PubMed · 515784
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G R McSwain, J A Ameriks. 1979. Doppler-improved Allen test.. https://doi.org/10.1097/00007611-197912000-00043
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OBJECTIVE: To examine the validity of a durometer to objectively measure skin hardness in systemic sclerosis (SSc), and to compare digital durometry with the modified Rodnan skin score (MRSS) and ultrasonography. METHODS: Patients with SSc and healthy controls underwent durometry measurements in 3 assessments: a Latin square experiment to establish durometry's intra- and interobserver reliability compared with skin scoring (5 SSc, 1 control); a longitudinal cohort to assess sensitivity to change in skin hardness (13 SSc, 5 controls); and an ultrasound cohort to evaluate correlation between durometry, ultrasound-measured skin thickness, and clinical skin scoring (30 SSc, 12 controls). RESULTS: Intraobserver reproducibility was higher for durometry than for clinical skin scoring (intraclass correlation coefficient [ICC] 0.97 versus 0.85), whereas interobserver reproducibility was similar (0.75 versus 0.73). Interobserver reproducibility of durometry was good for all body areas (ICC 0.61-0.85), but for skin scoring it was moderate in the legs (0.51) and poor in the abdomen (0.08), feet (0.09), and fingers (0.27). Durometry scores correlated with clinical skin scores (Latin square: r = 0.44, P = 0.03; longitudinal cohort: r = 0.81, P < 0.001) and ultrasound-measured skin thickness (hands: r = 0.58, forearms: r = 0.63, upper arms: r = 0.40; P < or = 0.001 for all). Uninvolved skin in patients with SSc was harder than skin from controls (mean +/- SD 23 +/- 7 durometer units [DU] versus 19 +/- 6 DU; P < 0.0001). Finally, there was a strong correlation between change in MRSS and change in durometry score (r = 0.77, P = 0.002). CONCLUSION: Durometer-measured skin hardness correlates well with MRSS and ultrasound-measured skin thickness, provides greater reliability than MRSS, and is sensitive to changes in skin hardness over time. Durometry should be considered for use in clinical therapeutic SSc trials.
Although understanding of the organization and control of visually guided reaching and aiming movements is still sketchy and incomplete, evidence from behavioural studies supports the contention that right-handed individuals typically execute aiming movements with better speed, smoothness and consistency, and with a greater degree of spatial precision when performing them with their right hand. Creative attempts to account for the superiority of the right hand on a variety of visually guided reaching and aiming tasks have focused on the processing characteristics of the contralateral or left cerebral hemisphere. This brief review summarizes the research conducted over the last few decades on the subject, highlights the theoretical interpretations offered to explain manual asymmetries in the organization and control of goal-directed movements and identifies directions for further empirical research. The theoretical and practical implications of laterality research efforts along the lines of goal-directed behaviour are discussed.
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