umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.ORCID iD: 0000-0002-0366-4609
2019 (English)In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 16, no 1, article id 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Impairments in dexterity after stroke are commonly assessed by the Nine Hole Peg Test (NHPT), where the only outcome variable is the time taken to complete the test. We aimed to kinematically quantify and to compare the motor performance of the NHPT in persons post-stroke and controls (discriminant validity), to compare kinematics to clinical assessments of upper extremity function (convergent validity), and to establish the within-session reliability.

METHODS: The NHPT was modified and standardized (S-NHPT) by 1) replacing the original peg container with an additional identical nine hole pegboard, 2) adding a specific order of which peg to pick, and 3) specifying to insert the peg taken from the original pegboard into the corresponding hole of the target pegboard. Eight optical cameras registered upper body kinematics of 30 persons post-stroke and 41 controls during the S-NHPT. Four sequential phases of the task were identified and analyzed for kinematic group differences. Clinical assessments were performed.

RESULTS: The stroke group performed the S-NHPT slower (total movement time; mean diff 9.8 s, SE diff 1.4), less smoothly (number of movement units; mean diff 0.4, SE diff 0.1) and less efficiently (path ratio; mean diff 0.05, SE diff 0.02), and used increased scapular/trunk movements (acromion displacement; mean diff 15.7 mm, SE diff 3.5) than controls (P < 0.000, r ≥ 0.32), indicating discriminant validity. The stroke group also spent a significantly longer time grasping and releasing pegs relative to the transfer phases of the task compared to controls. Within the stroke group, kinematics correlated with time to complete the S-NHPT and the Fugl-Meyer Assessment (rs 0.38-0.70), suggesting convergent validity. Within-session reliability for the S-NHPT was generally high to very high for both groups (ICCs 0.71-0.94).

CONCLUSIONS: The S-NHPT shows adequate discriminant validity, convergent validity and within-session reliability. Standardization of the test facilitates kinematic analysis of movement performance, which in turn enables identification of differences in movement control between persons post-stroke and controls that may otherwise not be captured through the traditional time-based NHPT. Future research should ascertain further psychometric properties, e.g. sensitivity, of the S-NHPT.

Place, publisher, year, edition, pages
BioMed Central, 2019. Vol. 16, no 1, article id 8
Keywords [en]
Clinical laboratory techniques, Outcome assessment, Stroke, Upper extremity
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-155494DOI: 10.1186/s12984-019-0479-yISI: 000455641600001PubMedID: 30642350OAI: oai:DiVA.org:umu-155494DiVA, id: diva2:1280305
Funder
Västerbotten County CouncilThe Swedish Brain FoundationAvailable from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-02-08Bibliographically approved

Open Access in DiVA

fulltext(1808 kB)53 downloads
File information
File name FULLTEXT01.pdfFile size 1808 kBChecksum SHA-512
506cfd7f9066ca9e2832ecf0646f326a521ca37188bc7bec49492e2a307ee0edfeac4ec2e7d55c01ec114c37b903903e2460e98199fe45429653218d64b5c6fc
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Johansson, Gudrun M.Häger, Charlotte K.

Search in DiVA

By author/editor
Johansson, Gudrun M.Häger, Charlotte K.
By organisation
Physiotherapy
In the same journal
Journal of NeuroEngineering and Rehabilitation
Physiotherapy

Search outside of DiVA

GoogleGoogle Scholar
Total: 53 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 419 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf