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

手部感觉功能障碍，即触觉、压力感、振动感（苍白感）等功能障碍的康复对于脑损伤患者的上肢和手部的操作技能非常重要。我们研制了一种新的“计算机化手部感觉训练与检测系统”，该系统由触觉刺激模块和振动刺激模块两部分组成，可以对手部的触觉和振动感觉进行反复训练和检测。触觉刺激模块具有尼龙单丝测试器，每个测试器自动移动以触摸指垫。该模块对手指随机施加一系列触觉刺激及其安慰剂，得到受试者的感觉反应。如果反应足够正确，则刺激水平降低。受试者最终达到的最小刺激水平被定义为受试者的触觉敏感性阈值。 关于我们 e主题。在触觉训练中，在感觉阈水平附近反复刺激，振动刺激模块中装有小型振动器，控制振动器输出128 Hz的变幅正弦振动。手指的第一关节由振动器的头部给予振动刺激。以与触觉敏感性阈值相同的方式测量振动敏感性阈值作为最小刺激水平。振动觉运动是在感觉阈水平附近反复刺激，每隔24小时以上测量一次感觉阈，计算出触觉检查和振动觉检查的相关系数分别为0.91和0.78。这些值对于使用刺激模块的敏感性阈值的可靠性和再现性来说是相当高的。康复训练表明，在一周的训练时间内，触觉和振动觉的感觉阈值均下降。这些结果表明，该系统是有用的检查和训练练习的触觉和振动感觉功能障碍的手。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