CA1282660C - Diagnostic and sensory re-education device - Google Patents
Diagnostic and sensory re-education deviceInfo
- Publication number
- CA1282660C CA1282660C CA 519457 CA519457A CA1282660C CA 1282660 C CA1282660 C CA 1282660C CA 519457 CA519457 CA 519457 CA 519457 A CA519457 A CA 519457A CA 1282660 C CA1282660 C CA 1282660C
- Authority
- CA
- Canada
- Prior art keywords
- disc
- projections
- sides
- pair
- sensory
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
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Abstract
ABSTRACT OF THE DISCLOSURE
There is provided a new and useful diagnostic and sensory re-education device comprising at least one disc having opposed surfaces and including at least eight sides; protruding in the plane of the disc from one of the sides an elongated projection and from others of the sides pairs of projections, each projection being at least ten millimeters in length and each pair of projections separated by predetermined distances; and a textured gripping area centrally on each of the surfaces of the disc.
There is provided a new and useful diagnostic and sensory re-education device comprising at least one disc having opposed surfaces and including at least eight sides; protruding in the plane of the disc from one of the sides an elongated projection and from others of the sides pairs of projections, each projection being at least ten millimeters in length and each pair of projections separated by predetermined distances; and a textured gripping area centrally on each of the surfaces of the disc.
Description
~2~
This application relates to a diagnostic and therapeutic device useful in testing sensory perception and in nerve re-education.
B~C~GROU~D OF TH~ INVgNTION
.
A Clinical Assessment Committe~ of the American Society for Surgery of the Hand has recommended that all evaluations of nerve repairs contain documentation of the patient's static and moving two point discrimination. Two-point testing has been utilized for many years as a means of evaluating sensory perception. The essence of the test is to apply one or two point pressure to the skin in the area under consideration to evaluate the patient's ability to sense the point or points.
The moving two~point discrimination test is used to evaluate the innervation density of the quickly-adapting fibre/receptor system; and the static two-point discrimination test will evaluate the innervation densi~y of the slowly-adapting fibre/receptor system~ Thus, the moving two-point test will assess hand function requiring moving touch as, for example, in object identification, fine discrlmination or manipulative tasks, and specific tasks such as buttoning a button. The static test will assess hand functi3n requiring precision sensory grip and constant touch as, for example, that required in holding a pencil to write, a needle to sew or a key to put into a lock. Adequate evaluation of these functions requires use of both the moving and ~, .
~;~8ZG6~3 static two-point discrimination tests.
The test procedure for the moving test re~uires that the points be moved over the area of interest in a specific manner. As well, it is essential that a variety of separation distances of the two points be available. Furthermore, the range of normal in the moving two-point discrimination test has been found to be very narrow indeed and it has now been discovered that the critical separation distance for determining an abnormal finding in this test is the four millimeter distance.
To date a variety of instruments have b~en made available to the medical profession, but none has functioned sufficiently satisfactorily that it has been widely accepted and there is therefore an ongoing need for a refinement in the one-and two-point discrimination testing device.
The above discussion has related to the diagnostic uses of the device. However, the present device is also a useful therapeutic tool. Following nerve damage, in the sensory re-education process a patient can utilize the invention to enhance that process and to check progress. Various aspects of ~0 the device, as will be discussed below, contribute to this very useful function. For example, a patient can attempt to distinguish during late-phase re-education, the difference between one and two point stimulae. Working with the present invention to reach higher levels o~ discrimination~ that is, the ability to distinguish increasingly narrowed two-point intervals, the patient can significantly enhance the re-education program.
~L28~i6~
It is against this background that the present invention arises.
PRIOR ART
The applicants are unaware of any pertinent prior patents in the field of interest. There are, however, two literature references which provide a background to the development of the invention of the present case. These are Greulich M: A Device For Simple Determination of Two-Point Discrimination. Handchir Uikrochir Plast Chir 8:97-199, 1976;
Padgett Instruments. The DeMayo Two-Point Discrimination Dévice.
J Hand Surg 9A:lOA, 1984.
The Greulich device has not been accepted in the hand surgery world to which it is addressed. The device comprised a ring from which a series of projections emanated at spaced intervals. A number of problems were inherent in the device.
These included the fact that the individual projections within pairs of spaced projection~ emanated at an angle to each other, so that contact would not be perpendicular to the area of interest. As well, the shape of the device could result in ~o interference by projections adjacent to the pair being used.
These and other difficulties resulted in lack of acceptance.
The DeMayo two-point discrimination device to which the Padgett Instrument reference relates attempted to improve on the Greulich device, but again included inherent difficulties which , , ~x~
resulted in lack of acceptance. This device was of octagonal shape with pairs of parallel spaced projections emanating from the flat sides. The projections in this case were very short, and resulted in substantial difficulties in utilizing the device. For example, particularly at wider projection spacings, in~erference would occur between the disc itself and the skin area under consideration.
This necessitated using the device in a way which made it very difficult for a user to observe the positioning of the projections.
For the reasons expressed and others, the Greulich and DeMayo type devices were felt not to be a satisfactory solution in terms of an acceptable two-point discrimination tester.
~:UNMt~RY OF THE INVE:NTIO~a The present applicants conducted extensive evaluations and reassessments of available instruments and discovered that a satisfactory device could be constructed which would avoid the problems inherent in prior art devices. Furthermore, it became apparent in the course of the study and testing that the device could be constructed with features that would facilitate the therapeutic as well as the diagnostic functions.
Accordingly, the device of the present invention comprises a diagnostic and sensory re-education device comprising at least one disc having opposed surfaces and including at least eiqht sides; protruding in the plane of the disc from one of the sides an elongated projection and from others of the sides pairs of projections, each projection being at least ten millimeters in length and each pair of prongs separated by predetermined distances; and textured gripping area centrally on each said surface of the disc.
BRI~F DE~CRIPTION OF ~E DR~ING8 In drawings which illustrate embodiments of thP
inventionO
FIGURE l is a perspective view of a device according to the invention; and FIGURE 2 is a top plan view of the device according to the invention.
While the invention will be described in conjunction with illustrated embodiments, it will be understood that it is not intended to limit the invention to such embodiments. On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims.
DE~AILED DE:~:C~RIPTION OF ~HE PREFERRED EMBODIMENT~3 In the following description, similar features in the drawings have been given similar reference numerals.
The two point discrimination tester l0 comprises a flat sided disc 12 from the sides of which emanate the projections 14.
As illustrated, the disc is in the form of an octagon, but other similar shapes would be suitable provided that the projections 14 are suitably spaced from the points of intersection 16 of sides 18 to avoid interferencP oX adjacent pairs of projections with the pair being used.
- ~8~6~3 As illustrated, the tester 10 includes one side 20 having a single projection 22. Each of the other sides 18 contain pairs o~ parallel projections which are spaced ~rom each other at predetermined distances. These distances may vary as required and in the illustrated embodiment are of two, three, four, five, six, seven and eight millimeters respectively. In the preferred case the invention contemplates a set of two octagonal discs in which the first disc is as just described and the second disc includes the single projection case and pairs of projections having spacings within the pairs at one millimeter intervals from nine to fifteen millimeters. In the preferred case the first disc will include a twenty millimeter spacing and the second a twenty-five millimeter spacing. These will be located across the int~rsection of two sides of the disc. Thus, for example, as illustrated in FIGURE 2 of the drawings, a twenty-five millimeter spacing is embossed between the single prong; and the near one of the pair marked l'2".
The set of 2 discs thus provides interval spacing from one to fifteen, and twenty and twenty-five millimeters. Thus the disc will be useful for measuring innervation density on any surface area, not just the finger tip. The sequential spacing from one to fifteen will make recording of innervation density easier and more accurate.
While less desirable, where a single disc is used a preferred spacing would have a single prong plus pairs at two, three, four, five, six, nine and twelve millimeters.
It is essential that a four millimeter spacing be available for diagnostic uses for determining an abnormal finding.
The projections are required to be a minimum of ten millimeters in length. This distance is chosen to avoid interference of the ~isc with the tes~ procedure both ir. terms of contact with the area of skin under consideration and the ability of the testing person to accurately observe the tesk area. These two concerns are essential for accurate and consistent testing.
The disc 12 is provided with a textured central area 24 on the opposed surfaces. These central areas preferably demonstrate two different textures with a rougher texture on one surface of the disc and a smoother texture on the other surface.
The disc is provided with a central texture area for two reasons.
First, the texture performs the normal function for such constructions of facilitating gripping the device in use. Second, however, and of substantial importance is that the textured area provides a test area for use by a patient in the early stages of the sensory re-education process. In the early stages of that process a patient can learn to distinguish the two textured areas from each other and from the smooth part of the disc.
As well, the disc is provided with embossing in the area between the textured area 24 and the edge 26 of th~ disc. This embossing preferably includes the numbering 28 defining the projection spacing as well as other types of embossing such as lettering 30. These embossments further facilitate the sensory re-education process as the patient moves from early to later stages in that process.
1~8Z~i6C~
The device as described has been found to be highly useful particularly in the field of hand surgery and overcomes the rather substantial difficulties which render unacceptable earlier such devices.
Thus it is apparent that there has been provided in accordance with the invention a diagnostic and sensory re-education device that fully satisfies the objects, aims and advantages set forth above. While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art in light of the foregoing description. Accordingly, it is intended to embrace all such alternatives, modifications and variations as fall within the spirit and broad scope of the invention.
, .
This application relates to a diagnostic and therapeutic device useful in testing sensory perception and in nerve re-education.
B~C~GROU~D OF TH~ INVgNTION
.
A Clinical Assessment Committe~ of the American Society for Surgery of the Hand has recommended that all evaluations of nerve repairs contain documentation of the patient's static and moving two point discrimination. Two-point testing has been utilized for many years as a means of evaluating sensory perception. The essence of the test is to apply one or two point pressure to the skin in the area under consideration to evaluate the patient's ability to sense the point or points.
The moving two~point discrimination test is used to evaluate the innervation density of the quickly-adapting fibre/receptor system; and the static two-point discrimination test will evaluate the innervation densi~y of the slowly-adapting fibre/receptor system~ Thus, the moving two-point test will assess hand function requiring moving touch as, for example, in object identification, fine discrlmination or manipulative tasks, and specific tasks such as buttoning a button. The static test will assess hand functi3n requiring precision sensory grip and constant touch as, for example, that required in holding a pencil to write, a needle to sew or a key to put into a lock. Adequate evaluation of these functions requires use of both the moving and ~, .
~;~8ZG6~3 static two-point discrimination tests.
The test procedure for the moving test re~uires that the points be moved over the area of interest in a specific manner. As well, it is essential that a variety of separation distances of the two points be available. Furthermore, the range of normal in the moving two-point discrimination test has been found to be very narrow indeed and it has now been discovered that the critical separation distance for determining an abnormal finding in this test is the four millimeter distance.
To date a variety of instruments have b~en made available to the medical profession, but none has functioned sufficiently satisfactorily that it has been widely accepted and there is therefore an ongoing need for a refinement in the one-and two-point discrimination testing device.
The above discussion has related to the diagnostic uses of the device. However, the present device is also a useful therapeutic tool. Following nerve damage, in the sensory re-education process a patient can utilize the invention to enhance that process and to check progress. Various aspects of ~0 the device, as will be discussed below, contribute to this very useful function. For example, a patient can attempt to distinguish during late-phase re-education, the difference between one and two point stimulae. Working with the present invention to reach higher levels o~ discrimination~ that is, the ability to distinguish increasingly narrowed two-point intervals, the patient can significantly enhance the re-education program.
~L28~i6~
It is against this background that the present invention arises.
PRIOR ART
The applicants are unaware of any pertinent prior patents in the field of interest. There are, however, two literature references which provide a background to the development of the invention of the present case. These are Greulich M: A Device For Simple Determination of Two-Point Discrimination. Handchir Uikrochir Plast Chir 8:97-199, 1976;
Padgett Instruments. The DeMayo Two-Point Discrimination Dévice.
J Hand Surg 9A:lOA, 1984.
The Greulich device has not been accepted in the hand surgery world to which it is addressed. The device comprised a ring from which a series of projections emanated at spaced intervals. A number of problems were inherent in the device.
These included the fact that the individual projections within pairs of spaced projection~ emanated at an angle to each other, so that contact would not be perpendicular to the area of interest. As well, the shape of the device could result in ~o interference by projections adjacent to the pair being used.
These and other difficulties resulted in lack of acceptance.
The DeMayo two-point discrimination device to which the Padgett Instrument reference relates attempted to improve on the Greulich device, but again included inherent difficulties which , , ~x~
resulted in lack of acceptance. This device was of octagonal shape with pairs of parallel spaced projections emanating from the flat sides. The projections in this case were very short, and resulted in substantial difficulties in utilizing the device. For example, particularly at wider projection spacings, in~erference would occur between the disc itself and the skin area under consideration.
This necessitated using the device in a way which made it very difficult for a user to observe the positioning of the projections.
For the reasons expressed and others, the Greulich and DeMayo type devices were felt not to be a satisfactory solution in terms of an acceptable two-point discrimination tester.
~:UNMt~RY OF THE INVE:NTIO~a The present applicants conducted extensive evaluations and reassessments of available instruments and discovered that a satisfactory device could be constructed which would avoid the problems inherent in prior art devices. Furthermore, it became apparent in the course of the study and testing that the device could be constructed with features that would facilitate the therapeutic as well as the diagnostic functions.
Accordingly, the device of the present invention comprises a diagnostic and sensory re-education device comprising at least one disc having opposed surfaces and including at least eiqht sides; protruding in the plane of the disc from one of the sides an elongated projection and from others of the sides pairs of projections, each projection being at least ten millimeters in length and each pair of prongs separated by predetermined distances; and textured gripping area centrally on each said surface of the disc.
BRI~F DE~CRIPTION OF ~E DR~ING8 In drawings which illustrate embodiments of thP
inventionO
FIGURE l is a perspective view of a device according to the invention; and FIGURE 2 is a top plan view of the device according to the invention.
While the invention will be described in conjunction with illustrated embodiments, it will be understood that it is not intended to limit the invention to such embodiments. On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims.
DE~AILED DE:~:C~RIPTION OF ~HE PREFERRED EMBODIMENT~3 In the following description, similar features in the drawings have been given similar reference numerals.
The two point discrimination tester l0 comprises a flat sided disc 12 from the sides of which emanate the projections 14.
As illustrated, the disc is in the form of an octagon, but other similar shapes would be suitable provided that the projections 14 are suitably spaced from the points of intersection 16 of sides 18 to avoid interferencP oX adjacent pairs of projections with the pair being used.
- ~8~6~3 As illustrated, the tester 10 includes one side 20 having a single projection 22. Each of the other sides 18 contain pairs o~ parallel projections which are spaced ~rom each other at predetermined distances. These distances may vary as required and in the illustrated embodiment are of two, three, four, five, six, seven and eight millimeters respectively. In the preferred case the invention contemplates a set of two octagonal discs in which the first disc is as just described and the second disc includes the single projection case and pairs of projections having spacings within the pairs at one millimeter intervals from nine to fifteen millimeters. In the preferred case the first disc will include a twenty millimeter spacing and the second a twenty-five millimeter spacing. These will be located across the int~rsection of two sides of the disc. Thus, for example, as illustrated in FIGURE 2 of the drawings, a twenty-five millimeter spacing is embossed between the single prong; and the near one of the pair marked l'2".
The set of 2 discs thus provides interval spacing from one to fifteen, and twenty and twenty-five millimeters. Thus the disc will be useful for measuring innervation density on any surface area, not just the finger tip. The sequential spacing from one to fifteen will make recording of innervation density easier and more accurate.
While less desirable, where a single disc is used a preferred spacing would have a single prong plus pairs at two, three, four, five, six, nine and twelve millimeters.
It is essential that a four millimeter spacing be available for diagnostic uses for determining an abnormal finding.
The projections are required to be a minimum of ten millimeters in length. This distance is chosen to avoid interference of the ~isc with the tes~ procedure both ir. terms of contact with the area of skin under consideration and the ability of the testing person to accurately observe the tesk area. These two concerns are essential for accurate and consistent testing.
The disc 12 is provided with a textured central area 24 on the opposed surfaces. These central areas preferably demonstrate two different textures with a rougher texture on one surface of the disc and a smoother texture on the other surface.
The disc is provided with a central texture area for two reasons.
First, the texture performs the normal function for such constructions of facilitating gripping the device in use. Second, however, and of substantial importance is that the textured area provides a test area for use by a patient in the early stages of the sensory re-education process. In the early stages of that process a patient can learn to distinguish the two textured areas from each other and from the smooth part of the disc.
As well, the disc is provided with embossing in the area between the textured area 24 and the edge 26 of th~ disc. This embossing preferably includes the numbering 28 defining the projection spacing as well as other types of embossing such as lettering 30. These embossments further facilitate the sensory re-education process as the patient moves from early to later stages in that process.
1~8Z~i6C~
The device as described has been found to be highly useful particularly in the field of hand surgery and overcomes the rather substantial difficulties which render unacceptable earlier such devices.
Thus it is apparent that there has been provided in accordance with the invention a diagnostic and sensory re-education device that fully satisfies the objects, aims and advantages set forth above. While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art in light of the foregoing description. Accordingly, it is intended to embrace all such alternatives, modifications and variations as fall within the spirit and broad scope of the invention.
, .
Claims (9)
1. A diagnostic and sensory re-education device comprising:
at least one disc having opposed surfaces and including at least eight sides;
protruding in the plane of said disc from one of said sides an elongated projection and from others of said sides a pair of projections, each said projection being at least ten millimeters in length and the projections of each said pair separated by predetermined distances; and a textured gripping area centrally on each of said surfaces of the disc.
at least one disc having opposed surfaces and including at least eight sides;
protruding in the plane of said disc from one of said sides an elongated projection and from others of said sides a pair of projections, each said projection being at least ten millimeters in length and the projections of each said pair separated by predetermined distances; and a textured gripping area centrally on each of said surfaces of the disc.
2. The device of claim 1 in which said disc is of octagonal configuration and in which seven sides of said disc each carry a pair of said projections.
3. The device of claim 2 in which the projections in each pair are separated respectively by distances of two, three, four, five, six, nine and twelve millimeters.
4. The device of claim 3 in which the said disc includes embossments on said surfaces between said sides and said textured areas.
5. The device of claim 4 in which said embossments include numbers defining the spacing between the projections in each pair.
6. The device of claim 1 in which said gripping surface on a first surface of said disc is of a different texture from that on the other surface of said disc.
7. The device of claim 2 wherein said device includes two said discs, each of which includes a single projection and seven said pairs, and in which the projections in the pairs are separated respectively by distances of two to sixteen millimeters.
8. The device of claim 7 in which the said discs include embossments on said surfaces between said sides and said textured areas.
9. The device of claim 8 in which said embossments include numbers defining the spacing between the prongs in each pair.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 519457 CA1282660C (en) | 1986-09-30 | 1986-09-30 | Diagnostic and sensory re-education device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 519457 CA1282660C (en) | 1986-09-30 | 1986-09-30 | Diagnostic and sensory re-education device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1282660C true CA1282660C (en) | 1991-04-09 |
Family
ID=4134053
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 519457 Expired CA1282660C (en) | 1986-09-30 | 1986-09-30 | Diagnostic and sensory re-education device |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1282660C (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2534885A (en) * | 2015-02-03 | 2016-08-10 | James Crispin Rashleigh Belcher Henry | Sensory assessment device |
| USD840538S1 (en) | 2016-03-28 | 2019-02-12 | 3D4MD Inc. | Two-point discriminator |
| USD840537S1 (en) | 2016-03-28 | 2019-02-12 | 3D4MD Inc. | Two-point discriminator |
| USD868252S1 (en) | 2016-03-28 | 2019-11-26 | 3D4MD Inc. | Two-point discriminator |
-
1986
- 1986-09-30 CA CA 519457 patent/CA1282660C/en not_active Expired
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2534885A (en) * | 2015-02-03 | 2016-08-10 | James Crispin Rashleigh Belcher Henry | Sensory assessment device |
| USD840538S1 (en) | 2016-03-28 | 2019-02-12 | 3D4MD Inc. | Two-point discriminator |
| USD840537S1 (en) | 2016-03-28 | 2019-02-12 | 3D4MD Inc. | Two-point discriminator |
| USD868252S1 (en) | 2016-03-28 | 2019-11-26 | 3D4MD Inc. | Two-point discriminator |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| MKEX | Expiry |