Development and validation of two new sensory tests of the hand for patients with stroke

Objective: To establish validity and reliability of two new sensory tests evaluating moving (MTP) and sustained (STP) touch-pressure and their relationship to hand function for patients with stroke. The STP had four components in which a light or heavy ball was applied passively or held actively. Participants: Twenty-eight participants with hemiparesis (1-109 months) from rehabilitation hospitals or outpatient programmes. Design: Content validity was established. Then reliability and concurrent and construct validity were determined. Sensation was compared with hand functional ability using the Modified Moberg recognition task, the Box and Block test and one task of the TEMPA test. Results: Reliability: Both types of reliability were significant for MTP (ICC = 0.92) and all components of STP (ICC = 0.62 to 0.92). Concurrent validity: MTP and STP correlated significantly (r= -0.39 to -0.83) with the Semmes-Weinstein Monofilament test used as a 'gold standard' comparison. Construct validity: MTP was significantly related to Moberg (r= 0.49). Three of four components of STP correlated with TEMPA (r= 0.49-0.53) and Moberg (0.45-0.71). Only STP (heavy ball) correlated with Box and Block (0.42-0.48). Of the four components of STP, only the passive STP (light ball) was riot related to hand function. Conclusion: The new sensory tests of moving, and three components of sustained touch-pressure were reliable. The passive STP (light ball) was discarded. All but this test were relevant to the two functional roles of sensation: exploration for MTP and dexterity during holding for STP.