Von Frey's method of measuring pressure sensibility in the hand: An engineering analysis of the Weinstein-Semmes pressure aesthesiometer

Levin, Scott; Pearsall, G. W.; Ruderman, Robert J.

doi:10.1016/s0363-5023(78)80084-7

Cited by 274 publications

(109 citation statements)

References 5 publications

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“…This considerable difference has been studied extensively before, pointing out some general problems inherent in the Semmes-Weinstein monofilament set: (1) the discontinuous scale of the Semmes-Weinstein monofilament test does not allow precise measurement; (2) the problem of measuring a force threshold rather than a pressure threshold; (3) the inability to know the true surface area in contact with the skin at the moment the filament buckles; (4) the variance in manufacturing allowing a 10 percent error in the initial applied force of the filaments; and (5) the fatigue of the nylon with more than 100 uses. 23,[38][39][40][41][42] These circumstances led to the conclusion that normative data are impossible to generate for the Semmes-Weinstein monofilament, thus harshly limiting its intrainstrument and interinstrument comparability. Indeed, the PressureSpecified Sensory Device clearly compensates for most of the mentioned points of criticism: it is measured on a continuous scale (with "open ends"), which even captures extreme values and outliers reliably; whereas the Semmes-Weinstein monofilament test is limited to five grades, potentially neglecting higher or lower values, thus pretending a smaller variance.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

Klein

Fakin

Ducommun

et al. 2016

Plastic &Amp; Reconstructive Surgery

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BACKGROUND: As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection. METHODS: Patients who underwent epineural coaptation after digital nerve transection at the authors' institution between June of 2006 and December of 2011 were asked to participate in a follow-up examination assessing spatial resolution (two-point discrimination and grating orientation test) and cutaneous pressure threshold (Semmes-Weinstein monofilament test and pressure-specifying sensory device). Interinstrument correlations were conducted and critically elucidated. RESULTS: Eighty-one patients (26 female and 55 male patients; median age, 42 years; interquartile range, 23 years) were examined with a mean follow-up period of 3.5 ± 1.4 years. Although all tests could differentiate between the healthy and operated fingers, poor to moderate correlations were found between two-point discrimination and grating orientation test ((operated) = 0.483, p < 0.0001; (healthy) = 0.350, p < 0.0001), and between SemmesWeinstein monofilament test and Pressure-Specified Sensory Device testing ((operated) = 0.287, p = 0.01; (healthy) = 0.382, p < 0.001), indicating that they measure different properties. Altogether, the grating orientation test proved superior to two-point discrimination, whereas Pressure-Specified Sensory Device testing was superior to Semmes-Weinstein monofilament testing. CONCLUSIONS: Thoughtful use of test instruments is advisable when assessing sensibility of the hand. This study suggests including Pressure-Specified Sensory Device testing to assess cutaneous pressure threshold and the grating orientation test to assess spatial resolution in clinical, routine test batteries. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, III. Zurich, SwitzerlandBackground: As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection. Methods: Patients who underwent epineural coaptation after digital nerve transection at the authors' institution between June of 2006 and December of 2011 were asked to participate in a follow-up examination assessing spatial resolution (two-point discrimination and grating orientation test) and cutaneous pressure threshold (Semmes-Weinstein monofilament test and pressure-specifying sensory device). Interinstrument correlations were conducted and critically elucidated. Results: Eighty-one patients (26 female and 55 male patients; median age, 42 years; interquartile range, 23 yea...

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Section: Discussionmentioning

confidence: 99%

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

Klein

Fakin

Ducommun

et al. 2016

Plastic &Amp; Reconstructive Surgery

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“…It had been shown to have a very high test-retest reliabillty and its force of application can be controlled. However, slippage of the filament on application and improper st()rage can decrease its rellability (Callahan, 1984;Jones, 1989;Levin, 1978).…”

Section: Sensibility Testsmentioning

confidence: 99%

The Determination of Sensory Deficits in Children With Hemiplegic Cerebral Palsy

et al. 1995

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Cerebral paisy is a non-progressive disorder associated with brain in jury, detect, or dlsease, of early onset. Emphasis IS placed on the more easily observable motor deficits, with any underlying sensory deficits often being overlooked. Existing sensory assessments have either been standardized on an adult population or for a paediatric population without significant neuromotor impalrment. Thus, there is a need to formulate a standardized sensory assessment battery that may be used to evaluate physically handicapped children. A review of the literature hlghlights the necessity to evaluate the presence and extent of sensory dysfunction in school-age hemipleglc children, us mg a standardlzed clinical sensory assessment battery, as weil as somatosensory evoked potentials.A relJable sensory battery, which asses ses 5 sensory modalltl8s, was formulated and normative data for school-age chlldren was derived. Sensory function was evaluated in 9 hemiplegic children (4-19 years) and 18 healthy age-matched controls. Significant bilateral sensory deficits were documented in hemiplegic childr9n. Thus a sensory assessment should be an integral part of the evaluation of a child with hemiplegia .

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“…The filaments were applied on the skin in an ascending way as advocated by Weinstein [15] until the filament slightly bent. The first monofilament that evoked a feeling of "touch" on the test sites was recorded by the log 10 values and then transformed into gram per square millimeter.…”

Section: Pressurementioning

confidence: 99%

The effect of superior pedicle breast reductions on breast sensation

et al. 2008

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The aim of this study was to assess nipple, areola and breast skin sensation after breast reductions with two different superior pedicle techniques: a short, vertical scar technique compared to a long, inverted-T scar technique. Thirty-six women with a vertical technique (group I) and ten women with an inverted-T technique (group II) with a resection weight of ≤500 g per breast completed their 1-year follow-up. The four modalities used to evaluate sensation were pressure with Semmes-Weinstein filaments, vibration with a vibrometer, and temperature and pain perception on a qualitative basis. The evaluation revealed that 1-year after breast reduction, the sensation was either reduced, unaltered, or improved in both groups. In the nipple, the mean sensation was markedly reduced throughout all qualities in both groups with the exception of pain, which was enhanced. In the areola, the mean sensation was also reduced in all qualities in both groups. In the quadrants of the skin, mean sensation was improved in terms of pressure and vibration in group I (8.3% normal pressure values preoperatively vs. 70% normal pressure values postoperatively) but reduced in the lower quadrant of the skin in group II with the inverted-T scar. This reduction of pressure was also significant (p=0.04) in comparison with group I. Apart from this difference between the two groups, this study showed that in breast reductions with a superior pedicle technique, the long-scar technique did not lead to a greater reduction of sensation in the nipple and areola than the short-scar technique.

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Von Frey's method of measuring pressure sensibility in the hand: An engineering analysis of the Weinstein-Semmes pressure aesthesiometer

Cited by 274 publications

References 5 publications

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

The Determination of Sensory Deficits in Children With Hemiplegic Cerebral Palsy

The effect of superior pedicle breast reductions on breast sensation

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