A comparison of five tests for determining hand sensibility

Area of Science:

• Neurology
• Orthopedics
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) significantly impacts hand sensibility.
• Accurate sensory testing is crucial for diagnosing and managing CTS.
• Current sensory testing methods have limitations in accuracy, portability, and cost.

Purpose of the Study:

• To evaluate the efficacy of Strauch's ten test compared to established sensory testing methods for CTS.
• To identify a reliable, sensitive, and practical tool for assessing hand sensibility in CTS patients.

Main Methods:

• Sensory testing of 317 normal fingers and 612 fingers in 153 hands with CTS.
• Utilized Weinstein Enhanced Sensory Test (WEST), static two-point discrimination (s2PD), moving two-point discrimination (m2PD), Disk-Criminator, and Strauch's ten test.
• Determined equivalent Semmes-Weinstein monofilament (SWM) test values as a gold standard.

Main Results:

• WEST and SWM test norms have wide interpretation latitude due to ordinal scales.
• WEST and Disk-Criminator tests missed some early sensory loss cases.
• SWM is reliable but not portable and time-consuming; WEST is expensive.
• Strauch's ten test demonstrated high sensitivity, reliability, and accuracy in detecting early sensory loss without instrumentation.

Conclusions:

• Strauch's ten test is a superior method for evaluating hand sensibility in carpal tunnel syndrome.
• The ten test offers a practical, sensitive, and accurate alternative to current sensory testing modalities.
• Its continuous analog scale and lack of instrumentation make it ideal for clinical use.