Dynamic Thumb Circumduction Measured With a Wearable Motion Sensor: A Prospective Comparison of Patients With Basal Joint Arthritis to Controls

Abstract

The purpose of this study was to compare the active range of motion in patients with thumb carpometacarpal (CMC) arthritis to healthy controls. A secondary objective of this study was to examine the feasibility of using wearable motion sensors in a clinical setting. Methods: Asymptomatic controls and patients with radiographic and clinical evidence of thumb CMC joint arthritis were recruited. The experimental setup allowed participants to rest their forearm in neutral pronosupination with immobilization of the second through fifth CMC joints. An electromagnetic motion sensor was embedded into a thumb interphalangeal joint immobilizer, and participants were asked to complete continuous thumb circumduction movements. Data were continuously recorded, and circumduction curves were created based on degrees of motion. Peak thumb abduction and extension angles were also extracted from the data. Results: A total of 29 extremities with thumb CMC arthritis and 18 asymptomatic extremities were analyzed. Bilateral disease was present in 64% of patients. Patient age range was 35e83 years, and the control group age range was 26e83 years. The most affected extremities had Eaton stage 3 disease (38%, N ¼ 11). The average maximum thumb abduction was 53.9 ± 19.6 in affected extremities and 70.8 ± 10.1 for controls. Average maximum thumb extension was 50.0 ± 15.2 in affected extremities and 58.4 ± 9.1 for controls. When comparing patients with Eaton stage 3 and 4 disease to controls, average maximum abduction and extension decreased with increasing disease stage (42.3 , 46.1 , and 70.8 for abduction, respectively, and 58.4 , 43.3 , and 41.3 for extension, respectively). Conclusions: We observed more severe motion limitations with increasing Eaton stage, and statistically significant differences were seen with stage 3 and 4 disease. A wearable motion sensor using a portable experimental setup was used to obtain measurements in a clinical setting. Type of study/level of evidence: Diagnostic II.

Disease severity versus pain severity: Range of motion differences during single‐ and multiplanar tasks in women with carpometacarpal osteoarthritis

“…However, the abduction/adduction angles aligned with the findings of a study that used computed tomography to measure kinematics 22 . Similarly, circumduction joint angles and area found in this study were smaller than in previous studies 8–10 . A possible explanation for these differences is that most participants in this study had intramuscular electrodes inserted into their palm, which may have limited their range of motion due to discomfort.…”

“…For example, thumb kinematics have been successfully evaluated to compare pre-and postsurgical range of motion 6,7 and range of motion differences in individuals with CMC OA and healthy participants. [8][9][10] Similarly, other studies have used kinematics to research indicators for CMC OA progression 11 or provided valuable information about coupled motion patterns in the CMC joint. 12 From all these studies, insights have been gained into the fact that surgical interventions can alleviate pain but may have the unintended consequence of constraining thumb mobility.…”

“…However, there is a lack of studies that comprehensively evaluate kinematics in individuals across the spectrum of disease severity or consider other variables, such as pain. Existing studies on thumb kinematics often focused on classifying participants based on radiographic severity with no mention of pain, 6 pain severity but no inclusion of radiographic images, 9,10,12 or unfortunately, no information on either metric. 7 Furthermore, the absence of radiographic images in the healthy cohorts makes it impossible to determine whether the studies compared individuals with CMC OA to healthy individuals, instead of symptomatic and asymptomatic individuals.…”

“…Kinematic studies have examined to what extent treatments for CMC OA restore range of motion and have also characterized the motion of the healthy and osteoarthritic CMC joint. For example, thumb kinematics have been successfully evaluated to compare pre‐ and postsurgical range of motion 6,7 and range of motion differences in individuals with CMC OA and healthy participants 8–10 . Similarly, other studies have used kinematics to research indicators for CMC OA progression 11 or provided valuable information about coupled motion patterns in the CMC joint 12 .…”