Digital vibrogram: A new diagnostic tool for sensory testing in compression neuropathy

Lundborg, Göran; Lie-Stenström, Anna-Karin; Sollerman, Christer; Strömberg, Trygve; Pyykkö, Ilmari

doi:10.1016/s0363-5023(86)80014-4

Cited by 113 publications

(40 citation statements)

References 24 publications

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“…Of these possibilities, recording degraded tactile sensation by measuring esthesiometer or vibrotactile perception thresholds has received the most attention, refined apparatus to control the stimulus entering the fingertip providing enhanced resolution (3,16). In addition, determining the vibrotactile threshold over a broad range of frequencies will provide data on more than one mechanoreceptor type (14,15) and, with appropriate conditions of stimulation, permit the sensitivity of each of the three receptor populations responsible for the sense of touch to be established (17). Substantial progress has also recently been made in quantifying the temperature sense, the magnitude of the neutral zone between warm and cool thresholds showing promise as an indicator of vibration-induced neuropathy (7).…”

Section: Discussion and Interpretationmentioning

confidence: 99%

Sensorineural stages of the hand-arm vibration syndrome.

Brammer¹,

Taylor²,

Lundborg³

1987

Scand J Work Environ Health

183

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stagesof the hand-arm vibration syndrome. Scand J Work Environ Health I3 (1987) [279][280][281][282][283]. Recent work has shown that the vascular signs and neurological symptoms commonly associated with exposure of the hand to vibration may develop independently. A classification for the neurologicalcomponent of the hand-arm vibration syndrome has been developed for those symptoms dominated by sensory afferent involvement, based on the results of objective tests on 634 hands. The first symptomatic stage (lSN) consistsessentiallyof episodic finger numbness with or without tingling, the second involves, in addition, reduced sensory perception (2SN), while the most severestage (3SN)focuses on reduced tactile discrimination and/or manipulative dexterity. Consistent implementation of this classificationby means of objectivetests requires one, or more, precise,quantitative measure of peripheral somatosensory dysfunction, in addition to the traditional neurological tests (fine touch, pain, and temperature). Measurements of tactile function by means of esthesiometry or vibrotactile perception appear suited to this purpose. A procedure for staging individual hands may then be based on combining numerical scores assigned to the results of the traditional neurological tests and, additionally, esthesiometer and/or vibrotactile perception thresholds.

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Section: Discussion and Interpretationmentioning

confidence: 99%

Sensorineural stages of the hand-arm vibration syndrome.

Brammer¹,

Taylor²,

Lundborg³

1987

Scand J Work Environ Health

183

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“…Apparatus: The concept for this technique was introduced by Lundborg et al (1986;1992). These researchers have shown that a modification of Bekesy audiometry can be used as a non-invasive semi-automatic system for vibrotactile assessment of hand function.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the psychophysical detection threshold level for vibrotactile and pressure stimulation of prosthetic limbs using bone anchorage or soft tissue support

Jacobs

Brånemark

Olmarker

et al. 2000

Prosthetics &Amp; Orthotics International

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In the present study the psychophysical detection threshold levels for mechanical stimulation of 32 prosthetic limbs were determined. Prosthetic limbs were anchored to the bone by means of an implant (n=17) or supported by a socket enclosing the amputation stump (n=15). Detection threshold levels were assessed for pressure and vibratory stimulation of the prosthesis and the limb at the contralateral side (control). Following vibratory stimulation, thresholds were increased on an avarage 20% for socket prostheses, but approached those of the control for bone-anchored prostheses. For pressure stimulation, thresholds were increased up to 60% for socket prostheses and 40% for bone-anchored prostheses compared to the control. While bone-anchored prostheses yielded significantly lower threshold levels than socket prostheses, there was no significant difference between both treatments regarding pressure stimulation. Results were applicable to both upper and lower limb amputees. It could be concluded that detection thresholds for pressure and especially vibratory stimulation of prosthetic limbs were generally higher than for control limbs. The outcome was related to the prosthetic limb design with bone-anchored prostheses yielding better perception than socket prostheses.

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“…Tests assessing the vibrotactile sense of the fingertips reflect sensorineural dysfunction in the hand and arm regardless of the level of the lesion. Such tests respond very early to both coinpression and vibration-induced nerve injury (8,9). They reflect dysfunction mainly in the rapidly adapting receptors in the fingertips or the colresponding nerve fiber components, which are large niyelinated AD nerve fibers (21).…”

Section: Discussionmentioning

confidence: 99%

“…A refined modification of previously described equipment (8,9) was used to assess vibrotactile sense. The pulps of the index and the little fingers of both hands -innervated by the median and ulnar nerves, respectively -were subjected to sinusoidal vibration at the 7 frequencies, in ascending order, of 8, 16, 32.5,65, 125, 250, and 500 Hz, auto~natically delivered by the equipment (1 1).…”

Section: Technique For Assessing Vibrotactile Sensementioning

confidence: 99%

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Vibrotactile sense in the hand-arm vibration syndrome

Strömberg¹,

Dahlin²,

Lundborg³

1998

Scand J Work Environ Health

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Stromberg T, Dahlin LB, Lundborg G. Vibrotactile sense in the hand-arm vibration syndrome. Scand J Work Environ Health 1998;24(6): 495-502. Objectives The pulyose of this study was to investigate disturbances of the vibrotactile sense and their relation to clinical symptoms and findings among male symptomatic workers suffering froin the hand-arm vibration syndrome. MethodsNinety-six such patients were interviewed and given a clinical and tactilo~netric examination. The symptoms were classified according to the Stockholm Workshop Scale. A sensibility index was used to quantify vibrotactile sense in the tactilogram.Results An abnormal sensibility index (<0.8) was recorded for 57.3% of the patients (mean of 4 fingers), at least 1 finger being ab~lormal in 72.9% of the patients. The sensibility index did not statistically differ between the patients suffering from sensorineural symptoms and those with vibration white finger. The stages of sensorineural symptoms, accordi~lg to the Stockholm Workshop Scale, corresponded with the sensibility index, whereas the stages of vibration white finger did not. There were significant differences in the sensibility index between the fingers, between the right and left hands, and between the fingers inllervated by the ulnar and median nerves. Bilateral symptoms and cold intolerance were associated with considerable impairment of the vibrotactile sense. Clinical median nerve involvement in the carpal tunnel was not reflected by the sensibility index. C O~C~U S~O~SThere is a considerable degree of neural involvement in all symptomatic vibration-exposed patients irrespective of symptoms. As symptoms progress, the severity of sensorineural symptoms, but not of vibration white finger, is reflected by the sensibility index. Cold intolerance is strongly related to nervous involvement and should be noted in the patient history. Tactilometry should be performed on 1 median and 1 ulnar nerve-innervated finger of both hands, as an examination of 1 finger alone may be misleading.

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Digital vibrogram: A new diagnostic tool for sensory testing in compression neuropathy

Cited by 113 publications

References 24 publications

Sensorineural stages of the hand-arm vibration syndrome.

Sensorineural stages of the hand-arm vibration syndrome.

Evaluation of the psychophysical detection threshold level for vibrotactile and pressure stimulation of prosthetic limbs using bone anchorage or soft tissue support

Vibrotactile sense in the hand-arm vibration syndrome

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