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Published on: September 16, 2013
The AuSpinal: a test of hand function for people with tetraplegia
S K Coates1, L A Harvey, S A Dunlop
1Occupational Therapy Department, Royal Perth Hospital, Perth, Western Australia, Australia.
Study Design:
Five-phased reliability and validity study.
Objectives:
To develop and test an assessment tool designed to quantify unilateral hand function in people with tetraplegia.
Setting:
Seven spinal injury units in Australia.
Methods:
The AuSpinal is a new assessment tool comprising seven tasks designed to quantify unilateral hand function in people with tetraplegia. There were five phases in this study: (1) development of the AuSpinal; (2) testing the test-retest and intrarater reliability of repeat ratings of 84 videos as determined by 13 therapists; (3) testing the interrater reliability and internal consistency of simultaneous real-life ratings of eight hands as determined by six therapists; (4) testing the range of scores from cross-sectional data obtained from 50 hands; and (5) quantifying sensitivity to change from longitudinal data collected over the course of rehabilitation from 16 hands.
Results:
The test-retest, intrarater and interrater reliabilities were high (intraclass correlation coefficients ranged from 0.79 to 0.98, 95% CI ranged from 0.72 to 1.0) with a Cronbach α-value of 0.93. There was a reasonable range in the scores obtained from the cross-sectional data of the 50 hands (interquartile range extended from 6 to 14). There was an obvious and marked change in AuSpinal scores over the course of patients' rehabilitation in 8 of the 16 hands.
Conclusion:
The AuSpinal provides a quick and reliable instrument to test hand function in people with tetraplegia. It is useful for people with poor hand function but requires the addition of more complex tasks for those with good hand function.
