The CUE measures functional limitation and assesses the amount of difficulty experienced in performing specific actions with one or both arms and hands in individuals with tetraplegia (Marino et al. 1998).

Number of items: 32: fifteen items inquire about unilaterally (left and right) hand and arm function and 2 items assess bilateral hand and arm use.

Procedure/Administration: Interview format. Questions focus on the individuals’ ability to reach or lift; pull and push with their arms; move and position their arm and wrist; use their hand and fingers; and press with the tip of the index finger.

How scored: Responses are given on a 7-point scale representing self-perceived difficulty in performing the action, with scores ranging from 1 (unable to perform) to 7 (can perform without difficulty).

Interpretability: Item by item results of the test are straight forward to interpret. Total scores range from 32 to 224 with higher scores reflecting better function. Left and right arm/hand function can be derived separately. A percent of normal function score is also possible using the following algorithm ((total score – 32) / 192 * 100%.

Acceptability: The method of item generation would suggest the CUE is likely to be widely accepted with therapists and individuals with an SCI.

Languages: English

Usability: N/a

Time to administer: 30 minutes.

Time to score: N/a

Training required: None.

Availability: N/a

Equipment required: None.

Summary:

• The CUE has considerable potential clinical appeal because it reflects hand and/or arm function and scores can be derived for either limb which is appealing given the number of individuals with incomplete injuries.

Psychometric Summary:

Note: TR= Test re-test; IC= Internal Consistency;Inter-O=Inter-observer; Intra-O=Intra-observer; SS=Sensitivity/Specificity.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

N/a= No information

References:  

• Marino RJ, Shea JA, Stineman MG. The Capabilities of Upper Extremity Instrument: Reliability and Validity of a Measure of Functional Limitation in Tetraplegia. Arch Phys Med Rehabil 1998;79:1512-21.
• Mulcahey MJ, Smith BT, Betz RR. Psychometric rigor of the Grasp and REslease Test for measuring functional limitation of persons with tetraplegia: a preliminary analysis. J Spinal Cord Med 2004; 27:41-6.