簡易上肢機能検査（ＳＴＥＦ）を用いた頚髄症術前後の上肢運動機能評価

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  • Evaluation of Upper Extremity Functions Using the Simple Test for Evaluating Hand Function (STEF) in Cervical Myelopathy Patients.
  • カンイ ジョウシ キノウ ケンサ STEF オ モチイタ ケイズイショウ ジュツゼン ゴ ノ ジョウシ ウンドウ キノウ ヒョウカ

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The upper extremity functions of 56 cervical myelopathy patients were evaluated using the Simple Test for Evaluating Hand Function (STEF), pre- and post-operatively. The patients were 39 males and 17 females, the average age of them was 56.8 years old, ranging from 35 to 77 years old. The STEF was designed to evaluate upper extremity functions, especially the smoothness of motions objectively and easily in a short time. It consists of 10 subtests, and 10 grades (1-10 points) of each subtest are established in accordance with the time to complete each subtest. Ten subtests are performed with right and left upper extremities respectively. The sum of 10 subtests is 100 points. Post-operative STEF scores were significantly higher than pre-operative scores. The STEF is useful when the effects of operation and rehabilitation are evaluated. Among 10 subtests, the subtest 8, 9, and 10 showed high improvement post-operatively when compared with pre-operatively. Patients who showed low scores could not perform these subtests quickly and sometimes failed to pick up the test objects. These subtests require patients to pinch with the thumb and index finger and the clumsiness of fingers can be quantitatively evaluated by these subtests. The Spearman's rank correlation coefficient between the STEF and the motor dysfunction of the upper extremity of the Japanese Orthopaedic Association (JOA) score was 0.70 (p<0.01) pre-operatively and was 0.55 (p<0.01) post-operatively. The JOA score, the 10 seconds test, and the Finger Escape Sign are commonly used when the upper extremity functions of cervical myelopathy patients are evaluated. The JOA score is easily used, but bilateral upper extremities cannot be evaluated respectively, and different scores are often observed by other examiners. The JOA score is often influenced by the examiner's subjectivity. The 10 seconds test and the Finger Escape Sign are also easily used, but they are not suitable for evaluating functions of the thumb and index finger that are essential for hand functions. When the upper extremity functions of cervical myelopathy patients are evaluated, the STEF's three main merits are objectivity, bilateral upper extremity functions can be evaluated respectively, and the clumsiness of fingers can be quantitatively evaluated by the subtest 8, 9, and 10 that require patients to pinch with the thumb and index finger.

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