https://handlab.com/media/wysiwyg/PDFs/Kraker_The_PollexoGraph_or_PollexBox.pdf

The Pollexograph: a new device for palmar abduction measurements of the thumb.

Question: What is the effectiveness of 12 weeks of nightly stretch in reducing thumb web-space contracture in people with neurological conditions? Design: Assessor-blinded, randomised controlled trial. Participants: Forty-four (one dropout) community-dwelling patients with a neurological condition (14 stroke, 7 traumatic brain injury, 23 spinal cord injury) who had unior bilateral thumb web-space contractures (60 thumbs). Intervention: The experimental thumbs were splinted into a stretched, abducted position each night for 12 weeks. The control thumbs were not splinted. Outcome measures: Thumb web-space was measured as the carpometacarpal angle during the application of a 0.9 Nm abduction torque before and after intervention. Results: The mean increase in thumb web-space after 12 weeks was 1 deg (95% CI, –1 to 2). Conclusion: Intensive stretch administered regularly over three months does not reduce thumb web-space contractures in neurological conditions. [Harvey L, de Jong I, Goehl G, Marwedel S (2006) Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition: a randomised controlled trial. Australian Journal of Physiotherapy 52: 251– 258]

Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition: a randomised controlled trial

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.

Palmar abduction: reliability of 6 measurement methods in healthy adults.

Purpose Previously, we studied normative and reliability data of palmar thumb abduction measurements (conventional goniometry, the Pollexograph thumb, the Pollexograph metacarpal, the Inter Metacarpal Distance, the American Society of Hand Therapists method, and the American Medical Association method) in healthy adults. Because many interventions aiming to improve palmar abduction are performed at an early age, the goal of this study was to assess normative and reliability data of these measurement methods in children. Methods We performed measurements with the Pollexograph thumb, the Pollexograph metacarpal and Inter Metacarpal Distance in 100 healthy children to acquire normative data. A retest was performed in 63 children to assess intraobserver reliability. Results Mean active and passive palmar abduction measured with the Pollexograph thumb was 62° (range, 40° to 76°). The range of motion of the Pollexograph metacarpal was smaller (mean 49°, range, 32° to 64°). The mean Inter Metacarpal Distance was 50 mm (range, 36–70 mm). Intraclass correlation coefficients of the Pollexograph thumb, Pollexograph metacarpal, and Inter Metacarpal Distance indicated excellent reliability (intraclass correlation coefficients between 0.85 and 0.92). Conclusions Normative Pollexograph thumb and Pollexograph metacarpal data showed that means measured in children are comparable to values found in healthy adults. Reliability data indicated that the Pollexograph thumb, the Pollexograph metacarpal, and Inter Metacarpal Distance are also reliable measurement methods in children.

Palmar abduction measurements: reliability and introduction of normative data in healthy children.

The purpose of this paper is to introduce a new design for a finger and wrist rehabilitation robot. Furthermore, a fuzzy sliding mode controller has been designed to control the system.,Following an introduction regarding the hand rehabilitation, this paper discusses the conceptual and detailed design of a novel wrist and finger rehabilitation robot. The robot provides the possibility of rehabilitating each phalanx individually which is very important in the finger rehabilitation process. Moreover, due to the model uncertainties, disturbances and chattering in the system, a fuzzy sliding mode controller design method is proposed for the robot.,With the novel design for moving the DOFs of the system, the rehabilitation for the wrist and all phalanges of fingers is done with only two actuators which are combined in one device. These features make the system a good choice for home rehabilitation. To control the robot, a fuzzy sliding mode controller has been designed for the system. The fuzzy controller does not affect the coefficient of the sliding mode controller and uses the overall error of the system to make a control signal. Thus, the dependence of the controller to the model decreases and the system is more robust. The stability of the system is proved by the Lyapunov theorem.,The paper provides a novel design of a hand rehabilitation robot and a controller which is used to compensate the effects of the uncertain parameters and chattering phenomenon.

Belinda Armstrong

Papers

A torque-controlled device to measure passive abduction of the thumb carpometacarpal joint.

A Meta-Analysis of Zephyr Endobronchial Valves for Management of Persistent Air Leaks