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Biomedical subjects

C B Novak

Publications and source records attributed to C B Novak.

45 records · Page 3Linked to original sources
PubMed1993

Establishment of reliability in the evaluation of hand sensibility.

Evaluation of hand sensibility using measures of threshold and tactile discrimination are standard assessment methods following nerve injury. Many of the available sensory measures for the quantification of hand sensibility lack verification of intertester reliability. Intertester reliability of vibration threshold, cutaneous pressure threshold, two-point discrimination, object identification, and texture identification was established. The intraclass correlation coefficient ranged from 0.96 to 0.99 for all variables except texture identification (r = 0.77). Comparisons were made between the sensory measures and each functional measure. The strongest correlational relationship was between two-point identification and object identification. Based on the results of this study, evaluation of hand sensibility may be attained with measurement of vibration and cutaneous pressure threshold, two-point discrimination, and object identification.

Adult↗
PubMed1993

Facial sensibility in patients with unilateral facial nerve paresis.

This study evaluated facial sensibility in 29 patients with unilateral lower motoneuron facial nerve paresis using standard clinical tests of sensory evaluation used at other anatomic sites, most commonly the hand. Vibratory and cutaneous pressure thresholds and moving and static two-point discrimination were measured. Statistically significant differences were found between the affected and unaffected sides of the face, with vibration threshold, cutaneous pressure threshold, and static two-point discrimination being greater on the affected side. Vibration thresholds and two-point discrimination (moving and static) progressively decreased, moving down the face from the forehead to the cheek, chin, and then the lip. Sensibility thresholds are altered in patients with unilateral lower motor neuron facial nerve paresis. These findings document a relationship between sensory disturbance and lower motoneuron facial nerve paresis. The potential functional significance of this relationship has clinical significance for patients undergoing rehabilitation training.

Adolescent↗
PubMed1992

Provocative sensory testing in carpal tunnel syndrome.

This study reports the relationship between three clinical tests in the diagnosis of carpal tunnel syndrome and the stages of nerve compression. Assessments of 158 patients with carpal tunnel syndrome were reviewed retrospectively. 77% of patients had at least one of the clinical signs present. The incidence of positive pressure-provocative and Phalen's tests were similar and more likely to occur in combination than separately. Tinel's sign was more likely to be positive in the later stages of nerve compression. Our results suggest that the presence or absence of a provocative test is dependent upon the severity of the nerve compression.

Adult↗
PubMed1992

Sensory recovery after median nerve grafting.

Fourteen patients were evaluated prospectively after median nerve grafts. Twelve male and two female patients with a mean age of 41 years were included. Mean time since surgery was 4 years. Detailed sensory evaluations were completed. Statistical evaluation analyzed relationships between object identification, sensory tests, and graft length. According to the S-0 to S-4 grading system, 11 patients were considered to be S-3+ or greater. Recovery of moving two-point discrimination of 2 to 3 mm. was achieved by 50% of the patients. Strong correlations were found between object identification and static two-point discrimination, moving two-point discrimination, and graft length. Cutaneous pressure threshold and vibration threshold correlated weakly with object identification.

Adult↗
PubMed1992

Verification of the pressure provocative test in carpal tunnel syndrome.

Three provocative tests (pressure, Phalen's test, and Tinel's sign) were studied in 30 patients with carpal tunnel syndrome and 30 control subjects. The pressure provocative test had a sensitivity of 100%. In contrast, Phalen's test was 88% sensitive and Tinel's sign only 67% sensitive. The pressure provocative test is a sensitive indicator of median nerve compression at the wrist with a faster reaction time than Phalen's test (mean time of 9 seconds vs 30 seconds). It is an appropriate provocative test in patients with stiff or painful wrists when wrist flexion is restricted.

Adult↗
PubMedDate not supplied

Evaluation of hand sensibility: a review.

Many assessment devices and measures have been described to evaluate sensibility, with little consensus on the optimal measurement tool. The purpose of this paper is to review the assessment methods and devices used in the evaluation of hand sensibility. Consideration is given to the characteristics of each measurement tool, the information necessary for complete patient evaluation, and the battery of valid and reliable measurements that provide the most complete and accurate patient assessment.

Differential Threshold↗
PubMedDate not supplied

Repetitive use and static postures: a source of nerve compression and pain.

Nerve compression or musculoskeletal diagnoses require consideration of both the repetitive movements and static postures that may be contributing to the problem. Certain postures and positions assumed at home, at work, and during sleep will have three major influences: (1) directly increasing pressure on nerves at entrapment sites; (2) placing muscles in shortened positions so that adaptive muscle shortening may then secondarily compress nerves; and (3) placing some muscles in elongated and weakened positions, resulting in other muscles being over-used, thus creating the cycle of muscle imbalance. Successful management of the patient with upper extremity pain, paresthesia, and numbness should begin with initial identification of all sites that are contributing to the presenting symptoms. Treatment must then be directed toward the sources of nerve compression and musculoskeletal dysfunction. Upper quadrant symptomatology can be alleviated with an appropriate therapy program, even in the patient with chronic symptoms, but only with patient education, compliance with an exercise program, and behavioral modification at home, work, and during sleep.

Arm↗