School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
Kids Rehab Western Australia, Child and Adolescent Health Service, Perth, Western Australia, Australia.
Aust Occup Ther J. 2022 Oct;69(5):637-646. doi: 10.1111/1440-1630.12825. Epub 2022 Jun 29.
We investigate the construct validity, test re-test reliability, and responsiveness of the Wrist Position Sense Test (WPST) for children with hemiplegic cerebral palsy (CP).
Twenty-eight children with spastic hemiplegic CP [mean age 10.8 years; SD 2.4 years] and 39 typically developing (TD) children [mean age 11 years; SD 2.9 years] participated in a cross-sectional study to investigate construct validity and association with an upper limb activity measure, the Box and Block Test (BBT). Twenty-two TD children were tested at a second time-point to examine reliability. Test responsiveness was determined by random allocation of 17 children with CP to a treatment (n = 10) or control (n = 7) group with assessments completed at four time-points.
Significantly greater differences were observed in mean error of indicated wrist position (p < 0.01) in children with CP at baseline (M = 21.6°, SD = 21.6°) than in TD children (M = 12.8°, SD = 11.0°). Larger WPST errors were associated with poorer performance on the BBT (p < 0.01) indicating a substantial association, and there were no consistent differences between time-points indicating test re-test reliability within a TD population. The WPST demonstrated responsiveness to intervention with a statistically significant reduction in mean error following treatment (p < 0.001), not seen in the control group (p = 0.28).
The WPST demonstrated construct validity in this preliminary study. Scores were associated with an upper limb activity measure, and scores changed significantly following somatosensory training. These findings support further research and future psychometric investigation of the WPST in children with CP.
This study provides psychometric knowledge about the WPST tool The WPST shows promise as a discriminative measure with preliminary evidence of responsiveness and intra-rater reliability Until further testing, the WPST can be used cautiously in future research studies to measure wrist position sense.
本研究旨在调查偏瘫脑瘫（CP）儿童腕关节位置觉测试（WPST）的结构效度、重测信度和反应度。
28 名痉挛性偏瘫 CP 患儿[平均年龄 10.8 岁；标准差 2.4 岁]和 39 名正常发育（TD）儿童[平均年龄 11 岁；标准差 2.9 岁]参与了横断面研究，以调查结构效度和与上肢活动测量（Box and Block Test，BBT）的相关性。22 名 TD 儿童在第二次测试时进行了可靠性测试。通过将 17 名 CP 患儿随机分配到治疗组（n=10）或对照组（n=7），并在四个时间点进行评估，来确定 WPST 的反应性。
CP 患儿在基线时的腕关节位置指示误差的平均值明显更大（p<0.01）（M=21.6°，SD=21.6°），而 TD 儿童的平均值为 12.8°，SD=11.0°。WPST 误差较大与 BBT 表现较差相关（p<0.01），表明两者存在显著关联，且 TD 人群内各时间点间没有一致性差异，表明重测信度良好。WPST 对干预有反应性，治疗后平均误差显著降低（p<0.001），而对照组没有（p=0.28）。
本研究初步证明了 WPST 的结构效度。得分与上肢活动测量相关，并且在接受体感训练后显著变化。这些发现支持进一步研究和未来对 CP 儿童 WPST 的心理测量学研究。
本研究为 WPST 工具提供了心理计量学知识 WPST 作为一种具有初步反应性和内部信度证据的鉴别性测量工具具有潜力，在进一步测试之前，WPST 可以在未来的研究中谨慎使用，以测量腕关节位置觉。
