Development of the modified simple test for evaluating hand function (modified STEF): Construct, reliability, validity, and responsiveness

Abstract

Study DesignClinimetric evaluation study. IntroductionDespite the availability of numerous performance tests to measure finger dexterity, there is no international consensus on hand function evaluation. Purpose of the StudyTo evaluate the reliability, validity, and responsiveness of the modified version of the simple test for evaluating hand function (STEF), which is widely used in Japan. MethodsThe intrarater (n = 40) and inter-rater (n = 32) reliability of the modified STEF was evaluated by calculating the intraclass correlation coefficient (ICC), models (1,1) and (2,1), respectively, in healthy individuals. The criterion validity of the modified STEF (n = 50) was evaluated by calculating the Pearson correlation coefficient relative to the STEF, the Purdue pegboard test (PPT), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The standardized response mean of the scores was calculated to determine responsiveness (n = 35). The modified STEF was used prospectively to measure the change in hand function in a cohort of patients with hand trauma injuries and inflammatory diseases (n = 30), as well as in a cohort of patients with cervical spondylosis (n = 20), from preoperative baseline to 1 and 3 months postoperatively. ResultsICC1.1 and ICC2.1 values were ≥0.80, indicative of high intrarater and inter-rater reliability. All correlation coefficients were significant (P < .05): STEF (r = 0.89), PPT (r = 0.69), and DASH (r = −0.34). The standardized response mean indicated greater responsiveness of the modified STEF (0.89) than the STEF (0.71) and PPT (0.68) but a lower responsiveness than the DASH (1.11). DiscussionIt must be mentioned that modified STEF and DASH cannot be compared without caution. The two types of tools should complement each other when measuring someone’s activity and participation level. ConclusionsThe modified STEF is a reliable measurement tool, with a moderate positive correlation with the PPT and a greater responsiveness than the STEF and PPT.