Developing a clinically useful measure of dynamic pinch

描述(由申请人提供)：目标：提供一种急需的简单、有效和可靠的动态拇指力量测量方法，以量化与骨科和神经疾病相关的功能表现、损伤和恢复。缺乏对拇指动力的客观和灵敏的结果测量，排除了信息丰富的临床研究，以优化每个患者的治疗选择、时机和选择。 方法：我们设计了一种新的测试来量化产生动态拇指力量的能力。强度-灵活性(S-D)测试基于细长弹簧的屈曲原理，目前的原型包括让一个人尝试压缩87个压缩弹簧，每个压缩弹簧具有不同的强度(刚度)和灵活性(屈曲倾向)要求的组合。我们过去的临床工作表明，S-D测试具有可重复性，并且比捏压强度测量更能反映腕掌骨性关节炎拇指神经肌肉骨骼的完整性。我们建议将S-D测试改进为一种临床上有用的拇指动力测量方法。 目标1：将患者和临床医生的负担降至最低。我们将S-D试验从87次弹簧压缩缩短为最多2次弹簧压缩，每次3次。嵌入在此弹簧中的指尖运动学和传感器的数字信号处理将通过3个连续参数来充分表征每个力量水平下的动态神经肌肉骨骼拇指功能。目的2：验证简化的S-D测验与已建立的手功能指标的一致性。我们将在特外科医院部署S-D测试，以检验以下假设。基本假设：S-D测验与手功能的可用测量相关。第二假设：与现有的手功能测量相比，S-D测试与CMCOA治疗后患者满意度的相关性更好。 影响：我们寻求开发一种既简单又快速管理的评估工具，并可以透露这一关键拇指功能的更全面/可靠和可量化的衡量标准。将S-D测试发展成为一种快速、客观和临床有效的动态拇指力量测量工具，将有助于在当今的临床环境下量化损害和评估治疗效果。

DESCRIPTION (provided by applicant): GOAL: To provide a much-needed simple, valid, and reliable measure of dynamic thumb forces that quantifies functional performance, impairment and recovery related to orthopedic and neurological diseases. The absence of an objective and sensitive outcome measure of dynamic thumb forces precludes informative clinical studies to optimize the choice, timing and options of treatment for each patient. APPROACH: We have designed a novel test to quantify the ability to produce dynamic thumb forces. The strength-dexterity (S-D) test is based on the principle of buckling of slender springs, and its current prototype consists of asking a person to attempt to compress each of 87 compression springs with different combinations of strength (stiffness) and dexterity (propensity to buckling) requirements. Our past clinical work has shown that the S-D Test is repeatable and is informative of the neuro-musculo-skeletal integrity of thumb with carpometacarpal osteoarthritis (CMC OA) better than measurements of pinch strength. We propose to refine the S-D Test into a clinically useful measure of dynamic thumb forces. AIM 1: Minimize burden to patient and clinician. We will shorten the S-D Test from 87 spring compressions to compressing at most 2 springs, 3 times each. Digital signal processing of fingertip kinematics and sensors embedded in this spring will fully characterize dynamic neuro-musculo-skeletal thumb function at each strength level via 3 continuous parameters. AIM 2: Validate the shortened S-D Test against established measures of hand function. We will deploy the S-D Test at the Hospital for Special Surgery to test the following hypotheses. PRIMARY HYPOTHESIS: The S-D Test correlates with available measures of hand function. SECONDARY HYPOTHESIS: The S-D Test correlates with patient satisfaction after treatment for CMC OA better than available measures of hand function. IMPACT: We seek to develop an assessment tool that is both simple and expeditious to administer, and can divulge a more comprehensive/reliable and quantifiable measure of this crucial thumb function. Developing the S-D Test into a quick, objective, and clinically valid measure of dynamic thumb forces will be instrumental to quantifying impairment and assessing effectiveness of treatments in today's clinical environment.