Clinical Examination of the Hand

Seftchick, Jodi; Detullio, Lauren M.; Fedorczyk, Jane M.; Aulicino, Pat L.

doi:10.1016/b978-0-323-05602-1.00006-4

Cited by 15 publications

(20 citation statements)

References 46 publications

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“…The fulcrum was perpendicular to the distal forearm with the fixed arm of the goniometer parallel to the longitudinal axis of the humerus and perpendicular to the floor and the movable arm placed at the level of the ulnar styloid process, on the dorsal surface of the wrist to asses pronation and on the anterior surface of the wrist, to assess supination ( Figure 2). 8,14,15,[17][18][19] All pronation and supination movements were measured three consecutive times, 10 with a 30-second interval between each measurement, by two trained physiotherapists following the same procedures, in a randomized order. Each examiner had no access to their previous records of ROM for each volunteer/ patient.…”

Section: Methodsmentioning

confidence: 99%

A study to compare two goniometric methods for measuring active pronation and supination range of motion

et al. 2013

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Introduction: Movement of the forearm allows positioning the hand during several functional activities of daily living. Assessing range of motion of supination and pronation is essential for clinical identification of functional limitations, although many methods can be used. Confounding values can be found due to different techniques used by therapists. The purpose of this study was to compare two standard goniometric methods for measuring active range of motion of forearm pronation and supination, aiming to define its reliability and ease of use. Methods: The study included 33 individuals, 13 injured and 20 non-injured volunteers. We analyzed two standard goniometric methods for measuring pronation and supination. For the first method, the volunteers had to hold a pencil as a guide for the movable arm of the goniometer and for the second method the movable arm was in contact with the distal dorsal surface of the wrist near the ulna head, and the hand was free. Two trained examiners performed the evaluations. Intraclass correlation coefficient and limits of agreement of Bland and Altman were used to analyze the data. Results: Intraclass correlation coefficient values were excellent for both groups and movements at inter-rater and intermethods comparison. Bland and Altman plots showed that, although excellent reliability, some data dispersion was present. Conclusion: These data suggest that both methods could be used in clinical practice with excellent reliability. The goniometric method with the movable arm placed in contact with the distal dorsal surface of the wrist near the ulna head might be easier to perform and useful in cases where finger prehension is absent or weak, which would prevent the use of a pencil as reference.

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Section: Methodsmentioning

confidence: 99%

A study to compare two goniometric methods for measuring active pronation and supination range of motion

et al. 2013

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“…The muscles used to evaluate hand strength were the abductor of the fifth finger, the fourth palmar, and the first dorsal interosseous. The results were graded from zero to five, according to the Highet scale 15 , and the values obtained for the three muscles were added and divided by 15 (the value for a normal individual).…”

Section: Methodsmentioning

confidence: 99%

Stimulus electrodiagnosis and motor and functional evaluations during ulnar nerve recovery

Fernandes¹,

Oliveira²,

Pelet³

et al. 2016

Braz. J. Phys. Ther.

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BACKGROUND: Distal ulnar nerve injury leads to impairment of hand function due to motor and sensorial changes. Stimulus electrodiagnosis (SE) is a method of assessing and monitoring the development of this type of injury. OBJECTIVE: To identify the most sensitive electrodiagnostic parameters to evaluate ulnar nerve recovery and to correlate these parameters (Rheobase, Chronaxie, and Accommodation) with motor function evaluations. METHOD: A prospective cohort study of ten patients submitted to ulnar neurorrhaphy and evaluated using electrodiagnosis and motor assessment at two moments of neural recovery. A functional evaluation using the DASH questionnaire (Disability of the Arm, Shoulder, and Hand) was conducted at the end to establish the functional status of the upper limb. RESULTS: There was significant reduction only in the Chronaxie values in relation to time of injury and side (with and without lesion), as well as significant correlation of Chronaxie with the motor domain score. CONCLUSION: Chronaxie was the most sensitive SE parameter for detecting differences in neuromuscular responses during the ulnar nerve recovery process and it was the only parameter correlated with the motor assessment.

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“…Since Tinel [ 17 ], many authors have described several approaches related to functional assessment after nerve lesion and repair [ 18 – 23 ]. These range from an ordinal “numerical grading system” based on a motor and sensory scale [ 18 , 20 ] to a multi-dimensional comprehensive scale based on sensory, motor, and pain domains in a model instrument for documentation of outcome after nerve repair [ 24 , 25 ], and a variety of other instruments [ 14 , 16 , 26 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…Selecting an instrument or a battery of tests for assessment of nerve outcomes requires knowledge of the clinical measurement properties of the potential test options. Ideally, the selected measurement should be reliable and be able to distinguish functional outcomes, measure change in clinical status, and predict the outcome of different interventions [ 21 , 23 , 26 , 30 – 32 ]. Based on principles of evidence-based practice [ 33 – 36 ], any outcome measurement [ 11 , 31 – 33 ], including those for peripheral nerve repair assessment, it is essential to know the psychometric [ 37 , 38 ] properties such as reliability, validity, and responsiveness [ 30 , 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

et al. 2018

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BackgroundOutcome after nerve repair of the hand needs standardized psychometrically robust measures. We aimed to systematically review the psychometric properties of available functional, motor, and sensory assessment instruments after nerve repair.MethodsThis systematic review of health measurement instruments searched databases from 1966 to 2017. Pairs of raters conducted data extraction and quality assessment using a structured tool for clinical measurement studies. Kappa correlation was used to define the agreement prior to consensus for individual items, and intraclass correlation coefficient (ICC) was used to assess reliability between raters. A narrative synthesis described quality and content of the evidence.ResultsSixteen studies were included for final critical appraisal scores. Kappa ranged from 0.31 to 0.82 and ICC was 0.81. Motor domain had manual muscle testing with Kappa from 0.72 to 0.93 and a dynamometer ICC reliability between 0.92 and 0.98. Sensory domain had touch threshold Semmes-Weinstein monofilaments (SWM) as the most responsive measure while two-point discrimination (2PD) was the least responsive (effect size 1.2 and 0.1). A stereognosis test, Shape and Texture Identification (STI), had Kappa test-retest reliability of 0.79 and inter-rater reliability of 0.61, with excellent sensibility and specificity. Manual tactile test had moderate to mild correlation with 2PD and SWM. Function domain presented Rosén-Lundborg score with Spearman correlations of 0.83 for total score. Patient-reported outcomes measurements had ICC of 0.85 and internal consistency from 0.88 to 0.96 with Patient-Rated Wrist and Hand Evaluation with higher score for reliability and Spearman correlation between 0.38 and 0.89 for validity.ConclusionsFew studies included nerve repair in their sample for the psychometric analysis of outcome measures, so moderate evidence could be confirmed. Manual muscle test and Rotterdam Intrinsic Hand Myometer dynamometer had excellent reliability but insufficient data on validity or responsiveness. Touch threshold testing was more responsive than 2PD test. The locognosia test and STI had limited but positive supporting data related to validity. Rosén-Lundborg score had emerging evidence of reliability and validity as a comprehensive outcome following nerve repair. Few questionnaires were considered reliable and valid to assess cold intolerance. There is no patient-reported outcome measurement following nerve repair that provides comprehensive assessment of symptoms and function by patient perspective.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0836-0) contains supplementary material, which is available to authorized users.

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Clinical Examination of the Hand

Cited by 15 publications

References 46 publications

A study to compare two goniometric methods for measuring active pronation and supination range of motion

A study to compare two goniometric methods for measuring active pronation and supination range of motion

Stimulus electrodiagnosis and motor and functional evaluations during ulnar nerve recovery

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

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