title: Reliability of the "Ten Test" for assessment of discriminative sensation in hand trauma.
abstract: "Ten Test" (TT) is a bedside measure of discriminative sensation, whereby the magnitude of abnormal sensation to moving light touch is normalized to an area of normal sensation on an 11-point Likert scale (0-10). The purposes of this study were to determine reliability parameters of the TT in a cohort of patients presenting to a hand trauma clinic with subjectively altered sensation post-injury and to compare the reliability of TT to that of the Weinstein Enhanced Sensory Test (WEST). Study participants (n = 29, mean age = 37 ± 12) comprised patients presenting to an outpatient hand trauma clinic with recent hand trauma and self reported abnormal sensation. Participants underwent TT and WEST by two separate raters on the same day. Interrater reliability, response stability and responsiveness of each test were determined by the intraclass correlation coefficient (ICC: 2, 1), standard error of measurement (SEM) with 95% confidence intervals (CI) and minimal detectable difference score, with 95% CI (MDD95), respectively. The TT displayed excellent interrater reliability (ICC = 0.95, 95% CI 0.89-0.97) compared to good reliability for WEST (ICC = 0.78, 95% CI 0.58-0.89). The range of true scores expected with 95% confidence based on the SEM (i.e. response stability), was ±1.1 for TT and ±1.1 for WEST. MDD95 scores reflecting test responsiveness were 1.5 and 1.6 for TT and WEST, respectively. The TT displayed excellent reliability parameters in this patient population. Reliability parameters were stronger for TT compared to WEST. These results provide support for the use of TT as a component of the sensory exam in hand trauma.
authors: Division of Physical Medicine & Rehabilitation, University of British Columbia, GF Strong Rehab Centre, 4255 Laurel Street, Vancouver, BC, V5Z 2G9, Canada. Electronic address: mikeberger38@gmail.com.
authors: Michael J
authors: MJ
authors: Berger
authors: Faculty of Medicine & Dentistry, University of Alberta, C/o Dr. Sean Bristol, 3rd. Floor 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: wregan@ualberta.ca.
authors: William R
authors: WR
authors: Regan
authors: Division of Plastic Surgery, University of British Columbia, 3rd. Floor 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: dr.alex.seal@gmail.com.
authors: Alex
authors: A
authors: Seal
authors: Division of Plastic Surgery, University of British Columbia, 3rd. Floor 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: Sean.Bristol@vch.ca.
authors: Sean G
authors: SG
authors: Bristol
mesh_terms: D000328:Adult; D005260:Female; D006230:Hand Injuries / Q000150:complications*; D006801:Humans; D006987:Hypesthesia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D012684:Sensory Thresholds; D055698:Touch Perception
keywords: Discriminative sensation; Hand trauma; Reliability; Ten Test; Weinstein enhanced monofilament test