Handgrip impairment in Charcot-Marie-Tooth disease

October 4, 2005

Eura Medicophys. 2005 Jun;41(2):131-4.

Handgrip impairment in Charcot-Marie-Tooth disease.

Vinci P, Villa LM, Castagnoli L, Marconi C, Lattanzi A, Manini MP,

Calicchio ML, Vitangeli L, Di Gianvito P, Perelli SL, i D.

U.O.C. di Medicina Fisica e Riabilitazione, Ospedale Spolverini,

Ariccia (Roma).

AIM: Charcot-Marie-Tooth disease (CMT) is a genetic neuropathy

causing muscle weakening in the feet, legs and hands, with consequent

impairment of ambulation and handgrip. For fast clinical evaluation

and rehabilitation management of handgrip deficits, a functional

classification in 4 stages or levels of clinical severity, based on

the loss of handgrip types from the finest to the roughest, has been

recently proposed. The aim of this study is to evaluate the

prevalence of each level of handgrip impairment in a wide population

of patients affected with demyelinating and axonal CMT.

METHODS: Two-hundred and forty-eight non-operated hands were examined

to evaluate if and how the pinch between the pulp of the thumb and

the pulp of the second or third finger was made, starting from the

palm-up position with the fingers abducted or, in case of

impossibility to do so, if a lateral pinch or only a grasp was

possible. Following to this observation, each hand was fitted in 1 of

the 4 stages described in the above-mentioned classification and then

the frequency of each stage was determined.

RESULTS: As a whole, 75.4% hands were at stage 1; 9.7 were at stage

2; 10.9% at stage 3; 4% at stage 4.

CONCLUSIONS: The results of this survey reveal that, in the majority

of the CMT cases, handgrip is affected mildly so that only simple

recommendations to prevent further muscle and joint damage are

required; however, in more than 1 out 5 cases, the handrip impairment

is quite severe and requires a detailed rehabilitative program with

daily exercises, and, in a small number of cases, is so severe that

independence in the daily living activities is lost or very reduced.

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