Development of the Hand Active Sensation Test: Reliability and validity

Objective: To develop and establish the reliability and validity of a new quantitative functional measure of haptic perception in the hand, the Hand Active Sensation Test (HASTe). Design: Reliability was assessed by test-retest sessions. Validity was assessed via discriminant analysis, concurrent validity with 2-point discrimination and wrist position test, and receiver operating characteristic (ROC) curve construction. Setting: Subject preference. Participants: Heterogeneous sample of 28 stroke survivors and 28 individually matched controls. Intervention: Subjects used I hand to manipulate HASTe objects that vary by weight or texture to complete 18 match-to-sample trials. Main Outcome Measures: Two-point discrimination threshold, Wrist Position Sense Test (WPST) average error, and HASTe accuracy score. Results: Test-retest reliability was strong (intraclass correlation coefficient model 3,1 =.77). The HASTe score significantly discriminated the groups (t=8.3, P<.001) and correlated with 2-point discrimination (r=-.67, P<.001) and WPST (r= -.60, P<.001). ROC curve area was .94 for test 1 and .92 for the average of 2 tests. Conclusions: The HASTe is a reliable and valid functional measure of haptic perception, appears to detect impairment of haptic perception even in stroke survivors with no reported sensory deficits, and may provide valuable quantitative clinical data about complex sensory loss and hand function after stroke.