Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Similar 2-point discrimination and stereognosia but better locognosia at long term with an independent home-based sensory reeducation program versus no reeducation after low-median nerve transection and repair
Antonopoulos DK, Mavrogenis AF, Megaloikonomos PD, Mitsiokapa E, Georgoudis G, Vottis CT, Antonopoulos GK, Papagelopoulos PJ, Pneumatikos S, Spyridonos SG
Journal of Hand Therapy 2019 Jul-Sep;32(3):305
clinical trial
This trial has not yet been rated.

STUDY DESIGN: Prospective controlled study. INTRODUCTION: Previous studies evaluated the effectiveness of sensory reeducation (SR) after peripheral nerve injury and repair. However, evidence for long-term clinical usefulness of SR is inconclusive. PURPOSE OF THE STUDY: The purpose of this study is to compare the sensory results of patients with low-median nerve complete transection and microsurgical repair, with and without SR at long term. METHODS: We prospectively studied 52 consecutive patients (mean age 36 years; range 20 to 47 years) with low-median nerve complete transection and microsurgical repair. When reinnervation was considered complete with perception of vibration with a 256 cycles per second tuning fork (mean 3.5 months after nerve injury and repair), the patients were sequentially allocated (into 2 groups (group SR 26 patients, SR; group R 26 patients, reassured on recovery without SR). SR was conducted in a standardized fashion, in 2 stages, as an independent home-based program: the first stage was initiated when reinnervation was considered complete, and included instruction in home exercises to identify familiar objects and papers of different roughness, and localization of light touch (eyes open and closed); the second stage was initiated when the patients experienced normal static and moving 2-point discrimination (2PD) at the index fingertip of injured hand, and included instruction in home exercises for stereognosia, supplementary exercises for localization of light touch, and identification of small objects (eyes open and closed). Exercises were prescribed for 5 to 10 minutes, 4 times per day. At 1.5, 3, and 6 years after nerve injury and repair, we evaluated the static and moving 2PD, stereognosia with the Moberg's pick-up test, and locognosia with the modified Marsh test. Comparison between groups and time points was done with the nonparametric analysis of variance (Kruskal-Wallis analysis of variance). RESULTS: Static and moving 2PD and stereognosia were not significantly different between groups at any study period. Locognosia was significantly better at 1.5 and 3 years in group SR; locognosia was excellent in 17 patients of group SR versus 5 patients of group R at 1.5-year follow-up and in 14 patients of group SR versus 5 patients of group R at 3-year follow-up. Locognosia was not different between the study groups at 6-year follow-up. CONCLUSION: A 2-stage home program of SR improved locognosia at 1.5 and 3 years after low-median nerve complete transection and repair without significant differences in other modalities or the 6-year follow-up of a small subsample.

Full text (sometimes free) may be available at these link(s):      help