Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity
Objective: Revisiting the sharp/dull discrimination as clinical measure of spinothalamic tract function considering the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Three clinically relevant factors were evaluated as to their impact on reliability: (1) the...
Gespeichert in:
| Hauptverfasser: | , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
01 July 2021
|
| In: |
Frontiers in neurology
Year: 2021, Jahrgang: 12 |
| ISSN: | 1664-2295 |
| DOI: | 10.3389/fneur.2021.677888 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fneur.2021.677888 Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fneur.2021.677888/full 
|
| Verfasserangaben: | Laura Heutehaus, Christian Schuld, Daniela Solinas, Cornelia Hensel, Till Kämmerer, Norbert Weidner, Rüdiger Rupp and Steffen Franz |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 176234677X | ||
| 003 | DE-627 | ||
| 005 | 20210821011236.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 210707s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fneur.2021.677888 |2 doi | |
| 035 | |a (DE-627)176234677X | ||
| 035 | |a (DE-599)KXP176234677X | ||
| 035 | |a (OCoLC)1264431829 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Heutehaus, Laura |e VerfasserIn |0 (DE-588)1161129243 |0 (DE-627)1024536858 |0 (DE-576)506372227 |4 aut | |
| 245 | 1 | 0 | |a Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity |c Laura Heutehaus, Christian Schuld, Daniela Solinas, Cornelia Hensel, Till Kämmerer, Norbert Weidner, Rüdiger Rupp and Steffen Franz |
| 264 | 1 | |c 01 July 2021 | |
| 300 | |a 10 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Gesehen am 07.07.2021 | ||
| 520 | |a Objective: Revisiting the sharp/dull discrimination as clinical measure of spinothalamic tract function considering the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Three clinically relevant factors were evaluated as to their impact on reliability: (1) the localization of dermatomes in relation to the sensory level, (2) the examination tool, and (3) the threshold of correct answers for grading of a preserved sharp/dull discrimination. Design: Prospective monocentric psychometric study. Setting: Spinal Cord Injury Center, Heidelberg University Hospital, Germany. Participants: Convenient sample of 21 individuals with subacute spinal cord injury (age: 31-82 years) and 20 individuals without spinal cord injury (age: 24-63 years). Assessment: All participants underwent three assessments for sharp/dull discrimination, applying five commonly used examination tools in seven dermatomes, performed by three trained examiners under conditions in accordance with ISNCSCI. Main Outcome Measures: Assessment of interrater reliability by determining both the Fleiss Kappa (κ) coefficient and the percentage agreement between raters. Data were dichotomized regarding the ISNCSCI threshold. Results: Interrater reliability in individuals with SCI was overall substantial (κ=0.68; CI 0.679-0.681) and moderate (κ=0.54; CI 0.539-0.543) in dermatomes below the sensory level. All applied tools led to at least moderate reliability below the sensory level (lowest κ=0.44; CI 0.432-0.440), with the officially endorsed safety pin achieving the highest (substantial) reliability (κ=0.64; CI 0.638-0.646). Percentage agreement differed between non-SCI (97.3%) and formally intact above level dermatomes in SCI (89.2%). Conclusions: Sharp/dull discrimination as a common clinical examination technique for spinothalamic tract function is a reliable assessment. Independent from the used examination tools, reliability was substantial, with the medium-sized safety pin delivering the most favorable results. Notwithstanding this, all other tools could be considered if a safety pin is not available. Regarding interrater reliability and guessing probability, a threshold of 80% correct responses for preserved sharp/dull discrimination appears to be most suitable, which is in line with current clinical approaches and ISNCSCI. The causal attribution of the identified differences in sharp/dull discrimination between clinically intact dermatomes of individuals with SCI and unaffected dermatomes of individuals without SCI requires future work. Clinical trial registration number (German Clinical Trials Register): DRKS00015334 (https://www.drks.de) | ||
| 650 | 4 | |a Interrater agreement and reliability | |
| 650 | 4 | |a interrater reliability | |
| 650 | 4 | |a neurological examination | |
| 650 | 4 | |a Pain measurement (PM) | |
| 650 | 4 | |a Pin prick | |
| 650 | 4 | |a sensory function assessment | |
| 650 | 4 | |a sharp/dull discrimination | |
| 650 | 4 | |a spinal cord injury (SCI) | |
| 650 | 4 | |a spinothalamic tract (STT) | |
| 700 | 1 | |a Schuld, Christian |e VerfasserIn |0 (DE-588)1035264773 |0 (DE-627)747112703 |0 (DE-576)382871928 |4 aut | |
| 700 | 1 | |a Hensel, Cornelia |d 1972- |e VerfasserIn |0 (DE-588)134245997 |0 (DE-627)565614355 |0 (DE-576)300400454 |4 aut | |
| 700 | 1 | |a Weidner, Norbert |e VerfasserIn |0 (DE-588)1035265907 |0 (DE-627)747116326 |0 (DE-576)176492577 |4 aut | |
| 700 | 1 | |a Rupp, Rüdiger |d 1969- |e VerfasserIn |0 (DE-588)135739608 |0 (DE-627)570578388 |0 (DE-576)281757496 |4 aut | |
| 700 | 1 | |a Franz, Steffen |d 1979- |e VerfasserIn |0 (DE-588)133692051 |0 (DE-627)551107723 |0 (DE-576)300029608 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Frontiers in neurology |d Lausanne : Frontiers Research Foundation, 2008 |g 12(2021) vom: 1. Juli, Artikel-ID 677888 |h Online-Ressource |w (DE-627)631498753 |w (DE-600)2564214-5 |w (DE-576)326550933 |x 1664-2295 |7 nnas |a Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity |
| 773 | 1 | 8 | |g volume:12 |g year:2021 |g day:1 |g month:07 |g elocationid:677888 |g extent:10 |a Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity |
| 856 | 4 | 0 | |u https://doi.org/10.3389/fneur.2021.677888 |x Verlag |x Resolving-System |z kostenfrei |3 Volltext |
| 856 | 4 | 0 | |u https://www.frontiersin.org/articles/10.3389/fneur.2021.677888/full |x Verlag |z kostenfrei |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20210707 | ||
| 993 | |a Article | ||
| 994 | |a 2021 | ||
| 998 | |g 133692051 |a Franz, Steffen |m 133692051:Franz, Steffen |d 910000 |d 911460 |e 910000PF133692051 |e 911460PF133692051 |k 0/910000/ |k 1/910000/911460/ |p 8 |y j | ||
| 998 | |g 135739608 |a Rupp, Rüdiger |m 135739608:Rupp, Rüdiger |d 910000 |d 911460 |d 50000 |e 910000PR135739608 |e 911460PR135739608 |e 50000PR135739608 |k 0/910000/ |k 1/910000/911460/ |k 0/50000/ |p 7 | ||
| 998 | |g 1035265907 |a Weidner, Norbert |m 1035265907:Weidner, Norbert |d 910000 |d 911460 |e 910000PW1035265907 |e 911460PW1035265907 |k 0/910000/ |k 1/910000/911460/ |p 6 | ||
| 998 | |g 134245997 |a Hensel, Cornelia |m 134245997:Hensel, Cornelia |d 910000 |d 911460 |e 910000PH134245997 |e 911460PH134245997 |k 0/910000/ |k 1/910000/911460/ |p 4 | ||
| 998 | |g 1035264773 |a Schuld, Christian |m 1035264773:Schuld, Christian |d 910000 |d 911460 |e 910000PS1035264773 |e 911460PS1035264773 |k 0/910000/ |k 1/910000/911460/ |p 2 | ||
| 998 | |g 1161129243 |a Heutehaus, Laura |m 1161129243:Heutehaus, Laura |d 910000 |d 911460 |e 910000PH1161129243 |e 911460PH1161129243 |k 0/910000/ |k 1/910000/911460/ |p 1 |x j | ||
| 999 | |a KXP-PPN176234677X |e 3946469973 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"title":[{"title":"Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity","title_sort":"Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrity"}],"type":{"media":"Online-Ressource","bibl":"article-journal"},"physDesc":[{"extent":"10 S."}],"id":{"eki":["176234677X"],"doi":["10.3389/fneur.2021.677888"]},"relHost":[{"titleAlt":[{"title":"Autonomic Neuroscience"},{"title":"Brain Imaging Methods"},{"title":"Dementia"},{"title":"Endovascular and Interventional Neurology"},{"title":"Epilepsy"},{"title":"Headache Medicine and Facial Pain"},{"title":"Movement Disorders"},{"title":"Multiple Sclerosis and Neuroimmunology"},{"title":"Neurocritical and Neurohospitalist Care"},{"title":"Neurodegeneration"},{"title":"Neurogenomics"},{"title":"Neurology Education"},{"title":"Neuromuscular Diseases"},{"title":"Neuro-Oncology"},{"title":"Neuro-Ophthalmology"},{"title":"Neuro-Otology"},{"title":"Neuropediatrics"},{"title":"Neuropharmacology"},{"title":"Neuroprosthetics"},{"title":"Neurotrauma"},{"title":"Sleep and Chronobiology"},{"title":"Spinal Cord Medicine"},{"title":"Sports Neurology"},{"title":"Stroke"},{"title":"Teleneurology"}],"disp":"Revisiting the examination of sharp/dull discrimination as clinical measure of spinothalamic tract integrityFrontiers in neurology","type":{"media":"Online-Ressource","bibl":"periodical"},"pubHistory":["2008 -"],"note":["Gesehen am 18.08.20","Specialty sections: Autonomic Neuroscience; Brain Imaging Methods; Dementia; Endovascular and Interventional Neurology; Epilepsy; Headache Medicine and Facial Pain; Movement Disorders; Multiple Sclerosis and Neuroimmunology; Neurocritical and Neurohospitalist; Care; Neurodegeneration; Neurogenomics; Neurology Education; Neuromuscular Diseases; Neuro-Oncology; Neuro-Ophthalmology; Neuro-Otology; Neuropediatrics; Neuropharmacology; Neuroprosthetics; Neurotrauma; Sleep and Chronobiology; Spinal Cord Medicine; Sports Neurology; Stroke; Teleneurology"],"part":{"text":"12(2021) vom: 1. Juli, Artikel-ID 677888","extent":"10","year":"2021","volume":"12"},"language":["eng"],"origin":[{"publisher":"Frontiers Research Foundation","dateIssuedDisp":"2008-","dateIssuedKey":"2008","publisherPlace":"Lausanne"}],"physDesc":[{"extent":"Online-Ressource"}],"id":{"issn":["1664-2295"],"eki":["631498753"],"zdb":["2564214-5"]},"title":[{"title_sort":"Frontiers in neurology","title":"Frontiers in neurology"}],"recId":"631498753","name":{"displayForm":["Frontiers Research Foundation"]}}],"origin":[{"dateIssuedKey":"2021","dateIssuedDisp":"01 July 2021"}],"language":["eng"],"name":{"displayForm":["Laura Heutehaus, Christian Schuld, Daniela Solinas, Cornelia Hensel, Till Kämmerer, Norbert Weidner, Rüdiger Rupp and Steffen Franz"]},"person":[{"given":"Laura","display":"Heutehaus, Laura","role":"aut","family":"Heutehaus"},{"role":"aut","family":"Schuld","display":"Schuld, Christian","given":"Christian"},{"role":"aut","family":"Hensel","given":"Cornelia","display":"Hensel, Cornelia"},{"given":"Norbert","display":"Weidner, Norbert","role":"aut","family":"Weidner"},{"role":"aut","family":"Rupp","given":"Rüdiger","display":"Rupp, Rüdiger"},{"display":"Franz, Steffen","given":"Steffen","family":"Franz","role":"aut"}],"recId":"176234677X","note":["Gesehen am 07.07.2021"]} | ||
| SRT | |a HEUTEHAUSLREVISITING0120 | ||