Suresh M, Nicholls Peter G, Das Loretta, Van Brakel Wim H
The Leprosy Mission Hospital, Purulia, West Bengal, India.
Lepr Rev. 2008 Sep;79(3):277-94.
To evaluate hand muscle weakness detected through dynamometry as an indicator for change in motor nerve function detected by Voluntary Muscle Testing (VMT) of ulnar and median nerves.
The research was carried out as part of the INFIR Cohort Study among 303 subjects newly diagnosed with MB leprosy in two centres in UP state, northern India.
To assess grip strength, key pinch and pulp-to-pulp pinch we adapted the cuffs of adult and neonatal sphygmomanometers. The testing was carried out at diagnosis and at each visit during a 2-year follow-up.
303 subjects with newly diagnosed MB leprosy were included in the study. We found statistically significant differences in grip strength, key pinch and pulp-to-pulp pinch between groups defined by ulnar VMT grades at time of diagnosis. There was also a statistically significant difference in hand grip between groups defined by median VMT at diagnosis. In each case, strength tended to reduce with increasing motor involvement. We explored reduction in grip strength, key pinch or pulp-to-pulp pinch as indicators of change in ulnar VMT during follow-up. A 25% reduction over two visits was the most effective indicator. Changes were also associated with marginal changes in motor and sensory nerve function, most commonly associated with Type I reactions.
Dynamometry is recommended as an additional method that may be used to monitor changes in nerve function in leprosy, particularly in subjects with early motor impairment of the ulnar nerve.
评估通过握力计检测到的手部肌肉无力，作为尺神经和正中神经自愿肌肉测试（VMT）检测到的运动神经功能变化的指标。
该研究是印度北部北方邦两个中心对303名新诊断为多菌型麻风病的受试者进行的INFIR队列研究的一部分。
为了评估握力、关键捏力和指尖对指尖捏力，我们对成人和新生儿血压计的袖带进行了改装。测试在诊断时以及2年随访期间的每次就诊时进行。
303名新诊断为多菌型麻风病的受试者被纳入研究。我们发现，在诊断时，根据尺神经VMT分级定义的组之间，握力、关键捏力和指尖对指尖捏力存在统计学上的显著差异。在诊断时，根据正中神经VMT定义的组之间，握力也存在统计学上的显著差异。在每种情况下，随着运动受累程度的增加，力量往往会降低。我们探讨了握力、关键捏力或指尖对指尖捏力的降低，作为随访期间尺神经VMT变化的指标。两次就诊期间降低25%是最有效的指标。这些变化还与运动和感觉神经功能的轻微变化有关，最常见于I型反应。
建议将握力计测量作为一种额外的方法，用于监测麻风病患者神经功能的变化，特别是在尺神经早期运动受损的患者中。
