Metacarpal Arc Motion: Comparison of Different Measurement Methods.

Introduction The range of motion of the carpometacarpal (CMC) joints is difficult to assess in clinical practice. Materials and Methods The purpose of this study was to measure a precise range of motion measurement of the metacarpal arc during maximum palmar flexion of the fifth CMC joint in healthy persons with three different methods: optical, electrogoniometrical, and sonographical. Results The metacarpal arc motion measured with the optical technique was 24.9 degrees (standard deviation [SD]: 6.2 degrees), with the electrogoniometric technique was 24.3 degrees (SD: 3.6 degrees) and with sonography was 25.1 degrees (SD: 3.5 degrees), with no differences between left and right hand for all methods. Conclusion This study shows that different techniques can be used for the measurement of the metacarpal arc motion. With these techniques, it is possible to assess the metacarpal arc in patients with fractures to the CMC joints to evaluate posttraumatic function und rehabilitation progress. This study shows level of evidence as III.

Reliability and validity of expert assessments of hand-wrist physical exposures.

BACKGROUND: General population job-exposure matrices (JEMs) based on expert assessments of physical exposures may be valuable tools for studying occupation-related musculoskeletal disorders. Wrist-hand JEMs are few and the reliability and validity of expert assessments of wrist-hand exposures is uncertain. METHODS: We examined intra- and inter-rater reliability of ratings of five experts of hand-wrist repetition, deviation, force, vibration, and computer work in 33 jobs selected to represent a large exposure variation. The validity of ratings of hand-wrist repetition was examined by comparison with electro-goniometer measurements of wrist angular velocity and mean power frequency (MPF), and the validity of hand-wrist deviation by comparison with goniometer measurements of range of motion (ROM). RESULTS: Intra-rater test-retest and inter-rater Spearman correlation coefficients controlling for rater effects, varied between 0.70 and 0.87. Corresponding kappa statistics of overall agreement showed similar high values, except for wrist deviation (kappa = 0.50). Regression analyses showed strong positive associations between expert assessments of repetition and goniometer measurements of wrist angular velocity (R2 = 0.56, p < 0.0001) and MPF (R2 = 0.37, p < 0.0003), while expert ratings of wrist deviation showed a weak statistically nonsignificant association with goniometer measurements of ROM (R2 = 0.032, p = 0.34). CONCLUSION: The reliability of expert assessments of wrist-hand physical exposures was high. Compared to goniometer measurements, the validity of assessments of wrist-hand repetition was also high, but it was low for assessments of wrist-hand deviation. The results are encouraging for establishing a hand-wrist JEM, but the results for wrist deviation emphasize that expert assessments should be validated against objective measurements.

Wrist Posture Estimation Differences and Reliability Between Video Analysis and Electrogoniometer Methods.

OBJECTIVE: The aim of this study was to determine the inter- and intrarater agreement of estimated wrist angles using video and to compare wrist angles from video analysis to electrogoniometers. BACKGROUND: Video analysis is used frequently in ergonomic assessments, but factors including parallax and complex angles may influence wrist angle estimates. Electrogoniometers are an alternative to video, but may not be reliable in complex postures. Given the limitations of each method, there is a need to determine the suitability of the measurement methods for field use. METHOD: Ten participants performed frame-by-frame wrist (flexion-extension, radioulnar deviation) and forearm (pronation-supination) posture estimation for worker tasks from three camera views (top, side, and oblique). Workers were equipped with electrogoniometers to record wrist posture during the tasks. The video estimate data was compared between 2 days and to sensor data. RESULTS: Percent agreement between participants ranged from 53% to 81% across all ratings. Agreement was highest from the side view (66%, κ = 0.56) for flexion-extension and top view for radioulnar deviation (77%, κ = 0.52) and pronation-supination (69%, κ = 0.58). Video-electrogoniometer agreement was lower, with peak agreement from the top view for flexion-extension (57%, κ = 0.49) and radioulnar deviation (68%, κ = 0.30) and the oblique view for pronation-supination (53%, κ = -0.1). CONCLUSION: Participant estimate agreement was moderate-substantial overall and aligns with previous reports. Disagreement between video and electrogoniometers may be attributed to camera angle and parallax effects and the small magnitude of wrist motions compared to other joints.

Wearable wireless low-cost electrogoniometer design with Kalman filter for joint range of motion measurement and 3D modeling of joint movements.

Joint movements are the key factor for the mobility of the people during daily activities. The evaluation of the joint movements is determined by the range of motion (ROM) parameters. The ROM might change due to age, gender, and some diseases. Therefore, it is essential to measure ROM accurately and compare it with the normal values of the healthy people. In this study, a low-cost, wireless, and wearable electrogoniometer was designed for highly precise and accurate measurements. The stability of the measurements is guaranteed with the quaternion based Kalman filter. The measurements of the developed system are compared with the traditional goniometer. The concordance correlation coefficient is calculated as a similarity metric, and the result is obtained as 1. In addition, a GUI was prepared to present 3D visualization of the movements in real-time with the ROM measurements and give visual feedback to the physiotherapists during physical examinations and to the patient during the home therapy sessions. The measurements also can be recorded using the GUI for retrospective analysis.

Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle.

BACKGROUND: Both universal goniometer and electro-goniometer are used for measuring joint range of motion in physiotherapy. Active knee extension test is a way to assess hamstring shortness in patients with chronic low back pain. The aim of this study was to assess universal goniometer and electro-goniometer reliability in measuring knee angle during active knee extension test. METHODS: This was an intra-examiner reliability study between three measurements of knee extension angle that conducted on 45 patients with chronic low back pain having short hamstring muscle that referring to Kermanshah University of Medical Sciences clinic from 2016 to 2017. Knee extension angle was measured three times during active knee extension test with both universal goniometer and electro-goniometer.The measurement of knee extension angle was done at the beginning, middle and the end of one single session by one experienced physiotherapist.The intra-class correlation coefficient (ICC) and standard error of measurements (SEM) were used to quantify intra-examiner reliability. RESULTS: For both methods, the reliability test values were found to be greater than 0.7 in the range of 0.92 to 0.99 (CI 95% ranged over = 0.94 to 0.99), which are classified as good reliability. The SEMs ranged from 1.04° to 2.16° for both scales. CONCLUSION: Universal goniometer in clinical evaluations of patients (as they are easy to be employed) and electro-goniometer in laboratory studies (as they are more accurate) are reliable.

A study on muscle activity based on the ankle posture for effective exercise with indoor horse riding machine.

[Purpose] Although much researches have been conducted on the hippotherapy, the intervention methods of the previous studies focus on the pelvis posture. Thus, this study analyzed the electromyogram (EMG) of trunk muscle and lower limb muscle to analyze the kinetic factors. Based on the analysis, this study aims to compare the muscle load and suggest effective exercise method. [Participants and Methods] This study checked the muscle activity of Rectus abdominis (RA), Erector spinae (ES), Rectus femoris (RF), Adductor magnus (AM) during the exercise using horse riding machine in dorsiflexion position by bending 20 degrees and in neutral position. Each position was performed for 5 minutes and the speed of the horse riding machine was set to medium speed. [Results] Rectus abdominis showed higher muscle activity in dorsiflexion position and the groups had significant differences. Elector spinae showed higher muscle activity in dorsiflexion position and the groups had significant differences. Rectus femoris showed higher muscle activity in dorsiflexion position and the groups had significant differences. Adductor magnus also showed higher muscle activity in dorsiflexion position and the groups had significant differences. [Conclusions] The study result showed that exercise with horse riding machine in dorsiflexion position activates trunk muscle and thigh muscle effectively. Thus, the study suggests more effective posture for the modern people who exercise with horse riding machine for strengthening physical health.

The better way to determine the validity, reliability, objectivity and accuracy of measuring devices.

BACKGROUND: In relation to statistical analysis, studies to determine the validity, reliability, objectivity and precision of new measuring devices are usually incomplete, due in part to using only correlation coefficient and ignoring the data dispersion. OBJECTIVE: The aim of this study was to demonstrate the best way to determine the validity, reliability, objectivity and accuracy of an electro-inclinometer or other measuring devices. Another purpose of this study is to answer the question of whether reliability and objectivity represent accuracy of measuring devices. METHODS: The validity of an electro-inclinometer was examined by mechanical and geometric methods. The objectivity and reliability of the device was assessed by calculating Cronbach's alpha for repeated measurements by three raters and by measurements on the same person by mechanical goniometer and the electro-inclinometer. Measurements were performed on "hip flexion with the extended knee" and "shoulder abduction with the extended elbow." The raters measured every angle three times within an interval of two hours. The three-way ANOVA was used to determine accuracy. RESULTS: The results of mechanical and geometric analysis showed that validity of the electro-inclinometer was 1.00 and level of error was less than one degree. Objectivity and reliability of electro-inclinometer was 0.999, while objectivity of mechanical goniometer was in the range of 0.802 to 0.966 and the reliability was 0.760 to 0.961. For hip flexion, the difference between raters in joints angle measurement by electro-inclinometer and mechanical goniometer was 1.74 and 16.33 degree (P<0.05), respectively. The differences for shoulder abduction measurement by electro-inclinometer and goniometer were 0.35 and 4.40 degree (P<0.05). CONCLUSION: Although both the objectivity and reliability are acceptable, the results showed that measurement error was very high in the mechanical goniometer. Therefore, it can be concluded that objectivity and reliability alone cannot determine the accuracy of a device and it is preferable to use other statistical methods to compare and evaluate the accuracy of these two devices.

Effectiveness of adaptive silverware on range of motion of the hand.

Background. Hand function is essential to a person's self-efficacy and greatly affects quality of life. Adapted utensils with handles of increased diameters have historically been used to assist individuals with arthritis or other hand disabilities for feeding, and other related activities of daily living. To date, minimal research has examined the biomechanical effects of modified handles, or quantified the differences in ranges of motion (ROM) when using a standard versus a modified handle. The aim of this study was to quantify the ranges of motion (ROM) required for a healthy hand to use different adaptive spoons with electrogoniometry for the purpose of understanding the physiologic advantages that adapted spoons may provide patients with limited ROM. Methods. Hand measurements included the distal interphalangeal joint (DIP), proximal interphalangeal joint (PIP), and metacarpophalangeal joint (MCP) for each finger and the interphalangeal (IP) and MCP joint for the thumb. Participants were 34 females age 18-30 (mean age 20.38 ± 1.67) with no previous hand injuries or abnormalities. Participants grasped spoons with standard handles, and spoons with handle diameters of 3.18 cm (1.25 inch), and 4.45 cm (1.75 inch). ROM measurements were obtained with an electrogoniometer to record the angle at each joint for each of the spoon handle sizes. Results. A 3 × 3 × 4 repeated measures ANOVA (Spoon handle size by Joint by Finger) found main effects on ROM of Joint (F(2, 33) = 318.68, Partial η (2) = .95, p < .001), Spoon handle size (F(2, 33) = 598.73, Partial η (2) = .97, p < .001), and Finger (F(3, 32) = 163.83, Partial η (2) = .94, p < .001). As the spoon handle diameter size increased, the range of motion utilized to grasp the spoon handle decreased in all joints and all fingers (p < 0.01). Discussion. This study confirms the hypothesis that less range of motion is required to grip utensils with larger diameter handles, which in turn may reduce challenges for patients with limited ROM of the hand.

The effects of work surface hardness on mechanical stress, muscle activity, and wrist postures.

BACKGROUND: Contact pressure is a risk factor which can contribute to musculoskeletal disorders. OBJECTIVE: The objective of the present study was to determine whether a work surface with a soft, pliable front edge could reduce contact pressure, muscle activity, and subjective musculoskeletal comfort, and improve wrist posture relative to a conventional, hard work surface. METHODS: In a repeated-measures blinded experiment with eighteen subjects (8 females and 10 males), contact pressure, wrist posture, typing productivity, perceived fatigue, wrist and shoulder muscle activity, and subjective comfort were compared between the two different work surfaces during keyboard use, mouse use and mixed mouse and keyboard use. RESULTS: The results showed that across the three modes of computer work, the contact pressure was lower on the soft-edge work surface compared to the conventional work surface (p's <0.03) and subjects reported to have less perceived fatigue in the forearms and wrists. No differences in muscle activity, wrist posture, and subjective comfort were measured between the two work surfaces. CONCLUSIONS: Given the significant reduction in contact pressure and corresponding lower ratings in perceived fatigue, the soft-edge work surface subjectively and objectively improved measures of contact stress which may reduce physical exposures associated with the onset and development of musculoskeletal disorders.

Assessment of Correlation between Electrogoniometer Measurements and Sports-Specific Movement in Karate Elites.

PURPOSE: To examine the intra-rater reliability of knee movement data in sagital plane obtained from electrogoniometer (EGM) in a basic, sport-specific task of karate. METHODS: A total of 23 elite karate athletes (13 females and 10 males; mean age of 16.10±1.26 yrs) participated in this study. The task was defined as performing three consecutive Zenkutsu-dachi in two sessions. The used EGM was a twin axis of Biometrics company. EGM curves were plotted in MATLAB software separately. The indices of three points in the plots corresponding to extremes of flexion and extension of knee in the first dachi were determined. There was also another (forth) point which was not in extremes of movement. As it was repeated in all curves, it was perceived as a biomechanical event and was assessed. The phases of movement between the points were scaled between 0 to 100% of activity. RESULTS: Repeatability of the forth point index was assessed by intraclass correlation method. Intraclass correlation of the ratio in the first testing session was 0.666 and in second was 0.448. The interval between points were considered as phases of movement. After determining three phases of dachi, it was shown that these phases pertained a specific ratio of the total plot which were 48%, 36% and 16% of total respectively. CONCLUSION: Dachi could be divided into three distinct phases; each of them should constitute a specific percent of the total in an elite athlete.

Peak torque and knee kinematics during gait after eccentric isokinetic training of quadriceps in healthy subjects / O pico de torque e a cinemática do joelho durante a marcha após treino isocinético excêntrico do quadríceps em sujeitos saudáveis

OBJECTIVE: To evaluate the effects of eccentric isokinetic training on knee range of motion (ROM) of healthy subjects. METHODS: The knee extensor and flexor isokinetic peak torques and ROM of flexion/extension and varus/valgus knee movements during gait of 18 healthy men (21.7±2.2 years; 1.73±0.10m; 68.7±9.4kg; body mass index: 22.6±2kg/m²) were analyzed, before and after six weeks of bilateral eccentric isokinetic training of the knee extensors at 30º/s. RESULTS: The knee extensor torque increased in both limbs (right, from 229±54 to 304±53Nm; p<0.01; and left, from 228±59 to 311±63Nm; p<0.01), without any difference in torque gain between them. The knee flexor peak torque increased (from 114±30 to 123±22Nm; p<0.05), but the hamstrings/quadriceps (H/Q) ratio decreased (from 0.5±0.08 to 0.39±0.07; p<0.01) after the training. There were no differences in the flexion/extension and varus/valgus movements after the training, except for a small change (4°) in valgus for the left knee. CONCLUSIONS: The eccentric isokinetic training of the knee extensors increased the extensor torque and decreased the H/Q ratio, although the effect on the gait pattern seemed negligible in healthy subjects. Associated training for flexors, complementary to the extensor training, seems to be necessary for balance between knee agonists and antagonists.

OBJETIVO: Avaliar os efeitos do treino isocinético excêntrico sobre a amplitude de movimento (ADM) do joelho em sujeitos saudáveis. MÉTODOS: Foram analisados os picos de torque isocinético dos extensores e flexores do joelho e a ADM de flexo/extensão e valgo/varo, durante a marcha, de 18 homens saudáveis (21,7±2,2 anos; 1,73±0,10m; 68,7±9,4kg; índice de massa corpórea: 22,6±2kg/m²) antes e após seis semanas de treino isocinético excêntrico bilateral dos extensores do joelho a 30º/s. RESULTADOS: O torque extensor do joelho aumentou em ambos os membros, direito (de 229±54 para 304±53Nm; p<0,01) e esquerdo (de 228±59 para 311±63Nm; p<0,01) sem diferença de ganho de torque entre eles. O pico de torque flexor aumentou (de 114±30 para 123±22Nm; p<0,05), mas a razão isquiotibiais/quadríceps (I/Q) diminuiu (de 0,5±0,08 para 0,39±0,07; p<0,01) após o treino. Não houve diferença para os movimentos de flexo/extensão e valgo/varo após o treino, exceto uma pequena mudança (4°) no valgo para o joelho esquerdo. CONCLUSÕES: O treino isocinético excêntrico dos extensores do joelho aumentou o torque extensor e diminuiu a razão I/Q, entretanto o efeito sobre o padrão da marcha parece desprezível em sujeitos saudáveis. Um treino associado dos flexores, complementar ao treino dos extensores parece ser necessário para o equilíbrio entre agonistas e antagonistas do joelho.

Risk Factor Assessment Using Surface Electromyography and Electrogoniometer among Automobile Part Manufacturers / 대한산업의학회지

OBJECTIVES: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. METHODS: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. RESULTS: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. CONCLUSIONS: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.

Correlation of spinal mobility with the severity of chronic lower back pain

The purpose of this study is to show the correlation between the range of spinal motion and the severity of chronic lower back pain. The subjects of this study were 40 female patients with chronic lower back pain over a 6 months' duration. The range of spinal and hip joint motion was measured with a electrogoniometer, and the severity of back pain was evaluated with the Rolland's score and Pollard's pain disability index. Results were as follows. There was a correlation between the severity of pain and the range of lumbar lateral flexion, rotation, and extension (p< 0.05). Age, height, weight and body mass index had no correlation with the range of spinal motion. These results suggest that the range of lumbar spinal motion can be used as an objective measure for the evaluation of classifying chronic lower back pain patients and for planning and following their treatment.