Hand function assessment: tests for adult patients with central nervous system disorders

Abstract

Dysfunction of the upper limb is a very common and severe problem in patients with central nervous system disorders. The restoring of arm and hand functions is one of the priority goal of medical rehabilitation in these patients. The development of new effective rehabilitation technologies, the implementation of a patient-centered approach and the objective assessment of rehabilitation outcomes requires the validated tools аvailability. The aim of this review is to introduce specialists to those tools that evaluate the rehabilitation outcomes based on the patient's performance of standardized tasks (tests). Attention is drawn to the fact that the functional abilities of the upper extremities should be assessed on the base of the International Classification of Functioning, Disability and Health. The general concepts of these tests are discussed. Standard requirements for measurement tools (validity, reliability, sensitivity) ensure the reliability of test results. A brief description of the tests focused on the hand and arm function is done. Only tests that have good psychometric characteristics and are suitable for monitoring the rehabilitation outcomes for patients with stroke, multiple sclerosis and spinal cord injury are presented in the review. It is concluded that the choice of a specific test is based on the purpose and objectives of the study (clinical practice or scientific research), the motor deficit peculiarities and the rehabilitation unit resources. It is emphasized that there is a need to create and validate new tools focused on the measuring the hand function abilities in patients with central nervous system disorders.