• The Journal of Korean Physical Therapy
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• 제22권4호
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• pp.97-101
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• 2010

Purpose: Sensory input is very important for proper performance of human. Two-point discrimination is the most widely used tactile sensory test. The purpose of this study was to find the changes in cortical activation patterns between tactile stimulation and two-point discrimination. Methods: Two healthy subjects participated in our study. fMRI scanning was done during 4 repeated blocks of tactile stimulation and two point discrimination of the right index finger tip. In one block, stimuli were repeated 10 times every three seconds. To determine the changes of cortical neurons during sensory input, intensity index was analyzed. Results: When tactile stimulation of the right index finger tip was completed, only contralateral primary somatosensory area was activated. In contrast, during two-point discrimination, both the primary somatosensory area and ipsilateral supplementary sensory area were activated. Conclusion: During two point discrimination, both primary somatosensory area and ipsilateral supplementary sensory area were activated. Therefore, two-point discrimination is required more complex and conscious activity than tactile stimulation.

• 한국전문물리치료학회지
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• 제4권2호
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• pp.10-17
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• 1997

The purpose of this study were to compare light touch, two-point discrimination, position sense, and static balance ability and to examine the relationship of static balance ability and different senses in those who are wearing various heights of high-heeled shoes. Each 29 women was classified two different heights (below 3 cm, above 7 cm) by experience in wearing shoes. A t-test was used to determine the differences between low- and high-heeled shoe in light touch, two-point discrimination, position sense, and static balance ability. Pearson correlation was used to examine the relationship of static balance ability to these sensation. The results were as follows: 1) No significant differences in average light touch, position sense between two groups were found(p>0.05). But significant differences in average two-point discrimination, static balance ability were found(p<0.05). 2) Static balance ability was not significantly correlated with light touch, position sense, two-point discrimination(p>0.05). The results suggest that long time experience in wearing high-heeled shoe may be caused local sensory change and decreased static balance ability. Even though, static balance ability was not significantly affected but correlated with two-point discrimination, position sense, and light touch in order.

• Journal of Oral Medicine and Pain
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• 제33권4호
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• pp.295-303
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• 2008

목적: 혀의 해부학적 위치에 따른 촉각식별능의 차이를 조사하고 이것과 심상유두의 개수 사이에 관련성이 있는지의 여부를 확인하기 위해서 본 연구를 시행하였다. 방법: 현재 복용 중인 약물이 없고, 과거 장기간 약물을 복용한 경험이 없었으며, 전신질환이 없는 건강한 남녀 13명(평균 연령 $30{\pm}3$세)을 대상으로 혀의 수초성 $A{\delta}$ 섬유와 무수초성 C 섬유와 관련한 촉각식별능을 알아보기 위해서 Castroviezo $caliper^{(R)}$를 이용한 두점식별검사를 실시하였다. 심상유두의 개수는 methylene blue로 혀를 염색해서 심상유두를 확인하여 개수를 세었다. 결과: 1. 혀의 전방부와 후측방부위의 심상유두개수를 세어 본 결과, 남자는 전방과 후측방이 각각$51.69{\pm}14.15$개, $12.92{\pm}6.13$개였으며, 여자는 $58.85{\pm}13.56$개, $16.23{\pm}6.38$개였다. 남녀 모두 후측방에 비해 전방부에서 유두의 개수가 3배 이상 많은 것을 관찰할 수가 있다. 2. 두 점으로 식별해내는 최소한의 거리는 전방에서 평균 $1.91{\pm}0.74mm$였으며, 성별에 따라 나눠 다시 분류했을 때, 남자의 인식 역치가 높은 것으로 관찰되었으나, 성별에 따른 통계적 유의성은 나타나지 않았다. 3. 두점식별거리를 기준으로 네 개의 그룹으로 나누었을 때, 거리가 증가할수록 심상유두의 개수가 감소하는 경향을 보였다. 그러나, 두점인지역치와 심상유두의 개수 간에 통계적 유의성은 없었다.

• 대한물리의학회지
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• 제7권4호
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• pp.481-491
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• 2012

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL's. And we also found relationship among somatosensory, hand function, and ADL performance.

• Archives of Plastic Surgery
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• 제47권6호
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• pp.559-566
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• 2020

Background Infraorbital nerve dysfunction is commonly reported after zygomaticomaxillary complex fractures. We evaluated sensory changes in four designated areas (eyelid, nose, zygoma, and lip) innervated by the infraorbital nerve. This evaluation was conducted using the static two-point discrimination test and the vibration threshold test. We assessed the diagnostic significance of the blink reflex in patients with infraorbital nerve dysfunction. Methods This study included 18 patients, all of whom complained of some degree of infraorbital nerve dysfunction preoperatively. A visual analog scale, the infraorbital blink reflex, static two-point discrimination, and the vibration threshold were assessed preoperatively, at 1 month postoperatively (T1), and at a final follow-up that took place at least 4 months postoperatively (T4). The results were analyzed using a multilevel generalized linear mixed model. Results Scores on the visual analog scale significantly improved at T1 and T4. The infraorbital blink reflex significantly improved at T4. Visual analog scale scores improved more rapidly than the infraorbital blink reflex. Two-point discrimination significantly improved in all areas at T4, and the vibration perception threshold significantly improved in the eyelid at T4. Conclusions Recovery of the infraorbital blink reflex reflected the recovery of infraorbital nerve dysfunction. We also determined that the lip tended to recover later than the other areas innervated by the infraorbital nerve.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.14-17
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• 2005

Purpose: Authors have performed free tissue transplantation in the upper and lower extremities with sensory flaps and evaluated the sensory function recovery. Materials and methods: Between 1992 through 2004, sensory free flap articles published in the journal of the Korean microsurgical society, were reviewed and recovery of sensory function was assessed by static two-point discrimination test. Results: Static two point discrimination test showed average 6.7 mm in the thumb, average 12 mm in the hand and 7 cm of the dorsalis pedis flap, 20.5 mm of the lateral arm flap and over 8 cm of the forearm flap in the foot. Conclusion: Sensory flaps provide the protective and useful coverage in the upper and lower extremities and have benefit for activities for daily life in free tissue transferred patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.262-269
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• 2023

Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.377-382
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• 2007

Purpose: Hook nail deformity is caused by inadequately supported nail bed due to loss of distal phalanx or lack of soft tissue, resulting in a claw-like nail form. A composite graft from the foot bencath the nail bed gives adequate restoration of tip pulp. Methods: From September of 1999 to March of 2004, six patients were treated for hook nail deformity and monitored for long term follow up. Donor sites were the lateral side of the big toe or instep area of the foot. We examined cosmetic appearance and nail hooking and sensory test. The curved nail was measured by the picture of before and after surgery. Results: In all cases, composite grafts were well taken, and hook nail deformities were corrected. The curved nail of the 4 patients after surgery were improved to average $28.7^{\circ}$ from average $55.2^{\circ}$ before surgery. The static two point discrimination average was 6.5mm and the moving two point discrimination average was 5.8mm in the sensory test. Conclusion: Composite graft taken from foot supports the nail bed with the tissue closely resembling the fingertip tissue, making it possible for anatomical and histological rebuilding of fingertip.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.144-154
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• 2001

Dysfunction of the inferior alveolar nerve indicated by various degree of numbness of the lower lip and chin is one of the few drawbacks of mandibular osteotomy, especially Bilateral Sagittal Split Ramus Osteotomy(BSSRO) and genioplasty. Although it has been recorded throughout the history of this techniques, it is true etiology poorly understood. In this study, 22 consecutive patients under class III malocclusiion impression and undergoing orthognathic surgery(BSSRO only 11 case, BSSRO with genioplasty 11 case) were studied using 4 neurosensory test(static light touch, directional discrimination, two-point discrimination, pin pressure nociception) with post OP 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks, On control group, 10 members without trauma and nerve damage history, nerve test was accomplished. We concluded majority of patients return of sensation during post operative 24 weeks. Althought immediate nerve deficit are 92.2%, 97.2% 88.9% these are recovered to 25%, 35.72%, 10.71% at 24 weeks. Nerve recovery rate increased prominently between post 4 weeks and 8 weeks. There is no statistically difference about neurosensory deficit among the chin area. Neurosensory deficit more severe when the BSSRO with genioplasty group than the only BSSRO group. Immediate neurosensory deficit is larger left side than right side but after 6 months, there is no significantly difference between left side and right side. Static light touch and pin pressure nociception are more sensitive method of neurosensory deficit than two point discrimination.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.663-668
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• 2011

Purpose: A modified free thenar flap was designed for coverage of volar finger defect with constant innervation using the palmar cutaneous branch of the median nerve. After clinical application of this flap, sensory results were evaluated in 6 cases. Methods: Patients were selected who have volar soft tissue defect with or without fingertip defect. The six cases of the innervated free thenar flap were performed since September 2009, and sensory outcomes were evaluated by the Semmes-Weinstein monofilament and two-point discriminator at four and half month after the surgery. Results: The Semmes-Weinstein Monofilament test revealed 3 cases showed 2.83, 1 case showed 3.61, 1 case showed 4.31 and 1 case showed 4.56. The static two-point discrimination test revealed 1 case showed 4 mm, 1 case showed 6 mm, 2 cases showed 9 mm, and 2 cases showed over 15 mm. The moving two-point discrimination test revealed 1 case showed 3 mm, 1 case showed 4 mm, 1 case showed 5 mm, 1 case showed 7 mm, and 2 cases showed over 15 mm. The donor sites showed no significant limitation of the thumb and neuroma formation. Conclusion: The innervated free thenar flap showed good sensory outcomes as a sensate free flap in a short time after surgery. It can be an option for coverage of volar finger defects that requires sensation.