Highlights
- •The Nine Hole Peg Test is one of the most used tools to assess manual dexterity.
- •Kinematic indexes during Nine Hole Peg Test were reliable.
- •Jerk revealed the best discriminant validity between dominant and non-dominant arms.
- •Kinematic indexes may help detection of subtle manual dexterity changes.
- •Kinematic indexes may provide characteristics of upper limb motor impairments.
Abstract
Background
The Nine Hole Peg Test (NHPT) is one of the most frequently used tools to assess manual
dexterity. However, no kinematic parameters are provided to describe the quality of
the motor performance, since time is the only score.
Purpose
To investigate test-retest and intra-rater reliability, correlation with clinical
test score, and discriminant validity of kinematic indexes during NHPT.
Study Design
A clinical measurement study.
Methods
Twenty-five healthy right-handed volunteers performed the NHPT. An experienced physiotherapist
administered two sessions at a 6-hour interval with two trials for dominant and non-dominant
upper limbs. An optoelectronic system was used to detect NHPT performance, which was
divided into nine consecutive peg-grasp, peg-transfer, peg-in-hole, hand-return phases,
and one final removing phase. Outcome measures were total and single phases times,
normalized jerk, mean, peak and time-to-peak of velocity, curvature index during peg-grasp
and hand-return phases, and trunk 3D displacement. The statistical analysis included
Intraclass Correlation Coefficients (ICCs) for test-retest and intra-rater reliability,
Pearson's coefficients for correlation with the NHPT score, and paired t-tests for
discriminant validity.
Results
Test-retest reliability was excellent for trunk rotation (ICC: 0.91) and good to moderate
for the other indexes (ICCs: 0.89-0.61). Intra-rater reliability was excellent for
total and removing times (ICCs: 0.91 and 0.94) and good to moderate for the other
indexes (ICCs: 0.84-0.66), except for trunk inclination (ICC: 0.37). NHPT phases,
normalized jerk, mean velocity, peak of velocity, time-to-peak and curvature index
correlated with total time (r-score: 0.8-0.3). NHPT phases and most kinematic indexes
discriminated the dominant from non-dominant upper limb, with the greatest effect
size for normalized jerk during hand-return (d = 1.16).
Conclusions
Kinematic indexes during NHPT can be considered for manual dexterity assessment. These
indexes may allow for the detection of kinematic changes responsible for NHPT score
variations in healthy subjects or patients with upper limb impairments.
Keywords
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Article info
Publication history
Published online: February 26, 2022
Accepted:
January 24,
2022
Received in revised form:
November 2,
2021
Received:
April 12,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: None.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
