Test-retest reliability of the two-point discrimination test on the sole of the foot in people with multiple sclerosis

Background: Two-point discrimination (TPD) is an assessment of tactile acuity. People with multiple sclerosis (MS) can have reduced foot sole tactile acuity, which has been linked to impaired balance. Objective: To quantify the test-retest reliability of TPD on the sole of the foot in people with MS. Approach: 41 participants (32 females), with mean (SD) age of 60 (9) years, and Expanded Disability Status Scale of <7.5, had their TPD measured at the head of the first metatarsal and the heel on two occasions, 2-14 d apart. Mean systematic change, within-subjects SD, limits of agreement (LOA), coefficient of variation and the intraclass correlation coefficient (ICC) were quantified as point estimates (95% CI). Main results: Systematic learning effects were evident. The within-subjects SD at the metatarsal and the heel was 6.7 mm (5.5-8.6) and 8.3 mm (6.7-10.8), and the LOAs were 18.6 mm (15.2-24.) and 23.7 mm (18.7-30.1), respectively. ICCs for metatarsal and heel was 0.87 (0.76-0.93) and 0.90 (0.80-0.95), respectively, but these were likely inflated by sample heterogeneity. Significance: In people with MS, TPD on the sole of the foot has an adequate test-retest reliability for research purposes, but there is substantial measurement variability for individual patients.