Archives of physical medicine and rehabilitation · 2025
Sensibility Evaluation in Children: Variability of Upper Limb Sensory Threshold Outcomes.
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Ulmann Eva T E, Ho Emily S, Davidge Kristen M
Аннотация
OBJECTIVE: To evaluate upper limb sensory thresholds in typically developing children.
DESIGN: Cross-sectional study.
SETTING: Tertiary referral center.
PARTICIPANTS: Consecutive sample of 50 children (N=50) with a mean age of 12.9±2.7 (range, 8-19) years with the absence of known upper limb deficits.
INTERVENTIONS: Sensory examination.
MAIN OUTCOME MEASURES: Weinstein Enhanced Sensory Test (WEST) sensory threshold scores in the 14 peripheral nerve dermatomes of the upper limb, dichotomized as 2.83 (normal sensation) versus >2.83.
RESULTS: In the first dorsal webspace, a WEST score of >2.83 was reported in 50%, and disagreement between limbs by 2 WEST levels (eg, 2.83 vs 4.31) in 34%. Proximal to the wrist, sensory thresholds of 2.83 were reported in 41%; more frequently on the lateral volar side (61%) compared with the dorsal side (48%) and the medial volar side (26%) (Cochran Q test: P<.001); and more frequently on the distal compared with the proximal arm (52% vs 39%, McNemar test: P<.001). Disagreement of ≥1 WEST level between the dominant and nondominant sides was reported in 55% and disagreement of ≥2 WEST levels in 33%. Sensory thresholds were not significantly associated with laterality, sex, age, or type of care, in the first dorsal webspace as well as proximal to the wrist.
CONCLUSIONS: Sensory thresholds in the upper limb of children without upper limb deficits are variable, proximal to the wrist as well as in the first dorsal webspace. This should be taken into consideration when evaluating sensibility in children with peripheral nerve injuries.
DESIGN: Cross-sectional study.
SETTING: Tertiary referral center.
PARTICIPANTS: Consecutive sample of 50 children (N=50) with a mean age of 12.9±2.7 (range, 8-19) years with the absence of known upper limb deficits.
INTERVENTIONS: Sensory examination.
MAIN OUTCOME MEASURES: Weinstein Enhanced Sensory Test (WEST) sensory threshold scores in the 14 peripheral nerve dermatomes of the upper limb, dichotomized as 2.83 (normal sensation) versus >2.83.
RESULTS: In the first dorsal webspace, a WEST score of >2.83 was reported in 50%, and disagreement between limbs by 2 WEST levels (eg, 2.83 vs 4.31) in 34%. Proximal to the wrist, sensory thresholds of 2.83 were reported in 41%; more frequently on the lateral volar side (61%) compared with the dorsal side (48%) and the medial volar side (26%) (Cochran Q test: P<.001); and more frequently on the distal compared with the proximal arm (52% vs 39%, McNemar test: P<.001). Disagreement of ≥1 WEST level between the dominant and nondominant sides was reported in 55% and disagreement of ≥2 WEST levels in 33%. Sensory thresholds were not significantly associated with laterality, sex, age, or type of care, in the first dorsal webspace as well as proximal to the wrist.
CONCLUSIONS: Sensory thresholds in the upper limb of children without upper limb deficits are variable, proximal to the wrist as well as in the first dorsal webspace. This should be taken into consideration when evaluating sensibility in children with peripheral nerve injuries.