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Manual Tactile Test Predicts Sensorimotor Control Capability of Hands for Patients With Peripheral Nerve Injury

  • Hsiu-Yun Hsu
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
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  • Shyh-Jou Shieh
    Affiliations
    Section of Plastic Surgery, Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Ta-Shen Kuan
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Hsiu-Ching Yang
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Fong-Chin Su
    Affiliations
    Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan

    Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
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  • Haw-Yen Chiu
    Affiliations
    Section of Plastic Surgery, Department of Surgery, ChiMei Medical Center, Tainan, Taiwan
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  • Li-Chieh Kuo
    Correspondence
    Corresponding author Li-Chieh Kuo, PhD, Department of Occupational Therapy, National Cheng Kung University, 1 University Rd, Tainan, 701 Taiwan.
    Affiliations
    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
Published:January 29, 2016DOI:https://doi.org/10.1016/j.apmr.2016.01.008

      Abstract

      Objectives

      To comprehend the merits of a Manual Tactile Test (MTT) in assessing hand sensorimotor functions by exploring the relations among 3 subtests along with the precision pinch performances for patients with peripheral nerve injuries (PNIs); and to understand the accuracy of the MTT by constructing the sensitivity and specificity of the test for patients with PNI.

      Design

      Case-control study.

      Setting

      Hospital and local community.

      Participants

      Patients with PNI (n=28) were recruited along with age-, sex-, and handedness-matched healthy controls (n=28) (N=56).

      Interventions

      Not applicable.

      Main Outcome Measures

      The Semmes-Weinstein monofilament, moving and static 2-point discrimination, roughness differentiation, stereognosis and barognosis subtests of the MTT, and precision pinch performance were used to examine the sensory and sensorimotor status of the hand.

      Results

      The worst results in all sensibility tests were found for the patients with PNI (P<.001) in comparison with the controls. Multiple linear regression analysis showed the MTT was a better indicator for predicting the sensorimotor capacity of hands in the patients with PNI (r2=.189, P=.003) than the traditional test (r2=.088, P=.051). The results of the receiver operating characteristic curve estimation show that the area under the curve was .968 and .959 for the roughness differentiation and stereognosis subtests, respectively, and .853 for the barognosis subtest, therefore revealing the accuracy of the MTT in assessing sensorimotor status for patients with PNI.

      Conclusions

      This study indicates that the MTT is highly accurate and a significant predictor of sensorimotor performance in hands of patients with PNI. The MTT could therefore help clinicians obtain a better understanding of the sensorimotor and functional status of the hand with nerve injuries.

      Keywords

      List of abbreviations:

      AUC (area under the curve), M2PD (moving 2-point discrimination), MTT (Manual Tactile Test), PHUA (pinch-holding-up activity), PNI (peripheral nerve injury), ROC (receiver operating characteristic), S2PD (static 2-point discrimination), SWM (Semmes-Weinstein monofilament examination)
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