頸椎症性脊髄症におけるPurdue Pegboard Testを用いた巧緻運動障害スクリーニング検査の有用性

Usefulness of the manual dexterity impairment screening test using the Purdue Pegboard Test in cervical spondylotic myelopathy

要旨：本研究の目的は，頸椎症性脊髄症（以下，CSM）患者におけるPurdue Pegboard Test（以下，PPT）を用いた巧緻機能検査の有用性を検討することである．方法は，CSM患者41例の簡易上肢機能検査，PPT，10秒テスト，握力，JOAスコアを評価し，PPTとの関係性を後ろ向きに調査した．また，PPTのカットオフ値を検討した．PPTは各検査と高い相関関係を認め，カットオフ値は25.5（個），AUC＝0.77，感度＝0.96，特異度＝0.56であった．PPTは短時間で行えるCSMの有用な検査と考えられカットオフ値は偽陽性率を考慮した上で巧緻障害のスクリーニングとして活用できることが示唆された.

　This study examined the usefulness of the Purdue Pegboard Test (PPT) for manual dexterity in cervical spondylotic myelopathy (CSM) patients. We investigated the relationship between PPT and other functional evaluations by evaluating the Simple Test for Evaluating Hand Function, the 10-second test, grip strength, and the Japanese Orthopedic Association criteria for cervical myelopathy in 41 patients with CSM. In addition, the PPT cut-off value for manual dexterity was examined. A strong correlation was found between the PPT and other functional evaluations. The cut-off value for discriminating manual dexterity impairment was 25.5 (pieces), AUC=0.77, sensitivity=0.96, and specificity=0.56. PPT is considered to be a useful test for CSM that can be performed in a short time. In addition, although it is necessary to consider the false-positive rate for the cut-off value, the results suggest that it can be used as a screening test in CSM patients.