The hypothesis of overwork weakness in CMT: a critical evaluation

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J Rehabil Med. 2009 Jan;41(1):32-4.

The hypothesis of overwork weakness in Charcot-Marie-Tooth: a

critical evaluation.

van Pomeren M, Selles RW, van Ginneken BT, Schreuders TA, Janssen WG,

Stam HJ.

Department of Rehabilitation, Erasmus MC, University Medical Center

Rotterdam, Rotterdam, The Netherlands.

OBJECTIVE: It has been reported that the non-dominant hand of

patients with Charcot-Marie-Tooth disease is stronger than the

dominant hand as a result of overwork weakness. The objective of this

study was to determine if this hypothesis could be verified in our

population.

DESIGN: Survey.

SUBJECTS: Twenty-eight patients with Charcot-Marie-Tooth disease type

I or II from a rehabilitation department of a university hospital in

the Netherlands.

METHODS: The strength of 3 intrinsic muscle groups of the dominant

and non-dominant hand were determined using the Medical Research

Council scale and the Rotterdam Intrinsic Hand Myometer. Furthermore,

grip strength, pinch and key grip strength were measured.

RESULTS: We found no differences in muscle strength for the dominant

and non-dominant hand, except for a stronger key grip strength of the

dominant hand in patients with Charcot-Marie-Tooth disease type II.

CONCLUSION: In our population, the dominant hand of patients with

Charcot-Marie-Tooth disease type I and II was equally strong as the

non-dominant hand, suggesting that there is no presence of overwork

weakness in the dominant hand in our group of patients. This implies

that patients with Charcot-Marie-Tooth disease do not have to limit

the use of their hands in daily life in order to prevent muscle

strength loss.