Agreement of classification decisions using two measures of motor co-ordination in persons with a traumatic brain injury.

Identification of motor co-ordination deficits in persons with a traumatic brain injury (TBI) is a vital part of both assessment and rehabilitation. The purpose of this study was to investigate the agreement of classification decisions based on clinical (subjective) and instrumented (objective) tests for measuring upper-limb co-ordination in persons with a TBI. Twenty-two subjects with TBI performed the 'finger-to-nose' test and a 'lateral reach tapping test' 12 months post-injury. After reduction to categorical form (deficit/no deficit), the data were interpreted using a generalized kappa statistic, to estimate the agreement between the two tests. The kappa values for the right and left upper extremities were 0.625 and 0.360, respectively, while the combined (right and left) value was 0.500, representing only 'moderate' agreement between the two testing protocols. This indicates that motor co-ordination deficits in persons with TBI can be documented using either clinical or instrumented tests. The choice of test does not appear to be based on the subjective/objective nature (dimension) of each test, but rather on more practical factors such as administration time, cost and level of objectivity desired by the clinician.