Arthritis Hand Function Test (AHFT)

Original Editor - Rucha Gadgil

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Introduction[edit | edit source]

The Arthritis Hand Function Test (AHFT) is an 11-item performance-based test designed to measure hand strength and dexterity in persons with arthritis and rhematoid arthritis. It deals with the areas of self-care, work and leisure in such patients[1].

This test is divided into 4 subscales and tests are performed bilaterally:

  1. Strength,
  2. Applied Strength,
  3. Dexterity, and
  4. Applied Dexterity
Finger arthritis.jpg

It was developed by Catherine Backman and Hazel Mackie in 1997 and requires purchasing the scoring forms from The University of British Columbia, Canada[2].

Intended Population[edit | edit source]

Useful in both research and clinical applications, the AHFT can be used for pre- and post-operative evaluations, and to measure treatment outcomes pertaining to hand function. It is particularly targeted towards:

  1. Osteo-arthritis
  2. Rheumatoid arthritis
  3. Systemic Sclerosis

Procedure[edit | edit source]

Equipment Required

The equipment required is:

  1. Sphygmomanometer,
  2. pinch meter,
  3. 9-hole pegboard,
  4. shoe,
  5. button board,
  6. 2 safety pins,
  7. theraplast,
  8. plate,
  9. knife and fork,
  10. coins and a box,
  11. wooden tray,
  12. 12 cans of soup,
  13. pitcher and a glass,
  14. 1 litre container,
  15. measuring cup,
  16. stopwatch.

Training Required

AFHT comes with a scoring and instruction Manual that describes the purpose of the test, the procedure for each item, and instructions for assembly of the test kit. It is not difficult to administer and does not require additional training.

Time Required

The test can be administered in approx. 20 minutes.


The 4 sub-scales are to be administered bilaterally and the scoring noted down on the manual sheet.

Dexterity: performed one hand at a time, 1 time, 1 item

  1. 9-hole peg test timed for place and removal in a 9-hole pegboard.

Strength: performed one hand at a time, 3 trials, 3 items

  1. gross grip strength (mm Hg)
  2. tip pinch with the thumb and index (kg)
  3. three-point pinch strength with the thumb, index and middle finger (kg)

Applied Dexterity: bilateral actions, 5 items

  1. Fasten and unfasten 4 buttons
  2. Lace a shoe and tie a bow;
  3. Pin and unpin two safety pins in a cloth;
  4. Pick up and manipulate four coins into a slot;
  5. Cut a piece of putty with a knife and fork into four pieces.

Applied Strength: bilateral actions, 2 items

  1. Individual lifts a tray with six filled tin cans, which added or subtracted depending on the patients’ lifting ability. Scored on the no. of cans filled (0-12)
  2. Individual lifts one liter of water. Water is added or subtracted depending on the patients’ lifting ability. Scored on the total amount of water obtained.


Scoring is according to the manual provided. the acquired scores are compared to established normative values.

Evidence[edit | edit source]

Reliability[edit | edit source]

  1. Interrater Reliability: In RA, intra-class correlation coefficient (ICC) ranged from 0.89 to 1.0. In OA, ICC ranged from 0.99 to 1.0. shows strong interrater reliability[3][4].
  2. Test Re-test Reliability: ICC of 0.53 to 0.95 in RA; ICC 0.74 – 0.96 in OA[3][4].

Validity[edit | edit source]

  1. with Jebson's Hand function Test: The AHFT correlated well (r=.63)for the right hand, but poorly (r=.08) for the left hand[5].
  2. with Arthritis Impact Measurement Scales: The AHFT correlated well (r=.71) with the dexterity component on the AIMS[5]

Links[edit | edit source]

Additional information at

References[edit | edit source]

  1. Poole JL. Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT), and Michigan Hand Outcomes Questionnaire (MHQ). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S189-99. doi: 10.1002/acr.20631. PMID: 22588744.
  2. Poole, J.L. (2003), Measures of adult hand function: Arthritis Hand Function Test (AHFT), Grip Ability Test (GAT), Jebsen Test of Hand Function, and The Rheumatoid Hand Functional Disability Scale (The Duruöz Hand Index [DHI]). Arthritis & Rheumatism, 49: S59-S66. doi:10.1002/art.11406
  3. 3.0 3.1 Backman C, Mackie H. Reliability and Validity of the Arthritis Hand Function Test in Adults with Osteoarthritis. The Occupational Therapy Journal of Research, 1997. 17:1,55-66.
  4. 4.0 4.1 Backman C, Mackie M, Harris J. Arthritis Hand Function Test: Development of a Standardized Assessment Tool. The Occupational Therapy Journal of Research, 1991.11:4, 245-256
  5. 5.0 5.1 Duruöz MT, Poiraudeau S, Fermanian J, Menkes C, Amor B, Dougados M, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol 1996; 23: 1167– 72.