Applicability of tactile memory examination as an option to visual- and verbal-based batteries / A aplicabilidade da avalição da memória tátil como uma opção para as baterias visuais a verbais

ABSTRACT The validity and applicability of tactile battery tests for the diagnosis and medical follow-up of patients with Alzheimer's disease and other dementia syndromes do not have their usefulness well understood in clinical practice. While haptic abilities in older individuals receive less attention, in earlier stages of human life they are well focused on. There are even fewer studies on tactile memory, including episodic memory of demented individuals with or without sensorial limitations. The applicability of a new haptic memory battery was evaluated in patients with Alzheimer's disease with mild or moderate commitment. Objective: The aim of this study is to apply a battery based on tactile perception, recognition, and recollection of everyday objects in patients with Alzheimer's disease, testing tactile delayed recall memory discrimination and late recognition to compare validated visual and verbal tests. Methods: Tactile-, visual-, and verbal-based memory performance was registered in 21 patients diagnosed with Alzheimer's disease. Results: Except for tactile identification, it showed that there was a close relationship between the three sensory modalities of memory, with an apparent better performance of tactile incidental memory and recognition compared with the test with pictures. Conclusions: The haptic evaluation of memory demonstrated applicability in the evaluation of memory dysfunction in patients with Alzheimer's disease. Further studies are needed to establish the sensibility and specificity of the proposed test that had a small sample size and many limitations.

RESUMO A aplicação de baterias baseadas em informações táteis para diagnóstico e acompanhamento de pacientes com doença de Alzheimer e outras demências não é muito difundida na prática clínica. Ao passo que a capacidade de reconhecimento tátil de objetos em crianças recebe bastante atenção dos pesquisadores, o mesmo não ocorre com indivíduos mais idosos. Existem ainda menos estudos abordando avaliação de memória episódica em pacientes idosos, com ou sem limitações sensoriais, como cegueira e surdez. O presente estudo propõe avaliar aplicabilidade de teste para avaliação de memória tátil em paciente com doença de Alzheimer. Objetivo: Aplicar em pacientes com doença de Alzheimer uma bateria baseada na percepção e reconhecimento táctil de objetos de uso cotidiano, avaliando a memória e reconhecimento tardio, comparado com testes visuais e verbais validados. Métodos: Foi avaliado o desempenho de baterias baseadas em informação táteis, visuais e verbais em 21 pacientes diagnosticados com a doença de Alzheimer. Resultados: Com a exceção da percepção tátil, foi demonstrada uma boa correlação entre as três modalidades de apresentação das informações a serem resgatadas tardiamente. Houve um desempenho aparentemente melhor do reconhecimento tátil quando comparado com apresentação de figuras impressas. Conclusões: A determinação da memória tátil em pacientes com doença de Alzheimer demonstrou ser aplicável como instrumento de avaliação dos distúrbios de memória presentes em portadores de doença de Alzheimer com comprometimento leve a moderado. As limitações do estudo, com reduzido tamanho da amostra, aponta para a necessidade de novos estudos com a devida validação, incluindo determinação de sensibilidade e especificidade, assim como pareamento, de acordo com sexo e idade com grupo controle.

Efeito de uma sessão de exercício resistido na sensibilidade cutânea em idosas hipertensas e normotensas fisicamente ativas / Effect of one session resistance exercise on skin sensibility in hypertensive and normotensive physically-active older woman

O estudo teve como objetivo analisar o efeito de uma sessão de exercícios resistidos na sensibilidade cutânea em idosas hipertensas e normotensas fisicamente ativas, bem como comparar a sensibilidade cutânea entre os dois grupos. Participaram deste estudo 32 mulheres (65,8 ± 5,1anos; 69,5 ± 13,7Kg; 1,60 ± 0,1m) fisicamente ativas, que foram classificadas em hipertensas (n = 15) e normotensas (n = 17). Todas as participantes responderam a um questionário de anamnese clínica e Questionário Baecke Modificado para Idosos. Antes e após a sessão de exercícios resistidos, a sensibilidade cutânea da mão dominante foi avaliada em sete pontos anatômicos das regiões dorsal e palmar, por meio da estimulação de seis monofilamentos de Semmes-Weinstein. As cargas empregadas durante a sessão de exercícios resistidos foram determinadas na semana anterior ao protocolo experimental. O teste de Wilcoxon revelou que não houve diferença estatisticamente significante no teste de sensibilidade cutânea, antes e após a sessão de exercícios resistidos, para ambos os grupos. Contudo, o teste U-Mann-Whitney apresentou diferença estatisticamente significante entre os grupos, em três pontos, no momento pré e um ponto, no momento pós-sessão de exercícios resistidos. Uma sessão de exercícios resistidos não modificou a sensibilidade cutânea de idosas hipertensas e normotensas. Entretanto, as participantes hipertensas apresentaram sensibilidade cutânea reduzida em alguns pontos quando comparadas com as normotensas.

The aim of this study was to analyze the effect of a single session of resistance training on skin sensitivity in physically active, hypertensive and normotensive older women, as well as compare skin sensitivity in both groups. Thirty-two physically active women (mean age 65.8 ± 5.1 years; weight, 69.5 ± 13.7 kg; height, 1.60 ± 0.1 m) participated in this study and were classified as hypertensive (n = 15) or normotensive (n = 17). All participants answered a clinical history questionnaire and the Modified Baecke Questionnaire for Older Adults. Before and after the resistance training session, the skin sensitivity of the dominant hand was assessed at seven anatomical sites on the dorsal and palmar surfaces by stimulation with a Semmes-Weinstein monofilament esthesiometer. The loads employed during the resistance training session were determined one week before the experimental protocol. The Wilcoxon test showed no statistically significant differences in the skin sensibility test before and after resistance training in either groups. However, the Mann-Whitney U revealed a statistically significant between-group difference in sensitivity at three sites before resistance training and at only site post-training. A single session of resistance training had no effect on the skin sensitivity of hypertensive and normotensive older women. However, hypertensive participants exhibited reduced skin sensibility at some anatomical sites as compared with normotensive women.

Early Objectified Detection Method of Sensorineural Component in Hand Arm Vibration Syndrome / 대한산업의학회지

OBJECTIVES: In order to determine find out the best methods for a more objective detection of neurologic abnormality in early hand arm vibration syndrome(HAVS), early with analyzing the validity of each of the detection methods was analyzed. We evaluated the relationships between the sensorineural stage of Stockholm-revised vibration syndrome classification and the results of several tests. METHODS: 497 workers were investigated for symptom, exposure duration, the types of tools used, and medical history from January 2000 to December 2007. Pain sense threshold, vibrotactile threshold, hand grasp force, finger grasp force, and a finger tapping frequency test were performed by the workers. RESULTS: The grinder(67.3%) was the most commonly used tool and the mean exposure duration was 14.8 years. Although the pain sense and vibrotactile threshold level tended to increase according to sensorineural stage of the Stockholm classification, there was statistically significant difference in the vibrotactile threshold of 125, 250 Hz (p=0.006~0.038) but not in the pain sense threshold. Hand and finger grasp force tended to decrease according to the sensorineural stage of Stockholm classification and there was statistically significant difference(p=0.041,<0.001, 0.034) only on the right hand side. The tapping frequency also generally decreased according to the sensorineural stage of the Stockholm classification and there was statistically significant difference (p=0.002~0.019) only on the left hand side. CONCLUSIONS: Although there is no single standardized method that can objectively diagnose the sensorineural component of early HAVS early, the combination of subjective symptoms, the sensorineural stage of Stockholm classification, the pain and vibrotactile threshold test, the hand and finger grasp force, and the finger agility (tapping) test can objectively detect sensorineural component of HAVS early.

Early Objectified Detection Method of Sensorineural Component in Hand Arm Vibration Syndrome / 대한산업의학회지

OBJECTIVES: In order to determine find out the best methods for a more objective detection of neurologic abnormality in early hand arm vibration syndrome(HAVS), early with analyzing the validity of each of the detection methods was analyzed. We evaluated the relationships between the sensorineural stage of Stockholm-revised vibration syndrome classification and the results of several tests. METHODS: 497 workers were investigated for symptom, exposure duration, the types of tools used, and medical history from January 2000 to December 2007. Pain sense threshold, vibrotactile threshold, hand grasp force, finger grasp force, and a finger tapping frequency test were performed by the workers. RESULTS: The grinder(67.3%) was the most commonly used tool and the mean exposure duration was 14.8 years. Although the pain sense and vibrotactile threshold level tended to increase according to sensorineural stage of the Stockholm classification, there was statistically significant difference in the vibrotactile threshold of 125, 250 Hz (p=0.006~0.038) but not in the pain sense threshold. Hand and finger grasp force tended to decrease according to the sensorineural stage of Stockholm classification and there was statistically significant difference(p=0.041,<0.001, 0.034) only on the right hand side. The tapping frequency also generally decreased according to the sensorineural stage of the Stockholm classification and there was statistically significant difference (p=0.002~0.019) only on the left hand side. CONCLUSIONS: Although there is no single standardized method that can objectively diagnose the sensorineural component of early HAVS early, the combination of subjective symptoms, the sensorineural stage of Stockholm classification, the pain and vibrotactile threshold test, the hand and finger grasp force, and the finger agility (tapping) test can objectively detect sensorineural component of HAVS early.