5 Hand Dexterity Assessments for Occupational Therapists

At this point, we’ve all (or at least all of us OT people) heard of the word ‘dexterity’. When we say ‘dexterity’, we’re talking about the fine motor coordination skills required for functional manipulation of objects in a timely manner.

If you have any interest in hand therapy, this is a term that you will become very familiar with.

If you don’t have any interest in hand therapy, this is (still) a term that you will become very familiar with.

Whether it’s your specialty interest or not, hands are and will forever be a key component to occupational therapy.

In honor of you embracing this (and using your theoretical dexterous skills to do so), I’m going to provide you with a list of five hand dexterity assessments that I believe you need to know, as well as a brief description and the cost of each one.

The Purdue Pegboard Test (PPBT)

Created in 1948, the Purdue Pegboard Test is a classic when it comes to dexterity testing. This test is used to measure the cursory movements of a person’s hands and wrists as well as their more fine tuned finger dexterity.

It should be known that there are 2 parts to this test.

Part 1: The Picking Up and Placing

The picking up and placing test simply involves pins and the pegboard. The client uses one hand at a time to pick up as many individual pins as possible and place them into peg holes. They have thirty seconds to show what they can do with their right hand, their left hand, and then both hands.

Part 2: The Assembly

The assembly test requires a client to use both hands to correctly ‘assemble’ a pin- washer-collar-washer combination properly into as many holes as possible (in a thirty second time-frame).

Ages: Children (6+), adults, older adults

Testing Equipment: pins, washers, collars, timer, pegboard.

Time: Quick! < 5 minutes.

Cost: $125-$200

The Box and Block Test (BBT)

The Box and Block Test measures more gross manual dexterity. Basically, a client is seated across from you (the therapist) and moves as many blocks as they can from one side of the ‘box’ to the other. It’s your job to take note of how many blocks are moved in 60 seconds.

Ages: Children (6+), adults, older adults

Testing Equipment: The ‘box,’ the partition dividing the box, 150 cubes, and a stopwatch.

Time Required: Quick! 2-5 minutes.

Cost: Around $200

The Nine-Hole Peg Test (9HPT or NHPT)

The Nine-Hole Peg Test is performed with one hand at a time. The client uses that hand to move all of the pegs individually from the container, to the board, and back. Fine motor dexterity is measured with this test.

Ages: 18+

Testing Equipment: 9 pegs, a pegboard with 9 holes, stopwatch.

Time Required: Quick! 1-3 minutes.

Cost: This one is cheaper because you can actually collect the necessary equipment on your own for around $30.00.

Jebson Taylor Hand Function Test (JHFT):

The Jebson Taylor Hand Function Test is a little different. A one-handed test with a twist, if you will. It measures hand function as related to activities of daily living. There are seven sub-tests to the JHFT, which means that it obviously takes up a little bit more time. The JHFT is arguably a little bit more occupation-based, but will also take up more time and space.

Ages: Children (6+), adults, older adults.

Testing Equipment: This one requires quite a bit of materials. It includes, but is not limited to: paper clips, a coffee can, bottle caps, index cards, a teaspoon, checkers, etc.

Time Required: 15 minutes.

Cost: $300 + 

Functional Dexterity Test (FDT)

The Functional Dexterity Test requires individuals to flip larger pegs over in a specific zig-zag pattern. Participants have 55 seconds to complete this. The test measures more dynamic dexterity and in-hand manipulation skills, since the individual has to flip the pegs in their hands. It also allows healthcare professionals to observe and measure grasping patterns.

Scores gathered are: 1. The total amount of time required to complete the test, and 2. The total amount of time + penalty points

Penalty points are added for dropping a peg, supinating one’s forearm, and touching the board.

Ages: Children (6+), adults, older adults

Testing Equipment: stopwatch, pegboard, pegs,

Time Required: 2-5 minutes

Cost: Around $114

Now You Know!

And now you know the 5 most common dexterity and upper extremity coordination assessments that you can start using in your inpatient or outpatient practice!

Most of these assessments serve similar populations, such as individuals with neuromuscular disorders (including those affected by stroke and TBI), as well as individuals with a hand injury or the onset of a disease such as arthritis. When choosing a test, you might look at what your facility already has, the costs of the assessment, and how long it takes to set up and administer in your setting.

Hopefully this helped you get a better grip and gain some insight regarding these some common hand dexterity assessments.

If we’ve missed your favorite, please share it in the comments below!