Dexterity Tests

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Introduction[edit | edit source]


Dexterity refers to the ability of a person to use the fingers, hands and arms to perform a task. The quality of performance in daily living skills, work-related functioning, and recreational activities is determined to a large degree by hand function and manual dexterity. The hand has to be able to undertake extremely fine and sensitive movements and must also be able to perform tasks requiring considerable force.[1] [2]

A high degree of manual dexterity is a central feature of the human upper limb. A rich interplay of sensory and motor components in the hand and fingers allows for independent control of fingers in terms of timing, kinematics and force.[3]

Dexterity tests measure the accuracy of hand and finger movements under controlled conditions. They help physical therapists to develop rehabilitation plans for patients and to measure the effectiveness of their programs. They can help identify and evaluate certain forms of brain damage, identify neurologically based learning disabilities, and musculoskeletal disabilities.

What are Different Types of Dexterity Tests?[edit | edit source]

Dexterity tests measure the accuracy of hand and finger movements under controlled conditions. There are several ways to assess dexterity and coordination; A few examples are given below.

The Nine-Hole Peg Test (NHPT) is considered as a gold standard measure of manual dexterity and most frequently used clinical practice[4]

Purdue Peg Board Test, see video below.


The Minnesota manual dexterity test involves having a person place round pegs into holes on a punched out sheet. It evaluates their ability to grab and place objects quickly. There are several different applications of this test, including an assessment of limitations caused by carpal tunnel, and dexterity problems from other hand and wrist injuries.

Box and Block test.jpg

The O’Connor finger dexterity test evaluates fine motor skills by requiring the extensive use of finger tips to place pins into a peg board. It is timed, so speed and accuracy are considered in the test scoring.

The box and block test uses cubes and focuses on picking up the cubes. Precise placement of the blocks is not required. Instead, they are dropped into a container that is close to the container from which they are picked up.

Why test? - Research Findings[edit | edit source]

Listed below are examples of findings related to testing

  • A rapid, nonlaboratory test of manual dexterity (eg the Purdue Pegboard Test) may help to identify persons at high risk for neurodegenerative diseases. This highlights the importance of motor function in the preclinical phase of both dementia and parkinsonism and may aid in selecting individuals for refined screening and neuroprotective trials.[6]
  • The NHPT is the optimal metric for measuring the impact of MS on upper extremity function. The majority of research suggests that a 20% change in test score is commonly used to define clinically meaningful worsening.[4]
  • Multiple aspects of sensorimotor control contribute to impaired manual dexterity in schizophrenia. Only visuomotor precision was related to antipsychotic medication. Good diagnostic accuracy and responsiveness to treatment suggest that manual dexterity may represent a useful clinical marker in schizophrenia.[7]
  • Manual dexterity measures can be useful for early detection of age-related functional decline and for prediction of cognitive decline.[8]

Resources[edit | edit source]

References[edit | edit source]

  1. Carmeli E, Patish H, Coleman R. The aging hand. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2003 Feb 1;58(2):M146-52. Available from: (last accessed 20.3.2020)
  2. Rehabmart Dexterity Tests Available from: (last accessed 20.3.2020)
  3. Térémetz M, Colle F, Hamdoun S, Maier MA, Lindberg PG. A novel method for the quantification of key components of manual dexterity after stroke. Journal of neuroengineering and rehabilitation. 2015 Dec 1;12(1):64. Available from: (last accessed 20.3.2020)
  4. 4.0 4.1 Feys P, Lamers I, Francis G, Benedict R, Phillips G, LaRocca N, Hudson LD, Rudick R, Multiple Sclerosis Outcome Assessments Consortium. The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. Multiple Sclerosis Journal. 2017 Apr;23(5):711-20. Available from: (last accessed 20.3.2020)
  5. Dittrick PPBT Available from: (last accessed 20.3.2020)
  6. Darweesh, S.K., Wolters, F.J., Hofman, A., Stricker, B.H., Koudstaal, P.J. and Ikram, M.A., 2017. Simple test of manual dexterity can help to identify persons at high risk for neurodegenerative diseases in the community. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences72(1), pp.75-81. (last accessed 20.3.2020)
  7. Térémetz M, Carment L, Brénugat-Herne L, Croca M, Bleton JP, Krebs MO, Maier MA, Amado I, Lindberg PG. Manual Dexterity in schizophrenia—a neglected clinical Marker?. Frontiers in psychiatry. 2017 Jul 10;8:120. Available from: (last accessed 20.3.2020)
  8. Carment L, Abdellatif A, Lafuente-Lafuente C, Pariel S, Maier MA, Belmin J, Lindberg PG. Manual dexterity and aging: a pilot study disentangling sensorimotor from cognitive decline. Frontiers in neurology. 2018 Oct 29;9:910.Available from: (last accessed 20.3.2020)