Gracia-Ibáñez Verónica, Agost Maria-Jesus, Bayarri-Porcar Vicente, Granell Pablo, Vergara Margarita, Sancho-Bru Joaquin L
Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain.
Consorci Hospitalari Provincial de Castelló, Castellón de la Plana, Spain.
Disabil Rehabil. 2023 Apr;45(7):1124-1130. doi: 10.1080/09638288.2022.2051082. Epub 2022 Mar 17.
To identify the impact of kinematic limitations on hand osteoarthritis patients' ability to perform daily living activities.
An experiment was performed on 33 patients and 32 healthy subjects. Active ranges of motion (AROM) of 16 hand joint angles were measured, together with scores of different hand tests of dexterity (Box and Block, Nine Hole Peg, Kapandji) and function (Sollerman Hand Function Test, SHFT). Functional ranges of motion (FROM) were recorded during SHFT tasks. Results by task are also reported.
Patients' AROM is limited in flexion of thumb carpometacarpal and interphalangeal, and finger metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and in palmar arch. Patients scored worse in gross dexterity and opposition, but only Kapandji score was correlated with AROM limitations. Pain is mostly reported in patients with limited extension of finger MCP and PIP joints. Patients used significantly different FROM in almost all the joints, and needed more time to accomplish the SHFT tasks.
AROM measurements can be used as indicators for early diagnosis. Patients use specific strategies to accomplish each task, arising from AROM limitations; some tasks with very extreme postures. The tasks where precision or force are required for thumb are the most affected ones.Implications for rehabilitationActive range of motion is an indicator for early hand osteoarthritis diagnosis.Patients' functional ranges are reduced, and thumb opposition and gross dexterity are hindered.Rehabilitation should focus especially on tasks requiring precision and thumb strength.Rehabilitation should favor the improvement of task completion times.
确定运动学限制对手部骨关节炎患者进行日常生活活动能力的影响。
对33例患者和32名健康受试者进行了一项实验。测量了16个手部关节角度的主动活动范围（AROM），以及不同手部灵活性测试（箱块测试、九孔插销测试、卡潘迪测试）和功能测试（索勒曼手部功能测试，SHFT）的得分。在SHFT任务期间记录功能活动范围（FROM）。还报告了按任务划分的结果。
患者的AROM在拇指腕掌关节和指间关节、手指掌指关节（MCP）和近端指间关节（PIP）的屈曲以及掌弓方面受到限制。患者在总体灵活性和对掌方面得分较差，但只有卡潘迪测试得分与AROM限制相关。疼痛主要出现在手指MCP和PIP关节伸展受限的患者中。患者在几乎所有关节中使用的FROM显著不同，并且完成SHFT任务需要更多时间。
AROM测量可作为早期诊断的指标。患者因AROM限制而采用特定策略来完成每项任务；有些任务姿势非常极端。拇指需要精确性或力量的任务受影响最大。对康复的启示主动活动范围是手部骨关节炎早期诊断的指标。患者的功能活动范围减小，拇指对掌和总体灵活性受到阻碍。康复应特别关注需要精确性和拇指力量的任务。康复应有利于缩短任务完成时间。
