The influence of proprioceptive impairment on hand function in patients with cervical myelopathy.

摘要

STUDY DESIGN: A prospective clinical study. OBJECTIVES: To quantitatively evaluate hand function in patients with cervical myelopathy and to assess the influence of proprioceptive impairment on hand function in patients with cervical myelopathy. SUMMARY OF BACKGROUND DATA: Clumsiness of the hands is one of the most common complaints in patients with cervical myelopathy. However, few reports have been published that evaluate hand dysfunction, and no reports have assessed the association between hand function and proprioceptive impairment. PATIENTS AND METHODS: A total of 129 patients (36 women and 93 men) with cervical myelopathy were examined. Hand function was evaluated as scores of ten subtests designed on the basis of various hand activities. The degree of proprioceptive impairment of the hand as well as that of light touch sensation loss is classified into four grades. Scores of the hand function test are compared according to the grade of proprioceptive impairment of the hands. RESULTS: Significant relation between the impairment of hand function and the extent of cervical myelopathy was observed. There was good correlation between the hand function scores and the grade of impairment of proprioception and light touch sensation. Furthermore, patients with impairment of proprioception obtained significantly lower scores in the hand function test than those with loss of light touch sensation. CONCLUSIONS: The hand function test is a useful battery to objectively and quantitatively evaluate impairment of cervical myelopathy, although longitudinal studies are needed to determine its practical usability. There was some relation between scores of hand function test and the extent of proprioceptive impairment. Thus, hand function test may be partly influenced by proprioceptive loss.