Measurement properties of the MacHANd Performance Assessment: A pilot study

Performance-based outcome measures of dexterity and hand function in person with hands and wrist injuries: A scoping review of measured constructs

BACKGROUND

Dexterity impairments are common and disabling. Currently, there is no consensus on an operational definition to measure dexterity.

PURPOSE

This review aims to provide an overview of constructs measured by performance-based outcome measures of dexterity and hand function (PBOMD) validated for use in persons with musculoskeletal hand and wrist conditions.

STUDY DESIGN

Scoping review, with qualitative content analysis.

METHODS

MEDLINE, Embase, CINAHL, PsycINFO were searched from inception until November 2019. Three reviewers identified studies investigating the psychometric properties of PBOMD in persons with hand and wrist conditions. Original articles and manuals of validated PBOMD were obtained. Reviewers independently extracted and performed a content analysis of constructs comparing the theoretical concepts of dexterity and function.

RESULTS

Twenty PBOMD were identified. PBOMD featured 1-57 tasks and 1-8 potential grasps patterns per tool. Description of the constructs measured indicated overlap between dexterity and hand function. In newer tools, there was a greater representation of daily activities to include domains like self-care and domestic life; and measurement of qualitative aspects of performance. Concurrently, there was less focus on mobility. The majority of identified tools (70%) used speed as the criterion evaluation of performance. None of the PBOMD evaluated dexterity associated with leisure activities or modern technologies like smartphones, nor measured the ability to adapt to changing demands when completing tasks.

CONCLUSIONS

Hand function and dexterity are imprecisely defined and operationalized in PBOMD. Dexterity is a complex construct that current PBOMD incompletely captures. PBOMD often quantified as the speed of movement, ignoring other important aspects like accommodating environmental changes during task performance. Clinicians should consider tasks included in PBOMD, the quantification method, and each PBOMD's limitations when choosing PBOMD.

Comparative study of millennials' (age 20-34 years) grip and lateral pinch with the norms

STUDY DESIGN

Cross-sectional research design.

INTRODUCTION

Clinical practice continues to use normative data for grip and pinch measurements that were established in 1985. There is no updated norms despite different hand usage patterns in today's society.

PURPOSE OF THE STUDY

Measuring and comparing grip and pinch strengths with normative data is a valid method to determine hand function. This research was implemented to compare the grip and pinch measurements obtained from healthy millennials to the established norms and to describe hand usage patterns for millennials.

METHODS

Grip and lateral pinch measurements were obtained from a sample of 237 healthy millennials (ages 20-34 years).

RESULTS

Strength scores were statistically lower that older normative data in all millennial grip strengths, with the exception of the women in the age group of 30-34 years. Specifically, this statistically significant trend was observed in all male grip strengths, as well as in women in the age group of 20-24 years (bilateral grip) and 25-29 years (right grip). However, the lateral pinch data reflected was similar to the older norms with variances of 0.5-1 kg.

CONCLUSION

Current data reflect statistically significant differences from the norms for all male grip measurements, as well as for women in the age group of 20-24 years (bilateral grip) and 25-29 years (right grip). No statistical significance was observed in the independent-sample t tests for the lateral pinch in men of all age groups. Statistical significance was noted for lateral pinch for female age groups for the left hand (20-24 years) and for bilateral lateral pinches (30-34 years).

LEVEL OF EVIDENCE

IV.