Brief Overview: How the NIH Toolbox Measures 5 Key Motor Skills

Brief Overview: How the NIH Toolbox Measures 5 Key Motor Skills

Brief Overview: How the NIH Toolbox Measures 5 Key Motor Skills

Key Takeaways

  • The NIH Motor Battery allows you to get a comprehensive look at your patient’s fine and gross motor skills
  • The Battery consists of five different tests that can be used to provide a good baseline and track your patient’s progress over time
  • Get a brief overview of the tests and what you’ll need to perform them now

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The NIH Motor Battery consists of five tests to provide a comprehensive look at your patient’s fine and gross motor skills. These tests can then be used to track changes over time. Measure your patient’s motor skills using these simple tests!

A Brief Overview of the NIH Motor Tests

NIH Motor Test Toolbox filled with helpful products

For these NIH Motor Tests, you’ll need:

The skills tested include:

Skill #1: Strength

Smart Digital Hand Dynamometer by Jamar

You'll need: Jamar Smart Hand Dynamometer

The Jamar Smart Digital Hand dynamometer ensures accurate, reliable grip strength measurements. It has a tablet app for graphing and tracking results and a Grip Strength Norms Calculator so you can see how your patient scores compared to the NIH normative data.

Test: Grip Strength Test

The user squeezes the hand dynamometer as hard as possible when instructed.

Skill #2: Dexterity

Blue 9-hole peg test kit by Jamar

You'll need: Jamar 9-Hole Peg Test Kit

A 2013 study by Reuben et. al recommends using this pegboard for the NIH dexterity test due to its “it’s reliability and validity, [and] the ability to be completed by all age groups.”

Test: 9 Hole Pegboard Test

The user places each peg into a hole and then removes them to place them into the bowl during this timed test.

Skill #3: Balance

Blue balance pad by AIREX

Gait belt by Sammons Preston

You'll need: Airex Balance Pad and Gait Belt

Use this dense foam surface for the balancing tasks that require a foam pad. It even comes in different firmness levels so you can use the same tool to improve balance with your patients during therapy.

Test: Standing Balance Test

The user stands in five poses, some on foam and others on a flat surface. Different poses involve different positions (ex. standing on one leg). This includes keeping your eyes open or closed.

The 5 Poses

  1. Flat surface, feet together, eyes open
  2. Flat surface, feet together, eyes closed
  3. On foam, feet together, eyes open
  4. On foam, feet together, eyes closed
  5. Flat surface, tandem, eyes open

Skill #4: Endurance

Endurance test setup graph

You'll need: Two cones and tape

Test: 2-Minute Walk Endurance

Create the course with cones 50 feet apart that the participant must walk around to complete the lap, and tape markings. The examiner records the number of laps completed and the distance from the participant’s stopping point to the end mark.

Skill #5: Locomotion

Locomotion test setup graph

You'll need: Two cones (you can use the same cones as skill four) and a different color tape

Test: 4 Meter Gait Speed Test

This is a timed test that measures the normal walking speed of the test taker. If the participant stumbles or runs, the trial should be stopped and repeated.

NIH Motor Test Protocols

Learn about the specific testing protocols prior to testing your patients.

After the NIH Motor Test

After the test, patients can work to improve their motor skills using these products!

TheraBand Stability Trainers are a great option to work on improving balance. If your patient struggled with the endurance or locomotion portions of the test, it might be time for them to start using a walker or Days Rollator for extra support. Help your patient increase their grip strength and enhance their dexterity using Sammons Preston Therapy Putty. Then use these five tests again to track changes in your patient’s fine and gross motor skills over time.


1. Health Measures. (2019). Motor Measures. Northwestern University. Retrieved from

2. Health Measures. (n.d.) NIH Toolbox iPad App eLearning. Northwestern University. Retrieved from

3. Reuben, D. B., Magasi, S., McCreath, H. E., Bohannon, R. W., Wang, Y. C., Bubela, D. J., Rymer, W. Z., Beaumont, J., Rine, R. M., Lai, J. S., … Gershon, R. C. (2013). Motor assessment using the NIH Toolbox. Neurology, 80(11 Suppl 3), S65-75. Retrieved from

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