How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives

Haw-Yen Chiu; Hsiu-Yun Hsu; Li-Chieh Kuo; Fong-Chin Su; Hui-I Yu; Shih-Che Hua; Chieh-Hsiang Lu

doi:10.1371/journal.pone.0094452

How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives

PLoS One. 2014 Apr 10;9(4):e94452. doi: 10.1371/journal.pone.0094452. eCollection 2014.

Authors

Haw-Yen Chiu¹, Hsiu-Yun Hsu², Li-Chieh Kuo³, Fong-Chin Su⁴, Hui-I Yu⁵, Shih-Che Hua⁵, Chieh-Hsiang Lu⁶

Affiliations

¹ Section of Plastic Surgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
³ Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁴ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Internal Medicine, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chiayi City, Taiwan.
⁶ Department of Internal Medicine, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chiayi City, Taiwan; Department of Business Administration, College of Management, National Chung Cheng University, Chiayi County, Taiwan; Ta Tung Institute of Commerce and Technology, Chiayi City, Taiwan.

Abstract

To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA) test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM) and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination (S2PD and M2PD), maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05) in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001) revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001) between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Case-Control Studies
Diabetes Complications
Diabetes Mellitus / diagnosis
Diabetes Mellitus / physiopathology*
Female
Hand / physiopathology*
Humans
Male
Median Neuropathy / complications
Median Neuropathy / diagnosis*
Median Neuropathy / physiopathology*
Middle Aged
Pinch Strength*
ROC Curve
Sensation

Grants and funding

This work was supported by a research grant from the Ditmanson Medical Foundation, Chiayi Christian Hospital, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.