Development of Computerized Sensation Exercise and Inspection System for Sensational Dysfunctions in Hand and Its Clinical Application in Rehabilitation

手的感觉功能障碍，即触觉、压力、振动（麻木感）等功能障碍的康复，对脑损伤患者的上肢和手的操作技能非常重要。我们开发了一种新的“电脑化的手部感觉练习和检查系统”，我们可以反复练习或检查手的触觉和振动敏感性。该系统由两个模块组成，触觉刺激模块和振动刺激模块。触觉刺激模块拥有尼龙单丝测试器，每个测试器自动移动以触摸手指垫。该模块随机给手指一系列的触觉刺激和安慰剂，并得到受试者的敏感性反应。如果反应足够正确，那么刺激水平就会降低。被试最终达到的最小刺激水平被定义为被试的触觉敏感性阈值。在触觉阈值水平周围给予触觉刺激。振动刺激模块配有小型振动器，控制该振动器输出可变振幅的128 hz正弦振动。通过振动器的头部对手指的第一个关节进行振动刺激。振动敏感性阈值以与触觉敏感性阈值相同的方式作为最小刺激水平来测量。振动感觉练习是围绕敏感阈值水平给予反复刺激。敏感度阈值每隔24小时测量一次，触觉检查阈值的相关系数为0.91，振动感觉检查阈值的相关系数为0.78。这些值对于使用刺激模块的敏感性阈值的可靠性和可重复性来说是相当高的。康复训练表明，触觉和振动感觉的敏感性阈值在一周的训练时间内都有所下降。这些结果表明，该系统对手部触觉和振动感觉功能障碍的检查和训练都是有用的。少

Rehabilitation of sensational dysfunctions in a hand, i.e. dysfunctions of tactile sensation, pressure sensation, vibratory sensation (pallesthesia) and so on, is very important for manipulation skill of an upper limb and a hand of brain damaged patients. We developed a new "Computerized Hand Sensation Exercise and Inspection System" with which we can be repeatedly to exercise or to examine the tactile and vibratory sensibilities of a hand.The system consists of two modules, a tactile stimulation module and a vibratory stimulation module. The tactile stimulation module possesses nylon monofilament testers, each of which automatically moves to touch a finger pad. The module gives a sequence of the tactile stimulation and its placebo to the finger randomly and gets sensibility responses of a subject. If the responses are correct enough, then the stimulation level is decreased. A minimum stimulation level finally reached by the subject is defined as the tactile sensibility threshold of th … More e subject. A tactile sensation exercise is given the repeated stimulations around the sensibility threshold level.A vibratory stimulation module is equipped with a small vibrator, which is controlled to output the 128 Hz-sinusoidal vibration with variable amplitude. The first joint of a hand finger is given vibratory stimulations by the head of the vibrator. A vibratory sensibility threshold is measured as a minimum stimulation level in the same manner of the tactile sensibility threshold. The vibratory sensation exercise is given the repeated stimulations around the sensibility threshold level.The sensibility thresholds were measured at intervals of over 24 hours and the correlation coefficients of the thresholds were calculated as 0.91 for the tactile sensation examination and 0.78 for the vibratory sensation examination. These values are reasonably high for the reliability and the reproducibility of the sensibility thresholds by using the stimulation modules. The rehabilitation exercises show that the sensibility thresholds decreased for the duration of one week training both of the tactile sensation and vibratory sensations. These results suggest that this system is useful for both of the examination and the training exercise for the tactile and vibratory sensation dysfunctions of a hand. Less