Sensorimotor Assessment

Hammond, Flora M.; Katta-Charles, Sheryl

doi:10.1007/978-3-319-56782-2_69-2

Cited by 2 publications

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“…In this regard, the most relevant tracts are the lemniscal (epicritic sensibility) and spinothalamic (protopathic sensibility) tracts. For testing the integrity of these tracts in clinical routine, frequently used techniques are the two-point discrimination or light touch sensation to assess the lemniscal tract system and the pin-prick examination to evaluate the spinothalamic tract function (6)(7)(8). The pin-prick examination conceptually contains two consecutive steps: firstly, evaluation of the ability to reliably discriminate between a sharp/pain and dull/pressure sensation, henceforth referred to as sharp/dull discrimination.…”

Section: Introductionmentioning

confidence: 99%

Revisiting the Examination of Sharp/Dull Discrimination as Clinical Measure of Spinothalamic Tract Integrity

et al. 2021

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Objective: Revisiting the sharp/dull discrimination as clinical measure of spinothalamic tract function considering the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Three clinically relevant factors were evaluated as to their impact on reliability: (1) the localization of dermatomes in relation to the sensory level, (2) the examination tool, and (3) the threshold of correct answers for grading of a preserved sharp/dull discrimination.Design: Prospective monocentric psychometric study.Setting: Spinal Cord Injury Center, Heidelberg University Hospital, Germany.Participants: Convenient sample of 21 individuals with subacute spinal cord injury (age: 31–82 years) and 20 individuals without spinal cord injury (age: 24–63 years).Assessment: All participants underwent three assessments for sharp/dull discrimination, applying five commonly used examination tools in seven dermatomes, performed by three trained examiners under conditions in accordance with ISNCSCI.Main Outcome Measures: Assessment of interrater reliability by determining both the Fleiss kappa (κ) coefficient and the percentage agreement between raters. Data were dichotomized regarding the ISNCSCI threshold.Results: Interrater reliability in individuals with SCI was overall substantial (κ = 0.68; CI 0.679–0.681) and moderate (κ = 0.54; CI 0.539–0.543) in dermatomes below the sensory level. All applied tools led to at least moderate reliability below the sensory level (lowest κ = 0.44; CI 0.432–0.440), with the officially endorsed safety pin achieving the highest (substantial) reliability (κ = 0.64; CI 0.638–0.646). Percentage agreement differed between non-SCI (97.3%) and formally intact above level dermatomes in SCI (89.2%).Conclusions: Sharp/dull discrimination as a common clinical examination technique for spinothalamic tract function is a reliable assessment. Independent from the used examination tools, reliability was substantial, with the medium-sized safety pin delivering the most favorable results. Notwithstanding this, all other tools could be considered if a safety pin is not available. Regarding interrater reliability and guessing probability, a threshold of 80% correct responses for preserved sharp/dull discrimination appears to be most suitable, which is in line with current clinical approaches and ISNCSCI. The causal attribution of the identified differences in sharp/dull discrimination between clinically intact dermatomes of individuals with SCI and unaffected dermatomes of individuals without SCI requires future work.Clinical Trial Registration Number (German Clinical Trials Register): DRKS00015334 (https://www.drks.de).

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Section: Introductionmentioning

confidence: 99%

Revisiting the Examination of Sharp/Dull Discrimination as Clinical Measure of Spinothalamic Tract Integrity

et al. 2021

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“…The examination of somatic sensation requires the assessment of a range of different processes, including tactile detection, acuity, pain, proprioception, vibration, temperature sensitivity, and stereognosis [ 1 ]. Somatosensory dysfunctions occur in many neurological conditions, affecting both the central and the peripheral nervous system [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Rivermead assessment of somatosensory performance: Italian normative data

et al. 2021

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The Rivermead assessment of somatosensory performance (RASP) provides a quantitative assessment of somatosensory processing, suitable for brain-damaged patients suffering from stroke. It consists of seven subcomponents: Subtest 1 (sharp/dull discrimination), Subtest 2 (surface pressure touch), Subtest 3 (surface localization), Subtest 4 (sensory extinction), Subtest 5 (2-point discrimination), Subtest 6 (temperature discrimination), and Subtest 7 (proprioception). Overall, the RASP assesses 5 bilateral body regions: face (cheek), hand (palm and back), and foot (sole and back). This study aimed at providing normative data and cut-off scores for RASP subtests, for each body region, in a large Italian population sample. We present results from 300 healthy Italian individuals aged 19 to 98 years. Data represent a comprehensive set of norms that cover each subtest and each body region tested. Performance in Subtests 1, 5, and 6 decreased, for some body regions, with increasing age. Based on these results, norms were stratified for age (seven groups), with the pathological/non-pathological cut-off coinciding with the 5th percentile. Conversely, other results were not influenced by age; in such cases, a single error, in each body region, has to be considered indicative of pathological performance. This independent investigation of all subcomponents of the somatosensory system, for each body region, further confirms RASP’s potential in clinical practice, for neurological assessment, as well as in research settings.

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Sensorimotor Assessment

Cited by 2 publications

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Revisiting the Examination of Sharp/Dull Discrimination as Clinical Measure of Spinothalamic Tract Integrity

Revisiting the Examination of Sharp/Dull Discrimination as Clinical Measure of Spinothalamic Tract Integrity

Rivermead assessment of somatosensory performance: Italian normative data

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