Institute of Myology, AP-HP, Groupe hospitalier La Pitié Salpétrière, Paris, France.
Neuromuscul Disord. 2013 Feb;23(2):139-48. doi: 10.1016/j.nmd.2012.10.022. Epub 2012 Dec 5.
Upper limb assessment in non-ambulant patients remains a challenge. We have designed new tools to precisely assess pinch (MyoPinch), grip (MyoGrip), wrist flexion and extension (MyoWrist) strength. We have also designed a new tool to assess the ability of patients to produce repetitive flexion/extension movements of wrist and fingers (MoviPlate). We have assessed the feasibility and reliability of these new tools in 30 non-ambulant patients with Duchenne muscular dystrophy and in 30 age-matched male controls. Existing measures, such as Motor Function Measure, Tapping, and the Brooke Upper Extremity Functional Rating Scale were also performed. Results demonstrated that assessments were feasible in nearly all upper limbs tested for MyoGrip, MyoPinch and MoviPlate. The reliability of all tests, including MyoWrist which was not feasible in the patients presenting with contractures, was excellent in patients as in controls. Motor capacities decrease with the number of months spent in the wheelchair. The scores in the tests were partially correlated with each other, and with clinical measures such as vital capacity, Motor Function Measure, functional hand scale and Brooke score. This study validates a panel of upper limb muscle strength and function measures for Duchenne Muscular Dystrophy which can be applied from controls to extremely weak patients.
非卧床患者的上肢评估仍然具有挑战性。我们设计了新的工具来精确评估捏力（MyoPinch）、握力（MyoGrip）、腕关节屈伸力量（MyoWrist）。我们还设计了一种新的工具来评估患者产生手腕和手指反复屈伸运动的能力（MoviPlate）。我们评估了 30 名患有杜氏肌营养不良症的非卧床患者和 30 名年龄匹配的男性对照组中这些新工具的可行性和可靠性。还进行了现有的测量，如运动功能测量、叩诊和布鲁克上肢功能评定量表。结果表明，在接受 MyoGrip、MyoPinch 和 MoviPlate 测试的几乎所有上肢中，评估都是可行的。在患者中，所有测试的可靠性都非常好，包括在有挛缩的患者中不可行的 MyoWrist。在轮椅上的月数越多，运动能力下降越多。测试中的得分部分相互关联，与肺活量、运动功能测量、功能手量表和布鲁克评分等临床测量相关。这项研究验证了一套用于杜氏肌营养不良症的上肢肌肉力量和功能测量方法，可用于从对照组到极度虚弱的患者。
