Validity, reliability, and sensitivity to motor impairment severity of a multi-touch app designed to assess hand mobility, coordination, and function after stroke.
Sara Mollà-Casanova, Roberto Llorens, Adrián Borrego and 2 others
PMID 33892763WHAT IT FOUND
Tapping and finger extension exercises on a tablet app correlated well with standard hand tests and distinguished mild from moderate stroke impairment.
Other exercises, like pincer grasps and writing, showed weaker validity or reliability. The app is not yet a standalone assessment tool.
Key findings
01Exercises involving tapping and maximum finger extension showed the best properties for assessing motor impairment, with moderate to excellent reliability.
02The app successfully distinguished between participants with mild and moderate motor impairments, but only for exercises involving tapping and maximum pincer grasp.
03Graphomotricity exercises showed poor convergent validity with the writing subtest of the Jebsen-Taylor Hand Function Test and failed to detect significant differences between impairment groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only participants with mild to moderate impairments, so it is unknown if the app works for severely impaired patients. Participants had to have fairly good cognitive function (MMSE > 23) and no severe neglect, limiting generalizability. The pincer grasp exercises may have been affected by fingernail contact with the screen, leading to measurement errors. There was a large imbalance between mild (n=69) and moderate (n=19) impairment groups, which may have affected the sensitivity analysis.
Declared interests
The authors declared no competing interests. The study was supported by non-U.S. government grants.
The easy way to misread this
Do not assume the entire app is valid for assessing hand function. While tapping and extension tasks correlated with clinical tests, the pincer grasp and writing tasks did not. Using the app's weaker exercises could misrepresent a patient's true functional capacity.