Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
PLoS One. 2019 Jul 11;14(7):e0219762. doi: 10.1371/journal.pone.0219762. eCollection 2019.
Hand function deterioration brings about inconvenience to the daily lives of the chronic kidney disease patients. However, a full spectrum of hand function examination is absent. Therefore, this study aimed to classify the hand sensorimotor functions of the chronic kidney disease patients using the novel sensorimotor assessment tools, manual tactile test (MTT) and pinch-holding-up activity (PHUA) test, and explore the feasibility in comparison with traditional evaluations in the clinical practice. 68 stage-5 chronic kidney disease patients and 50 healthy subjects were recruited in this study. A series of conventional evaluations and two novel hand function tools, manual tactile test and pinch-holding-up activity test were conducted from the perspective of hand dexterity, sensory input threshold, force generation and sensorimotor control. Independent t-test was used to find out group differences and the receiver operating characteristic curve was used to determine accuracy of the tests. In our results, significant reduction of hand dexterity, sensory input, force generation and sensorimotor control was found in patients from an overall perspective. This trend was discovered to be the same when dividing the subjects into the old and young age group. From the receiver operator characteristic curves, nearly all the areas under the curve of all tests were over 0.8. The novel evaluation tools, the manual tactile test and pinch-holding-up activity, were found to have comparable or even better accuracy than the traditional ones. The shape and weight subtests of the manual tactile test displayed the highest accuracy. To sum up, by incorporating the novel and conventional assessment tests, this study built up the fundamental understanding of the hand functions in multiple dimensions and consolidate the clinical merits of applying the two novel tools, manual tactile test and pinch-holding-up activity, on chronic kidney disease patients.
手部功能恶化给慢性肾脏病患者的日常生活带来不便。然而,目前缺乏全面的手部功能检查。因此,本研究旨在使用新型感觉运动评估工具(手动触觉测试[MTT]和握持上举活动[PHUA]测试)对慢性肾脏病患者的手部感觉运动功能进行分类,并探讨其在临床实践中与传统评估方法相比的可行性。本研究纳入了 68 名 5 期慢性肾脏病患者和 50 名健康对照者。从手灵巧性、感觉输入阈值、力量产生和感觉运动控制等方面对一系列常规评估和两种新型手部功能工具(手动触觉测试和握持上举活动测试)进行了评估。采用独立 t 检验比较组间差异,采用受试者工作特征曲线(ROC)评估各测试的准确性。结果显示,从整体上看,患者的手灵巧性、感觉输入、力量产生和感觉运动控制均显著降低。将研究对象分为老年组和年轻组后,也发现了同样的趋势。从 ROC 曲线来看,所有测试的曲线下面积均接近 0.8。新型评估工具(手动触觉测试和握持上举活动测试)的准确性与传统评估工具相当,甚至更好。手动触觉测试的形状和重量子测试显示出最高的准确性。总之,通过整合新型和传统评估测试,本研究从多个维度深入了解了手部功能,并证实了应用新型工具(手动触觉测试和握持上举活动测试)评估慢性肾脏病患者手部功能的临床价值。