Jebsen Hand Function Test (JHFT)

Purpose

The Jebsen Hand Function Test (JHFT) assesses fine motor skills, weighted and non-weighted hand function activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
during performance of activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living.

In-Depth Review

Purpose of the measure

The Jebsen Hand Function Test (JHFT) is a standardized evaluative measure of functional hand motor skills (Hummel et al., 2005).

Available versions

The JHFT was developed in 1969 by Jebsen, Taylor, Treischmann, Trotter, and Howard (Cook, McCluskey, & Bowman, 2006). The JHFT is also referred to as the Jebsen-Taylor Hand Function Test or the Jebsen-Taylor Test of Hand Function.

A 3-item version (Modified Jebsen Hand Function Test, MJT) was developed by Bovend’Erdt et al. (2004) to measure gross functional dexterity in patients with moderate unilateral or bilateral upper limb impairment.

An 8-item Australian version was developed by Agnew and Maas (1982). It consists of the original 7 items with the addition of a grip strength item, measured using the Jamar dynamometer (Cook, McCluskey, & Bowman, 2006).

Features of the measure

Items:

The JHFT consists of 7 items that measure: (a) fine motor skills; (b) weighted functional tasks; and (c) non-weighted functional tasks (Jebsen et al., 1969):

• Writing a short sentence (24 letters, 3rd grade reading difficulty)
• Turning over a 3×5 inch card
• Picking up small common objects
• Simulated feeding
• Stacking checkers
• Picking up large light cans
• Picking up large heavy cans

Administration guidelines specify that testing begin with the non-dominant hand (Jebsen et al., 1969). Further details about the administration procedures of the JHFT can be found in the original article by Jebsen et al. (1969).

Items of the Modified Jebsen Hand Function Test (MJT) (Bovend’Erdt et al., 2004):

• Turning over 5 cards
• Stacking 4 cones
• Spooning 5 kidney beans into a bowl (simulated feeding)

Scoring:

Each item is scored according to time taken to complete the task. Times are rounded to the nearest second (Spinal Cord Injury Rehabilitation Evidence, 2010). The scores for all 7 items are then summed for a total score. Jebsen et al. (1969) established norms with a sample of 300 healthy subjects of different age groups (20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-94 years). With the exception of writing, all items took under 10 seconds to perform. See Jebsen et al. (1969) for norms according to age, gender and hand use (dominant/non-dominant).

What to consider before beginning:

It is necessary to identify the patient’s dominant hand before beginning the JHFT. When working with patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. More it is recommended to take into consideration the area(s) of cortical insult, as damage to areas of the brain responsible for speech and language function may affect performance on the writing task (Celink et al., 2007). Prior to beginning the writing task, individuals should be reminded to use reading glasses if necessary (Jebsen et al., 1969).

Time:

The JHFT requires 15 – 45 minutes to complete.

Training requirements:

No specific training is required.

Equipment:

The JHFT does not require standardized equipment but the following equipment is used (Jebsen et al., 1969):

• wooden board (41 1/2 inches long x 11 1/4 inches wide x 3/4 inch thick)
• ball point pen
• 8×11 inch sheets unruled paper
• 5×8 inch index cards
• 3×5 inch index cards
• 1 pound coffee can
• 1 inch paper clips
• teaspoon
• 5 kidney beans
• standard size wooden checkers
• 5 empty 303 cans
• 5 full (1 pound) 303 cans.

Test equipment can be collated by the clinician or purchased as pre-packaged assessment kits from suppliers including:

• Performance Health (https://www.performancehealth.com/jamar-hand-function-test)
• Mobility Smart (https://www.mobilitysmart.co.uk/jebsen-taylor-hand-function-test-kit.html)
• Amazon (amazon.com)

Client suitability

Can be used with:

• Clients with neurological or musculoskeletal conditions, e.g. strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More, spinal cord injury, arthritis (Cook, McCluskey, & Bowman, 2006).
• This assessment has been administered in clients over 8 years of age (Cook, McCluskey, & Bowman, 2006).

Should not be used with:

• Individuals with speech and language disorders may have difficulty understanding instructions.
• The writing task can be excluded for individuals with speech and language difficulties due to dominant cerebral hemisphere strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More (Beebe & Lang, 2009, 2007; Hummel et al., 2005).

Languages of the measure

• English
• Portuguese (Ferreiro, dos Santos, & Conforto, 2010)

Summary

What does the tool measure?	Hand function
What types of clients can the tool be used for?	The JHFT can be use with, but is not limited to clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More.
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	Assessment
Time to administer	15-45 minutes
Versions	JHFT Modified Jebsen Hand Function Test (MJT) JHFT Australian version, Portuguese version
Other Languages	English, Portuguese
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More: One study reported excellent internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More of the JHFT (Portuguese version), and adequate to excellent internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More of individual items. Test-retest: One study reported adequate to excellent test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of JHFT individual items. One study reported excellent test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of the MJT. Intra-rater: One study reported excellent intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings. of the JHFT (Portuguese version). Inter-rater: One study reported excellent inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. of the JHFT (Portuguese version) and individual items.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: No studies have examined the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. of the JHFT. Criterion: Concurrent: Two studies reported excellent correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation. between the JHFT and grip strength, pinch strength, Action Research Arm Test, Nine Hole Peg Test, and StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More Impact Scale – Hand Domain. One study reported an excellent correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation. between the MJT and the Nine Hole Peg Test and an adequate correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation. with grip strength. Predictive: No studies have examined the predictive validityA form of criterion validity that examines a measure’s ability to predict some subsequent event. Example: can the Berg Balance Scale predict falls over the following 6 weeks? The criterion standard in this example would be whether the patient fell over the next 6 weeks. of the JHFT. Construct: No studies have examined the construct validityReflects the ability of an instrument to measure an abstract concept, or construct. For some attributes, no gold standard exists. In the absence of a gold standard , construct validation occurs, where theories about the attribute of interest are formed, and then the extent to which the measure under investigation provides results that are consistent with these theories are assessed. of the JHFT. One study reported no significant difference in scores on the JHFT (Portuguese version) according to education level or hand dominance.
Floor/Ceiling Effects	No studies have examined the floor or ceiling effects of the JHFT.
SensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” / SpecificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).	No studies have reported on the sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” or specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative). of the JHFT.
Does the tool detect change in patients?	One study reported moderate responsivenessThe ability of an instrument to detect clinically important change over time. of the JHFT from 1 to 3 months post-stroke, and from 3 to 6 months post-stroke.
Acceptability	The JHFT is comprised of simple, familiar, and functional tasks. Consideration must be paid to individuals with speech and language difficulties, who may have difficulty understanding instructions and performing the writing task.
Feasibility	The JHFT is easy to administer and does not require standardized equipment.
How to obtain the tool?	Information regarding test administration is provided in: Jebsen, R.H., Taylor, N., Trieschmann, R.B., Trotter, M.J., & Howard, L.A. (1969). An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation, 50(6), 311 – 319. Assessment kits can be purchased from: Performance Health (https://www.performancehealth.com/jamar-hand-function-test) Mobility Smart (https://www.mobilitysmart.co.uk/jebsen-taylor-hand-function-test-kit.html) Amazon (www.amazon.com)

Psychometric Properties

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Jebsen Hand Function Test (JHFT). While studies have been conducted with other patient groups, this review specifically addresses the psychometric properties relevant to patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. More. At the time of publication five studies were identified: three relating to the JHFT, and one each for the JHFT (Portuguese version) and the Modified Jebsen Hand Function Test (MJT).

Floor/Ceiling Effects

No studies have examined the floor or ceiling effects of the JHFT.

Reliability

Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More:
Ferreiro, dos Santos, & Conforto (2010) examined the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More of the JHFT (Portuguese version) with a sample of 40 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More using Cronbach’s alpha, and reported excellent internal consistency(α=0.924). Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. More of individual items, reported using Pearson’s correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
coefficient and Cronbach’s alpha , was adequate to excellent (writing: r=0.812, α=0.844; card turning r=0.857, α=0.632; small common objects r=0.657, α=0.651; simulated feeding r=0.813, α=0.646; checkers r=0.712, α=0.633; large light objects r=0.849, α=-0.681; large heavy objects r=0.898, α=0.687).

Test-retest:
Jebsen et al. (1969) examined test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the JHFT in a sample of 26 patients with a range of upper limb conditions including hemiparesis from cerebral vascular disease (n=5), using Pearson’s correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
coefficient. Test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of individual tasks was adequate to excellent (writing: r=0.67, 0.84; cards: r=0.91, 0.78; small objects: r=0.93, 0.85; simulated feeding: r=0.92, 0.60; checkers: r=0.99, 0.91; large light objects: r=0.89, 0.67; large heavy objects: r=0.89, 0.92, dominant and non-dominant hands respectively).

Bovend’Eerdt et al. (2004) examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the Modified Jebsen Hand Function Test (MJT) in a sample of 26 individuals with neurological disorders including strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More (n=12), Multiple Sclerosis (n=7), head injury (n=4), and tumours (n=3). The mean time between retesting was 9.6 days. The study reported excellent test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the MJT (r = 0.95), using Pearson’s correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
coefficient.

Intra-rater:
Ferreiro, dos Santos, & Conforto (2010) examined intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings.
of the JHFT (Portuguese version) with a sample of 40 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More and reported excellent intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings.
(ICC=0.997), using intraclass correlation coefficient (ICC)Intraclass correlation (ICC) is used to measure inter-rater reliability for two or more raters. It may also be used to assess test-retest reliability. ICC may be conceptualized as the ratio of between-groups variance to total variance..

Inter-rater:
Ferreiro, dos Santos, & Conforto (2010) examined the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the JHFT (Portuguese version) with a sample of 40 patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. More using intraclass correlation coefficient (ICC)Intraclass correlation (ICC) is used to measure inter-rater reliability for two or more raters. It may also be used to assess test-retest reliability. ICC may be conceptualized as the ratio of between-groups variance to total variance., and reported excellent inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
(ICC=1.0). Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
for individual items was also excellent (writing, ICC=0.999; card turning, ICC=0.977; small common objects, ICC=0.998; simulated feeding, ICC=0.991; checkers, ICC=0.995; large light objects, ICC=0.988; large heavy objects, ICC=0.991).

Validity

Content:

No studies have examined the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension.
of the JHFT

Criterion:

Concurrent:
Beebe & Lang (2009) examined the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the JHFT with grip and pinch strength (measured by dynamometer), the Action Research Arm Test (ARAT) , Nine Hole Peg Test (NHPT), and the StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More Impact Scale – Hand domain (SIS-Hand) in a sample of 33 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More, using Spearman’s correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
. Measures were administered at 1 month, 3 months and 6 months post-stroke. The JHFT demonstrated excellent correlations with grip strength (r=0.79-0.81), pinch strength (0.60-0.79), ARAT (r=0.87-0.95), NHPT (0.84-0.97) and SIS-Hand (0.61-0.83) at all time points.
Note: The study did not use the first task of the JHFT (writing a sentence) due to its dependence on hand dominance and education level.

Beebe & Lang (2007) examined concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the JHFT with grip and pinch strength (measured by dynamometer), Action Research Arm Test (ARAT), 9-Hole Peg Test (NHPT), and StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More Impact Scale – Hand Function SubscaleMany measurement instruments are multidimensional and are designed to measure more than one construct or more than one domain of a single construct. In such instances subscales can be constructed in which the various items from a scale are grouped into subscales. Although a subscale could consist of a single item, in most cases subscales consist of multiple individual items that have been combined into a composite score (National Multiple Sclerosis Society).
(SIS-Hand) in a sample of 32 participants with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More, using Pearson’s product moment correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
. The JHFT demonstrated excellent correlations with ARAT (r=-0.89), grip strength (r=-0.76), pinch strength (r=-0.68), 9-HPT (r=-0.89), and SIS-Hand Function (r=-0.82).
Note: The study did not use the first task of the JHFT (writing a sentence) due to its dependence on hand dominance and education level.

Bovend’Eerdt et al. (2004) examined the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the Modified Jebsen Hand Function Test (MJT) with the University of Maryland Arm Questionnaire for StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More (UMAQS), Nine Hole Peg Test (NHPT), and grip strength (measured by dynamometer) in a sample of 26 individuals with neurological disorders including strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More (n=12), Multiple Sclerosis (n=7), head injury (n=4), and tumours (n=3). Measures were administered on two occasions (T1, T2) on average 9.6 days apart. The MJT showed excellent correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
with the NHPT (r=0.86 and 0.88 on T1 and T2 respectively) and adequate correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
with grip strength (r=0.44, significant on T2 only), using Pearson’s correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
coefficient. Correlations between the MJT and UMAQS were not significant at either time point.

Predictive:
No studies have examined the predictive validityA form of criterion validity that examines a measure's ability to predict some subsequent event. Example: can the Berg Balance Scale predict falls over the following 6 weeks? The criterion standard in this example would be whether the patient fell over the next 6 weeks.
of the JHFT.

Construct:

No studies have examined the construct validityReflects the ability of an instrument to measure an abstract concept, or construct. For some attributes, no gold standard exists. In the absence of a gold standard , construct validation occurs, where theories about the attribute of interest are formed, and then the extent to which the measure under investigation provides results that are consistent with these theories are assessed.
of the JHFT.

Known Groups:
Ferreiro et al. (2010) reported no significant difference in scores on the JHFT (Portuguese version) according to education level or hand dominance in a sample of 40 patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. More.

Responsiveness

Beebe & Lang (2009) measured the responsivenessThe ability of an instrument to detect clinically important change over time.
of the JHFT with a sample of 33 patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More, using the single population effect sizeEffect size (ES) is a name given to a family of indices that measure the magnitude of a treatment effect. Unlike significance tests, these indices are independent of sample size. The ES is generally measured in two ways: as the standardized difference between two means, or as the correlation between the independent variable classification and the individual scores on the dependent variable. This correlation is called the “effect size correlation”.
method. Measures were taken at 1, 3 and 6 months post-stroke, during which time participants received conventional strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. More rehabilitation. The JHFT demonstrated moderate responsivenessThe ability of an instrument to detect clinically important change over time.
from 1 to 3 months post-stroke (ES=0.69) and from 3 to 6 months post-stroke (ES=0.73).

SensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
& SpecificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
:
No studies have examined the sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
and specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
of the JHFT.

References

• Beebe, J.A. & Lang, C.E. (2007). Relating movement control at 9 upper extremity segments to loss of hand function in people with chronic hemiparesis. Neurorehabilitation and Neural Repair, 21(3), 279 – 291.
• Beebe, J.A. & Lang, C.E. (2009). Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke. Journal of Neurologic Physical Therapy, 33(2), 96-103.
• Bovend’Erdt, T.J.H., Dawes, H., Johansen-Berg, H., & Wade, D.T. (2004). Evaluation of the Modified Jebsen Test of Hand Function and the University of Maryland Arm Questionnaire for Stroke. Clinical Rehabilitation, 18, 195-202
• Celnik, P., Hummel, F., Harris-Love, M., Wolk, R., & Cohen, L. (2007). Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke. Archives of Physical Medicine and Rehabilitation, 88, 1369-76.
• Cook, C., McCluskey, A., & Bowman, J. (2006). Jebsen Test of Hand Function. Penrith South, NSW: University of Western Sydney. Retrieved from http://www.maa.nsw.gov.au/default.aspx?MenuID=376
• Duncan, P., Richards, L., Wallace, D., Stoker-Yates, J., Pohl, P., Luchies, C., Ogle, A., & Studenski, S. (1998). A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke, 1998(29), 2055-2060.
• Ferreiro, K.N., dos Santos, R.L., & Conforto, A.B. (2010). Pyschometric properties of the Portuguese version of the Jebsen-Taylor test for adults with mild hemiparesis. Revista Brasileira de Fisioterapia (Brazilian Journal of Physiotherapy), 14(5), 377-81.
• Jebsen, R.H., Taylor, N., Trieschmann, R.B., Trotter, M.J., & Howard, L.A. (1969). An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation, 50(6), 311 – 319.
• Hummel, F., Celnik, P., Giraux, P., Floel, A., Wu, W., Gerloff, C., & Cohen, L. (2005). Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain, 2005(128), 490-9.
• Poole, J. (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 and Rhematism (Arthritis Care and Research), 49(5S), S59-66.
• Spinal Cord Injury Rehabilitation Evidence. (2010). Jebsen Hand Function Test. Retrieved from http://www.scireproject.com/outcome-measures/jebsen-hand-function-test
• Wu, C., Seo, H., & Cohen, L. (2006). Influence of electric somatosensory stimulation on paretic-hand function in chronic stroke. Archives of Physical Medicine and Rehabilitation, 87, 351-7.

See the measure

How to obtain the JHFT?

Administration instructions are published in Jebsen, R.H., Taylor, N., Trieschmann, R.B., Trotter, M.J., & Howard, L.A. (1969). An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation, 50(6), 311 – 319.

While the JHFT does not require standardized equipment, assessment kits can be purchased from:

• Performance Health (https://www.performancehealth.com/jamar-hand-function-test)
• Mobility Smart (https://www.mobilitysmart.co.uk/jebsen-taylor-hand-function-test-kit.html)
• Amazon (amazon.com)