Comparing tests of tactile sensibility: aspects relevant to testing children with spastic hemiplegia

Abstract

Children with hemiplegic cerebral palsy (CP) commonly exhibit tactile sensory deficiencies in their hands in addition to their motor problems. The aim of this study was to compare and evaluate the usefulness of some common tests of tactile sensibility for use with children with hemiplegic CP. Twenty‐five children with hemiplegia aged between 5 and 18 years, and 19 control individuals participated. All children were examined with Semmes‐Weinstein monofilaments, two‐point discrimination (2PD), stereognosis of familiar objects, stereognosis of forms, and functional sensibility. Dexterity, spasticity, and bimanual task performance were also assessed. Results from the different sensory tests deviated greatly. We found three tests to be useful: 2PD of 3mm spacing, which was the most sensitive test, stereognosis of familiar objects, and functional sensibility assessed through the Pick‐up test (comparing performance with and without the influence of vision). Stereognosis of forms and threshold values of touch (Semmes‐Weinstein monofilaments) are seemingly less useful tests for children with CNS impairments. Deficient sensibility was strongly related to dexterity. Aspects concerning the testing methodology are discussed.