VALIDITY AND RELIABILITY OF ARABIC VERSION OF JEBSEN TAYLOR HAND FUNCTION TEST

Document Type : Original Article

Abstract

ABSTRACT
Objective: The purpose of the study is to culturally translate and validate
the Arabic version of Arabic Jebsen Taylor hand function test (and
evaluate the test-retest reliability, internal consistency, construct validity
ceiling or floor effects of this instruments) in normal population to
measure the physical function and to ensure better care delivery. Subject
and Methods: Two expert panels (each consists of nine experts) and 150
normal population aged from 18 to 60 years old participated in this study.
Forward translation, development of preliminary initially translated
version, backward translation, and development of the pre-final version
and testing of pre-final version using experts then testing of the final
version on patients were done. Clarity index, expert proportion of
clearance, index of content validity, expert proportion of relevance,
descriptive statistics, missed item index, time taken to answer the scale,
Cronbach‘s coefficient alpha and Spearman‘s rank correlation
coefficients were used for statistical analysis. Results: The scale index of
clarity equaled 100%, while The scale index of content validity equaled
92.38%. With regard to internal consistency, the Cronbach's alpha
equaled 0.598 (range from 0.487 to 0.660). In addition, the Spearman‘s
rank correlations were moderate to strong in the majority of items.
Conclusion: The Arabic Jebsen Taylor hand function test is a valid and
reliable tool and is comparable to the original English version.

Highlights

IMPLEMENTATIONS
Depending on the findings of this study, the Arabic-language version
of jebsen taylor hand function test scale could be used in research and
clinical setting for physical therapy and other professionals to measure the
hand function in normal people as it is valid, feasible and reliable tool.
RECOMMENDATION
The results of this study indicated need to consider the following
recommendations:
Egypt. J. of Appl. Sci., 36 (7-8) 2021 129
8
1. Further studies should be conducted to establish the preliminary
psychometrics of the Arabic-language version of jebsen taylor hand
function test with bilingual participants.
2. Further studies should be conducted to establish the full psychometric
properties (construct and criterion validity) of Arabic-language version of
jebsen taylor hand function test in a sample of the target population of
interest.
3. Further studies should be conducted to translate, adapt and validate other
assessment instruments for hand function.
4. Further studies should be conducted to translate, adapt and validate other
assessment 

instruments for physical function in different health
conditions.

Keywords


VALIDITY AND RELIABILITY OF
ARABIC VERSION OF JEBSEN TAYLOR HAND
FUNCTION TEST
Mahmoud M. Shaaban*; Mohsen M. Elsayad**
and Amira H. Draz ***
* B.Sc in Physical Therapy (2013) Cairo University.
** Professor of Physical Therapy, Basic Science Department, Faculty of Physical
Therapy, Cairo University, Fr. Dean faculty of physical therapy, Modern
University, Dean collage of Applied sciences , Gulf medical university, Director of
biomechanics lab, Wichita state University USA.
*** Professor of Physical Therapy, Basic Science Department, Faculty of Physical
Therapy, Cairo University, Dean Faculty of physical therapy, Hertfordshire University.
Key Words: Validity-Reliability-Arabic Jebsen Taylor hand function test.
*E-mail- Shaaban.m@outlook.com
ABSTRACT
Objective: The purpose of the study is to culturally translate and validate
the Arabic version of Arabic Jebsen Taylor hand function test (and
evaluate the test-retest reliability, internal consistency, construct validity
ceiling or floor effects of this instruments) in normal population to
measure the physical function and to ensure better care delivery. Subject
and Methods: Two expert panels (each consists of nine experts) and 150
normal population aged from 18 to 60 years old participated in this study.
Forward translation, development of preliminary initially translated
version, backward translation, and development of the pre-final version
and testing of pre-final version using experts then testing of the final
version on patients were done. Clarity index, expert proportion of
clearance, index of content validity, expert proportion of relevance,
descriptive statistics, missed item index, time taken to answer the scale,
Cronbach‘s coefficient alpha and Spearman‘s rank correlation
coefficients were used for statistical analysis. Results: The scale index of
clarity equaled 100%, while The scale index of content validity equaled
92.38%. With regard to internal consistency, the Cronbach's alpha
equaled 0.598 (range from 0.487 to 0.660). In addition, the Spearman‘s
rank correlations were moderate to strong in the majority of items.
Conclusion: The Arabic Jebsen Taylor hand function test is a valid and
reliable tool and is comparable to the original English version.
INTRODUCTION
In clinical literature, there are multiple tests for the evaluation of
hand function. In spite of their specificity in particular patient
populations, the assessment of ADL, as fundamental self -care, remain
Egypt. J. of Appl. Sci., 36 (7-8) 2021 123-132
2
too general and focus on the global functions rather than the specific and
function. Moreover, standard performance, such as normative data for
comparison of limited and function is absent (Culicchia et al., 2016).
The hand function test of interest; jebsen hand function test
(JTHFT)evaluates common aspects of hand function commonly used in
ADL (Rhee, Yu and Kim, 2011).It also provides objective
measurements of standardized tasks relative to norms. Additionally, it
can be used in many local clinical settings and can be administrated in a
short time by using readily available materials (Jebsen et al., 1969)
Test-retest reliability was established from the original JTHFT,
where results were found to be fairly to moderately consistent over time.
In addition, no significant learning effect was found between the two
sessions (Jebsen et al., 1969). Several studies also demonstrated that the
JHFT had moderate to high test-retest reliability and excellent intra-rater
reliability (r=0.84 and 0.85,p < 0.05) with absent practice effect (p<0.05)
(Hackel et al., 1992).
Design of the study:
The study was a cross-sectional study that employed simple random
sample technique.
Subject (selection of patients):
Inclusion Criteria
- Subjects age from 20-50, then grouped according to age;(20-29,30-
39,40-50).
-All the subjects are able to read and write in Arabic.
- Being no handicap.
-Both males and females.
- All the subjects are high education.
Exclusive criteria
- Subjects were not able to read the questionnaire
- Subjects with handicap,
-Systematic inflammatory rheumatic diseases ,
-Neurological conditions,
-Psychiatric disorders.
- History of cerebral concussions, visual or vestibular disorders.
METHODS:
- Assessment scale
The JTHFT is a seven-part, timed diagnostic test to evaluate the
level of hand function. Each subtest was designed to test each subject in
precisely the same manner. The seven subtests include writing, simulated
124 Egypt. J. of Appl. Sci., 36 (7-8) 2021
3
page turning, lifting small objects, simulated feeding, stacking, and
lifting large, light weight, and heavy objects. The non dominant hand is
tested before the dominant hand, and each task is timed by using a
stopwatch.
- Procedures
First the English version of the scale was translated into Arabic
independently by two certified independent translator. The two
translations translated back to English by a two certified independent
translator.
The original and translated English versions were compared,
necessary corrections were made, and then final Arabic version was
obtained. The sample text was administered to 150 patients to test its
understand ability then the scale was administered to 150 patients for
reliability to estimate test-retest reliability the same questionnaire was readministered
to the same patients after a two-week interval as we did not
want the scores to be influenced by changes in symptoms.
MATERIAL
a) Assessment scale
Jebsen Taylor Hand Function Test
b) Procedures followed (Sousa and Rojjanasrirat, 2011):
1- Forward translation: Translation of the original JTHFT into Arabic
(forward translation or one-way translation):
2- Comparison of the two translated versions of the JTHFT (A1 and A2):
synthesis
3- Blind back-translation (blind backward translation or blind double
translation) of the preliminary initial translated version of the JTHFT:
4- Comparison of the two back-translated versions of the JTHFT (B1 and
B2).
5- Pilot testing of the pre-final Arabic version of the scale for face and
content validity.
6- Feasibility (ability to use on larger sample) was evaluated by the
assessment of the frequency of missing answers per item and
administration time.
RESULTS
Nine experts and 150 normal people in this study.
The results of this study were presented as follow:
Experts Results:
-Two experts were of gynecology specialty, four expert was of basic
science specialty and one expert was of neurology specialty one was
Egypt. J. of Appl. Sci., 36 (7-8) 2021 125
4
orthopedic specialty and one expert physical therapist (20 years'
experience).
1. Clarity index of the final version
The scale index of clarity equaled 100% as shown in table (1).
Table (1): Items index of clarity of the final version
Items index of clarity
Clear Response
Item
Item (1) 9 100%
Item (2) 9 100%
Item (3) 9 100%
Item (4) 9 100%
Item (5) 9 100%
Item (6) 9 100%
Item (7) 9 100%
Mean 9 100%
a) Expert proportion of clearance of the final version
The mean of proportion of clearance (clear responses) equaled
100% as shown in table (2).
Table (2): Expert proportion of clearance of the final version
Proportion of clearance
Number of experts’ agreement
(clear responses)
Expert
number
1 7 100%
2 7 100%
3 7 100%
4 7 100%
5 7 100%
6 7 100%
7 7 100%
8 7 100%
9 7 100%
Mean 7 100%
1. Index of content validity of the final version
The S-CVI equaled 92.38% as shown in table (3).
Table (3): Item index of content validity of the final version.
Number of very relevant I-CVI
responses
Items
Item (1) 8 89%
Item (2) 8 89%
Item (3) 9 100%
Item (4) 8 89%
Item (5) 9 100%
Item (6) 8 89%
Item (7) 9 100%
Mean 8.4 93.7%
126 Egypt. J. of Appl. Sci., 36 (7-8) 2021
5
a) Expert proportion of relevance of the final version
The mean of the proportion of relevance (relevant responses)
equaled 93.7% as shown in table (4).
Table (4): Expert proportion of relevance of the final version.
Proportion of very relevant
Number of very Relevant
responses
Expert No
1 6 85.7%
2 7 100%
3 6 85.7%
4 7 100%
5 7 100%
6 6 85.7%
7 6 85.7%
8 7 100%
9 7 100%
Mean 6.5 93.6%
Patients Results:
- Answers of first item
3
7
The descriptive statistics of answers of the first item showed that
78 sheets (representing 52%) reported the first response, 48 sheets
(representing 32%) reported the second response, and 21 sheets
(representing 14%) reported the third response.
- Answers of second item
15
135
The descriptive statistics of answers of the second item showed that
33 sheets (representing 22%) reported the first response, 99 sheets
(representing 66%) reported the second response, 3 sheet (representing
2%) reported the third response.
- Answers of third item
The descriptive statistics of answers of the third item showed that
27 sheets (representing 18%) reported the first response, 42 sheets
(representing 28%) reported the second response, 57 sheets (representing
38%) reported the third response, and 24 sheets (representing 16%)
reported the fourth response.
- Answers of fourth item
The descriptive statistics of answers of the fourth item showed that
15 sheets (representing 10%) reported the first response, 18 sheets
(representing 12%) reported the second response, 111 sheets
Egypt. J. of Appl. Sci., 36 (7-8) 2021 127
6
(representing 74%) reported the third response, 6 sheets (representing
4%) reported the fourth response.
- Answers of fifth item
The descriptive statistics of answers of the fifth item showed that 9
sheets (representing 6%) reported the first response, 57 sheets
(representing 38%) reported the second response, 36 sheets (representing
24%) reported the third response, 45 sheets (representing 30%) reported
the fourth.
- Answers of sixth item
The descriptive statistics of answers of the sixth item showed that 6
sheets (representing 4%) reported the first response, 9 sheets(representing
6%) reported the second response, 42 sheets (representing 28%) reported
the third response, 21 sheets (representing 14%) reported the fourth
response and 72 sheets (representing 48%) reported the fifth.
- Answers of seventh item
The descriptive statistics of answers of the seventh item showed
that 12 sheets (representing 8%) reported the first response, 39 sheets
(representing 26%) reported the second response, 12 sheets (representing
8%) reported the third response, 84 sheets (representing 56%) reported
the fourth response.
Correlation coefficients (spearman’s rank correlations)
Regarding that the two-tailed value of P is 0.01, Spearman‘s rank
correlations were calculated as shown in table (5).
Table (5): Spearman’s rank correlations coefficients
Results of test
regarding association
between pre- and post test
Correlation strength
R value
Item No
1 0.19 Weak Non-significant
2 0.52 Moderate Significant correlation
3 0.54 Moderate Significant correlation
4 0.33 Weak Non-significant
5 0.47 Moderate Significant correlation
6 0.798 Strong Significant correlation
7 0.50 Moderate Significant correlation
R: Spearman‘s rank correlation
DISCUSSION
The Arabic version of jebsen taylor hand function test has excellent
face validity as scale index of clarity equaled 100%, and the mean of
proportion of clearance (clear responses) equaled 100%, also it has excellent
128 Egypt. J. of Appl. Sci., 36 (7-8) 2021
7
content validity as S-CVI equaled 92.38%, and the mean of the proportion
of very relevance (very relevant responses) equaled 92.38%.
The Arabic version of jebsen taylor hand function test has high
feasibility because the scale items were filled out by 100% in all sheets and
it needed three minutes or less to be answered in about 75% of all sheets,
also it needed less than 5 minutes to be answered in about 99% of all sheets.
The Arabic version of jebsen taylor hand function test has good
internal consistency and good test retest reliability as Cronbach's alpha
equaled0.598 (ranged from 0.487 to 0.660).. However, Spearman‘s rank
correlation coefficients between test and retest results were statistically
significant (item 1: 0.19, item 2: 0.52, item 3: 0.54, item 4: 0.33, item 5:
0.47, item 6: 0.789, item 7: 0.50). According to (George and Mallery, 2003)
α between 0.7 and 0.9 is referred as good internal consistency, also
Spearman‘s rank correlation coefficient between 0.7 and 0.9 is referred as
good test retest reliability and Spearman‘s rank correlation coefficient
between 0.6 and 0.7 is referred as acceptable test retest reliability.
SUMMARY
This study was designed to test the face validity, the content validity,
the feasibility, the internal consistency reliability and the test retest reliability
of Arabic-language version of jebsen taylor hand function test to measure
the hand function level in normal people. Two expert panels (each consists
of nine experts)and 150 normal people participated in this study , this study
was conducted in outpatient clinics of Al-Kasr AlAini Hospital and
outpatient clinic of Faculty of Physical Therapy, Cairo University. Forward
translation, development of preliminary initially translated version,
backward translation, development of the pre-final version and testing of
pre-final version using experts then testing of the final version on patients
was done.
CONCLUSION
The results obtained from the current study and the discussion that
followed it can lead to concluding that Arabic-language version of the
jebsen taylor hand function test has face and content validity, feasibility and
internal consistency and test retest reliability enough to measure the physical
function in normal people.
IMPLEMENTATIONS
Depending on the findings of this study, the Arabic-language version
of jebsen taylor hand function test scale could be used in research and
clinical setting for physical therapy and other professionals to measure the
hand function in normal people as it is valid, feasible and reliable tool.
RECOMMENDATION
The results of this study indicated need to consider the following
recommendations:
Egypt. J. of Appl. Sci., 36 (7-8) 2021 129
8
1. Further studies should be conducted to establish the preliminary
psychometrics of the Arabic-language version of jebsen taylor hand
function test with bilingual participants.
2. Further studies should be conducted to establish the full psychometric
properties (construct and criterion validity) of Arabic-language version of
jebsen taylor hand function test in a sample of the target population of
interest.
3. Further studies should be conducted to translate, adapt and validate other
assessment instruments for hand function.
4. Further studies should be conducted to translate, adapt and validate other
assessment instruments for physical function in different health
conditions.
REFERENCES
Białkowska, J. ; B. Juśkiewicz-Swaczyna and M. Andrzejczak (2020)
‘Using the Jebsen-Taylor test in patients after radial bone fracture’,
Advances in Rehabilitation, 35(1): 24–31.
Culicchia, G. and et al. (2016) ‘Cross-Cultural Adaptation and Validation
of the Jebsen-Taylor Hand Function Test in an Italian Population’.
Hindawi Publishing Corporation, 2016. doi:
10.1155/2016/8970917.
Fabbri, B. and et al. (2021) ‘A systematic review of the psychometric
properties of the Jebsen–Taylor Hand Function Test (JTHFT)’,
Hand Surgery and Rehabilitation. Elsevier.
George, D. and P. Mallery (2003) ‘Reliability analysis’, SPSS for
Windows, step by step: a simple guide and reference, 14th edn.
Boston: Allyn & Bacon, pp. 222–232.
Hackel, M. E. and et al. (1992) ‘Changes in hand function in the aging
adult as determined by the Jebsen Test of Hand Function’, Physical
Therapy. Oxford University Press, 72(5): 373–377.
Jebsen, R. H. and et al. (1969) ‘An objective and standardized test of hand
function.’, Archives of physical medicine and rehabilitation, 50(6):
311–319.
Kamel, F.A.H. and M. A. Basha, (2021) ‘Effects of Virtual Reality and
Task-Oriented Training on Hand Function and Activity
Performance in Pediatric Hand Burns: A Randomized Controlled
Trial’, Archives of Physical Medicine and Rehabilitation. Elsevier.
Lee, S.M. (2014) ‘The Difference of Hand Functions in Dominant Hand
Types’, Journal of Korean Clinical Health Science. The Korean
Society of Clinical Health Science, 2(2): 119–125.
Lim, Y.X. and S.C. Chai (2020) ‘Standardized translated instruction versus
spontaneously translated instruction: Test-retest and interrater
reliability of a hand function test’, Journal of Hand Therapy.
Elsevier, 33(4): 553–561.
130 Egypt. J. of Appl. Sci., 36 (7-8) 2021
9
Panuccio, F. and et al. (2021) ‘Internal consistency and validity of the
Italian version of the Jebsen–Taylor hand function test (JTHFT-IT)
in people with tetraplegia’, Spinal cord. Nature Publishing Group,
59(3): 266–273.
Priya, B.A. and S.P. Desai (2011) ‘Normative data of Jebsen Taylor Hand
Function Test [modified version] on Indian Population’,
Physiotherapy and Occupational Therapy, 5(1): 24.
Rhee, H. l J. Yu and S. Kim (2011) ‘Influence of compression types on
hand function: a preliminary investigation’, Journal of Physical
Therapy Science. The Society of Physical Therapy Science, 23(3):
477–480.
Takla, M.K.N. ; E. A. K. Mahmoud and N.Abd El-Latif (2018) ‘Jebsen
Taylor Hand Function test: Gender, dominance, and age
differences in healthy Egyptian population’, Bulletin of Faculty of
Physical Therapy. Springer, 23(2): 85–93.
Tofani, M. and et al. (2020) ‘Examining reliability and validity of the
Jebsen-Taylor hand function test among children with cerebral
palsy’, Perceptual and motor skills. SAGE Publications Sage CA:
Los Angeles, CA, 127(4): 684–697.
اختبار صلاحية ومصداقية النسخة العربية من مقياس جايبسن
تايمور لقياس وظائف اليد
محمود ممدوح شعبان *, محسن محمد الصياد**, اميره د ا رز***
* بکالوريوس علاج طبيعي ) 2103 ( جامعة القاهرة.
**استاذ متفرغ العلاج الطبيعي قسم العموم الأساسية جامعة القاىرة ، عميد کمية العلاج الطبيعي، الجامعة
الحديثة ، عميد کمية العموم التطبيقية – جامعة الخميج، رئيس معمل الميکانيکا الحيوية ، الولايات المتحدة
الامريکية،
*** استاذ العلاج الطبيعي قسم العموم الأساسية، کمية العلاج الطبيعي، جامعة القاىرة، عميد کمية العلاج
الطبيعي، جامعة ىيرتفوردشايدر .
الخمفية: تم تصميم وتسجيل مقياس جايبسن تايمور لقياس وظائف اليد بشکل خاص لتقييم
وظائف اليد. الغرض: کان الغرض من الد ا رسو ترجمة النسخة العربية من مقياس جايبسن تايمور
لقياس وظائف اليد وتوثيقيا بشکل ثقافي )تقييم موثوقية إعادة الاختبار، الاتساق الداخمي، بناء
الوظيفة الفيزيائية أو التاثي ا رت الأرضية ليذه الأدوات( لقياس وظائف اليد وقياس الوظيفة
الفيزيائية وضمان تقديم رعاية أفضل. الموضوع والطرق: مجموعتان يتکون کل منيا من تسعة
خب ا رء و 051 شخص طبيعي شارکوا في ىذه الد ا رسو وقد تم القيام بالترجمة إلى الأمام، وتطوير
نسخة أولية مترجمة في البداية، وترجمة إلى الخمف، وتطوير النسخة السابقة والنيائية واختبار
النسخة قبل النيائية باستخدام الخب ا رء، ثم اج ا رء اختبار النسخة النيائية عمى المرضى. مؤشر
الوضوح، ونسبة الخب ا رء في التخميص، ومؤشر صحة المحتوى، ونسبة الخب ا رء ذات الصمو. تم
Egypt. J. of Appl. Sci., 36 (7-8) 2021 131
01
استخدام إحصائيات وصفية ومؤشر العناصر المفقودة والوقت المستغرق للإجابة عمى المقياس،
وتم استخدام معاملات ارتباط کرونباخ ألفا ومعامل ارتباط سبيرمان لمتحميل الإحصائي. النتائج:
کان مؤشر المقياس لموضوح مساوياً ل 000 :، بينما کان مؤشر الصلاحية مساوياً ل 93.28
:. فيما يتعمق بالاتساق الداخمي، کانت ألفا کرونباخ تساوي 0.598 )تت ا روح من 0.487 إلى
0.660 (. بالإضافة إلى ذلک، کانت ارتباطات سبيرمان للارتباط معتدلة إلى قوية في غالبية
العناصر. الخلاصة: إن العربية ىى أداة صالحة وموثوقة وقابمة لممقارنة مع النسخة الإنجميزية
الأصمية وغيرىا من النسخ المترجمة.
الکممات المفتاحية :المصداقية- المغة العربية.
132 Egypt. J. of Appl. Sci., 36 (7-8) 2021

REFERENCES
Białkowska, J. ; B. Juśkiewicz-Swaczyna and M. Andrzejczak (2020)
‘Using the Jebsen-Taylor test in patients after radial bone fracture’,
Advances in Rehabilitation, 35(1): 24–31.
Culicchia, G. and et al. (2016) ‘Cross-Cultural Adaptation and Validation
of the Jebsen-Taylor Hand Function Test in an Italian Population’.
Hindawi Publishing Corporation, 2016. doi:
10.1155/2016/8970917.
Fabbri, B. and et al. (2021) ‘A systematic review of the psychometric
properties of the Jebsen–Taylor Hand Function Test (JTHFT)’,
Hand Surgery and Rehabilitation. Elsevier.
George, D. and P. Mallery (2003) ‘Reliability analysis’, SPSS for
Windows, step by step: a simple guide and reference, 14th edn.
Boston: Allyn & Bacon, pp. 222–232.
Hackel, M. E. and et al. (1992) ‘Changes in hand function in the aging
adult as determined by the Jebsen Test of Hand Function’, Physical
Therapy. Oxford University Press, 72(5): 373–377.
Jebsen, R. H. and et al. (1969) ‘An objective and standardized test of hand
function.’, Archives of physical medicine and rehabilitation, 50(6):
311–319.
Kamel, F.A.H. and M. A. Basha, (2021) ‘Effects of Virtual Reality and
Task-Oriented Training on Hand Function and Activity
Performance in Pediatric Hand Burns: A Randomized Controlled
Trial’, Archives of Physical Medicine and Rehabilitation. Elsevier.
Lee, S.M. (2014) ‘The Difference of Hand Functions in Dominant Hand
Types’, Journal of Korean Clinical Health Science. The Korean
Society of Clinical Health Science, 2(2): 119–125.
Lim, Y.X. and S.C. Chai (2020) ‘Standardized translated instruction versus
spontaneously translated instruction: Test-retest and interrater
reliability of a hand function test’, Journal of Hand Therapy.
Elsevier, 33(4): 553–561.
130 Egypt. J. of Appl. Sci., 36 (7-8) 2021
9
Panuccio, F. and et al. (2021) ‘Internal consistency and validity of the
Italian version of the Jebsen–Taylor hand function test (JTHFT-IT)
in people with tetraplegia’, Spinal cord. Nature Publishing Group,
59(3): 266–273.
Priya, B.A. and S.P. Desai (2011) ‘Normative data of Jebsen Taylor Hand
Function Test [modified version] on Indian Population’,
Physiotherapy and Occupational Therapy, 5(1): 24.
Rhee, H. l J. Yu and S. Kim (2011) ‘Influence of compression types on
hand function: a preliminary investigation’, Journal of Physical
Therapy Science. The Society of Physical Therapy Science, 23(3):
477–480.
Takla, M.K.N. ; E. A. K. Mahmoud and N.Abd El-Latif (2018) ‘Jebsen
Taylor Hand Function test: Gender, dominance, and age
differences in healthy Egyptian population’, Bulletin of Faculty of
Physical Therapy. Springer, 23(2): 85–93.
Tofani, M. and et al. (2020) ‘Examining reliability and validity of the
Jebsen-Taylor hand function test among children with cerebral
palsy’, Perceptual and motor skills. SAGE Publications Sage CA:
Los Angeles, CA, 127(4): 684–697.
ا