School of Kinesiology, University of Western Ontario, London, Ontario, Canada.
Am J Phys Med Rehabil. 2011 Nov;90(11):923-9. doi: 10.1097/PHM.0b013e31822415b6.
The aim of this study was to compare the use of a custom intrinsic hand dynamometer (HD) with that of a standard pinch dynamometer (PD) in assessing strength in patients with ulnar neuropathy at the elbow.
Nine patients (age, 53 ± 3 yrs) with clinical and electrophysiological features of ulnar neuropathy at the elbow with conduction block (CB) were studied. All underwent bilateral ulnar motor nerve conduction studies recording from the first dorsal interosseous and a quantitative measurement of strength of the first dorsal interosseous using a custom-made HD and a standard PD.
The maximal strength of the ulnar neuropathy at the elbow-affected side (16.2 ± 8.0 N) was found to be significantly lower than that of the unaffected side (27.9 ± 11.2 N), as measured by HD. Strength differences were not significant between the affected (62.7 ± 26.4 N) and unaffected sides (48.0 ± 20.5 N) using PD. HD force decrement (in comparison with the unaffected limb) correlated strongly with CB percentage (r = 0.74). No relationship was found between PD and CB (r = 0.05).
HD was better able to measure the weakness of affected muscles than did PD, and its results correlated well with the extent of electrophysiological CB. Therefore, a custom HD would provide a better indication of disease severity, progression, or improvement in strength in studies of ulnar neuropathy at the elbow with CB.
本研究旨在比较定制型握力计（HD）与标准捏力计（PD）在评估肘管尺神经病患者力量方面的应用。
本研究纳入了 9 例（年龄 53±3 岁）具有肘管尺神经病临床和电生理特征且存在传导阻滞（CB）的患者。所有患者均接受双侧第一骨间背侧肌运动神经传导研究，并使用定制型 HD 和标准 PD 对其进行第一骨间背侧肌力量的定量测量。
HD 测量结果显示，肘管尺神经病受累侧的最大力量（16.2±8.0 N）明显低于未受累侧（27.9±11.2 N）。使用 PD 测量时，受累侧（62.7±26.4 N）与未受累侧（48.0±20.5 N）之间的力量差异无统计学意义。HD 力量减退（与未受累肢体相比）与 CB 百分比呈强相关（r=0.74）。PD 与 CB 之间无相关性（r=0.05）。
与 PD 相比，HD 更能测量受累肌肉的无力，其结果与电生理 CB 的程度密切相关。因此，在 CB 存在的肘管尺神经病研究中，定制型 HD 可以更好地提示疾病的严重程度、进展或力量的改善。
