Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Diabetes Metab Res Rev. 2015 May;31(4):385-94. doi: 10.1002/dmrr.2623. Epub 2015 Feb 3.
To understand the impacts of disease chronicity and hyperglycaemia on sensorimotor control of hands of diabetic patients, this study investigated the differences in hand sensation, strength and motor control by applying the pinch-holding-up activity test for patients with diabetes mellitus (DM) with different levels of glycaemic control and disease chronicity.
One hundred and fifty-nine patients with clinically defined DM were included. Semmes-Weinstein monofilament, static two-point discrimination and moving two-point discrimination, maximal pinch strength precision pinch performance tests and nerve conduction studies (NCS) of the subjects were carried out. Forty-seven (29.6%) patients were in the HbA(1c) < 7% category, and 112 (70.4%) patients were in the >7% group. There were 87 (54.7%) patients with the disease duration <10 years, and 72 (45.3%) patients with disease duration ≧10 years.
The severity of hyperglycaemia significantly impacts the results for Semmes-Weinstein monofilament, precision pinch force control, sensory and motor NCS tests (p < 0.05). In addition, the chronicity of disease influences the motor control of precision pinch performance and the amplitude of motor NCS (p < 0.05) for the diabetes patients.
The evidence suggests that disease chronicity and hyperglycaemia have impacts on sensorimotor control in the hands of DM patients. In addition, the efficiency of prehensile forces of hand-to-object interactions in the pinch-holding-up activity test could be significant for identifying hand function, as well as pathologic changes in median nerve function, for patients with DM.
为了了解疾病慢性和高血糖症对糖尿病患者手部感觉运动控制的影响，本研究通过应用夹捏保持活动测试，调查了不同血糖控制水平和疾病慢性程度的糖尿病患者手部感觉、力量和运动控制的差异。
共纳入 159 例临床确诊的糖尿病患者。对受试者进行 Semmes-Weinstein 单丝、静态两点辨别觉和两点移动辨别觉、最大捏力、精确捏力、运动控制测试和神经传导研究（NCS）。47 例（29.6%）患者 HbA1c＜7%，112 例（70.4%）患者 HbA1c＞7%。87 例（54.7%）患者病程＜10 年，72 例（45.3%）患者病程≧10 年。
高血糖的严重程度显著影响 Semmes-Weinstein 单丝、精确捏力控制、感觉和运动 NCS 测试的结果（p＜0.05）。此外，疾病的慢性程度影响糖尿病患者精确捏力表现的运动控制和运动 NCS 的振幅（p＜0.05）。
证据表明，疾病慢性和高血糖症对糖尿病患者手部的感觉运动控制有影响。此外，夹捏保持活动测试中手与物体相互作用的抓握力效率对于识别手功能以及糖尿病患者正中神经功能的病理变化可能具有重要意义。
