Reliability and agreement of the Nine Hole Peg Test in patients with unilateral spastic cerebral palsy

Abstract

Upper extremity involvement is one of the most common motor impairments in children with unilateral spastic cerebral palsy (CP). One tool for the assessment of manual function in CP is the Nine Hole Peg Test (NHPT). However, the reliability of the NHPT in patients with unilateral CP is unknown. This study aimed to analyze the intra-rater inter-session reliability of the NHPT in unilateral spastic CP, for its use in clinical practice and research. A total of 27 participants with spastic unilateral CP were included. Reliability was verified by the intraclass correlation coefficient (ICC), standard error of measurement, and minimum detectable change. The agreement was analyzed by the Bland-Altman method. An excellent intra-rater reliability was observed for the non-affected side (ICC = 0.94) and the affected side (ICC = 0.96). The minimal detectable change was 4 and 12 s for the non-affected and affected side, respectively. There were no significant biases between repetitions.Conclusions: The NHPT showed excellent intra-rater inter-session reliability in patients with spastic unilateral CP. In addition, the test shows adequate agreement and proportionally small errors to assess manual dexterity. What is Known:• The Nine Hole Peg Test (NHPT) is widely used to assess dexterity in patients with neurological conditions.• The NHPT has demonstrated appropriate measurement properties in healthy children and adults with neurological conditions. What is New:• The NHPT presents excellent reliability, small measurement errors, and adequate agreement for the assessment of patients with cerebral palsy.• The measurement error of the NHPT in unilateral cerebral palsy may be up to 13% of the total time to perform it.

Reliability Assessment of Sensory Outcome Measure a New Developed Tool for Children with Cerebral Palsy

“…The values of MD varies between (65.97to68.27) it was indicated for genuine differences (3) . The values of Cohen's kappa coefficient for inter rater reliability lies in between (0.048 to 0.188) accordingto values of kappa coefficient slight agreement was noted between two observers (4) .…”

“…A comprehensive assessment of sensory abnormalities in CP children will eventually result in an appropriate course of treatment, which will further enhance motor function as well (3) . Various reliability studies were also conducted earlier in the search of a reliable outcome measure for CP children but most of them solely focused on one domain like the Upper Extremity function (4) , assessment of balance-related tests (5) , motor power (6) , gross motor function assessment, and gait assessment (7) . However, other than SOMH, no scale has been developed yet for the Indian CPs to evaluate sensory impairments (8) .…”

Bibliometric Analysis of Research on the Use of the Nine Hole Peg Test

“…At the same time, researchers have also paid attention to issues related to the reliability and validity of measurement tools. In this respect, the NHPT has demonstrated appropriate measurement properties in healthy children and adults with neurological conditions [ 47 ].…”

Hand-Arm Bimanual Intensive Training in Virtual Reality: A Feasibility Study

“…The NHPT was performed with a 50-second time limit, as defined by the Shirley Ryan Ability Lab 23. The NHPT is a tool to measure fine motor abilities in children with CP, with an intrarater reliability of ICC = 0.94 for the nonaffected side and ICC = 0.96 for the affected side 24…”

“…23 The NHPT is a tool to measure fine motor abilities in children with CP, with an intrarater reliability of ICC = 0.94 for the nonaffected side and ICC = 0.96 for the affected side. 24…”