The effects of the surface texture and weight of a pinch apparatus on the reliability and validity of a hand sensorimotor control assessment in carpal tunnel syndrome

Publication date: Available online 5 September 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Hsiu-Yun Hsu, Ta-Shen Kuan, Hsiu-Ching Yang, Ching-Liang Tsai, Chien-Hsien Yeh, Chih-Chun Lin, Li-Chieh Kuo

Abstract

Objective

To investigate the reliability and validity of a modified pinch apparatus devised with three surface textures and two different weights for clinical application.

Design

Case-controlled study.

Setting

A university hospital.

Participants

The participants included 16 carpal tunnel syndrome (CTS) patients with 20 sensory neuropathy hands, and an equal number of age-gender matched healthy volunteers, as well as twenty healthy young volunteers used to analyze both the testing validity and reliability of the modified device.

Main Outcome Measures

The Semmes-Weinstein monofilament (SWM) and two-point discrimination (2PD) tests were conducted, and the force ratio between the FP_peak (peak pinch force during lifting phase) and FL_max (maximum load force at maximum upward acceleration onset) detected from a pinch-holding-up activity (PHUA) under various testing conditions was obtained.

Results

The range of the intra-class correlation coefficient of this pinch device was 0.369-0.952. The CTS patients exhibited poorer force modulation ability according to the inertial change in a dynamic lifting task when compared to the controls under all testing conditions (p<.001). The area under the receiver operating characteristic force ratio curve was 0.841, revealing high accuracy of the test for diagnosing CTS neuropathic hands under the testing condition in which the 125g coarse texture device was used. In addition, the weight factor was shown to have significant impacts on the sensitivity and accuracy of the PHUA assessment.

Conclusions

This study showed that the PHUA test via the modified pinch apparatus is a sensitive tool that can be used in clinical practice for detecting neuropathic CTS hands. In addition, changing the weight of the pinch device has a significant impact on the sensitivity and accuracy of the PHUA assessment.

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