The assessment of hand function: a critical review of techniques.

The tests and procedures used to evaluate the sensory and motor capabilities of the hand are reviewed in the context of normative studies that provide evidence of their reliability and validity. Three broad areas of assessment are distinguished, ranging from the measurement of strength and joint motion to the evaluation of the functional capacity of the hand. The strengths and limitations of the techniques used to evaluate hand function are examined, and the importance of considering a number of variables (e.g., hand preference, age) when interpreting test results from patients is discussed. The problems in predicting the functional capacity of the hand from scores on specialized sensory and motor tests suggest that more versatile measuring instruments are required. This issue is addressed with reference to recent studies of prehension in normal subjects.