de Kraker M, Selles R W, Schreuders T A R, Stam H J, Hovius S E R
Department of Plastic and Reconstructive Surgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Hand Surg Am. 2009 Mar;34(3):523-30. doi: 10.1016/j.jhsa.2008.10.028.
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.
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.
Mean active and passive angles measured with goniometry resembled values measured with the Pollexograph-thumb method (approximately 60 degrees). Mean angles found with the Pollexograph-metacarpal method were approximately 48 degrees. 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.
We found that the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal Distance are the most reliable measurement methods for palmar abduction.
本研究旨在评估6种拇指掌侧外展测量方法的可靠性：传统量角法、掌骨间距离法、美国医学协会描述的方法、美国手治疗师协会描述的方法，以及2种新方法：拇指Pollexograph法和掌骨Pollexograph法。
一位经验丰富的手治疗师和一位经验较少的检查者（整形外科实习生）对25名健康受试者的右手进行测量。分别测量掌侧外展的被动和主动活动度。计算掌侧外展的平均值和范围，并通过组内相关系数、测量标准误差和最小可检测差异来表示测量者内和测量者间的可靠性。
用量角法测量的主动和被动平均角度与拇指Pollexograph法测量的值相似（约60度）。掌骨Pollexograph法测得的平均角度约为48度。掌骨间距离的主动和被动平均距离为64毫米。美国手治疗师协会方法测得的主动和被动平均距离为97至101毫米，美国医学协会方法测得的主动和被动平均距离为67至70毫米。拇指Pollexograph法、掌骨Pollexograph法和掌骨间距离法的组内相关系数表明，主动和被动测量的测量者内一致性良好，且显著高于传统量角法、美国手治疗师协会方法和美国医学协会方法的组内相关系数，后三者仅显示出中等一致性。对于测量者间可靠性，发现相同的测量方法最可靠：拇指Pollexograph法、掌骨Pollexograph法和掌骨间距离法。
我们发现拇指Pollexograph法,掌骨Pollexograph法和掌骨间距离法是测量掌侧外展最可靠的方法。
