Determining Clinical Outcomes

Thomas M. Brushart

in Nerve Repair

Published on behalf of Oxford University Press

Published in print May 2011 | ISBN: 9780195169904
Published online September 2012 | e-ISBN: 9780199965168 | DOI:
Determining Clinical Outcomes

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  • Sensory and Motor Systems
  • Rehabilitation Medicine


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Cutaneous sensation is evaluated at three levels: detection of threshold stimuli, integration of stimuli for spatial discrimination, and object recognition. Touch threshold is measured by Semmes-Weinstein monofilament testing (SWMT) and spatial discrimination is evaluated most often by measuring two-point discrimination (2-PD). Tests of localization also depend upon spatial discrimination and often predict function, but have not been standardized. Until recently object recognition was tested with a variety of "pick-up" tests, but now the validated shape texture identification (STI) test is available. Manual muscle testing is imprecise; use of a hand-held dynamometer improves accuracy, as does measurement of grip and pinch strength with purpose-built devices. The results of electrodiagnostic testing correlate poorly with functional outcome. Frameworks for reporting the results of nerve repair have diverged widely from their WWII origin in the Medical Research Council. The first outcome instrument validated specifically for peripheral nerve has been introduced recently by Rosen and Lundborg.

Chapter.  11895 words.  Illustrated.

Subjects: Sensory and Motor Systems ; Rehabilitation Medicine

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