NEW CLINICAL MEASURES OF HAND AND WRIST PROPRIOCEPTION: A PILOT STUDY FOR EVALUATING DISCRIMINATIVE VALIDITY AND TEST-RETEST RELIABILITY IN INDIVIDUALS WITH WRIST DISABILITY.

Abstract

Objective: To evaluate psychometric properties of newly developed hand and wrist proprioception tests.

Design: Cross-sectional and test-retest comparisons.

Subjects/patients: Twenty-six individuals (mean age 40 years) with wrist disability (> 3 months) due to traumatic injury or general instability.

Methods: Pointing acuity (with eyes open and closed), active joint position sense (in extension, flexion, radial- and ulnar deviation) and grip force reproduction were measured by 1 rater on 2 occasions, 1 week apart. The mean absolute error was calculated for each test. Discriminative validity (affected vs non-affected hand/wrist) was evaluated by paired t-test and test-retest reliability with Intraclass Correlation Coefficient (ICC).

Results: The pointing acuity test with eyes closed gave higher errors for the affected hand/wrist (p = 0.08) and good ICCs (0.80-0.85), while the test with eyes open had poor discriminative ability (p = 0.32) and test-retest reliability (ICC 0.13-0.16). The active joint position sense test showed higher error in flexion for the affected wrist (p = 0.03), and the ICC was moderate (0.51). The remaining joint directions and the grip force reproduction test had poor discriminative ability (p = 0.21-0.94) and poor to moderate ICCs (0.00-0.65).

Conclusion: The pointing acuity test with eyes closed and the active joint position test in flexion show-ed promising results but need further evaluation in larger samples.