Introducing the 9-HPT from Agency of
Design and the Barts MS Research Team

Supporting innovation in MS management

At Biogen we are committed to supporting innovations in clinical practice.

This 9-HPT is the result of a collaboration between Agency of Design and the Barts MS research team at Queen Mary University of London. It utilizes the design principles of accessibility, sustainability and cost efficiency . In so doing they have produced a clinically validated test at a price which makes it accessible to people living with MS. The 9-HPT, once the domain of clinical research, can now be used for patient self-monitoring – a small, but significant step towards greater patient empowerment.

The 9-HPT in clinical practice

The 9-HPT is the gold standard for assessing upper limb function for people with MS.1

Due to its reliability, validity, ease of administration and sensitivity to treatment, it is recommended for use in clinical trials.1

The test requires participants to repeatedly place and then remove 9 pegs into 9 holes, one at a time, as quickly as possible.1

Both the dominant and non-dominant hands are tested twice and the time needed to complete the test in seconds is recorded on individual score sheets.1




  1. Feys P, et al. The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. MSJ 2017; 23(5): 711–720.