Posts Tagged audio–tactile interaction
[Abstract+References] Cortical and functional responses to an early protocol of sensory re-education of the hand using audio–tactile interaction.
Posted by Kostas Pantremenos in Paretic Hand on December 11, 2017
Abstract
Introduction
Early sensory re-education techniques are important strategies associated with cortical hand area preservation. The aim of this study was to investigate early cortical responses, sensory function outcomes and disability in patients treated with an early protocol of sensory re-education of the hand using an audio-tactile interaction device with a sensor glove model.
Methods
After surgical repair of median and/or ulnar nerves, participants received either early sensory re-education twice a week with the sensor glove during three months or no specific sensory training. Both groups underwent standard rehabilitation. Patients were assessed at one, three and six months after surgery on training-related cortical responses by functional magnetic resonance imaging, sensory thresholds, discriminative touch and disability using the Disabilities of the Arm, Shoulder and Hand patient-reported questionnaire.
Results
At six-months, there were no statistically significant differences in sensory function between groups. During functional magnetic resonance imaging, trained patients presented complex cortical responses to auditory stimulation indicating an effective connectivity between the cortical hand map and associative areas.
Conclusion
Training with the sensor glove model seems to provide some type of early cortical audio-tactile interaction in patients with sensory impairment at the hand after nerve injury. Although no differences were observed between groups related to sensory function and disability at the intermediate phase of peripheral reinnervation, this study suggests that an early sensory intervention by sensory substitution could be an option to enhance the response on cortical reorganization after nerve repair in the hand. Longer follow-up and an adequately powered trial is needed to confirm our findings.
References
| 1. | Lundborg, G. Sensory relearning and sensory re-education. In: Lundborg G (ed) Nerve injury and repair: regeneration, reconstruction and cortical remodeling. 2nd ed. New York: Elsevier, 2005, pp. 224–234. Google Scholar |
| 2. | Navarro, X, Vivo, M, Valero, CA. Neural plasticity after peripheral nerve injury and regeneration. Prog Neurobiol 2007; 82: 163–201. Google Scholar, Crossref, Medline |
| 3. | Lundborg, G, Rosén, B. Hand function after nerve repair. Acta Physiol (Oxf) 2007; 189: 207–217. Google Scholar, Crossref, Medline |
| 4. | Bach-y-Rita, P. Brain plasticity as a basis of sensory substitution. J Neuro Rehab 1987; 1: 67–71. Google Scholar, Abstract |
| 5. | Lundborg, G. Sensation and sensorimotor integration in hand function. In: Lundborg G (ed) Nerve injury and repair: regeneration, reconstruction and cortical remodeling. 2nd ed. New York: Elsevier, 2005, pp. 198–244. Google Scholar |
| 6. | Lundborg, G, Rosén, B, Lindberg, S. Hearing as a substitution for sensation: a new principle for artificial sensibility. J Hand Surg Am 1999; 24: 209–214. Google Scholar, Crossref |
| 7. | Mendes, RM, Mazzer, N, Barbosa, RI. Model. Acta Ortop Bras 2011; 19: 289–292. Google Scholar, Crossref |
| 8. | Lanzetta, M, Perani, D, Anchisi, D. Early use of artificial sensibility in hand transplantation. Scand J Plast Reconstr Surg Hand Surg 2004; 38: 106–111. Google Scholar, Crossref, Medline |
| 9. | Mendes, RM, Barbosa, RI, Salmón, CEG. Auditory stimuli from a sensor glove model modulate cortical audiotactile integration. Neurosci Lett 2013; 548: 33–37. Google Scholar, Crossref, Medline |
| 10. | Rosén, B, Lundborg, G. Enhanced sensory recovery after median nerve repair using cortical audio-tactile interaction. A randomized multicentre study. J Hand Surg Eur Vol 2007; 32: 31–37. Google Scholar, Link |
| 11. | Pettengill, K, Van Strien, G. Postoperative management of flexor tendon injuries. In: Skirven T, et al. (eds) Rehabilitation of the hand and upper extremity. Philadelphia, 2011, pp. 457–478. Google Scholar |
| 12. | ASHT, Clinical assessment recommendations. 1992. Google Scholar |
| 13. | Rosén, B, Lundborg, G. A new tactile gnosis instrument in sensibility testing. J Hand Ther 1998; 11: 251–257. Google Scholar, Crossref, Medline |
| 14. | Rosén, B, Lundborg, G. A model instrument for the documentation of outcome after nerve repair. J Hand Surg Am 2000; 25: 535–543. Google Scholar, Crossref, Medline |
| 15. | Beaton, DE, Katz, JN, Fossel, AH. Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther 2001; 14: 128–146. Google Scholar, Crossref, Medline |
| 16. | Roebroeck, A, Formisano, E, Goebel, R. Mapping directed influence over the brain using Granger causality and fMRI. Neuroimage 2005; 25: 230–242. Google Scholar, Crossref, Medline |
| 17. | Waxman, SG. Clinical neuroanatomy. 26th ed. Columbus: McGraw Hill Education, 2010. Google Scholar |
| 18. | Rosén, B, Lundborg, G. Sensory reeducation. In: Skirven T, et al. (eds) Rehabilitation of the hand and upper extremity. Philadelphia, 2011, pp. 634–645. Google Scholar |
| 19. | Lundborg, G, Björkman, A, Hansson, T. Artificial sensibility of the hand based on cortical audiotactile interaction: a study using functional magnetic resonance imaging. Scand J Plast Reconstr Surg Hand Surg 2005; 39: 370–372. Google Scholar, Crossref, Medline |
| 20. | Björkman, A, Waites, A, Rosén, B. Cortical sensory and motor response in a patient whose hand has been replanted: one-year follow up with functional magnetic resonance imaging. Scand J Plast Reconstr Surg Hand Surg 2007; 41: 70–76. Google Scholar, Crossref, Medline |
| 21. | Walbruch, B, Kalliainen, L. The optimization of peripheral nerve recovery using cortical reorganization techniques: a retrospective study of wrist level nerve repairs. J Hand Ther 2015; 28: 341–346. Google Scholar, Crossref, Medline |
| 22. | Jaquet, J-B, Luijsterburg, AJM, Kalmijn, S. Median, ulnar, and combined median-ulnar nerve injuries: functional outcome and return to productivity. J Trauma 2001; 51: 687–692. Google Scholar, Crossref, Medline |
| 23. | Fonseca, MCR, Mazzer, N, Barbieri, CH. Hand injuries: a retrospective study. Rev Bras Ortop 2006; 41: 181–186. Google Scholar |
| 24. | Trybus, M, Lorkowski, J, Brongel, L. Causes and consequences of hand injuries. Am J Surg 2006; 192: 52–57. Google Scholar, Crossref, Medline |
| 25. | Saadat, S, Eslami, V, Rahimi-Movaghar, V. The incidence of peripheral nerve injury in trauma patients in Iran. Ulus Travma Acil Cerrahi Derg 2011; 17: 539–544. Google Scholar, Crossref, Medline |
| 26. | Gupta, A, Gupta, AK, Uppal, SK Demographic profile of hand injuries in an industrial town of north India: a review of 436 patients. Indian J Surg 2013; 75: 454–461. Google Scholar, Crossref, Medline |
| 27. | Rosén, B, Lundborg, G. A new model instrument for outcome after nerve repair. Hand Clin 2003; 19: 463–470. Google Scholar, Crossref, Medline |
| 28. | Vordemvenne, T, Langer, M, Ochman, S. Long-term results after primary microsurgical repair of ulnar and median nerve injuries. A comparison of common score systems. Clin Neurol Neurosurg 2007; 109: 263–271. Google Scholar, Crossref, Medline |
| 29. | Svens, B, Rosén, B. Early sensory re-learning after median nerve repair using mirror training and sense substitution. Hand Ther 2009; 14: 75–82. Google Scholar, Link |
| 30. | Lundborg, G. Brain plasticity and hand surgery: an overview. J Hand Surg Br 2000; 25B: 242–252. Google Scholar, Link |
| 31. | Rosén, B, Balkenius, C, Lundborg, G. Sensory re-education today and tomorrow: a review of evolving concepts. Hand Ther 2003; 8: 48–56. Google Scholar, Link |
| 32. | Paula, MH, Barbosa, RI, Marcolino, AM. Early sensory re-education of the hand after peripheral nerve repair based on mirror therapy: a randomized controlled trial. Braz J Phys Ther 2016; 20: 58–65. Google Scholar, Crossref, Medline |
| 33. | Oud, T, Beelen, A, Eijffinger, E. Sensory re-education after nerve injury of the upper limb: a systematic review. Clin Rehabil 2007; 21: 483–494. Google Scholar, Link |
| 34. | Miller, L, Chester, R, Jerosch-Herold, C. Effects of sensory re-education programs on functional hand sensibility after median and ulnar nerve repair: a systematic review. J Hand Ther 2012; 25: 297–307. Google Scholar, Crossref, Medline |

