Gehrmann Sebastian, Tang Jie, Kaufmann Robert A, Goitz Robert J, Windolf Joachim, Li Zong-Ming
Hand Research Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
J Hand Surg Am. 2008 Sep;33(7):1069-75. doi: 10.1016/j.jhsa.2008.02.030.
Carpal tunnel syndrome (CTS) impairs the performance of fine motor tasks of the hand, leading to clumsiness. Precision pinch by the thumb and index finger is a frequent task that requires the fine control of each digit as well as the coordination of the 2 digits. The purpose of this study was to examine the performance of precision pinch movements impaired by CTS.
Sixteen CTS subjects and 16 gender- and age-matched control subjects were instructed to repetitively perform the precision pinch movement with the thumb and index finger. A marker-based motion analysis method was used to obtain the kinematic data of the thumb and index finger during the precision pinch movements. Pinch performance was quantified by the variability of tip positions, joint angles, and tip distance at the pinch closures in the repeated movements.
The CTS subjects performed the precision pinch movements less consistently compared with performance of the control subjects. The inconsistency was demonstrated by the increased variability of the tip positions of the 2 digits and the joint angles of the index finger. However, the variability of thumb joint angles was not significantly different between the 2 groups. The tip-to-tip distance, an indicator of thumb and index finger coordination, was relatively reproducible for both groups. Still, the CTS subjects showed a 50% greater variability of the tip distance compared with that of the control subjects.
Carpal tunnel syndrome impairs the performance of precision pinch movement as indicated by the increased variability. The results correlate with the observed clumsiness or lack of dexterity for patients with CTS.
腕管综合征（CTS）会损害手部精细运动任务的执行能力，导致动作笨拙。拇指和食指进行的精确捏取动作是一项常见任务，需要对每个手指进行精细控制以及两个手指之间的协调配合。本研究的目的是检查受CTS影响的精确捏取动作的执行情况。
指导16名CTS患者和16名性别与年龄匹配的对照受试者反复进行拇指和食指的精确捏取动作。采用基于标记的运动分析方法获取精确捏取动作过程中拇指和食指的运动学数据。通过重复动作中捏取闭合时指尖位置、关节角度和指尖距离的变异性来量化捏取表现。
与对照受试者相比，CTS患者进行精确捏取动作时的一致性较差。这种不一致表现为两个手指指尖位置和食指关节角度的变异性增加。然而，两组之间拇指关节角度的变异性没有显著差异。指尖到指尖的距离是拇指和食指协调性的一个指标，两组的该指标相对都具有可重复性。尽管如此，CTS患者的指尖距离变异性比对照受试者大50%。
如变异性增加所示，腕管综合征会损害精确捏取动作的执行。这些结果与CTS患者观察到的动作笨拙或灵活性不足相关。
