(LML) WHO disability grading and the term anaesthesia

Leprosy Mailing List – August 12,  2014 

Ref.:    (LML) WHO disability grading and the term anaesthesia

From:  Wim Brandsma, Hoevelaken, The Netherlands

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Dear Pieter,

 

I like to respond to Dr Narishma Rao’s invitation: WHO disability grading and the term anaesthesia.

 

Indeed the term anaesthesia is cause for confusion and not officially defined.  I would like to make reference to an article, the report of a consensus meeting on the neurologically impaired foot (Brandsma et al. Lepr Rev 2001;72:254-). In this article we propose to talk about loss of protective sensation (touch) which, depending on instrument used, is defined as follows: when on two or more locations on the foot (out of a maximum of ten sites, excluding the heel) the 10gm filament is not felt or if at any one site firm pressure with a ballpoint pen is not felt.

 

Above may need revision - therefore I would like to add this to the discussion. A more recent article discusses the WHO grading: A Delphi exercise to refine the WHO three-point Disability grading for leprosy, and to develop guidelines to promote greater accuracy and reliability of WHO disability recording (Cross etal, 2014:85:18) The consensus evolved around grade-2 issues. In hindsight, a possible omission that consensus was not asked for grade 1.

 

With kind regards,

 

Wim

Wim Brandsma, PT, PhD 

Koolmeeslaan 18

3871 HG HOEVELAKEN/Netherlands

33-8447266

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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