RESUMEN
OBJECTIVE: To propose an electronic method for sensitivity evaluation in leprosy and to compare it to the Semmes-Weinstein monofilaments. METHODS: Thirty patients attending the Dermatology outpatient clinic of HCFMRP-USP were consecutively evaluated by both the electronic aesthesiometer and Semmes-Weinstein monofilaments on hand and foot test points. The intraclass correlation coefficient (ICC) was calculated to determine the variability of the electronic measures and the Kappa coefficient was calculated to determine the agreement between methods according to their categories (altered and non-altered tactile sensitivity). RESULTS: The ICC was approximately 1, demonstrating repeatability. The Kappa coefficient showed more than 75 and 63% agreement on the hand and foot points, respectively. The mean agreement between the 2 methods for the 7 points of the right and left hand was 77.14 and 75.71%, respectively. The mean agreement for all 10 points was 74.33 and 63.66% on the right and left foot, respectively. In cases of disagreement the detection of altered tactile sensitivity by the electronic esthesiometer on the right and left foot was 90.91 and 84.25%, respectively, with no detection by the monofilaments. CONCLUSION: The results suggest that the electronic esthesiometer is a reliable and easy application, capable of evaluating alterations of tactile sensitivity in leprosy patients.
Asunto(s)
Electrodiagnóstico/instrumentación , Lepra/complicaciones , Dimensión del Dolor/instrumentación , Umbral Sensorial/fisiología , Trastornos Somatosensoriales/diagnóstico , Tacto/fisiología , Evaluación de la Discapacidad , Progresión de la Enfermedad , Electrodiagnóstico/métodos , Pie/inervación , Pie/fisiopatología , Mano/inervación , Mano/fisiopatología , Humanos , Nociceptores/fisiología , Dolor/diagnóstico , Dolor/fisiopatología , Dimensión del Dolor/métodos , Nervios Periféricos/patología , Nervios Periféricos/fisiopatología , Estimulación Física/instrumentación , Estimulación Física/métodos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Células Receptoras Sensoriales/fisiología , Piel/inervación , Piel/fisiopatología , Trastornos Somatosensoriales/etiología , Trastornos Somatosensoriales/fisiopatologíaRESUMEN
O eletrodiagnóstico nos casos de lepra pode fornecer os seguintes resultados: 1. Eletrodiagnóstico normal ou com reações elétricas anormais quantitativas e qualitativas isoladas, nos casos de lepra sem espessamentos nem amiotrofias ou com espessamentos sem amiotrofias e nas mutilações neurotróficas garves. 2. R.D. tipo ramuscular, nas neurites ramusculares, particularmente na paralisia facial periférica parcelada hanseniana. 3. R.D. tipo troncular, nas neurites tronculares, inclusive na paralisia facial periférica total hanseniana e, nas neurites múltiplas hansenianas. O eletrodiagnóstico na lepra, particularmente nos casos de R.D. tipo ramuscular, é útil para elucidação diagnóstica; também, auxilia o diagnóstico diferencial entre as neurites lepróticas e processos amiotróficos-paral¡ticos resultantes de lesões radiculares, plexuais e medulares. Ainda é valioso para orientação fisioterapêutica e na avaliação prognóstica da evolução da neurites hansenianas e epineurectomias.