A gap detection tactility test for sensory deficits associated with carpal tunnel syndrome. 1995

O J Jeng, and R G Radwin
University of Wisconsin-Madison 53706, USA.

An automated gap detection tactility test was investigated for quantifying sensory deficits associated with carpal tunnel syndrome (CTS). The test, which involved sensing a tiny gap in an otherwise smooth surface by probing with the finger, had functional resemblance to many work-related tactile activities such as detecting scratches or surface defects. Gap detection thresholds were measured using the converging staircase method of limits paradigm. Sixteen normal subjects between 21 and 66 years of age were tested for studying important factors affecting gap detection thresholds. Actively probing with the index finger had a threshold almost an order of magnitude more sensitive (mean = 0.19 mm, SD = 0.11 mm) than passive touch (mean = 1.63 mm, SD = 0.62 mm), which was similar to two-point discrimination. Average thresholds decreased by 24% as contact force increased from 25 to 75 g. Performance in this tactility test quickly stabilized and showed little learning effects over the period of the test, as evidenced by the lack of significant differences between six replicates. The results were highly repeatable. No significant threshold differences were observed between test and retest trials on different days, or between dominant and non-dominant hands. A contact force of 50 g was recommended as optimal for this test since it required moderate force but resulted in a smaller threshold compared with 25 or 75 g. A companion study was conducted using eight normal subjects and ten subjects diagnosed as having CTS. Average gap detection threshold, when finger probing was allowed, was 0.20 mm (SD = 0.11 min) for the normal subjects and increased two-fold to 0.40 mm (SD = 0.19 mm) for the CTS subjects. Average gap detection threshold, when the finger probing was not allowed, was 1.71 mm (SD = 0.53 mm) for the normal subjects and increased by 48% to 2.53 mm (SD = 0.87 mm) for the CTS subjects. The results suggest that people suffering from CTS may experience similar functional deficits in daily living and work activities. The small inter-subject variability makes this test a candidate for having utility as a monitoring test for loss of cutaneous tactile sensitivity.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D002349 Carpal Tunnel Syndrome Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45) Compression Neuropathy, Carpal Tunnel,Entrapment Neuropathy, Carpal Tunnel,Amyotrophy, Thenar, Of Carpal Origin,Median Neuropathy, Carpal Tunnel,Carpal Tunnel Syndromes,Syndrome, Carpal Tunnel,Syndromes, Carpal Tunnel
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012678 Sensation Disorders Disorders of the special senses (i.e., VISION; HEARING; TASTE; and SMELL) or somatosensory system (i.e., afferent components of the PERIPHERAL NERVOUS SYSTEM). Sensory Disorders,Special Senses Disorders,Sensation Disorder,Senses Disorder, Special,Senses Disorders, Special,Sensory Disorder,Special Senses Disorder
D012684 Sensory Thresholds The minimum amount of stimulus energy necessary to elicit a sensory response. Sensory Threshold,Threshold, Sensory,Thresholds, Sensory
D014110 Touch Sensation of making physical contact with objects, animate or inanimate. Tactile stimuli are detected by MECHANORECEPTORS in the skin and mucous membranes. Tactile Sense,Sense of Touch,Taction,Sense, Tactile,Senses, Tactile,Tactile Senses,Tactions,Touch Sense,Touch Senses

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