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首页> 外文期刊>BMC Musculoskeletal Disorders >Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review
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Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review

机译：力量握力，捏握力，手动肌肉测试或testing肌萎缩–腕管减压后应评估为运动结局吗？系统评价

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Background Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS). However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust. Methods The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers. Results Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS. Conclusion Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more sensitive if assessed using a hand held dynamometer – the Rotterdam Intrinsic Handheld Myometer. However further research is needed to evaluate its reliability and responsiveness and establish the most efficient and psychometrically robust method of evaluating motor function following surgery for CTS.
机译：背景运动功能的客观评估通常用于评估腕管综合症（CTS）的手术治疗结果。但是，使用了一系列结果指标，对于哪种运动功能指标能够有效地捕捉变化并没有达成共识。本系统综述的目的是确定用于CTS手术干预的随机对照试验中评估运动功能的方法。第二个目的是评估哪些仪器能够反映临床变化并且在心理上是可靠的。方法检索书目数据库Medline，AMED和CINAHL，以进行CTS手术干预的随机对照试验。由两名独立的审阅者提取了所用仪器，评估方法和运动功能测试结果的数据。结果共检索到22项研究，包括基于性能的运动功能评估。十九项研究评估了力量握力测功，十四项研究同时使用了力量握力法和捏握力测功，八项研究使用了手动肌肉测试，五项评估了是否存在nar肌萎缩。多项研究使用了多项运动功能测试。两项研究包括力量和捏力，并报告了描述性统计数据，能够计算效应大小以比较研究样本内抓握力和捏力的相对响应度。研究结果表明，在进行CTS手术后的12周内，尖端捏合比横向捏合或力量抓握更具响应性。结论尽管功率和关键收缩测功法使用最频繁且可靠，但并不是评估CTS术后12周运动结局的最有效或反应最快的工具。尖捏测力法更具体地针对鼻肌组织，并且似乎反应更快。如果使用手持式测功机-Rotterdam Intrinsic Handheld Myometer进行评估，则理论上最适合于nar肌的人工肌肉测试可能会更加灵敏。然而，需要进一步的研究来评估其可靠性和响应性，并建立一种最有效和心理上最健壮的方法来评估CTS手术后的运动功能。

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