Article

Decreased manual dexterity is common in persons after stroke.
Different measures are used to assess manual dexterity, but a lack of knowledge
exists about their reliability and how they are related. OBJECTIVE: To evaluate
the test-retest reliability and convergent validity of 3 manual dexterity
measures after stroke.
DESIGN: A test-retest design.
SETTING: University
Hospital. PARTICIPANTS:
Forty-five persons (mean age 65 years) with
mild-to-moderate impairments in the upper extremity at least 6 months after
stroke. MAIN OUTCOME MEASURES: Manual dexterity was assessed on 2 occasions, 1
week apart using the Box and Block Test (BBT), the Nine-Hole Peg Test (NHPT), and
the modified Sollerman Hand Function Test (mSHFT). The reliability of the BBT and
NHPT was evaluated with the intraclass correlation coefficient together with
systematic and random measurement errors. Reliability of the mSHFT was evaluated
with the Kappa coefficient and the Svensson rank-invariant method (percent
agreement and systematic and random disagreements). Convergent validity of the
total scores was evaluated with the Spearman rank correlation coefficients (rho).
RESULTS: The intraclass correlation coefficient for the BBT and the NHPT ranged
from 0.83 to 0.99. Significant systematic measurement errors were found for both
tests and hands. The Kappa coefficient for the total sum score of the mSHFT was
0.95 for the more affected hand and 0.59 for the less affected hand. One of the 3
items showed systematic disagreements for both hands. The convergent validity
(rho) for the more affected hand ranged from 0.41 (BBT versus mSHFT) to -0.68
(NHPT versus mSHFT). CONCLUSION: The test-retest reliability of the BBT, NHPT and
mSHFT was high but all measures showed learning effects. The relationships
between the 3 measures indicate that they partly complement one another. The BBT
may be preferred for persons with moderate impairments of the upper extremity and
the NHPT and the mSHFT for persons with milder impairments. As the mSHFT has the
advantage of reflecting activities in daily life it may be a suitable alternative to the NHPT.
LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS