Category: Cross-Cutting; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Measurement
To investigate the finger range of motion (ROM) required for individuals with rheumatoid arthritis (RA) to grip standard and built-up spoons. Our hypothesis was that less ROM would be required to grip built-up spoons compared to a standard one.
Setting : Outpatient Rheumatology Clinic in an Academic Teaching Hospital
Participants (or Animals, Specimens, Cadavers) : Thirty-eight individuals (76 hands) with RA between the ages of 38-79 were recruited. Inclusion criteria included 18 years or older and no comorbidities that could further impair ROM of the hands and fingers.
Participants placed their arm in a standarized position for eating and held a standard spoon and spoons with built-up handles of 1.0 inches and 1.5 inches. Measurements of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints were taken for digits 2-5, and the MCP and IP joints for the thumb. Measurements were obtained for both hands using a Biometrics F35 Single Axis Electrogoniometer (Biometrics Ltd, Ladysmith, VA, USA). All measurements were obtained in triplicate and averaged.
Main Outcome Measure(s) : Finger joint ROM used to hold a normal, and two sizes of built-up spoons during feeding.
Results : A 2X3 repeated measures ANOVA was performed for each finger joint. Main effects showed significant differences in ROM between handle conditions for all joints (p2=0.138 to 0.934), with the greatest effect sizes seen in the PIP and DIP joints. Further pairwise comparisons showed significant differences between all handle conditions with the exception of between the normal and 1 inch handles for the 1st, 3rd, 4thand 5thfinger MCP joints.
Conclusions : This study provides quantitative evidence supporting our hypothesis that using a built-up handle requires less AROM for grasp.
David Levine– Professor, The University of Tennessee at Chattanooga, Signal Mtn, Tennessee
Susan McDonald– Department Head & Associate Professor, The University of Tennessee at Chattanooga, Chattanooga, Tennessee
Hensley Barnes– Doctoral Student, The University of Tennessee at Chattanooga, Chattanooga, Tennessee
Anna Cornett– Doctoral Student, The Unversity of Tennessee at Chattanooga, Chattanooga, Tennessee
Kathleen Craig– Doctoral Student, The Unversity of Tennessee at Chattanooga, Chattanooga, Tennessee
Sally Langager– Doctoral Student, The University of Tennessee at Chattanooga, Chattanooga, Tennessee
Lauren Yeager– Student, The University of Tennessee at Chattanooga, Chattanooga, Tennessee
Michael Brit– Rheumatologist, Erlanger Health System, Chattanooga, Tennessee
Elizabeth Turner– Rheumatologist, Erlanger Health System, Chattanooga, Tennessee
Jim Richards– Professor, The University of Central Lancashire, Preston, England