Diagnostic performance of cold provocation test with hands immersion in water at 10°C for 5 min evaluated in vibration-induced white finger patients and matched controls.

PURPOSE: This study aimed to explore the diagnostic ability of the cold provocation test with hands immersion in water at 10°C for 5 min in diagnosing vibration-induced white finger (VWF). METHODS: Finger skin temperature (FST) was measured in 20 VWF patients and 20 matched healthy controls, at palmar side of the distal phalanges of fingers from both hands before, during, and after hands immersion in water at 10°C (for 5 min with waterproof coverings put on both hands). Data from 4 fingers (except thumb) were evaluated at five time points: just before immersion, last minute during immersion, and at 5th, 10th, and 15th min during the post-immersion or recovery period. RESULTS: A positive group difference between patients and controls was revealed during the recovery period. During recovery at 95 and 70% specificity, the sensitivity ranged from 20 to 30% and 50 to 70% for evaluation with average FST for 4 fingers and 15-35% and 60-65% for evaluation with minimum FST among 4 fingers, respectively. Overall, evaluation of absolute FST at 15th min of recovery offered better diagnostic ability. CONCLUSIONS: The cold provocation test with hands immersion in water at 10°C for 5 min could discriminate VWF patients from healthy controls; however, this test has a limited diagnostic value in diagnosing patients with VWF.

Vibrotactile perception at glabrous and nonglabrous skin of fingers: repeatability of measurements and changes induced by acute vibration exposure.

OBJECTIVES: We sought to determine the within-session and between-session repeatability of vibrotactile perception threshold (VPT) measurements and the response patterns in VPT induced by acute exposure to short-term vibration from grasping a vibrating handle, at both glabrous and nonglabrous skin of fingers. METHODS: Baseline VPT was recorded twice at glabrous and nonglabrous side of fingers in the right hand of eight healthy volunteers. Then, the subjects were exposed to three exposure conditions (vibration at 31.5 Hz and 250 Hz, and no vibration), from gripping a vertical handle by the right hand, conducted on 3 different days at an interval of 1-3 wk. After exposure, the subjects released the hand and further VPT measurements at each location were made. RESULTS: Compared to the nonglabrous side, VPT measurements at the glabrous side demonstrated better within-session and between-session repeatability with lower coefficient of repeatability and higher intraclass correlation coefficient. After exposure, a significant increase in VPT was noted under both 31.5 Hz and 250 Hz (p<0.05-0.001) exposure conditions in the glabrous finger. In the nonglabrous finger, a pronounced increase in VPT was revealed under 250 Hz exposure condition (p=0.05). CONCLUSIONS: While measuring VPT at glabrous and/or nonglabrous fingers, the importance of the site of measurement should be considered; the repeatability for such measurements appears to be better at the glabrous site. At high frequency, vibrotactile perception appears to be affected in both glabrous and nonglabrous skin from acute vibration exposure.