Scientific/Clinical Article| Volume 19, ISSUE 4, P403-409, October 2006

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A Torque-controlled Device to Measure Passive Abduction of the Thumb Carpometacarpal Joint


      The primary aim of this study was to design and then test the intrarater reliability of a torque-controlled method of measuring passive abduction of the thumb carpometacarpal (CMC) joint. A secondary aim was to quantify passive CMC abduction in patients with and without contracture. Initially, clinicians used subjective feel (without range of motion measurements) to identify 52 people with loss of passive thumb CMC abduction. All subjects had a neurological condition. Passive thumb CMC abduction was measured in both hands of these 52 people and the hands of another 20 healthy able-bodied individuals (total of 72 people and 144 hands). Passive thumb CMC abduction was measured using a newly designed torque-controlled device and the previously recommended caliper method. Repeat measurements were taken with both devices, two to three days later, by blinded assessors on a subgroup of 12 patients (24 hands). Median (interquartile range) CMC angle of thumbs deemed by clinicians to have contracture was 45° (41–52°) and that of subjects without contractures was 56° (53–60°). The intraclass correlation coefficient for the repeat measures attained with the torque-controlled device was 0.78 (95% confidence interval, 0.56–0.90). The torque-controlled device provides a way of standardizing torque when measuring passive thumb CMC abduction. The clear difference between passive CMC abduction of subjects with and without contracture confirms the ability of clinicians to use feel and subjective assessment to identify patients with contracture.
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      JHT Read for Credit

      Quiz: Article #042

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue. There is only one best answer for each question.
      • #1.
        The primary purpose of the study was to devise a:
        • a.
          valid method of measuring thumb CMC active abduction using standardized torque.
        • b.
          reliable method of measuring thumb CMC active abduction using standardized torque.
        • c.
          reliable method of measuring thumb CMC passive abduction using standardized torque.
        • d.
          valid method of measuring thumb MP motion using standardized torque.
      • #2.
        The arms of the goniometer were aligned with the:
        • a.
          1st & 2nd metacarpals.
        • b.
          1st & 2nd metacarpal heads
        • c.
          thumb & index long axes.
        • d.
          thumb & dorsal shaft of the 3rd metacarpal.
      • #3.
        A focus of the study was:
        • a.
          CMC vs. MCP reliability.
        • b.
          cross-population reliability.
        • c.
          interrater reliability.
        • d.
          intrarater reliability.
      • #4.
        The clinicians found the average thumb CMC adduction contracture of about:
        • a.
        • b.
        • c.
        • d.
      • #5.
        The ICC of the torque-controlled devise when measuring thumb CMC abduction was about:
        • a.
        • b.
        • c.
        • d.
      When submitting to the HTCC for recertification, please batch your JHT RFC certificates in groups of three or more to get full credit.