RehabMeasures Instrument
  1. Rehabilitation Measures Database
  2. Rivermead Assessment of Somatosensory Performance

Rivermead Assessment of Somatosensory Performance

Last Updated

Purpose

The RASP is a multi-modal sensory tool that tests 6 sensations (sharp/dull discrimination, surface pressure, tactile localization, temperature discrimination, joint movement and joint movement direction discrimination), and 2 secondary sensations (sensory extinction and two-point discrimination).

Link to Instrument

Instrument Details

Acronym RASP

Area of Assessment

Touch

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$261.07

Cost Description

Purchased in British Pounds from a UK supplier

Populations

Stroke

Key Descriptions

  • Sharp/dull discrimination: each Neurometer (one with sharp; one with dull Neurotip end showing) is applied to the test area in a pseudo-randomized order. A total of 60 trials are administered to 10 test regions. Twenty sham trials are given, two for each area. (The sham consists of the examiner moving the Neurometer to within 6 in of the patients’ skin surface and making the same audible sound with the instrument by applying it to his/her own hand.
  • Surface pressure touch: One Neurometer is set to Level 1 (15.5 g pressure) and is applied to designated testing areas for a total of 60 trials. Twenty sham trials are also included.
  • Surface localization: Using one Neurometer (Level 1; 15.5 g), the subject is requested to identify designated areas on their body where they have been touched.
  • Temperature discrimination: The Neurotemps are prepared prior to testing to ensure that the temperature settings are at the warmest of coolest end of the designated temperature window for each instrument. The patient indicates “warm” or “cold” when touched.
  • Joint movement: Examiner moves the following joints up and down in a random sequence: elbow, wrist, thumb or finger, ankle, toe. Each joint I is moved six times. The examiner first evaluates subject’s appreciation of limb position movement by asking the patient to indicate if a passive movement took place.
  • Joint movement discrimination: Then the patient is asked to indicate “up” or “down.”
  • Bilateral touch discrimination (sensory extinction): Two Neurometers (Setting 2; 67.5 g) are applied simultaneously and then separately to homologous testing areas on the hand or face. The patient is told they may feel either both areas touched together or a touch on the left or a touch on the right. They are requested to indicate what they feel.
  • Two-point discrimination: The Neurodisc is applied to the apds of the fingertips, perpendicular to the skin surface and depressed by approximately 1 mm briefly, before being released. The Neurodisc has three fixed distances of 3, 4,5 mm and a single point.

Number of Items

8

Equipment Required

  • Neurometer
  • Neurotemp
  • Two-point neurodiscriminator

Time to Administer

20-45 minutes

Length depends on client's level of sensory deficit

Required Training

No Training

Age Ranges

Adults

18 - 65

years

Older Adults

65 +

years

Instrument Reviewers

Initial review completed by Jane Sullivan, Co-Chair of the Neurology Section’s StrokEdge Task Force; Updated by Dorian Rose, Co-Chair of the Neurology Section’s StrokEdge II Task Force

Body Part

Upper Extremity
Lower Extremity
Head

ICF Domain

Body Structure
Body Function

Measurement Domain

Sensory

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Stroke Taskforce (StrokEDGE), These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

  

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

NR

NR

NR

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

NR

NR

NR

NR

NR

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

StrokEDGE

No

No

Yes

Yes

Considerations

  • The need for customized equipment and the length of test limit clinical utility

Stroke

back to Populations

Cut-Off Scores

Sub-Actue Stroke: (Winward et al., 2002; suggested impairment cut-off determined from testing n = 50 control participants)

  • Proprioceptive direction discrimination: < 28

  • Sharp/dull discrimination: < 22

  • Surface touch: < 29

  • Surface localization: < 28

  • Two-point discrimination: N/A

  • Temperature discrimination:  < 25

  • Proprioceptive Movement discrimination: < 28

Normative Data

Sub-Actue Stroke: (Winward et al., 2002; data from 50 control participants; mean ± SD (Range) provided)

  • Sharp/dull discrimination:

    • Left Side (26.6 ± 2.6;18-30)

    • Right Side (26.5 ± 2.5; 21-30)

  • Surface touch:

    • Left Side (29.9 ± 0.3;28-30)

    • Right Side (29.9 ± 0.7; 25-30)

  • Surface localization:

    • Left Side (29.9 ± 0.4;18-30)

    • Right Side (29.8 ± 1.1; 22-30)

  • Two-point discrimination:

    • Right Hand

      • 3mm: n = 16

      • 4mm: n = 18

      • 5mm: n = 14

    • Left Hand

      • 3mm: n = 18

      • 4mm: n = 15

      • 5mm: n = 16

  • Temperature discrimination: 

    • Left Side (28.4 ± 1.7;24-30)

    • Right Side (28.6 ± 1.8; 23-30)

  • Proprioceptive Movement discrimination:

    • Left Side (29.9 ± 0.8;24-30)

    • Right Side (30 ± 0.1; 29-30)

  • Proprioceptive direction discrimination:

    • Right Side (29.8 ± 0.9; 24-30)

    • Left Side (29.8 ± 0.9;24-30)

Test/Retest Reliability

Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)

  • Total RASP score:

    • Excellent, Pearson correlation, r = 0.92

  • Sharp/dull subtest:

    • Excellent, Pearson correlation, r = 0.84

  • Surface pressure touch subtest:

    • Excellent, Pearson correlation, r = 0.90

  • Surface localization subtest:

    • Excellent, Pearson correlation, r = 0.96

  • Temperature subtest: 

    • Excellent, Pearson correlation, r = 0.84

  • Proprioceptive movement subtest:

    • Excellent, Pearson correlation, r = 0.83

  • Proprioceptive direction subtest:

    • Adequate, Pearson correlation, r = 0.50

Interrater/Intrarater Reliability

Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)

  • Total RASP score: Pearson correlation, r = 0.92

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Sub-Acute Stroke: (Winward et al., 2002; n = 100; 4-6 weeks post-stroke)

  • Motricity Index and proprioception movement:

    • Adequate, Spearman rs = 0.31; (p < 0.01)

  • Motricity Index and proprioception direction detection:

    • Adequate, Spearman rs = 0.36; (p < 0.01)

  • Barthel Index and proprioception movement:

    • Adequate, Spearman rs = 0.35; (p < 0.01)

  • Barthel Index and proprioception direction detection:

    • Adequate, Spearman rs = 0.41; (p < 0.01)

Construct Validity

Discriminant Validity

 

Sub-Acute Stroke: (Winward et al., 2002)

  • Using a Mann-Whitney test, the RASP discriminated significantly between people with (n = 100; 4-6 weeks post-stroke) and without (n = 50) brain damage (p < 0.001)

Bibliography

Winward CE, Halligan PW, Wade DT. The Rivermead Assessment of Somatosensory Performance (RASP): standardization and reliability data. Clinical Rehabilitation. 2002;16(5):523-33. Find it on PubMed

Winward CE, Halligan PW, Wade DT. Rivermead Assessment of Somatosensory Performance. Suffolk, England: Thames Valley Test Company Limited; 2000.

rehabilitation measures

More Instruments Like This

We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.

updated Jan 14, 2024

Dynamic Lowenstein Occupat...

read more

updated Jan 9, 2024

Performance Assessment of ...

read more

updated Dec 22, 2023

Stroke-Specific Quality of...

read more