Abstract

Hand function deterioration brings about inconvenience to the daily lives of the chronic kidney disease patients. However, a full spectrum of hand function examination is absent. Therefore, this study aimed to classify the hand sensorimotor functions of the chronic kidney disease patients using the novel sensorimotor assessment tools, manual tactile test (MTT) and pinch-holding-up activity (PHUA) test, and explore the feasibility in comparison with traditional evaluations in the clinical practice. 68 stage-5 chronic kidney disease patients and 50 healthy subjects were recruited in this study. A series of conventional evaluations and two novel hand function tools, manual tactile test and pinch-holding-up activity test were conducted from the perspective of hand dexterity, sensory input threshold, force generation and sensorimotor control. Independent t-test was used to find out group differences and the receiver operating characteristic curve was used to determine accuracy of the tests. In our results, significant reduction of hand dexterity, sensory input, force generation and sensorimotor control was found in patients from an overall perspective. This trend was discovered to be the same when dividing the subjects into the old and young age group. From the receiver operator characteristic curves, nearly all the areas under the curve of all tests were over 0.8. The novel evaluation tools, the manual tactile test and pinch-holding-up activity, were found to have comparable or even better accuracy than the traditional ones. The shape and weight subtests of the manual tactile test displayed the highest accuracy. To sum up, by incorporating the novel and conventional assessment tests, this study built up the fundamental understanding of the hand functions in multiple dimensions and consolidate the clinical merits of applying the two novel tools, manual tactile test and pinch-holding-up activity, on chronic kidney disease patients.

Highlights

  • Chronic kidney disease (CKD) has an estimated prevalence of around 8.2% worldwide and the actual number varies with different areas.[1]

  • The following conditions were used as exclusion criteria: (1) traumatic nerve injuries of the upper limbs, (2) trauma to the hand or congenital anomalies of the wrist and hand, (3) skin infections or disease, (4) known vascular complications of diabetes mellitus (DM), such as stroke may have compromised the physical integrity of the patient, (5) grade 2 or higher arterial hypertension (>160/100 mmHg) or (6) cognitive deficits

  • A significant decrease in dexterity, sensory input, and sensorimotor control have been discovered in CKD patients in comparison with the healthy

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Summary

Introduction

Chronic kidney disease (CKD) has an estimated prevalence of around 8.2% worldwide and the actual number varies with different areas.[1] It has been a major problem for many people especially for those in stage five. Among various complications, peripheral neural dysfunction has brought a huge impact on the daily lives of patients with CKD. Mononeuropathies are commonly seen in patients with CKD, especially forearm nerves. Patients undergoing chronic dialysis are predisposed to mononeuropathies.[2] Ulnar nerve syndrome and carpal tunnel syndrome are all possible complications with a high incident rate, leading to finger numbness, hand muscle atrophy or adhesion of tendon sheaths.[3,4,5,6,7] Though mononeuropathies are quite common clinically, there is limited knowledge from previous studies, especially in comprehensive hand function assessment

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