Department of Occupational Therapy, Karolinska University Hospital , Stockholm , Sweden .
Disabil Rehabil. 2013 Oct;35(21):1798-807. doi: 10.3109/09638288.2012.754952. Epub 2013 Mar 12.
To investigate the effects of a hand-training programme on grip, pinch and wrist force, manual dexterity and activities of daily living, in adults with myotonic dystrophy type 1 (DM1).
In this randomised controlled trial with a crossover design, 35 adults with DM1 were, after stratification for grip force, assigned by lot to two groups. Group A started with 12 weeks of hand training, while group B had no intervention. After a wash-out period of 12 weeks, where none received training, the order was reversed. The Grippit® was used as primary outcome measure and the hand-held Microfet2™ myometer, the Purdue Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments were performed before and after training and control periods, i.e. four times altogether.
Ten persons dropped out and 13 had acceptable adherence. Intention-to-treat analyses revealed significant intervention effects for isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047) and satisfaction (p = 0.027). On an individual level, improvements were in general showed after a training period.
The hand-training programme had positive effects on wrist flexor force and self-perception of occupational performance, and of satisfaction with performance. No evident detrimental effects were shown.
Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease characterised by myotonia and muscle weakness and wasting. People with DM1 are often concerned about their ability to carry out ADL and to participate in, e.g. work, sports and hobbies when they gradually become weaker. This pilot study showed that a hand-training programme improved wrist flexor force and self-perception and satisfaction of occupational performance. Resistance training of hand muscles with a silicon-based putty can be a therapy option for people with DM1 in clinical practise.
研究手部训练计划对 1 型肌强直性营养不良（DM1）成人的握力、捏力和腕力、手灵活性以及日常生活活动的影响。
在这项随机对照交叉试验中，35 名 DM1 成人根据握力进行分层后，通过抽签分为两组。组 A 先进行 12 周手部训练，而组 B 不进行干预。12 周洗脱期后，两组均不进行训练，随后顺序颠倒。Grippit®作为主要结局测量指标，而手动 Microfet2™测力计、普渡钉板、加拿大职业表现测量（COPM）和运动技能评估（AMPS）则作为次要结局测量指标。在训练和对照期前后共进行了 4 次评估。
10 人中途退出，13 人依从性良好。意向治疗分析显示，等长腕屈肌力量（p = 0.048）和 COPM 表现（p = 0.047）和满意度（p = 0.027）有显著的干预效果。从个体水平来看，经过训练期后通常会有改善。
手部训练计划对腕屈肌力量以及对职业表现和对表现的满意度的自我感知产生了积极的影响。没有显示出明显的不利影响。
1 型肌强直性营养不良（DM1）是一种进行性神经肌肉疾病，其特征为肌强直和肌肉无力和萎缩。随着病情逐渐恶化，DM1 患者通常会担心自己进行日常生活活动以及参与例如工作、运动和爱好的能力。这项初步研究表明，手部训练计划可改善腕屈肌力量以及对职业表现和对表现的满意度的自我感知。使用硅基腻子对手部肌肉进行阻力训练可能是临床实践中 DM1 患者的一种治疗选择。
