Sollerman Hand Function Test
Purpose
The Sollerman Hand Function Test (SHFT) is a widely used method for evaluating hand functionality and performance in daily activities. It assesses the hand's ability and quality when performing routine tasks, making it particularly valuable in hand surgery for monitoring treatment outcomes. It serves both clinical and research purposes, and is instrumental in evaluating manual dexterity and functional capabilities in individuals with upper-limb impairments.[1][2]
Description
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.[3]
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 |
Sollerman Hand function test includes 20 subtests involving an ADL task, each designed to evaluate specific grip patterns and functional hand movements.[4] 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 |
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 |
Technique
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.
This assessment is widely valued for its clinical significance, as it replicates real-life activities. It is structured to account for various impairments, ensuring its suitability for a broad range of patient groups. However, its application calls for a competent therapist and specific tools which makes it taxing.[1][7]
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[3], chronic stroke[8], after replantation or revascularisation of upper extremity injuries[9], Dupuytren's contracture[10] and in patients undergoing long term haemodialysis[11].Recent research in 2024 shows use of this test as a part of exercises for stroke patients using computer screen & vision based hand rehabilitation system. The study proposed that it was effective in improving hand function in stroke patients.[12]
Validity
The SHFT has been extensively validated in numerous clinical contexts and among various demographic groups, consistently showing significant correlations with existing tools for measuring hand function and manual dexterity. Its outcomes are in strong agreement with patient-reported measures, such as the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, as well as objective assessments like dynamometers and the Nine-Hole Peg Test.[13][14]
It is particularly distinguished by its high correlation with the International Classification for Surgery of the Hand in Tetraplegia (Pearson's r = 0.88) and the Motor Capacities Scale (Spearman's r = 0.959).[3] For instance, in the realm of stroke rehabilitation, the SHFT provides an accurate assessment of functional recovery and improvements in motor control. Its application in Charcot-Marie-Tooth disease highlights its effectiveness in representing functional limitations and tracking progress in rehabilitation.[4][13]
Reliability
The SHFT has continuously exhibited high reliability under a variety of settings, with strong inter-rater and intra-rater consistency reflected in kappa coefficients ranging from 0.59 to 0.95, depending on the population and tasks assessed.[15][14]
Its test-retest reliability has been extensively tested in situations such as stroke and sporadic inclusion body myositis, ensuring consistent results over several assessments. Specifically, in situations of chronic stroke[8], the SHFT has remarkable test-retest reliability (ICC = 0.96-0.98), inter-rater reliability (ICC = 0.96-0.98), and intra-rater reliability (ICC = 0.96-0.99). Similarly, in people with chronic Burns[5], it has strong inter-rater and intra-rater reliability (ICC = 0.98), indicating its usefulness as a tool for tracking changes in hand function during rehabilitation.[16][15]
For chronic stroke:
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:
High Interrater reliability (ICC=0.98)
High Intrarater reliability (ICC=0.98)
Related Test
Jebsen-Taylor Hand Function Test
References
- ↑ 1.0 1.1 Lindqvist A, Hjalmarsson M, Nilsson O. DASH and Sollerman test scores after hand injury from powered wood splitters. Journal of hand surgery (European volume). 2011 Jan;36(1):57-61.
- ↑ Zestas ON, Tselikas ND. Sollerman Hand Function Sub-Test “Write with a Pen”: A Computer-Vision-Based Approach in Rehabilitation Assessment. Sensors. 2023 Jul 17;23(14):6449.
- ↑ 3.0 3.1 3.2 3.3 3.4 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.
- ↑ 4.0 4.1 Gandhi RA, Mendenhall SD, Severance G, Levy TJ, Ben-Amotz O, Levin LS. Measuring Functional Outcomes After Bilateral Vascularized Composite Hand Allotransplantation: A Report of 3 Cases. The Journal of hand surgery. 2020 Dec;45(12):1123-33.
- ↑ 5.0 5.1 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.
- ↑ Katie Smith. Sollerman Hand Function Test (SHFT). Available from https://www.youtube.com/watch?v=WywEIm-AqV0&t=91s [last accessed 7/10/2020]
- ↑ Lin SY, Chang JK, Chen PC, Mao HF. Hand function measures for burn patients: a literature review. Burns. 2013 Feb 1;39(1):16-23.
- ↑ 8.0 8.1 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.
- ↑ 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.
- ↑ 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.
- ↑ Tander B, Akpolat T, Durmus D, Canturk F. Evaluation of hand functions in hemodialysis patients. Renal failure. 2007 Jan 1;29(4):477-80.
- ↑ Neog DR, Dutta HP, Bhuyan MK. Hand function assessment using computer vision for hand rehabilitation. In2024 IEEE Conference on Artificial Intelligence (CAI) 2024 Jun 25 (pp. 659-664). IEEE.
- ↑ 13.0 13.1 Prada V, Robbiano G, Mennella G, Hamedani M, Bellone E, Grandis M, Schenone A, Zuccarino R. Validation of a new hand function outcome measure in individuals with Charcot‐Marie‐Tooth disease. Journal of the Peripheral Nervous System. 2020 Dec;25(4):413-22.
- ↑ 14.0 14.1 Ekstrand E, Lexell J, Brogårdh C. Test− retest reliability and convergent validity of three manual dexterity measures in persons with chronic stroke. PM&R. 2016 Oct 1;8(10):935-43.
- ↑ 15.0 15.1 Akatay EA, Bayraktar D, Aysin İK, Ustun O, Akad EO, Saraç DC, Atalay B, Ramazanoglu I, Tekin I, Kurum T, Gucenmez S. POS1479-HPR INVESTIGATING THE RELIABILITY OF THE SOLLERMAN HAND FUNCTION TEST AND THE ASSOCIATIONS WITH DISEASE-AND HAND-RELATED PARAMETERS IN PATIENTS WITH SYSTEMIC SCLEROSIS. Annals of the Rheumatic Diseases. 2022 Jun 1;81:1085-6.
- ↑ Eriksson M, Lindberg C. Hand function in 45 patients with sporadic inclusion body myositis. Occupational therapy international. 2012 Jun;19(2):108-16.