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9-Hole Peg Test – Upper Limb Dexterity — SCE Neurology MCQ

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EasyMultiple Sclerosis & CNS Inflammation9-Hole Peg Test – Upper Limb DexteritySCE Neurology

A 45-year-old woman with known MS has progressive difficulty with fine motor tasks — she cannot button her shirt or pick up small objects. Her 9-Hole Peg Test (9-HPT) time has increased from 25 seconds to 45 seconds over 2 years. What does the 9-HPT measure?

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Correct answer: B — Upper limb dexterity and fine motor function — it is a core component of the MSFC and is sensitive to changes in hand function in MS

The 9-Hole Peg Test measures upper limb fine motor dexterity: the patient picks up 9 pegs one at a time, places them in 9 holes, then removes them. It is timed and the dominant and non-dominant hands are tested separately. It is a core component of the MSFC (alongside T25FW for walking and SDMT/PASAT for cognition). A ≥20% change is considered clinically meaningful. It is sensitive to subtle hand function changes that may not be detected on clinical examination. A: Walking is T25FW. C: Cognition is SDMT/PASAT. D: Grip strength is measured by dynamometry. E: Visual acuity is Snellen/logMAR.

Reference: NICE NG100 MS; MSFC; Fischer et al. 9-HPT