Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke
Abstract
:1. Introduction
- (1)
- Assess the test-retest reliability of maximal tactile pressures and forces during a sustained grasp task using a TactArray device and determine which measures of maximal tactile pressures or forces are most reliable in people with stroke;
- (2)
- Determine whether the duration over which sustained grasp data are measured influences the reliability of a TactArray device pressure and force measures in people with stroke;
- (3)
- Evaluate the concurrent validity of measures of maximal tactile pressures or forces during a sustained grasp using a TactArray device relative to grip strength using the Jamar dynamometer in people with stroke.
- (1)
- Determine the percentage difference in maximal tactile measures between the affected and less affected hands in people with stroke;
- (2)
- Determine whether there are differences in maximal tactile measures under vision and no vision conditions.
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Data Collection with TactArray Device
2.3.1. Procedure for Assessment of Maximal Tactile Pressures
2.3.2. Data Processing
2.3.3. Determining Maximal Grasp Measures
2.4. Data Analysis
2.4.1. Test-Retest Reliability Analyses
2.4.2. Indices of Reliability
2.4.3. Analysis of Concurrent Validity
2.4.4. Analysis of Variance: Vision and No Vision
3. Results
3.1. Characteristics of Participants
3.2. Reliability of Values of Maximal Tactile Pressures/Forces in Participants with Stroke
3.3. Most Reliable Measures of Maximal Tactile Pressures or Forces
3.4. Systematic Error
3.5. Concurrent Validity of Measures of Maximal Tactile Pressures
3.6. Differences in Maximal Tactile Pressures between Vision Conditions and between Hands
4. Discussion
4.1. Reliability of Measures of Tactile Pressures and Forces
4.2. Concurrent Validity of Measures of Maximal Tactile Pressures
4.3. Impact of Testing with and without Vision in Both Hands
4.4. Implications for Research and Clinical Practice
4.5. Limitations
4.6. Recommendations for Future Trials
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Grasp Phase | Number of Trials | Definitions of Maximal Grasp Measures | Abbreviations |
---|---|---|---|---|
Pressure | 8 s | Highest value | Highest value of average pressure amongst the three repeat trials over complete grasp duration of 8 s | Pres(8s)max |
Mean of two trials | Average pressure of the mean of two repeat trials having least variation over complete grasp duration of 8 s | Pres(8s)avg2 | ||
Mean of three trials | Average pressure of the mean of three repeat trials over complete grasp duration of 8 s | Pres(8s)avg3 | ||
5 s | Highest value | Highest value of average pressure amongst the three repeat trials over plateau phase of 5 s | Pres(5s)max | |
Mean of two trials | Average pressure of the mean of two repeat trials having least variation over plateau phase of 5 s | Pres(5s)avg2 | ||
Mean of three trials | Average pressure of the mean of three repeat trials over plateau phase of 5 s | Pres(5s)avg3 | ||
Force | 8 s | Highest value | Highest value of average force amongst the three repeat trials over complete grasp duration of 8 s | Force(8s)max |
Mean of two trials | Average force of the mean of two repeat trials having least variation over complete grasp duration of 8 s | Force(8s)avg2 | ||
Mean of three trials | Average force of the mean of three repeat trials over complete grasp duration of 8 s | Force(8s)avg3 | ||
5 s | Highest value | Highest value of average force amongst the three repeat trials over plateau phase of 5 s | Force(5s)max | |
Mean of two trials | Average force of the mean of two repeat trials having least variation over plateau phase of 5 s | Force(5s)avg2 | ||
Mean of three trials | Average force of the mean of three repeat trials over plateau phase of 5 s | Force(5s)avg3 |
ID | Sex (M/F) | Age (y) | Hand Dominance (R/L) | Paretic Side (R/L) | Time Since Stroke (Mo) | Type of Stroke (Isch/Haem) | MOCA | SCT | RFCT | MTS Elbow V1:V2:V3 | MTS Wrist V1:V2:V3 | MTS Fingers V1:V2:V3 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
A1S | M | 66.2 | R | L | 79 | Haem | 23 | 53 | 34.5 | 0:0:0 | 0:0:0 | 0:0:0 |
B2S | M | 66.6 | R | L | 43 | Isch | 25 | 54 | 31 | 0:0:0 | 0:0:0 | 0:0:0 |
C3S | M | 59.3 | R | L | 224 | Haem | 23 | 53 | 18.5 | 0:0:0 | 0:1:1 | 0:0:1 |
D4S | F | 68.4 | R | L | 40 | Isch | 24 | 53 | 33 | 0:0:0 | 0:0:1 | 0:0:0 |
E5S | F | 77.0 | R | R | 24 | Haem | 23 | 53 | 33 | 0:0:0 | 0:0:0 | 0:0:0 |
F6S | M | 63.7 | R | R | 137 | Isch | 30 | 54 | 34 | 0:1:2 | 0:0:0 | 0:0:0 |
G7S | F | 46.3 | R | R | 47 | Isch | 28 | 54 | 36 | 0:0:0 | 0:0:0 | 0:0:0 |
H8S | M | 64.9 | L | R | 185 | Isch | 24 | 54 | 35 | 0:0:0 | 0:0:0 | 0:0:0 |
I9S | M | 70.4 | R | R | 76 | Isch | 25 | 54 | 36 | 0:0:0 | 0:0:0 | 0:0:0 |
J10S | M | 50.6 | R | L | 124 | Isch | 23 | 54 | 35 | 1:1:2 | 0:0:0 | 0:0:0 |
K11S | F | 71.4 | R | R | 79 | Isch | 16 | 54 | 32 | 0:0:0 | 0:0:0 | 0:0:0 |
ID | WMFT Score | WMFT Time/s | ARAT | BBT * | Grip Strength # | Pinch Strength * | FMA-UE Total Motor Score | FMA-UE Total Sensory Score | TDT Deficit Range Score | SIS Strength | SIS Memory | SIS Emotion | SIS Communication | SISADL | SIS Mobility | SIS Hand Function | SIS Participation | SIS Stroke Recovery | MAL How Much | MAL How Well |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
A1S | 63 | 50.5 | 41 | 34.0 | 30.0 | 10.0 | 66 | 12 | −5.8 | 20 | 34.3 | 55.6 | 22.9 | 56 | 51.1 | 24 | 30 | 50 | 1.1 | 1.3 |
B2S | 78 | 38.9 | 56 | 37.3 | 32.0 | 9.3 | 66 | 11 | −11.4 | 60 | 45.7 | 42.2 | 68.6 | 62 | 77.8 | 36 | 45 | 60 | 1.6 | 1.8 |
C3S | 41 | 168.0 | 30 | 15.3 | 18.7 | 7.3 | 44 | 9 | −198 | 40 | 57.1 | 53.3 | 77.1 | 32 | 31.1 | 4 | 57.5 | 40 | 0.7 | 0.4 |
D4S | 72 | 42.1 | 50 | 28.3 | 9.3 | 4.7 | 62 | 12 | −83.8 | 40 | 60.0 | 60.0 | 71.4 | 74 | 57.8 | 56 | 52.5 | 80 | 1.8 | 1.7 |
E5S | 76 | 43.9 | 51 | 36.7 | 17.3 | 8.0 | 66 | 12 | −57.8 | 75 | 62.9 | 68.9 | 65.7 | 40 | 75.6 | 40 | 67.5 | 80 | 3.5 | 3.2 |
F6S | 38 | 92.2 | 20 | 16.7 | 16.7 | 6.7 | 42 | 12 | −10.4 | 55 | 77.1 | 55.6 | 68.6 | 64 | 57.8 | 40 | 75 | 70 | 2.2 | 2.2 |
G7S | 80 | 38.7 | 56 | 45.3 | 29.7 | 9.3 | 66 | 12 | 74.8 | 50 | 57.1 | 66.7 | 54.3 | 48 | 57.8 | 52 | 60 | 75 | 4.7 | 4.1 |
H8S | 80 | 33.5 | 56 | 52.7 | 27.7 | 9.0 | 65 | 12 | −12.3 | 55 | 71.4 | 64.4 | 71.4 | 76 | 77.8 | 76 | 57.5 | 80 | 4.5 | 4.7 |
I9S | 80 | 39.3 | 57 | 37.3 | 17.7 | 7.3 | 64 | 12 | 71.8 | 20 | 74.3 | 60.0 | 62.9 | 68 | 57.8 | 28 | 65 | 60 | 5.0 | 3.2 |
J10S | 57 | 55.1 | 56 | 45.0 | 26.0 | 5.7 | 61 | 12 | −4.9 | 15 | 65.7 | 53.3 | 60.0 | 6 | 73.3 | 56 | 62.5 | 60 | 1.8 | 2.0 |
K11S | 79 | 40.2 | 57 | 46.0 | 18.0 | 6.0 | 66 | 12 | −81.9 | 35 | 2.9 | 28.9 | 20.0 | 72 | 55.6 | 56 | 42.5 | 80 | 3.9 | 4.3 |
ID | BBT * | Grip Strength # | Pinch Strength * |
---|---|---|---|
A1S | 51.8 | 39.7 | 8.4 |
B2S | 50.1 | 38.3 | 8.0 |
C3S | 48.9 | 26.3 | 7.9 |
D4S | 49.8 | 14.7 | 7.8 |
E5S | 50.0 | 26.0 | 7.9 |
F6S | 47.7 | 20.0 | 7.7 |
G7S | 53.2 | 33.3 | 7.6 |
H8S | 53.8 | 30.0 | 7.3 |
I9S | 53.0 | 16.7 | 6.3 |
J10S | 50.5 | 36.7 | 5.5 |
K11S | 46.0 | 15.3 | 5.0 |
Session 1 | Session 2 | Session 3 | Mean 3 Sessions | Change in Mean (%) | 90% CI for Change in Mean | CV (%) | 90% CI for Change in CV | Smallest Effect (%) * | 90% CI for Change in Smallest Effect | ICC | 90% CI for Change in ICC | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pressure (kPa) | ||||||||||||||
Pres(8s)max | Mean | 31.29 | 34.62 | 33.25 | 33.05 | Session 2-1 | 9.30 | −4.51, 25.12 | 19.11 | 13.80, 32.12 | 10.01 | 3.96, 13.79 | 0.91 | 0.74, 0.97 |
SD | 11.89 | 12.24 | 11.14 | 11.76 | Session 3-2 | 0.59 | −17.78, 23.06 | 29.81 | 21.27, 51.54 | 7.68 | −2.31, 11.32 | 0.71 | 0.34, 0.89 | |
Session 3-2 # | −8.99 | −17.55, 0.46 | 12.80 | 9.18, 21.92 | 9.09 | 4.06, 12.35 | 0.94 | 0.84, 0.98 | ||||||
Pres(8s)avg2 | Mean | 28.85 | 31.74 | 29.85 | 30.15 | Session 2-1 | 10.04 | −4.51, 26.80 | 20.14 | 14.52, 33.95 | 10.08 | 3.88, 13.92 | 0.90 | 0.73, 0.96 |
SD | 11.53 | 11.55 | 8.95 | 10.74 | Session 3-2 | −1.08 | −18.32, 19.80 | 28.12 | 20.10, 48.40 | 7.55 | −1.97, 11.06 | 0.73 | 0.36, 0.90 | |
Session 3-2 # | −10.01 | −18.18, −1.02 | 12.31 | 8.84, 21.05 | 8.84 | 3.96, 12.01 | 0.95 | 0.84, 0.98 | ||||||
Pres(8s)avg3 | Mean | 29.40 | 31.41 | 30.58 | 30.46 | Session 2-1 | 6.89 | −4.03, −19.06 | 14.97 | 10.86, 24.88 | 10.47 | 4.64, 14.26 | 0.94 | 0.84, 0.98 |
SD | 11.64 | 11.18 | 9.49 | 10.81 | Session 3-2 | 2.30 | −15.27, 23.51 | 27.61 | 19.74, 47.46 | 7.62 | −1.76, 11.12 | 0.74 | 0.38, 0.90 | |
Session 3-2 # | −7.18 | −13.84, 0.01 | 9.52 | 6.86- 16.14 | 9.00 | 4.24, 12.12 | 0.97 | 0.90, 0.99 | ||||||
Force (N) | ||||||||||||||
Force(8s)max | Mean | 46.00 | 46.73 | 43.66 | 45.46 | Session 2-1 | 5.62 | −5.49, 18.03 | 15.46 | 11.21, 25.74 | 12.54 | 5.71, 17.06 | 0.96 | 0.88, 0.99 |
SD | 23.23 | 18.79 | 11.59 | 18.50 | Session 3-2 | 0.02 | −13.74, 15.97 | 21.10 | 15.20, 35.67 | 8.69 | 2.80, 12.14 | 0.86 | 0.63, 0.95 | |
Force(8s)avg2 | Mean | 39.58 | 42.73 | 39.97 | 40.76 | Session 2-1 | 10.87 | 0.00, 22.91 | 14.28 | 10.37, 23.69 | 13.86 | 6.47, 18.83 | 0.97 | 0.91, 0.99 |
SD | 18.89 | 17.65 | 13.12 | 16.74 | Session 3-2 | 0.08 | −15.80, 18.95 | 25.05 | 17.96, 42.78 | 10.25 | 3.29, 14.35 | 0.86 | 0.63, 0.95 | |
Force(8s)avg3 | Mean | 40.52 | 43.15 | 39.83 | 41.17 | Session 2-1 | 9.73 | −0.15, 20.58 | 12.98 | 9.44, 21.47 | 13.28 | 6.25, 18.01 | 0.97 | 0.92, 0.99 |
SD | 20.20 | 17.97 | 11.66 | 17.00 | Session 3-2 | −0.65 | −15.84, 17.28 | 23.95 | 17.19, 40.78 | 9.40 | 2.84, 13.19 | 0.85 | 0.61, 0.95 |
Session 1 | Session 2 | Session 3 | Mean 3 Sessions | Change in Mean (%) | 90% CI for Change in Mean | CV (%) | 90% CI for Change in CV | Smallest Effect (%) * | 90% CI for Change in Smallest Effect | ICC | 90% CI for Change in ICC | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pressure (kPa) | ||||||||||||||
Pres(8s)max | Mean | 42.55 | 36.90 | 36.93 | 38.80 | Session 2-1 | −8.75 | −27.21, 14.40 | 33.99 | 24.14, 59.37 | 6.84 | −3.61, 10.57 | 0.61 | 0.16, 0.85 |
SD | 21.99 | 11.74 | 10.97 | 15.73 | Session 3-2 | 1.07 | −8.13, 11.19 | 13.15 | 9.56, 21.74 | 7.21 | 2.95, 9.86 | 0.91 | 0.76, 0.97 | |
Pres(8s)avg2 | Mean | 40.30 | 35.57 | 34.98 | 36.95 | Session 2-1 | −7.96 | −26.05, 14.55 | 32.73 | 23.27, 56.99 | 6.83 | −3.40, 10.47 | 0.62 | 0.18, 0.86 |
SD | 20.03 | 11.62 | 10.72 | 14.73 | Session 3-2 | −0.57 | −8.5, 8.11 | 11.43 | 8.33, 18.82 | 7.36 | 3.21, 10.01 | 0.93 | 0.81, 0.98 | |
Pres(8s)avg3 | Mean | 40.22 | 34.82 | 34.86 | 36.63 | Session 2-1 | −9.00 | −26.78, 13.08 | 32.47 | 23.10, 56.51 | 6.79 | −3.37, 10.41 | 0.63 | 0.19, 0.86 |
SD | 20.53 | 10.86 | 10.69 | 14.76 | Session 3-2 | 0.75 | −7.53, 9.77 | 11.73 | 8.54, 19.33 | 7.19 | 3.09, 9.79 | 0.93 | 0.80, 0.98 | |
Force (N) | ||||||||||||||
Force(8s)max | Mean | 50.91 | 45.04 | 49.16 | 48.37 | Session 2-1 | −11.29 | −25.01, 4.94 | 24.28 | 17.43, 41.38 | 7.49 | −0.13, 10.76 | 0.78 | 0.45, 0.92 |
SD | 18.98 | 16.79 | 14.43 | 16.83 | Session 3-2 | 11.52 | −0.27, 24.70 | 15.55 | 11.27, 25.89 | 7.50 | 2.83, 10.34 | 0.89 | 0.70, 0.96 | |
Force(8s)avg2 | Mean | 47.56 | 42.86 | 46.02 | 45.48 | Session 2-1 | −9.53 | −23.91, 7.56 | 25.10 | 18.00, 42.87 | 7.14 | −1.43, 10.37 | 0.75 | 0.40, 0.91 |
SD | 17.61 | 15.65 | 15.10 | 16.16 | Session 3-2 | 8.27 | −1.66, 19.21 | 13.25 | 9.64, 21.93 | 7.80 | 3.28, 10.64 | 0.92 | 0.78, 0.97 | |
Force(8s)avg3 | Mean | 46.70 | 41.79 | 45.05 | 44.51 | Session 2-1 | −9.35 | −23.71, 7.70 | 24.99 | 17.93, 42.68 | 7.22 | −1.30, 10.46 | 0.75 | 0.41, 0.91 |
SD | 17.66 | 14.73 | 14.29 | 15.63 | Session 3-2 | 8.81 | −0.67, 19.20 | 12.52 | 9.11, 20.67 | 7.52 | 3.20, 10.25 | 0.92 | 0.79, 0.97 |
Sessions | Measures of Maximal Tactile Pressure/Force Over Complete Grasp Duration | Complete Grasp Duration (8 s) With Vision | Complete Grasp Duration (8 s) Without Vision | Measures of Maximal Tactile Pressure/Force Over Complete Grasp Duration | Plateau Phase (5 s) With Vision | Plateau Phase (5 s) Without Vision | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | |||
Session 2-1 | Pres(8s)max | good | x | very good | x | x | good | Pres(5s)max | very good | x | very good | x | x | good |
Session 3-2 | very good | x | x | good | x | good | very good | x | x | good | x | good | ||
Session 3-2 # | good | acceptable | very good | good | good | Very good | ||||||||
Session 2-1 | Pres(8s)avg2 | good | x | very good | good | x | very good | Pres(8s)avg2 | x | x | very good | good | x | very good |
Session 3-2 | very good | x | x | very good | x | good | very good | x | x | very good | x | good | ||
Session 3-2 # | good | acceptable | very good | good | good | Very good | ||||||||
Session 2-1 | Pres(8s)avg3 | good | acceptable | very good | good | x | good | Pres(5s)avg3 | good | x | very good | good | x | good |
Session 3-2 | very good | x | x | very good | acceptable | very good | very good | x | x | very good | acceptable | very good | ||
Session 3-2 # | good | acceptable | very good | good | good | Very good | ||||||||
Session 2-1 | Force(8s)max | good | x | very good | very good | x | very good | Force(5s)max | good | x | very good | very good | x | very good |
Session 3-2 | very good | x | good | good | acceptable | very good | very good | x | good | good | x | very good | ||
Session 2-1 | Force(8s)avg2 | x | acceptable | very good | x | x | very good | Force(5s)avg2 | x | acceptable | very good | x | x | very good |
Session 3-2 | very good | x | good | x | acceptable | very good | very good | x | good | good | acceptable | very good | ||
Session 2-1 | Force(8s)avg3 | good | acceptable | very good | x | x | very good | Force(5s)avg3 | good | acceptable | very good | x | x | very good |
Session 3-2 | very good | x | good | x | acceptable | very good | very good | very good | good | good | acceptable | very good |
Sessions | Measures of Maximal Tactile Pressure/Force Over Complete Grasp Duration | Complete Grasp Duration (8 s) With Vision | Complete Grasp Duration (8 s) Without Vision | Measures of Maximal Tactile Pressure/Force Over Complete Grasp Duration | Plateau Phase (5 s) With Vision | Plateau Phase (5 s) Without Vision | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | Change in Mean (%) | CV (%) | ICC | |||
Session 2-1 | Pres(8s)max | good | x | x | good | good | very good | Pres(5s)max | good | x | x | good | good | very good |
Session 3-2 | very good | acceptable | good | very good | x | good | very good | x | good | very good | x | good | ||
Session 2-1 | Pres(8s)avg2 | good | x | x | x | x | very good | Pres(5s)avg2 | good | x | x | good | good | very good |
Session 3-2 | very good | acceptable | very good | good | good | very good | very good | x | good | very good | good | very good | ||
Session 2-1 | Pres(8s)avg3 | good | x | x | good | x | very good | Pres(5s)avg3 | x | x | x | good | good | very good |
Session 3-2 | very good | acceptable | very good | very good | good | very good | very good | x | good | very good | good | very good | ||
Session 2-1 | Force(8s)max | x | x | good | very good | x | very good | Force(5s)max | x | x | good | very good | good | very good |
Session 3-2 | x | x | good | very good | x | good | x | x | good | very good | good | good | ||
Session 2-1 | Force(8s)avg2 | good | x | good | x | x | very good | Force(5s)avg2 | x | x | good | good | good | very good |
Session 3-2 | good | acceptable | very good | good | x | good | x | x | very good | very good | good | good | ||
Session 2-1 | Force(8s)avg3 | good | x | good | very good | x | very good | Force(5s)avg3 | x | x | good | very good | good | very good |
Session 3-2 | good | acceptable | very good | very good | x | good | x | good | very good | very good | good | very good |
Group | Upper Limb | Average Difference between Consecutive Sessions | p Value | ||
---|---|---|---|---|---|
Session 2-1 | Session 3-2 | ||||
Stroke | Affected | Vision * | 6.67 | −7.45 | 0.07 |
No vision | 8.97 | −3.73 | 0.19 | ||
Less affected | Vision | −9.43 | 0.75 | 0.44 | |
No vision | 7.10 | −1.79 | 0.31 |
Upper Limb | Mean | SD | Mean Bias Raw | SD | Typical Error Raw | 90% CI of Typical Raw Error | Typical Error (CV) % | 90% CI of CV | Correlation (r) | 90% CI of r a | p Value | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Affected | Maximal tactile pressures #/kPa | 33.70 | 8.28 | |||||||||
Grip strength/kg | 22.09 | 7.26 | −2.20 | 5.91 | 8.18 | 5.96, 3.45 | 25.51 | 18.02, 45.32 | 0.37 | −0.19, 0.75 | 0.002 * | |
Less affected | Maximal tactile pressures #/kPa | 40.22 | 20.53 | |||||||||
Grip strength/kg | 27.00 | 9.36 | −2.51 | 8.89 | 17.97 | 13.10, 29.56 | 47.41 | 32.71, 89.35 | 0.64 | 0.17, 0.87 | 0.07 |
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Gopaul, U.; Laver, D.; Carey, L.; Matyas, T.; van Vliet, P.; Callister, R. Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke. Sensors 2023, 23, 3291. https://doi.org/10.3390/s23063291
Gopaul U, Laver D, Carey L, Matyas T, van Vliet P, Callister R. Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke. Sensors. 2023; 23(6):3291. https://doi.org/10.3390/s23063291
Chicago/Turabian StyleGopaul, Urvashy, Derek Laver, Leeanne Carey, Thomas Matyas, Paulette van Vliet, and Robin Callister. 2023. "Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke" Sensors 23, no. 6: 3291. https://doi.org/10.3390/s23063291