Flodmark B T, Lundborg G
Svedala-Skuruphälsan AB, Svedala, Sweden.
Occup Environ Med. 1997 Dec;54(12):880-7. doi: 10.1136/oem.54.12.880.
To study whether vibrotactile sense combined with questionnaires (subjective complaints) and a clinical examination (including scoring of the Stockholm workshop scale (sensorineural staging)) could serve as a screening procedure, in the health care service, for sensorineural symptoms. A group of blue collar workers exposed to vibration in a manufacturing industry (rock crushing plants) was used as the study group. Another group of workers not exposed to vibration but subjected to heavy manual work served as the control group.
Vibrotactile sense was determined. The index and the little fingers of both hands were investigated. A clinical examination was performed. Questionnaires were used for exposure data and for assessment of symptoms.
Important findings were that impairment in vibrotactile sense correlated with impairment in grip force, cold sensitivity, and other sensorineural symptoms--such as numbness and tendency to drop items. Clinical findings such as Phalen's test and two point discrimination were related only in those workers with the poorest vibrotactile sense. There was a relation between vibrotactile sense and the Stockholm workshop scale (sensorineural staging) for the sensorineural symptoms. Muscle and joint problems were more often seen in workers with decreased vibrotactile sense.
Tactilometry for assessment of vibrotactile sense is a useful tool in assessing and evaluating the severity of vibration induced neuromuscular symptoms and verifying the patients' clinical complaints. Heavy manual work without exposure to vibration may contribute to impairment of vibrotactile sense. The relation between impairment in vibrotactile sense and grip strength indicates that impaired sensory feedback may contribute to muscle weakness.
研究在医疗保健服务中,振动触觉感知结合问卷调查(主观症状)和临床检查(包括斯德哥尔摩研讨会量表评分(感觉神经分期))是否可作为感觉神经症状的筛查方法。以制造业(碎石厂)中接触振动的一组蓝领工人作为研究组。另一组未接触振动但从事重体力劳动的工人作为对照组。
测定振动触觉感知。对双手的食指和小指进行检查。进行临床检查。使用问卷收集暴露数据并评估症状。
重要发现是,振动触觉感知受损与握力受损、冷敏感性以及其他感觉神经症状(如麻木和物品掉落倾向)相关。诸如Phalen试验和两点辨别觉等临床检查结果仅在振动触觉感知最差的工人中有关联。振动触觉感知与感觉神经症状的斯德哥尔摩研讨会量表(感觉神经分期)之间存在关联。振动触觉感知下降的工人中肌肉和关节问题更为常见。
用于评估振动触觉感知的触觉测量法是评估和评价振动引起的神经肌肉症状严重程度以及核实患者临床症状的有用工具。未接触振动的重体力劳动可能导致振动触觉感知受损。振动触觉感知受损与握力之间的关联表明,感觉反馈受损可能导致肌肉无力。