Reliability of clinical nerve function assessment in peripheral neuropathies

[[[ Introduction: ]]] Sensory and/or motor nerve function impairment as a consequence of neuropathy is often assessed using electroneurophysiological tests. However, in low-resource countries where the required equipment is rarely available, manual muscle strength testing (MMST) and monofilament testing (MFT) offer very reliable alternatives. In six leprosy programmes in four Asian countries, a multi-centre randomised clinical trial (RCT) was carried out to assess the effect of corticosteroids on neuropathy in leprosy-affected people. The sensory and motor nerve function was tested using MMST and MFT, including new test sites for the sural and radial cutaneous nerves (MFT) and the posterior tibial and common peroneal nerves (MMST). The reliability studies of the MMST and MFT tests of the TENLEP (Treatment of Early Neuropathy in LEProsy) trials are presented here. [[[ Methods: ]]] Two assessors in each centre independently used the MFT and MMST in 30 leprosy-affected people. [[[ Results: ]]] Reliability is good to very good for MFT in nearly all nerves. MMST also shows good to very good agreement, with a few exceptions. [[[ Conclusion: ]]] Our study confirms that MMST and MFT can be performed reliably, and that the new tests also have acceptable reliability.