Measurement of manipulative dexterity in patients with hand-arm vibration syndrome.

Abstract

The purpose of the study was to assess quantitative measurements of the manipulative dexterity of patients suffering from hand-transmitted vibration disorder, and to investigate a possible link with impaired tactile perception in their hands. The subjects were 30 patients with hand-arm vibration syndrome, 30 office workers and 20 manual laborers of similar ages. Manipulative dexterity was assessed by measuring the performance time of buttoning-unbuttoning a work jacket with five buttons and of picking up and transferring 30 red beans, one by one, with the fingers from one plate to another. Patients were also examined on vibrotactile thresholds at 125 Hz as well as pain thresholds. The buttoning-unbuttoning time and the bean transfer time were significantly prolonged in the patients compared with the worker groups. The patients showed a close correlation between the buttoning-unbuttoning time and the bean transfer time. Performance times did not differ between patients with vibration-induced white finger and those without it. Those times also correlated with the vibrotactile and pain thresholds in the patients. When a cut-off value was set at 2 SDs from the mean performance times of the manual laborers, exceeding the cut-off value was found in 70% of the patients for the button-unbutton test and in 80% of those for the bean transfer test. All patients with moderately or severely increased vibrotactile and pain thresholds exceeded that value in performing the two tasks. The present measurements quantitatively showed impaired manipulation in patients with hand-arm vibration syndrome. Such difficulty with manipulation seems to be associated with the impaired tactile sensation in their hands.