Khabie V, Schwartz M C, Rokito A S, Gallagher M A, Cuomo F, Zuckerman J D
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, NY 10003, USA.
J Shoulder Elbow Surg. 1998 Sep-Oct;7(5):501-4. doi: 10.1016/s1058-2746(98)90202-6.
Twenty uninjured male volunteers were studied to characterize normal elbow proprioception and to investigate the effect of applying an elastic bandage to the extremity and injection of an intraarticular anesthetic. A modified Biodex dynamometer was used to study position sense and detection of motion. In part 1 of the study position sense was tested by flexing the elbow to a predetermined angle, returning to the starting position, and then asking the subject to identify that angle. In part 2 detection of motion was tested by asking the subject to disengage the apparatus by pressing a stop button when movement was detected. The testing conditions in part 1 and part 2 were repeated after the elbow was wrapped with an elastic bandage and again after an intraarticular injection of 3 cc 1% lidocaine with the bandage removed. Ten additional subjects underwent testing of both elbows to examine the effect of arm dominance. Mean position sense was within 3.3 degrees+/-1.3 degrees of the actual angle in trials without an elastic bandage or an anesthetic. A significant improvement in position sense was observed (2.2 degrees+/-1.2 degrees) after an elastic bandage was applied (P < .004). No significant difference was seen in position sense after lidocaine was injected. The mean threshold for detection of motion in trials without an elastic bandage or an anesthetic was 4.21 degrees+/-1.56 degrees. No significant differences were seen in detection of motion observed with the elastic bandage or intraarticular anesthetic. No significant differences were seen between dominant and nondominant extremities for both position sense and detection of motion. The application of an elastic bandage improved position sense, suggesting that tactile cues from cutaneous or other extraarticular receptors may play a role in elbow proprioception. Intraarticular anesthesia, however, had little effect, suggesting that intracapsular receptors play a lesser role in elbow proprioception. The determination of proprioceptive qualities for the normal elbow can aid in the understanding of elbow function and provide a basis for defining its role in elbow dysfunction.
对20名未受伤的男性志愿者进行了研究，以确定正常肘部本体感觉的特征，并研究在肢体上应用弹性绷带和关节内注射麻醉剂的效果。使用改良的Biodex测力计来研究位置觉和运动觉。在研究的第1部分中，通过将肘部弯曲到预定角度、回到起始位置，然后要求受试者识别该角度来测试位置觉。在第2部分中，通过要求受试者在检测到运动时按下停止按钮来脱离设备，从而测试运动觉。在肘部用弹性绷带包裹后以及在关节内注射3毫升1%利多卡因并去除绷带后，重复第1部分和第2部分的测试条件。另外10名受试者对双侧肘部进行测试，以检查优势手臂的影响。在没有弹性绷带或麻醉剂的试验中，平均位置觉在实际角度的3.3度±1.3度范围内。应用弹性绷带后，位置觉有显著改善（2.2度±1.2度）（P < .004）。注射利多卡因后，位置觉没有显著差异。在没有弹性绷带或麻醉剂的试验中，运动觉检测的平均阈值为4.21度±1.56度。使用弹性绷带或关节内麻醉剂时，运动觉检测没有显著差异。在位置觉和运动觉方面，优势肢体和非优势肢体之间没有显著差异。弹性绷带的应用改善了位置觉，表明来自皮肤或其他关节外感受器的触觉线索可能在肘部本体感觉中起作用。然而，关节内麻醉的影响很小，表明关节内感受器在肘部本体感觉中起的作用较小。确定正常肘部的本体感觉特性有助于理解肘部功能，并为确定其在肘部功能障碍中的作用提供依据。
