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Published on: June 30, 2014
Interrater Reliability of Four Sensory Measures in People with Multiple Sclerosis
Marcin Uszynski1, Helen Purtill1, Susan Coote1
1Clinical Therapies Department (MU, SC) and Department of Mathematics and Statistics (HP), University of Limerick, Limerick, Ireland; and Multiple Sclerosis Society of Ireland, Western Regional Office, Galway, Ireland (MU).
Background:
Sensory disturbances are a major problem for people with multiple sclerosis (MS), and up to 80% of people with MS present with various sensory deficits. To date, only one study has investigated the reliability of sensory measures in people with MS. We sought to determine the interrater reliability of the verbal analogue scale (VAS), the Erasmus MC modifications to the revised Nottingham Sensory Assessment (EmNSA), Semmes-Weinstein monofilaments (SWMs), and the neurothesiometer (NT) in people with MS.
Methods:
A random sample of 34 people with MS who could walk independently with or without a device was tested by two raters on the same day. For categorical data, percentage agreement, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa were used. For continuous data, interclass correlation coefficient (ICC[2,1]) with 95% confidence intervals (95% CIs), Bland and Altman analysis, and standard error of measurement (SEM) were calculated.
Results:
For NT, ICC(2,1) values were good, with the highest for first metatarsophalangeal joint (ICC[2,1] = 0.84, 95% CI = 0.69-0.92, SEM = 4.98). The highest ICC(2,1) for VAS was for the question relating to feeling numbness in the hand (ICC[2,1] = 0.93, 95% CI = 0.86-0.96, SEM = 0.64). Findings for EmNSA and SWMs need further verification owing to possible ceiling effects.
Conclusions:
The NT and VAS had good interrater reliability and should be considered for measuring sensation in ambulatory people with MS. Findings for EmNSA and SWMs revealed either questionable or poor reliability, suggesting the need for further investigation.
