P21
USE OF THE PURDUE PEGBOARD TEST TO DETERMINE SEVERITY OF SENSORINEURAL HAND ARM VIBRATION SYNDROME
R. A. Cooke, Cooke Medical Services Ltd, Genneteil, France
Background
The Stockholm workshop scale for classification of sensorineural Hand Arm Vibration Syndrome (HAVS) defined stage 3sn as including reduced manipulative dexterity (1). Since 2005 the UK HSE has recommended use of the Purdue pegboard test (PPT) or other means to do so (2), but discussion at the Society of Occupational Medicine HAVS Special Interest Group suggested inconsistency in approaches to undertaking and interpreting the results of this test.
Aims
The aim of this study was to review use of the PPT for assessment of manipulative dexterity among workers exposed to hand transmitted vibration, and consequent grading of sensorineural HAVS.
Methods
A literature review was undertaken using Pubmed, and a three-round Delphi study was performed with an initial 32 participants, each qualified to undertake statutory health surveillance for HAVS. Consensus agreement was defined as 75%.
Results
13 studies identified or quoted normative value data, although without standard stratification by age, gender or hand dominance. No single study provided normative data stratified in that way for the whole working age range.
A Delphi study revealed a range of approaches to undertaking and interpreting the results of the test. There was no consensus regarding the interpretation of the PPT.
Conclusions
This study confirms that diagnosis of stage 3sn remains inconsistent, being dependant on practitioners’ interpretation of data without consistently defined normal values stratified for age, gender and hand dominance. The possibility of over or underdiagnosis is high. There was no consensus regarding what further clinical test is required to diagnose stage 3.
References:
- Brammer AJ, Taylor W, Lundborg G. Sensorineural stages of the hand–arm vibration syndrome. Scandinavian Journal of Work and Environmental Health. 1987; 13: 279–83.
- Hand–arm vibration. The control of vibration at work regulations 2005. Guidance on regulations, L140. Bootle: HSE, 2005.
