過度使用智慧手機會影響手部功能


  【24drs.com】新研究顯示,相較於沒那麼常使用智慧手機者,最常頻繁使用智慧手機的大學生,最可能發生正中神經腫大,手部功能與捏的力量受損。不過,線上發表於6月3日Muscle & Nerve期刊的這篇文章是橫斷面研究,還未充分釐清過度使用智慧手機與腕隧道症候群(carpal tunnel syndrome,CTS)的關聯。
  
  第一作者、土耳其伊斯帕爾塔Suleyman Demirel大學物理醫學與復健系醫學部的Esra Erkol Inal醫師表示,這篇研究結果的實際臨床證據未知,需要後續研究探討智慧手機高度使用者正中神經腫大的臨床證據。
  
  另外,Inal醫師表示,青少年應該知道這些袖珍設備的危險。
  
  研究者指出,手持智慧手機強迫使用者必須反覆進行手腕的彎曲/伸展,使用大拇指打字,這些動作都與腕隧道症候群的病因-病理生理學有關。
  
  這個議題越來越重要,因為有更多年輕人使用智慧手機與其他手持裝置。研究者發現,學生們目前平均一天有3小時以上用他們的手機打字、收發郵件、安排行程、瀏覽網頁。
  
  這篇研究包括了102名大學生,其中66人用單手使用智慧手機,另外36人沒有使用智慧手機。研究者根據他們的智慧手機使用情況將他們分成3組:未使用者、低度使用者、高度使用者。
  
  他們是依據智慧手機成癮量表(Smartphone Addiction Scale,SAS)進行分類,土耳其版的問卷包括33個問題、使用6分量表,分數越高表示智慧手機成癮風險越高。
  
  Inal醫師表示,目前沒有官方的智慧手機成癮診斷準則,但是,根據網路成癮,過度使用智慧手機的定義是,它干擾了使用者的日常生活。有報告指出,智慧手機成癮有許多特徵,例如:耐受、戒斷症候群、全神貫注、情緒失調、渴求、失控。
  
  這篇研究中,學生們的SAS分數是84分(中位數分數)以上者,被視為高度使用者,分數低於84分者被視為低度使用者。
  
  研究者進行許多功能評估。為了評估手部功能,他們使用了「Duruoz Hand Index」這份有18個問題的問卷評估日常活動,包括需要力量和旋轉的動作、需要靈活度和精確度的動作、以及影響前3根手指靈活度的動作,研究對象對進行這些任務的困難度進行排序。
  
  為了評估抓與捏的強度,研究者使用Jamar手部測力計以及捏力計,研究對象盡可能施力擠壓手把、且維持最大握力。
  
  研究者還進行了雙側超音波檢查,在研究對象休息和被動屈曲/伸展時,從縱向和軸向觀察手腕遠端插入點的拇長屈肌(FPL)肌腱,他們也拍攝雙手大拇指的縱向和軸向影像。
  
  使用視覺類比量表(visual analogue scale,VAS),研究對象評比他們的慣用手在前一週時、手休息與手動作的疼痛程度。
  
  研究者發現,智慧手機高度使用者的正中神經比率顯著高於非使用者(P = .022),超音波也顯示各組的拇長屈肌肌腱都有擴大,但是以智慧手機高度使用者最顯著。
  
  Inal醫師指出,這代表過度使用,當檢查頻繁使用智慧手機者的手部時,醫師應注意正中神經與拇長屈肌肌腱。
  
  這篇研究也顯示,視覺類比量表分數與捏力強度有關,智慧手機高度使用者和未使用者動作時的VAS疼痛分數都高於智慧手機低度使用者(P值分別是P = .016和 P > .05)。
  
  Inal醫師指出,大拇指的疼痛隨著SAS分數增加而增加,大拇指過度使用可以解釋大拇指疼痛,也會影響過度使用者的捏力強度。
  
  藉由以雙手使用智慧手機取代單手使用,或許可以預防手腕的重複彎曲/伸展,減少正中神經的腫大;把按鍵設定在智慧手機的頂端也可以減少這些風險。
  
  Inal醫師表示,但是,我們認為,每天使用智慧手機的時間是影響正中神經、捏力強度與手部功能的最重要因素。
  
  資料來源:http://www.24drs.com/
  
  Native link:Smartphone Overuse May Affect Hand Function

Smartphone Overuse May Affect Hand Function

By Pauline Anderson
Medscape Medical News

New research shows that university students who most frequently use a smartphone are more likely to have an enlarged median nerve and to have impaired hand function and pinch strength compared with those who use their smartphones less often.

However, the study, published online June 3 in Muscle & Nerve, was cross-sectional and doesn't yet clearly link heavy smartphone use to carpal tunnel syndrome (CTS).

"The exact clinical relevance of the study findings is not known," said lead author Esra Erkol Inal, MD, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Suleyman Demirel University, Isparta, Turkey. "Future studies are warranted to address the clinical relevance of median nerve enlargement in high smartphone users."

Still, she adds, "Youngsters should be aware of the dangers of these pocket devices," said Dr Inal.

Increasing Use

A hand-held smartphone compels the user to engage in repetitive flexion/extension of the wrist and to use their thumb to text, movements that are involved in the etio-pathophysiology of CTS, the researchers note.

The issue is of increasing importance as more young people use smartphones and other hand-held devices. Research suggests that students now typically spend more than 3 hours a day texting, emailing, scheduling, and browsing the Internet on their mobile phone.

The current study included 102 university students, 66 of whom used a single-hand-held smartphone and 36 of whom didn't use a smartphone. Researchers divided participants into 3 groups according to their level of smartphone use: nonusers, low users, and high users.

They based this use according to the Smartphone Addiction Scale (SAS). The Turkish version of this scale consists of 33 questions rated on a 6-point scale, with higher scores indicating higher risk for smartphone addiction.

There are no official diagnostic criteria for smartphone addiction, but based on Internet addiction, it's defined as the overuse of smartphones to the extent that it disturbs the users' daily lives, said Dr Inal.

"It has been reported that smartphone addiction has many features of addiction, such as tolerance, withdrawal symptoms, preoccupation, mood dysregulation, craving, and loss of control," she noted.

Students in the study with an SAS score of 84 (the median score) or greater were considered high users and those with a score under 84 were considered low users.

Researchers carried out several functional evaluations. To assess hand function, they used the Duruoz Hand Index, an 18-item questionnaire that evaluates daily activities, including those requiring force and rotational motions, those requiring dexterity and precision, and those affecting the flexibility of the first 3 fingers. Participants rated the difficulty in performing these tasks.

To evaluate grip and pinch strength, researchers used a Jamar hand dynamometer and pinch meter while participants squeezed the handle as hard as possible and maintained maximal grip contraction.

Imaging Evaluations

The investigators also carried out bilateral ultrasonography. They observed the longitudinal and axial views of the flexor pollicis longus (FPL) tendon from the distal insertion point to the wrist, at rest and during passive flexion/extension. They imaged bilateral thumb joints axially and longitudinally.

Using a visual analogue scale (VAS), participants rated pain in the dominant hand during the previous week while the hand was at rest and while moving the hand.

The researchers found that the median nerve ratios were significantly higher in participants with high smartphone use compared with nonusers (P = .022). Ultrasonography also showed the enlargement of FPL tendon in all groups, but most markedly in high smartphone users.

This suggests overuse, noted Dr Inal. "Clinicians should be careful about the median nerve and the flexor pollicis longus tendon when examining the hand of someone who is a frequent smartphone user."

The study also showed that SAS scores correlated with pinch strength and that VAS pain in movement was significantly higher among high smartphone users and nonusers than in lower smartphone users (P = .016 and P > .05, respectively).

Pain in the thumb rose with an increase in SAS score, noted Dr Inal. Overuse of the thumb may explain the thumb pain, which could have affected pinch strength in overusers, she said.

It might be possible to prevent the repetitive flexion/extension of the wrist and lessen the enlargement of the medial nerve by using a smartphone with two hands instead of one. Putting the keys at the top of the smartphone may also lessen these risks.

"But we think that duration of daily smartphone use is the most important factor affecting the median nerve, pinch strength, and hand function," said Dr Inal.

Dr Inal has disclosed no relevant financial relationships.

Muscle Nerve. Published online June 3, 2015.

    
相關報導
乳糜瀉增加神經與精神異常風險
2010/1/14 下午 05:10:00
超音波診斷是一項精確且便宜的腕隧道症候群診斷法
2005/7/1 上午 09:16:00

上一頁
   1  
下一頁




回上一頁