Wie sinnvoll ist die Zweipunktdiskrimination als diagnostisches Mittel bei der Epicondylopathia humeri radialis?

Zusammenfassung

Die diagnostische Aussagekraft der Zweipunktdiskrimination (ZPD) als Indikator für chronische Krankheitsprozesse (z. B. Complex Regional Pain Syndrome, Chronic Low Back Pain) ist mehrfach untersucht und gilt als belegt. Das Ziel der vorliegenden Arbeit war es, die ZPD als diagnostisches Mittel in der Ellenbogenregion zu untersuchen.

Mithilfe eines Ästhesiometers (Schieblehre) wurde die ZPD im Bereich des lateralen Ellenbogens bei einer Patientengruppe (N = 21) mit der Diagnose Epicondylopathia humeri radialis sowie einer gesunden Kontrollgruppe (N = 40) mit folgender primärer Fragestellung untersucht: Kann die ZPD am Ellenbogen gesunde Proband(inn)en von Proband(inn)en mit Epicondylopathia humeri radialis unterscheiden? Als Basis wurden ZPD-Normwerte anhand der Kontrollgruppe am lateralen Ellenbogen erstellt. In einer vertiefenden Datenanalyse der Patientenpopulation wurden die Daten der Patient(inn)en mit einem akuten (N = 13) mit den Daten der Patient(inn)en mit einem chronischen (N = 8) Zustand verglichen.

Im Ergebnis scheint die ZPD kein geeignetes Diagnostikinstrument zur Differenzierung der Fall- von der Kontrollgruppe sowie von akuten und chronischen Verläufen in der lateralen Ellenbogenregion zu sein.

Abstract

The diagnostic value of two-point discrimination (2PD) as an indicator of chronic disease processes (e. g. Complex Regional Pain Syndrome, Chronic Low Back Pain) has been the subject of several studies and is considered proven. The aim of the present paper was to study the value of 2PD as a diagnostic tool in the elbow region.

Using an esthesiometer (caliper), 2PD in the lateral elbow region was examined in a group of patients diagnosed with epicondylitis humeri radialis (n = 21) and a healthy control group (n = 40) with the following primary research question: Can 2PD in the elbow region distinguish healthy subjects from subjects with epicondylitis humeri radialis? As a basis, 2PD standard values at the lateral elbow were established using the control group. In-depth data analysis of the patient population compared data from patients with an acute (n = 13) and chronic (n = 8) condition.

In conclusion, 2PD does not seem to be a suitable diagnostic tool to differentiate the case group from the control group and acute from chronic conditions in the lateral elbow region.

Schlüsselwörter

Zweipunktdiskrimination - Epicondylopathia humeri radialis - kortikale Reorganisation - chronischer Schmerz - Neuroplastizität

Key words

two-point discrimination - epicondylopathia humeri radialis - cortical reorganization - chronic pain - neuroplasticity

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