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Toronto Rehabilitation Institute Hand Function Test

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Purpose

The TRI-HFT is a two-part objective measure that assesses upper extremity manipulation and grip force.

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Instrument Details

Acronym TRI-HFT

Area of Assessment

Functional Mobility
Strength

Administration Mode

Paper & Pencil

Cost

Not Free

Cost Description

Cost Unknown

Diagnosis/Conditions

  • Spinal Cord Injury
  • Stroke Recovery

Populations

Spinal Injuries

Key Descriptions

  • Object Manipulation Test:
    10- item test using palmar and lateral pinch grasp
    Item-level scores range from 1-7, determined by ability to perform activity while forearm is pronated, neutral and supinated while holding various object for 20-30 seconds in each position
    Each item is scored in each of the 3 positions except the mug and the zip lock bag which are not scored in supination
    Minimum Score= 0
    Maximum Score =70
    ?
    Strength Test:
    1) Four-item test using items with dynamometers to measure lateral grip force and circular grip force
    2) Strength test is scored using Newtons
    3) Minimum Score= 0
    4) Maximum Score =63

    Total maximum score = 133
  • Strength Test:
    1) Four-item test using items with dynamometers to measure lateral grip force and circular grip force
    2) Strength test is scored using Newtons
    3) Minimum Score= 0
    4) Maximum Score =63

Number of Items

14

Equipment Required

  • Items for palmar grasp object manipulation:
  • Mug
  • Book
  • Paper
  • Can of soda
  • Mobile phone
  • Isosceles triangular sponge
  • Items for lateral pinch grasp:
  • Dice
  • Pencil
  • Ziploc bag filled with five golf balls
  • Credit card
  • Items for strength test:
  • Instrumented credit card
  • Instrumented cylinder
  • Nine rectangular wooden blocks
  • Wooden bar
  • (see Kapadia et al. (2012) for a detailed description)

Time to Administer

 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

Initially reviewed by Wendy Romney, PT, DPT, NCS, Cara Weisbach, PT, DPT, and the SCI EDGE task force of the Neurology Section of the APTA in 4/2012.

Body Part

Upper Extremity

ICF Domain

Body Structure
Body Function
Activity

Measurement Domain

Motor

Considerations

  • Developed to assess the effect of neuroprosthesis
  • Formerly named Rehabilitation Engineering Laboratory Hand Function Test
  • No published psychometric properties are available. However Kapadia et al. (2011) established reliability (r = 0.98) and validity (r = 0.73 for left and r = 0.50 for right) within their RCT, however specific information was not given.

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Spinal Injuries

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Interrater/Intrarater Reliability

Spinal Cord Injury: (Kapadia et al., 2012) n=21, SCI C4-C7 Incomplete, subacute

  • Interrater Reliability: Excellent ICC=0.98 for pretherapy total score of the right and left hand. ICC=0.99 for posttherapy total score of the right and left hand.

Construct Validity

Spinal Cord Injury: (Kapadia et al., 2012) n=21, SCI C4-C7 Incomplete, subacute

  • Construct validity post-therapy for the right hand between TRI-HFT and FIM self-care subscore: Adequate r=0.56
  • Construct validity post-therapy for the right hand between TRI-HFT and the SCIM self-care subscore: Adequate r = 0.48
  • Construct validity post-therapy for the left hand between TRI-HFT and FIM self-care subscore: Excellent r=0.73
  • Construct validity post-therapy for the left hand between TRI-HFT and the SCIM self-care subscore: Excellent r = 0.62

Bibliography

Kapadia, N. M., Zivanovic, V., Furlan, J. C., Craven, B. C., McGillivray, C., & Popovic, M. R. (2011). Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: randomized control trial. [Randomized Controlled Trial Research Support, Non-U.S. Gov't]. Artificial Organs, 35(3), 212-216. doi: 10.1111/j.1525-1594.2011.01216.x

Kapadia, N., Zivanovic, V., Verrier, M., & Popovic, M. R. (2012). Toronto Rehabilitation Institute–Hand Function Test: Assessment of Gross Motor Function in Individuals With Spinal Cord Injury. Topics in Spinal Cord Injury Rehabilitation, 18(2), 167–186.

Popovic, M., & Contway, C. (2003). Rehabilitation engineering laboratory hand function test for functional electrical stimulation assisted grasping. Proceedings of the 8th International Functional Electrical Stimulation Society Conference, Brisbane, Australia, 231-234.

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