Responsiveness and concurrent validity of the revised Capabilities of Upper Extremity-Questionnaire (CUE-Q) in patients with acute tetraplegia

Abstract

Study design: This is a longitudinal convenience sample. Objective: The objective of this study was to evaluate the responsiveness of the revised Capabilities of Upper Extremity-Questionnaire (CUE-Q), in which the item responses were reduced from seven to five levels, relative to the upper extremity motor score (UEMS) and to the self-care subscale of Functional Independence Measure (FIMsc). Methods: A total of 46 subjects with acute traumatic tetraplegia, 19 motor complete, 27 motor incomplete, completed the revised CUE-Q, UEMS and FIMsc at admission and discharge from rehabilitation. Results: Subjects were mostly male (n ¼ 42) and Caucasian (n ¼ 27). The mean age was 44 ± 21 years. Predominant etiologies were falls (n ¼ 18) and motor vehicle accidents (n ¼ 17). During rehabilitation, mean CUE-Q scores increased from 49.8±30.8 to 73.7 ± 36.3, UEMS increased from 19.6 ± 11.9 to 26.3 ± 13.4, and FIMsc increased from 9.8 ± 5.1 to 21.5 ± 9.7. At admission and discharge, CUE scores had excellent to good Spearman correlations (r s ) with UEMS (r s ¼ 0.89, 0.70) and FIMsc (r s ¼ 0.73, 0.80), but change scores had little to moderate correlations (CUE-UEMS, r s ¼ 0.07; CUE-FIMsc, r s ¼ 0.51), suggesting that the CUE, UEMS and FIM measure related but different constructs. Effect size of the change score was 0.92 for CUE-Q, 0.87 for UEMS and 1.38 for FIMsc. This compares to an effect size of 0.73 for the original 7-level response CUE-Q. Conclusion: The simplified response set of the CUE-Q maintains the responsiveness of the original version, whereas it increases the ease of use for the patient.

Responsiveness, Sensitivity, and Minimally Detectable Difference of the Graded and Redefined Assessment of Strength, Sensibility, and Prehension, Version 1.0

“…Psychometric properties of the CUE-Q have been reported as 0.92 for test-retest reliability and 0.74 for concurrent validity with the Functional Independence Measure. 14…”

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

“…Items were rated on a 7-point scale, which has since been revised to a 5-point scale, from 0 = unable/complete difficulty to 4 = no difficulty, with similar reliability. 15 The CUE-Q was always administered before the CUE-T so that responses would not be influenced by performance on the test.…”

Evaluation of the graded redefined assessment of strength, sensibility and prehension (GRASSP) in children with tetraplegia

“…The Capabilities of Upper Extremity-Questionnaire version 2.1 (CUE-Q) is a 17-item scale that is used to evaluate perceived difficulties or limitations associated with using the upper limbs to complete everyday activities [23]. The right and left limbs are evaluated and scored separately on a scale ranging between 0 (unable/complete difficulty) to 4 (no difficulty).…”

“…The CUE-Q was used as a comparator measure to establish validity, as done to establish validity of the GRASSP with the adult sample [5]. In adult studies, the CUE-Q version 2.1 has strong concurrent validity (FIM Instrument ® and ISNCSCI upper extremity motor score) and is responsive to change over time [23]. There are no previous pediatric studies on the CUE-Q.…”