Intra- and Inter-Rater Reliability, Parallel Test Reliability, and Internal Consistency of the Tuning Fork and Monofilament Tests

TL;DR

This study evaluates the reliability of two somatosensory tests in young adults, finding the tuning fork test reliable and the monofilament test inconsistent in some body regions.

Contribution

The study provides a detailed reliability analysis of tuning fork and monofilament tests for somatosensation in healthy young adults.

Findings

The tuning fork test showed moderate intra- and inter-rater reliability and good internal consistency.

The monofilament test had good reliability for foot and ankle locations but poor reliability for leg, thigh, and trunk locations.

Parallel test reliability between the two tests was not acceptable.

Abstract

Objectives: Somatosensation is the ability to detect various external and internal stimuli (such as pain, pressure, temperature, or joint position), and its objective and reproducible evaluation is essential for diagnosis, training, and rehabilitation. This study evaluates the methodological quality of two somatosensory assessments in young healthy adults. Methods: The tuning fork test (administered on five locations of each hemibody) and the monofilament test (administered on 27 locations of each hemibody, and divided into (i) foot and ankle, (ii) leg and thigh, and (iii) trunk subscales) were applied to 58 students by two raters at three different time points (rater 1 test, rater 1 retest, rater 2 test). The intra- and inter-rater reliability, parallel test reliability, and internal consistency were evaluated for each test and subtest. Results: The tuning fork test showed moderate intra- and inter-rater reliability and good internal consistency. The monofilament test showed good to moderate intra- and inter-rater reliability for foot and ankle locations, but poor intra- and inter-rater reliability for leg, thigh, and trunk locations. The total score, left hemibody score, and right hemibody score of the monofilament test showed good or acceptable consistency with leg and thigh subscales, but poor or unacceptable consistency with foot, ankle, and trunk subscales. No acceptable parallel test reliabilities were found between the tuning fork test and the monofilament test. Conclusions: The tuning fork test is a reliable assessment of deep somatosensory function in the lower extremities of healthy young adults. The commercially available monofilament test kits are sufficient to investigate the superficial somatosensitivity of feet and ankles, but are insufficient for an objective evaluation of leg, thigh, and trunk regions.

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