Minnesota Manual Dexterity Test

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Purpose

To evaluate unilateral and bilateral gross and fine manual dexterity.

Link to Instrument

Acronym MMDT

Area of Assessment

Movement
Mental Functions

Assessment Type

Performance Measure

Cost

Not Free

Actual Cost

$360.00

CDE Status

Not a CDE—last searched 5/5/2025

 

Diagnosis/Conditions

  • Multiple Sclerosis

Key Descriptions

  • Placing Test: Measures how quickly a subject picks up and places disks into a board using one hand. Disks are inserted in sequence from right to left, column by column. Timing starts at “GO” and stops when all disks are placed correctly. Multiple trials are recorded.
  • Turning Test: Assesses dexterity by having the subject pick up, flip, and replace disks using both hands in a specific row- by-row sequence. The test resets automatically as the flipped disks are ready for the next trial. Timing is recorded for multiple trials.
  • Scoring: The score is the total time (in seconds) to complete the required trials, excluding practice trials.
    o Composite Scores: When comparing or averaging
    multiple test scores, raw scores must be converted using norm charts.
    o Interpretation: Scores should be analyzed based on prior test applications. Employers or evaluators may set critical scores (e.g., the 75th percentile) to classify individuals. Follow-up studies can refine these thresholds for accurate performance predictions.

Number of Items

60 disks to be placed/turned on test board

Equipment Required

  • Instruction manual
  • 1 test board
  • 60 black and red plastic disks
  • Testing table (between 28 and 32 inches in height)
  • Stopwatch or clock

Time to Administer

Up to 56 minutes

Required Training

Reading an Article/Manual

Required Training Description

The test administrator is advised to carefully read the administration section of the manual and practice the administration of the MMDT before giving it.

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 - 80

years

Instrument Reviewers

Updated on 5/5/2025 by UIC Occupational Therapy Students Maya Smith, Olivia Newmark, Eliza Zarebski, and Taylor Latsonas under the direction of Sabrin Rizk, PhD, OTR/L, Department of Occupational Therapy, University of Illinois Chicago.

 

Body Structure

Upper Extremity

ICF Domain

Body Function
Activity

Measurement Domain

Motor

Professional Association Recommendation

None found—last searched 5/5/2025

Considerations

  • For individuals age 13 or older
  • Requires bilateral upper limb use, vision, and fine motor coordination
  • Not ideal for individuals with significant cognitive impairment
  • Minimal language requirements
  • Repeated administration can lead to improvements in testing because of familiarity
  • The WorkAbility Rate of Manipulation Test (WRMT) was introduced in 2013 to improve the utility of manual dexterity testing for disability evaluation and fitness monitoring. It incorporates the same black and red disks as the MMDT, but uses a different board and has four subtests (adds Turning-right hand and Turning-left hand to the Turning-Both hands of the MMDT). The simpler instructions and greater adaptability of the WRMT may make it more suitable for those with physical and cognitive limitations. Scores from the WRMT and the MMDT are not comparable. 

 

Multiple Sclerosis

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Normative Data

Multiple Sclerosis: (Ovacik et al., 2022; = 120 (= 80 persons w/MS, mean age = 35.86 (11.25) years, age range = 18-61 years, female = 60 (75%), MS type: Relapsing-Remitting MS = 70 (87.5%), Secondary-Progressive MS = 10 (12.5%), mean disease duration = 5.15 (5.84) years, mean Expanded Disability Status Scale score = 1.81 (1.69), range = 0-7; n = 40 controls, mean age = 34.6 (10.12) years, age range = 18-56 years)

 

Mean Scores on MMDT by Activity/hand and Subject Group

 

Activity/hand

 

MS Group (= 80)

 

Healthy Controls (= 40)

Placing-dominant

 

82.73 (32.19)

 

64.44 (5.09)

Placing-non-dominant

 

88.6 (40.64)

 

69.23 (4.8)

Two-hand turning and placing

61.75 (23.93)

44.25 (5.56)

 


 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Multiple Sclerosis: (Ovacik et al., 2022)

  • Excellent correlations between MMDT Placing-Dominant, Placing-Non-dominant, & Two-Hand Turning and Placing tests with Nine Hole Peg Test (NHPT) Dominant (r’s = 0.959, 0.843, and 0.687, respectively, all < 0.001)
  • Excellent correlations between MMDT Placing-Dominant, Placing-Non-dominant, & Two-Hand Turning and Placing tests with NHPT Non-dominant (r’s = 0.885, 0.972, and 0.750, respectively, all < 0.001)

 

Construct Validity

Convergent validity:

Multiple Sclerosis: (Ovacik et al., 2022)

  • Excellent correlations between MMDT Placing-Dominant, Placing-Non-dominant, & Two-Hand Turning and Placing tests and the Expanded Disability Scale (EDSS) (r’s= 0.740, 0.655, and 0.603, respectively, all < 0.001)
  • Adequate correlations between MMDT Placing-Dominant subtest and other variables:
    • Grip strength (Dominant): (= -0.325, = 0.004)
    • Tip pinch (Dominant): (= -0.380, = 0.001)
    • ABILHAND: (= -0.474, = 0.001)
    • Disease duration (year): (= 0.468, < 0.001)
  • Adequate correlations between MMDT Placing-Non-dominant subtest and other variables:
    • ABILHAND: (= -0.474, = 0.001)
    • Disease duration (year): (= 0.438, < 0.001)
  • Adequate correlations between MMDT Two-hand Turning and Placing  subtest and other variables:
    • ABILHAND: (= -0.384, = 0.009)
    • Disease duration (year): (= 0.571, < 0.001)
  • Poor correlations between MMDT Placing-Dominant subtest and other variables:
    • Lateral pinch (Dominant): (= -0.251, = 0.036)
    • Palmar pinch (Dominant): (= -0.286, = 0.016)
  • Poor correlation between MMDT Placing-Non-dominant subtest and the Tip pinch (Dominant): (= -0.270, = 0.024)
  • Poor correlations between MMDT Two-hand Turning and Placing subtest and the Palmar pinch (= -0.244, = 0.045)

 

Discriminant validity:

Multiple Sclerosis: (Ovacik et al., 2022)

  • Significant ability of scores on the Placing-Dominant, Placing Non-dominant, and Two-hand Turning and Placing subtests of the MMDT to discriminate between persons with MS and healthy controls (< 0.001 for all; see Normative Data for means and standard deviations for each group)

 

Mixed Conditions

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Normative Data

Older Adults and Geriatric Care: (Desrosiers et al., 1997; n = 247, mean age (SD) = 74.3 (7.2) years, age range = 63-91 years, majority (about 90%) French speaking)

  • Reference values for the MMDT by gender and age group (Mean (SD) in seconds):

Women (= 114)

Age Group

63-69 (= 44)

70-79 (= 44)

 80+ (= 26)

Placing Test (R. hand) 

72.8 (6.6)

78.1 (9.4)

85.2 (10.3)

Placing Test (L. hand)

77.4 (8.3)

83.7 (11.2)

92.7 (14.3)

Turning Test

60.5 (7.2)

63.1 (9.2)

70.3 (11.9)

 

Men (= 133)

Age Group

63-69 (= 34)

70-79 (= 61)

 80+ (= 38)

Placing Test (R. hand) 

73.0 (8.9)

81.0 (9.0)

87.7 (11.5)

Placing Test (L. hand)

76.8 (11.3)

85.0 (11.0)

93.1 (14.2)

Turning Test

59.5 (8.5)

68.1 (11.6)

77.7 (12.5)

 

Test/Retest Reliability

Older Adults and Geriatric Care: (Desrosiers et al., 1997, = 35, mean test-retest interval = 7 days)

  • Acceptable test-retest reliability for all MMDT subtests:
    • Placing test right hand (ICC = 0.88)
    • Placing test left hand (ICC = 0.83)
    • Turning test (ICC = 0.79)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Older Adults and Geriatric Care: (Desrosiers et al., 1997; = 247)

  • Excellent correlations between the subtests of the MMDT and the Minnesota Rate of Manipulation Test (MRMT), the Box and Block Test (BBT), and the Purdue Pegboard (PP)
    • MMDT and MRMT: r = 0.85 to 0.95
    • MMDT and BBT: = 0.63 to 0.67
    • MMDT and PP: = 0.63 to 0.67

 

Non-Patient

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Normative Data

Healthy Adults: (Wang et al., 2018; n = 66, mean age (SD) = 32 (13) years, age range = 21-64 years, female = 67%, 89% reported as right-hand dominant)

Mean (SD) of Time (seconds) to Complete an MMDT trial

Assessment

Mean (SD)

Minimum

Maximum

20 disks

   Placing Test

20.9 (2.8)

14.6

27.0

   Turning Test

18.0 (2.9)

13.1

27.2

60 disks

   Placing Test

63.9 (6.7)

45.1

81.0

   Turning Test

54.4 (7.4)

42.4

76.6

 

Test/Retest Reliability

Healthy Adults: (Wang et al., 2018; = 32)

  • Acceptable test-retest reliability for all MMDT subtests:
    • 20 disks placing test (ICC = 0.86)
    • 20 disks turning test (ICC = 0.87)
    • 60 disks placing test (ICC = 0.88)
    • 60 disks turning test (ICC = 0.86)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Healthy Adults: (Wang et al., 2018)

  • Excellent correlation between MMDT Placing Test and WorkAbility Rate of Manipulation Test (WRMT) Placing Test (r = 0.81, < 0.01 (2-tailed))
  • Adequate correlations between MMDT Turning Test and WRMT turning tests (all < 0.01 (2-tailed)):
    • WRMT Turning test (both hands): r = 0.51
    • WRMT Turning test (right hand): r = 0.44
    • WRMT Turning test (left hand): r = 0.51
    • WRMT Turning test (R + L hand/2): r = 0.52

 

Bibliography

Desrosiers J., Rochette, A., Hébert, R. & Bravo, G. (1997). The Minnesota Manual Dexterity Test: Reliability, validity and reference values studies with healthy elderly people. Canadian Journal of Occupational Therapy, 64(5), 270-276.

Lafayette Instrument Company. (1998). Examiner's Manual.

Ovacik, U., Tarakci, E., Gungor, F., Menengic, K. N., Leblebici, G., Acar, Z. O., & Soysal, A. (2022). The Minnesota manual dexterity test as a bimanual performance measure in people with multiple sclerosis. Multiple Sclerosis and Related Disorders, 64, 103943.

Wang, Y., Wickstrom, R., Yen, S., Kapellusch, J., & Grogan, K. A. (2017). Assessing manual dexterity: Comparing the WorkAbility Rate of Manipulation Test with the Minnesota Manual Dexterity Test. Journal of Hand Therapy, 31(3), 339-347.