Forget Nancy, Piotte France, Arsenault Josée, Harris Patrick, Bourbonnais Daniel
Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Site Institut de réadaptation de Montréal, Montréal, Québec, Canada.
J Hand Ther. 2008 Jul-Sep;21(3):276-84; quiz 285. doi: 10.1197/j.jht.2008.03.004.
The aims of the present study were to characterize the thumb active range of motion (AROM) and strength impairments resulting from unilateral de Quervain's disease; to verify the adequacy of standard clinical assessment tools to quantify impairments resulting from this pathology; and to validate the utilization of the asymptomatic thumb as a reference to quantify the symptomatic thumb's deficits by comparing the performances of asymptomatic to control thumbs. The thumb's AROM and strength were evaluated bilaterally in 31 participants with unilateral de Quervain's disease and 18 control participants using clinical assessments involving the flexors and adductors of the thumb and experimental assessment devices measuring strength and mobility in several directions of the thumb's movements. A comparison was made between the results obtained from the symptomatic, asymptomatic, and control thumbs. The AROM performance of symptomatic thumbs was found to be reduced when compared to the asymptomatic and control thumbs for maximal thumb flexion (p=0.008 and 0.003, respectively) and total circumduction displacement (p<0.001). The strength performance of the symptomatic thumb was also found to be reduced when compared to the asymptomatic and control thumbs for palmar pinch strength (p<0.001 and 0.002, respectively) and for maximal voluntary effort in all directions (p<0.001). Differences in performance were also found between the asymptomatic and control thumbs, reaching the significance level for some movement parameters of the thumb circumduction evaluations and when palmar pinch strength results are normalized (p<0.001 and 0.009, respectively). This study revealed bilateral impairments of thumb AROM and strength for participants with de Quervain's disease, the impairments being more pronounced on the symptomatic side. This finding may question the validity of using the asymptomatic thumb as a standard measure to identify the symptomatic thumb's impairments associated with de Quervain's disease. The study also demonstrated the validity of using clinical evaluations when assessing impairments associated with this disease.
描述因单侧桡骨茎突狭窄性腱鞘炎导致的拇指主动活动范围（AROM）和力量损伤情况；验证标准临床评估工具对量化该病症所致损伤的适用性；通过比较无症状拇指与对照拇指的表现，验证将无症状拇指用作量化有症状拇指功能缺陷参考标准的有效性。对31名单侧桡骨茎突狭窄性腱鞘炎患者和18名对照参与者的双侧拇指AROM和力量进行了评估，采用涉及拇指屈肌和内收肌的临床评估以及测量拇指多个运动方向力量和活动度的实验评估装置。对有症状拇指、无症状拇指和对照拇指的评估结果进行了比较。结果发现，与无症状拇指和对照拇指相比，有症状拇指在最大拇指屈曲（分别为p = 0.008和0.003）和全环转位移（p < 0.001）时的AROM表现降低。与无症状拇指和对照拇指相比，有症状拇指在掌侧捏力（分别为p <
