Quantification of the dart thrower’s motion in wrists with pathology
Research type
Research Study
Full title
Quantification of the dart thrower’s motion of the wrist in the presence of joint pathology
IRAS ID
221599
Contact name
Angela E Kedgley
Contact email
Sponsor organisation
Joint Research Compliance Office, Imperial College London
Duration of Study in the UK
1 years, 4 months, 27 days
Research summary
When we perform many activities of daily living (like drinking or pouring water), it has been found that our wrist follows a path that is described by the dart thrower’s motion (DTM). As its name suggests, DTM is the motion we do when we throw a dart.
Clinical measurement of wrist range of motion is based on goniometry. Despite the functional importance of DTM, therapists find it difficult to measure. A study performed last year by our group on a healthy population resulted on a proposed method that allows for improvement of the measurement of the DTM plane by hand therapists. Previous studies have shown that DTM can be preserved following reconstructive surgery or therapy.
Therefore, this study aims to investigate the accuracy of DTM measurement under clinical conditions and to determine whether the proposed mathematical correction can be used in the case of injured wrists. We also plan to investigate the correlation of the DTM with muscle activation patterns and other assessment measures used by hand therapists. We will use commercially-available optical motion tracking technology along with surface electromyography and an already established goniometric measurement protocol.
During this study, wrist motion when throwing a dart will be measured using a goniometer and an optical motion tracking system. Surface electromyography (EMG) electrodes will be used to measure the activity of forearm muscles during DTM and clinical information will be collected using the patient-rated wrist/hand evaluation (PRWHE) form (Appendix 2). This information will be used to assess the accuracy of the existing clinical method and improve the proposed correction method in order to improve this measurement.Summary of study results:
Wrist kinematics of a group of patients with unilateral wrist trauma were measured at the beginning and end of their rehabilitation using an optical tracking system and goniometry. Range of motion (ROM) measurements, including flexion-extension (FE) and DTM were recorded. A Theil-Sen estimator was used to define the DTM plane from the motion capture data. All differences were assessed using Wilcoxon signed-rank tests.
Significant differences were found between ROM of the injured and uninjured hands in both FE and DTM at baseline (p=0.001). No significant differences were found in DTM plane orientation between the two hands (p=0.25). Using the proposed method, there were no significant differences between the DTM plane quantified by goniometry and motion capture (p=0.13). There was a correlation between PRWE scores and the product of the normalised DTM ROM and the normalised grip strength of the patient (p=0.009).
The absence of statistical differences in DTM plane orientation suggests that although these injuries affected ROM, they did not have a significant effect on plane orientation. The proposed method allows the DTM plane to be quantified using goniometry following injury or different types of treatment.REC name
East of England - Essex Research Ethics Committee
REC reference
17/EE/0110
Date of REC Opinion
3 Apr 2017
REC opinion
Further Information Favourable Opinion