The Erasmus MC modifications to the (revised) Nottingham Sensory Assessment: a reliable somatosensory assessment measure for patients with intracranial disorders

Objective: To investigate the intra-rater and inter-rater reliability of the Erasmus MC modifications to the Nottingham Sensory Assessment (EmNSA). Subjects: A consecutive sample of 18 inpatients, with a mean age of 57.7 years, diagnosed with an intracranial disorder and referred for physiotherapy. Setting: The inpatient neurology and neurosurgery wards of a university hospital. Design: Through discussions between four experienced neurophysiotherapists, the testing procedures of the revised Nottingham Sensory Assessment were further standardized. Subsequently, the intra-rater and inter-rater reliabilities of the EmNSA were investigated. Results: The intra-rater reliability of the tactile sensations, sharp-blunt discrimination and the proprioception items of the EmNSA were generally good to excellent for both raters with a range of weighted kappa coefficients between 0.58 and 1.00. Likewise the inter-rater reliabilities of these items were predominantly good to excellent with a range of weighted kappa coefficients between 0.46 and 1.00. An exception was the two-point discrimination that had a poor to good reliability, with the range for intra-rater reliability of 0.11-0.63 and for inter-rater reliability -0.10-0.66. Conclusion: The EmNSA is a reliable screening tool to evaluate primary somatosensory impairments in neurological and neurosurgical inpatients with intracranial disorders. Further research is necessary to consolidate these results and establish the validity and responsiveness of the Erasmus MC modifications to the NSA.