Daley Pauline, Pomares Germain, Menu Pierre, Gadbled Guillaume, Dauty Marc, Fouasson-Chailloux Alban
CHU Nantes, Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, 44093 Nantes, France.
CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France.
Diagnostics (Basel). 2021 Aug 24;11(9):1529. doi: 10.3390/diagnostics11091529.
Neurogenic thoracic outlet syndrome (NTOS) is an impairing painful condition. Patients usually report upper-limb pain, weakness and paresthesia. Shoulder weakness is frequently reported but has never been described with objective strength evaluation. We aimed to compare isokinetic shoulder strength between patients with NTOS and healthy controls. Patients and controls were prospectively evaluated with an isokinetic strength test at 60 and 180°/s, and an endurance test (30 repetitions at 180°/s) of the shoulder rotators. Patients were functionally assessed with QuickDASH questionnaires. One hundred patients and one hundred healthy subjects were included. Seventy-one percent of patients with NTOS were females with a mean age of 39.4 ± 9.6. They were compared to controls, 73% females and the mean age of 38.8 ± 9.8. Patients' mean QuickDASH was 58.3 ± 13.9. Concerning the peak of strength at 60°/s, the symptomatic limbs of patients with NTOS had significantly 21% and 29% less strength than the control limbs for medial and lateral rotators, respectively ( ≤ 0.001). At 180°/s, the symptomatic limbs had significantly 23% and 20% less strength than the controls for medial and lateral rotators, respectively ( ≤ 0.001). The symptomatic limbs had significantly 45% and 30% less endurance than the controls for medial and lateral rotators, respectively ( ≤ 0.001). These deficits were correlated to the QuickDASH. Patients with NTOS presented a significant deficit of strength and endurance of the shoulder rotators correlated to disability. This highlights the interest in upper-limb strength evaluation in the diagnostic process and the follow-up of NTOS.
神经源性胸廓出口综合征(NTOS)是一种导致功能障碍的疼痛性疾病。患者通常会报告上肢疼痛、无力和感觉异常。经常有患者报告肩部无力,但从未通过客观的力量评估进行描述。我们旨在比较NTOS患者与健康对照者的等速肩部力量。对患者和对照者进行前瞻性评估,采用60°/秒和180°/秒的等速力量测试以及肩部旋转肌的耐力测试(180°/秒下重复30次)。使用QuickDASH问卷对患者进行功能评估。纳入了100例患者和100名健康受试者。NTOS患者中71%为女性,平均年龄为39.4±9.6岁。将他们与对照者进行比较,对照者中73%为女性,平均年龄为38.8±9.8岁。患者的平均QuickDASH评分为58.3±13.9。关于60°/秒时的力量峰值,NTOS患者患侧肢体的内旋肌和外旋肌力量分别比对照侧肢体显著低21%和29%(P≤0.001)。在180°/秒时,患侧肢体的内旋肌和外旋肌力量分别比对照侧显著低23%和20%(P≤0.001)。患侧肢体的内旋肌和外旋肌耐力分别比对照侧显著低45%和30%(P≤0.001)。这些力量和耐力的不足与QuickDASH评分相关。NTOS患者的肩部旋转肌力量和耐力存在显著不足,且与功能障碍相关。这凸显了在NTOS的诊断过程和随访中评估上肢力量的重要性。