title: Functional task kinematics of the thumb carpometacarpal joint.
abstract: BACKGROUND
  Abnormal biomechanical loading has been identified as an associated risk factor of osteoarthritis in the wrist and hand. Empirical data to date are insufficient to describe the role of altered biomechanics in thumb carpometacarpal (CMC) arthritis.
  
  
  OBJECTIVE
  This is a pilot study to evaluate motion analysis of the upper extremity while performing functional tasks. We wished to describe the in vivo kinematics of the thumb and hand in relation to the larger joints of the upper extremity in subjects without arthritis in functional positions at rest and while loading the CMC joint. If reproducible, we then planned to compare kinematics between these subjects and a subject with advanced thumb CMC arthritis.
  
  
  METHODS
  In vivo kinematics of the hand and upper extremity during the functional tasks of grasp, jar opening, and pinch with and without loading of the CMC joint were evaluated using cameras and a motion-capture system in four asymptomatic female subjects and one female subject with advanced radiographic (Eaton Stage IV) osteoarthritis.
  
  
  RESULTS
  Kinematics of the hand and upper extremity can be reliably quantified. Loading of the CMC joint did not alter the hand and forearm kinematics in control subjects. In the subject with osteoarthritis, the adduction-extension deformity at the CMC joint resulted in kinematic alterations as compared with the four control subjects.
  
  
  CONCLUSIONS
  This study represents preliminary steps in defining thumb CMC position, motion, and loading associated with activities of daily living. These findings enhance our understanding of motion at the CMC joint and how it differs in arthritic patients.
  
  
  METHODS
  Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Robert A. Chase Hand & Upper Limb Center, 770 Welch Road, Suite 400, Palo Alto, CA, 94304, USA, kluker@stanford.edu.
authors.forename: Kali R
authors.initials: KR
authors.lastname: Luker
authors.forename: Arnel
authors.initials: A
authors.lastname: Aguinaldo
authors.forename: Deborah
authors.initials: D
authors.lastname: Kenney
authors.forename: Katelyn
authors.initials: K
authors.lastname: Cahill-Rowley
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ladd
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001696:Biomechanical Phenomena; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D009048:Motor Skills; D009068:Movement; D009119:Muscle Contraction; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010865:Pilot Projects; D011859:Radiography; D016059:Range of Motion, Articular; D013933:Thumb / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D016474:Weight-Bearing
references.citation: Clin Biomech (Bristol, Avon). 2003 Jul;18(6):558-63
references.pmid: 12828906
references.citation: Ann Rheum Dis. 2005 May;64(5):682-7
references.pmid: 15374852
references.citation: Osteoarthritis Cartilage. 2006 Sep;14(9):953-7
references.pmid: 16759885
references.citation: Gait Posture. 2010 May;32(1):10-7
references.pmid: 20430623
references.citation: J Hand Surg Am. 1989 Jan;14(1):89-94
references.pmid: 2786020
references.citation: Gait Posture. 2011 Mar;33(3):490-5
references.pmid: 21269832
references.citation: J Hand Surg Am. 2010 Sep;35(9):1449-53
references.pmid: 20807622
references.citation: Clin Orthop Relat Res. 2005 Sep;438:266-76
references.pmid: 16131901
references.citation: J Bone Joint Surg Br. 1956 Nov;38-B(4):902-13
references.pmid: 13376678
references.citation: Clin Orthop Relat Res. 1992 Aug;(281):89-96
references.pmid: 1499233
references.citation: J Am Acad Orthop Surg. 2008 Mar;16(3):140-51
references.pmid: 18316712
references.citation: J Bone Joint Surg Am. 2004 Jul;86(7):1452-7
references.pmid: 15252092
references.citation: Gait Posture. 2010 May;32(1):72-7
references.pmid: 20378351
references.citation: Osteoarthritis Cartilage. 2006 May;14(5):496-500
references.pmid: 16545585
references.citation: J Hand Surg Am. 2003 Nov;28(6):898-903
references.pmid: 14642503
references.citation: Ann Rheum Dis. 1970 May;29(3):275-86
references.pmid: 5432594
references.citation: Clin Neurophysiol. 2012 Jun;123(6):1216-25
references.pmid: 22364723
references.citation: Hand Clin. 1987 Nov;3(4):455-71
references.pmid: 3693416
references.citation: Brain. 1995 Apr;118 ( Pt 2):495-510
references.pmid: 7735890
references.citation: Proc Inst Mech Eng H. 2002;216(4):257-63
references.pmid: 12206522
references.citation: J Bone Joint Surg Am. 1977 Jan;59(1):27-36
references.pmid: 833171
references.citation: Gait Posture. 2008 Jan;27(1):120-7
references.pmid: 17459709
references.citation: J Biomech. 1999 Dec;32(12):1337-41
references.pmid: 10569712
references.citation: Sci Am. 1962 Dec;207:56-62
references.pmid: 13937573