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The Hand Accumulation aNd Dexterity FUnctional Limits-Shriners (HANDFULS): A New Clinically Feasible Measure of Hand
Ingrid Parry1, Machelle Wilson2, Ana Starcevich3
1Ingrid Parry, MS, PT, BT-C, is PhD Candidate and Physical Therapist, Shriners Hospitals for Children, Sacramento, CA; ingridparry@gmail.com.
Importance:
Having a problem-specific hand function test that can be administered easily with children is important for consistency in measuring and monitoring outcomes.
Objective:
To introduce basic testing procedures for Hand Accumulation aNd Dexterity FUnctional Limits-Shriner (HANDFULS), a clinically feasible hand outcome measure for two common hand problems, in-hand manipulation and palmar workspace volume; examine its face validity and test-retest reliability; and provide reference values for children and adolescents with typically developed, noninjured hands as a foundation for further study.
Design:
Prospective cohort study.
Setting:
Pediatric hospital and surrounding community.
Participants:
Children and adolescents, ages 2 to 20 yr, with typically developed, noninjured hands.
Intervention:
A newly developed hand function test called HANDFULS.
Outcomes:
HANDFULS measured palmar workspace volume, represented by the number of marbles children and adolescents could comfortably fit in their hand, and in-hand manipulation, represented by seconds per marble needed to collect the marbles in the hand.
Results:
Results for the primary outcomes palmar workspace volume and the HANDFULS scores were reported by age group. For every year increase in age, HANDFULS score decreased by 0.02 s per marble (p < .001). The test showed moderately high test-retest reliability (intraclass correlation coefficient = .84) and was typically administered in less than 5 min with supplies costing about $30.
Conclusions And Relevance:
This study proposes a hand outcome measure that addresses a gap in the literature and clinical practice in the measurement of hand function. Plain-Language Summary: The Hand Accumulation aNd Dexterity FUnctional Limits-Shriners (HANDFULS) offers a new, clinically feasible outcome tool for measuring in-hand manipulation (the number of seconds per marble a child or adolescent needs to collect marbles in one hand). HANDFULS simultaneously considers palmar workspace volume (the number of marbles a child or adolescent can comfortably fit in one hand) as a foundation for future testing with various patient populations to provide meaningful and relevant information about hand function.
