Scientific article
Palmar Abduction: Reliability of 6 Measurement Methods in Healthy Adults

https://doi.org/10.1016/j.jhsa.2008.10.028Get rights and content

Purpose

The aim of the current study was to assess reliability of 6 palmar thumb abduction measurement methods: conventional goniometry, the Inter Metacarpal Distance, the method described by the American Medical Association, the method described by the American Society of Hand Therapists, and 2 new methods: the Pollexograph-thumb and the Pollexograph-metacarpal.

Methods

An experienced hand therapist and a less-experienced examiner (trainee in plastic surgery) measured the right hands of 25 healthy subjects. Palmar abduction was measured both passively and actively. Means and ranges for palmar abduction were calculated, and intrarater and interrater reliability was expressed in intraclass correlation coefficients, standard errors of measurement, and smallest detectable differences.

Results

Mean active and passive angles measured with goniometry resembled values measured with the Pollexograph-thumb method (approximately 60°). Mean angles found with the Pollexograph-metacarpal method were approximately 48°. Mean active and passive distances for the Inter Metacarpal Distance were 64 mm. Mean active and passive distances found with the American Society of Hand Therapists method were 97 to 101 mm, and mean distances found with the American Medical Association method were 67 to 70 mm for active and passive measurements. Intraclass correlation coefficients for the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal Distance indicated good and significantly higher intrarater agreement for active and passive measurements than intraclass correlation coefficients of conventional goniometry, the American Society of Hand Therapists method, and the American Medical Association method, which showed only moderate agreement. For interrater reliability, the same measurement methods were found to be most reliable: the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal Distance.

Conclusions

We found that the Pollexograph-thumb, Pollexograph-metacarpal, and the Inter Metacarpal Distance are the most reliable measurement methods for palmar abduction.

Section snippets

Subjects

Measurements were performed on the right hands of 25 healthy subjects recruited at the Erasmus MC, Rotterdam. Subjects had no prior injury to the upper extremity or systemic conditions affecting the muscular or nervous system. The group consisted of 9 men and 16 women, of whom 3 were left-handed. Mean age of the subjects was 30 years (standard deviation ± 7 years).

This study was approved by the medical ethics committee, and written informed consent was obtained from each subject.

Measurements

All

Mean values

Table 1 shows means, SDs, and ranges of angular and distance measurement methods for palmar abduction. It can be seen that mean active and passive angles measured with goniometry were comparable with Pollexograph-thumb values. Goniometry and Pollexograph-thumb means ranged from 57° to 64°, whereas Pollexograph-metacarpal mean angles were smaller, ranging from 47° to 49°.

Mean active and passive distances of the AMA method were 67 to 70 mm from the distal palmar crease to the IP joint. Mean

Discussion

The goal of our study was to compare reliability of the most common measurement methods for palmar thumb abduction. Although conventional goniometry may be used most often in daily clinical practice, it was found to be unreliable. The significantly smaller SDDs and SEMs for intrarater and interrater reliability indicated that the Pollexograph-thumb, Pollexograph-metacarpal, and the IMD methods were the most reliable methods for measuring palmar abduction.

There are many definitions of palmar

References (22)

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    We thank the NUTS-OHRA Foundation for their financial contribution to support this study.

    Support was received from the NutsOhra Foundation.

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