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J Rehabil Med. 2014 Sep;46(8):788-97. doi: 10.2340/16501977-1827.

Learning effects of repetitive administration of the Southampton Hand Assessment Procedure in novice prosthetic users.

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Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands.



The Southampton Hand Assessment Procedure (SHAP) evaluates the functionality of normal, injured or prosthetic hands. The aim was to evaluate the learning effects of SHAP tasks and the appropriateness of the time limits applied per task in novice prosthetic users.


Right-handed unimpaired volunteers (n = 24, mean age 21.8 years) completed 8 SHAP sessions over 5 consecutive days using a prosthetic simulator. The execution times of SHAP tasks were transformed into 6 prehensile patterns, the functionality profile, and the index of function, a general functionality score. Learning effects in task times were analysed using multilevel analysis.


Learning effects occurred in all SHAP tasks. Tasks, sex, sessions, tasks-sessions interaction, and the first session of the day contributed (p < 0.01) to the execution times. Tasks were performed more slowly by females and more slowly on the first session of the day. In several tasks time limits were exceeded by > 25% of participants in at least the first 3 sessions, which affected the calculation of the functionality profile and index of function scores.


The learning effects of SHAP in novice prosthetic users require consideration when conducting a reliability study. SHAP scores in novice prosthetic-hand users are confounded by learning effects and exceeded time limits.

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