Letters to the editor

Albers, James W.; M, Mitz; Sulaiman, A. R.; Chang, Gaofeng; Rask, Michael R.; Jm, Vallat; Dumas, Michel; Leboutet, M. J.; Loubet, A; Vallat, M; Sarkar, Satyapriya; Rogers, Peter A. W.; Jones, George H.

doi:10.1002/mus.880020612

Cited by 3 publications

(7 citation statements)

References 11 publications

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“…Furthermore, a training session where the raters agreed on how to interpret the NINDS scale as carried out by Litvan et al was not performed in the present study, because the aim was to imitate real-life conditions. Accordingly, a study by Manschot et al that was conducted using raters with a more heterogeneous professional background than in the study by Litvan et al reported far lower kappa values, ranging from slight to moderate, comparable with those obtained in the present study 6 . Both interrater agreement and intrarater agreement were found to be the lowest for the test of the BRR.…”

Section: Discussionsupporting

confidence: 82%

“…Studies assessing its validity in the detection of C8 and T1 nerve root and proximal median nerve lesions such as the anterior interosseus syndrome are now needed 6 …”

Section: Discussionmentioning

confidence: 99%

“…To make the interpretation of kappa statistics easier, Landis and Koch suggested the following benchmark scale: poor (<0.0), slight (0.0–0.2), fair (0.21–0.4), moderate (0.41–0.6), substantial (0.61–0.8), and almost perfect (0.81–1.0) 11 . The benchmarks for the estimated ACs using the probabilistic method proposed by Gwet were used in this study 6 …”

Section: Methodsmentioning

confidence: 99%

“…5 Furthermore, the reflex has been proposed as a useful method to assess for lesions of the anterior interosseous nerve, a branch of the median nerve that innervates the FPL. 6 The FPL originates from the anterior surface of the radius and inserts onto the base of the distal phalanx of the thumb (Fig. 1).…”

Section: What Is Newmentioning

confidence: 99%

“…Electromyographic myotome charts identify the flexor pollicis longus (FPL) as an ideal candidate for the evaluation of C8 and T1, as it is almost exclusively innervated through these 5 . Furthermore, the reflex has been proposed as a useful method to assess for lesions of the anterior interosseous nerve, a branch of the median nerve that innervates the FPL 6 …”

mentioning

confidence: 99%

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The Flexor Pollicis Longus Reflex

Gladitz

Schöttker-Königer

Sturm

et al. 2021

Am J Phys Med Rehabil

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Objective The aim of this study was to investigate the interrater reliability and intrarater reliability of the flexor pollicis longus muscle stretch reflex (FPLR) and compare it with clinically established reflexes. Design A total of 71 healthy volunteers participated. The FPLR, biceps reflex, brachioradialis reflex, and patellar tendon reflex of each participant were tested bilaterally and rated by eight examiners (four experienced, four inexperienced). For intrarater reliability evaluation, five examiners rated the reflexes of four volunteers at four different points in time. Results Analysis of the interrater reliability with Gwet’s AC1 demonstrated almost perfect agreement for FPLR (Gwet’s AC1 = 0.90), biceps reflex (Gwet’s AC1 = 0.90), and patellar tendon reflex (Gwet’s AC1 = 0.95) when using binary data (reflex present vs. absent). Only fair agreement was found for the brachioradialis reflex (Gwet’s AC1 = 0.56). Experienced raters had a higher agreement than inexperienced raters did when rating the biceps reflex and the patellar tendon reflex. The intrarater reliability was almost perfect for the patellar tendon reflex (Gwet’s AC1 = 0.94), followed by the FPLR (Gwet’s AC1 = 0.83) with substantial agreement and the biceps reflex (Gwet’s AC1 = 0.57) with moderate agreement. Conclusion The FPLR is a reliable diagnostic neuromuscular test and may therefore be useful in the clinical examination for C8/T1 nerve root lesions or pathologies of the interosseous anterior nerve. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Elicit the flexor pollicis longus muscle stretch reflex; (2) Discuss the disadvantage of kappa statistics in assessing the interrater reliability when the prevalence of the studied trait is very high or very low; and (3) Name the spinal nerves involved in the innervation of the flexor pollicis longus muscle. Level Advanced Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Section: Discussionsupporting

confidence: 82%

“…Studies assessing its validity in the detection of C8 and T1 nerve root and proximal median nerve lesions such as the anterior interosseus syndrome are now needed 6 …”

Section: Discussionmentioning

confidence: 99%