Early Sensory Re-education of the Hand With a Sensor Glove Model

Study Overview
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Brief Summary
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The implementation of early sensory re-education (SR) techniques, aimed to preserve the cortical hand area, such as the use of audio-tactile interaction, becomes an important strategy to obtain also a better sensory function. The aim of this study was to investigate sensory function outcomes (threshold monofilaments, two-point discrimination test, STI and DASH) and cortical responses (fMRI) in patients submitted to an early protocol of SR of the hand with a sensor glove model. After surgical repair of median and/or ulnar nerves, 17 participants were divided into two groups: the training group, trained on the protocol with the sensor glove model, and the control group, untrained. After six-month follow-up, no difference was observed between groups, related to sensory function, especially tactile gnosis. Despite this, the early training with this sensor glove model seems to provide some type of cortical audio-tactile interaction, contributing to previous studies that focus in early SR of the hand using the integration of different sensory modalities.

Official Title
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Cortical and Functional Responses to an Early Protocol of Sensory Re-education of the Hand Using Audio-tactile Interaction

Conditions
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Peripheral Nerve Injuries

Intervention / Treatment
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* Other: Early sensory re-education of the hand with a sensor glove model


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Injury of the ulnar and/or median nerves at the wrist or distal forearm level surgically repaired Exclusion Criteria: Neurological diseases Systemic diseases, which affected either directly or indirectly the central or peripheral nervous system Extensive traumas in the upper limbs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Training Group<br>Early sensory re-education of the hand protocol with a sensor glove model, after a median and/or ulnar nerve injury repair | Other: Early sensory re-education of the hand with a sensor glove model<br>* Training Group patients were submitted to application of a three-month protocol for early sensory re-education of the hand using the sensor glove model developed by Mendes et al. (2011). Patients also received conventional physical therapy for this type of injury in a specialized hand therapy center in a university hospital. Control Group patients received only conventional physical therapy treatment. No home sensory re-education program was established for any group and the CG patients were not submitted to any protocol for early sensory re-education of the hand.<br>* Other names: Physical Therapy;|
| No Intervention: Control Group<br>Conventional rehabilitation for peripheral nerve injuries if the hand, without application of any kind of early sensory re-education protocol | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensory Threshold - Mann Whitney non-parametric test | Sensory Threshold was assessed by esthesiometry at first, third and sixth month post-operative | First, Third and Sixth month post-operative | 
| Tactil Gnosis - Mann Whitney non-parametric test | Tactile Gnosis was assessed by Two-point discrimination and Shape and Texture Identification Test at first, third and sixth month post-operative | First, Third and Sixth month post-operative | 
| Self-report function - Mann Whitney non-parametric test | Self-report function was assessed by DASH questionnaire at first, third and sixth month post-operative | First, Third and Sixth month post-operative | 
| Cortical responses - fMRI data analysed by Granger Causality Map | Training group subjects were submitted to fMRI exam at third month post-operative | Three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Peripheral nerves/lesions; hands; rehabilitation; fMRI