Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Master of Science Occupational Therapy Program, Cox College, Springfield, MO, USA.
Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
J Hand Ther. 2023 Oct-Dec;36(4):923-931. doi: 10.1016/j.jht.2022.10.012. Epub 2023 Mar 12.
Cross-sectional and descriptive study BACKGROUND: Functional dart thrower's motion (F-DTM) is an obliquely oriented wrist motion that occurs in activities such as throwing and drinking from a cup. There is limited data on clinical measurement of F-DTM.
The purpose of this study was to 1) describe and establish reference scores for F-DTM measurement for nonoperative and postoperative wrist patients 2) compare F-DTM between the affected and nonaffected sides and 3) determine F-DTM score agreement across three consecutive trials.
Two certified hand therapists evaluated F-DTM in consecutive adult patients with a unilateral wrist condition undergoing nonoperative or postoperative therapy. Three trials of goniometer measurements for radial extension (RE) and ulnar flexion (UF) were assessed on the nonaffected and affected wrists. A total arc F-DTM was computed. Mean, 95% confidence intervals (CI), and Cohen's d effect size described side-to-side differences in RE, UF, and total arc F-DTM. Agreement in scores across trials was assessed with an intraclass correlation coefficient (ICC).
Thirty-one nonoperative (mean ± SD age = 40.0 ± 13.9 years, 74% female, 94% right hand dominant) and 44 postoperative patients (mean ± SD age = 44.9 ± 14.9 years, 66% female, 84% right hand dominant) were enrolled. The average side-to-side difference, in degrees, in the nonoperative group was -6.4 (95% CI: -9.4 to -3.4, Cohen's d = 0.8) for RE, -10.4 (-16.7 to -4.0, d = 0.6) for UF, and -16.8 (-24.3 to -9.2, d = 0.8) for total arc F-DTM. The average side-to-side difference in the postoperative group was -33.6 (-38.8 to -28.3, d = 1.9) for RE, -34.7 (-40.6 to -28.7, d = 1.8) for UF, and -68.2 (-77.9 to -58.5, d = 2.1) for total arc F-DTM. The range of ICCs for F-DTM measurements was 0.82-0.96.
Goniometer measurement of F-DTM is a clinically feasible method to quantify functional motion loss in an injured wrist population, particularly patients with postoperatively managed wrist conditions.
横断面和描述性研究
功能性飞镖投掷者的运动（F-DTM）是一种倾斜的腕关节运动，发生在投掷和从杯子中喝水等活动中。目前关于 F-DTM 的临床测量数据有限。
本研究旨在 1）描述和建立非手术和术后腕部患者 F-DTM 测量的参考评分，2）比较患侧和非患侧的 F-DTM，3）确定三次连续试验中 F-DTM 评分的一致性。
两名认证的手部治疗师对单侧腕部疾病接受非手术或术后治疗的连续成年患者进行 F-DTM 评估。在非患病和患病手腕上评估了三个连续的量角器测量桡侧伸展（RE）和尺侧屈曲（UF）的试验。计算了总弧 F-DTM。平均值、95%置信区间（CI）和 Cohen's d 效应大小描述了 RE、UF 和总弧 F-DTM 的侧间差异。通过组内相关系数（ICC）评估试验间评分的一致性。
纳入了 31 名非手术患者（平均±标准差年龄为 40.0±13.9 岁，女性占 74%，右手优势占 94%）和 44 名术后患者（平均±标准差年龄为 44.9±14.9 岁，女性占 66%，右手优势占 84%）。非手术组的平均侧间差异（以度为单位）分别为：RE-6.4（95%CI：-9.4 至-3.4，Cohen's d=0.8），UF-10.4（-16.7 至-4.0，d=0.6）和总弧 F-DTM-16.8（-24.3 至-9.2，d=0.8）。术后组的平均侧间差异分别为：RE-33.6（-38.8 至-28.3，d=1.9），UF-34.7（-40.6 至-28.7，d=1.8）和总弧 F-DTM-68.2（-77.9 至-58.5，d=2.1）。F-DTM 测量的 ICC 范围为 0.82-0.96。
量角器测量 F-DTM 是量化受伤腕部人群功能运动丧失的一种临床可行方法，特别是术后管理的腕部疾病患者。
