Li Ke, Evans Peter J, Seitz William H, Li Zong-Ming
Hand Research Laboratory, Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA.
Clin Neurophysiol. 2015 Jan;126(1):194-201. doi: 10.1016/j.clinph.2014.05.004. Epub 2014 May 17.
The purpose of this study was to investigate effects of carpal tunnel syndrome (CTS) on digit force control during a sustained precision pinch.
Eleven CTS individuals and 11 age- and gender-matched healthy volunteers participated in the study. The subjects were instructed to isometrically pinch an instrumented apparatus for 60s with a stable force output. Visual feedback of force output was provided for the first 30s but removed for the remaining 30s. Pinch forces were examined for accuracy, variability, and inter-digit correlation.
CTS led to a decrease in force accuracy and an increase in amount of force variability, particularly without visual feedback (p<0.001). However, CTS did not affect the structure of force variability or force correlation between digits (p>0.05). The force of the thumb was less accurate and more variable than that of the index finger for both the CTS and healthy groups (p<0.001).
Sensorimotor deficits associated with CTS lead to inaccurate and unstable digit forces during sustained precision pinch.
This study shed light on basic and pathophysiological mechanisms of fine motor control and aids in development of new strategies for diagnosis and evaluation of CTS.
本研究旨在探讨腕管综合征（CTS）对持续精确捏取过程中手指力量控制的影响。
11名CTS患者和11名年龄及性别匹配的健康志愿者参与了本研究。受试者被要求以稳定的力量输出等长捏取一个装有仪器的装置60秒。在最初30秒提供力量输出的视觉反馈，但在剩余30秒去除该反馈。检查捏力的准确性、变异性和手指间的相关性。
CTS导致力量准确性下降，力量变异性增加，尤其是在没有视觉反馈的情况下（p<0.001）。然而，CTS并未影响力量变异性的结构或手指间的力量相关性（p>0.05）。对于CTS组和健康组，拇指的力量比食指的力量更不准确且更具变异性（p<0.001）。
与CTS相关的感觉运动缺陷导致在持续精确捏取过程中手指力量不准确且不稳定。
本研究揭示了精细运动控制的基本和病理生理机制，并有助于开发用于CTS诊断和评估的新策略。
