Wrist Motion and Wrist Function: Are They Directly Related?Severe and chronic wrist pain may lead to surgery that affects wrist motion. Surgeons try to preserve motion as much as possible. The basic idea is that motion is directly linked with function. The more motion there is available, the more function will be possible. This study was designed to check this belief.
Adults over the age of 45 years with normal wrist motion and function were included in the study. The older age was to match results with adults of the same age likely to have arthritis and needing wrist surgery. Everyone was right-handed for the sake of consistency.
Subjects participated in two trials wearing two different splints. One splint restricted wrist motion partially. The other splint highly restricted motion. Each subject was tested for range of motion, opinions on function and satisfaction, and a timed test of function. A special device was built to help measure circular wrist motion. A new test to measure patient's satisfaction called the Modern Activity Subjective Survey (MASS) was developed.
The authors also developed their own special test of function called the Modern Activity Timed Test (MATT). This test measures the functional effects of restricted wrist motion on modern activities. Such activities are performed many times every day. Some of these tasks included making a cell phone call, taking money from a wallet, writing a check, using a computer mouse, or folding laundry.
Test results showed a big difference in function between the two splints. Common tasks took much longer to complete when wearing the more restrictive splint. Age and gender were not linked to the outcomes.
The authors did note that subjects in both groups had a surprisingly high degree of functional motion. This finding suggests that a large loss of motion doesn't necessarily mean an equally large loss of function.
Future studies are needed to validate the use of the two new tests (MASS, MATT) designed for this study. Further investigation of wrist function assessing more up-to-date tasks is needed. Understanding what tasks wrists can perform when motion is restricted will help surgeons and patients when planning surgery that can relieve pain but restricts motion and thereby function.
Orrin I. Franko, BS, et al. Functional Disability of the Wrist: Direct Correlation with Decreased Wrist Motion. In The Journal of Hand Surgery. April 2008. Vol. 33A. No. 4. Pp. 485-492.
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