Minimal detectable difference of the finger and wrist range of motion: comparison of goniometry and 3D motion analysis

Abstract

Background The measurement of finger and wrist range of motion (ROM) is of great importance to clinicians when assessing functional outcomes of therapeutic interventions and surgical procedures. The purpose of the study was to assess the repeatability of ROM measurements of the hand joints with manual goniometer and 3D motion capture system and to calculate the minimal detectable difference for both methods. Methods Active finger and wrist joints ROM of 20 healthy volunteers were assessed using a manual goniometer and 3D motion capture system. Minimal detectable difference (MDD) and standard error of measurement (SEM) were calculated for both measurement systems and compared within the same task. Maximal ROM of all joints was registered twice on two different days to evaluate the test-retest repeatability. The intraclass correlation coefficients (ICC) was calculated and examined to determine if reliability ≥ 0.70 existed. Results MDD for the 3D motion capture was between 5 and 12° except for the metacarpophalangeal joint (MCP) 1, interphalangeal joint (IP), and MCP5. SEM values lay between 2 and 4° for all joints except for the MCP5, IP, and MCP1. For the goniometric measurements, MDD and SEM were between 12–30° and 4–11°, respectively. The reliability criterion (ICC > 0.7) was achieved for the ROM measurement with the 3D motion capture system for 94% of the joints and in only 65% of the joints with the manual goniometer. Conclusions Joint ROM assessed with 3D motion analysis showed higher test-retest agreement demonstrating overall better repeatability for this method. Because of the smaller measurement error, the 3D motion capture system has a smaller MDD. Only individual test-rest differences bigger than the MDD can be considered as real changes, and therefore, in an experimental situation, the use of a more precise measurement method can greatly reduce the number of subjects needed for a statistical significance. Goniometer measurements of some joints should be carefully interpreted, due to a low repeatability and reliability. Trial registration This study is approved by the Ethical Committee Zurich ( Kek-ZH-Nr: 2015-0395 ).

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

“…The two IMU were applied with double-sided, hypoallergenic adhesive tape to the skin of the dorsal right hand and forearm of the test subjects, as shown in Figure 1. Skin markers were applied to anatomical landmarks, as described by Reissner et al [4], except that the markers at the third carpometacarpal joint and at the head of the third metacarpal were not used in this study because they would interfere with the positioning of the distal sensor. The sensor on the hand was placed outside the joint area of the wrist and the metacarpal joint with its longitudinal axis aligned along the metacarpal bone of the middle finger.…”

“…At least three markers per segment had to be visible simultaneously to allow for three-dimensional kinematic motion analysis of the segments. As described by Reissner et al, a functional approach from List et al [19] was adapted to the wrist to determine joint centers and axes in this study [4]. The wrist joint center was simulated as a ball joint and the functional flexion axis as a hinge joint.…”

“…This method has been in use since shortly after the first world war [2,3]. Its measurement quality is dependent on the raters abilities and it is restricted to a single plane and to static positions only [4]. Goniometer measurements are susceptible to considerable intra-observer variation, ranging from 5.2–8°, as well as inter-observer variation between 6–10° for the wrist [5].…”

“…They also show minimal detectable differences of 11° for wrist flexion and 8° for wrist extension [6]. Another study found even higher minimal detectable differences for goniometer measurements of wrist flexion-extension and radial-ulnar deviation movements of 18° each [4].…”

Development and User Evaluation of a Smartphone-Based System to Assess Range of Motion of Wrist Joint

“…A 5 change in ROM was considered to be clinically meaningful when measuring ROM in the wrist joint. 4,7,17 This was calculated with a sample size of 66 participants (33 participants/treatment group), giving the study 80% power to detect a 5 mean change in ROM of the wrist joint, with a type I error of 5%. 18,19…”