Assessment Overview

Purpose: Standardized, quantitative assessment used to measure finger dexterity.

Summary: There are 9 holes in a wooden board, and the individual must place one peg at a time in each hole as fast as they can. The individual then removes each peg as quickly as they can. One hand is used at a time and the time is recorded in seconds for how long it takes to place and remove the pegs. The test should be performed with both hands.

Equipment: Stopwatch, wood board with 9 holes, 9 pegs

ICF Category: Activity

Assessment Handout

Assessment Psychometrics

According to the ICF model, the 9-Hole Peg Test assesses activity level limitations: reach-and-grasp, coordination, and muscle performance. NeuroPT EDGE highly recommends (4/4) the use of this test in acute care, inpatient rehab, home health, skilled nursing facility, and outpatient therapy. It is highly recommended (4/4) for individuals with a disability level of 0.0-3.5, 4.0-5.5, and 6.0-7.5. The 9-Hole Peg Test is recommended (3/4) for those with a disability level of 8.0-9.5. This test depends on upper extremity function, so it may not be able to be used once upper extremity function begins to severely diminish. Students should learn to administer this tool, and it has been validated for use in research. The psychometrics that have been collected on this test with the MS population are reported below:

• Concurrent Validity: Moderate correlation (-0.7) with the Box and Blocks Test (n=68); Moderate correlation with the Fatigue Severity Scale (r=0.25 for dominant hand and r=0.13 for nondominant hand); MSQOL-54 (r=-0.37 and r=-0.38)

• Cutoff Score: A 20% worsening from baseline increases odds of one-point worsening in EDSS score by 5.0; Score > 0.27 sec pegs per second (33.3 sec total) indicates severe hand dysfunction

• Interrater Reliability: ICC=0.93, with a population size of 32

• Intrarater Reliability: ICC of 0.96 and 0.98 among two raters, with a population size of 32

• MCID: A 20% difference is considered reliable change

• MDC: Dominant hand= 19.4%; Nondominant hand= 29.1%

• SEM: Dominant hand = 1.58 sec; Nondominant hand = 2.69 sec

• Test-retest Reliability: n=21, SD within individuals is 7.74 sec.; between individuals, SD=10.62 sec; Excellent, ICC=0.95 for nondominant hand; ICC=0.94 for dominant hand

Application Video