Abstract
To examine the inter-rater reliability of the thumb localizing test (TLT) and its validity against quantitative measures of proprioception. The TLT was assessed by two raters in a standardized manner in 40 individuals with hemiparetic stroke. Inter-rater reliability was examined with weighted Kappa. For the quantitative measures, a bimanual matching task in a planar robotic device was performed. Without vision, each participant moved the unaffected hand to the perceived mirrored location of the affected hand, which was passively moved by the robot. Three measures were taken after 54 trials: Variability, trial-to-trial variability of the mirrored-matched locations; Area, the ratio of the area enclosed by the active hand relative to the passive hand; and Shift, systematic shifts between the passive and active hands. The correlation between the TLT and each robotic measure was examined with Spearman's rank correlation coefficient. The overall weighted kappa of the TLT was 0.84 (P<0.001). The TLT correlated highly with Area (r = -0.71, P<0.001) and moderately with Variability (r = 0.40, P = 0.011). No significant correlation was found between the TLT and Shift. The TLT had a high inter-rater reliability, and was validated against quantitative measures of proprioception reflecting the perceived area of movement and variability of the limb location.
Highlights
Proprioception is necessary for the control of limb posture, and the coordination of multijoint movements [1,2,3,4,5,6]
No significant correlation was found between the thumb localizing test (TLT) and Shift
The thumb localizing test (TLT) [13,14,15] or similar techniques [9, 16] are widely used for the assessment of proprioception for patients with stroke, both in clinical and research settings
Summary
Proprioception is necessary for the control of limb posture, and the coordination of multijoint movements [1,2,3,4,5,6]. Proprioceptive deficits are quite common [7, 8] and known to be partly related to motor recovery [9, 10]. As its longitudinal process of recovery has been partly revealed recently [8, 11, 12] and novel rehabilitative approaches are sought more than ever in clinical practice, indispensability for robust assessment tools of proprioception is increasing to accurately evaluate its improvement with progress of time or by any intervention. The thumb localizing test (TLT) [13,14,15] or similar techniques [9, 16] are widely used for the assessment of proprioception for patients with stroke, both in clinical and research settings. Validity of the TLT has yet to be revealed because there has been no other conventional assessment of proprioception that is reliable and quantitative enough to be regarded as a reference
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