The MacHAND performance assessment (MPA): Development and psychometric testing of the short English version (MPA-S) for the traumatic hand injury population.

Abstract

Background: Hand injuries are the most common work-related injuries in Canada, causing significant functional limitations, occupational performance issues, and delaying return to work. Standardized hand function measures are essential for guiding interventions, clinical decisions, and cost-effective care. However, few assessments have been developed for traumatic hand injuries, with even fewer being performance-based outcome (PerfOs) assessments. The MacHAND performance assessment (MPA) is a PerfO developed to evaluate hand function in the traumatic hand injury population.

Purpose: To revise the MPA instructions and scoring manual (MPA 2.0), produce a shortened version (MPA-S), and evaluate its psychometric properties in adults with traumatic hand injuries.

Study design: Mixed method.

Methods: The original MPA instruction's and scoring manual was revised to ensure language consistency, update pictures, and provide identical 3D-printed versions where appropriate (MPA 2.0). To produce the MPA-S, a combined statistical and Delphi approach with rehabilitation experts was used. An existing dataset from the original MPA was then used to determine MPA-S internal consistency, test-retest, and inter-rater reliability for the traumatic hand injury population and agreement with the MPA. Evidence-based dissemination strategies were used to promote clinical and research adoption.

Results: For the MPA-S, 10 items were retained for dominant and eight items for nondominant hand testing. The MPA-S showed good internal consistency (Cronbach's alpha and 95% CI: dominant hand: 0.85 [0.78, 0.90], nondominant hand: 0.88 [0.79, 0.92]), excellent test-retest reliability (r = 0.97, 95% CI [0.85, 1]), and inter-rater reliability (ICC 0.98, 95% CI [0.97, 0.99]), and the mixed-effects limits of agreement plots show good agreement with the MPA.

Conclusions: The MPA-S is one of the quickest task-based PerfOs to administer, uses many 3D-printed components, and everyday objects, making it highly accessible and affordable. We believe the MPA 2.0, the creation of the MPA-S, and targeted dissemination strategies will increase clinical and research uptake.