Open Access Research article

Preliminary study of the Southampton Hand Assessment Procedure for Children and its reliability

Ecaterina Vasluian1*, Raoul M Bongers2, Heleen A Reinders-Messelink14, Pieter U Dijkstra13 and Corry K van der Sluis1

Author Affiliations

1 Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

2 University of Groningen, University Medical Center Groningen, Center of Human Movement Sciences, Groningen, The Netherlands

3 Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

4 Rehabilitation Center ‘Revalidatie Friesland’, Beetsterzwaag, The Netherlands

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BMC Musculoskeletal Disorders 2014, 15:199  doi:10.1186/1471-2474-15-199

Published: 10 June 2014



The Southampton Hand Assessment Procedure (SHAP) is currently used in the adult population for evaluating the functionality of impaired or prosthetic hands. The SHAP cannot be used for children because of the relatively larger size of the objects used to perform SHAP tasks and unknown clinimetric properties. The aims of this study were to adapt the SHAP for use in children (SHAP-C), to determine norm values for the SHAP-C, and to analyze the reliability of the SHAP-C.


The SHAP-C was adapted based on the SHAP protocol. Some objects were downsized, and the timing of tasks was performed by the rater instead of the participant. Intra- and inter-rater reliability were assessed in 24 children (5 [0.54] y/o) with unimpaired hands. The repeatability coefficients (RCs) were calculated. An RC ≤ 75% of the mean SHAP-C task values was considered good reliability.


Participants were able to perform all SHAP-C tasks. The means of the SHAP-C tasks ranged from 0.75 to 1.21 seconds for abstract objects and from 0.64-19.13 seconds for activities of daily living. The RCs of a single assessor did not exceed 75% in 17/26 SHAP-C tasks, displaying a relatively good intra-rater reliability, whereas the RCs for the inter-rater reliability exceeded 75% in 22/26 SHAP-C tasks, thus displaying poor reliability.


In this first study that adjusted the SHAP for pediatric use, we found that all SHAP-C objects and tasks could be performed by children. The intra-rater reliability was better than the inter-rater reliability. Although the SHAP-C appears to be a promising instrument, the protocol requires further modifications to provide reliable measurements in children.

Reproducibility of results; Intra-observer variability; Inter-observer variability; Treatment outcome; Disability evaluation; Hand injuries; Physical and Rehabilitation Medicine