Development of an objective test of upper-limb function in tetraplegia: the capabilities of upper extremity test

Am J Phys Med Rehabil. 2012 Jun;91(6):478-86. doi: 10.1097/PHM.0b013e31824fa6cc.

Abstract

Objective: This study aimed to describe the development, internal consistency, and validity of the Capabilities of Upper Extremity Test (CUE-T) for persons with tetraplegia.

Design: This study used a cross-sectional sample of adults with spinal cord injury. CUE-T items and procedures were developed based on the CUE Questionnaire. Thirty adults with complete and incomplete spinal cord injury, neurologic levels C4-T6, were tested on one occasion. Each received upper limb manual muscle testing and the CUE Questionnaire followed by the CUE-T. Raw item scores were converted to a 0-4 scale. Internal consistency was evaluated using Cronbach alpha. Item score distributions were evaluated for ceiling and floor effects. Spearman correlations of total, right, and left CUE-T scores with upper-limb motor scores and international hand classification were performed.

Results: There were 23 men and 7 women, with an average age of 44.8 yrs. Twenty subjects had motor complete injuries; 13 had motor levels C4-C6, 13 had between C7 and C8, and 4 were T1 or below. The Cronbach alpha for the CUE-T was 0.96. Item score distributions found ceiling effects for the push/pull items, suggesting that these items were too easy. Correlations of right- and left-sided scores with upper-limb motor scores and international hand classification were strong, with all values greater than or equal to 0.89.

Conclusions: The CUE-T displays good internal consistency and excellent construct validity on preliminary testing. Push/pull tests should be revised to increase difficulty. Reliability and responsiveness should be determined.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Motor Skills / physiology
  • Muscle Strength / physiology*
  • Physical Examination / methods*
  • Pilot Projects
  • Quadriplegia / diagnosis
  • Quadriplegia / rehabilitation
  • Reproducibility of Results
  • Spinal Cord Injuries / diagnosis*
  • Spinal Cord Injuries / rehabilitation
  • Upper Extremity / physiopathology*
  • Young Adult