Comparison of palmar abduction in three wrist positions among healthy adults using conventional goniometer

Introduction: Measurement of palmar abduction at carpometacarpal joint (CMCJ) of thumb is routinely performed in various conditions of hand dysfunction. Different techniques and tools are employed to measure CMCJ range of motion (ROM). Although, measurement techniques are largely similar, the approach adopted for position of wrist varies. Present study explores association of wrist position with palmar abduction of CMCJ and provides discussion pertaining to method of range of motion measurement. Purpose: Present study intends to explore the association of wrist position and palmar abduction of CMCJ in healthy adults to recommend a biomechanically sound technique for range of motion measurement. Methods: Active and passive palmar abduction range of motion was measured on both hands of 300 healthy adults with wrist positioned in flexion, extension, and neutral. Data were analyzed to obtain statistical significance of the measured differences. Results: Significant difference was noted (p< 0.05) in average palmar abduction with wrist in neutral (51.6), flexion (47.8) and extension (56.8) positions in all age groups. Comparison of dominant hand and non-dominant hand range of palmar abduction revealed significant difference (p< 0.05) between dominant hand and non-dominant hand. Males demonstrated greater range of palmar abduction than females (p< 0.05). Conclusion: The position of wrist has significant influence on range of motion of palmar abduction. Therefore, while using standard goniometer for measurement of CMCJ, it is recommended that therapist should maintain same wrist position during each follow-up measurement. Alternatively, a tool which holds wrist in same position consistently during CMCJ ROM measurement may be used for more reliable measurement.