Wrinkling Test

Original Editor - Ehtisham Panhwar
Top Contributors - Ehtisham Panhwar and Kirenga Bamurange Liliane

Purpose

Wrinkle or wrinkling or shivel test is a special test for hands. Wrinkle test is used to check the nerve integrity of the hand by assessing the proper nervous response to an environmental stimulus i.e, water immersion for sustained period of time. Wrinkle test is used to diagnose a nerve injury or a digital denervation.

Technique

• Patient should be in sitting position
• Take warm water in a bowel
• Immerse patients affected or testing hand in the bucket
• Keep it immersed for around 10-30 minutes
• Take the hand out and look for wrinkles in hand
• A positive sign is not having wrinkle in any digit of the hand.

Evidence

In a study conducted by Rubin et al they mention that wrinkle test have a sensitivity of 69.5%, specificity of 62.5% with a confidence interval of 95% in diagnosing the digital nerve injury.

The journal of hand therapy explains the significance that it is quite helpful to denervation in an infant or a young child who have not yet developed enough skill to be able to understand the instructions of other examination. Wrinkle test do not require much cognitive understanding.

A research by Kava et al University of Texas at Austin is used to investigate the sympathetic nervous system integrity of the hand.

Resources

There are many videos demonstrating the wrinkling test are available on web from which i found this one to be useful and it exactly demonstrates how to do the test and shows the normal and clearly shows positive and negative sign. {{#ev:youtube|GIuVr9OgT_M}time=00:49}