A physical therapist working with a patient who has a C5 AIS A tetraplegia wants to comprehensively evaluate hand function including strength, sensation, and prehension. Which outcome measure was designed SPECIFICALLY for this purpose in cervical SCI?

A physical therapist working with a patient who has a C5 AIS A tetraplegia wants to comprehensively evaluate hand function including strength, sensation, and prehension. Which outcome measure was designed SPECIFICALLY for this purpose in cervical SCI?

• A. CUE (Capabilities of Upper Extremity) Functioning Instrument
• B. GRASSP (Graded and Redefined Assessment of Sensibility, Strength and Prehension)
• C. Handheld Dynamometry (HHD)
• D. Wheelchair User's Shoulder Pain Index (WUSPI)

Answer: (B)

The key idea is using an outcome measure designed specifically to capture hand function in cervical spinal cord injury, including how the hand works in terms of strength, sensation, and prehension. GRASSP is built for this purpose in cervical SCI and covers all three areas in a coordinated way. GRASSP has three components that align with the patient’s needs: Sensibility, which assesses hand-related sensory function relevant to using the hand; Strength, which evaluates the key intrinsic and extrinsic hand muscles involved in grasp and dexterity; and Prehension, which looks at functional grasp patterns and the ability to perform different types of grip (lateral pinch, palmar pinch, tip pinch, etc.). The scoring is structured to track meaningful changes over time and it has established reliability and validity for people with cervical SCI, making it well-suited to evaluate comprehensive hand function in this population. The other measures don’t fit as specifically. The CUE Functioning Instrument targets upper-extremity function in a broader sense but isn’t designed specifically for the cervical SCI hand function triad of strength, sensation, and prehension. Handheld dynamometry measures force in individual muscles or grips but omits sensory assessment and functional prehension tasks. The Wheelchair User's Shoulder Pain Index focuses on shoulder pain and its impact on wheelchair use, not on hand function per se. So, GRASSP is the best choice for a cervical SCI patient needing a comprehensive evaluation of hand function across strength, sensation, and prehension.

The key idea is using an outcome measure designed specifically to capture hand function in cervical spinal cord injury, including how the hand works in terms of strength, sensation, and prehension. GRASSP is built for this purpose in cervical SCI and covers all three areas in a coordinated way.

GRASSP has three components that align with the patient’s needs: Sensibility, which assesses hand-related sensory function relevant to using the hand; Strength, which evaluates the key intrinsic and extrinsic hand muscles involved in grasp and dexterity; and Prehension, which looks at functional grasp patterns and the ability to perform different types of grip (lateral pinch, palmar pinch, tip pinch, etc.). The scoring is structured to track meaningful changes over time and it has established reliability and validity for people with cervical SCI, making it well-suited to evaluate comprehensive hand function in this population.

The other measures don’t fit as specifically. The CUE Functioning Instrument targets upper-extremity function in a broader sense but isn’t designed specifically for the cervical SCI hand function triad of strength, sensation, and prehension. Handheld dynamometry measures force in individual muscles or grips but omits sensory assessment and functional prehension tasks. The Wheelchair User's Shoulder Pain Index focuses on shoulder pain and its impact on wheelchair use, not on hand function per se.

So, GRASSP is the best choice for a cervical SCI patient needing a comprehensive evaluation of hand function across strength, sensation, and prehension.