Kuroiwa Tomoyuki, Fujita Koji, Nimura Akimoto, Miyamoto Takashi, Sasaki Toru, Okawa Atsushi
Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-4-5, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-4-5, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
J Orthop Surg Res. 2018 Nov 16;13(1):288. doi: 10.1186/s13018-018-0999-3.
Thumb opposition is vital for hand function and involves pronation and palmar abduction. The improvement of pronation is often used as one of the evaluation items of the opponensplasty method for severe carpal tunnel syndrome. However, most of the studies used substitution evaluation methods for measurement of the pronation angle. Thus, there is still no appropriate method for measuring thumb pronation angle accurately in carpal tunnel syndrome patients. In recent reports, a wearable gyroscope was used to evaluate upper extremity motions and it can be possibly used for accurate measurement of the thumb pronation angle along the three-dimensionally moving bone axis. Thus, we investigated the reliability of measuring thumb pronation using a gyroscope and evaluated whether this method can be used to detect opposition impairment.
The participants were volunteers with unaffected upper limbs (32 hands) and patients with carpal tunnel syndrome (27 hands). The pronation and palmar abduction angles during opposition movements were measured using a three-axis gyroscope that included a three-axis accelerometer. The gyroscope was fixed onto the first metacarpal bone and the thumb phalanx.
The pronation and palmar abduction angles of the metacarpal bone and the palmar abduction angles of the phalanx significantly decreased in the carpal tunnel syndrome group. The pronation angle of the metacarpal bone during opposition movement peaked later than the palmar abduction angle in all hands.
We were able to measure the thumb pronation and palmar abduction angles using the three-axis gyroscope, and this tool was able to detect impairments of thumb opposition due to carpal tunnel syndrome. This could be a tool for measuring thumb and finger angles and for detecting impairments caused by various diseases.
拇指对掌功能对于手部功能至关重要,涉及旋前和掌侧外展。旋前功能的改善常被用作重度腕管综合征对掌成形术方法的评估项目之一。然而,大多数研究使用替代评估方法来测量旋前角度。因此,对于腕管综合征患者,仍没有准确测量拇指旋前角度的合适方法。在最近的报告中,可穿戴陀螺仪被用于评估上肢运动,并且它有可能用于沿三维移动骨轴准确测量拇指旋前角度。因此,我们研究了使用陀螺仪测量拇指旋前的可靠性,并评估该方法是否可用于检测对掌功能障碍。
参与者为上肢未受影响的志愿者(32只手)和腕管综合征患者(27只手)。使用包含三轴加速度计的三轴陀螺仪测量对掌运动过程中的旋前和掌侧外展角度。将陀螺仪固定在第一掌骨和拇指指骨上。
腕管综合征组中掌骨的旋前和掌侧外展角度以及指骨的掌侧外展角度显著降低。在所有手中,对掌运动过程中掌骨的旋前角度峰值出现时间晚于掌侧外展角度。
我们能够使用三轴陀螺仪测量拇指旋前和掌侧外展角度,并且该工具能够检测出由腕管综合征导致的拇指对掌功能障碍。这可能是一种用于测量拇指和手指角度以及检测由各种疾病引起的功能障碍的工具。