Functional Index of Hand Osteoarthritis (FIHOA)

Original Editor - Rucha Gadgil

Top Contributors - Rucha Gadgil, Shaimaa Eldib and Kim Jackson  


The FIHOA is a measure to assess hand function in persons with hand osteoarthritis (OA). It is a 10- item questionnaire developed by Dreiser et al in 1995[1][2]. It has been translated in French, Dutch and Argentinian versions. It is targeted towards the functional capacity of hands in OA affected patients[1]. It is also called as Dreiser's index.

Intended Population

The targeted population is Osteoarthritis patients but it can also be used in Rheumatoid arthritis, in patients whose hand functions need to be assessed.

Method of Use

Equipment Required:

None. Questionnaire based.

Time to administer:

5-10 mins.

Training Required:


Method of Administration:

Physician/ physiotherapist administered, self - reported.


It contains 10 question with a score range of 0-30[1].

Sr. no. Question asked Scoring
0 1 2 3
1 Are you able to turn a key in a lock?
2 Are you able to cut meat with a knife?
3 Are you able to cut cloth or paper with a pair of scissors?
4 Are you able to lift a full bottle with the hand?
5 Are you able to clench your fist?
6 Are you able to tie a knot?
7 For women: Are you able to sew? For men: Are you able to use a screwdriver?
8 Are you able to fasten buttons? 9. 10.
9 Are you able to write for a long period of time?
10 Would you accept a handshake without reluctance?

0=possible without difficulty, 1=possible with slight difficulty, 2=possible with important difficulty, 3=impossible.

Total scores indicate hand function. Lower the scores, better the hand function[1].

Psychometric Properties


  1. Interrater: in OA, Cronbach's alpha : 0.90[3][4]. In RA, Cronbach’s alpha test :0.94[5]
  2. Test- Retest: by administering the FIHOA 2 times 1 week apart gave an ICC of 0.74 and 2 times with a 5‐day interval yielded an ICC of 0.96 in OA[3][4]
  3. Intra-rater: by testing patients with OA 2 times 1 hour apart. Correlations between the scores were 0.95[3][4]


For OA, FIHOA correlated with[4]

  1. the Cochin Hand Function Scale (rs = 0.89) and
  2. Michigan Hand Outcomes Questionnaire (rs = 0.86),
  3. total Australian Canadian Osteoarthritis Hand Index (rs = 0.76)

Thus, it was found reliable, valid for OA.

For RA, FIHOA was found to be reliable, valid and reproducible[5].


  1. 1.0 1.1 1.2 1.3 Dreiser R, Maheu E, Guillou GB, Caspard H, Grouin JM. Validation of an algofunctional index for osteoarthritis of the hand. Rev Rhum Engl Ed. 1995; 62: 43S– 53S.
  2. Dreiser RL, Maheu E, Guillou GB. Sensitivity to change of the functional index for hand osteoarthritis. Osteoarthritis Cartilage 2000; 8: S25– 8.
  3. 3.0 3.1 3.2 Poole JL, Lucero SL, Mynatt R. Self‐reports and performance based tests of hand function in persons with osteoarthritis. Phys Occup Ther Geriatr 2010; 28: 249– 58.
  4. 4.0 4.1 4.2 4.3 Moe R, Garratt A, Slatkowsky‐Christensen B, Maheu E, Mowinckel P, Kvien T, et al. Concurrent evaluation of data quality, reliability and validity of the Australian/Canadian Osteoarthritis Hand Index and the Functional Index for Hand Osteoarthritis. Rheumatology (Oxford). 2010; 49: 2327– 36.
  5. 5.0 5.1 Bande JM, Caracciolo JÁ, Papasidero SB, Santa Cruz MJ, Medina MA, Klajn DS, Battaglia MG, Giantinoto J, Pelagagge F. Validation of the Functional Index for Hand Osteoarthritis (FIHOA) in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). Accessed October 24, 2020.