Radial and palmar active range of motion measurement: reliability of six methods in healthy adults

Abstract

The current study aims to assess the reliability of 6 range-of-motion measurement methods for the thumb carpometacarpal joint: Pollexograph-thumb, Pollexograph-metacarpal, radius-metacarpal goniometry, intermetacarpal goniometry, intermetacarpal distance, and thumb-distal-interphalangeal distance. A senior hand surgeon, an experienced resident, and a less experienced research fellow evaluated the dominant hands of 29 healthy subjects. All 6 methods were performed for radial adduction, radial abduction, and palmar abduction, but only distance methods were measured for palmar adduction. Intrarater and interrater reliability were computed using intraclass correlation coefficient, standard error of measurement, and smallest detectable difference. Pollexograph-thumb method showed the highest active range of movement for radial adduction (12) and abduction (71), while all the other angular methods resulted in approximately 20 for radial adduction and 50 for radial abduction. Distance methods showed comparable mean results for radial and palmar range of motion (adduction/abduction): intermetacarpal distance (50 mm/60 mm) and thumb-distal-interphalangeal distance (50 mm/120 mm). Interrater reliability using the results of the intraclass correlation coefficient demonstrates that Pollexograph-thumb and Pollexograph-metacarpal showed excellent reliability for radial adduction and abduction, whereas Pollexograph-thumb method revealed the best reliability for palmar abduction. Moreover, thumb-distal-interphalangeal distance also showed excellent reliability for radial and palmar abduction. Conventional goniometry showed a large variety of reliability results, ranging from poor to excellent. No clinical benefit can be derived from assessing the palmar adduction. We found that the Pollexograph-thumb showed excellent reliability results throughout all measurements. Thumb-distal-interphalangeal-joint distance is especially valuable for assessing radial and palmar abduction.

TOUCH® Prosthesis for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Case Series

“…Furthermore, the ROM outcomes have to be regarded as absolute, descriptive data. The significant, postoperative improvement in ROM values is more a statistical than a clinically relevant effect, because the median difference undercuts the ICC values resulting from reliability studies [13]. Moreover, the present study does not include a comparison cohort, consisting of e.g., trapeziectomy or resection-suspension-arthroplasty patients.…”

“…Pain was assessed while asking the patients to specify their average pain levels in everyday life caused by the affected thumb CMC joint on a visual analogue scale (VAS) ranging from 0 (no pain) to 10 (worst imaginable pain). Moreover, preoperative data acquisition included key-pinch strength measurement of the affected as well as contralateral thumb using a dynamometer, and range of motion (ROM) assessment: radial and palmar abduction via radius-metacarpal angle [13] as well as distance (in cm) between the thumb tip and the fifth metacarpophalangeal joint while the patients opposed their thumbs maximally.…”

Liparthroplasty for Thumb Carpometacarpal Joint Osteoarthritis: A Case Series with Median 5 Years of Follow-Up

“…Two years postinterventionally and at a final follow-up appointment, DASH Scores, pain levels, subjective change of grip strength, and grip strength using a Jamar Dynamometer were evaluated. The final follow-up appointment also included a range of motion assessment, including radial and palmar abduction via the Radius-metacarpal angle method [ 11 ], and opposition was assessed as distance (in cm) between the thumb tip and the fifth metacarpophalangeal joint.…”

The effects of motor imagery on trapeziometacarpal osteoarthritis in women during the post-surgical immobilisation period: A protocol for a randomised clinical trial

“…The intermetacarpal angle will be evaluated with the forearm in pronation, wrist in a neutral position and palm on the surface. The Moeltgen goniometer will be placed in the carpometacarpal joint of the thumb and both arms in the heads of the first and second metacarpals in maximum radial abduction (Holzbauer et al, 2021).…”