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Segmental exclusion syndrome is characterised by the non-use or under-use of a limb segment, most oftenly reported in the distal part, following an injury, without affecting the central nervous system. This syndrome has an important negative impact on the daily life of affected subjects; however, it remains poorly studied, particularly in terms of pathophysiology, and its management is still not specific. Currently, the main pathophysiological hypothesis is an alteration of the afferences related to a dysfunction of the sensorimotor loop. An hypothesis is that this dysfunction could concern the level of tactile perception and that the damage to the distal light touch receptors could play a role in the pathophysiology. The protocol is based on the performance of tests that explore different aspects of light touch: passive, active, dynamic and static sensitivity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with exclusion | Evaluation of the tactile sensitivity of the excluded finger using different tests: Static and dynamic two-points discrimination tests, the Semmes-Weinstein monofilament test, grating orientation task and the bar test inspired by the study of Louw et al. Realization of the same tests on the controllateral healthy finger. | ||
| Control | Evaluation of the tactile sensitivity of the finger using different tests: Static and dynamic two-points discrimination tests, the Semmes-Weinstein monofilament test, grating orientation task and the bar test inspired by the study of Louw et al. Realization of the same tests on the controllateral finger. |
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| Measure | Description | Time Frame |
|---|---|---|
| Difference in passive sensitivity discrimination orientation threshold between each hand in static condition. | Difference in thresholds of sensitive discrimination between the two hands in the Grating Orientation Task (mm) | once during the one-day evaluation session |
| Difference in passive sensitivity discrimination threshold between each hand in static condition. | Difference in thresholds of sensitive discrimination between the two hands in the Static Two Points discrimination test (mm) | once during the one-day evaluation session |
| Difference in passive sensitivity discrimination of pressure threshold between each hand in static condition. | Difference in thresholds of sensitive discrimination between the two hands in the monofilament test (Newton) | once during the one-day evaluation session |
| Difference in passive sensitivity discrimination threshold between each hand in dynamic condition. | Difference in thresholds of sensitive discrimination between the two hands in Moving Two-Points Discrimination Test (mm) | once during the one-day evaluation session |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in active sensitivity discrimination threshold between each hand in dynamic condition. | Percentage of correct answers to the bar test in both groups. | During the evaluation session |
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Inclusion Criteria:
Exclusion Criteria:
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The study population consisted of adults with a segmental exclusion of a finger more than 3 months after the initial injury. In order to study sensitivity disorders related to the exclusion, we decided to include only people who had no pathology that could have an impact on sensitivity and who had no truncal nerve damage at the time of the initial injury.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Régional de Médecine Physique et de Réadaptation | Nancy | 54000 | France |
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