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雷诺现象中手部功能、上肢残疾及其与外周血管改变的关系分析

Analysis of Hand Function, Upper Limb Disability, and Its Relationship with Peripheral Vascular Alterations in Raynaud's Phenomenon.

作者信息

Tapia-Haro Rosa Mª, García-Ríos Mª Carmen, Castro-Sánchez Adelaida Mª, Toledano-Moreno Sonia, Casas-Barragán Antonio, Aguilar-Ferrándiz Mª Encarnación

机构信息

Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain.

ibs.GRANADA Instituto de Investigación Biosanitaria, 18012 Granada, Spain.

出版信息

Diagnostics (Basel). 2023 Dec 30;14(1):93. doi: 10.3390/diagnostics14010093.

Abstract

This study aimed to compare vascular involvement, hand functionality, and upper limb disability between Raynaud's phenomenon participants and controls. Also, we analyzed the relationships between vascular impairment, mobility, and strength with disability in this Raynaud population. We conducted a case-control study with fifty-seven participants. We registered sociodemographic and clinical data; vascular variables (temperature, cold test, blood flow, and oxygen saturation); functional variables (pinch strength, range of motion), and disability (Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire) (Q-DASH). Raynaud participants present more disability in all Q-DASH subscales, lower hands' temperature pre and post cold test, decreased blood flow on radial artery, decreased ranges of motions at passive extension of index finger, and active flexion and extension of thumb than the healthy controls. The multivariate regression analysis showed that extension of the index finger, lateral pinch strength, and oxygen saturation were significantly associated with disability in RP, almost the 55% of the total variance on the upper limb, 27% at sports/arts, and 42% at work. Our findings suggest that RP has a disabling effect on the upper extremities and a practice of activities in people who suffer it. Also, disability in Raynaud seems to be more related with hand mobility and strength impairment than vascular injury.

摘要

本研究旨在比较雷诺现象参与者与对照组之间的血管受累情况、手部功能及上肢残疾程度。此外,我们还分析了雷诺病患者群体中血管损伤、活动能力和力量与残疾之间的关系。我们进行了一项包含57名参与者的病例对照研究。我们记录了社会人口统计学和临床数据;血管变量(温度、冷试验、血流和血氧饱和度);功能变量(捏力、活动范围)以及残疾程度(《手臂、肩部和手部功能障碍简化问卷》)(Q-DASH)。与健康对照组相比,雷诺现象参与者在所有Q-DASH子量表中的残疾程度更高,冷试验前后手部温度更低,桡动脉血流减少,食指被动伸展、拇指主动屈伸的活动范围减小。多因素回归分析表明,食指伸展、侧捏力和血氧饱和度与雷诺现象中的残疾显著相关,几乎占上肢总方差的55%,在体育/艺术方面占27%,在工作方面占42%。我们的研究结果表明,雷诺现象对上肢有致残作用,并影响患者的活动能力。此外,雷诺病中的残疾似乎与手部活动能力和力量受损的关系比与血管损伤的关系更大。

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