A study to compare the reliability of composite finger flexion with goniometry for measurement of range of motion in the hand

Ellis, Bridget; Bruton, Anne

doi:10.1191/0269215502cr513oa

Cited by 114 publications

(91 citation statements)

References 21 publications

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“…For radial/ulnar deviation the mean absolute difference between the two raters was 5.1 with a maximum absolute difference of 10.7 . In both cases, the mean absolute difference between the two raters is better than that defined in the literature for manual goniometry (between 7 and 9 ) which is considered in clinical practice to be the gold standard of joint angle measurement [24], [25].…”

Section: B Static Participant Trial-inter-rater Reliabilitymentioning

confidence: 71%

Validation and Application of a Computational Model for Wrist and Hand Movements Using Surface Markers

Metcalf

Notley

Chappell

et al. 2008

IEEE Trans. Biomed. Eng.

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Abstract-A kinematic model is presented based on surface marker placement generating wrist, metacarpal arch, fingers and thumb movements. Standard calculations are used throughout the model and then applied to the specified marker placement. A static trial involving eight unimpaired participants was carried out to assess inter-rater reliability. The standard deviations across the data were comparable to manual goniometers. In addition, a test-retest trial of ten unimpaired participants is also reported to illustrate the variability of movement at the wrist joint, metacarpal arch, and index finger as an example of model output when repeating the same task many times.

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Section: B Static Participant Trial-inter-rater Reliabilitymentioning

confidence: 71%

Validation and Application of a Computational Model for Wrist and Hand Movements Using Surface Markers

Metcalf

Notley

Chappell

et al. 2008

IEEE Trans. Biomed. Eng.

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“…Following completion of the case report form, a physical assessment was performed in a standardised order and standardised positions. This included the measurement of joint deformity (MCP ulnar/radial deviation in maximum pronation, where ulnar deviation is recorded as a positive value) and active range of motion (wrist flexion and extension from the neutral position with a goniometer, 47 combined finger flexion according to Ellis and Bruton, 48 combined finger extension and thumb opposition according to Kapandji). 49 A modified swollen and tender joint count (22 joints of hand and wrist) 50 was taken, along with a test of upper limb dexterity (nine-hole peg test according to Mathiowetz et al).…”

Section: Discussionmentioning

confidence: 99%

Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomised controlled trial and economic evaluation

Williams

Williamson

Heine

et al. 2015

Health Technology Assessment

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BackgroundThe effectiveness of exercise for improving hand and wrist function in people with rheumatoid arthritis (RA) is uncertain.ObjectivesThe study aims were (1) to estimate the clinical effectiveness and cost-effectiveness of adding an optimised exercise programme for hands and upper limbs to standard care for patients with RA; and (2) to qualitatively describe the experience of participants in the trial with a particular emphasis on acceptability of the intervention, exercise behaviours and reasons for adherence/non-adherence.DesignA pragmatic, multicentred, individually randomised controlled trial with an embedded qualitative study. Outcome assessors were blind to group assignment and independent of treatment delivery.SettingSeventeen NHS trusts in England comprising 21 rheumatology and therapy departments.ParticipantsAdults with RA who had pain and dysfunction of the hands and/or wrists and had been on stable medication for at least 3 months. Patients were excluded if they were under 18 years old, had undergone upper limb surgery/fracture in the last 6 months, were on a waiting list for upper limb surgery or were pregnant.InterventionsUsual care or usual care plus an individualised exercise programme. Usual care consisted of joint protection education, general exercise advice and functional splinting if required. The exercise programme consisted of six sessions of strengthening and stretching exercises with a hand therapist, daily home exercises and strategies to maximise adherence.Main outcome measuresThe primary outcome was the Michigan Hand Outcome Questionnaire (MHQ) overall hand function subscale score at 12 months. Secondary outcome measures included the full MHQ, pain, health-related quality of life (Short Form questionnaire-12 items), impairment (grip strength, dexterity and range of motion) and self-efficacy. European Quality of Life-5 Dimensions, medication and health-care use were collected for the health economics evaluation. Follow-up was at 4 and 12 months post randomisation. Analysis was performed on an intention-to-treat basis.ResultsWe randomised 490 patients (244 to usual care, 246 to exercise programme). Compliance with the treatments was very good (93% of usual care participants and 75% of exercise programme participants completed treatment). Outcomes were obtained for 89% of participants at 12 months (222 for usual care, 216 for exercise programme). There was a statistically significant difference in favour of the exercise programme for the primary outcome at 4 and 12 months [mean difference 4.6 points, 95% confidence interval (CI) 2.2 to 7.0 points; and mean difference 4.4 points, 95% CI 1.6 to 7.1 points, respectively]. There were no significant differences in pain scores or adverse events. The estimated difference in mean quality-adjusted life-years (QALYs) accrued over 12 months was 0.01 greater (95% CI –0.03 to 0.05) in the exercise programme group. Imputed analysis produced incremental cost-effectiveness ratio estimates of £17,941 (0.59 probability of cost-effectiveness at willingness-to-pay threshold of £30,000 per QALY). The qualitative study found the exercise programme to be acceptable and highlighted the importance of the therapist in enabling patients to establish a routine and incorporate the exercises into their lives.ConclusionsThe results of the Strengthening And stretching for Rheumatoid Arthritis of the Hand trial suggest that the addition of an exercise programme for RA hands/wrists to usual care is clinically effective and cost-effective when compared with usual care alone. No adverse effects were associated with the exercise programme. The economic analysis suggests that the intervention is likely to be cost-effective.Study registrationCurrent Controlled Trials ISRCTN 89936343.Funding detailsThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 19. See the NIHR Journals Library website for further project information. This report has been developed in association with the NIHR Collaboration for Leadership in Applied Health Research and Care Oxford and the NIHR Biomedical Research Unit Funding Scheme. This project benefited from facilities funded through Birmingham Science City Translational Medicine Clinical Research and Infrastructure Trials Platform, with support from Advantage West Midlands.

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“…Taking the ankle criterion as an example, the responses include, two (0°-2° of eversion), four (3°-5°), five (6°-10°) six (11°-15°), seven (>15°). This gives little margin for error when using a tool which is based on observer interpretation, and is impractical based on research which has shown that inter-rater goniometric measures fall within 7° to 9° of each other [31,32]. inherent error, as the values obtained will largely depend on the observer and method of assessment.…”

Section: Discussionmentioning

confidence: 99%

Inter- and intra-rater reliabilities of the Beighton Score compared to the Contompasis Score to assess Generalised Joint Hypermobility

Vallis¹,

Wray

Smith

2015

MYOPAIN

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Objectives: Generalised Joint Hypermobility (GJH) is a common connective tissue disorder associated with a range of musculoskeletal complaints. An effective screening tool to assess GJH may influence our understanding and choice of management. Diagnosis is clinical, using tools such as the Beighton Hypermobility Score and the Contompasis Scoring System. The comparable reliability of these tools has not been previously reported. The aim of the present study was to compare the intraand inter-rater reliability of the Beighton Score to the Contompasis Score to assess GJH. Methods:This was an observational study assessing 36 pain-free participants; 27 females and nine males; aged 18 to 32 years. Participants were assessed in random order, by two researchers over two sessions to determine intra-and inter-rater analyses. Intraclass Correlation Coefficient (ICC) and weighted Kappa statistics were used to calculate the level of agreement. Conclusions:The present study provides an indication of the measurement capabilities of the Beighton and Contompasis Scores. The Beighton score appears to be superior compared to the Contompasis score particularly based on inter-rater reliability.

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A study to compare the reliability of composite finger flexion with goniometry for measurement of range of motion in the hand

Abstract: In this study involving a subject with normal joints, goniometry is more reliable than CFF when only one measurer is involved. However, CFF may be a useful alternative where multiple joint measures are required, or when goniometry is impracticable.

Cited by 114 publications

References 21 publications

Validation and Application of a Computational Model for Wrist and Hand Movements Using Surface Markers

Validation and Application of a Computational Model for Wrist and Hand Movements Using Surface Markers

Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomised controlled trial and economic evaluation

Inter- and intra-rater reliabilities of the Beighton Score compared to the Contompasis Score to assess Generalised Joint Hypermobility

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