Sequential occupational dexterity assessment (SODA): a new test to measure hand disability.

Measuring hand-related disability poses a problem due to a lack of validated tests. This report introduces the sequential occupational dexterity assessment (SODA), a test that measures bimanual dexterity in daily life. The design of the SODA is described. Validity and reliability of the SODA are demonstrated in a sample of patients with rheumatoid arthritis (RA), in whom impairment of the hands may cause serious disability in daily life. Good reliability was found, as measured by internal consistency, test-retest correlation, and interrater stability. Validity was established by relating the SODA to a number of other variables. Current disease activity was only weakly related to the SODA score. Impairment of the hands is more strongly related to dexterity than to current disease activity. However, dexterity could vary considerably in patients with similar degrees of impairment. Pain during the SODA proved to be more important for dexterity than general level of pain. Considerable variation was found in self-reported and observed dexterity. It was concluded that the SODA may guide the therapist in making decisions about hand therapy. The use of the SODA allows standardized evaluation of the effects of hand surgery on bimanual dexterity.