Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox

J Hand Ther. 2011 Oct-Dec;24(4):313-20; quiz 321. doi: 10.1016/j.jht.2011.05.001. Epub 2011 Jul 28.


Study design: Clinical measurement.

Introduction: Manual dexterity is an important aspect of motor function across the age span.

Purpose of the study: To identify a single measure of manual dexterity for inclusion in the National Institutes of Health (NIH) Toolbox Assessment of Neurological and Behavioral Function.

Methods: A total of 340 subjects participated in our study. Two alternatives, Rolyan® 9-Hole Peg Test (9-HPT) and Grooved Pegboard test, were compared by assessing their score range across age groups (3-85 yr) and their test-retest reliability, concurrent, and known groups validity.

Results: The 9-HPT was a simple, efficient, and low-cost measure of manual dexterity appropriate for administration across the age range. Test-retest reliability coefficients were 0.95 and 0.92 for right and left hands, respectively. The 9-HPT correlated with Bruininks-Oseretsky Test (BOT) of Motor Proficiency, dexterity subscale, at -0.87 to -0.89 and with Purdue Pegboard at -0.74 to -0.75. The Grooved Pegboard had good test-retest reliability (0.91 and 0.85 for right and left hands, respectively). The Grooved Pegboard correlated with BOT at -0.50 to -0.63 and with Purdue Pegboard at -0.73 to -0.78. However, the Grooved Pegboard required longer administration time and was challenging for the youngest children and oldest adults.

Conclusions: Based on its feasibility and measurement properties, the 9-HPT was recommended for inclusion in the motor battery of the NIH Toolbox.

Level of evidence: NA.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Functional Laterality
  • Hand / physiology*
  • Humans
  • Male
  • Middle Aged
  • Motor Skills / physiology*
  • National Institutes of Health (U.S.) / standards*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sex Factors
  • United States