A Quantitative Test of Upper Extremity Function.

IN A number of clinical situations, there is a need for a simple semi-quantitative test of upper extremity function. Measurement of function is of particular importance in evaluating the results of hand surgery and upper extremity prosthesis, in following the development of hand deformities in rheumatoid arthritis and neurological diseases, and in judging the effectiveness of different forms of therapy. It must be kept clearly in mind that the test we are trying to develop is one which will have direct relationship to what the patient is able to do in every-day activities. Measurement of individual muscle strength and joint range of motion gives some idea of what the patient may be able to use his hands for, but the ingenuity and use of muscle substitution seen in chronic hand disabilities makes prediction of upper extremity function from muscle tests and range of motion tests inaccurate. Clinical observation and prosthetic research [l, 21 have shown that there are certain movements of the upper extremity which are of more value than others. To be sure, finger performance is of little functional value unless there is arm and shoulder stability and movement. It is also true that shoulder and arm function are of little use without finger movement. The upper extremity evaluation test described in this communication is simple and quick enough to be carried out in an outpatient department or office by the doctor or technician. A simple scoring method is used so that results can be compared at different time intervals. The assumption is made that complex upper ,extremity movements used in daily activities can be reduced to certain patterns of grasp, pinch and grip of the hand; supination and pronation of the forearm; extension and flexion of the elbow: and elevation of the arm.