M1-L14a: Ax Tactile - How To Flashcards
What is the tactile assessment in children like?
Quantitative assessment for tactile function in hands
What are the 7 tests for tactile perception?
- Single Point Localisation
- Static Two point Discrimination
- Moving Two Point Discrimination
- Double Simultaneous
- Stereognosis
- AsTex
- Temporal Order Judgement
What is a test for tactile registration/sensation?
Semmes Weinstein Monofilaments
What are the 6 things to consider for Tactile assessment?
- Goal of assessment
- Clinimetrics
- Equipment
- Method
- Scoring
- Interpretation
What is the goal of tactile registration using the Registration Semmes‐Weinstein Monofilaments?
- Assesses tactile registration (initial detection of tactile stimuli)
- Used in adult patients (stroke, peripheral neuropathy)
What is the tool of tactile registration using the Registration Semmes‐Weinstein Monofilaments?
20 monofilaments of graded stiffness
- 1 = 1 skinniest (hardest) and 20 = 20 fattest (easiest)
- 5 monofilament kit = better than nothing but does not see change
What is the stimulus of tactile registration using the Registration Semmes‐Weinstein Monofilaments?
3 dermatomes, 3 times each + 4 sham trials
- Applied in a perpendicular direction and stop once the monofilament starts to bend
What is the scoring of tactile registration using the Registration Semmes‐Weinstein Monofilaments?
At least 1 correct on each finger tested + 1 sham trial to move onto the next level
- Could just be saying that they can feel it
What is the goal of Unilateral Spatial Perception using Single Point Localisation?
Tests unilateral, unidermatomal spatial tactile perception
What is the tool of Unilateral Spatial Perception using Single Point Localisation?
Using largest monofilament (log 6.65)
So you don’t have to assess if they have recognition of tactile stimulus anymore, rather localise tactile sensation
What is the stimulus of Unilateral Spatial Perception using Single Point Localisation?
Four fingers tested on front / back / side
- When they identify it, they need to have the blindfold off
- Test if they can localise rather than orientation
- Prefer using the screen –> easier to indicate and they can still see the rest of the environment
What is the response of Unilateral Spatial Perception using Single Point Localisation?
Required to indicate finger and position
Need to know how they report:
- Point/ find it (these ones might have more difficulty)
- Tell
- Show (wiggling)
What is the scoring of Unilateral Spatial Perception using Single Point Localisation?
Number correct from 12 trials
What is the goal of Unilateral Spatial Perception when using Two Point Discrimination?
Unilateral spatial tactile perception
- One is static and one is moving
- Easier in the moving as will recruit a little more mechanoreceptors
What is the tool of Unilateral Spatial Perception when using Two Point Discrimination?
‘Disk-Criminator or paper clips (just more tricky to execute)
- This can be a bit needle-like
- Child can be more nervous –> try this on
What is the stimulus of Unilateral Spatial Perception when using Two Point Discrimination?
Static and Moving test with pressure to the point of blanching
What is the scoring of Unilateral Spatial Perception when using Two Point Discrimination?
Record minimum distance (mm) at which the child correctly achieves 7/10 trials
- Start at 4-5 mm (edge of typical performance)
What is the goal of Bilateral Spatial Perception when using Double Simultaneous?
Bilateral multi-dermatomal spatial tactile perception
What is the tool of Bilateral Spatial Perception when using Double Simultaneous?
2 suprathreshold monofilament-like devices
- 6.6 mm monofilaments or same monofilaments (eg. bristles, kebab stick)
What is the stimulus of Bilateral Spatial Perception when using Double Simultaneous?
Pseudorandom order (24 trials)
- four fingers (2 x 4 trials)
- each bilateral pair (4 x 4 trials)
Hardest one to execute as need to hit at the same time
Other tests –> You can hold their hand in supination
Can also do on dorsum (if child can’t supinate and no one to sustain a hold)
What is the scoring of Bilateral Spatial Perception when using Double Simultaneous?
Number correct /24
- Error –> write it down
- Registered on both side but defaulted to localise on the unaffected hand
What is the goal for Active multidermatomal using spatial perception?
Active multidermatomal spatial perception
- Use movement to gain information
- Memory past experience (holding ojects)
- Generally can be an advantage or a disadvantage
What is the tool for Active multidermatomal using spatial perception? What is a progression of this?
9 objects identified: 3 similar pairs and 3 random objects
- Coin and a button, pen and pencil, safety pin and paper clip
- Spoon, peg and ball
Test where you can also feel shape (while texture and temperature is the same)
What is the stimulus for Active multidermatomal using spatial perception?
- Tester moves objects in child’s hand
- Child also allowed to manipulate
What is the scoring for Active multidermatomal using spatial perception- sterognosis? What are some inaccuracies?
Number correct /9
<3 is atypical ?
Inaccuracies:
- Towel under the objects (can hear when you pick them up)
- Temperature (eg. cold = coin)
What is the goal of Texture Perception using AsTex?
Unilateral texture perception
What is the tool of Texture Perception using AsTex?
AsTex
What is the stimulus of Texture Perception using AsTex?
Child moves pad of index finger, then thumb and 5th digit along the surface of device (with guidance from tester) and stops as soon as it feels ‘smooth’.
What is the scoring of Texture Perception using AsTex?
Mean of three trials calculated and converted to tactile discrimination index.
What is the goal for Temporal Order Judgement?
Bilateral temporal perception
Also used in adult stroke population post stroke
What is the equipment for Temporal Order Judgement?
Laptop with LABview, large & small speaker set.
What is the stimulus for Temporal Order Judgement?
pairs of tactile stimuli to index fingers, at different stimulus onset asynchronies
- pairs of tactile stimuli to index fingers, at different stimulus onset asynchronies
What is the scoring for Temporal Order Judgement?
Point of Subjective Simultaneity (PSS); Just Noticeable Difference (JND)
What are the 3 tactile assessments to prioritise if you only have 10 mins?
- Always assess tactile registration
- If they can’t –> can be dangerous, most likely that they have significant deficits in other tactile assessments
- Always assess single point localisation
- Unimanual tasks
- Always assess double simultaneous
- Bimanual tasks
What is the 1 tactile assessment to prioritise if you only have 2 mins? Why?
Single Point Localisation
Unimanual tasks (where am I being touched on one hand0
- If well –> minimal problems
- If poor –> not sure how much but will know there is a problem
