Carpal tunnel syndrome impairs index finger responses to unpredictable perturbations.
Carpal tunnel syndrome impairs index finger responses to unpredictable perturbations.
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DOI：
10.1016/j.jelekin.2017.03.001
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Li ZM
中科院分区：
文献类型：
--
作者：
Grandy EL;Xiu K;Marquardt TL;Li C;Evans PJ;Li ZM
腕管综合征（carpal tunnel syndrome， CTS）会破坏手指力对物体特性的微调。CTS对手功能的影响主要通过可预测的操作任务进行研究；然而，在手动任务中经常遇到不可预测的扰动，这对CTS患者的手部损伤来说可能更具挑战性。本研究的目的是研究CTS患者的肌肉和力对不可预测的扰动的反应。9名CTS患者和9名无症状对照者被指示在意外扰动后通过增加食指力来停止滑动板的运动。记录第一背骨间肌的电活动和食指施加的力。与对照组相比，CTS患者的肌肉反应潜伏期增加20.9%，力反应潜伏期增加12.0% （p < 0.05）。两组间钢板滑动时间差异有统计学意义（p < 0.05）；CTS组持续时间为142.2±5.8 ms，对照组持续时间为133.1±8.4 ms。虽然CTS患者的肌肉和力反应持续时间相对增加，但这些差异没有统计学意义。本研究结果表明，cts诱导的感觉运动缺陷会干扰对不可预测扰动的准确检测、处理和反应。这些缺陷可以解释为周围和中枢神经系统的多个水平。延迟和减少的反应可能表明CTS患者对物体操作效率低下，并可能有助于解释为什么CTS患者倾向于掉落物体。
The fine-tuning of digit forces to object properties can be disrupted by carpal tunnel syndrome (CTS). CTS’ effects on hand function have mainly been investigated using predictable manipulation tasks; however, unpredictable perturbations are commonly encountered during manual tasks, presenting situations which may be more challenging to CTS patients given their hand impairments. The purpose of this study was to investigate muscle and force responses of the index finger to unpredictable perturbations in patients with CTS. Nine CTS patients and nine asymptomatic controls were instructed to stop the movement of a sliding plate by increasing index finger force following an unexpected perturbation. The electrical activity of the first dorsal interosseous muscle and forces exerted by the index finger were recorded. CTS patients demonstrated 20.9% greater muscle response latency and 12.0% greater force response latency compared to controls (p < 0.05). The duration of plate sliding was significantly different between groups (p < 0.05); the CTS group’s duration was 142.2 ± 5.8 ms compared to the control group’s duration of 133.1 ± 8.4 ms. Although CTS patients had increased muscle and force response durations comparatively, these differences were not statistically significant. Findings from this study suggest CTS-induced sensorimotor deficits interfere with accurate detection, processing and response to unpredictable perturbations. These deficits could be accounted for at multiple levels of the peripheral and central nervous systems. Delayed and decreased responses may indicate inefficient object manipulation by CTS patients and may help to explain why CTS patients tend to drop objects.
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