Establishment of a proper manual tactile test for hands with sensory deficits

Objectives: To (1) develop the Manual Tactile Test (MTT) for evaluating the hand perception to distinguish objects' characteristics; (2) establish the reliability and validity of the MTT for patients with carpal tunnel syndrome (CTS); and (3) integrate a normative database into the test. Design: Cohort and case-control studies. Setting: Hospital and local community. Participants: Participants included patients with CTS (n=70) and healthy volunteers (n=125). Twenty young volunteers were enrolled to evaluate the reliability of the test. Seventy patients with CTS and 70 age- and sex-matched controls were recruited to establish the discriminate validity and receiver operating characteristic (ROC) curves for the MTT. A normative database was constructed from 125 healthy, right-handed participants. Interventions: Not applicable. Main Outcome Measures: The MTT was designed to discriminate the characteristics of the objects' weight (barognosis test), texture (roughness differentiation test), and shape (stereognosis test) via active hand exploration. The times required discriminating the characteristics of objects and the accuracy of judgment were recorded and analyzed. Results: High Cronbach alpha values (.83-.91) and small coefficient of variation (.10-.16) values showed that the MTT is a reliable testing tool. The results significantly discriminated the patients from the control group (P<.001). The sensitivity and specificity were.64 to.81 and.73 to.76, respectively, for the 3 subtests. The ROC curve area for the 3 subtests ranged from.70 to.84. The results of the MTT obtained from 125 healthy subjects showed that age significantly affects hand perceptive function (P<.001). Conclusions: The MTT is a reliable, accurate, and valid tool for determining the impairment of manual touch sensibility for CTS and can help clinicians understand age-related degradation in sensorimotor control of the hand in the elderly population.