Chen Liheng, Ogalo Emmanuel, Haldane Chloe, Bristol Sean G, Berger Michael J
MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia.
International Collaboration on Repair Discoveries, Vancouver, British Columbia.
Arch Rehabil Res Clin Transl. 2021 Sep 20;3(4):100159. doi: 10.1016/j.arrct.2021.100159. eCollection 2021 Dec.
To investigate which tests of hand sensibility correlate with functional outcomes in patients with upper limb traumatic nerve injuries and to assess if composite scales of sensibility correlate with functions.
MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched in May 2020, with a supplementary search in July 2020. Reference lists of the included publications were hand searched.
Database search found 2437 records. Eligible studies reported on inferential association between sensibility tests and functions pertaining to adults after upper limb nerve repair. Two reviewers independently assessed eligibility. Fifteen publications were included.
Extracted data contain patient characteristics, surgical procedure, follow-up duration, sensibility tests, and functional assessments. Two reviewers independently assessed data quality.
Fifteen publications involving 849 patients were reviewed. All publications reported on median and/or ulnar nerve injuries. Monofilament tests correlated with Short-Form Health Survey (=0.548, <.05), pick-up test (=0.45, <.05), and function domain of Patient-Rated Wrist and Hand Evaluation Questionnaire (PRWHE) (=0.58, <.05). The 8 studies of static and moving 2-point discrimination provided conflicting correlations with activities of daily living (ADL) and/or the pick-up test. Data for area localization and object/shape identification were equivocal as well. No data were found for Ten test and vibration tests. Rosén score sensory domain correlated with ADL (=0.59; 95% confidence interval [CI], 0.41-0.72) and PRWHE function domain (=-0.56, <.05). Medical Research Council sensory scale was related to pick-up test; return to work status; and Disabilities of the Arm, Shoulder, and Hand questionnaire.
Monofilament tests allow practitioners to gather sensibility data meaningful to patients' overall recovery of functions after upper limb nerve trauma. For 2-point discrimination and other sensibility tests, practitioners should be aware that improvement in test performance does not necessarily translate to improved hand function. Findings from the composite scales indicate that hand sensibility, in general, is related to functions. Future research on other common sensibility tests is recommended to explore how the test relates to patients' functions.
探讨哪些手部感觉测试与上肢创伤性神经损伤患者的功能结局相关，并评估感觉综合量表是否与功能相关。
于2020年5月检索了MEDLINE、Embase和Cochrane对照试验中央注册库，并于2020年7月进行了补充检索。对纳入出版物的参考文献列表进行了手工检索。
数据库检索发现2437条记录。符合条件的研究报告了上肢神经修复后成人感觉测试与功能之间的推断关联。两名评审员独立评估入选资格。纳入了15篇出版物。
提取的数据包括患者特征、手术过程、随访时间、感觉测试和功能评估。两名评审员独立评估数据质量。
对涉及849例患者的15篇出版物进行了综述。所有出版物均报告了正中神经和/或尺神经损伤。单丝试验与简明健康调查相关（=0.548，<.05）、拾物试验（=0.45，<.05）以及患者自评腕手评估问卷（PRWHE）的功能领域相关（=0.58，<.05）。8项关于静态和动态两点辨别试验的研究与日常生活活动（ADL）和/或拾物试验的相关性存在冲突。区域定位以及物体/形状识别的数据也不明确。未找到关于Ten试验和振动试验的数据。罗森评分感觉领域与ADL相关（=0.59；95%置信区间[CI]，0.41 - 0.72）以及PRWHE功能领域相关（=-0.56，<.05）。医学研究委员会感觉量表与拾物试验、重返工作状态以及手臂、肩部和手部残疾问卷相关。
单丝试验使从业者能够收集对上肢神经创伤后患者功能全面恢复有意义的感觉数据。对于两点辨别试验和其他感觉测试，从业者应意识到测试表现的改善不一定转化为手部功能的改善。综合量表的结果表明，一般来说，手部感觉与功能相关。建议未来对其他常见感觉测试进行研究，以探索测试与患者功能的关系。
