Construct validity, reliability, and responsiveness of the Wrist Position Sense Test for use in children with...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Pediatric Physical Therapy

Background:

• Children with hemiplegic cerebral palsy (CP) often experience challenges with motor control and sensory perception.
• Accurate assessment of sensory-motor function, specifically proprioception, is crucial for effective intervention planning in pediatric rehabilitation.
• The Wrist Position Sense Test (WPST) is a tool designed to evaluate proprioception at the wrist joint.

Purpose of the Study:

• To investigate the construct validity, test-retest reliability, and responsiveness of the Wrist Position Sense Test (WPST).
• To assess the WPST's ability to differentiate between children with hemiplegic cerebral palsy (CP) and typically developing (TD) children.
• To determine if the WPST can detect changes in wrist position sense following an intervention.

Main Methods:

• A cross-sectional study involving 28 children with spastic hemiplegic CP and 39 TD children to assess construct validity.
• Test-retest reliability was examined in 22 TD children.
• Responsiveness was evaluated by randomly assigning 17 children with CP to a treatment or control group, with assessments at four time-points.

Main Results:

• Children with CP exhibited significantly greater errors in indicated wrist position compared to TD children (p < 0.01).
• Larger WPST errors were substantially associated with poorer performance on the Box and Block Test (BBT) (p < 0.01).
• The WPST demonstrated responsiveness to intervention, with a significant reduction in mean error following treatment (p < 0.001), unlike the control group (p = 0.28).

Conclusions:

• The WPST demonstrated construct validity in this preliminary study, showing significant differences between children with CP and TD children.
• The test scores were associated with an upper limb activity measure (BBT) and showed significant changes after somatosensory training.
• These findings support the WPST as a promising tool for measuring wrist position sense in children with CP, warranting further psychometric investigation.