The FIHOA, also known as Dreiser’s index, is a tool designed to evaluate hand function in individuals coping with hand osteoarthritis (OA). Developed by Dreiser et al. in 1995, this 10-item questionnaire has undergone translations into French, Dutch, and Argentinian versions, expanding its accessibility. Tailored to assess the functional capacity of hands in OA-affected patients, it is adaptable for use in Rheumatoid arthritis cases where hand function assessment is necessary.

Intended Population

Primarily intended for osteoarthritis patients, the FIHOA can be effectively employed in evaluating hand function for individuals with rheumatoid arthritis as well. Its applicability extends to any scenario requiring an assessment of hand function.

Method of Use

Equipment Required:
None. It is a questionnaire-based assessment.

Time to Administer:
5-10 minutes.

Training Required:
No specific training is necessary for administering the questionnaire.

Method of Administration:
The FIHOA can be administered by a physician or physiotherapist. Additionally, it can be self-reported by the individuals undergoing the assessment.


The questionnaire comprises 10 questions, with a scoring range of 0–30.

Sr. No.Question AskedScoring
1Can you turn a key in a lock?0 = Without difficulty, 1 = Slight difficulty, 2 = Important difficulty, 3 = Impossible
2Can you cut meat with a knife?
3Can you cut cloth or paper with a pair of scissors?
4Can you lift a full bottle with the hand?
5Can you clench your fist?
6Can you tie a knot?
7For women: Can you sew? For men: Can you use a screwdriver?
8Can you fasten buttons?
9-10Can you write for a long period of time?
10Would you accept a handshake without reluctance?

Total scores indicate hand function, with lower scores reflecting better hand function.

Psychometric Properties


  • Interrater reliability: In OA, Cronbach’s alpha is 0.90. In RA, the Cronbach’s alpha test yields 0.94.
  • Test-Retest reliability: Administering the FIHOA twice 1 week apart in OA resulted in an ICC of 0.74, and with a 5-day interval, an ICC of 0.96.
  • Intra-rater reliability: Testing OA patients twice, 1 hour apart, showed correlations between scores of 0.95.

For OA, FIHOA correlates with:

  • Cochin Hand Function Scale (rs = 0.89)
  • Michigan Hand Outcomes Questionnaire (rs = 0.86)
  • Total Australian Canadian Osteoarthritis Hand Index (rs = 0.76)

These correlations affirm the reliability and validity of FIHOA for assessing hand function in OA.



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