Instruments for assessment of impairments and activity limitations in patients with hand conditions: an European delphi study

Objective: To reach multidisciplinary European consensus on the assessment tools for impairments and activity limitations in patients with hand conditions. Design: Electronic Delphi method. Subjects: Thirty experts from European societies for hand therapy, hand surgery, and physical and rehabilitation medicine. Methods: In 3 rounds, participants were asked which of 13 preselected categories of the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Hand Conditions should be assessed. In addition, they were asked to choose which of 55 preselected instruments they preferred for each category by confirming or rejecting instrument-specific statements. Results: All 13 preselected ICF categories were considered relevant. Consensus was based on >= 75% agreement. After 3 rounds, 9 instruments were selected: Shape Texture Identification Test, Semmes Weinstein Monofilament Test, Visual Analogue Scale for pain, goniometer, Jamar Dynamometer, Pinch Gauge Device, Cold Intolerance Symptom Severity questionnaire, Canadian Occupational Performance Measure, and Disabilities of the Arm, Shoulder and Hand Questionnaire. It remained undecided whether to use the Nine-Hole Pegboard Test or the Purdue Pegboard Test. Conclusion: In this European Delphi study, multidisciplinary consensus was reached on 9 assessment tools for impairments and activity limitations in patients with hand conditions addressing 13 categories of the Brief ICF Core Set for Hand Conditions.