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The influence of visual and tactile perception on hand control in children with Duchenne muscular dystrophy
Denise Troise1, Simone Yoneyama, Maria Bernadette Resende
1Department of Physical Therapy, Speech and Communication Sciences, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
Insights
Males with Duchenne muscular dystrophy (DMD) have normal tactile perception but slower manipulation and worse manual dexterity without visual feedback. Their hand control relies more on sight than touch, suggesting altered neural control.
Area of Science:
- Neurology
- Physiology
- Rehabilitation Medicine
Background:
- Duchenne muscular dystrophy (DMD) is a progressive genetic disorder affecting muscle function.
- Understanding sensory and motor deficits in DMD is crucial for developing effective interventions.
Purpose of the Study:
- To evaluate tactile perception and manual dexterity in males with DMD, comparing performance with and without visual feedback.
- To explore the role of visual versus tactile input in hand control for individuals with DMD.
Main Methods:
- Forty males with DMD and 49 healthy controls participated.
- Tactile perception was assessed using two-point discrimination and stereognosis tests.
- Manual dexterity was measured using the Pick-Up test with eyes open and closed.
Main Results:
- Males with DMD showed no deficits in tactile perception.
- Stereognosis manipulation was significantly slower in males with DMD.
- Manual dexterity was markedly impaired in males with DMD when visual feedback was absent.
Conclusions:
- DMD affects manipulation speed and manual dexterity, particularly without visual input.
- Hand control in DMD is heavily reliant on visual information, not tactile sensation.
- Motor dysfunction in DMD may stem from disruptions in neural control mechanisms.
Aim:
To investigate tactile perception and manual dexterity, with or without visual feedback, in males with Duchenne muscular dystrophy (DMD).
Method:
Forty males with DMD (mean age 9 y 8 mo, SD 2 y 3 mo; range 5-14 y), recruited from the teaching hospital of the School of Medicine of the University of São Paulo, with disease severity graded as '1' to '6' on the Vignos Scale and '1' on Brooke's Scale, and 49 healthy males (mean age 8 y 2 mo; range 5-11 y; SD 1 y 11 mo), recruited from a local education center, participated in the study. We assessed tactile perception using two-point discrimination and stereognosis tests, and manual dexterity using the Pick-Up test with the eyes either open or closed. Analysis of variance was used to compare groups; a p value of less than 0.05 was considered statistically significant.
Results:
Males with DMD exhibited no impairment in tactile perception, as measured by the two-point discrimination test and the number of objects correctly named in the stereognosis test. Manipulation during stereognosis was statistically slower with both hands (p<0.001), and manual dexterity was much worse in males with DMD when there was no visual feedback (p<0.001).
Interpretation:
Males with DMD exhibited disturbances in manipulation during stereognosis and dexterity tests. Hand control was highly dependent on visual information rather than on tactile perception. Motor dysfunction in males with DMD, therefore, might be related to altered neural control.
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