Vibrotactile threshold testing in occupational health: a review of current issues and limitations.
Environ Res 1993 Jan; 60(1):145-159
The use of vibrotactile threshold testing in occupational health studies was reviewed with particular emphasis on current issues and limitations of the technique. Cutaneous vibrotactile thresholds, used for assessing peripheral nervous system function in environmental and occupational epidemiology, was a technique that permitted rapid, nonaversive, and quantitative assessment of the integrity of somatosensory pathways. An overview of neurologic assessment included the uses of vibrotactile threshold in occupational medicine (chemical exposure, hand/arm vibration, and carpal tunnel syndrome). Problems which emerged on a review of the literature related to standardization (hardware, test protocols) and covariates (age and height, gender, skin temperature, and alcohol consumption). A comparison of results from physical examination and measures of nerve conduction velocity with vibrotactile threshold measurements was presented. Correlations were good with vibration perception responses and electrophysiologic parameters such as F- wave and H-reflex, but correlations with other electrophysiologic parameters were poor. In distal axonopathy, with specificities set at 90 and 95%, age and height adjusted threshold were abnormal in 86 and 71%, respectively. In general, the vibrotactile thresholds did not measure the same neurologic attributes as nerve conduction velocity and electromyography, and were not fully equivalent. The authors conclude with a list of 10 recommendations on the choice and standardization of testing protocol and covariates, and indicate areas for future research.
NIOSH-Publication; NIOSH-Grant; Musculoskeletal-system-disorders; Diagnostic-tests; Cumulative-trauma-disorders; Ergonomics; Neuromuscular-system-disorders; Neuropathology; Occupational-exposure; Occupational-hazards; Vibration-effects; Quantitative-analysis
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