Tool for the functional assessment of
the hand based on its kinematics, for clinical use
Abstract:
The manipulation
ability of the hand is essential for the development of activities
of daily living (ADL), as reflected by the WHO that establishes the
ability to carry out ADL as the main factor to classify the degree
of disability. But this capacity is compromised by different
pathologies or injuries, whose incidence is increasing in a
population with an increasing life expectancy. The kinematics of the
hand plays an important role in this ability, but the methods
currently used for the functional assessment do not contemplate the
kinematic analysis of the hand during the performance of ADL. Some
methods of functional evaluation contemplate the capacity to perform
these activities, but in a qualitative (and subjective) way through
questionnaires. The evaluation of the kinematics in the assessment
of the functionality is usually reduced to measuring the maximum
ranges of mobility of the joints.
The project is based on the results obtained by the research team in
a previous research project in which the healthy hand kinematics was
experimentally characterized in a representative set of ADL,
selected from the International Classification of Functioning,
Disability and Health (ICF), of the WHO. This characterization was
carried out at different levels: (i) The functional mobility ranges
were obtained (those necessary to carry out the selected ADLs); (ii)
The patterns of kinematic coordination (synergies) used by the
healthy hand to develop the ADLs were identified, and it was
quantified how the healthy hand uses each of these synergies to
carry out each activity; (iii) The relevance for the personal
autonomy of the different types of grasp used in ADL was quantified.
The purpose of this project is to develop tools for clinical use,
based on the kinematic characterization of the hand, that are easy
to apply and that provide a more objective quantification of the
functional alterations during the performance of ADL. The specific
objectives can be summarized as follows: 1) To search for kinematic
parameters as indicators of loss of functionality through the
experimental kinematic characterization of pathological hands using
dimensional reduction techniques. 2) To improve the current
functional kinematics assessment tools and / or to propose new tools
based on the identified kinematic parameters, and on the results of
relevance of the grasps for personal autonomy, and functional
mobility ranges. These tools would be useful for the assessment of
disability, for the establishment of rehabilitative strategies and
even as an aid to select clinical criteria of surgical intervention.
