Reliability and validity of the capabilities of upper extremity test (CUE-T) in subjects with chronic spinal cord injury

Abstract

Objective: To determine the reliability and validity of the capabilities of upper extremity test (CUE-T), a measure of functional limitations, in patients with chronic tetraplegia. Design: Repeated measures. Setting: Outpatient rehabilitation center. Participants: Fifty subjects (36 male/14 female) with spinal cord injury (SCI) of ≥1-year duration participated. Subjects were 17-81 years old (mean 48.1 ± 18.2); neurological levels ranged from C2 through T6, American Spinal Injury Association Impairment Scale grades A-D. Interventions: Not applicable. Outcome measures: Intraclass correlation coefficients (ICC), weighted kappa and repeatability values for CUE-T; Spearman correlations of CUE-T with upper extremity motor scores (UEMS), and self-care and mobility portions of the Spinal Cord Independence Measure, vIII (SCIM III). Results: Score ranges for UEMS were 8-50, CUE-T 7-135, self-care SCIM 0-20, and mobility SCIM 0-40. The ICC values for total, right, and left side scores were excellent (0.97-0.98; 95% confidence interval 0.96-0.99). Item weighted kappa values were ≥0.60 for all but five items, four of which were right and left pronation and supination. Repeatability of total score was 10.8 points, right and left sides 6.3 and 6.1 points. Spearman correlations of the total CUE-T with the UEMS and SCIM self-care and mobility scores were 0.83, 0.70, and 0.55 respectively. Conclusions: The CUE-T displays excellent test-retest reliability, and good-excellent correlation with impairment and capacity measures in persons with chronic SCI. After revising pronation and supination test procedures, the sensitivity to change should be determined.

Evaluation of the Capabilities of Upper Extremity Test (CUE-T) in Children With Tetraplegia

“…Mean CUE-T scores are shown for the entire sample (N = 39) in Table 2, with adult values provided for comparison (R. Marino, unpublished data). 6 The administration time was statistically significant (p < .05) between the first CUE-T administration (n = 34; mean = 45.47 minutes; range, 15-86) and the second (n = 26; mean = 39.12 minutes; range, 10-70 minutes). When examined by AIS (Appendix 2), those with motor incomplete (AIS C/D) (n = 19) injuries had higher (better) CUE-T right and left hand subscores, but no statistically significant differences in arm or bilateral subscores.…”

“…Administration demonstrated a high level of reliability. 6 The CUE-T is an SCI-specific instrument developed by Marino and colleagues based on the Capabilities of the Upper Extremity Questionnaire (CUE-Q). 5,7 When used in combination, the CUE-T and CUE-Q provide an objective (CUE-T) and self-perceived (CUE-Q) assessment of UE function necessary for performance of basic and instrumental activities of daily living (ADL).…”

Preliminary Development of the Hand and Arm Function Measure for People With Neurological Conditions

“…Other conditions such as spinal cord injury (SCI) that can affect hand function were excluded from this study since the type of hand function problems in SCI are very unique to the condition (e.g., proximal more than distal issues in central cord syndrome), change considerably with the level of SCI (e.g., person with C6 tetraplegia with lost triceps function that is preserved in C7 tetraplegia), and involve special compensatory techniques (e.g., tenodesis in C6 tetraplegia). Moreover, specific measures such as the Capabilities of Upper Extremity (CUE) (Marino, Kern, Leiby, Schmidt-Read, & Mulcahey, 2015) and Grasp and Release Test (GRT) (Mulcahey, Smith, & Betz, 2004) have been developed in self-report (CUE) and performance-based (CUE and GRT) formats to measure hand and arm function in people with SCI. There are potentially many other neurological conditions, for which the measure would need to be validated.…”

Rho Inhibitor VX-210 in Acute Traumatic Subaxial Cervical Spinal Cord Injury: Design of the SPinal Cord Injury Rho INhibition InvestiGation (SPRING) Clinical Trial

“…Secondary endpoints evaluating functional recovery include 1) the Spinal Cord Independence Measure III (SCIM III) self-care subscore (a question-based evaluation of a patient's ability to feed, dress, groom, and bathe independently on a daily basis) at 6 months post-treatment 37–39 ; 2) the capabilities of upper extremity test (CUE-T) score (an evaluation of a patient's ability to perform specific functional movements or tasks with the arms and hands, such as grasping a pencil, pushing, or lifting a weight) at 6 months post-treatment 40 , 41 ; and 3) the graded redefined assessment of strength, sensibility, and prehension (GRASSP) quantitative prehension score (an assessment of a patient's ability to perform specific functions with the arms, hands, and fingers, such as turning a key in a lock or pouring water in a cup) at 6 months post-treatment. 42–46 Secondary endpoints evaluating neurological recovery include AIS grade conversion and motor level change from baseline to 6 months post-treatment, which are both derivatives of the ISNCSCI neurological assessment.…”