Inter-rater Reliability of Two-point Discrimination in Acute Stroke Patients

Background: The two-point discrimination (2PD) test is widely used in clinical practice to assess tactile acuity and central somatosensory function in stroke patients.

Objectives: The aim of this study was to evaluate the reliability of 2PD test in fingers on the affected and non-affected sides in acute stroke patients.

Methods: This was a single group repeated-measures inter-rater reliability study. Thirty adults with completed ischemic stroke and left paresis participated in the study. Static 2PD sensation was assessed using a standardized Dellon discriminator. Two examiners performed measurements of 2PD sensation on both hands. Each examiner made three series of measurements at intervals of 1 minute. After 15 minutes, the study was conducted in the same order by a second examiner.

Results: The ability for 2PD sensation was significantly reduced in all examined fingers on the affected side in comparison to the non-affected side. The difference was statistically significant (in each case, p < 0.0001). Inter-rater reliability (ICC2,1) for the first measurement at the affected site ranged from 0.95 to 0.98; at the non-affected site ranged from 0.30 to 0.82. Analysis of the average value of three measurements (ICC2,3) yielded values for the affected site ranging from 0.98 to 0.99; at the non-affected site ranged from 0.81 to 0.95.

Conclusions: The 2PD sensation values for all fingers were higher for the affected site in comparison to the non-affected site. Conducting three repeatable measurements ensures measurement reliability and repeatability when evaluating 2PD sensation in fingers on both sides in acute stroke patients.