title: Examination of the torque required to passively palmar abduct the thumb CMC joint in a pediatric population with hemiplegia and stroke.
abstract: Many activities of daily living involve precision grasping and bimanual manipulation, such as putting toothpaste on a toothbrush or feeding oneself. However, children afflicted by stroke, cerebral palsy, or traumatic brain injury may have lost or never had the ability to actively and accurately control the thumb. To translate insights from adult rehabilitation robotics to innovative therapies for hand rehabilitation in pediatric care, specifically for thumb deformities, an understanding of the torque needed to abduct the thumb to assist grasping tasks is required. Participants (n=16, 10 female, 13.2±3.1 years) had an upper extremity evaluation and measures were made of their passive range of motion, anthropometrics, and torques to abduct the thumb for both their affected and non-affected sides. Torque measures were made using a custom wrist orthosis that was adjusted for each participant. The torque to achieve maximum abduction was 1.47±0.61inlb for the non-affected side and 1.51±0.68inlb for the affected side, with a maximum recorded value of 4.87inlb. The overall maximum applied torque was observed during adduction and was 5.10inlb. We saw variation in the applied torque, which could have been due to the applied torques by the Occupational Therapist or the participant actively assisting or resisting the motion rather than remaining passive. We expect similar muscle and participant variation to exist with an assistive device. Thus, the data presented here can be used to inform the specifications for the development of an assistive thumb orthosis for children with "thumb-in-palm" deformity.
authors.affiliation: Massachusetts Institute of Technology, Cambridge, MA 77 Massachusetts Ave, BLDG 33-311, Cambridge, MA 02139, United States. Electronic address: leia@mit.edu.
authors.forename: Leia
authors.initials: L
authors.lastname: Stirling
authors.affiliation: Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States.
authors.forename: Mona Qureshi
authors.initials: MQ
authors.lastname: Ahmad
authors.affiliation: Grinnell College, Grinnell, IA, United States.
authors.forename: Damian
authors.initials: D
authors.lastname: Kelty-Stephen
authors.affiliation: Department of Physical and Occupational Therapy, Boston Children׳s Hospital, Boston, MA, United States.
authors.forename: Annette
authors.initials: A
authors.lastname: Correia
mesh_terms: D000293:Adolescent; D052737:Carpometacarpal Joints / Q000503:physiopathology*; D002648:Child; D005260:Female; D006227:Hand Deformities, Acquired / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006429:Hemiplegia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D016059:Range of Motion, Articular; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D013933:Thumb / Q000002:abnormalities; D019415:Torque
keywords: Anthropometry; Orthotic; Range of motion; Thumb torque