Usefulness of digital measurements for functional evaluation of paediatric elbow range of motion

Abstract

Background Elbow immobilization due to fractures of the upper limb is frequent in paediatric patients. Proper follow-up is critical to assess elbow functional recovery. Telemedicine can be an option for remote monitoring of these patients. The purpose of this study was to compare personal and virtual evaluation of elbow range of motion after long arm cast withdrawal in paediatric patients. Methods An observational cross-sectional study was carried out which included all paediatric patients with elbow immobilization in long arm casts treated at our centre. After cast withdrawal, elbow range of motion was evaluated by telemedicine and in office consultation in all four movements (flexion, extension, pronation and supination). Results Ninety-three patients met the selection criteria. Median age at time of immobilization was 8 years. Mean elbow immobilization time was 23 days (range 18–56 days). When comparing office and remote measurements, no statistical differences were found for any of the four elbow movements measured in our study. Conclusions Remote evaluation of elbow range of motion by telemedicine is technically feasible. We evaluated elbow range of motion in paediatric patients after immobilization and we did not find differences between digital and in office measurements. The results were similar to those obtained through assessment in the office. We believe that this is a useful tool to facilitate remote patient follow-up.

Automatic range of motion measurement via smartphone images for telemedicine examination of the hand

“…Equation ( 1 Measurement results were expressed by the mean and standard deviation (Mean ± SD). The reliability of the automatic methods was analyzed in the following steps: (1) The deviation between the two measurement methods was assessed for each parameter. Then the 95% confidence interval (CI) was calculated and compared with the range of clinical acceptance.…”

“…In this study, we followed the guides for hand impairment evaluation set by Swanson and the American Medical Association (AMA), [30][31][32] which suggest the required ROM parameters. According to the references, the following movement should be included: (1) The extension/flexion of the metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints and distal interphalangeal (DIP) joints of the index, middle, ring and little finger on the sagittal plane, as well as the MCP joint and interphalangeal (IP) joint of the thumb on the coronal plane; (2) The radial-abduction/ radial-adduction of the thumb carpometacarpal (CMC) joint on the coronal plane. (3) The opposition/adduction movement of the thumb.…”

“…The range of motion (ROM) is fundamental in the physical examination and the follow-ups in clinical practice. 1 , 2 For hand surgeons and therapists, measurement of hand ROM is an objective and quantified way to assess the retained or improved motor function of digits, and provide evidence for estimation of the outcome or the progress of surgery or rehabilitation therapy. 3 Traditionally, manual goniometry has been the widely accepted method for ROM measuring in clinical practice, 4 which could be traced back to the early 1900s.…”

Estimating the Thumb Rotation Angle by Using a Tablet Device With a Posture Estimation Artificial Intelligence Model

“…Measuring the range of motion of the hand enables hand surgeons and therapists to assess hand function objectively and quantitatively [1][2][3][4]. An accurate measurement of the kinematics of the thumb can be achieved by using several well-known techniques, and optical systems featuring infrared cameras and reflective markers are considered the gold standard method [5].…”