Relationship Between Sensibility Tests and Functional Outcomes in Patients With Traumatic Upper Limb Nerve Injuries: A Systematic Review.
Liheng Chen, Emmanuel Ogalo, Chloe Haldane and 2 others
PMID 34977541WHAT IT FOUND
Semmes-Weinstein monofilament and Weinstein Enhanced Sensory Test scores consistently tracked with hand function, quality of life, and return-to-work status.
Two-point discrimination results were inconsistent, so improved scores on that test do not reliably predict better daily function.
Key findings
01Semmes-Weinstein monofilament (SWMF) scores correlated with SF-36 quality of life (r=0.548) and PRWHE function domain (r=0.58), and differed significantly between those who returned to work and those who did not (P=.001).
02Static two-point discrimination (s2-PD) results were equivocal: two studies found strong/low correlations with pick-up tests, but two others found no association, and no significant correlation was demonstrated with ADL.
03Composite sensory scores (MRC sensory scale and Rosén score sensory domain) correlated with hand functions and activities of daily living, suggesting better overall sensibility tends to accompany better functional capacity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies were level IV evidence, and only 38% demonstrated high external validity. There was significant heterogeneity in how sensibility tests and functional outcomes were measured and reported, preventing quantitative aggregation (meta-analysis). Eight studies did not control for extraneous variables like age or surgery delay. The review only captured median and ulnar nerve injuries, excluding brachial plexus injuries. Some functional assessments were developed or validated by the study authors themselves, which may affect their psychometric properties.
Declared interests
None reported in the provided text.
The easy way to misread this
Do not assume that improving a patient's two-point discrimination score will lead to better hand function or daily living skills. The review found equivocal and often non-significant correlations between two-point discrimination and functional outcomes, unlike the consistent correlations seen with monofilament tests.