Functional Task Kinematics of the Thumb Carpometacarpal Joint
Tóm tắt
Abnormal biomechanical loading has been identified as an associated risk factor of osteoarthritis in the wrist and hand. Empirical data to date are insufficient to describe the role of altered biomechanics in thumb carpometacarpal (CMC) arthritis. This is a pilot study to evaluate motion analysis of the upper extremity while performing functional tasks. We wished to describe the in vivo kinematics of the thumb and hand in relation to the larger joints of the upper extremity in subjects without arthritis in functional positions at rest and while loading the CMC joint. If reproducible, we then planned to compare kinematics between these subjects and a subject with advanced thumb CMC arthritis. In vivo kinematics of the hand and upper extremity during the functional tasks of grasp, jar opening, and pinch with and without loading of the CMC joint were evaluated using cameras and a motion-capture system in four asymptomatic female subjects and one female subject with advanced radiographic (Eaton Stage IV) osteoarthritis. Kinematics of the hand and upper extremity can be reliably quantified. Loading of the CMC joint did not alter the hand and forearm kinematics in control subjects. In the subject with osteoarthritis, the adduction-extension deformity at the CMC joint resulted in kinematic alterations as compared with the four control subjects. This study represents preliminary steps in defining thumb CMC position, motion, and loading associated with activities of daily living. These findings enhance our understanding of motion at the CMC joint and how it differs in arthritic patients. Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Tài liệu tham khảo
Acheson RM, Chan YK, Clemett AR. New Haven survey of joint diseases. XII. Distribution and symptoms of osteoarthrosis in the hands with reference to handedness. Ann Rheum Dis. 1970;29:275–286.
Adams BD, Grosland NM, Murphy DM, McCullough M. Impact of impaired wrist motion on hand and upper-extremity performance. J Hand Surg Am. 2003;28:898–903.
Butler EE, Ladd Al, Louise SA, Wong W, Rose J. Three-dimensional kinematics of the upper limb during a reach and grasp cycle for children. Gait Posture. 2010;32:72–77.
Cooney WP III, Chao EY. Biomechanical analysis of static forces in the thumb during hand function. J Bone Joint Surg Am. 1977;59:27–36.
Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis. 2005;64:682–687.
Dewald JPA, Pope PS, Given JD, Buchanan TS, Rymer WZ. Abnormal muscle coactivation patterns during isometric torque generation at the elbow and shoulder in hemiparetic subjects. Brain. 1995;118:495–510.
Eaton RG, Glickel SZ. Trapeziometacarpal osteoarthritis. Staging as a rational for treatment. Hand Clin. 1987;3:455–471.
Gamble JG, Mochizuki C, Rinsky LA. Trapeziometacarpal abnormalities in Ehlers-Danlos syndrome. J Hand Surg Am. 1989;141:89–94.
Gehrmann SV, Tang J, Li ZM, Goitz RJ, Windolf J, Kaufmann RA. Motion deficit of the thumb in CMC joint arthritis. J Hand Surg Am. 2010;35:1449–1453.
Haara MM, Heliovaara M, Kroger H, Arokoski JP, Manninen P, Karkkainen A, Knekt P, Impivaara O, Aromaa A. Osteoarthritis in the carpometacarpal joint of the thumb. Prevalence and associations with disability and mortality. J Bone Joint Surg Am. 2004;86:1452–1457.
Kuo LC, Cooney WP 3rd, Oyama M, Kaufman KR, Su FC, An KN. Feasibility of using surface markers for assessing motion of the thumb trapeziometacarpal joint. Clin Biomech. 2003;18:558–563.
Miller LC, Dewald JPA. Involuntary paretic wrist/finger flexion forces and EMG increase with shoulder abduction load in individuals with chronic stroke. Clin Neurophysiol. 2012;123:1216–1225.
Napier J. The evolution of the hand. Sci Am. 1962;207:56–62.
Napier JR. The prehensile movements of the human hand. J Bone Joint Surg Br. 1956;38:902–913.
National Research Council and the Institute of Medicine. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington, DC, USA: National Academy Press; 2001.
O’Neill OR, Morrey BF, Tanaka S, An KN. Compensatory motion in the upper extremity after elbow arthrodesis. Clin Orthop Relat Res. 1992;281:89–96.
Pellegrini VD Jr. The ABJS 2005 Nicolas Andry Award: osteoarthritis and injury at the base of the human thumb: survival of the fittest? Clin Orthop Relat Res. 2005;438:266–276.
Rash GS, Belliappa PP, Wachowiak MP, Somia NN, Gupta A. A demonstration of validity of 3-D video motion analysis method for measuring finger flexion and extension. J Biomech. 1999;32:1337–1341.
Reid S, Elliott C, Alderson J, Lloyd D, Elliott B. Repeatability of upper limb kinematics for children with and without cerebral palsy. Gait Posture. 2010;32:10–17.
Sonne-Holm S, Jacobsen S. Osteoarthritis of the first carpometacarpal joint: a study of radiology and clinical epidemiology. Results from the Copenhagen Osteoarthritis Study. Osteoarthritis Cartilage. 2006;14:496–500.
Steif F, Bohm H, Schwirtz A, Dussa CU, Doderlein L. Dynamic loading of the knee and hip joint and compensatory strategies in children and adolescents with varus malalignment. Gait Posture. 2001;33:490–495.
Su FC, Kuo LC, Chiu HY, Hsu HY. The validity of using a video-based motion analysis system for measuring maximal area of fingertip motion and angular variation. Proc Inst Mech Eng H. 2002;216:257–263.
Van Andel CJ, Wolterbeek N, Doorenbosch CA, Veeger DH, Harlaar J. Complete 3D kinematics of upper extremity functional tasks. Gait Posture. 2008;27:120–127.
Van Heest AE, Kallemeier P. Thumb carpal metacarpal arthritis. JAAOS. 2008;16:140–151.
Wilder FV, Barrett JP, Farina EJ. Joint-specific prevalence of osteoarthritis of the hand. Osteoarthritis Cartilage. 2006;14:953–957.