title: Coordination tests in persons with acute central nervous system pathology:  assessment of interrater reliability and known-group validity.
abstract: OBJECTIVE
  Coordination testing is a standard part of the neurologic examination, yet the psychometric properties of many tests used by practitioners are unknown. This study investigated the interrater reliability and known-group validity of limb coordination tests in participants with acute central nervous system (CNS) pathology.
  
  
  METHODS
  Twenty-five participants with CNS pathology completed 20 different limb coordination tests administered at bedside by a physical therapist. Examinations were videotaped and independently rated by a neurologist, a physical therapist, and a student physical therapist using a 5-point ordinal scale. Nine tests were also timed. Results were analyzed for interrater reliability and the degree to which they differed between groups categorized as having or not having coordination deficits.
  
  
  RESULTS
  Participants were individuals who had been diagnosed with either a CNS vascular lesion or intracranial tumor. Timed test scores had higher levels of agreement (mean intraclass correlation coefficient [ICC], 0.69-0.97) than ordinal scores (mean κfree 0.56-0.91). Scores from 5 of the 9 timed measures and 8 of the 20 ordinal measures differed between groups.
  
  
  CONCLUSIONS
  Eleven tests were scored reliably between raters (κ > 0.60 or ICC > 0.75) and were performed differently between groups with and without coordination deficits (P ≤ 0.05). These tests are recommended for use when examining patients with acute neurologic pathology from a vascular lesion or tumor. They are simple to perform and require only a stopwatch to complete. Future studies should explore the sensitivity and specificity of these tests in disease states and their correlation with functional measures.
authors: Mayo School of Health Sciences and College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. Lanzino.desiree@mayo.edu
authors: Desiree J
authors: DJ
authors: Lanzino
authors: Alejandro
authors: A
authors: Rabinstein
authors: Denise
authors: D
authors: Kinlaw
authors: Stephanie B
authors: SB
authors: Hepburn
authors: Brandon M
authors: BM
authors: Ness
authors: Karen J
authors: KJ
authors: Olson
authors: Sarah M
authors: SM
authors: Sobie
authors: John H
authors: JH
authors: Hollman
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods / Q000592:standards*; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D055815:Young Adult