Clinical evaluation of the refined clothespin relocation test: a pilot study

Background - The Refined Clothespin Relocation Test (RCRT) is a test used to evaluate the performance of a prosthesis user by analyzing the compensatory motions and time to complete a grasping and placement exercise. The test has been studied previously with a motion capture laboratory and has now been adapted for a clinical setting. A comparison of prosthesis user to an able-bodied group is needed to determine efficacy as an assessment tool.

Objectives - To modify the previous RCRT and assess whether it can distinguish between able-bodied and prosthesis users.

Study Design - Comparative analysis.

Methods - 42 able-bodied subjects and 3 prosthesis users completed the adapted RCRT protocol. Average RCRT scores describing the degree of compensatory movements and the time to complete the protocol were compared using a Mann-Whitney U-test. 

Results - A significant difference was found in the RCRT score between the able-bodied (Md = 65.32, n = 42) and prosthesis users (Md = 23.07, n = 3) with a medium effect size (p<0.001, r = 0.43). 

Conclusion - Prosthesis users demonstrated larger compensations and longer completion times, as reflected in the RCRT final score. The RCRT has the potential to be a useful clinical tool to assess user performance on a functional task.

Clinical relevance - This preliminary study demonstrates that the adapted protocol can distinguish between the two groups based on refined clothespin relocation test score. A future multi-centre study is required using multiple raters and comparing it with the existing outcome measures to validate the refined clothespin relocation test and determine inter-rater reliability.