Purpose
The NSA has been used in clinical trials following stroke to test interventions such as electrical stimulation and task specific training.
Acronym
NSA
Assessment Type
Performance Measure
Administration Mode
Paper & Pencil
Cost
Not Free
Cost Description
Cost not known
- Multi-modal sensory examination includes tests of:
1) Tactile sensation (light, touch, touch localization, temperature discrimination, pinprick sensation, bilateral simultaneous stimulation)
2) Kinesthesia
3) Stereognosis
- Tactile scoring:
0) Absent – fails to identify the test sensations on 3 trials
1) Impaired – identifies the test sensation, but not on all 3 trials in each region of the body of feels duller
2) Normal – correctly identifies the test sensation on 3 trials
- Stereognosis scoring:
2) Normal – item is correctly named or matched
1) Impaired – some features of object identified or attempts descriptions of objects
0) Absent – unable to identify the object in any manner
- Kinesthesia scoring:
0) Absent – no appreciation of movement taking place
1) Appreciation of movement taking place – indicates on each movement that a movement takes place but the movement direction is incorrect
2) Direction of movement sense – able to appreciate and mirror the direction of the test movement, but is inaccurate in its new position
3) Joint Position Sense – accurately mirrors the test movement to within 10 degrees of the new test position
- For tactile sensation: blindfold, cotton ball, Neurotip, 2 test tubes for hot and cold water, talcum powder.
- For sterognosis assessment: blindfold, 2 different coins, pen, pencil, comb, scissors, sponge, piece of flannel cloth, cup, glass.
60 minutes
Entire test can take up to 60 minutes, depending on client's sensory impairment.
Kenesthesia and Sterognosis tests takeapproximately 15 minutes each.
Required Training
Training Course
Instrument Reviewers
Initially reviewed by Jane Sullivan, MPT, DHS and the Stroke EDGE task force in 2011.
ICF Domain
Body Structure
Body Function
Professional Association Recommendation
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
Abbreviations:
|
|
HR
|
Highly Recommend
|
R
|
Recommend
|
LS / UR
|
Reasonable to use, but limited study in target group / Unable to Recommend
|
NR
|
Not Recommended
|
Recommendations for use based on acuity level of the patient:
|
Acute
(CVA < 2 months post)
(SCI < 1 month post)
(Vestibular < 6 weeks post)
|
Subacute
(CVA 2 to 6 months)
(SCI 3 to 6 months)
|
Chronic
(> 6 months)
|
StrokEDGE
|
UR
|
UR
|
UR
|
Recommendations based on level of care in which the assessment is taken:
|
Acute Care
|
Inpatient Rehabilitation
|
Skilled Nursing Facility
|
Outpatient
Rehabilitation
|
Home Health
|
MS EDGE
|
NR
|
NR
|
NR
|
NR
|
NR
|
StrokEDGE
|
NR
|
UR
|
UR
|
UR
|
UR
|
Recommendations based on EDSS Classification:
|
EDSS 0.0 – 3.5
|
EDSS 4.0 – 5.5
|
EDSS 6.0 – 7.5
|
EDSS 8.0 – 9.5
|
MS EDGE
|
NR
|
NR
|
NR
|
NR
|
Recommendations for entry-level physical therapy education and use in research:
|
Students should learn to administer this tool? (Y/N)
|
Students should be exposed to tool? (Y/N)
|
Appropriate for use in intervention research studies? (Y/N)
|
Is additional research warranted for this tool (Y/N)
|
MS EDGE
|
No
|
No
|
No
|
Yes
|
StrokEDGE
|
No
|
Yes
|
Yes
|
Yes
|
Considerations
It is unlikely that the entire test will be performed in any of these practice settings, however components of the test may be appropriate if the systems review/screening exam indicates sensory loss and/or if sensory loss is hypothesized to underlie the patient’s movement dysfunction.
Clinical utility is poor due to the time to complete the entire test and the need for specific equipment that may not be available in the clinic (e.g. neurotip). The stereognosis and kinesthesia subscales have better clinical utility (equipment and time). Those two tests may be more appropriate for use in the clinic that they use standardized equipment procedures and have some acceptable psychometric data available.
The inclusion of sensory outcome measure in clinical trials could advance knowledge by identifying those intervention that are associated with sensory improvement as well as helping to determine those client characteristics (beyond motor and functional status) that are associated with improvement following selected interventions. This information would assist clinicians to target appropriate interventions based on client baseline characteristics.
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