Evaluation of the Capabilities of Upper Extremity Test (CUE-T) in Children With Tetraplegia.

Background: The Capabilities of Upper Extremity Test (CUE-T) is a spinal cord injury (SCI)-specific instrument based on the CUE Questionnaire (CUE-Q). Objective: To evaluate the psychometric properties of CUE-T in children with cervical SCI and determine the lowest age appropriate for test administration. Method: In this repeated measures multicenter study, 39 youths, mean age 12.3 years and mean time post injury 5.14 years, completed two administrations of the CUE-T. Test-retest reliability, internal consistency, and known groups validity were measured. Concurrent and discriminant validity were measured against previously validated measures: CUE-Q, Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), Spinal Cord Independence Measure (SCIM) III, SCIM III-Self Care (SCIM-SC), and SCIM-Mobility. Results: The CUE-T scores demonstrated strong test-retest reliability (ICC ≥ 0.95), strong internal consistency (α ≥ 0.90), and acceptable individual item agreement (κ ≥ 0.49). The hand subscale had better scores ( p < .05) for the motor incomplete versus complete known groups, and the arm, hand, and side subscales had better scores ( p < .05) for higher versus lower strength groups. The CUE-T had strong concurrent validity with the CUE-Q ( r = 0.85-0.87), GRASSP ( r = 0.78-0.90), and SCIM-SC ( r = 0.70) and moderate-to-weak correlation with the total SCIM ( r = 0.65) and SCIM-Mobility ( r = 0.51). Children older than 6 years with mature grasp patterns were able to complete the CUE-T. Conclusion: The CUE-T scores are reliable and valid for use in children with cervical SCI older than 6 years of age.
Competing Interests: This study was funded by the Craig H. Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592. Dr. Mulcahey reports grants from Shriners Hospitals for Children, National Institute for Neurological Diseases and Stroke, Craig H. Neilsen Foundation, and The Rick Hansen Institute during the conduct of the study; personal fees from Topics in Spinal Cord Injury Rehabilitation, from the textbook The Child and Young Adult with Spinal Cord Injury, from Department of Defense, and from Craig H. Neilsen Foundation outside the submitted work. Ms. Calhoun Thielen reports a portion of her salary was paid by grants issued to Thomas Jefferson University by Craig H. Neilsen Foundation. Mary Free Bed Rehabilitation Hospital was a subaward recipient of the Neilsen Foundation grant #282592 awarded to Principal Investigator MJ Mulcahey. Mary Free Bed Rehabilitation is also the current recipient of two other Neilsen Foundation grants that are not related to this study. The Department of Rehabilitation Medicine and Thomas Jefferson University receive payment for preparation and supply of CUE-T test kits if these are provided by the Department. Dr. Marino reports grants from Craig H. Neilsen Foundation during the conduct of the study. Ms. Dent reports grants and nonfinancial support from Thomas Jefferson University during the conduct of the study.