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.