Nine Hole Peg Test (NHPT)

Nine Hole Peg Test (NHPT) Evaluation Summary

What does the tool measure? Finger dexterity.
What types of clients can the tool be used for? The NHPT can be used with, but is not limited to clients with stroke.
There are no restrictions when administering it to clients with chronic stroke. With clients with acute stroke the mode of scoring should be observed in order to avoid floor effects.
Is this a screening or assessment tool? Assessment
Time to administer The amount of time it takes to administer the NHPT has not been reported and it will vary according to the client’s impairment or the mode of scoring.
Versions There are no alternative versions.
Other Languages There are no official translations.
Measurement Properties
Reliability – No studies have examined the internal consistency of the NHPT.
– 3 studies have examined the Pearson correlation.
– 3 studies have examined the inter-rater reliability of the NHPT and reported excellent Pearson correlation.
Validity Criterion:
Concurrent Validity. 2 studies have examined the predictive validity and reported that NHPT is not able to predict functional outcomes after six months of stroke.

Convergent validity. 1 study has examined convergent validity of the NHPT and reported excellent correlations between the NHPT and the Motricity Index using Pearson correlation coefficients.

Floor/Ceiling Effects 2 studies have examined floor effects.
Does the tool detect change in patients? 2 studies have examined the ability to detect change of the NHPT and reported that the NHPT is able to detect change.
Acceptability The NHPT should not be used clients with severe upper extremity impairment and those who are not able to pick up the pegs.
Feasibility The administration of the NHPT is quick and simple, however it requires standardized equipment.
1 study has examined the feasibility of the NHPT and reported that, on average, 52% of clients with acute stroke were not able to perform the NHPT (Jacob-Lloyd et al., 2005).
How to obtain the tool? The NHPT instructions can be obtained in the study by Mathiowetz et al., (1985). Also, a version of the measure can be obtained from the publication by Wade (1992).
Davis et al. (1999) reported the most used standardized equipments for NHPT in the United States are produced by Smith and Nephew Rehabilitation, Inc. and Sammons Preston.

Standardized equipment can be obtained at the website: