Sollerman Hand Function Test

Purpose

Sollerman Hand function test is used in the assessment of hand functions. It shows the ability and quality of the hand while performing activities of daily living. The test is highly significant in hand surgery for the assessment of treatments.

Description

Hand grip.jpg

Sollerman Hand function test was developed on the notion that the prehensile movements of the human hand can be expressed as variations of basic hand grips.[1]

The eight main hand grips in activities of daily living(ADL) into which a normal grip pattern can be divided.

Hand Grips Position Percentage use in ADL(%)
Pulp pinch The object is held between the thumb and the index or the middle finger, or both 20
Lateral pinch The object is held between the thumb and the radial side of the index finger 20
Tripod pinch The object is surrounded by the thumb, index and middle finger. It may have contact with the web of the thumb 10
Five-finger pinch The object is held between the thumb and the four fingers together. It has no contact with the palm 15
Diagonal volar grip The object is held with the thumb against the four fingers. It has contact with the palm and its axis is diagonal to that of the hand 15
Transverse volar grip The object is held with the thumb against the four fingers. It has contact with the palm and its axis is transverse to that of the hand 14
Spherical volar grip The object is surrounded by the thumb and the four fingers and has contact with the palm 4
Extension grip The object is held between the thumb and the four fingers, which are extended in the interphalangeal joints. It has no contact with the palm 2

[1]

Sollerman Hand function test includes 20 subtests, each involving an ADL task. The 20 subtests of the Sollerman hand function test and the prescribed hand grips include:

Subtest Hand Grips
Put key into Yale lock, turn 90 degrees Pulp pinch, lateral pinch
Pick up coins from flat surface, put into purse mounted on wall Pulp pinch
Open/close purse Pulp pinch, lateral pinch
Pick up coins from purses Pulp pinch
Lift wooden cubes over edge (5 cm in height) Five-finger pinch
Lift iron over edge (5 cm in height) Transverse volar grip
Turn screw with screwdriver Diagonal volar grip
Pick up nuts and put on bolts Pulp pinch, lateral pinch, tripod pinch
Unscrew lid of jars Spherical volar grip
Do up buttons Pulp pinch, lateral pinch
Cut modeling clay with knife and fork Tripod pinch, diagonal volar grip
Put tubigrip stocking on the other hand Lateral pinch, five-finger pinch
Write with a pen Tripod pinch
Fold paper, put into envelope Five-finger pinch, lateral pinch
Put paper clip on envelope Pulp pinch, lateral pinch
Pick up telephone receiver and put it to the ear Diagonal volar grip
Turn door handle 30 degrees Transverse volar grip
Pour water from 1-L paper milk package Five-finger pinch
Pour water from the jug Transverse volar grip
Pour water from the cup Pulp pinch, lateral pinch

[2]

The performance of each subtest is scored on a scale of 0 to 4 points and maximum points to be scored for all 20 tasks is 80points. The scoring system takes notes of the time taken to carry out tasks, the level of difficulty and the quality of hand performance. Patients with normal hand function would achieve 80 points with the dominant hand and 77-79 points with the non-dominant hand. The points are graded as follows:

Score Performance
0 The patient could not carry out the task
1 The task was partially performed within 60 seconds
2 The task was completed, but with great difficulty, or the task was not carried out with the prescribed hand-grip, or the task was not completed within 40 seconds but within 60 seconds
3 The task was completed, but with slight difficulty, or the task was carried out with the prescribed hand-grip but with slight divergence from normal, or the task was not completed within 20 seconds but within 40 seconds
4 The task was carried out without any difficulty within 20 seconds and with the prescribed hand-grip of normal quality

[1]

Technique

[3]

The patient is seated comfortably with the test equipment placed on the table. The tasks are to be carried out in this position unless when standing is required for the task. Each subtest is timed with a keen observation on the hand function. Most subtests require the task to be carried out separately by each hand while some require both hands to be used.

Evidence

Sollerman hand function test is easy to perform and reliable. It has been used in the assessment of hand functions in post-surgical patients with tetraplegic conditions[1], chronic stroke[4], after replantation or revascularisation of upper extremity injuries[5], Dupuytren's contracture[6] and in patients undergoing long term haemodialysis[7].

Validity

High with the international classification for surgery of hand in tetraplegia (Pearson's r=0.88) and the motor capacities scale(Spearman's r=0.959)[1]

Reliability

For chronic stroke:[4]

High test-retest reliability (ICC=0.96-0.98)

High Interrater reliability (ICC=0.96-0.98)

High Intrarater reliability (ICC=0.96-0.99)

For chronic Burns:[2]

High Interrater reliability (ICC=0.98)

High Intrarater reliability (ICC=0.98)

Related Test

  1. Jebsen-Taylor Hand Function Test

References

  1. 1.0 1.1 1.2 1.3 1.4 Sollerman C, Ejeskär A. Sollerman hand function test: a standardised method and its use in tetraplegic patients. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. 1995 Jan 1;29(2):167-76.
  2. 2.0 2.1 Weng LY, Hsieh CL, Tung KY, Wang TJ, Ou YC, Chen LR, Ban SL, Chen WW, Liu CF. Excellent reliability of the Sollerman hand function test for patients with burned hands. Journal of burn care & research. 2010 Nov 1;31(6):904-10.
  3. Katie Smith. Sollerman Hand Function Test (SHFT). Available from https://www.youtube.com/watch?v=WywEIm-AqV0&t=91s [last accessed 7/10/2020]
  4. 4.0 4.1 Brogårdh C, Persson AL, Sjölund BH. Intra-and inter-rater reliability of the Sollerman hand function test in patients with chronic stroke. Disability and rehabilitation. 2007 Jan 1;29(2):145-54.
  5. Blomgren I, Blomqvist G, Ejeskar A, Fogdestam I, Volkman R, Edshage S. Hand function after replantation or revascularization of upper extremity injuries: a follow-up study of 21 cases operated on 1979–1985 in Göteborg. Scandinavian Journal of Plastic and Reconstructive Surgery. 1988 Jan 1;22(1):93-101.
  6. Draviaraj KP, Chakrabarti I. Functional outcome after surgery for Dupuytren’s contracture: a prospective study. The Journal of hand surgery. 2004 Sep 1;29(5):804-8.
  7. Tander B, Akpolat T, Durmus D, Canturk F. Evaluation of hand functions in hemodialysis patients. Renal failure. 2007 Jan 1;29(4):477-80.