Schreuders Ton A R, Selles Ruud W, Roebroeck Marij E, Stam Henk J
Erasmus MC-University Medical Center Rotterdam, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
J Hand Ther. 2006 Oct-Dec;19(4):393-401; quiz 402. doi: 10.1197/j.jht.2006.07.024.
Numerous neurological diseases are accompanied by atrophy of the intrinsic muscles of the hand. Muscle strength testing of these muscles is frequently used for clinical decision making. Traditionally, these strength measurements have focused on manual muscle testing (MMT) or on grip and pinch strength dynamometry. We have developed a hand-held dynamometer, the Rotterdam Intrinsic Hand Myometer (RIHM), to measure this intrinsic muscle strength. The RIHM was designed such that it can measure a wide range of muscle groups, such as the abduction and adduction strength of the little finger and index finger, the opposition, palmar abduction (anteposition) and opposition strength of the thumb, and intrinsic muscles of the fingers combined in the intrinsic plus position. We found that the reliability of RIHM measurements in nerve injury patients was comparable to grip and pinch strength measurements and is appropriate to study the functional recovery of the intrinsic muscles of the hand in isolation. We have applied the RIHM in a recent study on the long-term outcome of muscle strength in patients with ulnar and median nerve injuries and found that while recovery of grip and pinch strength was relatively good, recovery of the ulnar nerve innervated muscles measured with the RIHM was poor. This poor recovery could not be detected with manual muscle strength testing or with grip and pinch dynamometry. We conclude that the RIHM provides an accurate clinical assessment of the muscle strength of the intrinsic hand muscles that adds valuable information to MMT and grip and pinch dynamometry.
许多神经系统疾病都伴有手部固有肌萎缩。这些肌肉的肌力测试常用于临床决策。传统上，这些肌力测量主要集中在徒手肌力测试（MMT）或握力和捏力测力计测量上。我们开发了一种手持测力计，即鹿特丹手部固有肌测力计（RIHM），用于测量这种固有肌肌力。RIHM的设计使其能够测量广泛的肌肉群，如小指和食指的外展和内收力量、拇指的对掌、掌侧外展（前位）和对掌力量，以及处于固有加位时手指的固有肌。我们发现，RIHM在神经损伤患者中的测量可靠性与握力和捏力测量相当，适用于单独研究手部固有肌的功能恢复。我们在最近一项关于尺神经和正中神经损伤患者肌力长期结果的研究中应用了RIHM，发现虽然握力和捏力恢复相对较好，但用RIHM测量的尺神经支配肌肉的恢复较差。徒手肌力测试或握力和捏力测力计测量无法检测到这种较差的恢复情况。我们得出结论，RIHM提供了对手部固有肌肌力的准确临床评估，为MMT以及握力和捏力测力计测量增添了有价值的信息。
