Before assessment, test administrator measures subject's hand length (distance from distal wrist crease to tip of middle finger).
Raise one arm, bend elbow, and reach down across back, with palm facing upper back. Position opposite arm down behind back and reach up across back with back of hand against back. Place thumbs on palms and make a fist with each hand.
In one movement, place fists on back as close as possible to one another. Repeat with arms in opposite position.
Administrator measures distance between both fists using units of hand lengths. Record lower score of both sides. Note any pain or discomfort during movement.