A new tactile gnosis instrument in sensibility testing.

A new quantitative test instrument for the assessment of tactile gnosis--the ability to identify shapes and textures without vision--is introduced. Introductory investigations of validity and reliability are presented. Fifty-four patients (60 hands) with carpal tunnel syndrome, vibration-induced neuropathy, or nerve repair at distal forearm level, and a matched asymptomatic control group were initially examined. After establishing the cut-off limit for normal tactile gnosis, sensitivity and specificity were calculated to determine the discriminative power of the new instrument. A high sensitivity (1.0) of the new shape/texture identification test was found in the group of patients with nerve repair. Given a cut-off limit, the sensitivity was lower in the groups with vibration-induced neuropathy and carpal tunnel syndrome (0.65 and 0.40, respectively), and the specificity of the test was 0.90 to 0.95. In a second step, a group of 52 patients who had had nerve repair at the distal forearm level were examined. Test-retest reliability was good, with a weighted kappa value of 0.79 to 0.81. Good reliability was also shown in the internal consistency of test items, with a Cronbach alpha value of 0.78. These introductory results indicate that the new shape/texture identification test can be useful in the assessment of tactile gnosis.