Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; Swiss Paraplegic Research Nottwil, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; International FES Centre®, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland.
Arch Phys Med Rehabil. 2024 Jan;105(1):75-81. doi: 10.1016/j.apmr.2023.06.014. Epub 2023 Jul 5.
To analyze factors associated with malposition that affects function of the thumb in individuals with tetraplegia.
Retrospective cross-sectional study.
Rehabilitation Center for Spinal Cord Injury.
Anonymized data from 82 individuals (68 men), mean age 52.9±20.2 (SD) with acute/subacute cervical spinal cord injury C2-C8 AIS A-D recorded during 2018-2020.
Not applicable.
Motor point (MP) mapping and manual muscle test (MRC) of 3 extrinsic thumb muscles (flexor pollicis longus (FPL), extensor pollicis longus (EPL), and abductor pollicis longus (APL)).
159 hands in 82 patients with tetraplegia C2-C8 AIS A-D were analyzed and assigned to "key pinch" (40.3%), "slack thumb" (26.4%), and "thumb-in-palm" (7.5%) positions. There was a significant (P<.0001) difference between the 3 thumb positions depicted in lower motor neuron (LMN) integrity tested by MP mapping and muscle strength of the 3 muscles examined. All studied muscles showed a significantly different expression of MP and the MRC values (P<.0001) between the "slack thumb" and "key pinch" position. MRC of FPL was significantly greater in the group "thumb-in-palm" compared with "key pinch" position (P<.0001).
Malposition of the thumb due to tetraplegia seems to be related to the integrity of LMN and voluntary muscle activity of the extrinsic thumb muscles. Assessments such as MP mapping and MRC of the 3 thumb muscles enable the identification of potential risk factors for the development of thumb malposition in individuals with tetraplegia.
分析影响四肢瘫患者拇指功能的错位相关因素。
回顾性横截面研究。
脊髓损伤康复中心。
2018 年至 2020 年间记录的 82 名（68 名男性）急性/亚急性颈脊髓损伤 C2-C8 AIS A-D 患者的匿名数据，平均年龄 52.9±20.2（SD）。
无。
3 个拇指外展肌（伸拇长肌（EPL）、屈拇长肌（FPL）和拇长展肌（APL））的运动点（MP）图和手动肌肉测试（MRC）。
分析了 82 例 C2-C8 AIS A-D 四肢瘫患者的 159 只手，并将其分为“关键捏合”（40.3%）、“拇指松弛”（26.4%）和“拇指内收”（7.5%）位。在通过 MP 图测试的下运动神经元（LMN）完整性和所检查的 3 块肌肉的肌力方面，3 种拇指位置之间存在显著差异（P<.0001）。所有研究肌肉在“拇指松弛”和“关键捏合”位置之间的 MP 和 MRC 值均有明显不同的表达（P<.0001）。与“关键捏合”位置相比，“拇指内收”组的 FPL 的 MRC 显著更大（P<.0001）。
由于四肢瘫导致的拇指错位似乎与 LMN 的完整性和拇指外展肌的自愿肌肉活动有关。MP 图和 3 个拇指肌肉的 MRC 评估可识别出四肢瘫患者拇指错位发展的潜在危险因素。
