METHODS: The Beighton scoring system (≥4) was used to diagnose GJH in 84 HD patients. All patients underwent assessments of cervical-flexion/extension ROM; motor unit number estimation in bilateral abductor pollicis brevis (APB) muscles; handgrip strength; and the disabilities of the arm, shoulder, and hand assessments.
RESULTS: Concomitant GJH was identified in 20 (23.8%) HD patients. The HD patients with GJH exhibited greater cervical-flexion (P < .001) and cervical-extension (P = .033) ROM than those without GJH. Both greater single motor unit potential amplitudes (symptomatic side: P = .005; less-symptomatic side: P = .011) and lower motor unit numbers (symptomatic side: P = .008; less-symptomatic side: P = .013) in bilateral APB, along with lower compound muscle action potential amplitudes on the symptomatic-side APB (P = .039), were observed in patients with GJH than those without GJH. There was a mild negative correlation between motor unit number and cervical-flexion ROM in HD patients (symptomatic side: r = -0.239, P = .028; less-symptomatic side: r = -0.242, P = .027).
CONCLUSIONS: The frequency of GJH in HD patients may be higher than in the general population. Importantly, GJH may exacerbate excessive cervical-flexion ROM, thereby worsening motor unit loss in HD patients. A cautious approach should be taken when treating HD due to possible comorbid GJH.
方法:采用Beighton评分系统(≥4)诊断84例HD患者的GJH。所有患者都接受了颈椎屈曲/伸展ROM的评估;双侧短外展肌(APB)肌肉的运动单位数估计;握力;和手臂的残疾,肩膀,手评估。
结果:在20例(23.8%)HD患者中发现合并GJH。与没有GJH的HD患者相比,GJH的HD患者表现出更大的颈椎屈曲(P<.001)和颈椎伸展(P=.033)ROM。双侧APB中较大的单个运动单位电位幅度(症状侧:P=.005;症状较小侧:P=.011)和较低的运动单位数量(症状侧:P=.008;症状较小侧:P=.013),随着较低的复合肌肉动作电位振幅在症状侧APB(P=0.039),在患有GJH的患者中观察到比没有GJH的患者。HD患者的运动单位数与颈屈曲ROM之间存在轻度负相关(症状侧:r=-0.239,P=.028;症状侧:r=-0.242,P=.027)。
结论:HD患者中GJH的频率可能高于一般人群。重要的是,GJH可能会加剧过度的颈屈曲ROM,从而加重HD患者的运动单位损失。由于GJH可能合并症,治疗HD时应采取谨慎的方法。