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

The overall goal of this procedure is to demonstrate how to fabricate the hand active sensation test or haste. This is accomplished by first gathering all of the necessary materials. The second step is to construct the haste test objects.

Next, assemble a visual screen which is used during testing. The final step is learning to administer the test using the standardized procedure provided. Ultimately, using the haste enables measurement of haptic performance in individuals with and without nervous system pathology.

So we became interested in sensory deficits post-stroke, and we were looking for a test that required little verbal capability and but also looked at haptics, the ability of the hand to sense objects. The main advantage of the hand active sensation test is that the simple design of the test objects and the 18 item matched to sample design of the paradigm results in a decreased likelihood that language or cognitive impairments would confound the results. It also reduces the likelihood that familiarity with the test objects would affect the results.

The implications of this test extend toward measurement of mild and moderate somatosensory impairment because unlike severe somatosensory loss, mild and moderate deficits are frequently under recognized by clinicians. Begin by cutting 21 4 inch pieces of 1.5 inch diameter PVC pipe. Cut a roll of cork into 21 4 by seven inch strips, overlay each cork piece over a four inch PVC piece to ensure there is no overlap at the seam or ends of the pipe.

Trimm any excess cork so that it is flushed to the edge of the pipe. Then coat each of the 21 pieces of pipe one by one with all purpose cement and wrap each pipe with a piece of cork. Next measure and cut six four by seven inch pieces of self adhesive laminate.

Wrap six of the 21 pieces of pipe with the self adhesive laminate trim any excess. Now measure and cut six four by seven inch pieces of brown paper from the 15 remaining core wrapped pipes. Coat six with all purpose cement and wrap each with a piece of brown paper.

Then from the final nine pieces of cork wrapped pipe coat three with all-purpose cement. Wrap one with sandpaper and wrap the other two with glossy card stock. Next, measure out 21 pieces of clay.

Wear eight pieces. Weigh 2.2 ounces. Six pieces weigh 3.2 ounces and seven pieces.

Weigh 4.2 ounces. Mold each piece of clay into a solid block so that it can fill the diameter of the pipe. Take two pipes wrapped in cork, two wrapped in brown paper, two wrapped in self adhesive laminate, one wrapped in glossy card stock and one wrapped in sandpaper.

Insert one 2.2 ounce piece of clay into each of these pipes. Then take two pipes wrapped in cork, two wrapped in brown paper and two wrapped in self adhesive laminate, and insert one 3.2 ounce piece of clay into each pipe. Finally, take two pipes wrapped in cork, two wrapped in brown paper, two wrapped in self-adhesive laminate, and one wrapped in cardstock.

Insert a 4.2 ounce piece of clay in each pipe. Fill each pipe to capacity with 0.1 ounces of closed cell packing foam coat each end cap with all purpose cement and firmly insert one cap into both ends of each pipe. Set aside the two pipes wrapped in card stock and one wrapped in sandpaper.

As example objects designate the remaining 18 pipes into two groups, either test or sample where the sample group has the exact duplicate set of pipes in wrapping and weight. As the test group pipes one through three in each group will be covered in brown paper and weigh six, seven, and eight ounces respectively. Pipes four through six in each group will only be wrapped in cork and weigh six, seven, and eight ounces respectively.

Lastly, pipes seven through nine will be covered in self adhesive laminate and weigh six, seven, and eight ounces. Label the tops of each pipe in the test group one T through nine T and label the tops of each identical pipe in the sample group one through nine. Finally, label the bottom of each pipe with its weight, either six, seven, or eight ounces is instruct the participant to grasp and lift the example objects to freely determine differences between weight and texture.

Then administer two demonstration trials prior to scoring and provide feedback. Instruct the participant to compare objects A and B to illustrate weight differences and to compare objects A and C.To illustrate differences in texture, place the participant's test arm under the visual screen to prevent them from seeing the test arm objects or the examiner during the scored test. Organize materials for all 18 trials in numerical order.

Do not offer any feedback or assist the patient with manual exploration of the objects. Instruct the participant that they will first use one hand to manually explore the test object. Then they must explore each of the three possible matches, which vary by either weight or texture and find the match.

They may touch each object as many times as needed. Repeat test instructions at the discretion of the examiner or upon request of the participant. Do not inform the participant as to which object property they are matching within the trial.

Let them know they don't need to explain their choice. Slide objects two and away from the participant's hand if their elbow or shoulder movement prevents them from the moving between objects. After each trial, have the participant indicate their choice verbally by pointing to their choice behind the visual screen or by indicating the number of the correct match.

Finally, score the test by determining the number of correct matches from a total of 18 trials. The hand active sensation test is a measure of haptic touch and is sensitive to haptic impairments in individuals with stroke. Here the number of correct matches for the paric hand or the matched control hand showed a positive correlation with the other non retic or matched control hands.

Furthermore, there was no relationship between age and non retic haste performance for the control or stroke participants Once mastered this test can be administered in 15 to 30 minutes while administering the hand act of sensation test. It's important not to provide feedback to the participant until after the testing has been completed. I would imagine that it applies to anyone that has a sensory discrimination disorder.

We've used it in children with cerebral palsy. I'm guessing that traumatic brain injury or other disorders that impair hand function and sensation in the hand would be appropriate.