Nine-Hole Peg Test: Difference between revisions
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'''Original Editor '''- | <div class="editorbox"> | ||
'''Original Editor '''- [[User:Sinead Greenan|Sinead Greenan]] | |||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
</div> | </div> | ||
== Objective<br> == | == Objective<br> == | ||
The '''Nine-Hole Peg Test''' (9HPT) is used to measure finger dexterity in patients with various neurological diagnoses. | The '''Nine-Hole Peg Test''' (9HPT) is used to measure finger dexterity in patients with various neurological diagnoses. | ||
== Intended Population<br> == | == Intended Population<br> == | ||
Patients with Stroke, Brain Injury, Parkinson's Disease | Patients with Stroke, Brain Injury, Parkinson's Disease | ||
== Method of Use == | == Method of Use == | ||
<u>Description:</u> | <u>Description:</u> | ||
*Administered by asking the client to take the pegs from a container, one by one, and place them into the holes on the board, as quickly as possible | *Administered by asking the client to take the pegs from a container, one by one, and place them into the holes on the board, as quickly as possible | ||
*Participants must then remove the pegs from the holes, one by one, and replace them back into the container | *Participants must then remove the pegs from the holes, one by one, and replace them back into the container | ||
*The board should be placed at the client's midline, with the container holding the pegs oriented towards the hand being tested | *The board should be placed at the client's midline, with the container holding the pegs oriented towards the hand being tested | ||
*Only the hand being evaluated should perform the test | *Only the hand being evaluated should perform the test | ||
*Hand not being evaluated is permitted to hold the edge of the board in order to provide stability | *Hand not being evaluated is permitted to hold the edge of the board in order to provide stability | ||
*Scores are based on the time taken to complete the test activity, recorded in seconds | *Scores are based on the time taken to complete the test activity, recorded in seconds | ||
*Alternative scoring - the number of pegs placed in 50 or 100 seconds can be recorded. In this case, results are expressed as the number of pegs placed per second | *Alternative scoring - the number of pegs placed in 50 or 100 seconds can be recorded. In this case, results are expressed as the number of pegs placed per second | ||
*Stopwatch should be started from the moment the participant touches the first peg until the moment the last peg hits the container | *Stopwatch should be started from the moment the participant touches the first peg until the moment the last peg hits the container | ||
<br> | |||
<u>Equipment Required:</u> | |||
*Board (wood or plastic): with 9 holes (10 mm diameter, 15 mm depth), placed apart by 32 mm (Mathiowetz et al, 1985<ref>Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74</ref>; Sommerfeld et al., 2004<ref>Sommerfeld, D. K., Eek, E. U., et al. "Spasticity after stroke: its occurrence and association with motor impairments and activity limitations." Stroke 2004 35(1): 134-139</ref>) or 50 mm (Heller, Wade, Wood, Sunderland, Hewer, & Ward, 1987<ref>Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719</ref>) | |||
*A container for the pegs: square box (100 x 100 x 10 mm) apart from the board or a shallow round dish at the end of the board (Grice et al, 2003<ref>Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573</ref>) | |||
*Board (wood or plastic): with 9 holes (10 mm diameter, 15 mm depth), placed apart by 32 mm (Mathiowetz et al, 1985<ref>Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74</ref>; Sommerfeld et al., 2004<ref>Sommerfeld, D. K., Eek, E. U., et al. "Spasticity after stroke: its occurrence and association with motor impairments and activity limitations." Stroke 2004 35(1): 134-139</ref>) or 50 mm (Heller, Wade, Wood, Sunderland, Hewer, & Ward, 1987<ref>Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719</ref>) | *9 pegs (7 mm diameter, 32 mm length) (Mathiowetz et al, 1985<ref>Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74</ref>) | ||
*A container for the pegs: square box (100 x 100 x 10 mm) apart from the board or a shallow round dish at the end of the board (Grice et al, 2003<ref>Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573</ref>) | |||
*9 pegs (7 mm diameter, 32 mm length) (Mathiowetz et al, 1985<ref>Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74</ref>) | |||
*A stopwatch | *A stopwatch | ||
Line 44: | Line 41: | ||
=== Reliability === | === Reliability === | ||
<u>Test-retest Reliability:</u> | <u>Test-retest Reliability:</u> | ||
<u></u>''Stroke:''<br>(Chen et al, 2009, Acute and Chronic Stroke) <ref>Chen, H. M., Chen, C. C., et al. "Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke." Neurorehabil Neural Repair 2009 23(5): 435-440</ref> | <u></u>''Stroke:''<br>(Chen et al, 2009, Acute and Chronic Stroke) <ref>Chen, H. M., Chen, C. C., et al. "Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke." Neurorehabil Neural Repair 2009 23(5): 435-440</ref> | ||
*Excellent test-retest reliability for entire group (ICC = 0.85) | *Excellent test-retest reliability for entire group (ICC = 0.85) | ||
*Adequate test-retest reliability for individuals with hand spasticity (ICC = 0.64)Excellent test-retest reliability for individuals without hand spasticity (ICC = 0.86) | *Adequate test-retest reliability for individuals with hand spasticity (ICC = 0.64)Excellent test-retest reliability for individuals without hand spasticity (ICC = 0.86) | ||
''Parkinson's Disease:'' | ''Parkinson's Disease:'' | ||
(Earhart et al, 2011) <ref>Earhart, G. M., Cavanaugh, J. T., et al. "The 9-hole PEG test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with Parkinson disease." J Neurol Phys Ther 2011 35(4): 157-163</ref> | (Earhart et al, 2011) <ref>Earhart, G. M., Cavanaugh, J. T., et al. "The 9-hole PEG test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with Parkinson disease." J Neurol Phys Ther 2011 35(4): 157-163</ref> | ||
*Excellent test retest reliability (ICC = 0.88 for dominant hand and ICC = 0.91 for nondominant hand) | *Excellent test retest reliability (ICC = 0.88 for dominant hand and ICC = 0.91 for nondominant hand) | ||
''Healthy Adults:'' | ''Healthy Adults:'' | ||
(Wang et al 2011; n = 305; mean age = 32 (26); age range = 3 - 85 years) <ref>Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321</ref> | (Wang et al 2011; n = 305; mean age = 32 (26); age range = 3 - 85 years) <ref>Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321</ref> | ||
*Excellent test retest reliability (ICC = 0.95 for right hand, ICC = 0.92 for left hand) | *Excellent test retest reliability (ICC = 0.95 for right hand, ICC = 0.92 for left hand) | ||
<br> | |||
<u>Interrater/Intrarater Reliability:</u><br> | |||
<u></u>''Healthy Adults:'' | |||
<u></u>''Healthy Adults:'' | |||
(Grice et al, 2003, Healthy Adults) <ref>Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573</ref> | (Grice et al, 2003, Healthy Adults) <ref>Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573</ref> | ||
*Excellent interrater reliability for the right hand (r = 0.984) | *Excellent interrater reliability for the right hand (r = 0.984) | ||
*Excellent interrater reliability for the left hand (r = 0.993) | *Excellent interrater reliability for the left hand (r = 0.993) | ||
''Stroke:'' | ''Stroke:'' (Heller et al, 1987; n = 56; mean age = 72 (9.9) years; assessed < 3 months post-stroke, Acute Stroke) <ref>Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719</ref> | ||
(Heller et al, 1987; n = 56; mean age = 72 (9.9) years; assessed < 3 months post-stroke, Acute Stroke) <ref>Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719</ref> | |||
*Adequate to excellent intrarater reliability (r = 0.68 to 0.99) | *Adequate to excellent intrarater reliability (r = 0.68 to 0.99) | ||
*Excellent interrater reliability (r = 0.75 to 0.99) | *Excellent interrater reliability (r = 0.75 to 0.99) | ||
=== Validity === | === Validity === | ||
<u>Criterion Validity:</u> | <u>Criterion Validity:</u> | ||
<u></u>''Stroke:''<br>(Sunderland et al, 1989; n = 38; mean age = 67, Acute Stroke) <ref>Sunderland, A., Tinson, D., et al. "Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator." British Medical Journal 1989 52(11): 1267</ref> | <u></u>''Stroke:''<br>(Sunderland et al, 1989; n = 38; mean age = 67, Acute Stroke) <ref>Sunderland, A., Tinson, D., et al. "Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator." British Medical Journal 1989 52(11): 1267</ref> | ||
*Poor concurrent validity with Frenchay Arm Test: 27% of cases incorrectly classified | *Poor concurrent validity with Frenchay Arm Test: 27% of cases incorrectly classified | ||
*Poor predictive validity: NHPT administered at 1 month did not predict functional outcomes at 6 months post stroke | *Poor predictive validity: NHPT administered at 1 month did not predict functional outcomes at 6 months post stroke | ||
''Healthy Adults:''<br>(Wang et al, 2011) <ref>Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321</ref> | ''Healthy Adults:''<br>(Wang et al, 2011) <ref>Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321</ref> | ||
*Adequate correlation with the Purdue Pegboard test (p = -0.74 to -0.75) | *Adequate correlation with the Purdue Pegboard test (p = -0.74 to -0.75) | ||
*Excellent correlation with the Bruininks-Oseretsky Test of Motor Proficiency (p = -0.87 to -0.89) | *Excellent correlation with the Bruininks-Oseretsky Test of Motor Proficiency (p = -0.87 to -0.89) | ||
<u>Construct Validity:</u> | <u>Construct Validity:</u> | ||
''Stroke:''<br>(Parker et al, 1986; 2 weeks, 3 & 6 months post onset, Acute Stroke) <ref>Parker, V. M., Wade, D. T., et al. "Loss of arm function after stroke: measurement, frequency, and recovery." Int Rehabil Med 1986 8(2): 69-73</ref><br> | ''Stroke:''<br>(Parker et al, 1986; 2 weeks, 3 & 6 months post onset, Acute Stroke) <ref>Parker, V. M., Wade, D. T., et al. "Loss of arm function after stroke: measurement, frequency, and recovery." Int Rehabil Med 1986 8(2): 69-73</ref><br> | ||
*Excellent convergent validity with Motricity Index (r = 0.82) | *Excellent convergent validity with Motricity Index (r = 0.82) | ||
Line 102: | Line 98: | ||
=== Responsiveness === | === Responsiveness === | ||
''Stroke:'' | ''Stroke:'' | ||
(Beebe and Lang, 2009, Acute Stroke) <ref>Beebe, J. A. and Lang, C. E. "Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke." J Neurol Phys Ther 2009 33(2): 96-103</ref> | (Beebe and Lang, 2009, Acute Stroke) <ref>Beebe, J. A. and Lang, C. E. "Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke." J Neurol Phys Ther 2009 33(2): 96-103</ref> | ||
{| width="200" border="1" cellpadding="1" cellspacing="1" | {| width="200" border="1" cellpadding="1" cellspacing="1" | ||
Line 111: | Line 107: | ||
|- | |- | ||
| | | | ||
| 1–3 months | | 1–3 months | ||
| 1–6 months | | 1–6 months | ||
|- | |- | ||
| Grip | | Grip | ||
| 0.50 | | 0.50 | ||
| 0.65 | | 0.65 | ||
|- | |- | ||
| Pinch | | Pinch | ||
| 0.52 | | 0.52 | ||
| 0.56 | | 0.56 | ||
|- | |- | ||
| ARAT | | ARAT | ||
| 0.55 | | 0.55 | ||
| 0.63 | | 0.63 | ||
|- | |- | ||
| 9HPT | | 9HPT | ||
| 0.52 | | 0.52 | ||
| 0.66 | | 0.66 | ||
|- | |- | ||
| SIS-Hand | | SIS-Hand | ||
| 1.02 | | 1.02 | ||
| 0.86 | | 0.86 | ||
|} | |} | ||
Responsiveness was calculated using the single population effect size method. Values closer to 1.00 = more responsive to change. Low responsiveness < 0.20; moderate responsiveness < 0.50, and high responsiveness < 0.80 | Responsiveness was calculated using the single population effect size method. Values closer to 1.00 = more responsive to change. Low responsiveness < 0.20; moderate responsiveness < 0.50, and high responsiveness < 0.80 | ||
=== Miscellaneous | === Miscellaneous<br> === | ||
== Links == | == Links == | ||
[http://www.rehabmeasures.org/PDF%20Library/Nine%20Hole%20Peg%20Test%20Instructions.pdf Nine-Hole Peg Test] | [http://www.rehabmeasures.org/PDF%20Library/Nine%20Hole%20Peg%20Test%20Instructions.pdf Nine-Hole Peg Test] | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
Line 151: | Line 147: | ||
References will automatically be added here, see [[Adding References|adding references tutorial]]. | References will automatically be added here, see [[Adding References|adding references tutorial]]. | ||
<references /> | <references /> | ||
[[Category:Outcome_Measures]] |
Revision as of 12:18, 4 September 2014
Original Editor - Sinead Greenan
Top Contributors - Sinead Greenan, Kim Jackson, Scott Buxton, Chloe Waller, Evan Thomas, Oyemi Sillo, Amrita Patro, Admin, Naomi O'Reilly and WikiSysop
Objective
[edit | edit source]
The Nine-Hole Peg Test (9HPT) is used to measure finger dexterity in patients with various neurological diagnoses.
Intended Population
[edit | edit source]
Patients with Stroke, Brain Injury, Parkinson's Disease
Method of Use[edit | edit source]
Description:
- Administered by asking the client to take the pegs from a container, one by one, and place them into the holes on the board, as quickly as possible
- Participants must then remove the pegs from the holes, one by one, and replace them back into the container
- The board should be placed at the client's midline, with the container holding the pegs oriented towards the hand being tested
- Only the hand being evaluated should perform the test
- Hand not being evaluated is permitted to hold the edge of the board in order to provide stability
- Scores are based on the time taken to complete the test activity, recorded in seconds
- Alternative scoring - the number of pegs placed in 50 or 100 seconds can be recorded. In this case, results are expressed as the number of pegs placed per second
- Stopwatch should be started from the moment the participant touches the first peg until the moment the last peg hits the container
Equipment Required:
- Board (wood or plastic): with 9 holes (10 mm diameter, 15 mm depth), placed apart by 32 mm (Mathiowetz et al, 1985[1]; Sommerfeld et al., 2004[2]) or 50 mm (Heller, Wade, Wood, Sunderland, Hewer, & Ward, 1987[3])
- A container for the pegs: square box (100 x 100 x 10 mm) apart from the board or a shallow round dish at the end of the board (Grice et al, 2003[4])
- 9 pegs (7 mm diameter, 32 mm length) (Mathiowetz et al, 1985[5])
- A stopwatch
Reference
[edit | edit source]
Evidence[edit | edit source]
Reliability[edit | edit source]
Test-retest Reliability:
Stroke:
(Chen et al, 2009, Acute and Chronic Stroke) [6]
- Excellent test-retest reliability for entire group (ICC = 0.85)
- Adequate test-retest reliability for individuals with hand spasticity (ICC = 0.64)Excellent test-retest reliability for individuals without hand spasticity (ICC = 0.86)
Parkinson's Disease:
(Earhart et al, 2011) [7]
- Excellent test retest reliability (ICC = 0.88 for dominant hand and ICC = 0.91 for nondominant hand)
Healthy Adults:
(Wang et al 2011; n = 305; mean age = 32 (26); age range = 3 - 85 years) [8]
- Excellent test retest reliability (ICC = 0.95 for right hand, ICC = 0.92 for left hand)
Interrater/Intrarater Reliability:
Healthy Adults:
(Grice et al, 2003, Healthy Adults) [9]
- Excellent interrater reliability for the right hand (r = 0.984)
- Excellent interrater reliability for the left hand (r = 0.993)
Stroke: (Heller et al, 1987; n = 56; mean age = 72 (9.9) years; assessed < 3 months post-stroke, Acute Stroke) [10]
- Adequate to excellent intrarater reliability (r = 0.68 to 0.99)
- Excellent interrater reliability (r = 0.75 to 0.99)
Validity[edit | edit source]
Criterion Validity:
Stroke:
(Sunderland et al, 1989; n = 38; mean age = 67, Acute Stroke) [11]
- Poor concurrent validity with Frenchay Arm Test: 27% of cases incorrectly classified
- Poor predictive validity: NHPT administered at 1 month did not predict functional outcomes at 6 months post stroke
Healthy Adults:
(Wang et al, 2011) [12]
- Adequate correlation with the Purdue Pegboard test (p = -0.74 to -0.75)
- Excellent correlation with the Bruininks-Oseretsky Test of Motor Proficiency (p = -0.87 to -0.89)
Construct Validity:
Stroke:
(Parker et al, 1986; 2 weeks, 3 & 6 months post onset, Acute Stroke) [13]
- Excellent convergent validity with Motricity Index (r = 0.82)
Responsiveness[edit | edit source]
Stroke:
(Beebe and Lang, 2009, Acute Stroke) [14]
Responsiveness: | ||
1–3 months | 1–6 months | |
Grip | 0.50 | 0.65 |
Pinch | 0.52 | 0.56 |
ARAT | 0.55 | 0.63 |
9HPT | 0.52 | 0.66 |
SIS-Hand | 1.02 | 0.86 |
Responsiveness was calculated using the single population effect size method. Values closer to 1.00 = more responsive to change. Low responsiveness < 0.20; moderate responsiveness < 0.50, and high responsiveness < 0.80
Miscellaneous
[edit | edit source]
Links[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74
- ↑ Sommerfeld, D. K., Eek, E. U., et al. "Spasticity after stroke: its occurrence and association with motor impairments and activity limitations." Stroke 2004 35(1): 134-139
- ↑ Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719
- ↑ Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573
- ↑ Mathiowetz, V., Kashman, N., et al. "Grip and pinch strength: normative data for adults." Arch Phys Med Rehabil 1985 66(2): 69-74
- ↑ Chen, H. M., Chen, C. C., et al. "Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke." Neurorehabil Neural Repair 2009 23(5): 435-440
- ↑ Earhart, G. M., Cavanaugh, J. T., et al. "The 9-hole PEG test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with Parkinson disease." J Neurol Phys Ther 2011 35(4): 157-163
- ↑ Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321
- ↑ Grice, K. O., Vogel, K. A., et al. "Adult norms for a commercially available Nine Hole Peg Test for finger dexterity." The American journal of occupational therapy 2003 57(5): 570-573
- ↑ Heller, A., Wade, D. T., et al. "Arm function after stroke: measurement and recovery over the first three months." Journal of Neurology, Neurosurgery and Psychiatry 1987 50(6): 714-719
- ↑ Sunderland, A., Tinson, D., et al. "Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator." British Medical Journal 1989 52(11): 1267
- ↑ Wang, Y. C., Magasi, S. R., et al. "Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox." Journal of Hand Therapy 2011 24(4): 313-320; quiz 321
- ↑ Parker, V. M., Wade, D. T., et al. "Loss of arm function after stroke: measurement, frequency, and recovery." Int Rehabil Med 1986 8(2): 69-73
- ↑ Beebe, J. A. and Lang, C. E. "Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke." J Neurol Phys Ther 2009 33(2): 96-103