手根管症候群において手関節肢位が手指の圧覚閾値に及ぼす影響

The influence of wrist position on pressure threshold in patients with carpal tunnel syndrome

要旨：健常手26手，手根管症候群罹患手5手を対象に，手関節肢位が示指の圧覚閾値にどのような影響を及ぼすのか調査した．圧覚閾値の測定にはDellonらによって開発されたPressure-Specified-Sensory-Deviceを用いた．結果，健常手の圧覚閾値は通常肢位1.3±0.3gm/mm²(mean±SD)，掌屈1分後1.2±0.4gm/mm²，3分後1.2±0.4gm/mm²，5分後1.2±0.4gm/mm²であり，条件間に統計学的有意差は認められなかった．一方罹患手の全てで，手関節掌屈によって，健常手とは異なる傾向で閾値の上昇が認められた．このことからこの方法は手根管症候群への客観的な症状誘発検査として利用できる可能性が期待された．

　This study investigated the influence of wrist position on pressure threshold for the index finger in 26 normal hands and 5 hands with carpal tunnel syndrom. Pressure threshold was measured with the Pressure-Specified-Sensory-Device that had been developed by Dellon, et al. In normal hands, the mean value (±SD) was 1.3±0.3gm/mm² at wrist-neutral position. When the measurement was performed at wrist-flexed position, the values were 1.2 ± 0.4, 1.2±0.4 and 1.2±0.4gm/mm², one minute, three minutes, and five minutes after flexion respectively. There was no significant difference between the four conditions. In all of the affected hands, the values were observed to increase after flexion with different a trend from the normal hands. It was expected that this procedure could be applied to a provocative test to specify objectively in carpal tunnel syndrome.