Hand tests begin by asking clients to pick up objects from a table. Stroke survivors would discover their affected hand can be useful earlier than they think is possible if hand-to-hand transfers were added to adult hand tests. A small amount of finger movement done close to the body can make an affected hand functional. If you pick up an object with your sound hand and open your affected hand 2 inches to receive the object, you may be able to do the tasks shown below.
A hand-to-hand transfer allows me to do 21 bimanual ADL tasks.
Example #1- Using a shower hose to spray water at the crotch does not take care of the nooks and crannies. After a hand-to-hand transfer, my affected hand holds the shower hose close to my body which frees my sound hand to do its job. This little bit of hand function means my mother, a nurse's aide in the hospital, and I are the only people who have washed my crotch. If my husband were still alive I would be mortified to have him do this intimate task. 
Example # 2 - When my affected hand was flaccid, I used to squeeze a deodorant bottle between my thighs so my sound hand could remove the cap. Now my affected hand opens to receive a deodorant bottle from my sound hand and then holds the bottle still while it is resting on my thigh. The two black lines show how little shoulder movement is needed when ADLs are done close to the body.
Example # 3 - There used to be teeth marks on the cap of my toothpaste tube. Now my affected hand can open to receive a tube of toothpaste from my sound hand which then removes the cap. The end of the tube is propped against my stomach because this new tube is heavy. I do not want to drop the tube and splatter sticky toothpaste on the floor. I live alone so I would have to clean up the mess.
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