[Interobserver reliability of a new horizontal pointing manoeuvre: comparison with conventional tests]

Area of Science:

• Neurology
• Clinical Assessment
• Motor Control

Background:

• Conventional clinical tests for evaluating upper limb voluntary movements include finger-to-nose, fine finger movements, maintaining arms against gravity, alternate hand movements, Barany's test, muscle tone evaluation, Stewart-Holmes test, and handwriting.
• These tests are frequently used in daily practice but may have varying degrees of interobserver reliability.

Purpose of the Study:

• To introduce and analyze the reliability of a new clinical maneuver for assessing upper limb voluntary movements.
• To compare the interobserver reliability of the new test with conventional clinical tests.

Main Methods:

• A new clinical maneuver involving a horizontal pointing movement of one upper limb towards the contralateral motionless limb was developed.
• The reliability of this new test and conventional tests was analyzed between two observers using kappa statistics.
• The study included a group of 34 right-handed neurological patients.

Main Results:

• The new horizontal pointing maneuver demonstrated very good interobserver agreement, with kappa values of 0.63 for the left upper limb and 0.64 for the right upper limb.
• Handwriting was the only conventional test with higher interobserver reliability.
• The new maneuver was found to be original, potentially due to its investigation of rapid proximal movements towards a fixed spatial target.

Conclusions:

• The novel horizontal pointing maneuver exhibits very good interobserver reliability.
• This maneuver is an original clinical assessment tool for upper limb voluntary movements.
• The test shows promise as a reliable and original addition to the neurological examination for evaluating motor function.