Evaluation of the effectiveness of sensory reeducation following digital replantation and revascularization

Abstract

Sensory recovery following digital replantation plays an important role in the restoration of hand function. Twelve patients with twenty-four replanted or revascularized digits were randomly selected to enter a program of sensory reeducation, and another 15 patients with 22 replanted or revascularized digits were selected as controls who did not receive sensory reeducation. A moving two-point discrimination and a Semmes-Weinstein pressure threshold test were evaluated for monitoring the sensory recovery. The period of sensory reeducation was 18.83 weeks on average, and the mean follow-up time was 11.94 months. The group that received sensory reeducation significantly improved to a better degree of moving two-point discrimination and Semmes-Weinstein threshold level by both univariate and multiple regression analysis. We suggest that sensory reeducation should be an integral part of the postoperative rehabilitation protocol following digital replantation and revascularization.

Functional sensibility assessment. Part I: develop a reliable apparatus to assess momentary pinch force control

“…The common sensory evaluations include the static and dynamic two-point discrimination tests and Semmes-Weinstein monofilament test. 7,8 However, classical sensibility tests do not reflect the true functional sensation of the injured hand. [9][10][11] Cutaneous sensory message is closely linked to motor areas, 12 and sensory feedback from the thumb and fingers may influence the coordination of precision grip.…”

Long-term effects of sensory reeducation following digital replantation and revascularization

“…1,[3][4][5][6][7][8][9]14 It is widely applied in patients following nerve repair, [4][5][6][7][8][9]15 digital replantation, 1,3,14 toe-to-hand transfer, 1,10-12 and free flap transfer. 13,15 Besides employing sensory reeducation in the peripheral lesion, it has also been used in patients who were hemiplegic 16 or who had cortical lesions.…”

“…According to our last article, 14 a total of 24 digits in 12 patients were entered into the formal sensory reeducation program following replantation or revascularization, and another 22 digits in 15 patients, as the control group, did not receive the sensory reeducation. We discontinued the proceeding of sensory reeducation in the formal reeducated group one year before this follow-up.…”

“…[3][4][5][6][7][8][9][10][11][12][13] The effectiveness of such a program has also been described in a previous article with statistical analysis. 14 However, the improvement of sensory recovery following reeducation has resulted from the retraining effect, or the real ameliorative central or peripheral regeneration process, which is still controversial and difficult to prove based on the biochemistry or neuroscientific studies. Some clinicians believe that the maintenance of sensory recovery depends on the continuous use of the hand, 1,2,15 but no statistical data has been available to confirm it.…”

Desensitization and Reeducation

“…This training may also prevent permanent pain pathways from forming within the central nervous system, thereby lessening the development of chronic pain disorders. 4,5 TREATMENT GOALS…”