Carey L M, Oke L E, Matyas T A
School of Occupational Therapy, La Trobe University, Bundoora, Victoria, Australia.
Arch Phys Med Rehabil. 1996 Dec;77(12):1271-8. doi: 10.1016/s0003-9993(96)90192-6.
A quantitative measure of wrist position sense was developed to advance clinical measurement of proprioceptive limb sensibility after stroke. Test-retest reliability, normative standards, and ability to discriminate impaired and unimpaired performance were investigated.
Retest reliability was assessed over three sessions, and a matched-pairs study compared stroke and unimpaired subjects. Both wrists were tested, in counterbalanced order.
Patients were tested in hospital-based rehabilitation units.
Reliability was investigated on a consecutive sample of 35 adult stroke patients with a range of proprioceptive discrimination abilities and no evidence of neglect. A consecutive sample of 50 stroke patients and convenience sample of 50 healthy volunteers, matched for age, sex, and hand dominance, were tested in the normative-discriminative study. Age and sex were representative of the adult stroke population.
The test required matching of imposed wrist positions using a pointer aligned with the axis of movement and a protractor scale.
The test was reliable (r = .88 and .92) and observed changes of 8 degrees can be interpreted, with 95% confidence, as genuine. Scores of healthy volunteers ranged from 3.1 degrees to 10.9 degrees average error. The criterion of impairment was conservatively defined as 11 degrees (+/-4.8 degrees) average error. Impaired and unimpaired performance were well differentiated.
Clinicians can confidently and quantitatively sample one aspect of proprioceptive sensibility in stroke patients using the wrist position sense test. Development of tests on other joints using the present approach is supported by our findings.
开发一种手腕位置觉的定量测量方法，以推进中风后本体感觉肢体感觉的临床测量。研究了重测信度、规范标准以及区分受损和未受损表现的能力。
在三个阶段评估重测信度，并进行配对研究以比较中风患者和未受损受试者。对双侧手腕进行测试，测试顺序采用平衡法。
在医院康复科对患者进行测试。
对35例具有不同本体感觉辨别能力且无忽视证据的成年中风患者连续样本进行信度研究。在规范 - 辨别性研究中，对50例中风患者连续样本和50例年龄、性别及利手相匹配的健康志愿者便利样本进行测试。年龄和性别代表成年中风人群。
测试要求使用与运动轴对齐的指针和量角器刻度来匹配施加的手腕位置。
该测试具有可靠性（r = 0.88和0.92），观察到8度的变化有95%的把握可解释为真实变化。健康志愿者的平均误差得分范围为3.1度至10.9度。损伤标准保守定义为平均误差11度（±4.8度）。受损和未受损表现得到了很好的区分。
临床医生可以使用手腕位置觉测试自信地、定量地对中风患者本体感觉的一个方面进行采样。我们的研究结果支持采用本方法开发其他关节的测试。
