Using active or functional range of motion as a further indicator to detect hand osteoarthritis. A preliminary study

Abstract

Purpose: Propose further indicators for helping to detect hand osteoarthritis (HOA) using either active or functional ranges of motion (AROM or FROM).

Method: Hand kinematics data of 16 hand joint angles from previous studies were used, taken from healthy participants and HOA patients with differently affected joints and distinct levels of compromise. Data consisted of: (i) AROM (extreme values and ranges); (ii) FROM while performing the Sollerman Hand Function Test (mean, extreme percentiles and ranges). Two linear discriminant analyses (stepwise method) were conducted, one per dataset (AROM and FROM), with condition (healthy/patient) as the grouping variable. The potential predictors were the data from the joints with significant differences between samples for each analysis (A-predictors and F-predictors).

Results: Good sensitivity-specificity values of 85.2-90.9% and 93.8-93.9% for F-predictors and A-predictors, respectively. Sets of predictors corresponded to the joints more commonly affected by HOA. F-predictors: lower maximal flexion of carpometacarpal and interphalangeal thumb joints, higher maximal flexion of thumb metacarpal joint, lower flexion/extension range of ring proximal interphalangeal joint and higher maximal little finger adduction. A-predictors: narrower flexion/extension range of the thumb carpometacarpal joint, lesser extension of the ring metacarpophalangeal joint; lower flexion of the middle finger proximal interphalangeal joint along with a narrower palmar arch range.

Conclusion: Both sets of predictors provide discrimination capacity of HOA with good sensitivity-specificity, slightly better for A-predictors. The AROM measurement is technically less demanding and can be clinically applied even with manual goniometry.

Keywords: Hand osteoarthritis; discriminant function; hand kinematics; non-invasive test; ranges of motion.