The Effect of Altered Hand Position and Motor Skills on Stereognosis
The Effect of Altered Hand Position and Motor Skills on Stereognosis
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DOI：
10.1016/j.jhsa.2009.01.029
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发表时间：
2009-05-01
影响因子：
1.9
通讯作者：
Brooks, Catherine
中科院分区：
文献类型：
--
作者：
Carlson, Michelle Gerwin;Brooks, Catherine
目的脑性瘫痪患者的立体感差被认为是大脑感觉功能异常的标志，是上肢手术的相对禁忌证。手的位置和运动功能对立体感的影响还没有研究;手的流动性下降，可以降低一个人的能力，认识到在手中的物体，可以是一个重要组成部分的stereogniosis.Methods 21名正常受试者有他们的非优势臂定位到模拟偏瘫手的姿势前臂旋前和手腕和手指屈曲。受试者被要求在3个连续的试验中识别12个共同的物体，第一和第三次试验在模拟偏瘫的位置，第二次试验在正常的手的位置和运动功能。结果正常被试在学习过程中，（p <0.0001）当放置在模拟偏瘫手位置时减少的立体感，识别更少的项目偏瘫手位比正常手位的平均值分别为7.6和9.3结论脑性瘫痪患者的立体感下降可能与手的活动能力改变有关，而不仅仅是中枢神经系统功能障碍。在指导手术适应症时应谨慎使用，因为它可能是手术矫正的。（J Hand Surg 2009;34A：896-899. (C)2009年由Elsevier Inc.出版美国手外科学会（American Society for Surgery of the Hand）
Purpose Poor stereognosis has been considered to be indicative of abnormal cerebral sensory function, and therefore a relative contraindication for upper extremity surgery in hemiplegic cerebral palsy. The effect of hand position and motor function on stereognosis has not been studied; decreased hand mobility can decrease a person's ability to recognize objects in the hand and can be an important component of stereognosis.Methods Twenty-one normal subjects had their nondominant arm positioned to simulate the hemiplegic hand posture of forearm pronation and wrist and digital flexion. Subjects were asked to identify 12 common objects in 3 successive trials, with the first and third trials in the simulated hemiplegic position and the second trial in normal hand position and motor function. This accounted for a learning effect.Results Normal subjects had significantly (p < .0001) decreased stereognosis when placed in a simulated hemiplegic hand position with decreased digital and wrist extension, identifying fewer items (means 7.6 and 9.3 in successive trials) in the hemiplegic hand position than in the normal hand position (mean 11.7).Conclusions Decreased stereognosis in cerebral palsy patients might be related to altered hand mobility and not solely to central nervous system dysfunction. It should be used cautiously when guiding surgical indication, as it may be surgically correctable. (J Hand Surg 2009;34A:896-899. (C) 2009 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.)