The AsTex ®: clinimetric properties of a new tool for evaluating hand sensation following stroke

Abstract

Objectives: To investigate the clinimetric properties and clinical utility of the AsTex^®, a new clinical tool for evaluation of hand sensation following stroke.

Design: The AsTex^® was administered on two occasions separated by a week to appraise test—retest reliability, and by three assessors on single occasion to establish inter-rater reliability. Pilot normative values were collected in an age-stratified sample. Clinical utility was evaluated based on ease of administration, ceiling and floor effects, and responsiveness to sensory recovery.

Participants: Test—retest (n = 31) and inter-rater (n = 31) reliability and normative values (n = 95) for the AsTex^® were established in neurologically normal participants aged 18—85 years. Test—retest reliability was investigated in 22 individuals a mean of 46 months (range 12—125) post stroke and clinical utility was evaluated in an additional 24 subacute stroke participants a mean of 29.4 days (range 12—41) post stroke.

Main measure: The AsTex^®.

Results: The AsTex^® demonstrated excellent test—retest (intraclass correlation coefficient (ICC) = 0.98, 95% confidence interval (95% CI) = 0.97—0.99) and inter-rater reliability (ICC = 0.81, 95% CI = 0.73—0.87) in neurologically normal participants. Test—retest reliability of the AsTex^® in individuals following stroke was excellent (ICC = 0.86, 95% CI = 0.68—0.94). The AsTex^® was simple to administer, demonstrated small standard error of measurement (0.14 mm), minimal floor and ceiling effects (12.5% and 8.3%) and excellent responsiveness (standardized response mean = 0.57) in subacute stroke participants.

Conclusion: The AsTex^® is a reliable, clinically useful and responsive tool for evaluating hand sensation following stroke.

Get full access to this article

View all access options for this article.

References

Harris JE , Eng JJ Paretic upper-limb strength best explains arm activity in people with stroke . Phys Ther 2007; 87: 88-97.

Varney NR Somesthesis. In Hannay HJ ed. Experimental techniques in human neuropsychology. New York , Sage, 1986, 212-37.

Lincoln NB , Crow JL , Jackson JM , Waters GR , Adams SA , Hodgson P. The unreliability of sensory assessments. Clin Rehabil 1991; 5: 273-82.

Bell-Krotoski J. Light touch-deep pressure testing using Semmes-Weinstein monofilaments. In Hunter JM , Schneider LH , Mackin EJ , Callahan AD eds. Rehabilitation of the hand ., third edition. St Louis: CV Mosby , 1990: 585-93.

Carey LM , Oke LE , Matyas TA Impaired touch discrimination after stroke: a quantitative test. J Neurol Rehabil 1997; 11: 219-32.

Williams PS , Basso DM , Case-Smith J. , Nichols-Larsen DS Development of the Hand Active Sensation Test: reliability and validity. Arch Phys Med Rehabil 2006; 87: 1471-77.

Dannenbaum RM , Michaelsen SM , Desrosiers J. , Levine MF Development and validation of two new sensory tests of the hand for patients with stroke. Clin Rehabil 2002; 16: 630-39.

Winward CE , Halligan PW , Wade DT The Rivermead Assessment of Somatosensory Performance (RASP): standardization and reliability data. Clin Rehabil 2002; 16: 523-33.

Kim JS , Choi-Kwon S. Discriminative sensory dysfunction after unilateral stroke. Stroke 1996; 27: 677-82.

10.

Johansson RS , Cole KJ Sensory-motor coordination during grasping and manipulative actions. Curr Opin Neurobiol 1992; 2: 815-23.

11.

Blennerhassett JM , Matyas TA , Carey LM Impaired discrimination of surface friction contributes to pinch grip deficit after stroke. Neurorehabil Neural Repair 2007; 21: 263-72.

12.

Harris M. , Horvitz DG , Mood AM On determination of sample sizes in designing experiments. J Am Stat Assoc 1948; 43: 391-402.

13.

Bryden MP Measuring handedness with questionnaires. Neuropsychologia 1977; 15: 617-24.

14.

Stratford PW , Goldsmith CH Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength data. Phys Ther 1997; 77: 745-50.

15.

Eliasziw M. , Young SL , Woodbury MG , Fryday-Field K. Statistical methodology for the concurrent assessment of interrater and intrarater reliability using goniometric measurements as an example. Phys Ther 1994; 74: 777-88.

16.

Liang MH , Fossel AH , Larson MG Comparisons of five health status instruments for orthopedic evaluation. Med Care 1990; 28: 632-42.

17.

Gowland C. , Stratford P. , Ward M. et al. Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment. Stroke 1993; 24: 58-63.

18.

Carr JH , Shepherd RB , Nordholm L. , Lynn D. Investigation of a new motor assessment scale for stroke patients. Phys Ther 1985; 65: 175-79.

19.

Durand A. , Malouin F. , Richards CL , Bravo G. Intertrial reliability of work measurements recorded during concentric isokinetic knee extension and flexion in subjects with and without meniscal tears. Phys Ther 1991; 71: 804-12.

20.

Lederman SJ Tactile roughness of grooved surfaces: the touching process and effects of macro- and microsurface structure. Percept Psychophys 1974; 16: 386-95.

21.

Lederman SJ , Taylor MM Fingertip force, surface geometry, and the perception of roughness by active touch. Percept Psychophys 1972; 12: 401-408.

22.

Morley JW , Goodwin AW , Darian-Smith I. Tactile discrimination of gratings. Exp Brain Res 1983; 49: 291-99.

23.

Darian-Smith I. , Oke LE Peripheral neural representation of the spatial frequency of a grating moving across the monkey’s finger pad. J Physiol 1980; 309: 117-33.

24.

Lamb GD Tactile discrimination of textured surfaces: psychophysical performance measurements in humans. J Physiol 1983; 338: 551-65.

25.

Andresen EM , Rothenberg BM , Panzer R. , Katz P. , McDermott MP Selecting a generic measure of health-related quality of life for use among older adults: a comparison of candidate instruments . Eval Health Prof 1998; 21: 244-64.

26.

McHorney CA , Tarlov AR

Individual-patient monitoring in clinical practice: are available health status surveys adequate?

Qual Life Res 1995; 4: 293-307.

27.

Julkunen L. , Tenovuo O. , Jaaskelainen SK , Hamalainen H. Recovery of somatosensory deficits in acute stroke. Acta Neurol Scand 2005; 111: 366-72.