The psychometric properties of the toe tap test in people with stroke

Objectives: To investigate the: (i) inter-rater and test-retest reliability of the toe tap test for people with stroke, (ii) the convergent validity of toe tap test counts with stroke-specific impairments, (iii) minimum detectable change in toe tap test counts, (iv) toe tap test cutoff counts which best discriminating the performance between stroke survivors and healthy controls. Design: Cross-sectional study. Setting: University-based rehabilitation center. Participants: Thirty-seven people with stroke and 35 healthy controls. Main Outcome Measures: The toe tap test was administered along with the Fugl?Meyer lower extremity assessment, muscle strength of ankle dorsiflexors and plantarflexors, five times sit-to-stand test, Berg Balance Scale, limit of stability test, timed up and go test, and Community Integration Measures questionnaire. Results: Excellent inter-rater and test-retest reliabilities (intraclass correlation coefficient?=?0.868?0.995 on the affected side) were found. A minimal detectable change of 8.7 counts and a cutoff score of 21 counts was found on the affected side, while 12.6 counts and 25 counts were found on the unaffected side, respectively. Toe tap test counts on the affected side were significantly associated with Fugl?Meyer lower extremity assessment scores, ankle muscle strength, Berg Balance Scale scores and timed up and go test times. Conclusions: Toe tap test count on the affected side is a simple and reliable tool for assessing ankle control in people with stroke.