND METHODS A total of 59 children with a previous supracondylar humerus fracture were clinically examined by means of free-hand (transparent goniometer and hydraulic dynamometer; Jamar, Lafayette Ltd.) and computer-assisted (E-Link System Packages, Biometrics Ltd.) methods. The range of motion and grip strength were measured separately using both methods. Agreement between the measurements was evaluated using the Bland-Altman method. RESULTS The results between the two methods were incongruent and the differences between measurements increased along with the mean of measurements in all categories except elbow extension. Rotational range of motions were smaller and grip strength was weaker while measuring with the computer-assisted method. The mean discrepancy was 0.97° (95% confidence interval = -2.46 to 0.53) for elbow extension and 7.97° (95% confidence interval = 6.60-9.33) for elbow flexion. CONCLUSIONS Grip strength is used to evaluate impairment of hand function. The study method showed slightly lower results in grip strength. Range of motion is essential when evaluating the outcome of supracondylar humerus fracture, while >10° of change in elbow range of motion associate with impaired function. As compared with the gold-standard goniometer, the methods were not congruent. However, all differences were under 10° and probably beyond clinical importance. Because of its advantages in recording the outcomes to electronical charts, the computer-assisted method is recommended option in performing the follow-up of complicated pediatric supracondylar humerus fractures.
Collapse
Affiliation(s)
- L Korhonen
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit, Oulu University, MRC Oulu
| | - T Pokka
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit, Oulu University, MRC Oulu
| | - A Holappa
- Department of Physiatry, Northern Ostrobothnia Hospital District, Oulu, Finland
| | - W Serlo
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit, Oulu University, MRC Oulu
| | - J-J Sinikumpu
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit, Oulu University, MRC Oulu
| |
Collapse
|