Two-point discrimination test. A valuable part of hand surgical rehabilitation, e.g. in tetraplegia

Abstract

In assessing the prospects for surgical and other kinds of rehabilitation in tetraplegia and stroke patients the two-point discrimination test, correctly performed by experienced examiners, is of great value. Valid and repeatable results depend on exact technique and proper tools. There is a firm correlation between the thresholds of two-point discrimination on the pulps of the fingers and the accuracy of position sense at the metacarpophalangeal and interphalangeal joints. Microneurography has shown that cutaneous receptors have proprioceptive as well as exteroceptive functions. Thus the two-point discrimination test can be used as a measure of proprioceptive function. The results can be expressed numerically. A two-point threshold less than 10 mm on the pulp is a valid measure of useful finger proprioception. It also shows tactile gnosis, necessary for precision sensory grips.