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Sensory Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Two-point discrimination, localization and the Moberg pick-up test are functional tests to assess sensation quality [9]. The function test helps find prevention, daily living activities recognizing and manipulating objects with vision occluded. Two-point discrimination is the ability to distinguish two points simultaneously applied to the skin and most helpful in the fingertips to quickly test normal versus abnormal sensation. The normal minimal distance is 3 cm for the hand or foot. With the patient's eyes closed, the examiner uses a pair of measured callipers or a bent paperclip to randomly touch the patient with either one or two points and indicate whether one or two points are perceived. Always compare the test with the opposite sides of the body. The following are the normal distances at which two points can be discriminated on various body parts:
Examination of Pediatric Hand and Wrist
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Mohsina Subair, Satyaswarup Tripathy, Ranjit Kumar Sahu
Static two-point discrimination: the two points are applied simultaneously, starting with 15 mm and sequentially brought together. The least distance the patient is able to discriminate is the measured value.5,8
Impairment of functions of the nervous system
Published in Ramar Sabapathi Vinayagam, Integrated Evaluation of Disability, 2019
Cortical sensation consists of stereognosis, “Two-Point” discrimination, and graphesthesia. Stereognosis refers to the ability of a person to recognize known objects, such as a coin, key, or pen, with their eyes closed. Astereognosis indicates the inability of a person to recognize objects by touch sensation with the eyes closed. “Two-Point” discrimination represents the ability to perceive the double stimuli applied simultaneously by a pair of calipers with blunt ends. If the person is unable to discriminate and recognize two points, they are deemed to have an impairment of “Two-Point” discrimination. In graphesthesia, a person can recognize either the alphabet or numbers written on their skin by the perception of touch (Tables 6.36 through 6.38).
Clinical effects of resurfacing fingertip amputations in long fingers using homodigital dorsal neurofascial broaden pedicle island flaps
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Zhongqing Ji, Rongjun Nie, Shiyan Li, Chuancheng Liu, Bin Wei, Chunyong Zhu
Mean Semmes Weinstein monofilament score in the flap was 3.89 ± 0.37 g (range: 3.6–4.56 g, contralateral side 3.18 ± 0.39 g, range: 2.83–3.61 g, p < 0.05). Mean Semmes Weinstein monofilament score at the donor site was 3.22 ± 0.40 g (range: 2.83–3.61 g) (contralateral side 3.00 ± 0.33 g, range 2.83–3.61 g, p < 0.05). Mean values for static two-point discrimination in the flap was 5.6 ± 1.2 mm (range: 4–8 mm), including 9 excellent and 9 good results (contralateral side: 3.7 ± 0.8 mm, range: 3–5 mm, p < 0.05). Mean values of the static two-point discrimination in the donor zone was 4.3 ± 0.6 mm (range: 4–6 mm), including 17 excellent and 1 good results (contralateral side. 3.6 ± 0.6 mm, range 3–5 mm, p > 0.05). Mean quick dash scores was 5.81 (range: 0–20). Mean VAS score in the flap and donor site was 0.7 (range: 0–4) and 0.2 (range: 0–2) (Table 3).
Comparison of reliability and efficiency of two modified two-point discrimination tests and two-point estimation tactile acuity test
Published in Physiotherapy Theory and Practice, 2022
Kory Zimney, Gina Dendinger, Macey Engel, Jordan Mitzel
Two-point discrimination (TPD) testing is a cutaneous sensory assessment that measures the tactile acuity of an individual to distinguish between two light touch stimuli applied simultaneously to the body (Nolan, 1982). TPD has been used to objectively evaluate sensory deficits and recovery of touch following peripheral nerve injury or surgery (Lundborg and Rosén, 2004; Moberg, 1990). A tactile acuity measurement, like TPD, was originally thought to be based solely on changes in peripheral nerve innervation density in the area being tested following peripheral nerve injury (Johansson and Vallbo, 1979; Lundborg and Rosén, 2004). Subsequent research and understanding of tactile acuity has been expanded to include not only the function of peripheral nerve innervation fields, but also the somatotopic organization through the spinal cord pathways and into the sensory cortices of the brain (Lotze and Moseley, 2007; Yang et al, 1994). This helps explain why some individuals can have changes in their tactile acuity without any history of peripheral nerve damage.
Lifetime vibration dose correlates with severity of the neurological component of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia
Published in International Journal of Occupational Safety and Ergonomics, 2021
Asraf Ahmad Qamruddin, Nik Rosmawati Nik Husain, Muhd Yusof Sidek, Muhd Hafiz Hanafi, Zaidi Mohd Ripin, Nizam Ali
In the second phase of data collection, all subjects were invited to Hospital Universiti Sains Malaysia in Kelantan, Malaysia. Three specific hand function assessments were carried out: the Purdue pegboard test (Lafayette, USA) for hand dexterity examination, the Semmes-Weinstein monofilament test (Stoelting, USA) for finger sensation measurement and the two-point discrimination test (McKesson, USA) for tactile discrimination measurement. For the Purdue pegboard test, the discrimination threshold for an abnormal finding was 1 SD below the normative population mean for male maintenance and service employee data (15.49 for right hand, 15.25 for left hand, 12.31 for both hands, 43.04 for right + left + both and 38.71 for assembly) [16]. The Semmes-Weinstein monofilament test was recorded as abnormal if the subject’s threshold response was 3.61 mm and above [17]. For the two-point discrimination test, any value at and above 6 mm was recorded as abnormal [17]. The severity of the neurological component of HAVS was then staged according to the Stockholm workshop scale criteria. The LVD (m2 h3 s−4) was then calculated according to the equation [18]: ahv = total vibration value for the impact wrench; thi is the daily vibration exposure duration of each subject (h/day); tdi is the number of working days/year for each subject; tyi is the total number of years of use for each subject.