The RASP is a multi-modal sensory tool that tests 6 sensations (sharp/dull discrimination, surface pressure, tactile localization, temperature discrimination, joint movement and joint movement direction discrimination), and 2 secondary sensations (sensory extinction and two-point discrimination).
8
20-45 minutes
Length depends on client's level of sensory deficit
Adults
18 - 65
yearsOlder Adults
65 +
yearsInitial review completed by Jane Sullivan, Co-Chair of the Neurology Section’s StrokEdge Task Force; Updated by Dorian Rose, Co-Chair of the Neurology Section’s StrokEdge II Task Force
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Stroke Taskforce (StrokEDGE), 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:
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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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) |
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StrokEDGE |
NR |
NR |
NR |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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StrokEDGE |
NR |
NR |
NR |
NR |
NR |
Recommendations for entry-level physical therapy education and use in research:
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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) |
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StrokEDGE |
No |
No |
Yes |
Yes |
The need for customized equipment and the length of test limit clinical utility
Sub-Actue Stroke: (Winward et al., 2002; suggested impairment cut-off determined from testing n = 50 control participants)
Proprioceptive direction discrimination: < 28
Sharp/dull discrimination: < 22
Surface touch: < 29
Surface localization: < 28
Two-point discrimination: N/A
Temperature discrimination: < 25
Proprioceptive Movement discrimination: < 28
Sub-Actue Stroke: (Winward et al., 2002; data from 50 control participants; mean ± SD (Range) provided)
Sharp/dull discrimination:
Left Side (26.6 ± 2.6;18-30)
Right Side (26.5 ± 2.5; 21-30)
Surface touch:
Left Side (29.9 ± 0.3;28-30)
Right Side (29.9 ± 0.7; 25-30)
Surface localization:
Left Side (29.9 ± 0.4;18-30)
Right Side (29.8 ± 1.1; 22-30)
Two-point discrimination:
Right Hand
3mm: n = 16
4mm: n = 18
5mm: n = 14
Left Hand
3mm: n = 18
4mm: n = 15
5mm: n = 16
Temperature discrimination:
Left Side (28.4 ± 1.7;24-30)
Right Side (28.6 ± 1.8; 23-30)
Proprioceptive Movement discrimination:
Left Side (29.9 ± 0.8;24-30)
Right Side (30 ± 0.1; 29-30)
Proprioceptive direction discrimination:
Right Side (29.8 ± 0.9; 24-30)
Left Side (29.8 ± 0.9;24-30)
Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)
Total RASP score:
Excellent, Pearson correlation, r = 0.92
Sharp/dull subtest:
Excellent, Pearson correlation, r = 0.84
Surface pressure touch subtest:
Excellent, Pearson correlation, r = 0.90
Surface localization subtest:
Excellent, Pearson correlation, r = 0.96
Temperature subtest:
Excellent, Pearson correlation, r = 0.84
Proprioceptive movement subtest:
Excellent, Pearson correlation, r = 0.83
Proprioceptive direction subtest:
Adequate, Pearson correlation, r = 0.50
Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)
Total RASP score: Pearson correlation, r = 0.92
Concurrent validity:
Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)
Motricity Index and proprioception movement:
Adequate, Spearman rs = 0.31; (p < 0.01)
Motricity Index and proprioception direction detection:
Adequate, Spearman rs = 0.36; (p < 0.01)
Barthel Index and proprioception movement:
Adequate, Spearman rs = 0.35; (p < 0.01)
Barthel Index and proprioception direction detection:
Adequate, Spearman rs = 0.41; (p < 0.01)
Discriminant Validity
Sub-Acute Stroke: (Winward et al., 2002)
Using a Mann-Whitney test, the RASP discriminated significantly between people with (n = 100; 4-6 weeks post-stroke) and without (n = 50) brain damage (p < 0.001)
Winward CE, Halligan PW, Wade DT. The Rivermead Assessment of Somatosensory Performance (RASP): standardization and reliability data. Clinical Rehabilitation. 2002;16(5):523-33.
Winward CE, Halligan PW, Wade DT. Rivermead Assessment of Somatosensory Performance. Suffolk, England: Thames Valley Test Company Limited; 2000.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.