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与肌腱炎和局灶性手部肌张力障碍的重复性劳损相关的感觉功能障碍:一项比较研究。

Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study.

作者信息

Byl N, Wilson F, Merzenich M, Melnick M, Scott P, Oakes A, McKenzie A

机构信息

Physical Therapy, University of California, San Francisco 94143-0736, USA.

出版信息

J Orthop Sports Phys Ther. 1996 Apr;23(4):234-44. doi: 10.2519/jospt.1996.23.4.234.

Abstract

Repetitive strain injuries are reaching epidemic levels among workers who perform heavy schedules of rapid alternating movements (eg., computer programmers, data entry workers) or repetitive, sustained, coordinated movements (eg., editors, writers, salespeople). The purpose of this study was to determine if patients with repetitive strain injury demonstrated degraded sensory motor performance with their hands. Sixty age-matched adults were recruited, with 15 each assigned to a healthy adult control group, a healthy musician control group, a tendinitis group, or a focal dystonia group. Four sensory motor subtests from the Sensory Integration and Praxis Test were given to the subjects according to a standardized protocol. Using multiple one-factor analyses of variance in the parametric or nonparametric mode followed by post hoc pairwise testing, no significant differences were found between the healthy controls and the musician controls. On the test of kinesthesia, using the left hand, subjects with tendinitis performed significantly worse than controls and subjects with focal dystonia. Compared with controls, subjects with focal dystonia did significantly worse on graphesthesia and manual form perception (part 1 and part 2). Subjects with focal dystonia also did significantly worse than subjects with tendinitis when using the left hand on graphesthesia and manual form perception (part 2). When treating patients with repetitive strain injury, discriminative sensory motor skills must be carefully assessed and may need to be addressed as part of an effective treatment program.

摘要

重复性劳损在从事高强度快速交替动作(如计算机程序员、数据录入员)或重复性、持续性、协调性动作(如编辑、作家、销售人员)的工人中呈流行趋势。本研究的目的是确定重复性劳损患者的手部感觉运动功能是否退化。招募了60名年龄匹配的成年人,每组15人,分别为健康成人对照组、健康音乐家对照组、肌腱炎组或局灶性肌张力障碍组。根据标准化方案,对受试者进行了感觉统合与实践测试中的四项感觉运动子测试。采用参数或非参数模式下的多因素方差分析及事后两两检验,健康对照组和音乐家对照组之间未发现显著差异。在本体感觉测试中,肌腱炎患者用左手测试时表现明显比对照组和局灶性肌张力障碍患者差。与对照组相比,局灶性肌张力障碍患者在图形觉和手工形状感知(第1部分和第2部分)测试中表现明显更差。在图形觉和手工形状感知(第2部分)测试中,局灶性肌张力障碍患者用左手测试时也比肌腱炎患者表现更差。在治疗重复性劳损患者时,必须仔细评估其辨别性感觉运动技能,并且可能需要将其作为有效治疗方案的一部分加以解决。

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