title: Kinematic Analyses of the Thumb during Simulated Posteroanterior Glide Mobilization.
abstract: OBJECTIVE
  Thumb problems are common in some health professionals such as physical therapists. The purpose of this case-control study is to investigate the influence of clinical experience and different mobilization techniques on the kinematics of the thumb.
  
  
  METHODS
  Twenty-three participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopedic experience (the Experienced Group) participated. The kinematics of the thumb while performing 3 different simulated posteroanterior (PA) glide mobilization techniques on a load cell was monitored. These 3 techniques were: 1) unsupported, 2) with digital support and 3) with thumb interphalangeal joint supported by the index finger. The amount of forces exerted were 25% to 100% of maximum effort at 25% increments. The main effects of experience and technique on thumb kinematics were assessed.
  
  
  RESULTS
  Both experience and technique had main effects on the flexion/extension angles of the thumb joints. Experienced participants assumed a more flexed position at the carpometacarpal (CMC) joint, and the novice participants performed with angles closer to the neutral position (F = 7.593, p = 0.010). Participants' metacarpophalangeal (MCP) joints were in a more flexed position while performing PA glide with thumb interphalangeal (IP) joint supported by the index as compared to the other two techniques (p < .001).
  
  
  CONCLUSIONS
  Negative correlations were generally obtained between the sagittal plane angles of adjacent thumb joints during mobilization/manipulation. Therapists are recommended to treat patient with more stable PA glide mobilization techniques, such as PA glide with thumb interphalangeal joint supported by the index finger, to prevent potential mobilization-related thumb disorders.
authors: Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.|Department of Physical Therapy, Tzu Hui Institute of Technology, Ping Tung, Taiwan.
authors: Meng-Tzu
authors: MT
authors: Hu
authors: Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: Ar-Tyan
authors: AT
authors: Hsu
authors: Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.|Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
authors: Fong-Chin
authors: FC
authors: Su
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D009068:Movement; D016059:Range of Motion, Articular; D013933:Thumb / Q000502:physiology*; D055815:Young Adult