Feys Peter, Duportail Marijke, Kos Daphne, Ilsbroukx Stephan, Lamers Ilse, Van Asch Paul, Helsen Werner, Moumdjian Lousin
REVAL Rehabilitation Research Center, Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
University MS Centre Hasselt-Pelt, 3500 Hasselt, Belgium.
J Clin Med. 2023 Jul 7;12(13):4549. doi: 10.3390/jcm12134549.
Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition. In experiment 2, 22 patients underwent whole arm cooling for 15 min using multiple cold packs. In both experiments, patients were tested at four time points (pre- and post-0, -25 and -50 min cooling) on unilateral tasks of the Test Evaluant les Membres supérieurs des Personnes Agées (TEMPA), Fahn's tremor rating scale (FTRS), Nine Hole Peg Test (NHPT). In experiment 1, the mean FTRS ranged from 13.2 to 14.1 across conditions. A two-way ANOVA showed mainly time effects, showing that cooling the forearm significantly reduced the FTRS, the performance on the NHPT, and three out of four items of the TEMPA, mostly independent of the cooling modality. In experiment 2, the mean FTRS was 13.1. A repeated measures ANOVA showed that cooling the whole arm reduced the FTRS and time needed to execute two out of four items of the TEMPA. These effects occurred immediately after cooling lasting at least 25 min. Cooling the whole upper limb led to a clinically noticeable effect on tremor severity and improved functional performance, which was pronounced during the first half-hour after cooling.
多发性硬化症患者（pwMS）的上肢意向性震颤会影响其日常生活活动能力，且难以治疗。本研究调查了外周上肢冷却对患有意向性震颤的MS患者震颤严重程度和功能表现的影响。在实验1中，17名患者接受了两种为期15分钟的前臂冷却条件（冷敷袋和冷冻按摩器）以及一种对照条件。在实验2中，22名患者使用多个冷敷袋进行了15分钟的全臂冷却。在两个实验中，患者均在四个时间点（冷却前、冷却后0、-25和-50分钟）接受了上肢老年人测试评估（TEMPA）、法恩震颤评定量表（FTRS）、九孔插板试验（NHPT）的单侧任务测试。在实验1中，各条件下FTRS的平均值在13.2至14.1之间。双向方差分析主要显示出时间效应，表明前臂冷却显著降低了FTRS、NHPT的表现以及TEMPA四项中的三项，且大多与冷却方式无关。在实验2中，FTRS的平均值为13.1。重复测量方差分析表明，全臂冷却降低了FTRS以及执行TEMPA四项中的两项所需的时间。这些效应在冷却后立即出现，持续至少25分钟。冷却整个上肢对震颤严重程度产生了临床上明显的影响，并改善了功能表现，这种影响在冷却后的前半小时内较为显著。
