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Matheson, L, Kaskutas V, Mada, D. (2001). Development and construct validation of the Hand Function Sort. Journal of Occupational Rehabilitation, 11(2): 75–86. (PubMed ID: 11706533)
The purpose of the EPIC Hand Function Sort (HFS) is to quantify ability to perform work tasks that involve the hands and upper extremities. The HFS quantifies and documents reported functional capacity with very little effort or expense.
In treatment programs, the patient’s progress can be documented easily. The HFS provides a baseline measure of function in everyday tasks, to compare to progress in subsequent treatment, extending the benefits beyond the clinic’s walls, into the patient’s life at home, at work, and in the community. In comparison with functional tests, magnification of dysfunction can be identified.
In employment screening programs in industrial settings, the HFS compares the job applicant’s current abilities to job demands and sets a baseline of abilities.
In the HFS, drawings of handling and fingering tasks are supplemented by drawings that depict common activities of daily living and work tasks. The drawings have been selected by experts in rehabilitation from hundreds of tasks that persons with upper extremity impairments report present significant challenges. Each of the 62 drawings in the test booklet is accompanied by a simple task description.
The HFS is an untimed paper and pencil test. The evaluee is instructed to “Look at each drawing and read the description. On a separate answer sheet, indicate your current level of ability to perform the task.”
The answer sheet provides a 5-point rating from “Able” to “Restricted” to “Unable.” Operational definitions of these adjectives are provided in the standardized instructions. There is also a sixth rating which is depicted as “?” and indicates, “I don’t know.”
The HFS can be administered by a technician following standardized instructions. Although administration is not timed, the HFS usually requires 8 to 10 minutes to complete. Items can be read to the evaluee who is illiterate, although the combination of text and pictures allows evaluees with low literacy levels to complete the test independently.
The HFS is easily scored by hand and yields a single “Rating of Perceived Capacity” which ranges from zero to 248. Three “internal validity check” drawings are included that are similar to drawings presented earlier. These are used to screen for inconsistent responding, along with a graded scoring strategy that evaluates intra-test consistency.
Computerized Scoring and Analysis
Through use of an Excel spreadsheet that is available at no charge ( (download worksheets in zip file)), the evaluee’s Ability Profile can be derived. The Ability Profile analyzes each response in terms of 18 physical demand constructs, including Hand Dexterity, Hand Strength, Lift Capacity, and Upper Extremity Coordination.
Interpretation and Reporting
Normative values for both healthy and disabled males and females are provided in the HFS examiner’s manual. In addition, the HFS Rating of Perceived Capacity score is cross-referenced to the U.S. Department of Labor’s Physical Demand Characteristic of Work system, described below:
|Physical Demand Level||Occasional|
0–33% of the workday
34–66% of the workday
67–100% of the workday
|Typical Energy Required|
|Sedentary||10 lbs.||Negligible||Negligible||1.5–2.1 METS|
|Light||20 lbs.||10 lbs. and/or Walk/Stand/Push/Pull of Arm/Leg controls||Negligible and/or Push/Pull of Arm/Leg controls while seated||2.2–3.5 METS|
|Medium||20 to 50 lbs.||10 to 25 lbs.||10 lbs.||3.6–6.3 METS|
|Heavy||50 to 100 lbs.||25 to 50 lbs.||10 to 20 lbs.||6.4–7.5 METS|
|Very Heavy||Over 100 lbs.||Over 50 lbs.||Over 20 lbs.||Over 7.5 METS|
Through use of the PDC crosswalk, the evaluee’s score can be linked to performance on the EPIC Lift Capacity test, and to more than 12,000 occupational descriptions in the Dictionary of Occupational Titles.
Figure 11. Cut a piece of steak with a fork and sharp knife.
Figure 26. Prune a small shrub with shears.
Figure 31. Change a light bulb overhead.
Figure 58. Break loose a large fitting with a pipe wrench.
Leonard N. Matheson, PhD
Mary L. Matheson, MS
Janet E. Grant, BS