title: Setup of a novel biofeedback prototype for sensorimotor control of the hand and preliminary application in patients with peripheral nerve injuries.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan.
authors.forename: Haw-Yen
authors.initials: HY
authors.lastname: Chiu
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Hsu
authors.forename: Fong-Chin
authors.initials: FC
authors.lastname: Su
authors.forename: I-Ming
authors.initials: IM
authors.lastname: Jou
authors.forename: Cheng-Feng
authors.initials: CF
authors.lastname: Lin
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D003430:Cross-Sectional Studies; D005260:Female; D006225:Hand / Q000294:innervation*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D011597:Psychomotor Performance; D012677:Sensation / Q000502:physiology; D018709:Statistics, Nonparametric