Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Department of Rehabilitation, Cardinal Tien Hospital, New Taipei City, Taiwan.
Disabil Rehabil. 2020 May;42(9):1247-1253. doi: 10.1080/09638288.2018.1522548. Epub 2019 Jan 28.
The aims of this study were to compare the differences in forearm muscle activities between two types of thumb orthoses and the optimal handle diameter when the orthosis is worn during a power grasp for individuals with chronic de Quervain's Tenosynovitis. A 2 × 3 (Group × orthosis) and a 2 × 2 × 3 (Group × orthosis × diameter) repeated factorial design were used. Grip strength and muscle load were measured. A 2 × 3 mixed repeated measures ANOVA was conducted, and the Least Significant Difference (LSD) test was used for post hoc analysis. Cohen's d was used to calculate the effect size between groups and handle diameters. Grip strength was significantly lower (in long/short/no-orthosis conditions) and muscle load was higher in 12 participants with chronic de Quervain's Tenosynovitis than in 16 healthy participants ( < 0.001). No differences in muscle activities were found when the two different orthoses were worn. The muscle activities were higher during grasping of the 33 mm handle diameter. Individuals with chronic de Quervain's Tenosynovitis require greater muscle loads than healthy controls to produce the same power grasp, and when one of the two orthoses is worn, the optimal handle diameters for performing a power grasp are relatively larger (45 and 55 mm).Implications for RehabilitationBoth the long and short thumb orthoses can be worn by individuals with de Quervain's Tenosynovitis during daily activities because wearing both orthoses requires the same exertion of muscle load.When performing a power grasp, individuals with de Quervain's Tenosynovitis tend to exert greater muscle loads than healthy controls to produce the same power grasp.We suggest that patients with de Quervain's Tenosynovitis use utensils with larger handle diameters, such as 45 mm and 55 mm.
本研究旨在比较两种拇指支具在慢性德奎文氏腱鞘炎患者佩戴支具进行动力握力时前臂肌肉活动的差异，以及最佳手柄直径。采用 2×3（组×支具）和 2×2×3（组×支具×直径）重复因子设计。测量握力和肌肉负荷。进行 2×3 混合重复测量方差分析，并用 LSD 检验进行事后分析。组间和手柄直径之间使用 Cohen's d 计算效应大小。在患有慢性德奎文氏腱鞘炎的 12 名参与者和 16 名健康参与者中，握力明显较低（在长/短/无支具条件下），肌肉负荷较高（<0.001）。当佩戴两种不同的支具时，肌肉活动没有差异。在 33mm 手柄直径下，抓握时肌肉活动更高。患有慢性德奎文氏腱鞘炎的个体需要比健康对照组更大的肌肉负荷来产生相同的动力握力，当佩戴两种支具中的一种时，执行动力握力的最佳手柄直径相对较大（45 和 55mm）。康复意义患有德奎文氏腱鞘炎的个体可以在日常活动中佩戴长和短拇指支具，因为佩戴两种支具需要相同的肌肉负荷。在进行动力握力时，患有德奎文氏腱鞘炎的个体产生相同动力握力所需的肌肉负荷大于健康对照组。我们建议德奎文氏腱鞘炎患者使用直径较大的餐具，如 45mm 和 55mm。
