The Effects of Complex Wrist and Forearm Posture on Wrist Range of Motion

1997 ◽  
Vol 41 (1) ◽  
pp. 629-633
Author(s):  
Matthew M. Marshall ◽  
Jacqueline Reynolds Mozrall ◽  
Jasper E. Shealy
Keyword(s):  
Range Of Motion ◽  
Ulnar Deviation ◽  
Wrist Motion ◽  
Practical Applications ◽  
Motion Data ◽  
Flexion Extension ◽  
Repetitive Trauma

In order to minimize the risk of repetitive trauma injuries, postures or motions that place joints near the limits of their range of motion (RoM) should be avoided. Before it can be determined that a posture or motion approaches the limit of a joint's motion, these limits need to be established. Previous research on wrist functionality has focused almost entirely on RoM in two or three isolated planes (flexion/extension, radial/ulnar deviation, and forearm pronation/supination), without investigating potential effects of complex wrist/forearm posture on RoM. Since most practical applications of this wrist motion data involve more than these isolated planar deviations, the effects of complex wrist/forearm posture on wrist functionality need to be understood.

The Effect of Radioscapholunate Fusion On Wrist Movement and the Subsequent Effects of Distal Scaphoidectomy and Triquetrectomy

2010 ◽  
Vol 35 (9) ◽  
pp. 740-745 ◽  
Author(s):  
M.J. Berkhout ◽  
M.N. Shaw ◽  
L.J. Berglund ◽  
K.N. An ◽  
R.A. Berger ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Salvage Procedure ◽  
Ulnar Deviation ◽  
Radiocarpal Joint ◽  
Flexion Extension ◽  
Radioscapholunate Fusion ◽  
Tracking Device ◽  
Radioscapholunate Arthrodesis

Radioscapholunate arthrodesis is a salvage procedure indicated for osteoarthritis of the radiocarpal joint involving the lunate facet of the radius. This cadaver study examines changes in wrist motion resulting from radioscapholunate arthrodesis, and the effects of surgical techniques to improve the range of motion. Simulated radioscapholunate arthrodesis, distal scaphoidectomy and triquetrectomy were carried out sequentially on six cadaver forearms and measurements (maximum flexion/extension and radial/ulnar deviation) were taken in the intact situation and after each surgical step using a magnetic tracking device. Radioscapholunate arthrodesis diminishes the amplitudes of movements of the wrist in all directions, but range of motion in the radioscapholunate fused wrist improves after scaphoidectomy and improves further after triquetrectomy (88% of original flexion/extension and 98% of original radial/ulnar deviation). Radioscapholunate arthrodesis causes a significant change in kinematics between the hamate and the triquetrum in flexion/extension.

scholarly journals Biomechanical Comparison of Dart-Throw Motions after Partial Wrist Fusions

2021 ◽  
Author(s):  
Dami O. Oluyede ◽  
Frederick W. Werner ◽  
Garrett Esper ◽  
Michael Schreck
Keyword(s):  
Range Of Motion ◽  
Limited Information ◽  
Wrist Motion ◽  
Flexion Extension ◽  
Dart Throwing ◽  
Fresh Frozen ◽  
Biomechanical Comparison ◽  
Other Orientation ◽  
Comprehensive Compilation ◽  
Throwing Motion

Abstract Background Multiple partial wrist fusions exist for the management of arthritic disease. Limited information is available on their effect on wrist range of motion in the dart-throwing direction of wrist motion, even though it is used in most activities of daily living. Purpose The purpose of this study was to measure the retained motion for different orientations of dart-throwing motion for seven different partial wrist fusions and proximal row carpectomy (PRC). Methods Eight fresh frozen right cadavers were tested with the wrist intact and followed simulated fusions. Fusions were performed using an external fixation technique and included scaphocapitate, scapholunate (SL), capitolunate, radiolunate, radioscapholunate, scaphotrapeziotrapezoid, 4 corner fusion, and PRC. Results In the intact wrist, the average arc of wrist motion with the wrist oriented at 20 degrees away from the flexion-extension axis was significantly larger than at any other orientation of motion. All partial wrist fusions and the PRC had significantly smaller average dart-throw arc of motion compared with intact at an orientation 20 and 25 degrees away from flexion-extension. The SL fusion provided a significantly larger arc of motion than most of the other fusions at most orientations. Conclusion/Clinical Relevance This study provides a comprehensive compilation of the range of motion in a functional plane, “the dart-throw motion,” for limited wrist fusions and PRC. These data provide the clinician with important information that can be used to educate patients regarding expectations after surgery.

scholarly journals A Comparative Study of Efficacy and Functionality of Ten Commercially Available Wrist-Hand Orthoses in Healthy Females: Wrist Range of Motion and Grip Strength Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Alejandra Aranceta-Garza ◽  
Karyn Ross
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Evidence Base ◽  
Secondary Outcome ◽  
Functional Study ◽  
Strength Analysis ◽  
Hand Position ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
The Impact

Objective: Wrist-hand orthoses (WHOs) are prescribed for a range of musculoskeletal/neurological conditions to optimise wrist/hand position at rest and enhance performance by controlling its range of motion (ROM), improving alignment, reducing pain, and optimising grip strength. The objective of this research was to study the efficacy and functionality of ten commercially available WHOs on wrist ROM and grip strength.Design: Randomised comparative functional study of the wrist/hand with and without WHOs.Participants: Ten right-handed female participants presenting with no underlying condition nor pain affecting the wrist/hand which could influence motion or grip strength. Each participant randomly tested ten WHOs; one per week, for 10 weeks.Main outcome measures: The primary outcome was to ascertain the impact of WHOs on wrist resting position and flexion, extension, radial, and ulnar deviation. A secondary outcome was the impact of the WHOs on maximum grip strength and associated wrist position when this was attained.Results: From the 2,400 tests performed it was clear that no WHO performed effectively or consistently across participants. The optimally performing WHO for flexion control was #3 restricting 86.7%, #4 restricting 76.7% of extension, #9 restricting 83.5% of radial deviation, and #4 maximally restricting ulnar deviation. A grip strength reduction was observed with all WHOs, and ranged from 1.7% (#6) to 34.2% (#4).Conclusion: WHOs did not limit movement sufficiently to successfully manage any condition requiring motion restriction associated with pain relief. The array of motion control recorded might be a contributing factor for the current conflicting evidence of efficacy for WHOs. Any detrimental impact on grip strength will influence the types of activities undertaken by the wearer. The design aspects impacting wrist motion and grip strength are multifactorial, including: WHO geometry; the presence of a volar bar; material of construction; strap design; and quality of fit. This study raises questions regarding the efficacy of current designs of prefabricated WHOs which have remained unchanged for several decades but continue to be used globally without a robust evidence-base to inform clinical practise and the prescription of these devices. These findings justify the need to re-design WHOs with the goal of meeting users' needs.

Effect of Wrist Posture on Discomfort for Simple Repetitive Exertions

2000 ◽  
Vol 44 (30) ◽  
pp. 5-473-5-476 ◽  
Author(s):  
Eilís J. Carey ◽  
Timothy J. Gallwey
Keyword(s):  
Range Of Motion ◽  
The Other ◽  
Maximum Strength ◽  
Angular Deviation ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
Male Subjects

This study investigated the effects of exertion, pace and level of simple and combined flexion/extension and radial/ulnar deviation of the wrist on discomfort for simple repetitive exertions. Eight male subjects participated in the study and the level of exertion and angular deviation were defined relative to the maximum strength and Range of Motion (ROM) of the subjects respectively. Extreme flexion caused higher discomfort than the other simple types of deviation, and the combination of flexion and ulnar deviation resulted in higher discomfort than the other types of combined deviation. Exertion was the most significant factor, followed by level of deviation.

Smartphone photography utilized to measure wrist range of motion

2017 ◽  
Vol 43 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Eric R. Wagner ◽  
Megan Conti Mica ◽  
Alexander Y. Shin
Keyword(s):  
Range Of Motion ◽  
High Reliability ◽  
Wrist Flexion ◽  
Wrist Movement ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Wrist Motion ◽  
Observer Reliability ◽  
Clinical Measurements ◽  
Very High

The purpose was to determine if smartphone photography is a reliable tool in measuring wrist movement. Smartphones were used to take digital photos of both wrists in 32 normal participants (64 wrists) at extremes of wrist motion. The smartphone measurements were compared with clinical goniometry measurements. There was a very high correlation between the clinical goniometry and smartphone measurements, as the concordance coefficients were high for radial deviation, ulnar deviation, wrist extension and wrist flexion. The Pearson coefficients also demonstrated the high precision of the smartphone measurements. The Bland–Altman plots demonstrated 29–31 of 32 smartphone measurements were within the 95% confidence interval of the clinical measurements for all positions of the wrists. There was high reliability between the photography taken by the volunteer and researcher, as well as high inter-observer reliability. Smartphone digital photography is a reliable and accurate tool for measuring wrist range of motion. Level of evidence: II

scholarly journals Comparison of a New Inertial Sensor Based System with an Optoelectronic Motion Capture System for Motion Analysis of Healthy Human Wrist Joints

Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5297 ◽  
Author(s):  
Michael Alexander Wirth ◽  
Gabriella Fischer ◽  
Jorge Verdú ◽  
Lisa Reissner ◽  
Simone Balocco ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Motion Capture ◽  
Inertial Measurement Unit ◽  
Absolute Difference ◽  
Measurement Unit ◽  
Good Precision ◽  
Motion Capture System ◽  
Ulnar Deviation ◽  
Inertial Measurement ◽  
Flexion Extension

This study aims to compare a new inertial measurement unit based system with the highly accurate but complex laboratory gold standard, an optoelectronic motion capture system. Inertial measurement units are sensors based on accelerometers, gyroscopes, and/or magnetometers. Ten healthy subjects were recorded while performing flexion-extension and radial-ulnar deviation movements of their right wrist using inertial sensors and skin markers. Maximum range of motion during these trials and mean absolute difference between the systems were calculated. A difference of 10° ± 5° for flexion-extension and 2° ± 1° for radial-ulnar deviation was found between the two systems with absolute range of motion values of 126° and 50° in the respective axes. A Wilcoxon rank sum test resulted in a no statistical differences between the systems with p-values of 0.24 and 0.62. The observed results are even more precise than reports from previous studies, where differences between 14° and 27° for flexion-extension and differences between 6° and 17° for radial-ulnar deviation were found. Effortless and fast applicability, good precision, and low inter-observer variability make inertial measurement unit based systems applicable to clinical settings.

OUTCOMES OF FOUR-CORNER ARTHRODESIS USING THE HUBCAPTM CIRCULAR PLATE

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 215-220 ◽  
Author(s):  
Sameer K. Khan ◽  
Syed M. Ali ◽  
Andrew McKee ◽  
Jonathan W. M. Jones
Keyword(s):  
Range Of Motion ◽  
Circular Plate ◽  
Functional Outcomes ◽  
Circular Plates ◽  
Ulnar Deviation ◽  
Non Union ◽  
Flexion Extension ◽  
Radiological Union

We present results of four-corner carpal arthrodesis with the Acumed® HubcapTM circular plate performed at our unit. Eight patients underwent eight procedures over five years, for scapholunate advanced collapse (five wrists) and scaphoid non-union advanced collapse (three wrists). Outcomes included range of motion, quickDASH scores, and visual analogue scores for satisfaction. At final follow-up, mean flexion-extension arc was 56°, mean radial-ulnar deviation 29° and mean quickDASH score was 23/100. Mean score for satisfaction was 7.7/10 (77%). Seven out of eight (87.5%) patients said they would have it done again, and would also recommend it to others. Radiological union was achieved in all cases. One screw broke in one arthrodesis without causing symptoms. The functional outcomes with our use of the HubcapTM are comparable to those reported in literature to date with other circular plates (e.g. Spider plate). There were no non-unions, which is the main reported complication with these plates.

FUNCTIONAL AND KINEMATIC ANALYSIS OF A WRIST RADIAL HEMIARTHROPLASTY DESIGN

2018 ◽  
Vol 21 (01) ◽  
pp. 1850005
Author(s):  
Alexander W. Hooke ◽  
Eric Wagner ◽  
Kurt Pettersson ◽  
Per Fischer ◽  
Marco Rizzo
Keyword(s):  
Range Of Motion ◽  
Moment Arm ◽  
Ulnar Deviation ◽  
Functional Changes ◽  
Flexor Carpi Radialis ◽  
Moment Arms ◽  
Flexion Extension ◽  
Flexion Moment ◽  
The Mean ◽  
Extensor Carpi Radialis

Purpose: A biomechanical functional assessment was performed on a newly designed wrist hemiarthroplasty implant with aimed to identifying differences between the native wrist and wrist following the hemiarthroplasty procedure with [Formula: see text] and without a proximal row carpectomy (Hemi). Methods: Six cadaveric wrists were mounted on a custom testing fixture and underwent a series of functional tests to investigate differences in range of motion, muscles moment arms, and axis of rotation between the intact and post-operative wrists. The tested movements included manually-driven flexion-extension, radial-ulnar deviation, dart throwers motion, and circumduction. Results: The only significant change in range of motion was a decrease in flexion between the intact [Formula: see text] and both the Hemi [Formula: see text] and [Formula: see text] [Formula: see text] conditions. Minor differences in the mean position and variability of the axis of rotation’s piercing point were identified. A statistically significant decrease in the flexion moment arm of the flexor carpi radialis was identified between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions. Statistically significant decreases were also identified in the radial deviation moment arms of the extensor carpi radialis brevis’ between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions and the flexor carpi radialis’ between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions as well as in the ulnar deviation moment arm of the extensor carpi ulnaris between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions. Conclusions: While some statistically significant functional changes were identified between the native and hemiarthroplasty wrist, the findings suggest that post-operative function is equally acceptable in hemiarthroplasty with and without resection of the proximal carpal row.

Scaphoid Motion of the Wrist with Scapho-trapezio-trapezoidal Osteoarthritis-A Pilot Study

2020 ◽  
Vol 16 (3) ◽  
pp. 206-209
Author(s):  
Ronit Wollstein ◽  
Hisao Moritomo ◽  
Iida Akio ◽  
Shohei Omokawa
Keyword(s):  
Neutral Position ◽  
Wrist Flexion ◽  
Wrist Movement ◽  
Ulnar Deviation ◽  
Wrist Motion ◽  
3 Dimensional ◽  
Active Flexion ◽  
Extended Position ◽  
Flexion Extension ◽  
Surface Models

Background: The purpose of this study was to investigate scaphoid motion within the scapho-trapezio-trapezoidal (STT) joint during wrist motion in the presence of STT joint osteoarthritis (OA). Methods: We studied 11 wrists with STT OA and 5 normal wrists. Computed tomography (CT) images were acquired in five wrist positions (maximum active flexion, extension, radial deviation, ulnar deviation, and neutral position). The 3-dimensional surface models of the radius and scaphoid were constructed and the motion of scaphoid relative to the radius was calculated. Results and Conclusion: During wrist flexion/extension motion, the scaphoid rotated mostly in the flexion/extension plane. The angle tended to be smaller in STT OA than in normal. During wrist radioulnar deviation, the scaphoid was in an extended position in neutral wrist in STT OA. The motion of scaphoid in STT OA was divided into two types: a rigid type and mobile type. The mobile type rotated closer to the flexion/extension plane than the rigid type. Taking into account scaphoid motion during wrist movement before surgery may provide better results in the treatment of STT OA.

scholarly journals At Home Photography-Based Method for Measuring Wrist Range of Motion

2017 ◽  
Vol 06 (04) ◽  
pp. 280-284 ◽  
Author(s):  
Samir Trehan ◽  
Schneider Rancy ◽  
Parker Johnsen ◽  
Howard Hillstrom ◽  
Steve Lee ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Digital Images ◽  
Intraclass Correlation ◽  
Office Visits ◽  
Wrist Flexion ◽  
Ulnar Deviation ◽  
Digital Photographs ◽  
Physician Contact ◽  
Flexion Extension ◽  
At Home

Purpose To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer. Methods Sixty-nine postoperative patients were enrolled in this study at least 3 months postoperatively. Active and passive wrist flexion/extension and radial/ulnar deviation were recorded by one of the two attending surgeons with a 1-degree resolution goniometer at the last postoperative office visit. Patients were provided an illustrated instruction sheet detailing how to take digital photographic images at home in six wrist positions (active and passive flexion/extension, and radial/ulnar deviation). Wrist position was measured from digital images by both the attending surgeons in a randomized, blinded fashion on two separate occasions greater than 2 weeks apart using the same goniometer. Reliability analysis was performed using the intraclass correlation coefficient to assess agreement between clinical and photography-based goniometry, as well as intra- and interobserver agreement. Results Out of 69 enrolled patients, 30 (43%) patients sent digital images. Of the 180 digital photographs, only 9 (5%) were missing or deemed inadequate for WROM measurements. Agreement between clinical and photography-based measurements was “almost perfect” for passive wrist flexion/extension and “substantial” for active wrist flexion/extension and radial/ulnar deviation. Inter- and intraobserver agreement for the attending surgeons was “almost perfect” for all measurements. Discussion This study validates a photography-based goniometry protocol allowing accurate and reliable WROM measurements without direct physician contact. Passive WROM was more accurately measured from photographs than active WROM. This study builds on previous photography-based goniometry literature by validating a protocol in which patients or their families take and submit their own photographs. Clinical Relevance Patient-performed photography-based goniometry represents an alternative to traditional clinical goniometry that could enable longer-term follow-up, overcome travel-related impediments to office visits, improve convenience, and reduce costs for patients.

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