Comparison between healthy and reduced hand function using ranges of motion and a weighted fingertip space model.

Detection and quantification of changes in hand function are important for patients with loss of function and clinicians who are treating them. A recently developed model, the weighted fingertip space (WFS) quantifies the hand function of individuals in three-dimensional space and applies kinematic weighting parameters to identify regions of reachable space with high and low hand function. The goal of this research was to use the WFS model to compare and contrast the functional abilities of healthy individuals with the abilities of individuals with reduced functionality due to arthritis (RFA). Twenty two individuals with no reported issues with hand function and 21 individuals with arthritis affecting the hand were included in the research. Functional models were calculated from the ranges of motion and hand dimension data for each individual. Each model showed the volume of reachable space for each fingertip of each hand, the number of ways to reach a point in space, the range of fingertip orientations possible at each point, and the range of possible force application directions (FADs) at each point. In addition, two group models were developed that showed how many individuals in both the healthy and RFA groups were able to reach the same points in space. The results showed differences between the two groups for the range of motion (ROM) measurements, the individual model calculations, and the group models. The ROM measurements showed significant differences for the joints of the thumb, extension of the nonthumb metacarpophalangeal (MCP) joints, and flexion of the distal interphalangeal (DIP) joints. Comparing the models, the two groups qualitatively showed similar patterns of functional measures in space, but with the RFA group able to reach a smaller volume of space. Quantitatively, the RFA group showed trends of smaller values for all of the calculated functional weighting parameters and significantly smaller reachable volume for all of the fingers. The group models showed that all healthy individuals were able to reach an overlapping space, while 18 of 21 RFA individuals were able to reach similar spaces. Combined, the results showed that the WFS model presents the abilities of the hand in ways that can be quantitatively and qualitatively compared. Thus, the potential of this hand model is that it could be used to assess and document the changes that occur in hand function due to rehabilitation or surgery, or as a guide to determine areas most accessible by various populations.