手部骨关节炎的早期阶段不会影响手部外在肌肉：一项横断面研究。
Initial stages of hand osteoarthritis do not affect the extrinsic muscles of the hand: a cross-sectional study.
机构信息
Departament of Physical Therapy, Federal University of São Carlos, Highway Washington Luiz, km 235, São Carlos, SP, CEP: 13565-905, Brazil.
出版信息
Sci Rep. 2021 Mar 8;11(1):5381. doi: 10.1038/s41598-021-85054-3.
The objective of this study was to verify whether women in the initial stages of hand osteoarthritis (HOA) already have impaired grip strength and flexor and extensor torque of the wrist compared to healthy women. It also aimed to correlate these variables with pain, stiffness, and function of the hand. Twenty-six women were divided into a control group [CG, n = 13; 56 (51-61) years old] and a hand osteoarthritis group [HOAG, n = 13; 58 (53-63) years old]. Grades II and III were included in the HOA group according to the criteria of Kellgren and Lawrence. All volunteers answered an initial assessment form, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). The grip strength and isometric wrist flexor and extensor torque were evaluated by a hydraulic dynamometer. Comparisons between groups used Student's t test for independent samples and the Mann-Whitney test. Spearman's correlation was used to correlate grip strength and flexor and extensor wrist torque to the degree of disease and DASH and AUSCAN scores. There were no differences between the groups in grip strength or flexor and extensor torque values. In terms of the DASH and the AUSCAN, the HOA group had higher scores, indicating worse hand function. A strong negative correlation was found between grip strength and the degree of HOA (r = - 0.70, p = 0.008), and a moderate positive correlation was found between flexor torque and the degree of HOA (r = 0.53, p = 0.05). The pain (r = - 0.61, p = 0.02) and function (r = - 0.66, p = 0.01) sections of the AUSCAN correlated negatively with grip strength. Pain can be an important feature in the HOA rehabilitation process, as it can influence handgrip strength and function. It is important that rehabilitation is implemented as soon as possible to guarantee the maintenance of strength and function since with the severity of the disease, patients tend to have deficits in grip strength and function.
本研究旨在验证手部骨关节炎（HOA）初期女性与健康女性相比，其握力以及手腕屈肌和伸肌扭矩是否已经受损。本研究还旨在分析这些变量与手部疼痛、僵硬和功能之间的相关性。26 名女性被分为对照组[CG，n=13；56（51-61）岁]和手部骨关节炎组[HOAG，n=13；58（53-63）岁]。根据 Kellgren 和 Lawrence 的标准，HOA 组纳入 II 级和 III 级患者。所有志愿者均回答初始评估表、手臂、肩部和手部残疾问卷（DASH）和澳大利亚/加拿大手部骨关节炎指数（AUSCAN）。使用液压测力计评估握力和等长手腕屈肌和伸肌扭矩。使用独立样本 Student's t 检验和 Mann-Whitney 检验比较组间差异。Spearman 相关性用于分析握力和腕部屈肌和伸肌扭矩与疾病程度以及 DASH 和 AUSCAN 评分之间的相关性。两组之间的握力或屈肌和伸肌扭矩值无差异。在 DASH 和 AUSCAN 方面，HOA 组的得分更高，表明手部功能更差。HOA 严重程度与握力呈强负相关（r=−0.70，p=0.008），HOA 严重程度与屈肌扭矩呈中度正相关（r=0.53，p=0.05）。AUSCAN 的疼痛（r=−0.61，p=0.02）和功能（r=−0.66，p=0.01）部分与握力呈负相关。疼痛可能是 HOA 康复过程中的一个重要特征，因为它会影响手握力和功能。重要的是，应尽快进行康复治疗，以保证力量和功能的维持，因为随着疾病的严重程度增加，患者握力和功能会出现缺陷。
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