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. 2024 Apr 21;14(4):407.
doi: 10.3390/brainsci14040407.

Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis

Víctor Navarro-López  1   2 , Roberto Cano-de-la-Cuerda  1   2 , Pilar Fernández-González  1   2 , Selena Marcos-Antón  3 , Aitor Blázquez-Fernández  3 , María Fernández-Cañas  3 , Diego Fernández-Vázquez  1   2
Affiliations

Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis

Víctor Navarro-López et al. Brain Sci. .

Abstract

The finger tapping test (FTT) is a tool to evaluate the motor performance of the hand and fingers and eye-hand coordination with applicability in people with multiple sclerosis (pwMS). The aim of this study was to evaluate the intra- and inter-rater reliability of the TappingPro® mobile app and the construct validity between this app and validated clinical scales for motor performance in healthy subjects and pwMS. 42 healthy subjects (mean age 25.05) and 13 pwMS (mean age 51.69, EDSS between 3 and 7.5E) participated. FTT was performed with the TappingPro® mobile app. All participants were examined twice, with a one-week interval between the two appointments. For the analysis of construct validity, the Jamar® hydraulic hand dynamometer, Box and Blocks Test (BBT), and Nine Hole Peg Test (NHPT) were used. The intra-rater reliability showed a good correlation (Intraclass Correlation Coefficient, ICC > 0.787) for both upper limbs and both times of FTT for healthy subjects, and an excellent correlation (ICC > 0.956) for upper limbs and both times of FTT for pwMS. The ICC for the inter-rater reliability was good (ICC = 0.869) for the non-dominant upper limb in the FTT 10 s of the healthy subjects, and excellent (ICC > 0.904) for all the other measurements of the healthy subjects and pwMS. However, the Bland-Altman plots showed disagreement between observers and measurements that should be considered in the interpretation of clinical evaluations. The correlation analysis for healthy subjects showed poor associations between all variables, except for the association between hand grip strength and the FTT 60 s in the non-dominant upper limb, which had a moderate coefficient. For pwMS, there were moderate to excellent associations between BBT and the NHPT and FTT for both upper limbs. The correlations between hand grip strength and FFT were poor. This mobile app could be a useful and low-cost assessment tool in pwMS, allowing a simple evaluation and follow-up that has excellent correlation with clinical scales validated in this pathology.

Keywords: finger tapping test; mobile applications; multiple sclerosis; neurologic examination; upper extremity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Bland–Altman plots of healthy subjects comparing results between sessions of measurements (for the Finger Tapping Test (FFT)) for the dominant upper limb during 10 (a) and 60 s (b) and for the non-dominant upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
Figure 2
Figure 2
Bland–Altman plots of healthy subjects comparing results between sessions of measurements (for the Finger Tapping Test (FFT)) for the dominant upper limb during 10 (a) and 60 s (b) and for the non-dominant upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
Figure 3
Figure 3
Bland–Altman plots for people with multiple sclerosis comparing results between sessions of measurements for the Finger Tapping Test (FFT) for the less-affected upper limb during 10 (a) and 60 s (b) and for the more-affected upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
Figure 4
Figure 4
Bland–Altman plots of healthy subjects comparing results between raters for the Finger Tapping Test (FFT) for the dominant upper limb during 10 (a) and 60 s (b) and for the non-dominant upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
Figure 5
Figure 5
Bland–Altman plots of people with multiple sclerosis comparing results between sessions of measurements for the Finger Tapping Test (FFT) for the less-affected upper limb during 10 (a) and 60 s (b) and for the more-affected upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
Figure 5
Figure 5
Bland–Altman plots of people with multiple sclerosis comparing results between sessions of measurements for the Finger Tapping Test (FFT) for the less-affected upper limb during 10 (a) and 60 s (b) and for the more-affected upper limb during 10 (c) and 60 s (d). The mean score is plotted on the x-axis, and the difference between observers (mean of the differences) is plotted on the y-axis (mean difference ± 1.96 SD).
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