Comparison of Responsiveness and Minimal Clinically Important Difference of the Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP)

Abstract

The Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) were both developed to detect change in upper extremity (UE) function in persons with tetraplegia. To compare the responsiveness and minimal clinically important difference (MCID) of the CUE-T and the quantitative prehension (QtP) scale of the GRASSP. Subjects included 69 persons with tetraplegia: 60 with acute and 9 with chronic injuries. Subjects were assessed twice 3 months apart using the CUE-T, QtP-GRASSP, and upper extremity motor scores (UEMS). Subjects rated their impression of change in overall and right/left UE function from -7 to +7. The standardized response mean (SRM) was determined for acute subjects. MCID was estimated using a small subjective change (2-3 points) and change in UEMS. Subjects were 41.9 ± 18.1 years old, neurological levels C1-C7; 25 were motor complete. For acute subjects, the SRMs for total/side CUE-T scores were 1.07/0.96, and for the QtP-GRASSP they were 0.88/0.78. MCIDs based on subjective change for total/side CUE-T scores were 11.7/6.1 points and for QtP-GRASSP were 6.4/3.0 points. Based on change in UEMS, MCIDs for total/side were 11.9/6.3 points for CUE-T and 6.0/3.3 points for QtP-GRASSP. Some subjects had changes in the CUE-T due to its arm items that were not seen with the QtP-GRASSP. Both the CUE-T and QtP-GRASSP are responsive to change in persons with acute cervical spinal cord injury with large SRMs. The CUE-T detects some changes in UE function not seen with the QtP-GRASSP.

Transcutaneous Electrical Spinal Cord Stimulation to Promote Recovery in Chronic Spinal Cord Injury

“…This suggests that those with more incomplete injuries (AIS C) may demonstrate a better response to this intervention than those with more complete injuries, but results should be interpreted with caution due to the limited sample size. In regards to UE function, (CUE-T), only one participant (07) demonstrated a changed that exceeded the MCID for this measure of 12.0 points ( 21 ). None of the participants met the MCID for LEMS [3.66 points ( 20 )]; however, the two individuals with AIS C injuries, exceeded the MCID for the 10MWT (0.10 m/s) ( 28 ).…”

“…The Capabilities of Upper Extremity—Test (CUE-T), an assessment that measures the amount of difficulty experienced in performing specific actions with one or both arms and hands. The CUE-T has 32 items, each scored on a 0–4 point scale with total scores ranging from 0 to 128 (higher scores demonstrating greater UE function) along with right/left subscale scores ( 21 ). The CUE-T has been shown to valid, reliable ( 22 ), and responsive in SCI ( 21 ).…”

“…The CUE-T has 32 items, each scored on a 0–4 point scale with total scores ranging from 0 to 128 (higher scores demonstrating greater UE function) along with right/left subscale scores ( 21 ). The CUE-T has been shown to valid, reliable ( 22 ), and responsive in SCI ( 21 ). The published MCID for the CUE-T Total score is 12.0 ( 21 ).…”

“…The CUE-T has been shown to valid, reliable ( 22 ), and responsive in SCI ( 21 ). The published MCID for the CUE-T Total score is 12.0 ( 21 ). Nine-Hole Peg Test measures finger dexterity after neurologic injury.…”

Multi-center, single-blind randomized controlled trial comparing functional electrical stimulation therapy to conventional therapy in incomplete tetraplegia

“…The dose of therapy could also be a contributing factor to the observed differences. In the that the type of therapy may be more important than the dose of therapy in regard to improving hand function in individuals with incomplete tetraplegia (23).…”