Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, United States of America.
Department of Health and Human Performance, University of Houston, Houston, Texas, United States of America.
PLoS One. 2024 Nov 15;19(11):e0312468. doi: 10.1371/journal.pone.0312468. eCollection 2024.
Despite the growing evidence highlighting reduced functional independence in persons living with heart failure (PwHF), the underlying mechanisms that lead to reduced functional independence in this patient population are unknown. Given the association between functional independence and fine motor skills, which are functionally related to hand sensory and motor functions, we hypothesized that PwHF exhibit reduced sensory and motor function of hands compared to healthy individuals. We recruited a total of 10 PwHF (age: 57.6 ± 12.5 years old, four females) and a total of age- & sex-matched healthy control individuals (age: 58.2 ± 12.2 years old, four females). Participants performed a wide range of tests assessing the level of independence, fitness, cognitive function, and hand sensorimotor function. While the level of independence was comparable between two groups, PwHF exhibited reduced sensory and motor function. Compared to healthy participants, the ability to identify an object via tactile and proprioceptive inputs was reduced in PwHF, though the tactile mechanoreceptor function showed normal integrity. Similarly, PwHF exhibited a decline in manipulating small objects and steady grip force production. Heart failure seems to have repercussions that extend to the sensorimotor control of hand actions in advance to a decline in functional independence. These results underscore the need of further investigation as to the underlying mechanisms of reduced sensorimotor function, potential intervention targets, and determine whether assessments of hand sensorimotor function can serve as a vehicle to quantify restoration of self-care functionality.
尽管越来越多的证据强调心力衰竭（HF）患者的功能独立性降低，但导致这一患者群体功能独立性降低的潜在机制尚不清楚。鉴于功能独立性与精细运动技能之间存在关联，而精细运动技能与手部感觉和运动功能在功能上相关，我们假设与健康个体相比，HF 患者的手部感觉和运动功能降低。我们共招募了 10 名 HF 患者（年龄：57.6 ± 12.5 岁，女性 4 名）和年龄及性别匹配的健康对照组个体（年龄：58.2 ± 12.2 岁，女性 4 名）。参与者进行了一系列广泛的测试，评估独立性、体能、认知功能和手部感觉运动功能的水平。虽然两组的独立性水平相当，但 HF 患者的感觉和运动功能降低。与健康参与者相比，HF 患者通过触觉和本体感觉输入识别物体的能力降低，尽管触觉机械感受器功能显示正常完整性。同样，HF 患者在操纵小物体和稳定握持力产生方面表现出下降。心力衰竭似乎对手部动作的感觉运动控制产生了影响，导致功能独立性下降。这些结果强调了需要进一步研究感觉运动功能降低的潜在机制、潜在的干预靶点，并确定手部感觉运动功能评估是否可以作为量化自我护理功能恢复的手段。
