Prada Valeria, Schizzi S, Poggi I, Mori L, Gemelli C, Hamedani M, Accogli S, Maggi G, Grandis M, Mancardi G L, Schenone A
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy.
Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy.
J Neurol Neurophysiol. 2018 Jul 30;9(4):465. doi: 10.4172/2155-9562.1000465.
Charcot-Marie-Tooth neuropathy affects mainly and early the lower limbs, but hands deformities are a relevant problem, which involves the quality of life of the patients. Unfortunately, there are few studies about the evaluation of the upper limbs and very rare works about the rehabilitation. A treatment study at the moment is missing and it is important to search rehabilitation exercises to improve the dexterity and the quality of life of the patients.
We recruited 9 patients with clinical and genetic diagnosis of CMT and we proposed a rehabilitation protocol which includes muscle recruitment, stretching and proprioceptive exercises for the hand with the duration of 4 weeks (two sessions for week). We evaluated the patients before and one week after the treatment with Thumb Opposition Test, Sollerman Hand Function Scale, dynamometry (tripod pinch and hand grip).
The rehabilitation protocol has been well tolerated and there were not dropouts. We did not observe any worsening in every scale we used. Every parameter tested showed an improvement especially in the right/dominant hand.
This study demonstrates that this three phases treatment is well tolerated by patients, it is not detrimental for the hands status and perfectly reproducible by professionals. Moreover, this could be the basis for future randomized single blind projects.
夏科-马里-图斯神经病变主要且早期影响下肢,但手部畸形是一个相关问题,涉及患者的生活质量。不幸的是,关于上肢评估的研究很少,关于康复的研究更是罕见。目前缺少一项治疗研究,寻找康复锻炼以提高患者的灵活性和生活质量很重要。
我们招募了9名临床和基因诊断为CMT的患者,并提出了一项康复方案,其中包括手部的肌肉募集、拉伸和本体感觉锻炼,为期4周(每周两次)。我们在治疗前和治疗后一周用拇指对掌试验、索勒曼手功能量表、测力计(三点捏力和握力)对患者进行评估。
康复方案耐受性良好,没有患者退出。我们在所使用的每个量表中均未观察到任何恶化情况。每个测试参数均显示有改善,尤其是在右手/优势手。
本研究表明,这种三阶段治疗患者耐受性良好,对手部状况无害且专业人员可完美重复。此外,这可能是未来随机单盲项目的基础。