Specific components of manual dexterity are affected in patients with writer's cramp: an observational comparative study and preliminary rehabilitation report.
Jean-Pierre Bleton, Raphael B Takyi, Marion Verneau, Cedric Monchaud, Thierry Peron Magnan, Sophie Sangla, Amélie Yavchitz, Marc A Maier, Påvel G Lindberg
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引用次数: 0
Abstract
Objective: To compare manual dexterity in patients with writer's cramp and healthy controls to determine which components of dexterity are impaired in writer's cramp. In addition, to assess the effects of rehabilitation.
Subjects/patients: 23 patients with writer's cramp and 20 healthy age- and sex-matched control subjects.
Methods: Degree of manual dexterity (through 3 tasks) and handwriting symptoms were assessed, and effects of rehabilitation probed.
Results: Patients with writer's cramp showed significantly lower handwriting speed (97 letters/min) and legibility (BFM score = 1.3) compared with control subjects (171 letters/min, p < 0.001; BFM score = 0.15, p < 0.001). Only the task quantifying finger independence showed weaker finger selectivity (median = 0.84) in patients compared with controls (median = 0.89, p = 0.01). The other 2 tasks, maximal finger tapping and visuomotor finger force-tracking, did not reveal significant group differences (all p > 0.44). In patients, automated writing legibility correlated with finger selectivity (r = 0.50, p = 0.02). Rehabilitation improved dexterity (selectivity and force-tracking) and automated writing legibility.
Conclusion: In this multi-component analysis of manual dexterity, reduced selectivity of finger movements was identified as the main behavioural mechanism (deficit) in writer's cramp, associated with writing speed. In contrast, force control and tapping speed were unaffected. Selective finger activation can be improved with therapy targeting dextrous finger movements.
目的：比较写作者性痉挛患者和健康对照者的手灵巧性，以确定写作者性痉挛中哪些部分的灵巧性受损。此外，对康复效果进行评估。设计：横断面初步研究，纵向二次研究。受试者/患者：23例作家痉挛患者和20例年龄和性别匹配的健康对照受试者。方法：评估手灵巧度（通过3个任务）和书写症状，并探讨康复效果。结果：书写痉挛患者书写速度（97个字母/min）和易读性（BFM评分= 1.3）明显低于对照组（171个字母/min， p 0.44）。在患者中，自动书写易读性与手指选择性相关（r = 0.50, p = 0.02）。康复改善了灵巧性（选择性和力跟踪）和自动书写的易读性。结论：在这项手巧的多成分分析中，手指运动选择性的降低被确定为作家抽筋的主要行为机制（缺陷），与写作速度有关。相比之下，力控制和攻丝速度不受影响。选择性手指激活可以改善治疗针对灵巧的手指运动。
期刊介绍：
Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year.
Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.
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