Test-retest reliability of Purdue Pegboard performance in thermoneutral and cold ambient conditions

The effect of exposure to cold on dexterity and temperature of the skin and hands

Objectives. This study aimed to determine the impact of low temperature (-1 °C, +5 °C) on manual dexterity and hand skin temperature after 1 h of exposure when using two types of protective gloves. Methods. Ten male participants wore double gloves or single gloves, when spending 1 h in a climatic chamber at -1, +5 or +20 °C. Before and after the cold exposure, measurements of mean weighted body skin temperature, hand skin temperature, the Purdue Pegboard Test and hand grip strength were performed. Results. There were statistically significant differences in the values of mean weighted body skin temperature and left and right hand skin temperature between the study variants. Conclusion. No effect of cold exposure (-1 °C, +5 °C) on manual dexterity was observed, but there was an effect of -1 °C temperature change on weighted mean skin temperature and hand skin temperature during 1 h of exposure. The decrease in both right and left hand skin temperature after cold exposure was the largest for -1 °C while using single gloves, and differed significantly from the other variants.

The standardised Malay version of purdue pegboard test: Content validity and test-retest reliability testing

Introduction

Purdue Pegboard Test (PPT) is a valid and reliable instrument for measuring hand dexterity among individuals with or without medical conditions. In the Southeast Asia region where Malay is widely spoken, there is a need to have a Malay translation of Purdue Pegboard Test. This study aimed to translate the PPT into the Malay version (PPT-M) and to determine the content validity and test-retest reliability of this translated version.

Methods

This study involved: (1) four English teachers (translators) for forward and backward translation procedures; (2) 10 experts in the field of occupational therapy (expert reviewers) for content validity testing; and (3) 60 undergraduate students (participants) for test-retest reliability testing.

Results

PPT-M had excellent content validity with Item-Content Validity Index = 0.9-1.0, Scale-Content Validity Index/Average = 0.93-0.95, and a slightly lower Scale-Content Validity Index/Universal Agreement = 0.25-0.75. Test-retest reliability for 3-trial administration (n = 30; Intraclass Correlation Coefficients, ICCs = 0.76-0.85; good) was higher compared to 1-trial administration (n = 30; ICCs = 0.34-0.46; poor) for all subtests. Both trial administrations were mostly affected by systematic errors, especially practice effect as the retests gave higher scores. Random errors mostly affected Subtest 3 of 1-trial administration, evident by its Minimal Detectable Change Percent values = 30.84% that fell beyond the acceptable range.

Conclusion

PPT-M has the potential to be a valuable instrument for measuring hand dexterity among Malay speaking individuals especially when the 3-trial administration is used.

Wuqinxi Exercise Improves Hand Dexterity in Patients with Parkinson's Disease

Objective

This study was designed to evaluate the effect of Wuqinxi after one session and 12-week intervention on hand dexterity in patients with Parkinson's disease (PD).

Methods

Forty-six elderly participants with mild-to-moderate PD were randomly assigned to the groups trained with Wuqinxi (n = 23) or stretching (n = 23). All participants practiced 60 min session of either of these exercises, 2 sessions a week for 12 weeks in standing position. The score of Purdue Pegboard Test (PPT) and time for Soda Pop Test (SPT) were performed to assess hand dexterity and motor function along assessing the 39 items of Parkinson's Disease Questionnaire before and after 12-week interventions. In addition, the PPT scores were compared before vs. after one session of either of these two exercise modes.

Results

Single session with either Wuqinxi or stretching exercise tended to improve PPT scores in PD patients. Furthermore, the improved SPT time was significant (P < 0.01) following 12-week training interventions with Wuqinxi (−1.32 ± 0.38 sec) or stretching (−0.89 ± 0.16 sec), which showed no group difference (P=0.734). However, only the participants in Wuqinxi group significantly improved the PPT scores of the dominant hand (+0.61 ± 1.34), both hand (+1.83 ± 3.13) and assemble (+2.04 ± 3.44) performance after 12-week training intervention. In parallel with improved hand dexterity and motor function, 12-week Wuqinxi training also significantly improved the patient's emotional wellbeing.

Conclusion

The Wuqinxi intervention could be safely and effectively applied to improve hand dexterity following single-session exercise or 12-week training, which were accompanied by improved quality of life in patients with mild-to-moderate PD.

Impaired Fine Motor Function of the Asymptomatic Hand in Unilateral Parkinson's Disease

The early detection of Parkinson's disease (PD) still remains a challenge to date. Although studies have previously reported subtle motor function abnormalities in early PD patients, it is unclear whether such clinical signs can be better detected while patients are concurrently performing a cognitive task, and whether they can be useful in predicting patients' clinical conversion state. Seventy-two right-handed participants (40 drug-naive patients with idiopathic unilateral PD and 32 age-matched healthy controls) were enrolled in this study. All participants were asked to perform the Purdue Pegboard test (PPT) either alone (single-task condition) or during a concurrent mental subtraction-by-3 task (dual-task condition). A 4-year telephone follow-up was later conducted to determine whether PD patients converted to bilateral signs. We found that PD patients showed a significant reduction in dexterity on the PPT compared to the controls in both single- and dual-task conditions. Yet patients' performance in the dual-task condition revealed a greater interference effect when patients performed the task with their right hand than with their left hand. PPT also revealed reasonable discriminative ability for prediagnosing PD. However, dual-tasking did not have added value in differentiating early patients and controls. At follow-up, the baseline PPT performance of the asymptomatic hands was positively correlated with time to convert from unilaterally to bilaterally affected states (r = 0.62, P = 0.031). Together, these findings suggest that PPT can serve as a useful auxiliary tool in evaluating early PD, and shed light on the neuroplasticity mechanism of fine motor deficit at this very early stage.

Motor Learning Improvement Remains 3 Months After a Multisession Anodal tDCS Intervention in an Aging Population

Healthy aging is associated with decline of motor function that can generate serious consequences on the quality of life and safety. Our studies aim to explore the 3-month effects of a 5-day multisession anodal transcranial direct current stimulation (a-tDCS) protocol applied over the primary motor cortex (M1) during motor sequence learning in elderly. The present sham-controlled aging study investigated whether tDCS-induced motor improvements previously observed 1 day after the intervention persist beyond 3 months. A total of 37 cognitively-intact aging participants performed five consecutive daily 20-min sessions of the serial-reaction time task (SRTT) concomitant with either anodal (n = 18) or sham (n = 19) tDCS over M1. All participants performed the Purdue Pegboard Test and transcranial magnetic stimulation (TMS) measures of cortical excitability were collected before, 1 day after and 3 months after the intervention. The last follow-up session also included the execution of the trained SRTT. The main findings are the demonstration of durable effects of a 5-day anodal tDCS intervention at the trained skill, while the active intervention did not differ from the sham intervention at both the untrained task and on measures of M1-disinhibition. Thus, the current article revealed for the first time the durability of functional effects of a-tDCS combined with motor training after only 5 days of intervention in an aging population. This finding provides evidence that the latter treatment alternative is effective in achieving our primary motor rehabilitation goal, that is to allow durable motor training effects in an aging population.

Is it possible to change handedness after only a short period of practice? Effects of 15 days of intensive practice on left-hand writing in strong right-handers

Previous studies have argued that a person's ability to write legibly with the non-dominant hand after a limited amount of practice suggests that manual skill can be easily transferred. The present study investigated the degree to which handedness can be altered by short-term practice on the highly complex manual activity of handwriting. Nine strongly right-handed individuals practiced writing with their left hand daily for 15 consecutive days. On three occasions, at baseline, at the end of the practice period and after a one-month retention interval, the similarity of left- and right-hand writing was inspected and handedness was tested by means of the Purdue Pegboard as well as handedness questionnaires. All participants demonstrated more legible writing with their left hand after practice, and the writing was more similar to that of their preferred, right-hand writing, although to different degrees. Pegboard performance improved with the left hand, but equally as much with the right, and there were no other changes in participants' manual preference patterns. The findings of the present study do not indicate any degree of change in handedness, outside the impressive progress in left-hand writing. The large inter-individual variability, suggests that further research should focus on more individual analyses.

The Combined Effect of Cold and Moisture on Manual Performance

Objective The aim of this study was to investigate the combined effect of cold and moisture on manual performance and tactile sensitivity. Background People working in the ocean environment often perform manual work in cold and wet conditions. Although the independent effects of cold and moisture on hand function are known, their combined effect has not been investigated. Method Participants completed sensory (Touch-Test, two-point discrimination) and motor (Purdue Pegboard, Grooved Pegboard, reef knot untying) tests in the following conditions: dry hand, wet hand, cold hand, and cold and wet hand. Results For the Purdue Pegboard and knot untying tasks, the greatest decrement in performance was observed in the cold-and-wet-hand condition, whereas the decrements seen in the cold-hand and wet-hand conditions were similar. In the Grooved Pegboard task, the performance decrements exhibited in the cold-and-wet-hand condition and the cold-hand condition were similar, whereas no decrement was observed in the wet-hand condition. Tactile sensitivity was reduced in the cold conditions for the Touch-Test but not the two-point discrimination test.

CONCLUSION

The combined effect of cold and moisture led to the largest performance decrements except when intrinsic object properties helped with grasp maintenance. The independent effects of cold and moisture on manual performance were comparable. Application Tools and equipment for use in the cold ocean environment should be designed to minimize the effects of cold and moisture on manual performance by including object properties that enhance grasp maintenance and minimize the fine-dexterity requirements.

Multisession anodal transcranial direct current stimulation induces motor cortex plasticity enhancement and motor learning generalization in an aging population

OBJECTIVES

The present aging study investigated the impact of a multisession anodal-tDCS protocol applied over the primary motor cortex (M1) during motor sequence learning on generalization of motor learning and plasticity-dependent measures of cortical excitability.

METHODS

A total of 32 cognitively-intact aging participants performed five consecutive daily 20-min sessions of the serial-reaction time task (SRTT) concomitant with either anodal (n = 16) or sham (n = 16) tDCS over M1. Before and after the intervention, all participants performed the Purdue Pegboard Test (PPT) and Transcranial Magnetic Stimulation (TMS) measures of cortical excitability were collected.

RESULTS

Relative to sham, participants assigned to the anodal-tDCS intervention revealed significantly greater performance gains on both the trained SRTT and the untrained PPT as well as a greater disinhibition of long-interval cortical inhibition (LICI). Generalization effects of anodal-tDCS significantly correlated with LICI disinhibition.

CONCLUSION

Anodal-tDCS facilitates motor learning generalisation in an aging population through intracortical disinhibition effects.

SIGNIFICANCE

The current findings demonstrate the potential clinical utility of a multisession anodal-tDCS over M1 protocol as an adjuvant to motor training in alleviating age-associated motor function decline. This study also reveals the pertinence of implementing brain stimulation techniques to modulate age-associated intracortical inhibition changes in order to facilitate motor function gains.

Use of objective psychomotor tests in health professionals

Evaluation of psychomotor skills is undertaken in a number of broad contexts. This includes testing of health professional populations as a measure of innate ability, to evaluate skill acquisition, or to compare professions. However, the use of psychomotor tests is frequently confounded by a lack of understanding of a particular tool's psychometric properties, strengths, and weaknesses. To identify and appraise the most commonly used tests on health professional populations, 86 articles were reviewed and the top nine tests identified. Few tests have had sufficient validity or reliability testing on health professionals. Based on the evidence available, use of the Grooved Pegboard Test, the Purdue Pegboard Test, or the Finger Tapping Test is recommended for the evaluation of dexterity in a health professional population; however, this choice may be dependent on the task(s) to which findings are generalised. More rigorous evaluation of validity and other psychometric properties is required.

Cold habituation does not improve manual dexterity during rest and exercise in 5 °C

When exposed to a cold environment, a barehanded person experiences pain, cold sensation, and reduced manual dexterity. Both acute (e.g. exercise) and chronic (e.g. cold acclimatization or habituation) processes might lessen these negative effects. The purpose of this experiment was to determine the effect of cold habituation on physiology, perception, and manual dexterity during rest, exercise, and recovery in 5 °C. Six cold weather athletes (CWA) and eight non habituated men (NON) volunteered to participate in a repeated measures cross-over design. The protocol was conducted in 5 °C and was 90 min of resting cold exposure, 30 min of cycle ergometry exercise (50 % VO2 peak), and 60 min of seated recovery. Core and finger skin temperature, metabolic rate, Purdue Pegboard dexterity performance, hand pain, thermal sensation, and mood were quantified. Exercise-induced finger rewarming (EIFRW) was calculated for each hand. During 90 min of resting exposure to 5 °C, the CWA had a smaller reduction in finger temperature, a lower metabolic rate, less hand pain, and less negative mood. Despite this cold habituation, dexterity performance was not different between groups. In response to cycle ergometry, EIFRW was greater in CWA (~12 versus 7 °C) and occurred at lower core temperatures (37.02 versus 37.31 °C) relative to NON but dexterity was not greater during post-exercise recovery. The current data indicate that cold habituated men (i.e., CWA) do not perform better on the Purdue Pegboard during acute cold exposure. Furthermore, despite augmented EIFRW in CWA, dexterity during post-exercise recovery was similar between groups.

Blood pressure and Purdue pegboard scores in individuals with hypertension after alternate nostril breathing, breath awareness, and no intervention

Background

Previously alternate nostril yoga breathing (anuloma-viloma pranayama) was shown to reduce the blood pressure (BP) in people with hypertension. An elevated BP has been associated with poor performance in certain tasks requiring attention and co-ordination. The Purdue pegboard task assesses manual dexterity and eye-hand co-ordination.

Material/Methods

In the present study there were ninety participants with essential hypertension. Their ages ranged from 20 to 59 years (group average age ±S.D., 49.7±9.5 years; sixty males). Participants were randomized as three groups, with thirty participants in each group. One group practiced alternate nostril yoga breathing for 10 minutes, the second group practiced breath awareness for the same duration and the third group was given a control intervention (i.e., reading a magazine with neutral content). Assessments were taken before and after the interventions for participants of the three groups. Assessments included the blood pressure and performance in the Purdue pegboard task. Data were analyzed with a repeated measures ANOVA and post-hoc analyses were Bonferroni adjusted.

Results

Following alternate nostril breathing (ANYB) there was a significant decrease in systolic and diastolic blood pressure (p<0.001 and p<0.05), and an improvement in Purdue pegboard task scores for both hands (p<0.05), and for the right hand (p<.001). Breath awareness (the control session) also showed a significant decrease in systolic blood pressure (p<0.05). The right hand scores improved in the group reading a magazine (p<0.05).

Conclusions

The results suggest that the immediate effect of ANYB is to reduce the BP while improving the performing in a task requiring attention, bimanual dexterity and visuo-motor co-ordination.

Incidence of maternal GBS colonization and neonatal GBS disease among very low birth weight Polish neonates

Background

In 2008, the Polish Gynecological Society issued recommendations to screen pregnant women for GBS colonization and offer antibiotic prophylaxis at delivery. The goal of this study was to assess compliance with these recommendations among women delivering very low birth weight infants (VLBW) in Poland.

Material/Methods

The 6 Polish Perinatological Institutions managing infections in the framework of the Polish Perinatological Network were subjected to the analysis. A retrospective case-cohort study for 2009 was conducted using the standard protocols and definitions. The collected data pertained to 812 pregnant women who gave birth to 910 babies with VLBW.

Results

The statistical variation across the 6 studied centers associated with GBS prevention of infections was noted. Bacteriological examinations of samples taken from the vagina were performed only in 273 (34%) of the women, ranging between 2% and 93%, depending on the center. GBS carriage was proven in 19% of these women, ranging between 8% and 27%. The culture method was inadequate because of highly variable results. It was found that the rate of GBS determination is statistically connected with the number of women’s screenings performed in the study centers. The intrapartum antibiotic prophylaxis (IAP) was used only in the half of GBS-positive women (47%). Six cases of early-onset GBS infections (5 blood stream infections and 1 pneumonia) were registered in the studied newborns, of which 4 neonates were born to women who received IAP against GBS. The incidence rate of GBS infection in VLBW neonates was 6.6 per 1000 live births, with a high death rate (up to 33%).

Conclusions

Poor compliance with GBS screening and antibiotic prevention were observed among women delivering very low birth weight infants. GBS infection was noted in a significant proportion of VLBW neonates; we believe a uniform policy should be put in place to manage these high-risk women and babies.

The effects of temperature on service employees' customer orientation: an experimental approach

Numerous studies have demonstrated how temperature can affect perceptual, cognitive and psychomotor performance (e.g. Hancock, P.A., Ross, J., and Szalma, J., 2007. A meta-analysis of performance response under thermal stressors. Human Factors: The Journal of the Human Factors and Ergonomics Society, 49 (5), 851-877). We extend this research to interpersonal aspects of performance, namely service employees' and salespeople's customer orientation. We combine ergonomics with recent research on social cognition linking physical with interpersonal warmth/coldness. In Experiment 1, a scenario study in the lab, we demonstrate that student participants in rooms with a low temperature showed more customer-oriented behaviour and gave higher customer discounts than participants in rooms with a high temperature - even in zones of thermal comfort. In Experiment 2, we show the existence of alternative possibilities to evoke positive temperature effects on customer orientation in a sample of 126 service and sales employees using a semantic priming procedure. Overall, our results confirm the existence of temperature effects on customer orientation. Furthermore, important implications for services, retail and other settings of interpersonal interactions are discussed. Practitioner Summary: Temperature effects on performance have emerged as a vital research topic. Owing to services' increasing economic importance, we transferred this research to the construct of customer orientation, focusing on performance in service and retail settings. The demonstrated temperature effects are transferable to services, retail and other settings of interpersonal interactions.