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Validation of French upper limb Erasmus modified Nottingham Sensory Assessment in stroke - 25/01/19

Doi : 10.1016/j.rehab.2018.03.004 
Claire Villepinte a, b, c, , Emilie Catella d, Magali Martin d, Sylvie Hidalgo d, Sabrina Téchené b, Claire Lebely e, Evelyne Castel-Lacanal d, f, Xavier de Boissezon d, f, HuiJun Chih c, David Gasq a, f
a Department of Physiological Functional Exploration, University Hospital of Toulouse, 31059 Toulouse, France 
b School of Occupational Therapy, PREFMS, University Hospital of Toulouse, 31059 Toulouse, France 
c School of Public Health, Faculty of Health Sciences, Curtin University, 6102 Perth, Australia 
d Department of Neurorehabilitation, University Hospital of Toulouse, 31059 Toulouse, France 
e Clinical Investigation Center, University Hospital of Toulouse, University of Toulouse 3 and Inserm, 31059 Toulouse, France 
f ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, 31024 Toulouse, France 

Corresponding author. School of Occupational Therapy, PREFMS, University Hospital of Toulouse, 74, voie du TOEC, TSA 40031, 31059 Toulouse cedex 9, France.School of Occupational Therapy, PREFMS, University Hospital of Toulouse, 74, voie du TOEC, TSA 40031, 31059 Toulouse cedex 9, France.

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Highlights

The French EmNSA is a measure of somatosensory function in adults after stroke.
It includes both somatosensory and stereognosis components.
The somatosensory component is appropriate for screening and monitoring recovery.
The stereognosis component is applicable for screening purposes.
The hierarchical testing procedure was revised to reduce loss of total points.

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Abstract

Background

Somatosensory impairment of the upper limb (UL) occurs in approximately 50% of adults post-stroke, associated with loss of hand motor function, activity and participation. Measurement of UL sensory impairment is a component of rehabilitation contributing to the selection of sensorimotor techniques optimizing recovery and providing a prognostic estimate of UL function. To date, no standardized official French version of a measure of somatosensory impairment has been established.

Objective

To develop and validate a French version of the Erasmus modified Nottingham Sensory Assessment somatosensory (EmNSA-SS) and stereognosis (EmNSA-ST) component for evaluating the UL among adults with stroke.

Methods

This study is a single-center observational cross-sectional study. A French version of the EmNSA for UL was developed by forward-backward translation and cross-cultural adaptation. Fifty stroke patients were recruited to establish concurrent-criterion-related validity, internal consistency, intra- and inter-rater reproducibility with intracorrelation coefficients (ICCs) for reliability and the minimal detectable change with 95% confidence interval (MDC95) for agreement, as well as ceiling and floor effects. Criterion validity was assessed against the Fugl-Meyer Assessment-Sensory (FMA-S) for the UL.

Results

The median (range) EmNSA-SS score was 41.5 (1–44). The Spearman rank correlation coefficient between EmNSA-SS and FMA-S total scores was moderate (rho=0.74, P<0.001). The EmNSA-SS/ST internal consistency was adequate across subscales; with Cronbach α ranging from 0.82–0.96. For the EmNSA-SS total score, intra- and inter-rater reliability was excellent (ICC=0.92 in both cases), with MDC95 of 12.3 and 14.6, respectively. EmNSA-SS/ST total scores demonstrated no ceiling or floor effects.

Conclusions

The French EmNSA is a valid and reproducible scale that can be used for comprehensive and accurate assessment of somatosensory modalities in adults post-stroke. Taking less than 30min to administer, the instrument has clinical utility for use in patients with cognitive comorbidities and at various stages of recovery in multidisciplinary clinical practice and research settings.

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Keywords : Stroke, Upper extremity, Outcome assessment, Somatosensory disorders, Reproducibility of results


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Vol 62 - N° 1

P. 35-42 - janvier 2019 Retour au numéro
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