Differential recovery of touch thresholds and discriminative touch following nerve repair with focus on time dynamics

Abstract

Introduction The purpose of this secondary analysis of pooled data from two randomised controlled trials was to explore the differential rate of recovery of sensory and motor functions over time following repair of median or ulnar nerve. Methods Recovery over two years following median or ulnar nerve repair at wrist level using the Rosen score was analysed in 67 patients. Results Within the sensory domain of the Rosen score, a substantial gap was observed between recovery of touch thresholds and discriminative touch. Within the motor domain, manual muscle strength and grip strength showed a closer and more parallel recovery rate. Conclusion The differential recovery rates in touch thresholds and discriminative touch after a peripheral nerve injury are likely due to neurobiological factors that cannot be influenced by surgical interventions. However, new knowledge about brain plasticity opens up the possibility that this differential recovery may diminish through the use of revised rehabilitation programs focused on the use of guided plasticity, and the timing of onset of sensory re-learning.