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Published on: January 11, 2016
Reproducibility of tactile assessments for children with unilateral cerebral palsy
Megan Louise Auld1, Robert S Ware, Roslyn Nancy Boyd
1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. mauld@uq.edu.au
Insights
This study evaluated the test-retest reliability of tactile assessments in children with cerebral palsy (CP). Semmes-Weinstein monofilaments and two-point discrimination tests showed good reliability for CP assessment.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- A systematic review identified tactile assessments for children with cerebral palsy (CP).
- The reproducibility of these tactile assessments in children with CP was previously unknown.
- Accurate tactile assessment is crucial for understanding sensory deficits in CP.
Purpose of the Study:
- To determine the test-retest reliability of various tactile sensory assessments in children with unilateral CP.
- To compare the reliability of these assessments between children with unilateral CP and typically developing children (TDC).
- To recommend reliable tactile assessments for research and clinical practice in CP.
Main Methods:
- Assessed 16 children with unilateral CP and 31 TDC on tactile tests.
- Evaluated test-retest reliability over 2-4 weeks using percent agreement and intraclass correlation coefficients (ICC).
- Included Semmes-Weinstein monofilaments, single-point localization, static and moving two-point discrimination, registration, unilateral spatial tactile perception, double simultaneous, tactile texture perception, and stereognosis.
Main Results:
- Semmes-Weinstein monofilaments, single-point localization, static and moving two-point discrimination showed good test-retest reliability in children with CP.
- High ICC values (0.79-0.96) were found for registration and unilateral spatial tactile perception.
- Double simultaneous and tactile texture perception exhibited learning effects; stereognosis showed ceiling effects in TDC and variability in CP.
Conclusions:
- Semmes-Weinstein monofilaments, single-point localization, and two-point discrimination tests are recommended for tactile assessment in children with CP.
- Measures like double simultaneous, stereognosis, and tactile texture perception may have limitations in detecting changes over time in children with unilateral CP.
- These findings aid in selecting appropriate tactile assessments for research and clinical practice in pediatric CP.
Abstract:
A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were Semmes-Weinstein monofilaments: 75% (90%); single-point localization: 69% (97%); static two-point discrimination: 93% (97%); and moving two-point discrimination: 87% (97%). Test-retest reliability for registration and unilateral spatial tactile perception tests was high in children with CP (intraclass correlation coefficient [ICC] = 0.79-0.96). Two tests demonstrated a learning effect for children with CP, double simultaneous and tactile texture perception. Stereognosis had a ceiling effect for TDC (ICC = 0) and variability for children with CP (% exact agreement = 47%-50%). The Semmes-Weinstein monofilaments, single-point localization, and both static and moving two-point discrimination are recommended for use in practice and research. Although recommended to provide a comprehensive assessment, the measures of double simultaneous, stereognosis, and tactile texture perception may not be responsive to change over time in children with unilateral CP.
