Thumb Muscle Activation During First Dorsal Interosseous Activities of Daily Living in Thumb Base Osteoarthritis

Official title

A Between-Group Comparison of First Dorsal Interosseous and Abductor Pollicis Longus Muscle Activation During First Dorsal Interosseous Activities of Daily Living in Individuals With and Without Thumb Base Osteoarthritis

Overview

The aim of this study is to investigate whether there are differences in muscle activation of the First Dorsal Interosseous (FDI) and the Abductor Pollicis Longus (APL) between individuals with and without trapeziometacarpal osteoarthritis (TMC OA) of the thumb during the performance of six activities of daily living (ADLs). The FDI has been defined as a key stabilizer of the TMC joint of the thumb. However, the literature reports limited information on FDI and APL activation during ADLs. TMC OA of the thumb can cause pain, decreased thumb strength, impaired hand function, and difficulty performing ADLs. Understanding muscle activation patterns during these activities is essential to comprehend how this condition affects hand function and to guide more specific and effective rehabilitation strategies. Participants will perform six ADLs: turning a key to open, turning a key to close, picking up a coin, writing, squeezing a tube of toothpaste, and holding a glass of water. Muscle activity will be recorded using surface electromyography (sEMG) during all tasks. Adults aged 30 years and older, both men and women, with TMC osteoarthritis and healthy controls without osteoarthritis will be invited to participate. Researchers will measure the activation patterns of the FDI and APL muscles during the ADLs, with the aim of identifying differences between both groups and providing evidence to guide the rehabilitation of patients with thumb base osteoarthritis.

Detailed description

Trapeziometacarpal osteoarthritis (OA TMC) of the thumb is a chronic and progressive degenerative disease characterized by loss of articular cartilage, subchondral sclerosis, capsuloligamentous laxity, and osteophyte formation in the first metacarpal. Patients typically present with pain and muscle weakness, which impair hand function and limit activities of daily living (ADLs), resulting in a considerable personal and social burden, including reduced quality of life and work disability. Previous studies have highlighted the clinical importance of thumb TMC joint stabilizers. Research has demonstrated that the first dorsal interosseous (FDI) functions as the main stabilizer of the TMC joint, whereas the abductor pollicis longus (APL) acts as a primary destabilizer. These findings suggest that rehabilitation programs should focus on strengthening the FDI to improve joint stability. However, despite the clinical importance of targeting these muscles, the literature reports limited information on how the FDI and APL behave during activities of daily living.

The aim of this study is to investigate whether there are differences in muscle activation of the FDI and APL between individuals with and without thumb OA TMC during the performance of six activities of daily living, in order to inform rehabilitation strategies. Adequate rehabilitation is essential for maintaining muscle function, slowing the progression of joint degeneration, and improving hand performance, yet it remains unclear how these muscles are engaged during functional daily tasks.

This is a cross-sectional observational comparative study with both within-subject and between-group analyses. The study includes two groups: adults aged 30 years and older, both men and women, with a clinical diagnosis of OA TMC and healthy controls without musculoskeletal or neurological disorders affecting the hand. Exclusion criteria include sensory disturbances such as numbness or tingling, cardiac pacemaker implantation, upper limb entrapment neuropathies or cervical radiculopathy, neuromuscular diseases, systemic conditions including diabetes or hypothyroidism, history of cancer, rheumatoid arthritis, anticoagulation therapy, chemotherapy, exposure to neurotoxins, or recent upper limb trauma or surgery.

Surface electromyography (sEMG) is used to record muscle activity of the FDI and APL. Skin is prepared by shaving if necessary and cleaning with alcohol to reduce impedance and ensure optimal adherence of surface electrodes. Bipolar surface electrodes with a diameter of 20 millimeters and an inter-electrode distance of 20 millimeters are placed according to SENIAM guidelines. For the FDI, electrodes are positioned over the dorsal belly of the muscle aligned with fiber direction, with one electrode in the distal ulnar region between the first and second metacarpals. For the APL, electrodes are placed approximately five centimeters distal to the wrist, medial to the radius, longitudinally aligned and transversely away from adjacent muscles. Electrode placement is verified by palpation and selective activation tasks.

Participants perform six standardized tasks simulating ADLs: turning a key toward the ulnar side, turning a key toward the radial side, picking up a coin, writing a word with a pen, squeezing a full tube of toothpaste, and holding a glass of water while performing a drinking gesture. Each task is performed in three consecutive three-second isometric repetitions with a thirty-second rest between repetitions to minimize fatigue.

It is hypothesized that individuals with thumb TMC osteoarthritis will demonstrate altered activation patterns of the FDI and APL compared with healthy controls, and that specific functional tasks will elicit greater FDI activation, supporting targeted interventions to enhance joint stability and hand function in patients with thumb base osteoarthritis.

Primary outcome measures

• Surface electromyographic amplitude of the First Dorsal Interosseous muscle. [Time frame: Day 1]
• Surface electromyographic amplitude of the Abductor Pollicis Longus muscle [Time frame: Day 1]

Eligibility criteria

Inclusion criteria for the TMC OA group:

\- Clinical diagnosis of thumb TMC osteoarthritis.

Inclusion criteria for the healthy group:

\- Participants with no history of musculoskeletal or neurological disorders affecting the dominant hand were included.

Exclusion criteria

• Presence of numbness, tingling, or other sensory disturbances
• Cardiac pacemaker implantation
• Upper limb entrapment neuropathy or cervical radiculopathy
• History of neuromuscular disease, polyneuropathy, or plexopathy
• Systemic diseases such as diabetes, hypothyroidism, or chronic liver or kidney disease
• History of cancer, rheumatoid arthritis, active anticoagulation therapy, chemotherapy, or exposure to neurotoxins
• Recent upper limb soft tissue or bone injury (trauma, fracture, or surgery of the arm or neck).

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Case-crossover

Study locations

Spain · 1 center

• Universidad de Málaga — Málaga

Publications

• Whitford M, Kukulka CG. Task-related variations in the surface EMG of the human first dorsal interosseous muscle. Exp Brain Res. 2011 Nov;215(2):101-13. doi: 10.1007/s00221-011-2875-9. Epub 2011 Oct 1. PMID 21964867
• Calder KM, Galea V, Wessel J, MacDermid JC, MacIntyre NJ. Muscle activation during hand dexterity tasks in women with hand osteoarthritis and control subjects. J Hand Ther. 2011 Jul-Sep;24(3):207-14; quiz 215. doi: 10.1016/j.jht.2010.11.003. Epub 2011 Feb 9. PMID 21306871
• Parker EA, Meyer AM, Garcia Fleury I, Buckwalter JA 5th. Menstrual hormone-induced cyclic thumb CMC instability and degeneration in women: a systematic review. Biol Sex Differ. 2022 Jun 20;13(1):32. doi: 10.1186/s13293-022-00438-y. PMID 35725646
• Penn IW, Chuang TY, Chan RC, Hsu TC. EMG power spectrum analysis of first dorsal interosseous muscle in pianists. Med Sci Sports Exerc. 1999 Dec;31(12):1834-8. doi: 10.1097/00005768-199912000-00021. PMID 10613436
• Adams JE, O'Brien V, Magnusson E, Rosenstein B, Nuckley DJ. Radiographic Analysis of Simulated First Dorsal Interosseous and Opponens Pollicis Loading Upon Thumb CMC Joint Subluxation: A Cadaver Study. Hand (N Y). 2018 Jan;13(1):40-44. doi: 10.1177/1558944717691132. Epub 2017 Feb 16. PMID 28719976
• McGee C, O'Brien V, Van Nortwick S, Adams J, Van Heest A. First dorsal interosseous muscle contraction results in radiographic reduction of healthy thumb carpometacarpal joint. J Hand Ther. 2015 Oct-Dec;28(4):375-80; quiz 381. doi: 10.1016/j.jht.2015.06.002. Epub 2015 Jun 27. PMID 26209165
• Ooishi D, Ueba H, Aso K, Izumi M, Ikeuchi M. Kinematics of Trapeziometacarpal Joint During First Dorsal Interosseous Maneuver in Osteoarthritic Patients: An Imaging Study Using Real-Time Magnetic Resonance Imaging and Ultrasonography. J Hand Surg Am. 2025 Nov;50(11):1408.e1-1408.e9. doi: 10.1016/j.jhsa.2024.12.018. Epub 2025 Feb 7. PMID 39918527
• Buschbacher RM, Bayindir O, Malec J, Akyuz G. Ulnar motor study to first dorsal interosseous: Best reference electrode position and normative data. Muscle Nerve. 2015 Aug;52(2):231-3. doi: 10.1002/mus.24524. Epub 2015 Jan 16. PMID 25407952

Identifiers

NCT: NCT07668986 · UMA-AOTMC-2026-002

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗