The aim of this study was to compare fingertip tactile sensation, hand and finger grip strength, and hand pain thresholds in children diagnosed with specific learning disorder with impairment in written expression and healthy controls.
Diagnosis of specific learning disorder with impairment in written expression according to the DSM-5 diagnostic criteria
Age between 6 and 12 years
Clinically normal intellectual functioning
Voluntary agreement to participate in the study
Presence of verbal or visual communication problems
History of perinatal complications or physical head trauma
Presence of psychiatric disorders other than specific learning disorder according to the DSM-5 diagnostic criteria
History of known chronic physical or neurological disease (such as cerebral palsy, diabetes, epilepsy, autoimmune disease, liver failure, or kidney failure)
The study will include 33 children diagnosed with specific learning disorder with impairment in written expression and 33 healty control children.
Case-control
Cross-sectional
Treatment outcome
Other interventionThe participants' fingertip light touch and pain sensory thresholds, as well as hand and fingertip pinch strength, will be evaluated.
Fingertip light touch
The participants' light touch sensory thresholds will be assessed using Semmes-Weinstein monofilaments, which consist of calibrated synthetic monofilaments that differ in thickness and the amount of pressure applied. Measurements will be taken from the midpoint of the distal phalanx on the palmar surface of the first, second, and third fingers of the right hand. The test will be performed with the participants' eyes closed; starting with the smallest monofilament, contact will be applied to the test area and progressively larger monofilaments will be used. The test will be terminated when the participant first perceives the touch, and the corresponding value will be recorded.
Hand grip strength
Hand grip strength will be assessed using a Jamar dynamometer (Patterson Medical, Green Bay, WI, USA). During the assessment, the participant will be seated with the shoulders adducted and in neutral rotation, the elbow flexed at 90°, the forearm in a neutral position, and the wrist between 0° and 30° of dorsiflexion. The evaluator will gently support the base of the dynamometer, place it in the participant's hand, and instruct the participant to squeeze as hard as possible. Three measurements of maximum voluntary contraction will be obtained for the right hand, and the highest value will be recorded in kilograms.
Finger pinch strength
The pinch strength between the thumb and index finger of the participants' right hand will be assessed using a Jamar pinch gauge. During the assessment, the shoulder will be in adduction and neutral rotation, the elbow flexed at 90°, the forearm in mid-rotation, and the wrist in a neutral position. The participant will be instructed to squeeze the pinch gauge between the thumb and index finger as hard as possible. Three measurements of maximum voluntary contraction will be obtained for the right hand, and the highest value will be recorded in kilograms.
Pressure pain threshold
The pressure pain threshold will be used to assess the patients' pain perception threshold. Pressure pain threshold will be measured using a manual pressure algometer (Baseline Dolorimeter®). The patients' pain perception thresholds will be measured at the right lateral epicondyle and at the midpoint of the web space between the first and second fingers. During the measurement, the algometer's flat circular probe with a surface area of 1.52 cm² will be placed on the relevant site, and pressure will be increased at a rate of 1 kg/second. The patients will be instructed to indicate the onset of pain by saying "stop" or by raising their hand when they begin to feel slight discomfort. For each reference site, the value will be calculated as the arithmetic mean of two measurements taken 30 seconds apart.
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