“What test should I use?” We often hear this question from clinicians and researchers who are looking for valid, objective measures of motor function. Some clinical measures of motor function like manual muscle testing may be influenced by several factors that can affect both validity and reliability. There are many ‘valid & reliable’ measures out there, but which do we choose?
In 2013, the National Institutes of Health (NIH) released the NIH Toolbox for Assessment of Neurological and Behavioral Function (Gerson et al. 2013). This initiative was established to develop a ‘brief but comprehensive set of standard measures of motor, cognitive, sensory, and emotional function” across the lifespan, from 3 to 85 years. The toolkit was designed to be used across diverse populations and study designs.
The motor function assessment tools (Reuben et al. 2013) were specifically developed by researchers in 3 phases:
- Identify subdomains of motor function
They identified dexterity, strength, balance, locomotion, and endurance as key measurement areas.
- Pre-testing phase
The researchers tested the testing feasibility in children and older adults.
- Validation phase
340 healthy subjects from 3 to 85 years old were tested on gross and fine motor skills for validity and reliability
The authors of the Motor Function Toolkit identified specific measures for each domain, recommending testing in this order:
- Dexterity: Rolyan 9-hole pegboard assessment
- Strength: JAMAR Plus digital hand dynamometer (single trial per hand)
- Balance: Standing Balance Test using an accelerometer
- Locomotion: 4 minute walk, 2 trials (1 at usual pace and 1 “as quickly as possible”)
- Endurance: 2 minute walk, 1 trial on 50 foot course
In summary, the researchers established a set of measurements that is “valid, but practical and inexpensive. (Reuben et al. 2013).
Sources:
Gershon RC et al. NIH toolbox for assessment of neurological and behavioral function. Neurology. 2013 Mar 12;80(11 Suppl 3):S2-6.
Reuben DB et al. Motor assessment using the NIH Toolbox. Neurology. 2013 Mar 12;80(11 Suppl 3):S65-75.
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