Name: design, fabrication, and administration of the hand active sensation test (haste)
Uploaded: 2015-09-08T15:00:00.000+00:00
Duration: 7 min 54 s
Description: Watch this Scientific Journal Video about Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe at JoVE.com

This work was supported in part by OSU&#8217;s CCTS Program through TL1TR001069 award to Dr. Borstad.&#160; We would like to acknowledge Amelia Siles, DPT, NCS for her valuable measurement insights and Sarah Alexander for her assistance with editing the final draft of this manuscript.

1. Design and Fabrication of Visual Screen and HASTe (See &#34;Table of Materials&#34;&#160;for All Required Equipment and Materials):
<ol>
	<li>Assemble Visual Screen (Figure 1):
	<ol>
		<li>Cut four pieces of 0.5-inch PVC pipe (material a) to 10 inches (these form the base of the screen). Cut three pieces of 0.5-inch PVC pipe to 20 inches (these form the upright portion of the screen).</li>
		<li>Insert two pieces of 10-inch pipe into both PVC Tee&#8217;s (parallel openings) (material b). Insert two pieces of 20-inch pipe into each of the remaining holes of the PVC Tee&#8217;s (perpendicular to the 10-inch pieces). Insert PVC elbows (material c) on each of the open ends of the 20-inch pipes.</li>
		<li>Insert each end of the third 20-inch PVC pipe into each of the open PVC elbows. Do not glue PVC joints if easier folding/storage of visual screen is desired. Glue PVC joints for a permanent visual screen, if desired. Drape pillow case (material d) over top pipe. Secure with binder clips (material e) or safety pins.</li>
	</ol>
	</li>
</ol>
<img alt="Figure 1" src="/files/ftp_upload/53178/53178fig1.jpg" /> 
Figure 1: Set-up of the HASTe. Participants should be seated at a table. The visual screen between the participant and the test objects. The objects for one trial are removed from the test kit and offered to the participant in the following order: test object first, then each of the three possible matches, in the order indicated in Appendix 1: Administration Instructions and Score Sheet. <a href="https://jove.unicartagenaproxy.elogim.com/files/ftp_upload/53178/53178fig1large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<ol start="2">
	<li>Assemble HASTe Testing Kit (includes 9 test objects, a duplicate set of 9 sample objects, and 3 example objects) (Figure 2)
	<ol>
		<li>Cut 21 pieces of 1.5-inch diameter PVC pipe (material f) into 4-inch lengths. Cut cork (material g) into 21 strips, each 4 x 7 inches. Overlay each cork over PVC to ensure no overlap at seam or ends of pipe.</li>
		<li>Trim excess cork flush to edge. Coat each of the 21 pieces of pipe (one-by-one) with all purpose cement (material h) and wrap with cork.</li>
		<li>Measure and cut six 4 x 7-inch pieces of self-adhesive laminate (material i) and six 4 x 7-inch pieces of brown paper (material j). Trim excess. Wrap six pieces with self-adhesive laminate.</li>
		<li>Coat six pieces with all purpose cement and wrap with brown paper wrapping. Coat one piece with all purpose cement and wrap with sandpaper (material k). Coat two pieces with all purpose cement and wrap with glossy cardstock (material l).</li>
		<li>Measure and lay out eight pieces of clay (material m), each weighing 2.2 ounces. Measure and lay out six pieces of clay, each weighing 3.2 ounces. Measure and lay out seven pieces of clay, each weighing 4.2 ounces.</li>
		<li>Mold two 2.2-ounce, 3.2-ounce, and 4.2-ounce pieces of clay into a solid block to fill the diameter of the pipe. Insert each into the center of a pipe covered in brown paper wrapping. Repeat step with pipes covered with cork and self-adhesive laminate.</li>
		<li>Mold two 2.2-ounce pieces of clay into a solid block to fill the diameter of the pipe. Insert one into the center of a pipe covered in glossy cardstock and one into the pipe covered in sand paper.</li>
		<li>Mold one 4.2-ounce piece of clay into a solid block to fill the diameter of the pipe. Insert into the center of a pipe covered in glossy cardstock .</li>
		<li>Fill each pipe to capacity with closed-cell packing foam (material n). Weigh components to ensure accuracy of weight to 0.1 ounce.</li>
		<li>Coat each end cap (material o) with all purpose cement and firmly insert into both ends of each pipe.</li>
		<li>Label each object with weight (on the bottom) and number (on the top) as to be visible to the examiner.</li>
		<li>Cover test objects 1T, 2T and 3T with cork, then brown paper, and weigh to 6, 7, and 8 ounces, respectively. Cover test objects 4T, 5T, and 6T only and weigh to 6, 7, and 8 ounces, respectively. Cover test objects 7T, 8T, and 9T with cork, then self-adhesive laminate, and weigh to 6, 7, and 8 ounces, respectively.</li>
		<li>Label sample objects 1-9 (exact duplicates of the test objects).</li>
		<li>Label the three example objects A, B, and C. Cover example objects A and B with glossy card stock (weighing 6 and 8 ounces, respectively). Cover example object C in sand paper (weighing 6 ounces). (Example objects are not shown in Figure 2.)</li>
		<li>Sore and transport all test items in a plastic storage box (material p).</li>
	</ol>
	</li>
</ol>
<img alt="Figure 2" src="/files/ftp_upload/53178/53178fig2.jpg" /> 
Figure 2: Organization of the HASTe Test Objects. The test objects are ordered 1-9 and marked with a &#8216;T&#8217;. The nine sample objects, which participants match to the test objects by weight or texture, are also numbered 1-9 and ordered, as shown.
2. Administration of HASTe:
<ol>
	<li>Seat participants at a standard height table (~29 inch) and chair (~18 inch). Adjust the heights such that the participant can rest and move the test arm comfortably on the table. Place the test arm under a visual screen, as shown in Figure 3, to prevent participant from seeing the test arm, the objects, or the examiner. 
	Note: Test the less impaired upper extremity first, if the participant being tested has a more impaired upper extremity.</li>
	<li>Instruct participant to grasp and lift the example objects to freely determine differences between weight and texture. Provide feedback for the two demonstration trials only.</li>
	<li>Administer two demonstration trials prior to scoring. Have participant compare objects A and B to illustrate differences in weight. Have participant compare objects A and C to illustrate differences in texture.</li>
	<li>Do not offer feedback on the patient&#8217;s performance during trials of the scored test. Do not assist the patient with manual exploration of the objects. Organize test materials for all 18 trials by keeping objects in numerical order. (Figure 2)</li>
	<li>Provide verbal instructions to the participant: &#8220;Use one hand to manually explore the test object first. Then, explore each of the three possible matches, which vary by either weight or texture but never both within one trial.&#160; Find the match. Touch each object as many times as needed to determine the answer. There will be 18 trials. With a maximum of 5 min for each trial.&#8221;</li>
	<li>Repeat test instructions during test administration at the discretion of the examiner or upon request of the participant. Do not inform participant as to which object property (weight or texture) they are matching within a trial.</li>
	<li>Slide objects to and away from the participant&#8217;s hand, per the participant&#8217;s request, if his or her elbow or shoulder movement prevents them from moving between objects (Figure 3).</li>
	<li>Have the participant indicate their choice verbally or by pointing to their choice upon finding the match. Administer the next trial.&#160;Do not have participant describe, in any manner, the object properties or explain why they chose the match that they did.</li>
	<li>Score the test by determining the number of correct matches from a total of 18 trials per hand. Use Appendix 1: Administration Instructions and Score Sheet and the overall organization shown in Figure 2 in order to reduce examiner error.</li>
	<li>Analyze and interpret HASTe scores as a measure of haptic performance with the following considerations. &#160; 
	Note: The intervals between ranks on the HASTe, an ordinal scale, may not be consistent and may not be known. However, like many clinical measures, it may be meaningful and appropriate to apply statistical inference as though the data were interval, as shown in Figure 4.</li>
</ol>

<img alt="Figure 3" src="/files/ftp_upload/53178/53178fig3.jpg" /> 
Figure 3: Offering the HASTe Objects to the Participant. The objects can be placed in the participant&#8217;s hand, but the examiner should avoid assisting the participant with object manipulation.

<ol>
	<li>Nakayama, H., Jgtgensen, H., Stig, K., Raaschou, H. O., Olsen, T. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recovery+of+upper+extremity+function+in+stroke+patients:+the+Copenhagen+Stroke+Study.">Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study.</a> Age (SD). 74, 12 (1994).</li><li>Carey, L. M., Matyas, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Frequency+of+discriminative+sensory+loss+in+the+hand+after+stroke+in+a+rehabilitation+setting.">Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting.</a> Journal of Rehabilitation Medicine. 43, 257-263 (2011).</li><li>Winward, C. E., Halligan, P. W., Wade, D. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory+recovery:+A+longitudinal+study+of+the+first+6+months+after+unilateral+stroke.">Somatosensory recovery: A longitudinal study of the first 6 months after unilateral stroke.</a> Disability &amp; Rehabilitation. 29, 293-299 (2007).</li><li>Sullivan, J. E., Hedman, L. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sensory+Dysfunction+Following+Stroke:+Incidence,+Significance,+Examination,+and+Intervention.">Sensory Dysfunction Following Stroke: Incidence, Significance, Examination, and Intervention.</a> Topics in Stroke Rehabilitation. 15, 200-217 (2008).</li><li>Connell, L. A., Lincoln, N. B., Radford, K. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory+impairment+after+stroke:+frequency+of+different+deficits+and+their+recovery.">Somatosensory impairment after stroke: frequency of different deficits and their recovery.</a> Clinical Rehabilitation. 22, 758 (2008).</li><li>Winward, C. E., Halligan, P. W., Wade, D. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Current+practice+and+clinical+relevance+of+somatosensory+assessment+after+stroke.">Current practice and clinical relevance of somatosensory assessment after stroke.</a> Clinical rehabilitation. 13, 48-55 (1999).</li><li>Torre, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Somatosensory-related+limitations+for+bimanual+coordination+after+stroke.">Somatosensory-related limitations for bimanual coordination after stroke.</a> Neurorehabilitation and neural repair. , (2013).</li><li>Nichols-Larsen, D. S., Clark, P. C., Zeringue, A., Greenspan, A., Blanton, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+influencing+stroke+survivors'+quality+of+life+during+subacute+recovery.">Factors influencing stroke survivors' quality of life during subacute recovery.</a> Stroke. 36, 1480-1484 (2005).</li><li>Borstad, A. L., Nichols-Larsen, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+and+treating+Higher-level+Somatosensory+Impairments+Post+Stroke.">Assessing and treating Higher-level Somatosensory Impairments Post Stroke.</a> Topics in Stroke Rehabilitation. 21, 290-295 (2014).</li><li>Byl, N., Leano, J., Cheney, L. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Byl-Cheney-Boczai+Sensory+Discriminator:+reliability,+validity,+and+responsiveness+for+testing+stereognosis.">The Byl-Cheney-Boczai Sensory Discriminator: reliability, validity, and responsiveness for testing stereognosis.</a> Journal of Hand Therapy. 15, 315-330 (2002).</li><li>Lincoln, N. B., Jackson, J. M., Adams, S. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+and+revision+of+the+Nottingham+Sensory+Assessment+for+stroke+patients.">Reliability and revision of the Nottingham Sensory Assessment for stroke patients.</a> Physiotherapy. 84, 358-365 (1998).</li><li>Carey, L. M., Nankervis, , et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> , (2006).</li><li>Ayres, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Sensory integration and praxis test (SIPT). , (1989).</li><li>Kalisch, T., Tegenthoff, M., Dinse, H. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvement+of+sensorimotor+functions+in+old+age+by+passive+sensory+stimulation.">Improvement of sensorimotor functions in old age by passive sensory stimulation.</a> Clinical Interventions in Aging. 3, 673 (2008).</li><li>Meyer, S., Kattunen, A. H., Thijs, V., Feys, H., Verheyden, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+do+somatosensory+deficits+in+the+arm+and+hand+relate+to+upper+limb+impairment,+activity,+and+participation+problems+after+stroke?+A+systematic+Review.">How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic Review.</a> Physical Therapy. 94, (2014).</li><li>Williams, P. S., Basso, D. M., Case-Smith, J., Nichols-Larsen, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+the+Hand+Active+Sensation+Test:+reliability+and+validity.">Development of the Hand Active Sensation Test: reliability and validity.</a> Arch. Phys. Med. Rehabil. 87, 1471-1477 (2006).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> International Classification of Functioning, Disability and Health (ICF). , (2001).</li><li>McDonnell, M. N., Hillier, S. L., Miles, T. S., Thompson, P. D., Ridding, M. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+combined+afferent+stimulation+and+task-specific+training+following+stroke:+a+pilot+randomized+controlled+trial.">Influence of combined afferent stimulation and task-specific training following stroke: a pilot randomized controlled trial.</a> Neurorehabilitation and neural repair. 21, 435-443 (2007).</li><li>Byl, N. N., Pitsch, E. A., Abrams, G. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+outcomes+can+vary+by+dose:+learning-based+sensorimotor+training+for+patients+stable+poststroke.">Functional outcomes can vary by dose: learning-based sensorimotor training for patients stable poststroke.</a> Neurorehabilitation and neural repair. 22, 494 (2008).</li><li>Carey, L., Macdonell, R., Matyas, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=SENSe:+Study+of+the+Effectiveness+of+Neurorehabilitation+on+Sensation+A+Randomized+Controlled+Trial.">SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation A Randomized Controlled Trial.</a> Neurorehabilitation and neural repair. 25, 304-313 (2011).</li></ol>

The authors declare they have no competing financial interests.

Evidence suggests that similar to motor recovery following stroke, somatosensory recovery requires task specific training. 18,19,20 Therefore, if we aim to improve the hands performance as a haptic receptor, haptic impairments must be identified. 15 The opportunity to quantify haptic ability in the clinic and laboratory has been limited, to some extent, based on the availability of valid and reliable outcome measures. &#160;The large number of stroke survivors with somatosensory impairmen...

Imagine the feel of a loved one&#8217;s hand. It is calloused or smooth? Strong or delicate? Warm or cool? Do you hold it in a handshake or with fingers intertwined? If you have evoked a memory, it is likely grounded in your ability to use movement of your hands to solicit somatosensory information, which is called haptic touch, or active sensation. Characteristics that can be determined with haptic touch include size, shape, weight, texture, surface compliance, and temperature. &#160;Haptic receptors include proprioceptors, which are found in the skin, muscles, tendons, and joints, as well as cutaneous receptors, both of which are activated during manual exploration of objects. Different hand actions aid in the determination of object characteristics. For example, repeatedly performing a lateral rubbing motion across an object may expose texture properties, or lifting the object in the hand may reveal object weight. Therefore, both manual dexterity and somatosensation are vital to haptic performance and the human experience.
Following stroke, both somatosensory and motor impairments contribute to diminished haptic performance. 1 Poststroke motor impairments are common and well defined, with approximately 70% of stroke survivors experiencing some level of paresis. 1 Somatosensory impairments after stroke are also common, occurring in 47-89% 2-4 of individuals. Researchers agree that both cutaneous and proprioceptive impairments are common after stroke. For a thorough characterization of the consequences of stroke on somatosensory domains the reader is referred to the works by of Carey et al., 2 Connell et al., 5 and Sullivan. 4
Somatosensory impairments contribute to diminished rehabilitation outcomes, 6 upper limb coordination, 7 function and quality of life.8 However, quantification of somatosensory impairments, especially active sensation, is lacking in clinical practice in part due to the fact that somatosensory loss is less apparent and more difficult to quantify than motor impairments.9 Measures which have been developed to quantify active sensation include the Byl-Chyney-Boczai Sensory Discriminator (BCB), 10 the stereognosis component of the Revised Nottingham Sensory Assessment, 11 the Functional Tactile Object Recognition Tests (fTORT), 12 &#160;the Manual Form Perception Test (a subset of the Sensory Information and Praxis Test), 13 and the Haptic Object Recognition Test (HORT). 14 Although these measures are available, a recent systematic review, which sought to describe how somatosensory impairments in the arm and hand relate to upper limb problems following stroke, concluded that clinicians and researchers currently lack valid and reliable tests of somatosensation. 15 Therefore, addressing the availability of clinically useful and parametrically sound measures of haptic performance is essential.
The Hand Active Sensation Test (HASTe) is an 18-item match-to-sample test of weight and texture discrimination, originally published by Williams and colleagues in 2006. 16 The HASTe is a measure of haptic touch and is sensitive to haptic impairments in individuals with stroke (indicated by fewer than 13 correct matches). As the HASTe seeks to measure haptic perception, as minimum criteria, individuals need the abilities to grasp and lift with the hand and arm and follow the test instructions. In the International Classification of Functioning, Disability and Health (ICF) model, 17 the HASTe is considered an activity level measurement. The HASTe takes between 15-30 min to administer per hand tested. Advantages of the HASTe include that it is inexpensive, total of material prices for 2015 estimated at $100, and easy to construct and that it&#8217;s 18-point scale provides greater resolution regarding performance than more common dichotomous characterization of &#8220;intact&#8221; or &#8220;impaired&#8221;.
The purpose of this paper is to describe the design, fabrication and administration of the HASTe. While it is possible to infer the test set-up from the original HASTe publication, this paper provides detailed methods for fabricating a visual screen and a HASTe test kit, both to be used during testing. The equipment required for assembly, as well as a detailed list of all required materials is listed in the Table of&#160;Materials. A single sheet with instructions for administering and scoring the HASTe is also provided as the following:
APPENDIX 1: HASTe&#160; Administration Instructions and Score Sheet &#160;&#160;&#160; &#160;&#160;&#160; Participant ID#_______&#160; Date_______
Set Up:&#160; Seat the test participant at a table (table ~29 inches high and chair seat ~18 inches high) with, initially, the dominant or less impaired upper extremity resting on the table and placed under the assembled visual screen. During the test, keep all objects in numerical order to maintain organization.
Demonstration Trials:&#160; Administer two demonstration trials prior to scoring. Provide the participant with objects A and B, and instruct him/her to compare the objects&#8217; weights. Then, provide the participant with objects A and C, and instruct him/her to compare the objects&#8217; textures. Offer feedback only for the demonstration trials.
Scored Trials:&#160; There will be 18 trials scored per extremity, with a maximum of 5 min allowed for each. Instruct the participant to manually explore the specified test object (identified &#8220;test&#8221; in the tables below) with the dominant or less impaired hand, then explore each of the three possible object matches (numbered otherwise within each trial box below) with this same hand. The possible matches will vary by either weight or texture, but never by both within one trial.&#160; Instruct the participant to find the match of the original object and tell him/her they can touch each object as many times as needed to determine an answer.&#160; Do not inform the participant as to which object property (texture or weight) he or she is matching within a trial, and do not assist the participant with manual exploration of the objects. Indicate the participant&#8217;s final answer for each trial in the tables below by circling the number of that object. Test the more impaired upper extremity after the participant completes the test with the less impaired upper extremity. Using the tables below, score the test by determining the number of correct matches from a total of 18 trials per hand (one box per trial below).
Verbal Instructions to Participant: &#8220;Use one hand to manually explore the test object first. Then, explore each of the three possible matches, which vary by either weight or texture but never by both within one trial.&#160; Find the match. You can touch each object as many times as you need to determine your answer. There will be 18 trials. You have a maximum of 5 min for each trial.&#8221;
<img alt="Score card" src="/files/ftp_upload/53178/53178scorecard.jpg" />

<table><tbody><tr><td>Equipment Needed for Assembly</td><td></td><td></td><td></td></tr><tr><td>Tape measure</td><td></td><td></td><td>To measure lengths of materials</td></tr><tr><td>PVC saw</td><td></td><td></td><td>To cut PVC pieces to appropriate lengths given below</td></tr><tr><td>Scissors</td><td></td><td></td><td>To cut paper, cork and laminating material</td></tr><tr><td>Scale accurate to 0.1 ounce</td><td></td><td></td><td>To determine exact weight of test objects</td></tr><tr><td>Sharpie Permanent Marker</td><td></td><td></td><td>To label test item number and weight</td></tr><tr><td>Visual Screen Materials</td><td>Company</td><td>Catalog Number</td><td></td></tr><tr><td>0.5-inch PVC Pipe (Sch. 40 Plain-End Pipe)</td><td>Home Depot</td><td>530048</td><td>104 inches total, will be cut into four 10-inch and three 20-inch pieces</td></tr><tr><td>0.5-inch PVC Tee (Sch. 40 SxSxS Tee)</td><td>Home Depot</td><td>406005RMC</td><td>Two pieces</td></tr><tr><td>PVC Elbow (Lasco 0.5-inch Dia 90 degree PVC Sch 40 Side Outlet Elbow)</td><td>Home Depot</td><td>413005RMC</td><td>Two pieces</td></tr><tr><td>Pillowcase</td><td></td><td></td><td>One to be hung from the PVC frame as a visual shield</td></tr><tr><td>ACCO Binder Clips, Medium</td><td>amazon.com</td><td>72050</td><td>Two to hold the pillowcase to the PVC frame</td></tr><tr><td>Testing Kit Materials</td><td></td><td></td><td></td></tr><tr><td>1.5-inch PVC Sch. 40 DWV Plain End Pipe</td><td>Home Depot</td><td>531111</td><td>85 inches total, will be cut into 21 4-inch pieces</td></tr><tr><td>Quartet Cork Roll, 1/16-inch thick</td><td>amazon.com</td><td>NA</td><td>1 roll, 24x48 inches, will be cut into 42 4x7-inch pieces to cover all test and example items</td></tr><tr><td>Oatey all purpose cement for CPVC and PVC</td><td>Home Depot</td><td>308213</td><td>8 ounce can, to use to adhere cork, paper and end caps to PVC test items</td></tr><tr><td>Avery Self-Adhesive Laminating Roll</td><td>amazon.com</td><td>73610</td><td>One 24x600-inch roll, will be cut into six 4x7-inches pieces to cover cork on six test objects</td></tr><tr><td>Brown Builder&#039;s Paper</td><td>Home Depot</td><td>35140</td><td>One roll, will be cut into six 4x7-inch pieces to cover cork on six test objects</td></tr><tr><td>3M Pro Grade 9 Sandpaper</td><td>Home Depot</td><td>25060P-G</td><td>One piece 4x7 inches, to use to cover one example item</td></tr><tr><td>Ranger Glossy Cardstock</td><td>amazon.com</td><td>NA</td><td>One 8.5x11-inch, 10-Pack, white, will be cut into two 4x7-inch pieces to cover example items</td></tr><tr><td>Marblex-durable self modeling clay in moist form</td><td>amaco.com/shop/</td><td>X-242</td><td>One 5-pound package, used to achieve correct weights of test objects</td></tr><tr><td>Medium density polyethylene packing foam</td><td>amazon.com</td><td>NA</td><td>One foam sheet, 220 poly, charcoal, 2x24x18 inches, to fill the remaining space in test objects after clay has been inserted</td></tr><tr><td>Knock Out Plug for 1.5-inch PVC</td><td>Home Depot</td><td>85000</td><td>42 caps to seal the ends of the 21 test items</td></tr><tr><td>Sterilite 6-quart plastic storage box</td><td>Home Depot</td><td>16428960</td><td>One to store/transport test objects</td></tr></tbody></table>

design, fabrication, and administration of the hand active sensation test (haste)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of outcome measures of upper extremity motor performance has grown. However, clinicians and researchers lack practical, quantitative measures of the hand&#8217;s natural role as a receptor of the environment. The Hand Active Sensation Test (HASTe), developed by Williams and colleagues in 2006, is a valid and reliable measure of haptic performance. Though not available commercially, the HASTe can be fabricated from inexpensive materials, and it has been used successfully to identify impairments in haptic touch in individuals with stroke. (Williams, 2006). This paper presents the methods of design and fabrication of the HASTe testing kit, as well as a visual screen to be used during administration, and instructions for the tests administration and scoring.

Williams and colleagues published the original study, which established the reliability and validity of the HASTe, in 2006. Based on that study, individuals scoring fewer than 13 correct matches on the HASTe are considered to have impaired haptic performance, while those scoring between 13 and 18 are considered to have unimpaired haptic performance. 16 When an individual scores 6 or fewer correct matches, it is considered a chance score, based on the odds in an 18 trial/3 item match to sample design.
<p cl...

Watch this Scientific Journal Video about Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe at JoVE.com

Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe.

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of ...

design-fabrication-administration-hand-active-sensation-test

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

9.0K Views.  The Ohio State University. The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe. 

Video: Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

Haptic/Graphic Rehabilitation: Integrating a Robot into a Virtual Environment Library and Applying it to Stroke Therapy

Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other forms of biofeedback. Previous human-robot interactive systems have required different software commands to be implemented for each robot leading to unnecessary developmental overhead time each time a new system becomes available. For example, when a haptic/graphic virtual reality environment has been coded for one specific robot to provide haptic feedback, that specific robot would not be able to be traded for another robot without recoding the program. However, recent efforts in the open source community have proposed a wrapper class approach that can elicit nearly identical responses regardless of the robot used. The result can lead researchers across the globe to perform similar experiments using shared code. Therefore modular "switching out"of one robot for another would not affect development time. In this paper, we outline the successful creation and implementation of a wrapper class for one robot into the open-source H3DAPI, which integrates the software commands most commonly used by all robots.

Recently, a vast amount of prospects have come available for human-robot interactive systems. In this paper we outline the integration of a new robotic device with open source software that can rapidly make possible a library of interactive functionality. We then outline a clinical application for a neurorehabilitation application.

Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other ...

Bioengineering

Testing Tactile Masking between the Forearms

Masking, in which one stimulus affects the detection of another, is a classic technique that has been used in visual, auditory, and tactile research, usually using stimuli that are close together to reveal local interactions. Masking effects have also been demonstrated in which a tactile stimulus alters the perception of a touch at a distant location. Such effects can provide insight into how components of the body's representations in the brain may be linked. Occasional reports have indicated that touches on one hand or forearm can affect tactile sensitivity at corresponding contralateral locations. To explore the matching of corresponding points across the body, we can measure the spatial tuning and effect of posture on contralateral masking. Careful controls are required to rule out direct effects of the remote stimulus, for example by mechanical transmission, and also attention effects in which thresholds may be altered by the participant's attention being drawn away from the stimulus of interest. The use of this technique is beneficial as a behavioural measure for exploring which parts of the body are functionally connected and whether the two sides of the body interact in a somatotopic representation. This manuscript describes a behavioural protocol that can be used for studying contralateral tactile masking.

Here we explore contralateral tactile masking between the forearms in which tactile detection thresholds are modulated by vibration applied to a remote site. The details of which remote sites have an effect can tell us about how the body is represented in the brain.

Masking, in which one stimulus affects the detection of another, is a classic technique that has been used in visual, auditory, and tactile research, ...

Behavior

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study demonstrates a quantitative sensory testing protocol using techniques to measure tactile sensation and pain threshold for pressure and heat using portable and easily accessed equipment. These techniques and equipment are ideal for new laboratories and clinics where cost is a concern or a limiting factor. We demonstrate measurement techniques for the following: cutaneous mechanical sensitivity on the arms and legs (von-Frey filaments), radiant and contact heat sensitivity (with both threshold and qualitative assessments using the Visual Analog Scale (VAS)), and mechanical pressure sensitivity (algometer, with both threshold and the VAS). The techniques and equipment described and demonstrated here can be easily purchased, stored, and transported by most clinics and research laboratories around the world. A limitation of this approach is a lack of automation or computer control. Thus, these processes can be more labor intensive in terms of personnel training and data recording than the more sophisticated equipment. We provide a set of reliability data for the demonstrated techniques. From our description, a new laboratory should be able to set up and run these tests and to develop their own internal reliability data.

The goal of this procedure is to demonstrate a battery of quantitative techniques for sensory and pain measurement in humans. The equipment and techniques described are commonly found in pain clinics or are easy to obtain.

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study ...

A Tactile Automated Passive-Finger Stimulator (TAPS)

Although tactile spatial acuity tests are used in both neuroscience research and clinical assessment, few automated devices exist for delivering controlled spatially structured stimuli to the skin. Consequently, investigators often apply tactile stimuli manually. Manual stimulus application is time consuming, requires great care and concentration on the part of the investigator, and leaves many stimulus parameters uncontrolled. We describe here a computer-controlled tactile stimulus system, the Tactile Automated Passive-finger Stimulator (TAPS), that applies spatially structured stimuli to the skin, controlling for onset velocity, contact force, and contact duration. TAPS is a versatile, programmable system, capable of efficiently conducting a variety of psychophysical procedures. We describe the components of TAPS, and show how TAPS is used to administer a two-interval forced-choice tactile grating orientation test.
Corresponding Author: Daniel Goldreich

A Tactile Automated Passive-Finger Stimulator TAPS

We describe a computer-controlled device for investigating the sense of touch: the Tactile Automated Passive-finger Stimulator (TAPS). We describe the components of TAPS, and show how TAPS is used to administer a two-interval forced-choice tactile grating orientation test.

Although tactile spatial acuity tests are used in both neuroscience research and clinical assessment, few automated devices exist for delivering ...

Biology

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient&#8217;s home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research.

The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the ...

Tactile Semiautomatic Passive-Finger Angle Stimulator (TSPAS)

Passive tactile perception is the ability to passively and statically perceive stimulus information coming from the skin; for example, the ability to sense spatial information is the strongest in the skin on the hands. This ability is termed tactile spatial acuity, and is measured by the tactile threshold or discrimination threshold. At present, the two-point threshold is extensively used as a measure of tactile spatial acuity, although many studies have indicated that critical deficits exist in two-point discrimination. Therefore, a computer-controlled tactile stimulus system was developed, the tactile semiautomated passive-finger angle stimulator (TSPAS), using the tactile angle discrimination threshold as a new measure for tactile spatial acuity. The TSPAS is a simple, easily operated system that applies raised angle stimuli to a subject&#39;s passive fingerpad, while controlling movement speed, distance, and contact duration. The components of the TSPAS are described in detail as well as the procedure to calculate the tactile angle discrimination threshold.

Tactile Semiautomatic Passive-Finger Angle Stimulator TSPAS

Presented is the tactile semiautomated passive-finger angle stimulator TSPAS, a new way to assess tactile spatial acuity and tactile angle discrimination using a computer-controlled tactile stimulus system that applies raised angle stimuli to a subject&#39;s passive fingerpad, while controlling for movement speed, distance, and contact duration.

Passive tactile perception is the ability to passively and statically perceive stimulus information coming from the skin; for example, the ability to ...

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm

Avoidance behavior is a key contributor to the transition from acute pain to chronic pain disability. Yet, there has been a lack of ecologically valid paradigms to experimentally investigate pain-related avoidance. To fill this gap, we developed a paradigm (the robotic arm-reaching paradigm) to investigate the mechanisms underlying the development of pain-related avoidance behavior. Existing avoidance paradigms (mostly in the context of anxiety research) have often operationalized avoidance as an experimenter-instructed, low-cost response, superimposed on stimuli associated with threat during a Pavlovian fear conditioning procedure. In contrast, the current method offers increased ecological validity in terms of instrumental learning (acquisition) of avoidance, and by adding a cost to the avoidance response. In the paradigm, participants perform arm-reaching movements from a starting point to a target using a robotic arm, and freely choose between three different movement trajectories to do so. The movement trajectories differ in probability of being paired with a painful electrocutaneous stimulus, and in required effort in terms of deviation and resistance. Specifically, the painful stimulus can be (partly) avoided at the cost of performing movements requiring increased effort. Avoidance behavior is operationalized as the maximal deviation from the shortest trajectory on each trial. In addition to explaining how the new paradigm can help understand the acquisition of avoidance, we describe adaptations of the robotic arm-reaching paradigm for (1) examining the spread of avoidance to other stimuli (generalization), (2) modeling clinical treatment in the lab (extinction of avoidance using response prevention), as well as (3) modeling relapse, and return of avoidance following extinction (spontaneous recovery). Given the increased ecological validity, and numerous possibilities for extensions and/or adaptations, the robotic arm-reaching paradigm offers a promising tool to facilitate the investigation of avoidance behavior and to further our understanding of its underlying processes.

Avoidance is central to chronic pain disability, yet adequate paradigms for examining pain-related avoidance are lacking. Therefore, we developed a paradigm that allows investigating how pain-related avoidance behavior is learned (acquisition), spreads to other stimuli (generalization), can be mitigated (extinction), and how it may subsequently re-emerge (spontaneous recovery).

Avoidance behavior is a key contributor to the transition from acute pain to chronic pain disability. Yet, there has been a lack of ecologically valid ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Throughout the last decade, there has been a rapid development of existing test procedures and methods evaluating the human vestibular system. In 2009 and 2013, commercially available video Head Impulse Testing (vHIT) has enabled clinicians to examine the function of all three paired semicircular canals within the vestibular system. The vHIT test has revolutionized vestibular testing and, at many clinics and hospitals around the world, this test is now considered the most important initial test of vertiginous patients. There are several manufacturers of vHIT systems around the world. A test protocol for two of the most widespread vHIT systems, EyeSeeCam and ICS Impulse, will be presented. Included in this protocol is a description of the two different test methods termed 2D vHIT testing and 3D vHIT testing. The vHIT system includes a lightweight goggle with accompanying software. The test is fast (5-10 min) and can be done with minimal discomfort to the person being examined. However, there are many steps of the test, and each of these steps may alter the final test results, if the individual steps of the test are not performed correctly. It is therefore of paramount importance that the examiner is familiar with the potential noise and/or artifact triggers. Systematic training of future examiners before performing vHIT in a clinical setting and compliance with this protocol may minimize these challenges of the test. The vHIT test is not just a &#8220;plug and play&#8221; test. However, if carried out correctly, this test offers excellent objective assessment of the function of the high frequency domain of the vestibular system. It has a very high positive predictive value and offers a specificity very close to one hundred percent.

This protocol describes how to correctly perform the video head impulse test with two separate test systems commonly used worldwide. Both the 2D and 3D video head impulse test methods are described.

Throughout the last decade, there has been a rapid development of existing test procedures and methods evaluating the human vestibular system. In 2009 and ...

Development of a Novel Task-oriented Rehabilitation Program using a Bimanual Exoskeleton Robotic Hand

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor control. However, it is unclear how conventional occupational training strategies can be applied to the use of rehabilitation robots. Novel robotic technologies and occupational therapy concepts are used to develop a protocol that allows patients with impaired upper limb function to grasp objects using their affected hand through a variety of pinching and grasping functions. To conduct this appropriately, we used five types of objects: a peg, a rectangular cube, a cube, a ball, and a cylindrical bar. We also equipped the patients with a robotic hand, the Mirror Hand, an exoskeleton&#160;hand that is fitted to the subject&#8217;s affected hand and follows the movement of the sensor glove fitted to their unaffected hand (bimanual movement training (BMT)). This study had two stages. Three healthy subjects were first recruited to test the feasibility and acceptability of the training program. Three patients with hand dysfunction caused by stroke were then recruited to confirm the feasibility and acceptability of the training program, which was conducted on 3 consecutive days. On each day, the patient was monitored during 5 min of movement in a passive range of motion, 5 min of robot-assisted bimanual movement, and task-oriented training using the five objects. The results showed that both healthy subjects and subjects who had suffered a stroke in conjunction with the robotic hand could successfully grasp the objects. Both healthy subjects and those who had suffered a stroke performed well with the robot-assisted task-oriented training program in terms of feasibility and acceptability.

This study reports the development of a novel robot-assisted task-oriented program for hand rehabilitation. The developmental process consists of experiments using both healthy subjects and subjects who have had a stroke and suffered from subsequent motor control dysfunction.

A robot-assisted hand is used for the rehabilitation of patients with impaired upper limb function, particularly for stroke patients with a loss of motor ...