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测量方法，用于量化与骨科和神经系统疾病相关的功能表现、损伤和恢复。缺乏客观和敏感的动态拇指力量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的能力。强度-灵活性（S-D）测试基于细长弹簧的屈曲原理，其当前原型包括要求一个人尝试压缩87个压缩弹簧中的每一个，这些弹簧具有强度（刚度）和灵活性（屈曲倾向）要求的不同组合。我们过去的临床工作表明，S-D测试是可重复的，是信息的神经-肌肉-骨骼完整性的拇指与腕掌骨关节炎（CMC OA）优于捏强度的测量。我们建议将S-D测试改进为临床上有用的动态拇指力测量。 目标1：最大限度地减少患者和临床医生的负担。我们将S-D测试从87个弹簧压缩缩短为最多压缩2个弹簧，每个弹簧压缩3次。指尖运动学的数字信号处理和嵌入该弹簧的传感器将通过3个连续参数在每个强度水平下充分表征动态神经肌肉骨骼拇指功能。目的2：将缩短的S-D测试与已建立的手功能测量进行比较。我们将在特殊外科医院部署S-D检验，以检验以下假设。主要假设：S-D测试与手功能的可用测量相关。次要假设：S-D检验与CMC OA治疗后患者满意度的相关性优于现有的手功能指标。 影响：我们寻求开发一种评估工具，既简单又快捷的管理，并可以透露一个更全面/可靠和量化的措施，这一关键的拇指功能。将S-D测试发展成一种快速、客观和临床有效的动态拇指力量测量方法，将有助于量化损伤和评估当今临床环境中治疗的有效性。

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.