Effects of the Surface Texture and Weight of a Pinch Apparatus on the Reliability and Validity of a Hand Sensorimotor Control Assessment

Hsiu-Yun Hsu; Ta-Shen Kuan; Hsiu-Ching Yang; Ching-Liang Tsai; Chien-Hsien Yeh; Chih-Chun Lin; Li-Chieh Kuo

doi:10.1016/j.apmr.2018.07.440

Effects of the Surface Texture and Weight of a Pinch Apparatus on the Reliability and Validity of a Hand Sensorimotor Control Assessment

Arch Phys Med Rehabil. 2019 Apr;100(4):620-626. doi: 10.1016/j.apmr.2018.07.440. Epub 2018 Sep 5.

Authors

Hsiu-Yun Hsu¹, Ta-Shen Kuan², Hsiu-Ching Yang³, Ching-Liang Tsai², Chien-Hsien Yeh⁴, Chih-Chun Lin⁴, Li-Chieh Kuo⁵

Affiliations

¹ Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. Electronic address: jkkuo@mail.ncku.edu.tw.

PMID: 30193951
DOI: 10.1016/j.apmr.2018.07.440

Abstract

Objectives: To investigate the reliability and validity of a modified pinch apparatus devised with 3 surface textures and 2 different weights for clinical application.

Design: Case-controlled study.

Setting: A university hospital.

Participants: The participants (N=32) included carpal tunnel syndrome (CTS) patients (n=16) with 20 sensory neuropathy hands, and an equal number of age-sex matched volunteers without CTS, as well as young volunteers without CTS (n=16 with 20 hands) used to analyze both the testing validity and reliability of the modified device.

Interventions: Not applicable.

Main outcome measures: The Semmes-Weinstein monofilament (SWM) and two-point discrimination (2PD) tests were conducted, and the force ratio between the FP_peak (peak pinch force during lifting phase) and FL_max (maximum load force at maximum upward acceleration onset) detected from a pinch-holding-up activity (PHUA) under various testing conditions was obtained.

Results: The range of the intraclass correlation coefficient of this pinch device was 0.369-0.952. The CTS patients exhibited poorer force modulation ability according to the inertial change in a dynamic lifting task when compared to the controls under all testing conditions (P<.001). The area under the receiver operating characteristic force ratio curve was 0.841, revealing high accuracy of the test for diagnosing CTS neuropathic hands under the testing condition in which the 125-g coarse texture device was used. In addition, the weight factor was shown to have significant effects on the sensitivity and accuracy of the PHUA assessment.

Conclusions: This study showed that the PHUA test via the modified pinch apparatus is a sensitive tool that can be used in clinical practice for detecting neuropathic CTS hands. In addition, changing the weight of the pinch device has a significant effect on the sensitivity and accuracy of the PHUA assessment.

Keywords: Carpal tunnel syndrome; Dexterity, hand; Measurement, pinch force; Rehabilitation; Sensorimotor control.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Carpal Tunnel Syndrome / diagnosis*
Case-Control Studies
Female
Hand / physiopathology
Humans
Lifting*
Male
Middle Aged
Pinch Strength*
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Surface Properties
Symptom Assessment / instrumentation*
Weights and Measures / instrumentation*