Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano / Alterations in dexterity and manual function in patients with focal hand dystonia

Introducción: La distonía focal de la mano es un trastorno del movimiento cuya sintomatología produce una alteración en el desempeño de tareas que requieren un nivel de destreza alto. Actualmente no se dispone de un modelo de interpretación de la enfermedad y son escasos los estudios que identifican las dificultades de las personas con distonía al desempeñar las actividades de la vida diaria (AVD). Por todo ello, el objetivo del estudio es describir la destreza manipulativa y su influencia en las AVD de los pacientes con distonía focal de la mano.Material y métodoSe realizó un estudio observacional, transversal, tipo casos y controles. Se reclutaron 24 participantes: 12 pacientes y 12 sujetos control. Los pacientes fueron derivados por el Servicio de Neurología del Hospital Ramón y Cajal. Se obtuvieron datos sociodemográficos y clínicos retrospectivos en el grupo de casos. Posteriormente, se administraron pruebas de evaluación, en el siguiente orden: Nine Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT) y Jebsen-Taylor Test of Hand Function (JTTHF).ResultadosEn la muestra del estudio participaron un total de 24 personas, siete mujeres y 17 hombres, con una media de edad de 50,79 ± 14,40 años. Del total de participantes con distonía focal se observó que, aunque la mitad de la muestra no identificó signos de afectación neuromuscular, ni problemas psicoemocionales, un menor porcentaje de estos pacientes identificaron dificultades asociadas con el hombro derecho (25%) y el estado ansioso (33,3%).ConclusionesLos hallazgos encontrados en el presente trabajo señalan que la distonía focal de la mano afecta a la destreza manipulativa de estos pacientes, presentando una peor ejecución y requiriendo más tiempo para su ejecución. (AU)

Introduction: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia.Materials and methodsWe performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF).ResultsThe study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%).ConclusionsOur results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks. (AU)

Alterations in dexterity and manual function in patients with focal hand dystonia.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Sensibilidad y dolor en distonías focales de la mano / Sensitivity and pain in focal dystonia of the hand

Introducción: Considerando las evidencias acumuladas actualmente es importante estudiar la fisiopatología tanto sensorial como motora de las distonías focales para comprenderlas y mejorar su tratamiento. Por ello, los objetivos del presente estudio son evaluar las aferencias somatosensoriales de los pacientes con distonía focal o segmentaria con afectación del miembro superior, comprobar si se corresponde con la mano de más uso, analizar la tolerancia al dolor y examinar la posible relación con la percepción del dolor en los pacientes con distonía segmentaria de la mano.MétodosSe contó con una muestra total de 24 participantes: 12 pacientes con distonía focal de la mano y 12 sujetos sin distonía. Todos ellos fueron evaluados con un algómetro electrónico (Somedic AB®, Farsta, Suecia), con los monofilamentos de Semmes-Weinstein y con la escala visual analógica.ResultadosLos datos hallados muestran, en la población estudiada, una mayor afectación en la sensibilidad superficial comparada con el grupo control, tanto en la mano dominante como en la no dominante, así como presencia de dolor (p > 0,001). Además, el grupo de distonía focal obtuvo una correlación negativa entre el dolor percibido y en el umbral de tolerancia de dolor a la presión (rho = −0,83; p < 0,001).ConclusionesLas personas con distonía segmentaria de la mano presentan una alteración en la sensibilidad y manifiestan mayor dolor percibido que las personas sin distonía. Se requieren más estudios con una muestra mayor que detecten las implicaciones clínicas y cotidianas, tanto del dolor objetivo como subjetivo. (AU)

Introduction: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia.MethodsWe recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain.ResultsAccording to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = −0.83; P < .001).ConclusionsPatients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain. (AU)

Sensitivity and pain in focal dystonia of the hand.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = -0.83; P < .001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.

Alterations in dexterity and manual function in patients with focal hand dystonia. / Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Sensitivity and pain in focal dystonia of the hand. / Sensibilidad y dolor en distonías focales de la mano.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P>.001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho=-0.83; P<.001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.