Purpose
The aim of the current study was to assess reliability of 6 palmar thumb abduction
measurement methods: conventional goniometry, the Inter Metacarpal Distance, the method
described by the American Medical Association, the method described by the American
Society of Hand Therapists, and 2 new methods: the Pollexograph-thumb and the Pollexograph-metacarpal.
Methods
An experienced hand therapist and a less-experienced examiner (trainee in plastic
surgery) measured the right hands of 25 healthy subjects. Palmar abduction was measured
both passively and actively. Means and ranges for palmar abduction were calculated,
and intrarater and interrater reliability was expressed in intraclass correlation
coefficients, standard errors of measurement, and smallest detectable differences.
Results
Mean active and passive angles measured with goniometry resembled values measured
with the Pollexograph-thumb method (approximately 60°). Mean angles found with the
Pollexograph-metacarpal method were approximately 48°. Mean active and passive distances
for the Inter Metacarpal Distance were 64 mm. Mean active and passive distances found
with the American Society of Hand Therapists method were 97 to 101 mm, and mean distances
found with the American Medical Association method were 67 to 70 mm for active and
passive measurements. Intraclass correlation coefficients for the Pollexograph-thumb,
Pollexograph-metacarpal, and the Inter Metacarpal Distance indicated good and significantly
higher intrarater agreement for active and passive measurements than intraclass correlation
coefficients of conventional goniometry, the American Society of Hand Therapists method,
and the American Medical Association method, which showed only moderate agreement.
For interrater reliability, the same measurement methods were found to be most reliable:
the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal Distance.
Conclusions
We found that the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal
Distance are the most reliable measurement methods for palmar abduction.
Key words
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References
- Deformity in leprosy.in: Cochrane R.G. Leprosy in theory and practice. 2nd ed. John Wright & Sons Ltd, Bristol, UK1964: 485-496
- Terminology for hand surgery.in: Harcourt Health Sciences, Edinburgh, UK2001: 53
- Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition.J Bone Joint Surg. 2001; 83A: 1470-1478
- Examination of the hand and wrist.in: Martin Dunitz Ltd, London1998: 195-196
- Guides to the evaluation of permanent impairment.in: 4th ed. American Medical Association, Chicago, IL1993: 28-29
- Reconstructive surgery in treatment of deformities of hand.in: Dharmendra Leprosy. Kothari Medical Publishing House, Bombay1978: 567-617
- Brief or new: measuring cone for thumb abduction/extension.Am J Occup Ther. 1984; 38: 263-264
- Reliability of thumb web measurements.J Hand Ther. 2004; 17: 58-63
- A torque-controlled device to measure passive abduction of the thumb carpometacarpal joint.J Hand Ther. 2006; 19: 403-408
- Clinical assessment and recommendations.in: 2nd ed. American Society of Hand Therapists, Chicago, IL1992: 64-65
- Video-computer quantitative evaluation of thumb function using workspace of the thumb.J Biomech. 2003; 36: 937-942
- The use of the motion analysis system for evaluation of loss of movement in the finger.J Hand Surg. 2000; 25B: 195-199
- Three-dimensional rotations of human three-joint fingers: an optoelectronic measurement.Surg Radiol Anat. 2005; 27: 43-50
- Feasibility of using a video-based motion analysis system for measuring thumb kinematics.J Biomech. 2002; 35: 1499-1506
- J Hand Surgery. 2009; (in press)
- Statistical methods for assessing agreement between two methods of clinical measurement.Lancet. 1986; 1: 307-310
- Assessing intrarater, interrater and test-retest reliability of continuous measurements.Statistics Med. 2002; 21: 3431-3446
- The application of generalizability theory to reliability assessment: an illustration using isometric force measurements.Phys Ther. 1993; 73: 386-401
- Generalizability theory.Am Psychol. 1989; 44: 922-932
- Reliability assessment of isometric knee extension measurements with a computer-assisted hand-held dynamometer.Arch Phys Med Rehab. 1998; 79: 442-448
- Strength of the intrinsic muscles of the hand measured with a hand-held dynamometer: reliability in patients with ulnar and median nerve paralysis.J Hand Surg. 2000; 25B: 560-565
- Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength.Phys Ther. 1997; 77: 745-750
Article info
Publication history
Accepted:
October 28,
2008
Received:
May 8,
2008
Footnotes
We thank the NUTS-OHRA Foundation for their financial contribution to support this study.
Support was received from the NutsOhra Foundation.
Identification
Copyright
© 2009 Published by Elsevier Inc.
