Department of Neurology, Rehabilitation, Ophthalmology, Genetics and Child/Maternal Sciences (DINOGMI), University of Genoa, Genoa, Italy.
J Peripher Nerv Syst. 2018 Jun;23(2):124-128. doi: 10.1111/jns.12270. Epub 2018 May 7.
The occurrence of the overwork weakness (OW) in Charcot-Marie-tooth (CMT) disease has been debated for a long time. Especially at the hands level, it is still unclear as to whether OW occurs. Contrasting results may relate to the different muscle groups evaluated and the instruments used. We concentrated to the upper limbs (UL). We recruited 120 subjects, 60 CMT patients and 60 normal controls and evaluated the strength of the tripod pinch and of the hand-grip with a dynamometer, the opposition ability with the thumb opposition test (TOT) and applied an innovative instrumental testing of hand function using the sensor engineered glove test (SEGT), which previously demonstrated its sensitiveness to measure severity of hands dysfunction in CMT patients. In CMT patients, TOT scores were significantly higher in the non-dominant hand (NDH) compared to dominant hand (DH), strength in the NDH was slightly but not significantly better than the DH. Finally, SEGT results were similar between the NDH and DH, whereas in normal controls the DH performed better. In conclusion, this study supports the existence of the overwork weakness in CMT. We can speculate that the dexterity and overall ability of the hands appear more impaired in the DH as a result of a weakness and incapacity of opposition. Our results support the importance of avoiding supramaximal exercises and educating patients to prevent incorrect movements.
过度劳累性无力（OW）在遗传性运动感觉神经病（CMT）中出现的问题已经争论了很长时间。特别是在手部，OW 是否出现仍不清楚。对比结果可能与评估的不同肌肉群和使用的仪器有关。我们集中在上肢（UL）。我们招募了 120 名受试者，60 名 CMT 患者和 60 名正常对照者，并使用测力计评估三指捏力和手握力、拇指对指测试（TOT）评估对指能力，以及使用传感器工程手套测试（SEGT）进行创新性手部功能仪器测试，该测试先前证明其能够敏感地测量 CMT 患者手部功能障碍的严重程度。在 CMT 患者中，非优势手（NDH）的 TOT 评分明显高于优势手（DH），NDH 的力量稍好但无统计学意义。最后，NDH 和 DH 的 SEGT 结果相似，而在正常对照组中，DH 的表现更好。总之，这项研究支持 CMT 存在过度劳累性无力。我们可以推测，由于无力和对指能力不足，DH 的手部灵巧度和整体能力看起来更受损。我们的结果支持避免超最大运动量锻炼和教育患者预防不正确运动的重要性。
