Reliability and Validity of Hand Function Tests in Carpal Tunnel Syndrome

Jebsen-Taylor Hand Function Test

A standardized, timed assessment designed to evaluate a broad range of uni-manual hand functions utilizing everyday functional activities. It consists of seven distinct subtests: writing, card turning, picking up small objects, simulated feeding, stacking checkers, picking up large light cans, picking up large heavy cans. The physiotherapist will demonstrate the test first, followed by a practice trial for the participant. A maximum time limit of 120 seconds is set for each subtest; if a task cannot be completed, the score is recorded as 120 seconds.

Minnesota Dexterity Test

The Minnesota Dexterity Test is a standardized objective instrument used to evaluate rapid eye-hand coordination and gross arm-hand dexterity. It consists of two primary subtests: the Placing Test and the Turning Test. In the Placing Test, the subject fills the board with 60 cylindrical blocks as quickly as possible. In the Turning Test, the subject turns the blocks over in a specified sequence using both hands alternately. Each subtest will be performed two times. Separate total scores will be calculated for the Placing Test and the Turning Test based on the total time (in seconds) required to complete the trials. Higher scores (longer times) indicate greater impairment and poorer manual dexterity.

Nine-Hole Peg Test

The Nine-Hole Peg Test is a brief, standardized quantitative assessment used to measure finger dexterity and fine manual velocity. The apparatus consists of a plastic board with nine holes and nine pegs. The participant will be instructed to pick up the pegs one by one from a container, place them into the nine holes as fast as possible, and then remove them one by one, returning them to the container. The test will be performed one time. The score will be recorded as the total time (in seconds) taken to complete the entire task. Higher scores (longer times) indicate worse fine motor dexterity and coordination.

Boston Carpal Tunnel Questionnaire

The Boston Carpal Tunnel Questionnaire is a patient-reported, disease-specific outcome measure designed to evaluate the severity of symptoms and functional status in patients with carpal tunnel syndrome. It comprises two independent subscales: the Symptom Severity Scale (11 items) and the Functional Status Scale (8 items). Each item is scored on a 5-point Likert scale ranging from 1 (no symptoms/no difficulty) to 5 (most severe symptoms/cannot perform activity). The score for each subscale is calculated as the mean of the completed items, yielding a final score between 1 and 5. Higher scores represent more severe symptoms and worse functional limitation.

Michigan Hand Outcomes Questionnaire

The Michigan Hand Outcomes Questionnaire is a comprehensive, hand-specific psychometric instrument designed to assess a patient's perception of their hand function and quality of life. It contains 57 items divided into six distinct domains: Overall Hand Function, Activities of Daily Living, Work Performance, Pain, Aesthetics, and Patient Satisfaction. Items are scored on a 5-point scale, and responses are normalized and converted to a standardized score ranging from 0 to 100 for each domain. For the pain domain, a higher score denotes greater pain severity. For the remaining five domains, higher scores represent better hand performance, appearance, and satisfaction.

QuickDASH

The QuickDASH is a shortened, 11-item version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, used to measure physical symptoms and disability in individuals with musculoskeletal disorders of the upper limb. It evaluates symptoms (such as pain and tingling) and the ability to perform specific physical activities during the past week. Each item is rated on a 5-point Likert scale. The scores are summated and transformed to a standardized scale of 0 to 100, where 0 represents no disability and 100 represents the most severe disability and symptom expression.

EuroQol 5D-5L

The EuroQol 5D-5L is a standardized, generic instrument used to measure health-related quality of life. It consists of two main components: the EQ-5D descriptive system and the EQ Visual Analogue Scale (EQ VAS). The descriptive system covers five dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. Each dimension is rated on 5 levels of severity ranging from 1 (no problems) to 5 (extreme problems). The EQ VAS records the respondent's self-rated health on a vertical visual analogue scale ranging from 0 (the worst health you can imagine) to 100 (the best health you can imagine)

Mini-Mental State Examination

The Mini-Mental State Examination (MMSE) will be utilized as a brief screening tool to objectively assess the cognitive competence of the participants. The test evaluates global cognitive domains including orientation to time and place, registration, attention and calculation, short-term recall, language, and visuospatial praxis. Total scores range from 0 to 30, with higher scores reflecting better cognitive function. A cut-off score of 24 or above will be required for inclusion to ensure that participants possess the necessary cognitive capacity to fully understand, cooperate with, and accurately execute the multi-step instructions of the physical performance tests.