Psychometric properties of body structures and functions measures in non-surgical thumb carpometacarpal osteoarthritis: A systematic review.
Corey McGee, Kristin Valdes, Caitlin Bakker and 1 others
PMID 37591727WHAT IT FOUND
For non-surgical thumb arthritis, only a few objective tests have proven reliability.
Use the Kapandji index for opposition, the intermetacarpal distance method for abduction, and three pain-free trials with standard dynamometers for grip and pinch. Avoid unvalidated dexterity or sensory measures.
Key findings
01The Kapandji index and intermetacarpal distance method have excellent inter-rater reliability and acceptable precision for assessing thumb opposition and abduction.
02Three pain-free maximal trials using standard dynamometers yield excellent test-retest reliability for grip and pinch strength, with minimal detectable changes established.
03There are no psychometrically validated tests for dexterity, sensory function, or hand function measures in this population, so these should not be used as primary outcome measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 11 studies met the inclusion criteria, resulting in a small volume of evidence. Only 3 of the 11 studies were rated as having 'very good' methodological quality. The review excluded studies on patients who had received steroid injections or surgery, limiting generalizability to those groups. No meta-analysis was possible due to the low number of studies per measurement type. Many common clinical measures (dexterity, sensory, hand function) had no psychometric data available in this population, so recommendations for them are absent rather than negative.
Declared interests
The authors declare no competing financial interests or personal relationships.
The easy way to misread this
Do not assume that widely used tests like goniometry for thumb flexion or provocative tests like the grind test are reliable or valid. The review found poor methodological quality or insufficient evidence for these measures in this specific population, meaning their results may be misleading.