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评估肝硬化患者的直觉和触觉功能:与健康对照组的对比研究。

Assessment of gnostic and stereognostic functions in patients with liver cirrhosis: A comparative study with healthy controls.

机构信息

Faculty of HealthCare, Slovak Medical University, Banská Bystrica, Slovakia.

Faculty of Sports Science and Health, Matej Bel University, Banská Bystrica, Slovakia.

出版信息

J Back Musculoskelet Rehabil. 2024;37(6):1685-1694. doi: 10.3233/BMR-240114.

Abstract

BACKGROUND

Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease's progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function.

OBJECTIVES

The main objective of the study is to compare the gnostic function and stereognostic function in individuals with liver cirrhosis and those in a healthy population.

METHODS

The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25 women and 49 men). The control group consisted of a 63 healthy population (including 23 women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests.

RESULTS

The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p< 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p< 0.05), except for the second attempt with the left upper limb (p= 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p> 0.05).

CONCLUSION

Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis.

摘要

背景

肝硬化患者通常会经历多种症状。疾病进展的关键阶段是失代偿期,其特征是出现明显的临床体征。这些体征通常包括腹水、出血倾向、肝性脑病和黄疸。此外,值得注意的是,负责感觉运动和知觉功能的感觉运动皮层区域与顶枕叶皮层区域紧密相邻。肝硬化也可能对人类运动功能的这一方面产生影响。

目的

本研究的主要目的是比较肝硬化患者和健康人群的知觉功能和触觉功能。

方法

我们的登记册中的患者称为 RH7,他们被纳入我们的研究。第一组包括 74 名肝硬化患者(包括 25 名女性和 49 名男性)。对照组由 63 名健康人群组成(包括 23 名女性和 40 名男性)。两组均接受了 Petrie 测试和动觉测试。

结果

Petrie 测试结果显示,与健康参与者相比,肝硬化患者的右上肢和左上肢均有显著差异(p<0.05)。与肝硬化患者相比,健康人群在动觉测试中也有显著差异(p<0.05),除了左上肢的第二次尝试(p=0.267)。根据 LFI,在 Petrie 测试的初始和第二次尝试中,左右上肢均无显著差异(p>0.05)。

结论

与健康人群相比,肝硬化患者的知觉功能明显较差。这种情况还导致运动功能显著受损,影响运动的准确性和协调性。尽管存在这些缺陷,但虚弱本身似乎并不是知觉或触觉功能恶化的指标。因此,尽管肝硬化对运动和认知能力有明显的负面影响,但虚弱的存在并不一定加剧这些特定的认知缺陷。这一区别对于针对肝硬化患者的运动和认知康复的临床评估和干预至关重要。

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Cognitive Impairment and Cirrhosis in Older Patients: A Systematic Review.老年患者的认知障碍与肝硬化:一项系统评价
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