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NINDS CDE Notice of Copyright
Grooved Pegboard Test
Available for purchase from Lafayette Instrument:

NeuroRehab Supplemental - Highly Recommended
Recommended for general use in disorders affecting the CNS. However, its results should be interpreted with care (or in some cases the test should not be used at all) with patients who have significant peripheral injuries affecting hand or finger movement, or long fingernails that affect ability to manipulate small objects, or severe visual disturbance that may invalidate the test for measuring CNS effects: In general, it is indicated for studies requiring a measure for eye-hand motor coordination.
It is not recommended for particular use in specific NINDS CDE Disorder(s), but rather is broadly applicable across many CNS disorders.
Supplemental: Epilepsy, Multiple Sclerosis (MS), Stroke, and Traumatic Brain Injury (TBI)
Exploratory: Sport-Related Concussion (SRC) and Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage (SAH)
Short Description of Instrument
Construct measured: Finger and manual dexterity, perceptual-motor speed
Generic vs. disease specific: Generic
Intended respondent: Patients 20-85 years old
# of items: 25 pegs
# of subscales and names of sub-scales: N/A
# of items per sub-scale: N/A
Comments/Special Instructions
Background: The Grooved Pegboard is a manipulative dexterity test. This unit consists of 25 holes with randomly positioned slots. Pegs, which have a key along one side, must be rotated to match the hole before the can be inserted. This test requires more complex visual-motor coordination than most pegboards.
Scoring and Psychometric Properties
Scoring: For the right hand trial, the examiner demonstrates that the pegs are placed from subject's left to right, and from right to left for the left hand trial. The dominant hand trial is administered first, followed by the nondominant hand trial. Only one peg is to be picked up at a time and the subject should immediately be told if more than one is picked up. Also, only one hand is to be used. If necessary, the board should be held steady for the patient. In the case of severe motor impairment, the subject should attempt the task just to see if any of the pegs can be put in. Any factor that may effect the subject's performance should be noted, e.g., sore finger, bandage, etc.
Record, in seconds, the length of time required to perform each trial beginning when the subject starts the task until the last peg is put in, or the test is discontinued. A trial may be discontinued after five minutes. In such cases, the difficulty is described and the scores are given "A" flags indicating an incomplete test. The second score is the number of "drops" made during each trial. A "drop" is any unintentional drop of a peg from the time the subject attempts to pick up the peg from the tray until it is placed correctly in the hole. If one peg is turned with the hand not being tested, this is noted. If, however, this occurs more than once, the score is given a "D" flag for a nonstandard assessment. The third score is the number of pegs correctly placed in the holes for each trial. The score for each trial is the total time (in seconds) to correctly place the 25 pegs; if the person is unable to complete the test in the allotted time, the score may be prorated.
The examiner encourages the subject to perform the task as quickly as possible, telling him or her to speed up if necessary. The pegs must be put in the board in the exact order and in the correct direction. The task is performed once with the dominant and then once with the non-dominant hand.
Psychometric Properties: The Grooved Pegboard had good test-retest reliability (0.91 and 0.85 for right and left hands, respectively). The Grooved Pegboard correlated with BOT at -0.50 to -0.63 and with Purdue Pegboard at -0.73 to -0.78.
Strengths/Weaknesses: The Grooved Pegboard required longer administration time and was challenging for the youngest children and oldest adults.
Administration: Each trial typically takes 60-70 seconds; a trial may be discontinued if it takes more than 5 minutes.
TBI Rationale:
The GPT is a widely used test of fine motor skill that has proven sensitive to the effects of TBI and many other CNS disorders.
Epilepsy Rationale:
Motor speed may be assessed by a variety of procedures including measures of reaction time (Thompson & Trimble, 1983) or more conventional measures of motor speed used in clinical neuropsychological evaluations (Grooved Pegboard, Finger Tapping). While reaction time measures are perhaps extremely pure motor speed measures and have been used in epilepsy research (Thompson & Trimble, 1983), they are not widely used clinically and have limited normative data. More conventional clinical measures have the advantage of familiarity and strong normative databases and are brief and direct in administration time and directions.
Grooved Pegboard was selected due to its widespread use and its purported greater sensitivity to lateralized brain impairment than other motor speed measures such as finger tapping. Importantly, one of the reasons that finger tapping was not selected is that it has historically been given with various sets of instructions and the timing of each 10 second trial introduces significant measurement error. Grooved pegboard has been effectively used to characterize fine motor speed in multiple epilepsy studies.
Subarachnoid Hemorrhage (SAH) Rationale:
The GPT has been used in various SAH studies, including large scale prospective trials such as the IHAST, and institutional databases such as from the Columbia group. It is well-normed and reference values are available for the age range of SAH patients. For these reasons, the Swiss national standard of neuropsychological assessment after SAH includes the GPT.
NeuroRehab Rationale:
Supplemental-Highly Recommended measure because it has perceptual-motor, sustained attention/effort and processing speed components.
Strengths: Quick to administer, good normative standards, appropriate for use across a broad range of CNS disorders.
Weakenesses: Requires the purchase of the pegboard and metal pegs (Lafayette Instrument Company, or Psychological Assessment Resources, Inc.), and may not be valid in patients with peripheral injuries to the upper extremities or significant visual disturbance.
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Zweifel-Zehnder AE, Stienen MN, Chicherio C, Studerus-Germann A, Bl?si S, Rossi S, Gutbrod K, Schmid N, Beaud V, Mondadori C, Brugger P, Sacco L, Müri R, Hildebrandt G, Fournier JY, Keller E, Regli L, Fandino J, Mariani L, Raabe A, Daniel RT, Reinert M, Robert T, Schatlo B, Bijlenga P, Schaller K, Monsch AU; Swiss SOS study group. Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations. Acta Neurochir (Wien). 2015;157(9):1449-1458.  
Document last updated January 2022