Un instrument d’analyse et de mesure
du handicap en quatre dimensions

Selon le Système d’Identification et
de Mesure du Handicap « S.I.M.H. »
(Paris, Porto, Montréal, Tunis,
Jérusalem, Padoue, Belgrade)

Handitest

Evaluation of disability severity

 

Individual identification

Last name:..........................................................

First name:..........................................................

Sex:                  M                  F

Date of birth:        /      /

No. of social security:

Address:

 

Phone number:

Marital status

 Single                   Married                   Divorced                   Widowed

Number of children or the people in charge:

Is your spouse employed?                  Yes                  No

 

Illness identification

Illness or trauma	Date of appearance	Prognosis
		stable	improvement	deterioration
1)
2)
3)
4)
5)

 

Physical Exam

	0	1	2	3	4
Brain
Vertebra l column
Auditory system
Visual system
Mastication organs
Phonation organ
Face, head and neck
Swallowing organs
Olfactory organs
Respiratory system
Cardio–vascular system
Urinary system
Digestive system including anorectum
Endocrine glands
Hematopoietic and immune system
Genital and reproductive system
Skin
Superficial sensibility organs
System of the spine
Chest
Right upper limb
Left upper limb
Right lower limb
Left lower limb

Height:................................cm                    Weight:................................kg

 

Functional evaluation

Laterality: Right-handed           Left–handed           Ambidextrous		Severity
		0	1	2	3	4
Maintaining and movement	Remaining in a lying posture
	Remaining in a standing posture
	Remaining in a sitting posture
	Turning around in a lying posture
	Passing from sleeping position to sitting position
	Passing from sitting position to standing position
	Walking or moving horizontally
	Running
	Getting up from the floor
	Keeping balance (risk of fall)
Manipulation Préhension	Holding with right hand
	Holding with left hand
	Moving right hand in the air
	Moving left hand in the air
Communication	Speaking
	Writing
	Other forms of communication
	Hearing with right ear
	Hearing with left ear
	Vision with right eye
	Vision with left eye
Cognition	Memory
	Logic and reasoning
	Learning capacity
	Temporal and spatial orientation
	Tolerance
	Affectivity
Control of sphincters	Urine control
	Feces control
Sexuality Procreation	Sexual activities
	Fertility
	Adapting to physical activity
	Mastication
	Ingestion
	Possibility of ordinary cough
	Cutaneous protection against pathologic factor
	Sleep
	Vigilance

 

Situational evaluation

Laterality: Right-handed           Left–handed           Ambidextrous		Severity
		0	1	2	3	4
Activities of daily living	Eating and drinking
	Going to the toilet
	Toileting
	Getting dressed and undressed      - superior part of the body      - Inferior part of the body
	Calling in case of distress
	Getting into and out of bed
	Moving around inside the house
	Doing ones personal tasks
	Picking sth up from the floor
	Writing
	Phoning
	Managing one’s budget
	Taking medication
	Going out and coming back to the house
	Going up and coming down the stairs
	Doing the shopping and outdoor activities
	Using public transportation
	Using private transportation
Social and affective life	Having affective relations with family
	Having affective relations with friends and neighbors
	Doing leisure activities
	Doing non-professional social activities
	Doing a professional activity
	Moving towards school or work
	Establishing an ordinary relationship with colleagues and friends
	Establishing and ordinary relationship
Appearance and beauty	Being considered not beautiful by others:   1 : slight or discrete   2 : rather compensable by cosmetics and clothes   3 : important accompanied by the change in other’s behavior   4 : very important accompanied by a major obstacle in social life
Care constraint	Necessity of care by professionals:   1 : once / month   2 : once / week   3 : several time / week   4 : everyday

 

Subjectivity evaluation

	0	1	2	3	4
View point of the individual on their situation as a disabled person
View point on their body modification (do they feel different from others?)
View point on their current functional capacities (do they feel dampened?)
View point on their current situation as a disabled person (feeling of exclusion?)
View point on the possibility of evolution and return to the usual situation
Suffering:      - Organic origin      - Physical origin

 

Mode of use

Handi test is an interactive instrument which requires full participation of the patient and that of their family

Obtained responses (for instance getting up from the floor or eating on one′s own) can be verified by the evaluated person, their family or other people through direct observation on the occasion of on occupational therapy outcome. They can also he gained though deduction of common sense. (It is evident that you cannot ask a quadriplegic to go up the stairs or to get up from the floor)

This test can be studied on babies in order to observe the evolutions since birth you can notice the situations of the disabled in their usual environment on account of inadequacy of the height of the step of the staircases.

The quantification system relies on the notion of dependence in order to measure functional state as well as situational state.

This leads directly to the study of the types of necessary compensation.

0	No dependence
1	Discomfort in the functional realization or in a particular task.
2	Limitation in the realization, including usage of a medication, of a technical function or situational aid (leaning for instance) or of an animal aid. Necessity of momentary interruption pauses, position modification (sitting when you are standing) are the equivalents.
3	A human aid is partially necessary
4	The function or the tasks is impossible or must be totally compensated by another person.

Horizontal study of the document draw to draw a kind of curve and will enable you to situate the location of lesions, functional and situational typology as well as person′ s own viewpoint on their state.

So, you have four rates at you disposal by averaging the rates: lesional, functional, situational and of subjectivity.

Severity scale
0	There is no disability but sometimes a discomfort : slowness or difficulty
1	Slight disability: limitation of the capacities with the situations of partial disability and few numerous: without dependence.
2	Average disability: evident restriction of activity often with a medicamentous dependence, of a technical aid or of adaptation of environment, without dependence on human aid.
3	Important disability: fundamental limitation of activities necessitating partial human aid
4	Very important disability: severe dependence on human aid of total substitution.

 

Translation by:
Doctor Mohammad Farjad, Professor of physical medicine and rehabilitation, University of Tehran, Iran.
Doctor M. Asheghan, Tehran, Iran.
Doctor S. Farjad, Physical Medicine & rehabilitation, Henri Mondor Universitary Hospital, Créteil, France.

See first version (translation by Edna Gregg, Paris)