Nottingham Assessment of Somato-Sensations

Stroke:

(Lincoln NB et al, 1991; n = 20 acute stroke patients)

Inter-rater

• Assessed by two physical therapists within 2-52 days of each other. Kappa coefficients = 0.01-0.89; only 1 item k >0.7

Intra-rater

• One physical therapist tested patients on two occasions between 2-52 days apart. Kappa coefficients = -0.13-0.92; k >0.7 for 17/54 items

(Lincoln NB et al, 1998; n = 27 stroke patients)

• Kappa coefficients showed acceptable agreement on 12 out of the 86 items for inter rater reliability. Light touch and pressure scales were most reliable and pin-prick and temperature scales were least reliable
• For inter rater reliability of the stereognosis subtest reported kappa coefficients 0.38 to 1.0. Coefficients were higher on the unaffected side and for certain items (scissors, sponge, cup) Intracranial Disorders: 

(Stolk-Hornsveld F et al, 2006; n = 18 inpatients; mean age = 57.7 years; diagnosed with intracranial disorder)

• Intra rater and inter rater reliability of the Erasmus MC modifications to the Nottingham Sensory Assessment (EmNSA), kappa coefficients 0.58 to 1.00. Two-point discrimination was less reliable 0.11 to 0.63. Inter rater reliability of EmNSA, kappa coefficients of 0.46 to 1.00. Two-point discrimination was less reliable of 0.10 to 0.66

Stroke: Stereognosis Assessment

(Gaubert CS and Mockett SP; 2000, n = 20 stroke patients ( 3.85±2.78 weeks post-stroke)

• The stereognostic ability of the subjects was assessed using the NSA procedures by 2 of 3 examiners within a 24-hour period.

• Kappa values ranged from 0.42 (moderate) to 0.85 (almost perfect) between Examiners 1 and 2

• Kappa values ranged from 0.38 (fair) to 0.84 (almost perfect) between Examiners 1 and 3

• Kappa values ranged from 0.40 (fair) to 0.80 (substantial) between Examiners 1 with Examiners 2 and 3.

For all 3 levels of comparison, the lowest Kappa value was for the pencil item.

Stroke:

(Connell LA et al, 2008; n = 70 stroke patients)

• Upper limb tactile sensation at rehab admission (within 6 wks of stroke onset) predictive of upper limb tactile sensation at 6-months post-stroke (R² =0.554; p < 0.001)

• Lower limb tactile sensation at rehab admission (within 6 wks of stroke onset) predictive of lower limb tactile sensation at 6-months post-stroke (R² =0.464; p < 0.001)

• Stereognosis and proprioception at rehab admission (within 6 wks of stroke onset) predictive of stereognosis at 6-months post-stroke (R² =0.709; p < 0.001)

• Proprioception and upper limb tactile sensation at rehab admission (within 6 wks of stroke onset) predictive of proprioception at 6-months post-stroke (R² =0.510; p < 0.001)

(Meyer et al, 2016; n = 32 acute stroke patients)

• Proprioception (movement sense) as measured by the Erasmsus MC (revised) NSA at one week post-stroke, moderately predicted motor ability at 6-months post-stroke as measured by the UE Fugl-Meyer (Spearman ƿ = 0.27), the Motricity Index (Spearman ƿ = 0.27) and the Action Research Arm Test (Spearman ƿ = 0.26).

• Stereognosis measured by the NSA at one week post-stroke moderately predicted motor ability at 6-months post-stroke as measured by the UE Fugl-Meyer (Spearman ƿ = 0.41), the Motricity Index (Spearman ƿ = 0.37) and the Action Research Arm Test (Spearman ƿ = 0.56).

Stroke:

(Scalha et al, 2011; n = 20 stroke patients (> 2 yrs post-stroke)

• Total Fugl-Meyer (FM) UE Sensation (proprioception and light touch) correlated with UE Nottingham Stroke Assessment (NSA) score; Spearman’s r=0.691; p<0.001)

• UE FM arm light touch correlated with NSA tactile sensation subscale (p< 0.005)

• UE FM palm light touch correlated with NSA tactile sensation subscale (p<0.005)

• UE FM shoulder/elbow proprioception correlated with NSA proprioception subscale (r=0.586; p=0.007)

• UE FM wrist/hand proprioception correlated with NSA proprioception subscale (r=0.75;p < 0.001).