The Hand Accumulation aNd Dexterity FUnctional Limits-Shriners (HANDFULS): A New Clinically Feasible Measure of Hand Volume and In-Hand Manipulation for Children.

Abstract

Having a problem-specific hand function test that can be administered easily with children is important for consistency in measuring and monitoring outcomes. To introduce basic testing procedures for Hand Accumulation aNd Dexterity FUnctional Limits-Shriner (HANDFULS), a clinically feasible hand outcome measure for two common hand problems, in-hand manipulation and palmar workspace volume; examine its face validity and test-retest reliability; and provide reference values for children and adolescents with typically developed, noninjured hands as a foundation for further study. Prospective cohort study. Pediatric hospital and surrounding community. Children and adolescents, ages 2 to 20 yr, with typically developed, noninjured hands. A newly developed hand function test called HANDFULS. HANDFULS measured palmar workspace volume, represented by the number of marbles children and adolescents could comfortably fit in their hand, and in-hand manipulation, represented by seconds per marble needed to collect the marbles in the hand. Results for the primary outcomes palmar workspace volume and the HANDFULS scores were reported by age group. For every year increase in age, HANDFULS score decreased by 0.02 s per marble (p < .001). The test showed moderately high test-retest reliability (intraclass correlation coefficient = .84) and was typically administered in less than 5 min with supplies costing about $30. This study proposes a hand outcome measure that addresses a gap in the literature and clinical practice in the measurement of hand function. Plain-Language Summary: The Hand Accumulation aNd Dexterity FUnctional Limits-Shriners (HANDFULS) offers a new, clinically feasible outcome tool for measuring in-hand manipulation (the number of seconds per marble a child or adolescent needs to collect marbles in one hand). HANDFULS simultaneously considers palmar workspace volume (the number of marbles a child or adolescent can comfortably fit in one hand) as a foundation for future testing with various patient populations to provide meaningful and relevant information about hand function.