Upper Extremity Function Test (UEFT)

Purpose of the measure

The Upper Extremity Function Test (UEFT) is an evaluative measure to assess upper extremity functional impairment and the severity of impairment in patients exhibiting dysfunction in the upper extremity. The test assesses function based on the assumption that complex upper extremity movements used in everyday activities are made up of certain movement patterns (e.g. supination/pronation, grasp/release, pinch grip, etc.), so that evaluation of these movement patterns can predict the patient’s ability to perform functional activities. The UEFT was designed primarily to quantify the patient’s ability to execute upper extremity activities of a general nature, and does not take into consideration factors such as skill, speed, range of motion, endurance, sensation etc. The selected list of test items is believed to represent the upper limb movements that are necessary to perform many of the major activities of daily living. The UEFT has not yet been correlated to vocational activities of the upper extremity.

Available versions

The Action Research Arm Test (ARAT) was developed by Ronald Lyle in 1981 by adapting theUpper Extremity Function Test (UEFT)(Carroll, 1965). TheUEFTtest administration and scoring was simplified, the time required to administer the test was shortened, and items were grouped based on the hierarchical scale (Guttman Scale) (Lang, Wagner, Dromerick, & Edwards, 2006). Due to the need for more specific and detailed instructions related to the client’s position, scoring and test administration, Yozbatiran, Der-Yeghiaian, and Cramer (2008) proposed a standardized approach to the ARAT.

Please visit our Action Research Arm Test module for further information.

Features of the measure

Items:

The UEFT consists of 33 items or tasks, detailed below.

Description of tasks:

The patient is positioned comfortably in a chair in front of the table used for testing. The patient is evaluated while performing different tasks, such as moving objects to a shelf, placing objects over a peg, writing their name, etc. The objects are of varying shapes and weights in order to evaluate the patient’s grasp, grip, pinch, placing, arm extension and elevation, pronation and supination, and functional strength.

Please note that the patient is not permitted to move from the chair during testing (unless a break is required), although weight transfer and rolling from side to side of the buttock is permitted. Each arm is tested individually. Demonstration of tasks are permitted (Carroll, 1965)

Scoring and Score Interpretation:

The UEFT uses a simple scoring method where results can be compared at different time intervals.

Scoring:

3 Performs test normally.
2 Completes test, but takes abnormally long time or has great difficulty.
1 Performs test partially. This grade is assigned when the patient is able to pick up or lift the test item from the table but is unable to place the object in its correct end position. For example, in items 27 to 29, the patient is able to lift the pitcher or glass but is unable to pour the water into the proper receptacle.
0 Can perform no part of the test. If the patient pushes objects out of their slots or around on the table a grade of 0 is assigned.

The total score is tallied. The maximum score for the dominant hand is 99 as compared to a maximum score of 96 for the non-dominant hand, because item 33 consists of writing of the patient’s name with the dominant hand.

The authors of the test concluded that a score increase or decrease of 10 points represents a meaningful gain or loss of important function, respectively.

Nearly equal scoring points have been allotted for the two functions prehension’ (grasp, grip and pinch) and placing’ (shoulder stability; shoulder abduction and flexion/extension; elbow flexion/extension; wrist flexion/extension and pronation/supination); as such, both functions need to be intact in order for a high score to be awarded.

Score interpretation:

0 to 25: Trace function
26-50: Very poor
51-75: Poor
76-89: Partial function
90-98: Functional
99 (dominant hand) / 96 (non-dominant hand): Maximal function

Functional Implications of UEFT:

Basmajian et al. (1982) investigated the functional implications of UEFT scores and found the following scores to be indicative of the following patient capabilities:

  • 0: no function
  • 10: holding a book for reading
  • 20: driving
  • 30: carrying objects from place to place
  • 40: dressing
  • 50: feeding
  • 60: shaving/make-up
  • 70: hand crafts
  • 80: fine crafts (needlework, gardening, capentry)
  • 90: card playing
  • 100: letter writing/typing

Adapted from Basmajian, Gowland, Brandstater, Swanson & Trotter (1982).

Time:

The UEFT takes approximately 1 hour to administer (Lyle, 1981).

Training requirements:

None typically reported, however it is recommended that the clinician is familiar with the assessment tool.

Subscales:

None typically reported.

Equipment:

  • 17.5 in. width x 28.5 in. length x 30.75 in. height table
  • 3.75 in. width shelf mounted 14.75 in. from the table
  • Wooden cubes: 4 x 4 x 4in. (576g); 3 x 3 x 3in. (243g); 2 x 2 x 2in. (72g); 1 x 1 x 1 (9g)
  • Large iron pipe: 1.625 O.D. x 6.125in. (500g)
  • Small iron pipe: 0.87 O.D. x 4.125 (125g)
  • Slate: 4.125 x 1 x .375 (61g)
  • Wooden ball: 3 O.D. (100g)
  • Glass marble 0.625 O.D. (6.3g)
  • Metal sphere 0.44 O.D. (6.6g); 0.25 O.D. (1.0g); 0.16 (0.34g)
  • Steel washer 0.16 thick x 1.375 O.D. x 0.56 I.D. (14.5g)
  • Iron 6 lb approximately
  • 2 Plastic tumblers 8 fl. oz
  • Aluminum water pitcher 3 qt capacity
  • Pencil

**O.D. = outside diameter; I.D. = inside diameter

Please refer to Carroll (1965) for further information regarding administration set-up of the UEFT.

Alternative form of the Action Research Arm Test

None typically reported.

Client suitability

Can be used with:

  • Clients with stroke.

Should not be used with:

  • When administering the UEFT to clients with upper extremity amputations, the total score should be adjusted according to the following scale.

Total UEFT Scores for people with amputations:

Wrist: 0
Three fingers: 41
Middle finger: 87
Index finger and 2nd metacarpal: 84
Thumb and metacarpal-phalangeal joint: 91
Index finger at proximal interphalangeal joint: 93
Languages of the measure?

There are no official translations of the UEFT.