Article

The aim of this study was to validate direct tendon palpation during agonist
contraction and antagonist co-contraction as a method to assess wrist flexor and
extensor muscle function in cases of upper limb paralysis.
On one occasion, five
doctors examined 17 patients with partial paralysis of the upper limb resulting
from brachial plexus or cervical spinal cord injury.
We asked examiners to
determine if the extensor carpi radialis longus (ECRL), extensor carpi radialis
brevis (ECRB), extensor carpi ulnaris (ECU), flexor carpi radialis (FCR), flexor
carpi ulnaris (FCU) and palmaris longus (PL) were paralyzed, weak or strong in
each patient. Examiners tested flexion - extension and radial - ulnar deviation
against resistance and palpated wrist motor tendons. While palpating tendons,
co-contractions were encouraged by soliciting finger extension to evaluate the
FCU, thumb extension to evaluate the ECU, and finger flexion to evaluate the
ECRB. Kappa values were 0.8 for the ECRL, 0.7 for the ECRB, 0.5 for the ECU, 0.8
for the FCR, 0.6 for the PL,
and 0.8 for the FCU, indicating moderate to almost
perfect agreement between examiners. Tendon palpation during muscle examination
was adequate to identify complete paralysis, as well as weak and strong muscle
contractions. This assessment helps to identify muscles that could be used during
nerve or tendon transfer for reconstruction of extensive upper limb paralysis.
CI - Copyright (c) 2015 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS