Rasch-Built Measure of Pleasant Touch through Active Fingertip Exploration

Background: Evidence suggests that somatic sensation has a modality for pleasant touch. Objective: To investigate pleasant touch at the fingertip level (i.e., glabrous skin site) through the elaboration of a linear unidimensional scale that measures (i) various materials according to the level of pleasantness they elicit through active fingertip explorations and (ii) subjects according to their pleasantness leniency levels. Subjects: We enrolled 198 healthy subjects without any neurological disease. Methods: Blindfolded subjects actively explored 48 materials with their index fingertips and reported the perceived pleasantness of each on a 4-level scale. The fingertip moisture levels on each subject were measured before the experimental session. Data were analyzed using the Rasch model. Results: We elaborated unidimensional linear scale that included 37 materials according to their pleasantness of touch. The pleasantness level of 21 materials was perceived differently, depending on the fingertip moisture levels of the subjects. Conclusion: Based on our findings, we formulated a Pleasant Touch Scale. Fingertip moisture levels appeared to be a major factor for (un)pleasant feelings during active exploration

Hand functioning in children with cerebral palsy / Le fonctionnement de la main chez les enfants infirmes moteurs d'origine cérébrale

The purpose of the present work was to study hand impairments and manual ability in children with cerebral palsy (CP) as well as to clarify their relationship. Appraising the degree of hand impairments requires normative data to differentiate the real dysfunctions of CP children from the normal difficulties according to their age, sex, or handedness. As there is no normative data for gross manual and fine finger dexterity, a first experiment focused on the normal development of manipulative functions was conducted to establish these norms. A second experiment was carried out to develop and validate through the Rasch model a measure of manual ability in children with CP since such a measure was not yet available. The invariance of the ABILHAND-Kids questionnaire was also tested across relevant demographic and clinical subgroups of CP children. Finally, a third experiment was performed to quantify the hand impairments in children with CP and to investigate their relationship with manual ability as measured with the ABILHAND-Kids questionnaire. Hand motor impairments, markedly more prevalent than hand sensory impairments, were moderately correlated with manual ability measures and predicted 58% of their variance. Consequently, manual ability cannot simply be inferred from hand impairments and should be measured and treated per se. / L'objectif de ce travail était d'étudier les déficiences de la main et l'habileté manuelle chez les enfants infirmes moteurs d'origine cérébrale (IMOC) ainsi que de clarifier leur relation. Apprécier la gravité des déficiences de la main nécessite des données normatives afin de différencier les dysfonctionnements réels des enfants IMOC des difficultés normales compte tenu de leur âge, sexe, ou latéralité. Etant donné l'absence de normes quant à la dextérité manuelle grossière et la dextérité digitale fine, une première étude a été réalisée afin d'examiner le développement normal de ces deux types de dextéritéDes normes sur les dextérités manuelle grossière et digitale fine ont ainsi pu être établies. Une deuxième étude a été effectuée afin de développer et valider à travers le modèle de Rasch une mesure de l'habileté manuelle chez les enfants IMOC. L'invariance du questionnaire ABILHAND-Kids a également testée à travers différents sous-groupes démographiques et cliniques d'enfants IMOC. Enfin, une troisième étude a été réalisée afin de quantifier les déficiences de la main chez les enfants IMOC et d'investiguer leur relation avec l'habileté manuelle. Les déficiences motrices de la main, plus prévalentes que les déficiences sensitives, étaient modérément corrélées avec les mesures d'habileté manuelle et prédisaient 58% de leur variance. En conséquence, l'habileté manuelle ne peut être simplement inférée à partir des déficiences de la main et devrait donc être mesurée et traitée pour elle-même.(READ 3)--UCL, 200

Normative values and discriminative ability across functional levels of ACTIVLIM-CP, a measure of global activity performance for children with cerebral palsy

PURPOSE: This study aims to provide normative values of a global activity performance questionnaire (ACTIVLIM-CP) and investigate its ability to discriminate children with cerebral palsy of various functional levels. METHODS: Parents of 503 typically developing children aged 2-18 years old (mean age ± standard deviation (SD): 9.56 ± 4.62 years) and 285 children with cerebral palsy aged 2-18 years old (mean age ± SD: 10.08 ± 4.09 years) answered ACTIVLIM-CP. To provide normative values, influence of typically developing children's characteristics on ACTIVLIM-CP measures was investigated with a multiple linear regression. A Kruskal-Wallis test and Dunn's post-hoc tests were performed to investigate age differences in ACTIVLIM-CP measures. Discriminative ability of ACTIVLIM-CP was investigated using a one-way analysis of variance and post-hoc tests between children with cerebral palsy who differed in manual and gross motor functional levels. RESULTS: In typically developing children, age was the strongest predictor, explaining 74% of the variance of ACTIVLIM-CP measures (β = 0.86, t = 38.21, p < 0.001). ACTIVLIM-CP measure increased with age until 17-18 years old where all children reached the maximal value, although 50% of the children at 12 years old already reached the maximal measure. Normative values were developed for each age bracket. In addition, ACTIVLIM-CP was able to discriminate children with CP's performance measures across most manual ability and gross motor functional levels. CONCLUSIONS: Normative values developed in this study with a representative sample of typically developing children allow clinicians to appraise the functional delay of children with cerebral palsy from the normal development of global activity performance. The good discriminative ability of ACTIVLIM-CP support its precision, construct validity, and clinical relevance to describe global activity limitations in children with cerebral palsy with manual ability levels and gross motor function levels II-V.Implications for rehabilitationNormative data of ACTIVLIM-CP developed with a representative sample of typically developing children can be used with children with CP to differentiate the age effect from the disruption caused by cerebral palsy.ACTIVLIM-CP showed the ability to discriminate across children with cerebral palsy having different manual and gross motor function, highlighting its precision, construct validity, and its clinical relevance to describe limitations in children with manual ability levels and gross motor function levels II-V.ACTIVLIM-CP covers a wide age range, is a cost-effective, easy and freely-available assessment of global activity performance in activities of daily living for clinicians

Développer et interpréter une échelle de mesure. Applications du modèle de Rasch

Les questionnaires d'évaluation sont les instruments les plus utilisés aujourd'hui dans le domaine de la médecine et des sciences humaines pour évaluer des variables telles que l'incapacité physique, l'altruisme ou la douleur. Pourtant les praticiens connaissent souvent mal ces instruments. Que mesurent-ils vraiment ? Comment les résultats doivent-ils être interprétés ? Le présent ouvrage s'efforce de répondre à ces questions. Il ne s'agit pas d'un simple mode d'emploi des questionnaires d'évaluation. Son objectif principal est de fournir à tous, chercheurs et praticiens, les bases méthodologiques nécessaires pour développer un tel instrument et pour en interpréter les résultats. Après avoir exposé les fondements d'une mesure objective formulés par le modèle de Rasch, les auteurs adressent une série de questions fréquemment posées dans leur contexte d'application. Quels sont les critères d'une mesure objective ? Les résultats peuvent-ils être interprétés de manière quantitative ? Comment valider un tel instrument de mesure ? Peut-on comparer les réponses observées chez différents groupes de sujets ? Six chapitres, agrémentés de nombreux exemples pratiques et d'exercices résolus, exposent les bases méthodologiques de l'évaluation quantitative à l'aide du modèle de Rasch. Le septième chapitre décrit, pas à pas, les étapes du développement et de la validation d'une échelle de mesure de l'habileté manuelle

Satis-stroke: A satisfaction measure of activities and participation in the actual environment experienced by patients with chronic stroke.

OBJECTIVE: To develop a satisfaction measure of activities and participation in the actual environment experienced by patients after chronic stroke using the Rasch measurement model.METHODS: A 36-item questionnaire based on the International Classification of Functioning, Disability and Health model and existing scales was developed. The questionnaire was submitted to 101 patients (70% men; mean age 63 years) without major intellectual deficits who live in different types of residences (homes and nursing homes). The questionnaire was resubmitted after one month. The patients' responses were analysed separately using RUMM Rasch software to select items presenting an ordered rating scale, sharing the same discrimination, and fitting a unidimensional scale. RESULTS: The final SATIS-Stroke scale consisted of 36 items rated by the patients. The patients reported perceptions over a wider range of measurement with high reliability (r = 0.94) and good reproducibility over time (intraclass correlation coefficient = 0.98). The SATIS-Stroke measures are significantly related to age and place of residence. CONCLUSION: SATIS-Stroke is a functional scale specifically developed to measure satisfaction with activities and participation, providing goal-setting guidelines for treatment planning. Its range and measurement precision are appropriate for clinical practice

Hand impairments and their relationship with manual ability in children with cerebral palsy.

OBJECTIVE: To study hand impairments and their relationship with manual ability in children with cerebral palsy. DESIGN: Cross-sectional survey. PATIENTS: A total of 101 children with cerebral palsy (mean age 10 years, age range 6-15 years) were assessed. METHODS: Three motor and 3 sensory impairments were measured on both hands. Motor impairments included grip strength (Jamar dynamometer), gross manual dexterity(Box and Block Test) and fine finger dexterity (Purdue Peg-board Test). Sensory impairments included tactile pressure detection (Semmes-Weinstein aesthesiometer), stereognosis(Manual Form Perception Test) and proprioception (passive mobilization of the metacarpophalangeal joints). Manual ability was measured with the ABILHAND-Kids questionnaire.The relationship between hand impairments and manual ability was studied through correlation coefficients and a multiple linear forward stepwise regression analysis. RESULTS: Motor impairments were markedly more prevalent than sensory ones. Gross manual dexterity on the dominant hand and grip strength on the non-dominant hand were the best independent predictors of the children's manual ability,predicting 58% of its variance. CONCLUSION: Hand impairments and manual ability are not related in a predictable straightforward relationship. It is important that, besides hand impairments, manual ability is also measured and treated, as it is not simply the integration of hand functions in daily activities

Satisfaction with activity and participation and its relationships with body functions, activities, or environmental factors in stroke patients.

Bouffioulx É, Arnould C, Thonnard JL. Satisfaction with activity and participation and its relationships with body functions, activities, or environmental factors in stroke patients