The GRT was designed to assess hand neuro-prosthesis in individuals with C5-C6 SCIs, but has also been used to assess hand function prior to and following tendon transfers in people with C6-7 level injuries (Harvey et al. 2001). The GRT assesses the ability to pick up, move, and release six objects of varying sizes, weights and textures using a palmar or lateral grasp (Stroh Wuolle et al. 1994, Harvey et al. 2001). Each object was chosen to represent one or more objects routinely manipulated for activities of daily living (ADL) that represented a range of difficulties.

Number of items: 6 tasks

Procedure/Administration: Clinician administered standardized performance test. Specific instructions are provided for establishing the start position and for recording a successful completion of the task.

How scored: Subjects are scored on their ability to successfully move each of the objects as many times as possible in 30 seconds. Each hand is tested and scored separately. A pretrial practice test for each object is permitted and practice continues until a successful completion is achieved

Interpretability: A summed score is calculated by adding the item scores. If a subject fails to move an item, they score zero for that particular item. Single items may be used.

Acceptability: N/a

Languages: N/a

Usability: Completion of the tool may vary depending on the individual’s abilities. For example, subjects with paralysis of the finger and/or thumb flexor muscles are generally unable to hold the fork or paperweight between the thumb and index finger so floor effects are possible.

Time to administer: Approximately 20 minutes, including the pretest.

Time to score: Minimal

Training required: N/a

Availability: N/a

Equipment required: The objects used in the GRT include a peg, paperweight, fork, block, can and videotape.

Summary: This is a well standardized quick test of hand function that would be appropriate for a limited sub-sample of individuals with SCI.

Psychometric Summary

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity; N/a= No information.

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.

This test was not readily available and has not been included in this summary.

References

• Harvey LA, Batty J, Jones R, Crosbie J. Hand function of C6 and C7 tetraplegics 1-16 years following injury. Spinal Cord 2001;39:37-43.
• 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.
• Stroh Wuolle K, Van Doren CL, Thorpe GB, Keith MW, Peckham PH. Development of Quantitative Hand Grasp and Release Test for Patients with Tetraplegia using a Hand Neuroprosthesis. The Journal of Hand Surgery: 1994;19:209-18.
• Taylor P, Esnouf J, Hobby J. The functional impact of the Freehand System on tetraplegic hand function. Clinical results. Spinal Cord 2002;11:550-6.