Study On The Rehabilitation Of Upper Limb Peripheral Nerve Injury By Finger Frequency Meter

Objective: Patients with upper limb peripheral nerve,the feeling,exercise and nutrition function will be affected,which seriously affected the life of patients.After surgery and medication,the patient will be treated with rehabilitation therapy.It has been a long history using finger tapping test in evaluating motor skills.The finger tapping frequency(abbreviation finger tapping)used in medicine to assess the integrity of the nerve and muscle,the toxic substances effected on the nervous system;used in sports is often to evaluate the motor skills between people has the difference;used in neuropsychology is often to evaluate the cognitive function of patients.In our previous study,we found that it is effective to evaluate the recovery of hand function in stroke patients.In the present study,we aimed to analyze the correlation between finger tapping frequency and the traditional evaluation hand function scales of the affected hand of patients presenting with upper limb peripheral nerve injury to provide a reference for tapping frequency applications in hand function assessment.We also want to understand whether there exists the limits of finger tapping frequency in the upper limb peripheral nerve detection,and the effects of rehabilitation treatment on upper limb peripheral nerve through finger tapping.Methods: Fifty four patients with upper limb peripheral nerve injury(36 males and 18 females)were selected from cases that were admitted to the Hand Surgery and Rehabilitation Medicine Department of Shanghai Fudan University affiliated Huashan Hospital.These cases included 21 subjects with left upper limb peripheral nerve injury and 33 with right upper limb peripheral nerve injury.These case covered nine subjects with brachial plexus nerve injury,nine with ulnar nerve injury,eight with radial nerve injury,four with median nerve injury,fifteen with cervical radiculopathy,and nine with a variety of upper limb peripheral nerve injuries.All of the subjects are right-handed.Before the test,the doctor and hospital acquired consent,check patients,according to the test standard screening subjects,explaining the purpose and experimental procedures to patients and families of patients,and matters needing attention,and invite them to participate in this experiment.All participants who agreed to participate in the study signed informed consent before testing.First we measured lind-mark hand function assessment of the subject.Lind-mark hand function assessment include eight movement,with a maximum score of 24.Then,subjects were asked to sit under the normal posture in the process of test(head straight,eyes staring in front of the swing frame),metacarpophalangeal joint arch,the pain heel and three lateral fingers contacting with desktop,index finger extension stretch into the swing frame.Subjects started the formal test after 1-2 exercise.When the tester and the subject were both ready.the subject began to swing his index finger tap rapidly and repetitively as soon as he heard the starting the gun and at the same time the instrument started timing automatically.The data were inputted into computer within the setting time.After 2-week rehabilitation treatment in Rehabilitation Medicine Department of Huashan Hospital affiliated to Shanghai Fudan University,we measured finger tapping test,and lind-mark hand function assessment of the 54 subjects again.Results:1 Finger tapping and lind-mark score have a high positive correlation regardless of which side of upper limb with peripheral nerve injury or before-and after the rehabilitation treatment(Right: before treatment R~2=0.795,p=0.000,After treatment R~2=0.793,p=0.000;Left: before treatment R~2=0.668,p=0.000,After treatment R~2=0.762,p=0.000)2 The lind-mark score of the affected hand is higher than that before treatment,but there is no significant improvement after 2-week rehabilitation treatment.3 We find that finger tapping of the right affected hand is significantly higher than that before treatment(male: p<0.05,female: p<0.01),but finger tapping of the left affected hand has no significant improvement.4 We also find that finger tapping of the unaffected hand of female subjects is significantly higher than that before treatment(left: p<0.01,right: p<0.05),but there is no such kind of improvement in male subjects after 2-week rehabilitation treatment.5 We don't find any correlation between finger tapping and lind-mark score of the affected hand with median nerve injury and ulnar nerve.6 Finger tapping and lind-mark score of the nine subjects with brachial plexus nerve injury have a high positive correlation after treatment(R~2=0.980,p=0.000).Finger tapping and lind-mark score of the affected hand of the nine subjects with brachial plexus nerve injury are higher than that before treatment,but there is no significant improvement after 2-week rehabilitation treatment.7 Finger tapping and lind-mark score of the eight subjects with radial nerve injury have a high positive correlation after treatment(R~2=0.805,p=0.003).Finger tapping and lind-mark score of the affected hand of the eight subjects with radial nerve injury are higher than that before treatment,but there is no significant improvement after 2-week rehabilitation.8 Finger tapping and lind-mark score of 15 subjects with cervical radiculopathy have a low positive correlation(pre-treatment:R~2=0.302,p=0.034 post-treatment: R~2=0.0357,p=0.019).Finger tapping of the affected hand of the 15 patients with cervical rediculopathy is significantly higher than that before treatment(p<0.01).However,no difference has been found in lind-mark score before-and-after treatment.Conclusion: Finger tapping and lind-mark score have a high positive correlation regardless of which side of upper limb with peripheral nerve injury or before-and-after the rehabilitation treatment.Therefore,finger tapping can be used clinically to detect changes of peripheral nerve injury upper limb during rehabilitation therapy and subsequent.After the 2-week,the scores of the Lind-mark scale and the finger tapping were improved.This shows that patients with upper limb peripheral nerve injury should be actively rehabilitation treatment,cannot be ignored in this process.There is no correlation between finger tapping and lind-mark score of the subjects with ulnar nerve injury and median nerve injury.There is low correlation between finger tapping and lind-mark score of the subjects with cervical radiculopathy.So the finger tapping test is limited to the index finger,there will be difficulty in its elaboration to other kind of nerve injury.