Department of Medicine, Graduate School, Jeju National University, Jeju, Korea.
Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea.
Sci Rep. 2020 Nov 6;10(1):19278. doi: 10.1038/s41598-020-74795-2.
Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients' hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.
骨关节炎是一种常见的退行性疾病，最常累及手部。本研究旨在比较不同年龄组手部骨关节炎患者（伴或不伴腕管综合征）的临床功能（包括握力、侧捏力和灵巧度）与各种电生理测量结果。纳入 2015 年 6 月至 2016 年 6 月间接受手部功能测试和运动及感觉神经传导研究（NCS）的手部骨关节炎患者（208 例，404 只手）。将患者的手部分为腕管综合征（CTS）（206 只手；平均年龄 56.37±10.52；男：女，46：160）或对照组（198 只手；平均年龄 57.88±9.68；男：女，55：143）。测量和比较了各组年龄间以及伴或不伴 CTS 的手部间的握力和侧捏力、完成 9 孔插板测试（9HPT）所需的时间以及运动和感觉神经传导参数。与对照组相比，CTS 组的手部握力和侧捏力明显较低，完成 9HPT 的时间也较长。女性患者的手部握力和侧捏力明显低于男性患者。然而，两性之间完成 9HPT 的时间并无差异。多变量回归分析确定正中神经复合肌肉动作电位（CMAP）的幅度、年龄和男性为握力的独立预测因子（调整后的 R2=0.679），正中神经 CMAP 的幅度和男性为侧捏力的独立预测因子（调整后的 R2=0.603）。正中神经 CMAP 的速度、正中感觉神经动作电位的幅度和年龄为 9HPT 时间的独立预测因子（调整后的 R2=0.329）。神经传导测量与手部功能测试结果显著相关，CTS 导致手部力量和功能明显受损。
