Sensorimotor recovery Surgery Hand surgery
Conditions
Interventions
The plastic surgeons at UHB have agreed to identify and refer patients directly to the key members of the project (Sue Beale, Clinical Specialist Occupational Therapist, Upper Limb Unit (ULU), Carolin
Sponsors
Record Provided by the NHSTCT Register - 2007 Update - Department of Health
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Each participant must have experienced a surgical repair of a median and/or ulnar nerve lesion 2. They must have a good understanding of the English language or have an interpreter present, as many of the measurements involve detailed instructions
Exclusion criteria
Exclusion criteria: 1. Extensive tissue loss within the forearm and or hand 2. Subjects who are currently prescribed medication for psychiatric illness 3. Communication difficulties where the subject may be unable to provide reliable understanding of: 3.1. Verbal instructions 3.2. Written instructions 3.3. Verbal responses 3.4. Written responses The methods of testing used within this study require complex verbal instruction, therefore language impairments may confound any results of the investigation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Tactile sensation, measured by: 1.1. Touch detection threshold test - Monofilaments. This is composed of lucite rods within nylon threads which bend at a certain force when applied against the skin. This will provide a sensory map of the hand. 1.2. Tactile gnosis - Shape and Texture Identification test (STI). This requires participants to identify 3 shapes and 3 textures in three different sizes without visual input. A participants ability to recognise patterns provides an awareness of their spatial acuity. In the absence of a sophisticated test for texture, the above may be replaced with alternatives as experiments are devised by "The Artificial Finger" project being conducted at The Dept of Psychology, University of Birmingham. 1.3. Finger Proprioception - the ability to sense the position of the fingers will be measured by asking participants to judge the relative size of pairs of cubes, held consecutively between fingers and thumb of the impaired hand. By systematically reducing the size difference between the pairs of cubes, the point at which differences between the cubes begin to be reliably discriminated, will be measured as an index of finger proprioception. 2. Motor control, measured by: 2.1. Mid-pronation grasp - Jamar dynamometer is a sealed hydraulic mechanism that registers force in pounds/kg's and is deemed the most reliable of the tools available to measure the pressure of grip 2.2. Pincer grip - Preston pinch gauge - a pneumatic instrument that depends on compression of air by means of a rubber bulb. 2.3. Grip force - participants will be asked to hold an object between their index and thumb whilst varying loads are applied. Force transducers attached to the object will measure the forces applied by the grasping hand, together with the load forces created by the mass of the object. The participants' ability to modify their grip of the o | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Function, measured by the nine hole peg test. This is a commercially available test (Smith and Nephew Rehabilitation Division). This consists of a plastic console with a shallow round dish to contain the pegs. The participants will be asked to perform the task of removing the nine pegs from nine holes spaced equally along the console and place them into the dish. The participants are timed from the moment they touch the first peg until the last peg hits the dish. 2. Sollerman Hand Function Test: participants are requested to complete tasks 4, 8 and 10, pick up coins from a flat surface and place in a purse, pick up nuts and do up buttons respectively | — |
Countries
United Kingdom
Outcome results
None listed