Thermal Perception Threshold Testing for the Evaluation of Small Sensory Nerve Fiber Injury in Patients with Hand-Arm Vibration Syndrome.

Toibana, Norikuni; Sakakibara, Hisataka; Hirata, Mamoru; Kondo, Takaaki; Toyoshima, Hideaki

doi:10.2486/indhealth.38.366

Cited by 21 publications

(23 citation statements)

References 16 publications

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“…These findings are consistent with those reported in a Japanese study of patients affected with HAVS (Toibana et al 2000), but the results of other studies are contrasting with respect to the sensitivity of thermal indices for the detection of vibration-induced nerve impairment. Some authors reported that an abnormally wide neutral zone between warm and cold thresholds represented a sensitive index of vibration-induced neuropathy (Ekenvall et al 1986), while others found that either warmth or cold perception thresholds discriminated better between controls and HTV workers with nerve damage (Hirosawa et al 1983;Virokannas and Virokannas 1995;Strömberg et al 1999).…”

Section: Discussionsupporting

confidence: 93%

“…Over the past years, several clinical and epidemiological investigations have reported sensory dysfunction in the fingers of vibration-exposed workers, such as dockyard and shipyard workers, chain sawyers, miners, platers and grinders (Brammer et al 1987a, b;Virokannas 1992;Lindsell and Griffin 1999;Lundström et al 1999;Toibana et al 2000;Nilsson and Lundström 2001;Sakakibara et al 2002). Although significant associations between deterioration of sensory thresholds and usage of vibratory tools were found, no clear exposure-response relationships could be established because of the possible selection bias intrinsic to the cross-sectional approach of most studies.…”

Section: Discussionmentioning

confidence: 97%

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A longitudinal study of peripheral sensory function in vibration-exposed workers

Bovenzi

Ronchese

Mauro

2010

Int Arch Occup Environ Health

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

A longitudinal study of peripheral sensory function in vibration-exposed workers

Bovenzi

Ronchese

Mauro

2010

Int Arch Occup Environ Health

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“…These ®ndings were in accordance with previous measurements [4,8,18]. All indices of thermotactile testing, such as warm threshold, cold threshold, the dierence between a warm threshold and ®nger skin temperature, between a cold threshold and ®nger skin temperature, and the neutral zone between a warm and cold threshold, severely deteriorated in the patient group.…”

Section: Discussionsupporting

confidence: 91%

“…These ®ndings suggest that thermotactile (warm and cool) thresholds can quantitatively re¯ect the degree of nerve dysfunction, as shown by previous studies as well [8,18]. Such trends were also found among vibration-exposed subgroups classi-®ed by vibrotactile and pain thresholds.…”

Section: Discussionsupporting

confidence: 82%

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Thermotactile threshold testing for the evaluation of sensory nerve function in vibration-exposed patients and workers

Sakakibara

Maeda

Yonekawa

2002

IAOEH

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Objectives: The aim of the present study was to ascertain the usefulness of thermotactile testing under the measuring conditions clari®ed by our previous study in the evaluation of vibration-induced neuropathy. Method: Thermal (warm and cold) thresholds were examined on the index ®ngers of both hands of ten patients with hand-arm vibration syndrome, 36 workers exposed to hand-transmitted vibration, and ten healthy controls, using an aesthesiometer under the following measuring conditions: change rate of the applicator temperature was ®xed at a rate of 1°C/s; ®nger contact force on the applicator was kept at 0.5 N; and forearm was positioned on a support. Vibrotactile thresholds at 125 Hz and pain thresholds were also measured on the index ®ngers. Results: Both warm and cold thresholds had more severely deteriorated in the patients than in the controls. Vibrotactile and pain thresholds were also increased in the patients. In the vibration-exposed workers, the neutral zone between the warm and cold threshold diered from in the controls. Thermotactile thresholds were likely to have deteriorated with advanced nerve impairment. Likelihood ratios of thermotactile testing were signi®cantly high between the patients and the controls. For vibration-exposed work-ers with elevated vibrotactile and pain thresholds, the ratios were also signi®cantly high, particularly in the neutral zone, though the accuracy tended to be lower than in the patients. Thermotactile thresholds appeared to be more closely correlated with pain thresholds than vibrotactile thresholds. Conclusions: Thermotactile threshold testing under the present measuring conditions can be useful for evaluating small sensory nerve ®bre dysfunction in vibration-exposed subjects, and the neutral zone may be a sensitive indicator in vibrationexposed workers who may have slight or mild nerve impairments.

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The Challenge of Hand Arm Vibration Syndrome (HAVS)

Katz

2007

AMA Guides® Newsletter

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Hand arm vibration syndrome (HAVS) has been defined as a constellation of vascular, neurological, and musculoskeletal signs and symptoms in workers who use hand-held vibrating tools (eg, drills, grinders, saws, or jackhammers); pathological features affect primarily vascular, neurological, and muscle tissues. Researchers have hypothesized changes in central nervous system processing, but no significant somatotopic cortical changes have been found using functional magnetic resonance imaging. Differential diagnosis of HAVS includes a variety of anatomical, circulatory, and vasospastic disorders and was standardized in the Stockholm Workshop classification scale (1987). Available laboratory tests generally are incapable of grading the severity of individual cases, and no protocol reliably distinguishes between psychogenic and organic abnormalities. Some proposed tests are impractical, and multimodality testing is confounded by statistical fallacies. Vascular tests, including the cold provocation tests, correlate poorly with disease staging according to the Stockholm Scale, and plethysmography before and after cold provocation, were found to be unsatisfactory. Job tasks that involve vibrating machines are associated with musculoskeletal symptoms but sorting out the roles and latency periods of vibration, repetitive movements, grip and push factors, and worker postures is imprecise. The AMA Guides to the Evaluation of Permanent Impairment, does not provide directions about rating impairment associated with HAVS, but evaluators can use Chapter 16 The Upper Extremities, basing the rating on motion, neurological, and/or vascular deficits.

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Thermal Perception Threshold Testing for the Evaluation of Small Sensory Nerve Fiber Injury in Patients with Hand-Arm Vibration Syndrome.

Cited by 21 publications

References 16 publications

A longitudinal study of peripheral sensory function in vibration-exposed workers

A longitudinal study of peripheral sensory function in vibration-exposed workers

Thermotactile threshold testing for the evaluation of sensory nerve function in vibration-exposed patients and workers

The Challenge of Hand Arm Vibration Syndrome (HAVS)

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