American Society for Peripheral Nerve

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Using the Scratch Collapse Test To Detect Clinical Or Subclinical Peroneal Palsy In The Hospitalized Patient In Order To Prevent Falls
Isaac Fernandez, BS; Jessica Avila, BS; Vincent Battafarano, BA; Gilberto Agustin Gonzalez Trevizo, MD
Texas Tech University Health Sciences Center El Paso, El Paso, TX

INTRODUCTION: The Scratch Collapse Test (SCT), an exam that is used to evaluate localized nerve compression after a superficial region of the affected nerve is grazed. The use of this test in identifying nerve palsies in the lower extremity has not been extensively studied. Patients who are interned in a hospital for several days and who do not routinely present as a fall risk may present with insidious peroneal nerve palsy (PNP) and related foot drop(FD). As a result, these patients may be at a greater risk for a fall, since they may be allowed to ambulate freely. The purpose of our study is to evaluate the use of SCT in a subset of hospitalized patients in order to identify the presence of subclinical PNP and thereby prevent falls.

METHODS: We will prospectively recruit 87 patients over a 3 month period. Male or female patients between the ages of 18-70 years of age who have been at the hospital for 5 days or longer, are cognizant, able to ambulate will be included in the study. In addition to using the SCT to detect PNP, a detailed neuromuscular exam will be performed to clinically determine the presence of FD. Weakness or lack of dorsiflexion and loss of sensation between the first and second toe will be categorized as a positive test for foot drop. Any patients with peripheral nerve damage, a history of knee or spinal surgery, a spinal cord injury will be excluded from the study. The following data will be collected: age, gender, length of hospital stay, reason for hospital stay, the result of the SCT, fall risk classification, and whether or not PNP is clinically present. Moreover, in order to determine the effectiveness of the SCT to reduce the incidence of falls, falls statistics from the same 3 month period (in the past year) will be compared to the present period.

RESULTS: Currently, no patients have been enrolled in the study, so data is pending. The study will formally start in August of 2018.

CONCLUSION: We anticipate that using this inexpensive test will help decrease the incidence of falls over a 3 month period. We hope to demonstrate the clinical utility of the SCT for identifying nerve palsies in the lower extremity.

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