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手部优势对无症状工作者正中神经和尺神经感觉诱发电位幅度及潜伏期的影响。

Hand dominance effect on median and ulnar sensory evoked amplitude and latency in asymptomatic workers.

作者信息

Werner R A, Franzblau A

机构信息

Physical Medicine and Rehabilitation Service, VA Medical Center, Ann Arbor, MI 48105, USA.

出版信息

Arch Phys Med Rehabil. 1996 May;77(5):473-6. doi: 10.1016/s0003-9993(96)90036-2.

Abstract

OBJECTIVE

To examine the relative effect of hand dominance on the median and ulnar sensory evoked responses and grip strength in active workers.

DESIGN

A cross-sectional or survey design.

SETTING

Workers from 4 different sites underwent on-site testing of the median and ulnar sensory nerves in both hands (antidromic stimulation, 14 cm), and testing of bilateral grip strength.

PATIENTS

224 workers, asymptomatic of hand, wrist, or finger pain, numbness, or tingling: 87% were right handed.

MAIN OUTCOME MEASURES

Amplitude and latency of the median and ulnar sensory response and the grip strength of each hand.

RESULTS

The amplitude of the median sensory response in the dominant hand was significantly lower in right handed individuals (34.6 microm V versus 38.8 microm V) but not in left handed workers (34.2 microm V versus 34.3 microm V). A similar relationship held for the ulnar evoked responses and the grip strength. Median and ulnar sensory latencies in right handed individuals did not differ side to side, whereas left handed workers had a slightly shorter latency on the left.

CONCLUSIONS

The left hand of a right handed worker may not be exposed to as much trauma, resulting in relative protection of the nerves in the hand and a higher amplitude of the left median and ulnar evoked response. Left handed individuals may be more likely to use both hands equally and thus expose the nerves in each hand to an equal amount of trauma, resulting in their sensory amplitudes being equivalent (and also equal to the dominant hand of a right handed individual).

摘要

目的

研究惯用手对在职劳动者正中神经和尺神经感觉诱发电位及握力的相对影响。

设计

横断面或调查设计。

地点

来自4个不同地点的劳动者接受了双手正中神经和尺神经的现场检测(逆向刺激,14厘米)以及双侧握力测试。

患者

224名劳动者,无手部、腕部或手指疼痛、麻木或刺痛症状,其中87%为右利手。

主要观察指标

正中神经和尺神经感觉反应的波幅和潜伏期以及每只手的握力。

结果

右利手个体优势手的正中神经感觉反应波幅显著较低(34.6微伏对38.8微伏),但左利手劳动者并非如此(34.2微伏对34.3微伏)。尺神经诱发电位和握力也存在类似关系。右利手个体正中神经和尺神经的感觉潜伏期左右无差异,而左利手劳动者左侧的潜伏期略短。

结论

右利手劳动者的左手可能未受到同等程度的创伤,从而对手部神经起到相对保护作用,使左侧正中神经和尺神经诱发电位的波幅更高。左利手个体可能更倾向于同等程度地使用双手,因此每只手的神经受到的创伤量相等,导致其感觉波幅相等(且与右利手个体的优势手相等)。

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