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Rehab Measures Database

Sequential Occupational Dexterity Assessment

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Purpose

The SODA measures bimanual hand function in ADLs under controlled conditions. This test was developed for individuals with Rheumatoid Arthritis (RA) It measures an individual’s ability to control objects with their fingers (fine dexterity) and their ability to use coordinated hand and finger movements to grasp and manipulate objects (manual dexterity).

Acronym SODA

Area of Assessment

Activities of Daily Living
Dexterity

Assessment Type

Observer

Cost

Not Free

Actual Cost

$200.00

Cost Description

Cost figure is approximate and includes the manual for the SODA (available in Dutch and English) that describes each task in detail with photographs.

CDE Status

Not a CDE—last searched 3/13/2024.

Populations

Key Descriptions

  • Each task is described, and the patient is asked to complete the task in the described way. The occupational therapist observes whether the patient could perform the task (0 = unable, 1 = able to perform the task in a different way, 4 = able to perform the task as described).
  • The patient is then asked whether the task was difficult to perform (0 = very difficult, 1 = some difficulty, 2 = not difficult).
  • Combining the two scores results in an evaluation score for each task (0 = unable to perform; 6 = able to perform as requested without difficulty). Score range: 0 - 108.

Number of Items

Twelve different tasks:
1. Writing a sentence
2. Picking up an envelope
3. Picking up coins
4. Holding the receiver of a telephone to one ear
5. Unscrewing the cap of a tube of toothpaste
6. Squeezing toothpaste onto a toothbrush
7. Handling a spoon and knife
8. Buttoning a blouse
9. Unscrewing a large bottle
10. Pouring water into a glass
11. Washing hands
12. Drying hands

Equipment Required

  • Pen or pencil/paper
  • Envelope
  • Coins
  • Telephone receiver
  • Tube of toothpaste/toothbrush
  • Spoon & knife
  • Blouse/shirt with buttons
  • Large bottle with screw lid
  • Glass/water pitcher
  • Soap & water
  • Drying towel

Time to Administer

15 minutes

15 minutes on average, plus about 2 minutes to score

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Reviewed in April, 2024 by University of Illinois Entry-level Occupational Therapy Doctorate students Abby Ambler, Sarah Gruettner, Elizabeth Hume, and Cara Younkin under the direction of Sabrin Rizk, PhD, OTR/L, Department of Occupational Therapy, University of Illinois Chicago.

Body Part

Upper Extremity

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Motor

Professional Association Recommendation

None found—last searched 3/13/2024.

Considerations

  • The SODA evaluates the quality of movement, instead of using the time to measure the performance.
  • A shortened (from 12 tasks down to 6) version of the SODA (the SODA-S) exists that uses the six tasks that showed significant changes from baseline to one-year follow-up. The SODA-S demonstrated excellent internal consistency (α = 0.81) and excellent convergent validity with the SODA (= 0.93) (van Lankveld et al., 1999)

 

Arthritis

back to Populations

Standard Error of Measurement (SEM)

Rheumatoid Arthritis (RA): (van Lankveld et al., 1996; = 109 patients randomly selected from the RA outpatient population; mean age = 54.5 (15) years; mean duration of disease = 13.2 (9.7) years; mean score on SODA = 85.2 (19.1; range = 14-108; Dutch sample)

  • SEM (calculated) = 5.73

 

Rheumatoid Arthritis (RA): (Massey-Westropp et al., 2004; = 62; mean age = 65 years, age range = 24-90 years; mean score on SODA Ability Scale = 53 (17; range = 9-72)

  • SEM (calculated) = 5.64

 

Minimal Detectable Change (MDC)

RA: (van Lankveld et al., 1996)

  • MDC95 (calculated) = 15.88

 

RA: (Massey-Westropp et al., 2004)

  • MDC95 for SODA Ability Scale (calculated) = 15.63

 

Normative Data

RA: (van Lankveld et al., 1996).

  • Mean score on SODA = 85.2 (SD = 19.1; range = 14-108)

Test/Retest Reliability

RA: (Massy-Westropp et al., 2004)

  • Acceptable test-retest reliability: (ICC Overall = 0.89)
  • Acceptable test-retest reliability: (ICC for Scales = 0.88-0.89)

 

RA: (van Lankveld et al., 1996, = 22; mean age = 60.3 (11.4) years; female/male ratio = 7/3, mean duration of disease = 12.4 (6.4) years; SODA repeated twice within 14 days)

  • Excellent test-retest reliability: (Pearson Correlation = 0.93)

 

Interrater/Intrarater Reliability

RA: (van Lankveld et al., 1996; scores on SODA as measured by three occupational therapists in six patients (mean age = 59.6 (19.6) years; female/male ratio = 4/2; mean duration of disease = 11.4 (9.1) years)

  • Excellent interrater reliability (= 6): Kendall’s coefficient of concordance W = 0.78, p < 0.01) 

 

Internal Consistency

RA:

  • Excellent: Cronbach’s alpha = 0.91 (van Lankveld et al., 1996, n = 109)
  • Excellent for ability: (Cronbach’s alpha = 0.91) (Massy-Westropp et al., 2004, n = 62)
  • Excellent for physical function: (Cronbach’s alpha = 0.9) (Massy-Westropp et al., 2004, n = 62)
  • Excellent for pain: (Cronbach’s alpha = 0.8) (Massy-Westropp et al., 2004, n = 62)

 

Criterion Validity (Predictive/Concurrent)

Concurrent Validity: 

RA:

  • Excellent concurrent validity between the SODA and SODA-S (shortened version) (correlations at baseline and one-year follow-up were 0.93 and 0.94, respectively) (van Lankveld et al., 1999; = 109; mean age = 54.54 (15.02) years; mean disease activity score = 4.73 (1.09); mean duration of disease = 13.20 (9.69) years; Dutch sample)
  • Adequate concurrent validity between the SODA and the Disease Activity Score (= -0.34, < 0.05) (van Lankveld et al., 1999)

 

Construct Validity

Convergent validity:

RA:

  • Excellent correlation between SODA scores and scores on the Sollerman Hand Function Test (= 25) (= 0.79) (O’Connor et al., 1999; = 25; mean age = 70 (7.7); age range = 56-84; female = 14; all subjects reporting bilateral upper limb RA, with a mean duration from first symptom of 21 (14.0, range = 1-55) years.
  • Excellent correlation between the Australian Canadian Osteoarthritis Hand Index (AUSCAN) and SODA physical function scales (= 0.81) (Massy-Westropp et al., 2004)
  • Adequate multiple correlations between measures of hand impairment and SODA scores (van Lankveld et al., 1996, all < 0.01):
    • Motion of wrist (= 0.49)
    • Mobility of fingers (= 0.53)
    • Grip strength for cylinder grip (Jamar) (= 0.49)
    • Motion and strength (= 0.71)
  • Adequate correlations and partial correlations between pain measures and SODA scores:      

Pain Measure

Correlationa

Partial Correlationa

Visual analog scale

-0.54

-0.34

IRGL-pain

-0.41

-0.33

SODA-pain

-0.57

-0.53

IRGL = Invloed van Reuma op Gezondheid en Leefwijze (a Dutch health status questionnaire)

aAll values < 0.01 

 

Content Validity

  • The research occupational therapist saw all participants to measure hand-related disability or dexterity (van Lankveld et al., 1996).
  • 23 standardized tasks were included that in a previous study had been judged by patients to be important for everyday functioning (van Lankveld et al., 1996).

 

Face Validity

  • Not statistically measured, but only 10% of the variance in scores on the SODA was related to disease activity. Impairment of hands measured by grip strength explained only half the variance in SODA scores (van Lankveld et al., 1996).
    • This is important because people with similar levels of impairment may have different levels of dexterity, and the SODA measures dexterity, not impairment.

 

Responsiveness

RA: 

  • Significant increase in the average SODA score from 70.5 (20.6) before surgery to 88.43 (16.8) post-operatively in patients undergoing hand surgery (t = 3.65, < 0.01) (van Lankveld et al., 1996; = 14, mean age = 54.6 (13.5) years, female/male ratio = 10/4; mean duration of disease = 16.4 (5.4) years, patients whose operations were without complications and needed no revisional surgery)
  • Significant decrease in scores on 6 of the 12 tasks of the SODA from baseline to one-year follow-up among RA patients (van Lankveld et al., 1999; = 94)

 

 

Bibliography

Massy-Westropp, N., Krishnan, J., & Ahern, M. (2004). Comparing the AUSCAN Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and Sequential Occupational Dexterity Assessment for patients with rheumatoid arthritis. The Journal of Rheumatology, 31(10), 1996-2001.

O’Connor, D., Kortman, B., Smith, A., Ahern, M., Smith, M., & Krishnan, J. (1999). Correlation between objective and subjective measures of hand function in patients with rheumatoid arthritis. Journal of Hand Therapy, 12, 323-329. 

Stamm, T. A., Cieza, A., Machold, K. P., Smolen, J. S., & Stucki, G. (2004). Content comparison of occupation‐based instruments in adult rheumatology and musculoskeletal rehabilitation based on the International Classification of Functioning, Disability and Health. Arthritis Care & Research, 51(6), 917-924. 

van Lankveld, W. G. J. M., Graff, M. J. L., & van’t Pad Bosch, P. J. I. (1999). The short version of the sequential occupational dexterity assessment based on individual tasks’ sensitivity to change. Arthritis Care & Research, 12(6), 417-424. 

van Lankveld, W., van’t Pad Bosch, P., Bakker, J., Terwindt, S., Franssen, M., & van Kiel, P. (1996). Sequential occupational dexterity assessment (SODA): A new test to measure hand disability. Journal of Hand Therapy, 9(1), 27–32.