gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Impaired fine motor skills in patients with Complex regional pain syndrome (CRPS)

Meeting Abstract

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  • presenting/speaker Kathrin Allgöwer - Technical University of Munich, München, Germany
  • Waltraud Fürholzer - kbo - Munich Children's Center, München, Germany
  • Joachim Hermsdörfer - Technical University of Munich, München, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1322

doi: 10.3205/19ifssh1538, urn:nbn:de:0183-19ifssh15383

Published: February 6, 2020

© 2020 Allgöwer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Clinical issue/s: Fine motor skills are essential in a variety of activities of daily living. The diagnosis of fine motor deficits is often limited to the measurement of muscle strength or the assessment of instructed motor activities. Quantifiable and objective methods in different disorders that affect the hands and fingers are rare.

Clinical reasoning: The aim of the study was to determine characteristics of fine motor performance in patients with complex regional pain syndrome (CRPS) with an extensive testing battery.

Innovative, analytical or new approach: Measurements of this study were done with a wireless, bluetooth-powered manipulandum.The manipulandum was equipped with sensors for measuring grip forces, load forces and 3-dimensional acceleration.

It was used to perform a test battery consisting of: A) lifting tasks with different variations of weight and surface, B) cyclic movements, C) visuomotor tracking, D) fast force changes and E) maximum grip strength.

In addition, functional performance was tested with the Jebsen-Taylor Hand Function Test (JTHFT) and the Nine-Hole-Peg Test (9-HPT). To determine sensory deficits, the two-point discrimination (2PD) was tested.

Eight people with CRPS and eight healthy controls were examined. People with CRPS showed impaired performance visuomotor tracking (p<.05) and the 9-HPT (p<.05). There was a statistical trend to significance for the fast force change (p =.076).

Contribution to advancing HT practice: Patients with CRPS revealed abnormalities in complex fine motor performance in tasks with high requirements on speed, coordination and visual components. Patients with writer's cramp were tested with the same test battery in a previous study. They showed similar deviations from healthy controls as the CRPS patients. This suggests that both patient groups share similar deficits in visuomotor integration and coordination.

These results can serve a basis for improving clinical diagnosis of fine-motor deficits and enabling a more targeted therapy.