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Spinal Cord (2013) 51, 120125 & 2013 International Spinal Cord Society All rights reserved 1362-4393/13 http://www.nature.com/SC
Web End =www.nature.com/sc
ORIGINAL ARTICLE
Reliability of the electrical perceptual thresholdand Semmes-Weinstein monolament tests of cutaneous sensibility
PH Ellaway and M Catley
Study design: Prospective experimental.
Objectives: To compare the reliability and repeatability of the electrical perceptual threshold (EPT) and Semmes-Weinstein monolament (SWM) tests for cutaneous sensibility. EPT and SWM tests have potential as quantitative and sensitive adjuncts to the American Spinal Injuries Association (ASIA) Impairment Scale (AIS) assessment of spinal cord injury (SCI).
Setting: London, UK.
Methods: EPT and SWM tests were carried out on 40 neurologically healthy individuals (20 male). One examiner carried out all the tests. Each individual was examined for EPT and SWM sensitivity at ASIA key points on four dermatomes (C4, T1, T6, L4) on both sides of the body. The tests were repeated after an interval of approximately 1 week. Intra-rater reliability was determined using intra-class correlation coefcients (ICC). Repeatability was determined using the method of Bland and Altman.
Results: There were no signicant differences in the mean values of EPT or SWM between assessments for any dermatome. Signicant difference in mean values for both EPT and SWM were observed between some dermatomes. ICC ranged from 0.67 to 0.81 for the EPT and from 0.46 to 0.61 for the SWM. Higher ICC for the EPT compared with the SWM was again revealed when male and female subjects were assessed separately. Correlation between EPT and SWM was weak or (largely) absent.
Conclusion: EPT has better reliability than SWM in healthy subjects. However, as both tests have the potential to add sensitivity and resolution to the AIS assessment, a further comparison of their repeatability in SCI is warranted.
Spinal Cord (2013) 51, 120125; doi:http://dx.doi.org/10.1038/sc.2012.96
Web End =10.1038/sc.2012.96; published online 4 September 2012
Keywords: quantitative sensory tests; sensory perceptual threshold; electric current; monolaments
INTRODUCTIONThe International Standards for Neurological Classication of Spinal Cord Injury (ISNSCI) is the established clinical neurologic practice for the characterisation of spinal cord injury (SCI). The ISNCI incorporates the current gold standard for neurological assessment of SCI, the American Spinal Injuries Association (ASIA) Impairment Scale (AIS).1 These scales were initially developed primarily to classify the neurologic decit following a SCI, but are now...