Department of Physiological Functional Exploration, University Hospital of Toulouse, 31059 Toulouse, France; School of Occupational Therapy, PREFMS, University Hospital of Toulouse, 31059 Toulouse, France; School of Public Health, Faculty of Health Sciences, Curtin University, 6102 Perth, Australia.
Department of Neurorehabilitation, University Hospital of Toulouse, 31059 Toulouse, France.
Ann Phys Rehabil Med. 2019 Jan;62(1):35-42. doi: 10.1016/j.rehab.2018.03.004. Epub 2018 Apr 13.
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.
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.
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.
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.
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.
约有 50%的脑卒中成年患者存在上肢（UL）感觉障碍，这与手部运动功能、活动和参与丧失有关。UL 感觉障碍的测量是康复的一个组成部分，有助于选择优化恢复的感觉运动技术，并提供 UL 功能的预后估计。迄今为止，尚未建立 UL 感觉障碍测量的标准化官方法语版本。
制定并验证用于评估脑卒中成人 UL 的 Erasmus 改良诺丁汉感觉评估体感（EmNSA-SS）和实体觉（EmNSA-ST）分量的法语版本。
这是一项单中心观察性横断面研究。通过正向-反向翻译和跨文化适应制定 UL 的法语版 EmNSA。招募了 50 名脑卒中患者，以建立同时性标准相关的有效性、内部一致性、内部和观察者间的重现性，采用内相关系数（ICC）评估可靠性和 95%置信区间的最小可检测变化（MDC95）以评估一致性，以及天花板和地板效应。标准效度是通过 UL 的 Fugl-Meyer 感觉评估（FMA-S）进行评估的。
EmNSA-SS 的中位数（范围）为 41.5（1-44）。EmNSA-SS 与 FMA-S 总分之间的 Spearman 秩相关系数为中度（rho=0.74，P<0.001）。EmNSA-SS/ST 各分量的内部一致性良好；Cronbach α 范围为 0.82-0.96。对于 EmNSA-SS 总分，观察者内和观察者间的可靠性均为优秀（ICC 分别为 0.92 和 0.92），MDC95 分别为 12.3 和 14.6。EmNSA-SS/ST 总分无天花板或地板效应。
法语版 EmNSA 是一种有效且可重复的量表，可用于全面、准确地评估脑卒中后成人的体感和实体觉。该量表的评估时间不到 30 分钟，具有临床实用价值，可用于患有认知共病和在多学科临床实践和研究环境中处于不同康复阶段的患者。
