Kinästhesie der Kraft und Bewegung und die taktile Diskrimination bei Patienten mit einer leichten Form des Karpaltunnelsyndroms

Zusammenfassung

Einleitung: Das Karpaltunnelsyndrom (KTS) charakterisiert sich sowohl durch sensorische und motorische Störungen als auch durch Muskelschwund im fortgeschrittenen Stadium. Aus diesem Grund nutzen viele Autoren die Untersuchung der Sensibilität, der Greifkraft und des Bewegungsumfangs, um den klinischen Zustand und die Therapieergebnisse zu beurteilen.

Ziel: Das Ziel der Untersuchung war die Beurteilung des Verhaltens der Muskelkraft und deren kinästhetischen Differenzierungsfähigkeit, der Beweglichkeit und deren kinästhetischen Differenzierungsfähigkeit sowie der 2-punkt-Diskrimination bei Personen im leichten Stadium des KTS.

Material und Methoden: An der Untersuchung nahmen insgesamt 32 Personen teil: 16 gesunde Personen und 16 Personen mit KTS. Alle Untersuchten waren Rechtshänder. Das KTS trat in der dominierenden rechten Hand auf. Beurteilt wurden die Muskelkraft, die kinästhetische Differenzierungsfähigkeit der Kraft, der Bewegungsumfang im Radiokarpalgelenk, die kinästhetische Differenzierungsfähigkeit der Bewegung und die 2-punkt-Diskrimination.

Ergebnisse: Bei der Beurteilung der Kraft und der kinästhetischen Differenzierungsfähigkeit der Kraft in den beiden untersuchten Gruppen wurde ein signifikanter Unterschied in Bezug auf die prozentualen Werte der kinästhetischen Differenzierungsfähigkeit der Kraft des Daumens beobachtet (p=0,01). In sonstigen Fällen wurden keine signifikanten Unterschiede festgestellt. Lediglich unterschied sich in der Beurteilung der Beweglichkeit der Bewegungsumfang der Beugung in der Gruppe mit KTS wesentlich von der Kontrollgruppe (p=0,03). In der Beurteilung der 2-punkt-Diskrimination zeigten die Ergebnisse einen wesentlich kleineren Wert der taktilen Diskrimination aller untersuchten Finger in der Gruppe mit KTS im Vergleich zu der gesunden Gruppe (p<0,001).

Schlussfolgerungen: Es sind wesentliche Unterschiede in der Beurteilung der kinästhetischen Sensibilität des Zangengriffs, des Bewegungsumfangs der Beugung und der 2-punkt-Diskrimination aufgetreten. Schon in der frühen Phase des KTS tritt erhebliches Defizit der Diskriminationsempfindung im Vergleich zu der Population der gesunden Menschen auf.

Abstract

Introduction: The carpal tunnel syndrome (CTS) is characterised by both sensory and motor disorders as well as muscular atrophy in more advanced stages. For that reason a lot of authors examine the sensation, grip strength and range of motion to assess the clinical condition and the results of a therapy.

Aim: The aim of this study was the assessment of the muscle strength and its kinesthetic differentiation, range of motion and its kinesthetic differentiation as well as 2-point discrimination in people with a mild stage of CTS.

Material and methods: 32 people in total took part in the research: 16 healthy people and 16 people with CTS. All of the participants were right-handed. The CTS occurred in the dominant right extremity. Muscle strength, kinesthetic differentiation of strength, range of motion in the radiocarpal articulation as well as the kinesthetic differentiation of movement and 2-point discrimination were subjected to assessment.

Results: The assessment of strength and kinesthetic differentiation of strength between the studied groups showed significant difference regarding the percentage value of the kinesthetic differentiation of thumb strength (p=0.01). No significant differences were found in the remaining instances. In the assessment of the range of motion, only the flexion motion differed significantly between the group with CTS and the control group (p=0.03). Results of assessment of 2-point discrimination show significantly lower value of tactile discrimination of all the examined fingers in CTS group in relation to the healthy people group (p<0.001).

Conclusions: Significant differences occurred in the assessment of kinesthetic sensation of pincer grip, flexion range of motion and 2-point tactile discrimination. Two-point discrimination may be a useful diagnostic tool even in mild forms of CTS.

Schlüsselwörter

Muskelkraft - Bewegungsumfang - kinästhetischen Differenzierungsfähigkeit - diskriminierende Empfindung

Key words

muscle strength - range of motion - kinesthetic differentation - discrimination sense

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