Scientific/Clinical ArticlesDevelopment of the Functional Dexterity Test (FDT): Construction, validity, reliability, and normative data☆,☆☆,★
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
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One of the authors has a financial interest in one or more products mentioned in the article.
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Correspondence and reprint requests to Dorit H. Aaron, MA, OTR, CHT, FAOTA, 2723 Amherst, Houston, TX 77005. E-mail: [email protected].