Subject(s)
Humans , Peripheral Nervous System Diseases/surgery , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/physiopathology , Peroneal Neuropathies/physiopathology , Ulnar Neuropathies/physiopathology , Skin Ulcer/surgery , Skin Ulcer/diagnosis , Skin Ulcer/physiopathologyABSTRACT
Leprosy is primarily a disease of skin and peripheral nerves. Because of nerve function impairment, leprosy patients may develop primary nerve related impairments such as, loss of sensation and weakness or paralysis. These primary impairments may lead to secondary impairments such as ulceration and contractures. Many other diseases and disorders present with similar impairments as seen in leprosy e.g. diabetes and peripheral nerve injuries. Nerve function assessment and ulcer prevention and treatment are areas that have been researched in leprosy but these research findings are not yet commonly known and adopted in diseases and disorders that 'relate' to leprosy. Rehabilitation is a relatively new field in medicine and not (well) developed in many developing countries. Rehabilitation requires an integrated approach from different disciplines and professionals. As for other medical specialty fields, rehabilitation demands evidence based practice.
Subject(s)
Humans , Activities of Daily Living , Patient Care Team/organization & administration , Leprosy/classification , Leprosy/complications , Leprosy/diagnosis , Leprosy/rehabilitation , Evidence-Based Medicine , Physical and Rehabilitation Medicine/methods , Physical and Rehabilitation Medicine/standards , Physical Therapy Modalities/methods , Physical Therapy Modalities/standardsABSTRACT
Sensory testing with Semmes-Weinstein filaments was conducted on: 112 normal subjects to determine the effects of age, gender and occupation on threshold perception, 27 Hansen's disease (HD) patients to determine inter-observer and intra-observer reliability of testing, and 101 patients with HD and a history of hand and/or foot ulceration to identify thresholds for injury risk. Filament thresholds were found related to age (p 0.1). Inter-observer and intra-observer reliability was found to be high (intraclass correlation coefficient = 0.88-0.93). The 4.93 (7.0-7.7 g) filament had 97% sensitivity and 100% specificity for identifying a history of foot injuries, and the 4.17 (1.2-1.6 g) filament had 100% sensitivity and 100% specificity for identifying hand injuries.