Validity of the Michigan Hand Outcomes Questionnaire in Patients With Stroke

Published:October 08, 2015DOI:



      To investigate the measurement properties of the Dutch version of the Michigan Hand Outcomes Questionnaire (MHQ) in patients with stroke.


      Validation study.


      Outpatient rehabilitation clinic.


      Consecutive patients with stroke (N=51; mean age, 60±11y; 16 women [31%]).


      Patients were asked to complete the MHQ (57 items) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Additional assessments included the Barthel Index and performance tests for hand function (Action Research Arm Test, Nine Hole Peg Test, Frenchay Arm Test, Motricity Index).

      Main Outcome Measures

      Associations between the MHQ and other outcome measures were determined using Spearman correlation coefficients and the internal consistency of the MHQ using Cronbach α. Floor or ceiling effects were present if >15% of the patients scored minimal or maximal scores, respectively. Test-retest reliability was established by the intraclass correlation coefficient.


      The mean MHQ total score was 70.0±22.4, with Cronbach α being .97. The MHQ total score correlated significantly with the physical component summary of the SF-36, the Barthel Index, and all hand function performance tests (P<.01). The MHQ total score showed no floor or ceiling effects. The test-retest intraclass correlation coefficient was .97.


      This study provides preliminary evidence that the MHQ is an internally consistent, valid, and reliable hand function questionnaire in outpatients after stroke, although these results need to be further confirmed.


      List of abbreviations:

      ARAT (Action Research Arm Test), ICF (International Classification of Functioning, Disability and Health), FAT (Frenchay Arm Test), MCS (mental component summary), MHQ (Michigan Hand Outcomes Questionnaire), MI (Motricity Index), NHPT (Nine Hole Peg Test), PCS (physical component summary), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey)
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