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Voluntary muscle testing and dynamometry in diagnosis of motor impairment in leprosy: a comparative study within the INFIR Cohort Study.
Lepr Rev. 2008 Sep; 79(3):277-94.LR

Abstract

AIM

To evaluate hand muscle weakness detected through dynamometry as an indicator for change in motor nerve function detected by Voluntary Muscle Testing (VMT) of ulnar and median nerves.

DESIGN

The research was carried out as part of the INFIR Cohort Study among 303 subjects newly diagnosed with MB leprosy in two centres in UP state, northern India.

METHODS

To assess grip strength, key pinch and pulp-to-pulp pinch we adapted the cuffs of adult and neonatal sphygmomanometers. The testing was carried out at diagnosis and at each visit during a 2-year follow-up.

RESULTS

303 subjects with newly diagnosed MB leprosy were included in the study. We found statistically significant differences in grip strength, key pinch and pulp-to-pulp pinch between groups defined by ulnar VMT grades at time of diagnosis. There was also a statistically significant difference in hand grip between groups defined by median VMT at diagnosis. In each case, strength tended to reduce with increasing motor involvement. We explored reduction in grip strength, key pinch or pulp-to-pulp pinch as indicators of change in ulnar VMT during follow-up. A 25% reduction over two visits was the most effective indicator. Changes were also associated with marginal changes in motor and sensory nerve function, most commonly associated with Type I reactions.

CONCLUSION

Dynamometry is recommended as an additional method that may be used to monitor changes in nerve function in leprosy, particularly in subjects with early motor impairment of the ulnar nerve.

Authors+Show Affiliations

The Leprosy Mission Hospital, Purulia, West Bengal, India.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19009977

Citation

Suresh, M, et al. "Voluntary Muscle Testing and Dynamometry in Diagnosis of Motor Impairment in Leprosy: a Comparative Study Within the INFIR Cohort Study." Leprosy Review, vol. 79, no. 3, 2008, pp. 277-94.
Suresh M, Nicholls PG, Das L, et al. Voluntary muscle testing and dynamometry in diagnosis of motor impairment in leprosy: a comparative study within the INFIR Cohort Study. Lepr Rev. 2008;79(3):277-94.
Suresh, M., Nicholls, P. G., Das, L., & Van Brakel, W. H. (2008). Voluntary muscle testing and dynamometry in diagnosis of motor impairment in leprosy: a comparative study within the INFIR Cohort Study. Leprosy Review, 79(3), 277-94.
Suresh M, et al. Voluntary Muscle Testing and Dynamometry in Diagnosis of Motor Impairment in Leprosy: a Comparative Study Within the INFIR Cohort Study. Lepr Rev. 2008;79(3):277-94. PubMed PMID: 19009977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voluntary muscle testing and dynamometry in diagnosis of motor impairment in leprosy: a comparative study within the INFIR Cohort Study. AU - Suresh,M, AU - Nicholls,Peter G, AU - Das,Loretta, AU - Van Brakel,Wim H, PY - 2008/11/18/pubmed PY - 2008/12/17/medline PY - 2008/11/18/entrez SP - 277 EP - 94 JF - Leprosy review JO - Lepr Rev VL - 79 IS - 3 N2 - AIM: To evaluate hand muscle weakness detected through dynamometry as an indicator for change in motor nerve function detected by Voluntary Muscle Testing (VMT) of ulnar and median nerves. DESIGN: The research was carried out as part of the INFIR Cohort Study among 303 subjects newly diagnosed with MB leprosy in two centres in UP state, northern India. METHODS: To assess grip strength, key pinch and pulp-to-pulp pinch we adapted the cuffs of adult and neonatal sphygmomanometers. The testing was carried out at diagnosis and at each visit during a 2-year follow-up. RESULTS: 303 subjects with newly diagnosed MB leprosy were included in the study. We found statistically significant differences in grip strength, key pinch and pulp-to-pulp pinch between groups defined by ulnar VMT grades at time of diagnosis. There was also a statistically significant difference in hand grip between groups defined by median VMT at diagnosis. In each case, strength tended to reduce with increasing motor involvement. We explored reduction in grip strength, key pinch or pulp-to-pulp pinch as indicators of change in ulnar VMT during follow-up. A 25% reduction over two visits was the most effective indicator. Changes were also associated with marginal changes in motor and sensory nerve function, most commonly associated with Type I reactions. CONCLUSION: Dynamometry is recommended as an additional method that may be used to monitor changes in nerve function in leprosy, particularly in subjects with early motor impairment of the ulnar nerve. SN - 0305-7518 UR - https://www.unboundmedicine.com/medline/citation/19009977/Voluntary_muscle_testing_and_dynamometry_in_diagnosis_of_motor_impairment_in_leprosy:_a_comparative_study_within_the_INFIR_Cohort_Study_ L2 - https://medlineplus.gov/mycobacterialinfections.html DB - PRIME DP - Unbound Medicine ER -