Sensory re-education after median nerve lesions

Parry, C. B. Wynn; Salter, Michael W.

doi:10.1016/0072-968x(76)90010-3

Cited by 127 publications

(69 citation statements)

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“…The time points were selected based on their use in clinical studies of the impact of sensory reeducation in patients with injured median or ulnar nerve (11) and in clinical studies of sensory impairment in patients following orthognathic surgery. (25)(26)(27)(28) The exercises were started early after surgery --1 week when the affected area was often insensate --to obtain the maximum affect of sensory retraining.…”

Section: Exercise Programs and Trainingmentioning

confidence: 99%

“…Sensory retraining or sensory reeducation has been used, with documented clinical success, in patients with injured hand nerves since the 1960's. (10)(11)(12)(13)(14)(15) Anecdotally, the use of sensory retraining has been reported in patients with injured trigeminal nerves. (16,17) The intent of this physical/ behavioral therapy is to improve the patient's ability to interpret the altered sensory response from injured sensory nerves and to improve the patient's perception of function.…”

Section: Introductionmentioning

confidence: 99%

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Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Phillips

Essick

Preisser

et al. 2007

Journal of Oral and Maxillofacial Surgery

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Purpose-The primary research hypothesis was that the magnitude and duration of the perceived burden from altered sensation reported by patients following bilateral sagittal split osteotomy (BSSO) and trauma to the third division of the trigeminal nerve is lessened when facial sensory retraining exercises are performed in conjunction with standard opening exercises as compared to standard opening exercises alone.Subjects and Methods-186 subjects were enrolled in a multi-center double-blind two parallel group stratified block randomized clinical trial. Oral and facial pain, unusual sensations, numbness and loss of sensitivity, were scored from "no problem" to "serious problem" before surgery, 1,3, and 6 months after surgery.Analysis-A proportional odds model for the ordered multinomial response was used to compare the responses of the two exercise groups.Results-The two exercise groups did not differ significantly at any postsurgical time in the perceived problem level from mouth or face pain. The difference between the two groups at each visit was not statistically significant for unusual sensations although the trend was for the sensory retraining group to have a higher likelihood of reporting fewer problems. By 6 months, the likelihood of a subject reporting lower problem or interference level related to numbness or less lip sensitivity was significantly higher in the sensory-retraining group, approximately twice that of the opening exercise only group.Corresponding Author: Ceib Phillips, Professor, Department of Orthodontics, CB 7450, University of North Carolina, Chapel Hill, NC 27599, Telephone:(919)966-2763, Fax: (919)843-8864, Email: ceib_phillips@dentistry.unc.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

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Section: Exercise Programs and Trainingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Phillips

Essick

Preisser

et al. 2007

Journal of Oral and Maxillofacial Surgery

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“…1,[3][4][5][6][7][8][9]14 It is widely applied in patients following nerve repair, [4][5][6][7][8][9]15 digital replantation, 1,3,14 toe-to-hand transfer, 1,10-12 and free flap transfer. 13,15 Besides employing sensory reeducation in the peripheral lesion, it has also been used in patients who were hemiplegic 16 or who had cortical lesions.…”

Section: Discussionmentioning

confidence: 99%

“…1-3 A sensory reeducation program gives the patient opportunity to fulfill sensory potential provided by the surgery, and should definitely have a major role in the strategy for management of nerve injuries, digital replantation, toe-to-hand transfer, and free flap transfer. [3][4][5][6][7][8][9][10][11][12][13] The effectiveness of such a program has also been described in a previous article with statistical analysis. 14 However, the improvement of sensory recovery following reeducation has resulted from the retraining effect, or the real ameliorative central or peripheral regeneration process, which is still controversial and difficult to prove based on the biochemistry or neuroscientific studies.…”

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confidence: 93%

Long-term effects of sensory reeducation following digital replantation and revascularization

1998

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The long-term maintenance of sensory gain following sensory reeducation is still unknown for replanted digits. Ten patients with 18 replanted or revascularized digits, who had received a formal sensory reeducation program for 1.5 years postoperatively, were reevaluated with moving two-point discrimination and Semmes-Weinstein pressure threshold test after discontinuing sensory reeducation for 1 year. Another four patients with seven replanted or revascularized digits, who have never received sensory reeducation after surgery, were also followed up in the same way. After cessation of sensory reeducation, the degree of moving two-point discrimination became significantly worse in the formal sensory-reeducated group (P < 0.05) and significantly improved in the group without sensory reeducation initially (P < 0.05), whereas it showed a nonsignificant change of Semmes-Weinstein threshold both in the group with formal sensory reeducation and without sensory reeducation. Sensory retraining did influence the progressive change of moving two-point discrimination, but not in a parallel way with the Semmes-Weinstein threshold test.

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“…Sensory re-education programmes are started when some perception of touch can be demonstrated in the distal palm, i e about three months after nerve repair at the wrist level (Dellon et al, 1974;Wynn-Parry and Salter, 1976). The insensate hand and the changes in the corresponding cerebral cortical areas which occur after injury are left unattended, from the sensory relearning point of view, for a time period of several months.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Sensory Recovery after Median Nerve Epair Using Cortical Audio–Tactile Interaction. A Randomised Multicentre Study

Rosén

Lundborg

2007

J Hand Surg Eur Vol

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__________________________________________________This is an author produced version of a paper published in Tidskriftstitel. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the published paper: Rosén, B and Lundborg, G. "Enhanced sensory recovery after median nerve repair using cortical audio-tactile interaction. A randomised multicentre study. The "Sensor Glove System" offers an alternate afferent inflow from the hand early after nerve repair in the forearm, mediated through the hearing sense, implying that deprivation of one sense can be compensated by another sense.This "sensory by-pass" was used early after repair of the median nerve with the intention of improving recovery of functional sensibility by maintaining an active sensory map of the hand in the somatosensory cortex during the deafferentation period. In a prospective multicentre clinical study one group (n=14) started early after surgery with sensory re-education using the Sensor Glove System and the control group (n=12) received conventional sensory reeducation starting three months postoperatively. The patients were checked regularly during a one-year period with focus on recovery of tactile gnosis.

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Sensory re-education after median nerve lesions

Cited by 127 publications

References 3 publications

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Long-term effects of sensory reeducation following digital replantation and revascularization

Enhanced Sensory Recovery after Median Nerve Epair Using Cortical Audio–Tactile Interaction. A Randomised Multicentre Study

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