Early sensory re-education of the hand after peripheral nerve repair based on mirror therapy: a randomized controlled trial

Paula, Mayara H; Barbosa, Rafael Inácio; Marcolino, Alexandre Márcio; Elui, Valéria Meirelles Carril; Rosén, Birgitta; Fonseca, Marisa de Cássia Registro

doi:10.1590/bjpt-rbf.2014.0130

Cited by 25 publications

(10 citation statements)

References 38 publications

(45 reference statements)

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“…These represent the newest dedicated outcome measures for nerve repair. While they are promising, the number of studies examining them is insufficient [ 65 – 67 ]. Future studies validating these tools are needed.…”

Section: Discussionmentioning

confidence: 99%

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

et al. 2018

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BackgroundOutcome after nerve repair of the hand needs standardized psychometrically robust measures. We aimed to systematically review the psychometric properties of available functional, motor, and sensory assessment instruments after nerve repair.MethodsThis systematic review of health measurement instruments searched databases from 1966 to 2017. Pairs of raters conducted data extraction and quality assessment using a structured tool for clinical measurement studies. Kappa correlation was used to define the agreement prior to consensus for individual items, and intraclass correlation coefficient (ICC) was used to assess reliability between raters. A narrative synthesis described quality and content of the evidence.ResultsSixteen studies were included for final critical appraisal scores. Kappa ranged from 0.31 to 0.82 and ICC was 0.81. Motor domain had manual muscle testing with Kappa from 0.72 to 0.93 and a dynamometer ICC reliability between 0.92 and 0.98. Sensory domain had touch threshold Semmes-Weinstein monofilaments (SWM) as the most responsive measure while two-point discrimination (2PD) was the least responsive (effect size 1.2 and 0.1). A stereognosis test, Shape and Texture Identification (STI), had Kappa test-retest reliability of 0.79 and inter-rater reliability of 0.61, with excellent sensibility and specificity. Manual tactile test had moderate to mild correlation with 2PD and SWM. Function domain presented Rosén-Lundborg score with Spearman correlations of 0.83 for total score. Patient-reported outcomes measurements had ICC of 0.85 and internal consistency from 0.88 to 0.96 with Patient-Rated Wrist and Hand Evaluation with higher score for reliability and Spearman correlation between 0.38 and 0.89 for validity.ConclusionsFew studies included nerve repair in their sample for the psychometric analysis of outcome measures, so moderate evidence could be confirmed. Manual muscle test and Rotterdam Intrinsic Hand Myometer dynamometer had excellent reliability but insufficient data on validity or responsiveness. Touch threshold testing was more responsive than 2PD test. The locognosia test and STI had limited but positive supporting data related to validity. Rosén-Lundborg score had emerging evidence of reliability and validity as a comprehensive outcome following nerve repair. Few questionnaires were considered reliable and valid to assess cold intolerance. There is no patient-reported outcome measurement following nerve repair that provides comprehensive assessment of symptoms and function by patient perspective.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0836-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

et al. 2018

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“…présentent une meilleure évolution clinique que ceux qui ne sont pas entraînés, alors qu'ils n'ont pas fait plus d'exercice physique… Pratiquer une activité mentale améliore donc la revalidation des patients après arthroplastie de la hanche [6]. L'importance de la plasticité neuronale et de la complexité des différents circuits neuronaux mis en place est donc fondamentale.…”

Section: Liens D'intérêtunclassified

“…Exemples d'exercices de revalidation « conventionnelle » effectués à l'aide d'un miroir (d'après[6]). SYNTHÈSEREVUESpratique du clinicien mais également pour la recherche en neuroscience et en sciences cognitives.…”

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Revalidation physique, entraînez le cerveau !

Bonnechère

2017

Med Sci (Paris)

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Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in neurophysiology over the last decades have challenged many principles and theories, mainly based on empirical observations, generally well accepted in clinical practice. These new findings, achieved through functional "magnetic resonance imaging", awake brain surgery and allow new techniques and opportunities in physical rehabilitation. More than ever the body and the brain must be considered and treated as a functional entity, the distinction between body and soul developed by Platon should no longer be applied. The development of new technologies, in particular the virtual reality, lends itself perfectly to this global approach. The aim of this article is to present how a purely cognitive training can have beneficial effects on the body and the motor performances in clinics.

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“…Some of these simple techniques use the same principles of cortical audio-tactile integration and other use visual-tactile integration like mirror training, sensory imagery and observation of touch. 18,[29][30][31][32] Systematic reviews remain inconclusive on what are the best techniques of sensory re-education of the hand and highlight the need for more high-quality studies to define protocols for each recovery phase after surgical repair of peripheral nerve injuries. Finally, documentation of outcomes also needs standardization in order to compare treatments and clinical findings.…”

Section: Limitationsmentioning

confidence: 99%

Cortical and functional responses to an early protocol of sensory re-education of the hand using audio–tactile interaction

et al. 2017

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Introduction: Early sensory re-education techniques are important strategies associated with cortical hand area preservation. The aim of this study was to investigate early cortical responses, sensory function outcomes and disability in patients treated with an early protocol of sensory re-education of the hand using an audio-tactile interaction device with a sensor glove model. Methods: After surgical repair of median and/or ulnar nerves, participants received either early sensory re-education twice a week with the sensor glove during three months or no specific sensory training. Both groups underwent standard rehabilitation. Patients were assessed at one, three and six months after surgery on training-related cortical responses by functional magnetic resonance imaging, sensory thresholds, discriminative touch and disability using the Disabilities of the Arm, Shoulder and Hand patient-reported questionnaire. Results: At six-months, there were no statistically significant differences in sensory function between groups. During functional magnetic resonance imaging, trained patients presented complex cortical responses to auditory stimulation indicating an effective connectivity between the cortical hand map and associative areas. Conclusion: Training with the sensor glove model seems to provide some type of early cortical audio-tactile interaction in patients with sensory impairment at the hand after nerve injury. Although no differences were observed between groups related to sensory function and disability at the intermediate phase of peripheral reinnervation, this study suggests that an early sensory intervention by sensory substitution could be an option to enhance the response on cortical reorganization after nerve repair in the hand. Longer follow-up and an adequately powered trial is needed to confirm our findings.

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Early sensory re-education of the hand after peripheral nerve repair based on mirror therapy: a randomized controlled trial

Cited by 25 publications

References 38 publications

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties

Revalidation physique, entraînez le cerveau !

Cortical and functional responses to an early protocol of sensory re-education of the hand using audio–tactile interaction

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