Management of the Osteoarthritic Thumb Carpometacarpal Joint

Badía, Alejandro

doi:10.1016/b978-0-323-05602-1.00105-7

Cited by 3 publications

(3 citation statements)

References 64 publications

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“…Among thumb joints, the basal joint of the thumb, i.e., the carpometacarpal (CMC) joint, represents one of the most common sites of osteoarthritis and repetitive stress injuries due to both the complexity of its motion and the concentration of mechanical forces [ 10 ]. In fact, since pinch grip is ubiquitous at work as well as in everyday life, all joints of the involved fingers but especially the basal joint continue to experience stress [ 11 ], especially during isometric functional tasks [ 12 ]. Furthermore, the carpometacarpal (CMC) joint of the thumb is the second most common joint in the hand affected by osteoarthritis (OA).…”

Section: Introductionmentioning

confidence: 99%

Pinch Grip per SE Is Not an Occupational Risk Factor for the Musculoskeletal System: An Experimental Study on Field

Sala

Lopomo

Romagnoli

et al. 2022

IJERPH

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Introduction: Some ergonomic evaluation methods define pinch grip as a risk factor independent of the exerted force. The present experimental study was performed with the main aim of objectively measuring the muscle engagement during the execution of pinch grip. Methods: the participants of the study were healthy workers occupationally involved in a high-intensity repetitive job related to the sorting of letters and small packages. Surface electromyography (sEMG) was used to study the activity of the abductor pollicis brevis and first dorsal interosseous fibers related to the execution of the required working tasks, while the force exerted during voluntary muscle contraction for pinch grip was measured by a portable acquisition system. The subjects were specifically asked to exert the maximum voluntary isometric contraction (MVIC) and further voluntary isometric contractions with a spontaneous force (SF) equal to 10%,20% and 50% of the MVIC; finally, the workers were asked to hold in pinch grip two types of envelopes, weighing 100 g and 500 g, respectively. Results: The force required to pinch 100 and 500 g envelopes by the fifteen subjects of the study corresponded to 4 and 5% MVIC, respectively. The corresponding sEMG average rectified values (ARV) were approximately 6% of that at MVIC for first dorsal interosseus (FDI) fibers and approximately 20–25% of MVIC for abductor pollicis brevis (ABP) fibers. Bivariate correlation analysis showed significant relationships between force at MVIC and FDI ARV at MCV. Conclusions: The obtained results demonstrate that muscle recruitment during pinch grip varies as a function of the SF: not only the position but also the exerted force should be considered when assessing the pinch grip as risk factor for biomechanical overload of the upper limb.

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Section: Introductionmentioning

confidence: 99%

Pinch Grip per SE Is Not an Occupational Risk Factor for the Musculoskeletal System: An Experimental Study on Field

Sala

Lopomo

Romagnoli

et al. 2022

IJERPH

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“…It is a major reason why patients seek consultation with a hand surgeon and referral to hand therapy. 9 Irrespective of whether patients are managed conservatively or surgically, clinicians need to obtain subjective and objective measures of impairment and functioning. Subjectively, symptom history and the use of patient-rated outcome measures form an important aspect of conservative management.…”

Section: Introductionmentioning

confidence: 99%

“…It is a major reason why patients seek consultation with a hand surgeon and referral to hand therapy. 9…”

Section: Introductionmentioning

confidence: 99%

Intra-tester reliability of a single trial of pinch strength in patients with osteoarthritis of the first carpometacarpal joint

Miller

2013

Hand Therapy

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Objectives: To compare pain, patient preference and the test-retest reliability between the Jamar dynamometer and the MIE myometer using a single trial of pinch strength in patients with first carpometacarpal joint (CMCJ) osteoarthritis (OA). Methods: A prospective, within patient, repeated measures design was used. A digital strain gauge torsion dynamometer (MIE) and a hydraulic dynamometer (Jamar) were used to measure tripod pinch strength using a single trial on two occasions. Pain was assessed after each trial of pinch strength using a numeric pain rating scale (NRPS). Patients were asked which instrument they preferred and why. The test-retest reliability of each instrument was calculated using an intra-class correlation coefficient. Results: Thirty-eight patients with a confirmed diagnosis of OA of the CMCJ referred to hand therapy took part in the study. There were no statistically significant differences in mean pain scores (NPRS 0-10) between the Jamar and the MIE (mean difference 0.3, p ¼ 0.24, 95% CI À0.214 to 0.846). There was no clear preference for one or the other instrument. Test-retest reliability using a single trial of pinch strength was excellent with both instruments (MIE, ICC ¼ 0.914; Jamar ICC ¼ 0.891). Conclusions: Although patients had a slightly lower pain score with the MIE these differences were not statistically significant and an almost equal number of patients preferred each instrument. The use of a single trial of pinch strength still confers high reliability when using the MIE and Jamar justifying the continued use of both instruments for clinical practice and research

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