# NEW CLINICAL MEASURES OF HAND AND WRIST PROPRIOCEPTION: A PILOT STUDY FOR EVALUATING DISCRIMINATIVE VALIDITY AND TEST-RETEST RELIABILITY IN INDIVIDUALS WITH WRIST DISABILITY

## TL;DR

This study tested new methods to measure hand and wrist proprioception in people with wrist injuries, finding that some tests could reliably detect differences between injured and uninjured wrists.

## Contribution

The study introduces and evaluates new clinical tests for proprioception in wrist disability, identifying promising measures for future use.

## Key findings

- The pointing acuity test with eyes closed showed good discriminative validity and reliability for affected wrists.
- The active joint position sense test in flexion also demonstrated promising discriminative ability.
- Other tests like grip force reproduction had poor reliability and discriminative ability.

## Abstract

To evaluate psychometric properties of newly developed hand and wrist proprioception tests.

Cross-sectional and test-retest comparisons.

Twenty-six individuals (mean age 40 years) with wrist disability (> 3 months) due to traumatic injury or general instability.

Pointing acuity (with eyes open and closed), active joint position sense (in extension, flexion, radial- and ulnar deviation) and grip force reproduction were measured by 1 rater on 2 occasions, 1 week apart. The mean absolute error was calculated for each test. Discriminative validity (affected vs non-affected hand/wrist) was evaluated by paired t-test and test-retest reliability with Intraclass Correlation Coefficient (ICC).

The pointing acuity test with eyes closed gave higher errors for the affected hand/wrist (p = 0.08) and good ICCs (0.80–0.85), while the test with eyes open had poor discriminative ability (p = 0.32) and test-retest reliability (ICC 0.13–0.16). The active joint position sense test showed higher error in flexion for the affected wrist (p = 0.03), and the ICC was moderate (0.51). The remaining joint directions and the grip force reproduction test had poor discriminative ability (p = 0.21–0.94) and poor to moderate ICCs (0.00–0.65).

The pointing acuity test with eyes closed and the active joint position test in flexion show-ed promising results but need further evaluation in larger samples.

Wrist injuries or instability can affect proprioception – the body’s ability to sense movement, position and force – leading to poorer control of hand movements and reduced joint stability. To support recovery, proprioception training is included in rehabilitation, and accurate clinical tests are needed to measure progress. This study evaluated 3 new clinical tests of proprioception in individuals with wrist disability due to trauma or instability: pointing acuity test (with eyes open and closed) and the ability to reposition the wrist-angle and reproduce grip force (with eyes closed). The tests were analysed for their ability to detect differences between injured and uninjured wrists and their reproducibility over time. The pointing acuity test with eyes closed and the wrist-angle reposition test in flexion showed the most promising results. This suggests that selected proprioception tests may support more precise clinical assessments and enable more targeted and effective rehabilitation for individuals with wrist injuries.