Barroso P N, Vecchio S D, Xavier Y R, Sesselmann M, Araújo P A, Pinotti M
Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Brazil.
Clin Biomech (Bristol). 2011 Nov;26(9):937-43. doi: 10.1016/j.clinbiomech.2011.05.006.
The present study examines the hand movements of children with cerebral palsy during functional tests and compares the childrens' performance with and without the aid of an orthosis that provides wrist extension and thumb abduction.
The range of motion of the trapeziometacarpal joint was assessed for 32 participants via a reflexive markers image system. Observed motions included flexion-extension and abduction-adduction motions performed in the course of four tests for manual ability; the rest position, lateral and tripod pinches and cylindrical grasp. Muscle strength and manual ability were evaluated using dynamometry and the Jebsen-Taylor test.
The range of motion tests for the rest position, lateral and tripod pinches and cylindrical grasp demonstrated improvements from 17% to 42% (P<0.001) for flexion/extension and from 36% to 54% for abduction/adduction (P<0.001) with the use of the orthosis. Dynamometry measurements showed that the improvement in muscle strength obtained through use of the orthosis was 50% (P<0.001). Improvements in the time required to perform the movements as determined using the Jebsen-Taylor test varied from 13% to 24% (P<0.01) for the four considered tests of manual ability.
The orthosis improved the range of motion of the trapeziometacarpal joint, muscle strength and manual ability. The combination of the three techniques may provide the basis for a quantitative assessment of hand dysfunction/improvement in cerebral palsy that will ultimately guide health professionals in their clinical interventions.
本研究考察了脑瘫儿童在功能测试中的手部动作，并比较了他们在使用提供腕部伸展和拇指外展功能的矫形器辅助与不辅助情况下的表现。
通过反射标记图像系统对32名参与者的大多角骨掌骨关节活动范围进行评估。观察到的动作包括在四项手部能力测试过程中进行的屈伸和内收外展动作；休息位、侧捏和三指捏以及圆柱抓握。使用测力计和杰布森 - 泰勒测试评估肌肉力量和手部能力。
对于休息位、侧捏和三指捏以及圆柱抓握的活动范围测试表明，使用矫形器后，屈伸动作改善了17%至42%（P<0.001），内收外展动作改善了36%至54%（P<0.001）。测力计测量显示，使用矫形器后肌肉力量提高了50%（P<0.001）。根据杰布森 - 泰勒测试确定的完成动作所需时间，在四项考虑的手部能力测试中改善了13%至24%（P<0.01）。
该矫形器改善了大多角骨掌骨关节的活动范围、肌肉力量和手部能力。这三种技术的结合可能为脑瘫患者手部功能障碍/改善的定量评估提供基础，最终指导医疗专业人员进行临床干预。
