Simón-Vicente Lucía, Rivadeneyra Jéssica, Mariscal Natividad, Aguado Laura, Miguel-Pérez Irene, Saiz-Rodríguez Miriam, García-Bustillo Álvaro, Muñoz-Siscart Ignacio, Díaz-Piñeiro Dolores, Cubo Esther
Faculty of Health Sciences, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Madrid, Spain.
Research Unit, Burgos University Hospital, 09006 Burgos, Spain.
J Clin Med. 2024 Dec 31;14(1):168. doi: 10.3390/jcm14010168.
: Huntington's disease (HD) is a neurodegenerative movement disorder associated with significant disability and impairment of Activities of Daily Living (ADLs). The impact of upper limb disability on quality of life (QoL) and its influence on ADLs is not well known yet. The aim of this study was to describe the manipulative dexterity, strength, and manual eye coordination of patients with manifest and premanifest-HD compared to healthy individuals and to analyze its influence on ADLs and QoL. We performed an observational, cross-sectional study including 71 ambulatory participants (27 manifest-HD patients, 15 premanifest-HD, and 29 controls). We gathered sociodemographic data, as well as clinical data, including cognition (MMSE), HD motor severity (Unified HD rating scale, UHDRS-TMS), QoL (Neuro-QoL), and ADLs (HD-ADL). Hand dexterity and strength in the dominant and non-dominant hand were assessed with the Nine Hole Peg Test, Ten Neurotest, Nut and Bolt Test, dynamometry, and Late-Life FDI. Analysis of covariance (ANCOVA) models were performed to investigate differences in hand function between manifest-HD, premanifest-HD, and controls. Manifest-HD patients had significantly worse performance in manual and finger dexterity, fine-motor coordination, and poorer handgrip strength than premanifest-HD and controls. Premanifest-HD required more time to complete the test than controls. Significant correlations were found between hand variables and Late-Life FDI, Neuro-QoL, HD-ADL, and UHDRS-TMS. HD affects manipulative dexterity and hand function in premanifest and manifest patients. Therefore, to prevent disability and decreased QoL, evaluating the progression of upper limb dysfunction in HD is important to offer the best possible therapeutic interventions.
亨廷顿舞蹈症(HD)是一种神经退行性运动障碍,会导致严重残疾和日常生活活动(ADL)受损。上肢残疾对生活质量(QoL)的影响及其对ADL的作用尚不明确。本研究旨在描述显性和症状前HD患者与健康个体相比的操作灵活性、力量和手眼协调性,并分析其对ADL和QoL的影响。我们进行了一项观察性横断面研究,纳入71名能走动的参与者(27名显性HD患者、15名症状前HD患者和29名对照)。我们收集了社会人口学数据以及临床数据,包括认知(简易精神状态检查表,MMSE)、HD运动严重程度(统一HD评定量表,UHDRS-TMS)、QoL(神经QoL)和ADL(HD-ADL)。使用九孔插板测试、十项神经测试、螺母和螺栓测试、握力测量以及老年FDI评估优势手和非优势手的手部灵活性和力量。进行协方差分析(ANCOVA)模型以研究显性HD、症状前HD和对照之间手部功能的差异。显性HD患者在手部和手指灵活性、精细运动协调性方面的表现明显比症状前HD患者和对照差,握力也更弱。症状前HD患者完成测试所需时间比对照更长。手部变量与老年FDI、神经QoL、HD-ADL和UHDRS-TMS之间存在显著相关性。HD会影响症状前和显性患者的操作灵活性和手部功能。因此,为防止残疾和生活质量下降,评估HD患者上肢功能障碍的进展对于提供最佳治疗干预措施很重要。