Elsevier

Journal of Hand Therapy

Volume 16, Issue 1, January–March 2003, Pages 12-21
Journal of Hand Therapy

Scientific/Clinical Articles
Development of the Functional Dexterity Test (FDT): Construction, validity, reliability, and normative data,☆☆,

The original test was presented at the 1983 annual meeting of the American Society of Hand Therapists in the scientific session. A summary of reliability and validity studies was presented in a poster at the 1992 annual meeting of the American Society of Hand Therapists.
https://doi.org/10.1016/S0894-1130(03)80019-4Get rights and content

Abstract

Dexterity tests take time to administer; however, the information obtained is an important component of a comprehensive examination of the hand. This article introduces a dexterity test suitable for use as part of routine examination of the hand. The Functional Dexterity Test (FDT) was developed as a measure of dexterity that takes a minimum amount of time to administer, yet provides information regarding the patient's ability to use the hand for daily tasks requiring a 3-jaw chuck prehension between the fingers and the thumb. The test was developed over 20 years. Interrater and intrarater reliability ranges between good and excellent. Construct validity was confirmed in 2 clinical studies. Preliminary normative data were obtained in 6 samples of convenience. Along with statistical data, this article provides equipment standards and instructions. J HAND THER. 2003;16:12-21.

Section snippets

Review of the literature

Hand therapists and physicians, such as Bunnell and Kanavel,3 have been concerned with hand function since the early 1900s. Many measures have been developed and published to describe the quality of hand function and to quantify performance of the hand. Function is defined as doing; function can describe performance such as functional strength, functional range of motion, and functional skill.4 Hinojosa and Kramer5 define function as the ability to do something that involves an action or a

Purpose of the functional dexterity test

The purpose of the FDT is to provide the clinician with an assessment tool that requires a minimum amount of time to administer and that gives information regarding the patient's ability to use the hand for functional tasks requiring a dynamic 3-jaw chuck prehension pattern.

Equipment construction standards

The FDT is made of a square wooden pegboard and 16 pegs. The dimensions of the board are 20.6 cm × 20.6 cm, and 3.7 cm deep. Each of the peg holes measures 3 cm in depth and 2.5 cm in diameter. Holes are separated from each

Scoring

Using a stopwatch, the examiner records the time, in seconds, that it takes for the patient to turn over all the pegs on the board with one hand. A 5-second penalty is added each time if the patient supinates or touches the board for assistance. If a patient drops a peg, time is stopped, and a 10-second penalty is added. The patient retrieves the peg and puts it in the pegboard in the unturned position. The patient is instructed to continue to turn the pegs with the peg that he or she just put

Reliability estimates

Reliability is defined as the extent to which a measurement is consistent and free from error.23 First, reliability estimates were obtained by Stegink Jansen24 involving 30 hand-injured patients. The purpose of the study was to investigate the effects of instruction by different instructors, scoring by different raters, and repeated scoring by the same rater. A mixed study design23 was used with one between-subjects factor and two repeated, within-subjects factors. The between-subjects factor,

Validity of the test

Validity is the extent to which an instrument measures what it is intended to measure. Portney and Watkins23 stated that validity emphasizes the objectives of a test and the ability to derive proper inferences from the measurements.

Aaron17 investigated the validity of the FDT to determine if a relationship exists between scores on the FDT and activities of daily living that require the use of a 3-jaw chuck prehension pattern. The dexterity of 46 hand-injured patients was tested. The patients

Normative data

Normative data have been collected in various studies grouping subjects by age, hand dominance, and occupation.29, 30, 31, 32, 33 Table 5 summarizes the normative data obtained in these studies.

French29 investigated the influence of age and hand dominance on the FDT test scores using 67 female college students without upper extremity injuries. There were 37 students who ranged in age from 20 to 29 and 30 students who ranged in age from 30 to 39. French used the total time without penalties

Discussion

The FDT was developed to supply the clinician with a dexterity test to be used in a busy clinic. The FDT requires a minimum amount of time for administration (about 15 seconds to 2 minutes) and provides information regarding the patient's ability to use the hand for functional daily tasks that require 3-jaw-chuck prehension between the fingers and the thumb. The “time only” score quantifies the speed of the hand dexterity; the “time plus penalty” score quantifies the quality of the performance.

Conclusion

The FDT is a reliable measurement tool that can be used realistically in a busy clinical practice treating hand-injured patients. It is small in size, easy to make, and quick to administer. The FDT evaluates only a small part of the overall hand function, dexterity, as it relates to the capability of subjects to perform activities of daily living that require 3-jaw chuck prehension. The measure should be used in conjunction with other appropriate tests for a complete evaluation of a subject's

Acknowledgements

The authors thank the research advisors at Texas Woman's University, as well as Barbara Withrop Rose, OTR, CHT, CVE, FAOTA, for their guidance and support of this project.

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    University of Texas Medical Branch, School of Allied Health Sciences, Department of Physical Therapy, Galveston, Texas

    ☆☆

    One of the authors has a financial interest in one or more products mentioned in the article.

    Correspondence and reprint requests to Dorit H. Aaron, MA, OTR, CHT, FAOTA, 2723 Amherst, Houston, TX 77005. E-mail: [email protected].

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