Article

PURPOSE: To investigate the effects of a hand-training programme on grip, pinch
and wrist force, manual dexterity and activities of daily living, in adults with
myotonic dystrophy type 1 (DM1). METHOD: In this randomised controlled trial with
a crossover design, 35 adults with DM1 were, after stratification for grip force,
assigned by lot to two groups. Group A started with 12 weeks of hand training,
while group B had no intervention. After a wash-out period of 12 weeks, where
none received training, the order was reversed.
The Grippit(R) was used as
primary outcome measure and the hand-held Microfet2 myometer, the Purdue
Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment
of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments
were performed before and after training and control periods, i.e. four times
altogether. RESULTS: Ten persons dropped out and 13 had acceptable adherence.
Intention-to-treat analyses revealed significant intervention effects for
isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047)
and satisfaction (p = 0.027). On an individual level, improvements were in
general showed after a training period. Conclusion: The hand-training programme
had positive effects on wrist flexor force and self-perception of occupational
performance, and of satisfaction with performance. No evident detrimental effects
were shown. IMPLICATIONS FOR REHABILITATION: Myotonic dystrophy type 1 (DM1) is a
slowly progressive neuromuscular disease characterised by myotonia and muscle
weakness and wasting. People with DM1 are often concerned about their ability to
carry out ADL and to participate in, e.g. work, sports and hobbies when they
gradually become weaker. This pilot study showed that a hand-training programme
improved wrist flexor force and self-perception and satisfaction of occupational
performance. Resistance training of hand muscles with a silicon-based putty can
be a therapy option for people with DM1 in clinical practise.

Langue : ANGLAIS