Does the Finger-to-Nose Test measure upper limb coordination in chronic stroke?
Marcos R M Rodrigues, Matthew Slimovitch, Gevorg Chilingaryan and 1 others
PMID 28114996WHAT IT FOUND
In chronic stroke, finger-to-nose test time tracked shoulder-elbow timing, went with arm impairment and activity, and a 10.6-second cut-off separated mild from moderate-to-severe impairment.
Key findings
01In stroke, shoulder-elbow timing, shoulder movement range, and spatial coupling explained 82% of variance in inward-reach time, and shoulder-elbow timing explained 94% of variance in outward-reach time.
02In stroke, FNT-time was related to Fugl-Meyer upper limb and arm scores, biceps spasticity, and Box and Blocks activity, but not to proprioception.
03FNT-time discriminated mild from moderate-to-severe impairment with an area under the curve of 0.85, and a 10.6-second cut-off had sensitivity 0.714 and specificity 0.692.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 20 people with stroke were studied, and all could already perform the test at Chedoke-McMaster arm level 3 to 7, so the results do not apply to more severe stroke. Visual and perceptual deficits were not formally assessed, although neglect and apraxia were excluded, so conclusions may not apply to patients with vision or perception problems. The findings apply only to this version of the Finger-to-Nose Test, with a target at 90% arm length, self-paced movement, and inward and outward reaches analysed separately. The logistic odds ratio for each additional second did not reach significance (p = 0.07), even though the ROC analysis gave an area under the curve of 0.85. The paper reports assessment data only, not therapy outcomes.
Declared interests
Funding was provided by the Richard and Edith Strauss Foundation, Canada Research Chairs, and the Heart and Stroke Foundation of Canada. The supplied text does not include an author disclosure list.
The easy way to misread this
Do not use the 10.6-second cut-off as a general stroke test or as evidence that a treatment works. It was derived from 20 chronic stroke patients who could already perform the test, and the logistic odds ratio for each additional second did not reach significance (p = 0.07).