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Handitest

Evaluation of disability severity

 

Individual identification

Last name:..........................................................

First name:..........................................................

Sex:                  M                  F

Date of birth:        /      /

No. of social security:

Address:

 

Phone number:

Marital status

 Single                   Married                   Divorced                   Widowed

Number of children or the people in charge:

Is your spouse employed?                  Yes                  No

 

Illness identification

Illness or trauma
Date of appearance
Prognosis
stable
improvement
deterioration
1)        
2)        
3)        
4)        
5)        

 

Physical Exam

 
0
1
2
3
4
Brain          
Vertebra l column          
Auditory system          
Visual system          
Mastication organs          
Phonation organ          
Face, head and neck          
Swallowing organs          
Olfactory organs          
Respiratory system          
Cardio-vascular system          
Urinary system          
Digestive system including anorectum          
Endocrine glands          
Hematopoietic and immune system          
Genital and reproductive system          
Skin          
Superficial sensibility organs          
System of the spine          
Chest          
Right upper limb          
Left upper limb          
Right lower limb          
Left lower limb          

Height:................................cm                    Weight:................................kg

 

Functional evaluation

Laterality:
Right-handed           Left-handed           Ambidextrous  
Severity
0
1
2
3
4

Maintaining

and

movement

Remaining in a lying posture          
Remaining in a standing posture          
Remaining in a sitting posture          
Turning around in a lying posture          
Passing from sleeping position to sitting position          
Passing from sitting position to standing position          
Walking or moving horizontally          
Running          
Getting up from the floor          
Keeping balance (risk of fall)          

Manipulation

Préhension

Holding with right hand          
Holding with left hand          
Moving right hand in the air          
Moving left hand in the air          

Communication

Speaking          
Writing          
Other forms of communication          
Hearing with right ear          
Hearing with left ear          
Vision with right eye          
Vision with left eye          

Cognition

Memory          
Logic and reasoning          
Learning capacity          
Temporal and spatial orientation          
Tolerance          
Affectivity          
Control of
sphincters
Urine control          
Feces control          
Sexuality
Procreation
Sexual activities          
Fertility          
  Adapting to physical activity          
Mastication          
Ingestion          
Possibility of ordinary cough          
Cutaneous protection against pathologic factor          
Sleep          
Vigilance          

 

Situational evaluation

Laterality:
Right-handed           Left-handed           Ambidextrous  
Severity
0
1
2
3
4

Activities

of

daily

living

Eating and drinking          
Going to the toilet          
Toileting          
Getting dressed and undressed
     - superior part of the body
     - Inferior part of the body
         
Calling in case of distress          
Getting into and out of bed          
Moving around inside the house          
Doing ones personal tasks          
Picking sth up from the floor          
Writing          
Phoning          
Managing one's budget          
Taking medication          
Going out and coming back to the house          
Going up and coming down the stairs          
Doing the shopping and outdoor activities          
Using public transportation          
Using private transportation          
Social
and
affective
life
Having affective relations with family          
Having affective relations with friends and neighbors          
Doing leisure activities          
Doing non-professional social activities          
Doing a professional activity          
Moving towards school or work          
Establishing an ordinary relationship with colleagues and friends          
Establishing and ordinary relationship          
Appearance
and
beauty
Being considered not beautiful by others:
  1 : slight or discrete
  2 : rather compensable by cosmetics and clothes
  3 : important accompanied by the change in other's behavior
  4 : very important accompanied by a major obstacle in social life
         
Care
constraint
Necessity of care by professionals:
  1 : once / month
  2 : once / week
  3 : several time / week
  4 : everyday
         

 

Subjectivity evaluation

 
0
1
2
3
4
View point of the individual on their situation as a disabled person          
View point on their body modification (do they feel different from others?)          
View point on their current functional capacities (do they feel dampened?)          
View point on their current situation as a disabled person (feeling of exclusion?)          
View point on the possibility of evolution and return to the usual situation          
Suffering:
     - Organic origin
     - Physical origin
         

 

Mode of use

Handi test is an interactive instrument which requires full participation of the patient and that of their family

Obtained responses (for instance getting up from the floor or eating on one's own) can be verified by the evaluated person, their family or other people through direct observation on the occasion of on occupational therapy outcome. They can also he gained though deduction of common sense. (It is evident that you cannot ask a quadriplegic to go up the stairs or to get up from the floor)

This test can be studied on babies in order to observe the evolutions since birth you can notice the situations of the disabled in their usual environment on account of inadequacy of the height of the step of the staircases.

The quantification system relies on the notion of dependence in order to measure functional state as well as situational state.

This leads directly to the study of the types of necessary compensation.

0
No dependence
1
Discomfort in the functional realization or in a particular task.
2
Limitation in the realization, including usage of a medication, of a technical function or situational aid (leaning for instance) or of an animal aid. Necessity of momentary interruption pauses, position modification (sitting when you are standing) are the equivalents.
3
A human aid is partially necessary
4
The function or the tasks is impossible or must be totally compensated by another person.

Horizontal study of the document draw to draw a kind of curve and will enable you to situate the location of lesions, functional and situational typology as well as person' s own viewpoint on their state.

So, you have four rates at you disposal by averaging the rates: lesional, functional, situational and of subjectivity.

Severity scale
0
There is no disability but sometimes a discomfort : slowness or difficulty
1
Slight disability: limitation of the capacities with the situations of partial disability and few numerous: without dependence.
2
Average disability: evident restriction of activity often with a medicamentous dependence, of a technical aid or of adaptation of environment, without dependence on human aid.
3
Important disability: fundamental limitation of activities necessitating partial human aid
4
Very important disability: severe dependence on human aid of total substitution.

 

Translation by:
Doctor Mohammad Farjad, Professor of physical medicine and rehabilitation, University of Tehran, Iran.
Doctor M. Asheghan, Tehran, Iran.
Doctor S. Farjad, Physical Medicine & rehabilitation, Henri Mondor Universitary Hospital, Créteil, France.