Establishing a standardized clinical assessment tool of pathologic and prosthetic hand function: Normative data, reliability, and validity

Objective: To develop a new assessment procedure, the Southampton Hand Assessment Procedure (SHAP), that allows contextual results of hand function to be obtained readily in a clinical environment. Design: Reliability (test-retest, interrater) and validity (criterion, content) of new assessment procedure against standard medical outcome measure techniques. Setting: Normative data collected in a university laboratory. Participants: Twenty-four volunteers selected on the basis of optimum hand function using these criteria: age (range, 18-25y), and no adverse hand trauma. neurologic condition. or disabling effects of the upper limb. Interventions: Not applicable. Main Outcome Measures: The normative control group was assessed for variability, and the procedure measured in terms of interrater and test-retest reliability. The absence of a direct comparison prevents a criterion standard from being established; however, content validity was shown by expert peer review. Results: The control group data were shown to be multivariate gaussian; test-retest and interrater reliability were demonstrated at the 95% confidence level. The content validity was demonstrated by peer panel approval. Conclusions: Results of the control group established the statistical integrity of SHAP. Clinical trials are under-way, although more extensive use of the procedure is advocated in primary care and rehabilitation centers where physiotherapy and occupational therapy are actively used in hand rehabilitation.