Abstract
Background Biofeedback training is widely used for rehabilitative intervention in patients with central or peripheral nervous impairment to train correct movement patterns; however, no biofeedback apparatus is currently available to correct pinch force ratios for patients with sensory deficiencies.
Design A cross-sectional and longitudinal design was used in an observational measurement study for establishing a prototype and to determine the effects of biofeedback intervention, respectively.
Objective This study aimed to develop a computerized evaluation and re-education biofeedback (CERB) prototype for application in clinical settings.
Methods A CERB prototype was developed integrating pinch apparatus hardware, a biofeedback user-controlled interface, and a data processing/analysis interface to detect momentary pinch performances in 79 people with normal hand sensation. Nine patients with hand sensory impairments were recruited to investigate the effects of training hand function with the CERB prototype.
Results Hand dominance, pinch pattern, and age significantly affected the peak pinch force and force ratio for lifting a 480-g object with a steel surface. In the case of the 79 volunteers with normal hand sensation, hand dominance affected the time lag between peak pinch force and maximum load; however, it was unaffected by pinch pattern or age. Training with the CERB prototype produced significant improvements in force ratio and better performance in the pin insertion subtests, although the results for both 2-point discriminative and Semmes-Weinstein monofilament tests did not change significantly.
Limitations The intervention findings are preliminary.
Conclusions This study developed a conjunct system suited for evaluating and restoring sensorimotor function for patients with impaired hand sensibility. The results from the participants with normal hand sensation could serve as a reference database for comparison with patients with nerve injuries.
Footnotes
Professor Chiu, Professor Su, and Professor Kuo carried out the establishment of the evaluation and biofeedback system. Ms Hsu and Professor Kuo were the main contributors of the study design, data collection, and clinical assessments. Ms Hsu, Professor Jou, and Professor Kuo participated in the data analysis and interpretation. Ms Hsu, Professor Lin, and Professor Kuo helped to draft the manuscript. All authors read and approved the contents and format of the final manuscript.
The study was approved by the Institutional Review Board of National Cheng Kung University Hospital.
This work was supported by National Science Council grant NSC 97-2314-B-006-047-MY2, Taiwan.
- Received February 5, 2012.
- Accepted September 17, 2012.
