Die Hand positionieren, um zu agieren – Validierung des 8-Punkte-Greifraum-Tests

Abstract

Background: The standardized geriatric assessment of the upper extremities is often limited to measurement of hand strength. The only other instrument mentioned in the S1 guidelines on level 2 geriatric assessment is the 20 cents test (20-C-T); however, in addition to strength and fine motor skills, successful hand placement is a prerequisite for self-care. Objective: The 8‑point reaching range test (8P-GRT) was developed for standardized separate testing of sides in a seated person concerning hand positioning relevant to daily living. The purpose of the study was to determine quality criteria of the 8P-GRT in geriatric hospital patients. Material and methods: Between 31 July 2019 and 23 September 2019, a total of 82 inpatients were examined at the Hospital Red Cross Lübeck Geriatrics Center using the 8P-GRT, shoulder pain and disability index (SPADI), a questionnaire on self-care activities corresponding to the hand positions of the 8P-GRT, hand strength measurement and the 20-C‑T. Results: The interrater reliability was 0.99 and the retest reliability was 0.95 for the right side and 0.90 for the left side. On the individual level a ceiling effect (both sides score 8) occurred in 4.1% (n = 3) but no floor effect was observed. The internal consistency (Cronbachʼs alpha) of the two-factorial test according to factor analysis was 0.78 (right) and 0.76 (left). Each of the other tests correlated more closely with the 8P-GRT on the right side, whereby the correlation was highest with the abovenamed questionnaire (−0.72), followed by the SPADI (−0.60). Conclusion: A standardized survey of hand strength, fine motor skills and active positioning of the hand (e.g., 8P-GRT) synthesizes the main aspects of upper extremity functioning into an overall picture.