Background

Thumb orthoses are a standard treatment modality, with substantial evidence to support its usage for multiple conditions affecting the upper extremity. Despite commonly prescribed, little is known about the immediate impact of such devices on the upper extremity, including potential modifications on motor patterns.

Research question

We aimed to determine the changes in the upper limb kinematics during the usage of thumb orthotics, comparing differences in orthotic design, length, and fabrication materials.

Methods

In this cross-sectional study, subjects performed a standardized reaching task and the placing subtest of the Minnesota Manual Dexterity Test (MMDT) while wearing five unique thumb orthoses. Besides the active range of motion of the shoulder, elbow, wrist and hand joints, movement smoothness (Number of Movement Units-NMU), speed, and motion control strategies were analyzed through eight Qualisys Oqus 300 cameras (Qualisys AB, Göteborg, Sweden).

Findings

Ten non-disabled, university students participated in this study. Despite differences in fabrication materials, all orthotics reduced thumb's abduction (13.3° to 4.3°), and metacarpophalangeal flexion (11.5° to 4.2°). Although orthotics impacted movement smoothness and hand function during its usage, forearm-based devices further increased the NMUs and the time required for the MMDT performance (Control: NMU = 4.8, MMDT = 58.1; Long Orthotics: NMU = 6.6, MMDT = 78.2), while short, flexible orthoses provided thumb stabilization without significant impact on upper extremity movement strategies.

Significance

Although joint stabilization was similar among orthotics fabricated with rigid and flexible materials, the improved hand dexterity observed during the use of flexible devices suggests an advantage of flexible orthotics for enhanced stability and hand function. These results can assist healthcare professionals during the selection and prescription of thumb orthotics, providing information not only on the range of motion but other sensorimotor aspects involved in upper extremity movement patterns that may be affected by orthotics usage.

中文翻译：

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拇指矫形器对上肢运动的直接影响：对五个独特装置的运动学分析。

背景

拇指矫形器是一种标准的治疗方式，有充分的证据支持拇指矫形器用于影响上肢的多种情况。尽管有通常的规定，但对于这种装置对上肢的直接影响，包括对运动模式的潜在修改，知之甚少。

研究问题

我们旨在确定拇指矫形器使用过程中上肢运动学的变化，比较矫形器设计，长度和制造材料方面的差异。

方法

在这项横断面研究中，受试者戴着五个独特的拇指矫形器，执行了标准的伸手拿法和明尼苏达州人体敏捷测试（MMDT）的放置子测试。除了肩膀，肘部，腕部和手部关节的活动范围之外，还通过八台Qualisys Oqus 300摄像机（Qualisys AB，哥德堡，瑞典）分析了运动平滑度（运动单位数-NMU），速度和运动控制策略。 。

发现

十名非残疾大学生参加了这项研究。尽管制作材料有所不同，所有矫形器均减少了拇指外展（13.3°至4.3°）和掌指弯曲（11.5°至4.2°）。尽管矫形器在使用过程中会影响运动的平滑度和手部功能，但基于前臂的设备进一步增加了NMU和MMDT性能所需的时间（控制：NMU = 4.8，MMDT = 58.1；长矫形器：NMU = 6.6，MMDT = 78.2）短而灵活的矫形器可以稳定拇指，而对上肢的运动策略没有明显影响。

意义

尽管在用刚性和柔性材料制造的矫形器中关节稳定性相似，但是在使用柔性装置期间观察到的手部灵活性的改善表明，柔性矫形器具有增强稳定性和手功能的优势。这些结果可以在选择和矫正拇指矫形器期间为医疗保健专业人员提供帮助，不仅提供有关运动范围的信息，而且还提供与可能受矫形器使用方式影响的上肢运动方式有关的其他感觉运动方面的信息。