Validating Ten Test efficacy of sensation in patients with traumatic upper extremity injuries
Erin Weber
Primary Investigator
Brief description of study
What will happen during the study?
This study aims to enhance our understanding of the effectiveness of a noninvasive, simplistic examination for hand sensation to help determine the need for invasive intervention. Hopefully, this will lead to improved quality of care provided for individuals with traumatic nerve injuries to the upper extremity. It has the potential to contribute to advancements in clinical practice, resulting in more favorable outcomes for patients undergoing such treatments
Detailed description of study
What will happen during the study?
Research interactions for this study will involve the recruitment of participants from the hand surgery service. The study will focus on children and adolescents aged 5-17 years, as well as adults over 18 years, who have sustained traumatic injury to the upper extremity with possible nerve injury.
To assess sensibility to the hand light/gentle, moving touch will be applied to both reportedly normal and affected hand. During this process, the examiner will simultaneously lightly stroke both the normal area and its corresponding contralateral (opposite) side, applying equal pressure.
Participants will be actively engaged in the evaluation process by providing subjective ratings of sensibility on a scale of 1 to 10. A rating of 10 will represent normal sensibility, while a rating of 1 will indicate a total lack of sensibility. For each anatomical site, a ratio between 1/10 and 10/10 will be derived from the participant's ratings. These ratios will provide a quantifiable measure of sensibility, enabling a nuanced analysis of the data.
Every patient will be assessed with the standard two-point discrimination test. The two-point discrimination test utilizes a “two-point discriminator” tool that has metal tines evenly spaced at increasing mm distances apart. The patient is asked to identify two distinct points versus one point when applied to their finger. Normal is 5mm. This will serve as a control in order to compare the Ten Test.
For those patients undergoing surgery, the findings of the Ten Test will be correlated with presence or absence of actual nerve injury. This can also be used as a tool to monitor the degree of recovery following nerve repair. Patients who undergo nerve repair will be reassessed with the Ten Test and two-point discrimination at each post op visit until sensation returns to normal or the patient is discharged from regular follow-ups.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Traumatic nerve injury upper extremity
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Age: 5 years - 100 years
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Gender: All
Inclusion criteria
- Children 5 and older and adults greater than or equal to 18 yrs of age.
- English or Spanish speaking adults who are able to consent. (Note: Once English versions of the consents/assents are approved, they will be translated and submitted as an amendment before Spanish speaking subjects are consented.)
- Unilateral traumatic upper extremity injury with suspected nerve involvement
Exclusion criteria
- Patients with a history of peripheral or central neurological abnormalities, seizures, attention-deficit/hyperactivity disorder or congenital hand anomaly will be excluded from the study.
- Any history of a traumatic nerve deficits of the upper extremity
- Bilateral traumatic injury or history of any prior traumatic nerve injury
- Any prior surgery to the spine or upper extremity that resulted in reduced sensation
- Any brachial plexus or C-spine injury
- Any patient who is not able to understand or follow instructions
