Purdue Pegboard Test (PPT)

Evidence Reviewed as of before: 06-09-2012
Author(s): Katie Marvin, MSc.PT
Editor(s): Annabel McDermott, OT; Nicol Korner-Bitensky, PhD OT

Purpose

The Purdue Pegboard Test (PPT) is a test of fingertip dexterity and gross movement of the hand, fingers and arm in patients with impairments of the upper extremity resulting from neurological and musculoskeletal conditions.

In-Depth Review

Purpose of the measure

The Purdue Pegboard Test (PPT) was developed by Joseph Tiffin in 1948. The PPT is now used widely by clinicians and researchers as a measure of (1) gross movement of the arm, hand and fingers, and (2) fingertip dexterity. The PPT is suitable for use with patients with impairments of the upper extremity resulting from neurological and musculoskeletal conditions.

Available versions

None typically reported

Features of the measure

Description of tasks:

The PPT measures:

  • (1) Gross movement of the fingers, hand and arm; and
  • (2) Fingertip dexterity

The patient should be seated comfortably at a testing table with the PPT on the table in front of him/her. The testing board consists of a board with 4 cups across the top and two vertical rows of 25 small holes down the centre. The two outside cups contain 25 pins each; the cup to the immediate left contains 40 washers and the cup to the immediate right of the center contains 20 collars.

Picture: Google Images

The clinician demonstrates and then administers the following 5 subtests:

  • Right hand(30 seconds): Clients use their right hand to place as many pins as possible down on the row within 30 seconds.
  • Left hand(30 seconds): Clients use their left hand to place as many pins as possible down on the row within 30 seconds.
  • Both hands(30 seconds): Clients use both hands simultaneously to place as many pins as possible down both rows.
  • Right + Left + Both hands: **Please note that this is not an actual test, it is a mathematical sum calculation of the above scores
  • Assembly(60 seconds): Clients use both hands simultaneously while assembling pins, washers and collars.

Specific administration instructions can be found in the instruction manual that accompanies the PPT.

Scoring and Score Interpretation:

The clinician compiles 5 separate scores from the complete test procedure, one for each of the following tasks:

  • Right hand(30 seconds): the total number of pins placed in the right hand column using the right hand in the allotted time.
  • Left hand(30 seconds): the total number of pins placed in the left hand column using the left hand in the allotted time.
  • Both hands(30 seconds): the total number of pairs of pins placed in both columns using both hands in the allotted time.
  • Right + Left + Both hands: the sum of scores for the previous three tasks (right hand + left hand + both hands).
  • Assembly(60 seconds): the total number of pins, washers and collars assembled in the allotted time.

The testing should commence in the order outlined above, unless the patient is left-handed; tasks 1 and 2 should then be reversed. The preferred method of administration is the three-trial method: the patient should be permitted to attempt three trials for each task after a single demonstration by the clinician. (The one-trial administration method only permits the patient one trial following demonstration by the clinician). The test can be administered in an individual or group setting.

Desrosiers, Hebert, Bravo and Dutil (1995) developed predictive equations for Purdue Pegboard subtest scores, based on normative data resulting from their study. The normative data portion of the study involved 360 healthy participants over the age of 60 years. The following predictive equations were determined:

Purdue subtests Females Males
Right hand 24.0 – 0.15 x (age) 22.5 – 0.15 x (age)
Left hand 23.7 – 0.16 x (age) 24.1 – 0.18 x (age)
Both hands 19.9 – 0.14 x (age) 20.0 – 0.15 x (age)
Right + Left + Both hands 67.7 – 0.45 x (age) 66.5 – 0.48 x (age)
Assembly 59.4 – 0.45 x (age) 62.2 – 0.53 x (age)

Example: The expected score for an 80 year old woman on the right hand task is: 24.0 –

Time:

The PPT takes approximately 5 to 10 minutes to administer and score.

Training requirements:

None typically reported, however it is recommended that the clinician is familiar with the assessment tool. The clinician should be able to demonstrate to clients performance of the PPT at an average speed.

Equipment:

Purdue Pegboard Test (Model #32020)

  • Instruction manual
  • One test board
  • Pins x 50, collars x 20, washers x 40
  • Score sheets
  • Testing table approximately 30 inches tall
  • Stopwatch or clock that reads in seconds

Alternative forms of the Purdue Pegboard Test

None typically reported.

Client suitability

Can be used with:

  • Clients presenting with lateral brain damage (Costa et al., 1963)
  • Clients with hemiplegia resulting from stroke (Ashford, Slade, Malaprad & Turner-Stokes, 2008)
  • Clients requiring assessment for vocational rehabilitation (Hemm and Curtis, 1980)
  • Clients with dyslexia (Leslie, Davidson and Batey, 1985)
  • Clients of all ages

Should not be used in:

  • None reported

In what languages is the measure available?

No formal translations of the PPT have been reported. Because of the non-verbal nature of the assessment it can be used by non-English groups.

Summary

What does the tool measure? Dexterity and gross movement of the upper limb
What types of clients can the tool be used for? The PPT can be used with, but is not limited to clients with stroke.
Is this a screening or assessment tool? Assessment tool
Time to administer The PPT takes approximately 5 to 10 minutes to administer.
Versions There are no alternative versions of the PPT.
Other Languages None typically reported.
Measurement Properties
Reliability

Test-retest:

Several studies have investigated the test-retest reliability of the PPT in healthy patients and found adequate to excellent test-retest reliability for all subtests. A three-trial administration method has been found to be more reliable than a one-trial method.

Validity

Known groups:

One study examined the known groups validity of the PPT and found to have 70% accuracy for detecting lateralization of brain damage and 90% accuracy for detecting brain damage regardless of lateralization.

Floor/Ceiling Effects No studies have examined the floor/ceiling effects of the PPT in clients with stroke.
Does the tool detect change in patients? No studies have formally investigated the responsiveness of the PPT in clients with stroke.
Acceptability The PPT has been criticized for not being reflective of real life activities of daily living (Ashford, Slade, Malaprade & Turner-Stokes, 2008). The test is quick to complete and should not produce undue fatigue for patients.
Feasibility The PPT is short and easy to administer and score.
How to obtain the tool?

The PPT can be ordered by contacting the manufacturer directly at:

Lafayette Instruments
3700 Sagamore Parkway North
P.O. Box 5729 | Lafayette, IN 47903 USA
Tel: 765.423.1505 | 800.428.7545
Fax: 765.423.4111
E-mail: info@lafayetteinstrument.com
www.lafayetteinstrument.com

Psychometric Properties

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Purdue Pegboard Test (PPT). Several studies have been conducted, however only one study was specific to clients with stroke.

Reliability

Internal consistency:
No studies have examined the internal consistency of the PPT in clients with stroke.

Test-retest:
Buddenberg and Davis (1999) examined the 1-week test-retest reliability of the PPT using the one-trial and three-trial administration procedures, in 47 healthy participants. The three-trial administration method was found to have excellent test-retest reliability for all subtests (ICC=0.82, 0.89, 0.85, 0.89 and 0.81 for the right hand, left hand, both hands, R+L+B and assembly subtests respectively). The one-trial administration method was found to have poor to adequate test-retest reliability using Interclass Correlation Coefficient (ICC=0.37, 0.61, 0.58, 0.70, 0.51 for the right hand, left hand, both hands, R+L+B and assembly subtests respectively).

Several studies have investigated the test-retest reliability of the one-trial administration method of the PPT in healthy participants. The following chart has been adapted from Buddenberg and Davis (1999).

Reliability Coefficients Reported for One-Trial Administrations of the Purdue Pegboard Test

Subtests Tiffin & Asher (1948) Bass & Stucki (1951) Tiffin (1968) Reddon, Gill, Gauk & Maerz (1988) (men/women) Desrosiers, Bravo & Dutil (1995)
Right hand 0.63 0.67 0.68 0.63/0.76 0.66
Left hand 0.60 0.66 0.65 0.64/0.79 0.66
Both hands 0.68 0.71 0.73 0.67/0.81 0.81
Right + Left + Both hands 0.71 0.79 0.71 NR 0.90
Assembly 0.68 0.72 0.67 0.81/0.83 0.84

NR=not reported

Desrosiers, Hebert, Bravo and Dutil (1995) investigated the test-retest reliability of the PPT in 35 healthy individuals aged 60-89 years with no-known upper-limb impairment. Each individual completed the PPT on 2 occasions with approximately 1 week between testing. Test-retest reliability, calculated using ICC was found to be adequate to excellent for the 5 subtests (ICC=0.66, 0.83, 0.81, 0.90 and 0.84 for Right hand, Left hand, Both hands, Right+Left+Both hands and Assembly subtests respectively). Scores from the second administration were higher, indicating a practice effect.

Intra-rater:
No studies have examined the intra-rater reliability of the PPT in clients with stroke.

Inter-rater:
No studies have examined the inter-rater reliability of the PPT in clients with stroke.

Validity

Content:

No studies have examined the content validity of the PPT in clients with stroke.

Criterion:

Concurrent:
No studies have examined the concurrent validity of the PPT in clients with stroke.

Predictive:
No studies have examined the predictive validity of the PPT in clients with stroke.

Construct:

Convergent/Discriminant:
No studies have examined the convergent or discriminant validity of the PPT in clients with stroke.

Known Groups:
Costa, Vaughan, Levita & Farber (1963) examined the known groups validity of Purdue Pegboard subtests (Right, Left and Both hands) in 54 clients with brain damage resulting from neoplasms, traumatic injury or degenerative, vascular or infectious diseases; and 26 clients with peripheral nervous system lesions or lesions below the level of the thoracic spine (control group). Clinical neurological examination, electroencephalography and neuroradiographic procedures were used to confirm diagnosis. The PPT accurately identified clients below the age of 60 years as having brain damage if one or more of the following were found on scoring: left score < 11; right score < 13; both hands score < 10; or left score > right score +3; and a lesion on the left if left score > right score, and on the right if right score > left score + 3. The PPT accurately identified clients above the age of 60 years as having brain damage if one or more of the following were found on scoring: left score < 10; right score < 10; both hands score < 8; or left > right +3; and a lesion on the left if left > right, and on the right if right > left + 3. If the client’s scores accurately classified the client as having brain damage but neither left or right lesions were identified based on the scores, the brain damage is categoried as bilateral. The above PPT cutoff scores were found to have a 70 percent accuracy for lateralization and a 90 percent accuracy for brain damage without regard to lateralization.

Sensitivity/specificity

No studies have examined the sensitivity/specificity of the PPT in clients with stroke.

Responsiveness

No studies have examined the responsiveness of the PPT in clients with stroke.

References

  • Ashford, S., Slade, M., Malaprade, F., Turner-Stokes, L. (2008). Evaluation of functional outcome measures for the hemiparetic upper limb: A systematic review. Journal of Rehabilitation Medicine, 40, 787-795
  • Buddenberg, L.A. & Davis, C. (1999). Test-retest reliability of the Purdue Pegboard Test. The American Journal of Occupational Therapy, 54(5), 555-558
  • Costa, L.D., Vaughan, H.G., Levita, E. & Farber, N. (1963). Purdue Pegboard as a predictor of the presence and laterality of cerebral lesions. Journal of Consulting Psychology, 27(2), 133-137
  • Desrosiers, J., Hebert, R, Bravo, G. and Dutil, E. (1995). The Purdue Pegboard Test: Normative data for people aged 60 and over. Disability and Rehabilitation, 17(5), 217-224

See The Measure

How to obtain the Purdue Pegboard Test?

The PPT can be ordered by contacting the manufacturer directly at:

Lafayette Instruments
3700 Sagamore Parkway North
P.O. Box 5729 | Lafayette, IN 47903 USA
Tel: 765.423.1505 | 800.428.7545
Fax: 765.423.4111
E-mail: info@lafayetteinstrument.com
Web: www.lafayetteinstrument.com

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