Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 1994 Jan;51(1):57–61. doi: 10.1136/oem.51.1.57

Sensorineural objective tests in the assessment of hand-arm vibration syndrome.

K L McGeoch 1, W H Gilmour 1, W Taylor 1
PMCID: PMC1127903  PMID: 8124466

Abstract

Assessment (staging) of workers exposed to vibration, based solely on a subjective history, has been shown to be unsatisfactory. The internationally agreed use of a sensorineural component in the Stockholm classification requires the use of sensory objective tests. Four hundred and twenty two subjects were assessed by a subjective history supplemented by multiple objective tests. These tests covered the vascular, sensorineural, musculoskeletal and dexterity aspects of hand-arm vibration syndrome. Tests to help with the differential diagnosis were also performed. Sensorineural tests are reported as are the associations between the subject's final Stockholm sensorineural staging and the subject's aesthesiometry, temperature threshold results, and grip strength. Scoring systems for these tests were evolved. Data showed that multiple sensory tests increased the accuracy of staging. Aesthesiometry, the temperature neutral zone tests, and grip strength were appropriate for the assessment of the sensory component, especially in separating sensorineural stages 0 and 1 from sensorineural stages 2 and 3. This is an important separation for an occupational physician monitoring subjects exposed to vibration. Analyses of the sensory tests clearly indicated that they need to be done on all digits. In this survey the sensorineural damage was greatest in the forefinger (second) and the little (fifth) fingers. No association was found between smoking and the final staging, aesthesiometry, temperature neutral zone thresholds, or grip strength.

Full text

PDF
61

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bovenzi M. Finger systolic pressure during local cooling in normal subjects aged 20 to 60 years: reference values for the assessment of digital vasospasm in Raynaud's phenomenon of occupational origin. Int Arch Occup Environ Health. 1988;61(3):179–181. doi: 10.1007/BF00381016. [DOI] [PubMed] [Google Scholar]
  2. Brammer A. J., Taylor W., Lundborg G. Sensorineural stages of the hand-arm vibration syndrome. Scand J Work Environ Health. 1987 Aug;13(4):279–283. doi: 10.5271/sjweh.2050. [DOI] [PubMed] [Google Scholar]
  3. Carlson W. S., Samueloff S., Taylor W., Wasserman D. E. Instrumentation for measurement of sensory loss in the fingertips. J Occup Med. 1979 Apr;21(4):260–264. [PubMed] [Google Scholar]
  4. Ekenvall L., Nilsson B. Y., Gustavsson P. Temperature and vibration thresholds in vibration syndrome. Br J Ind Med. 1986 Dec;43(12):825–829. doi: 10.1136/oem.43.12.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ekenvall L., Nilsson B. Y., Gustavsson P. Temperature and vibration thresholds in vibration syndrome. Br J Ind Med. 1986 Dec;43(12):825–829. doi: 10.1136/oem.43.12.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harada N. Esthesiometry, nail compression and other function tests used in Japan for evaluating the hand-arm vibration syndrome. Scand J Work Environ Health. 1987 Aug;13(4):330–333. doi: 10.5271/sjweh.2032. [DOI] [PubMed] [Google Scholar]
  7. Lundström R. J. Responses of mechanoreceptive afferent units in the glabrous skin of the human hand to vibration. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):413–416. [PubMed] [Google Scholar]
  8. Olsen N. Diagnostic tests in Raynaud's phenomena in workers exposed to vibration: a comparative study. Br J Ind Med. 1988 Jun;45(6):426–430. doi: 10.1136/oem.45.6.426. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. RENFREW S. Aesthesiometers. Lancet. 1960 May 7;1(7132):1011–1011. doi: 10.1016/s0140-6736(60)90896-5. [DOI] [PubMed] [Google Scholar]
  10. Renfrew S. Fingertip sensation: a routine neurological test. Lancet. 1969 Feb 22;1(7591):396–397. doi: 10.1016/s0140-6736(69)91359-2. [DOI] [PubMed] [Google Scholar]
  11. Swerup C., Nilsson B. Y. Dependence of thermal thresholds in man on the rate of temperature change. Acta Physiol Scand. 1987 Dec;131(4):623–624. doi: 10.1111/j.1748-1716.1987.tb08284.x. [DOI] [PubMed] [Google Scholar]
  12. Taylor W., Ogston S. A., Brammer A. J. A clinical assessment of seventy-eight cases of hand-arm vibration syndrome. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):265–268. doi: 10.5271/sjweh.2141. [DOI] [PubMed] [Google Scholar]
  13. Wasserman D. E., Taylor W. Lessons from hand-arm vibration syndrome research. Am J Ind Med. 1991;19(4):539–546. doi: 10.1002/ajim.4700190411. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES