Zusammenfassung
Hintergrund: Zur Messung der Geschicklichkeit der Hand nach Paresen oder Verletzungen werden in der Literatur verschiedene Modelle des Nine-hole-peg-Tests (NHPT) beschrieben.
Ziel: Die Studie verglich 2 verschiedene Modelle des NHPT bei Patienten nach Schlaganfall anhand folgender Fragestellungen: Unterscheiden sich die Testergebnisse der beiden NHPT-Versionen? Gibt es Lerneffekte bei der Testdurchführung? Zeigen die Versionen eine vergleichbare Verlaufssensitivität?
Methode: In der Quer- und Längsschnitt-Pilotstudie absolvierten 9 Patienten mit verminderter manueller Geschicklichkeit in der Frühphase nach Schlaganfall vor und nach 3 Wochen Therapie je 6 Messungen mit beiden NHPT-Versionen.
Ergebnisse: Die beiden NHPT-Versionen unterschieden sich bei Patienten nach Schlaganfall nicht signifikant. Bei beiden konnte während der 6 Testwiederholungen kein signifikanter Lerneffekt gezeigt werden. Beide Versionen sind sensitiv für Verbesserungen der manuellen Geschicklichkeit innerhalb von 3 Wochen.
Schlussfolgerungen: Im Sinne eines Screening-Tests eignen sich beide NHPT-Versionen zur Verlaufsdokumentation. Dafür spielt es keine Rolle, welche Testversion benutzt wird. Da innerhalb der 6 Messwiederholungen kein Lerneffekt zu beobachten ist, genügt 1 Messung pro Testtag. In dieser Studie waren zwar auch Patienten mit schlechter manueller Geschicklichkeit eingeschlossen, der NHPT eignet sich aber eher für Patienten mit mittlerer bis guter Handfunktion.
Abstract
Background: To measure hand dexterity after paresis or injury, in literature different models of the nine-hole-peg test (NHPT) are described.
Objective: This study compared 2 different NHPT versions in stroke patients according to the following questions: Do the test results of both NHPT versions differ? Is there a learning effect during the test procedure? Do they show comparable sensitivity performance changes?
Methods: In this cross-sectional and longitudinal pilot study 9 patients with reduced manual dexterity in early phases after stroke performed 6 times both NHPT versions before and after 3 weeks of therapy.
Results: The 2 NHPT versions did not show significant differences for stroke patients. There was no evidence for a significant learning effect within the 6 test reruns. Both versions are sensitive for improvements of the manual dexterity within 3 weeks.
Conclusions: In terms of a screening test both NHPT versions are suitable for documenting manual dexterity changes. It is irrelevant which of the versions is used. As there is no learning effect within the 6 test reruns 1 measurement for each test day is sufficient. However, it must be considered that this study included also patients with poor manual dexterity, but the NHPT is rather suitable for patients with moderate to good hand dexterity.
Schlüsselwörter
Nine-hole-peg-Test - Sensitivität - Handfunktion - Lerneffekte
Key words
nine hole peg test - sensitivity - hand function - learning effects
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Dipl. Physiotherapeut, MSc Kaspar Herren
Physiotherapie Neurologie
Anna-Seiler-Haus
Inselspital
3010 Bern
Schweiz
eMail: kaspar.herren@insel.ch
