Dynamometry of intrinsic hand muscles in CMT patients

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Neurology. 2006 Dec 12;67(11):2022-7.

Dynamometry of intrinsic hand muscles in patients with Charcot-Marie-

Tooth disease.

Selles RW, van Ginneken BT, Schreuders TA, Janssen WG, Stam HJ.

Department of Rehabilitation Medicine, Erasmus MC-University Medical

Center Rotterdam, Rm. h.016, PO Box 2040, 3000 CA Rotterdam, the

Netherlands.

BACKGROUND: Several problems are associated with manual muscle

testing and dynamometry in the hands of patients with Charcot-Marie-

Tooth (CMT) disease.

OBJECTIVE: To evaluate the efficacy of the Rotterdam Intrinsic Hand

Myometer (RIHM) to directly measure intrinsic hand muscle strength

in CMT disease.

METHODS: We measured hand muscle strength and hand function in 41

patients with CMT disease.

RESULTS: RIHM measurement of intrinsic strength had excellent

reliability. We found overlapping RIHM strength values in Medical

Research Council grades 3 to 5. High grip and pinch strength could

be found in patients with severe intrinsic muscle weakness. RIHM

measurements were more strongly correlated with fine motor skills of

the hand than grip and pinch strength.

CONCLUSIONS: The Rotterdam Intrinsic Hand Myometer is a reliable

instrument to measure intrinsic hand muscles strength in patients

with Charcot-Marie-Tooth disease, providing more detailed

information than manual muscle testing and a more direct assessment

of intrinsic muscle loss than grip and pinch dynamometers.